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Sample records for schizophrenia remain poorly

  1. Self-disorders and Schizophrenia: A Phenomenological Reappraisal of Poor Insight and Noncompliance

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    Henriksen, Mads G.; Parnas, Josef

    2013-01-01

    Poor insight into illness is considered the primary cause of treatment noncompliance in schizophrenia. In this article, we critically discuss the predominant conceptual accounts of poor insight, which consider it as an ineffective self-reflection, caused either by psychological defenses or impaired metacognition. We argue that these accounts are at odds with the phenomenology of schizophrenia, and we propose a novel account of poor insight. We suggest that the reason why schizophrenia patient...

  2. Reasons for Schizophrenia Patients Remaining out of Treatment: Results from a Prospective Study in a Rural South Indian Community.

    Science.gov (United States)

    Kumar, Channaveerachari Naveen; Thirthalli, Jagadisha; Suresha, Kudumallige Krishnappa; Venkatesh, Basappa K; Kishorekumar, Kengeri V; Arunachala, Udupi; Gangadhar, Bangalore N

    2016-01-01

    A few studies have examined the factors associated with schizophrenia patients remaining untreated in India. We identified 184 schizophrenia patients in a rural community, offered the treatment with antipsychotics and followed them up in their Primary Health Centers for 1-year. Twenty-nine (15.8%) patients remained untreated at both the baseline and 1-year follow-up despite our best attempts to keep them under the treatment umbrella. They were interviewed in detail regarding the reasons for remaining untreated. This group was compared with another group of patients (n = 69) who had stopped the treatment at baseline but were successfully brought under the treatment umbrella throughout the 1-year follow-up period. The reasons for remaining untreated were (n; %): (a) Unsatisfactory improvement with previous treatment attempts (19; 65.5%), (b) poor bond between the patients and the families (6; 20.7%), (c) active symptoms not allowing any treatment efforts from the family members (6; 20.7%), (d) magico-religious beliefs about the illness and its treatment (4; 13.8%), (e) poor social support (3; 10.3%), (f) adverse effects of the medications (2; 6.9%), and (g) perception of recovery and cure (1; 3.4%). For many patients, a constellation of these reasons was responsible for them remaining untreated. In contrast, the common reasons for those who restarted medications to have stopped the treatment at some time were the lack of awareness, the need to continue medications (47; 68.1%), and the financial constraints (28; 40.6%). The predominant reason for schizophrenia patients not remaining on the treatment in this rural community was the families' lack of faith in antipsychotic treatment. Provision of comprehensive treatment package including medical, psychosocial and rehabilitative services, and sensitizing the community about benefits of the treatment may help in ensuring that all patients with psychosis receive the best care.

  3. Factors associated with poor satisfaction with treatment and trial discontinuation in chronic schizophrenia.

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    Schoemaker, Joep H; Vingerhoets, Ad J J M; Emsley, Robin A

    2018-06-05

    IntroductionDespite consistently high discontinuation rates due to withdrawal of consent (WOC) and insufficient therapeutic effect (ITE) in schizophrenia trials, insight into the underlying factors contributing to poor satisfaction with treatment and dropout is limited. A better understanding of these factors could help to improve trial design and completion rates. Using data from 1,136 trial participants with schizophrenia or schizoaffective disorder, we explored associations between predictor variables with (1) dropout due to WOC and ITE and (2) satisfaction with treatment among patients and investigators by means of hierarchic multiple regression analyses. ITE was associated with poor clinical improvement, poor investigator satisfaction with treatment, and poor patient insight into their own disease, whereas WOC only showed a meaningful association with poor patient satisfaction with treatment. Investigator satisfaction with treatment appeared most strongly associated with Positive and Negative Syndrome Scale (PANSS) positive factor endpoint scores, whereas patient satisfaction with treatment was best predicted by the endpoint score on the PANSS emotional distress factor. The occurrence of severe side effects showed no meaningful association to satisfaction with treatment among investigators and patients, and neither did a patient's experienced psychopathology, nor their self-rating of functional impairment. Whereas trial discontinuation due to ITE is associated with poor treatment effectiveness, a patient's decision to withdraw from an antipsychotic trial remains unpredictable and may occur even when the investigator observes a global clinical improvement and is satisfied with the treatment.

  4. Risk factors for poor work functioning of persons with schizophrenia in rural China.

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    Ran, Mao-Sheng; Chen, Sheying; Chen, Elaina Y; Ran, Bo-Yu; Tang, Cui-Ping; Lin, Fu-Rong; Li, Li; Li, Si-Gan; Mao, Wen-Jun; Hu, Shi-Hui

    2011-11-01

    The long-term work performance of persons with schizophrenia in the community is unclear. This study examined the status of long-term work functioning and the predictors of poor work status among patients with schizophrenia in a Chinese rural area. A 10-year follow-up investigation (1994-2004) of a cohort (n = 510) of persons with schizophrenia was conducted in Xinjin County, Chengdu, China. Compared with baseline data, work functioning of patients with schizophrenia deteriorated after 10 years. The rates of not working increased significantly from 12.0% in 1994 to 23.0% in 2004. Bivariate analyses showed that the poor work functioning in 2004 was significantly associated with male gender, older age, older age of first onset, higher level of education, longer duration of illness, lower family economic status, lack of caregivers, poor work status in 1994, living in shabby or unstable house, marked symptoms, and higher score on the Social Disability Screening Schedule (SDSS). In multiple logistic regression analyses, higher score of SDSS and poor work status in 1994 were identified as unique predictors of poor work status in 2004. The status of work functioning of persons with schizophrenia decreased over the course of the illness. The risk factors for poor work functioning and specific socio-cultural environment should be considered in planning community mental health services and rehabilitation for these patients.

  5. Self-disorders and schizophrenia: a phenomenological reappraisal of poor insight and noncompliance.

    Science.gov (United States)

    Henriksen, Mads G; Parnas, Josef

    2014-05-01

    Poor insight into illness is considered the primary cause of treatment noncompliance in schizophrenia. In this article, we critically discuss the predominant conceptual accounts of poor insight, which consider it as an ineffective self-reflection, caused either by psychological defenses or impaired metacognition. We argue that these accounts are at odds with the phenomenology of schizophrenia, and we propose a novel account of poor insight. We suggest that the reason why schizophrenia patients have no or only partial insight and consequently do not comply with treatment is rooted in the nature of their anomalous self-experiences (ie, self- disorders) and the related articulation of their psychotic symptoms. We argue that self-disorders destabilize the patients' experiential framework, thereby weakening their basic sense of reality (natural attitude) and enabling another sense of reality (solipsistic attitude) to emerge and coexist. This coexistence of attitudes, which Bleuler termed "double bookkeeping," is, in our view, central to understanding what poor insight in schizophrenia really is. We suggest that our phenomenologically informed account of poor insight may have important implications for early intervention, psychoeducation, and psychotherapy for schizophrenia.

  6. Reduced connectivity in the self-processing network of schizophrenia patients with poor insight.

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    Edith J Liemburg

    Full Text Available Lack of insight (unawareness of illness is a common and clinically relevant feature of schizophrenia. Reduced levels of self-referential processing have been proposed as a mechanism underlying poor insight. The default mode network (DMN has been implicated as a key node in the circuit for self-referential processing. We hypothesized that during resting state the DMN network would show decreased connectivity in schizophrenia patients with poor insight compared to patients with good insight. Patients with schizophrenia were recruited from mental health care centers in the north of the Netherlands and categorized in groups having good insight (n= 25 or poor insight (n = 19. All subjects underwent a resting state fMRI scan. A healthy control group (n = 30 was used as a reference. Functional connectivity of the anterior and posterior part of the DMN, identified using Independent Component Analysis, was compared between groups. Patients with poor insight showed lower connectivity of the ACC within the anterior DMN component and precuneus within the posterior DMN component compared to patients with good insight. Connectivity between the anterior and posterior part of the DMN was lower in patients than controls, and qualitatively different between the good and poor insight patient groups. As predicted, subjects with poor insight in psychosis showed decreased connectivity in DMN regions implicated in self-referential processing, although this concerned only part of the network. This finding is compatible with theories implying a role of reduced self-referential processing as a mechanism contributing to poor insight.

  7. Evidence that communication impairment in schizophrenia is associated with generalized poor task performance.

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    Merrill, Anne M; Karcher, Nicole R; Cicero, David C; Becker, Theresa M; Docherty, Anna R; Kerns, John G

    2017-03-01

    People with schizophrenia exhibit wide-ranging cognitive deficits, including slower processing speed and decreased cognitive control. Disorganized speech symptoms, such as communication impairment, have been associated with poor cognitive control task performance (e.g., goal maintenance and working memory). Whether communication impairment is associated with poorer performance on a broader range of non-cognitive control measures is unclear. In the current study, people with schizophrenia (n =51) and non-psychiatric controls (n =26) completed speech interviews allowing for reliable quantitative assessment of communication impairment. Participants also completed multiple goal maintenance and working memory tasks. In addition, we also examined (a) simple measures of processing speed involving highly automatic prepotent responses and (b) a non-cognitive control measure of general task performance. Schizophrenia communication impairment was significantly associated with poor performance in all cognitive domains, with the largest association found with processing speed (r s =-0.52). Further, communication impairment was also associated with the non-cognitive control measure of poor general task performance (r s =-0.43). In contrast, alogia, a negative speech symptom, and positive symptoms were less if at all related to cognitive task performance. Overall, this study suggests that communication impairment in schizophrenia may be associated with relatively generalized poor cognitive task performance. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  8. Reduced Connectivity in the Self-Processing Network of Schizophrenia Patients with Poor Insight

    NARCIS (Netherlands)

    Liemburg, Edith J.; van der Meer, Lisette; Swart, Marte; Curcic-Blake, Branislava; Bruggeman, Richard; Knegtering, Henderikus; Aleman, Andre

    2012-01-01

    Lack of insight (unawareness of illness) is a common and clinically relevant feature of schizophrenia. Reduced levels of self-referential processing have been proposed as a mechanism underlying poor insight. The default mode network (DMN) has been implicated as a key node in the circuit for

  9. Cancer in adolescents and young adults: Who remains at risk of poor social functioning over time?

    Science.gov (United States)

    Husson, Olga; Zebrack, Bradley J; Aguilar, Christine; Hayes-Lattin, Brandon; Cole, Steve

    2017-07-15

    The objective of the current study was to examine social functioning among adolescents and young adults (AYAs) within the first 2 years after a cancer diagnosis and compare their scores with population norms and identify trajectories of social functioning over time and its correlates. A multicenter, longitudinal study was conducted among 215 AYA patients with cancer aged 14 to 39 years. A total of 141 patients completed a self-report measure of social functioning within the first 4 months of diagnosis and again at 12 months and 24 months later. AYA patients with cancer were found to have significantly worse social functioning scores around the time of diagnosis (52.0 vs 85.1; Pcancer who had consistently low social functioning were more often off treatment at the time of follow-up, reported more physical symptoms and higher levels of distress at baseline and follow-up, and perceived less social support at baseline compared with the other 3 groups. Although improved over time, social functioning still was found to be compromised 24 months after the primary diagnosis. Nearly one-third of these patients remain at risk of poor social functioning. Reducing physical symptoms and psychological distress and enhancing social support by interventions during the period after treatment may potentially help these young survivors to better reintegrate into society. Cancer 2017;123:2743-51. © 2017 American Cancer Society. © 2017 American Cancer Society.

  10. Why does Bangladesh remain so poor? Part I: the situation and efforts to change it.

    Science.gov (United States)

    Maloney, C

    1985-01-01

    This 1st part of the discussion of the poverty in Bangladesh reviews efforts on the part of individuals, donor agencies, and the government to alleviate poverty, and some goals of the new Third Five Year Plan. More than 3/4 of the people of Bangladesh live in poverty or close to it, according to development and economic criteria. Bangladesh society has hardly any parallel in the world if viewed from the perspective of its capacity, like a biological species, to adapt to an ecological niche and then reproduce to fill that niche. This defines success in biological terms. The Bangladesh society that developed was highly in tune with the natural environment of the rice growing plains. Social organization, kinship, settlement pattern, economic transactions, beliefs systems, and reproductive biology all developed in close symbiosis with the land. From a humanitarian perspective, Bangladesh is also highly successful. The human interaction, the expressive culture, the fullness of life, and the verbal arts all are more fully expressed than in many cultures. By "development" criteria, Bangladesh appears highly unsuccessful. Per capita income is about $130 a year. Bangladesh ranks very low in such indices as literacy, housing, roads, health services, infant survival, loan recovery, exportable goods, and control of the population growth rate. There is no question but that individuals usually are well aware if their situation is precarious, and they take rational action to improve their security; the government and private agencies have a multitude of programs aimed at alleviating poverty. For Bangladesh as a whole, domestic savings in 1984-85 was 8%, and during the Second Five Year Plan the rate of domestic savings increased faster than was expected, compared with income. Almost all the nongovernmental organizations (NGOs), many bilateral donor agencies, and huge segments of government target their efforts to the poor and the small farmers. There are over 150 NGOs of

  11. Behavioral health care for adolescents with poorly controlled diabetes via Skype: does working alliance remain intact?

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    Freeman, Kurt A; Duke, Danny C; Harris, Michael A

    2013-05-01

    Increasingly various technologies are being tested to deliver behavioral health care. Delivering services via videoconferencing shows promise. Given that the patient-provider relationship is a strong predictor of patient adherence to medical regimens, addressing relationship quality when services are not delivered face-to-face is critical. To that end, we compared the therapeutic alliance when behavioral health care was delivered to youth with poorly controlled type 1 diabetes mellitus (T1DM) and their caregivers in-clinic with the same services delivered via Internet-based videoconferencing (i.e., Skype™). Seventy-one adolescents with poorly controlled T1DM (hemoglobin A1c ≥9%) and one of their caregivers received up to 10 sessions of a family-based behavioral health intervention previously shown to improve adherence to diabetes regimens and family functioning; 32 were randomized to the Skype condition. Youth and caregivers completed the working alliance inventory (WAI), a 36-item measure of therapeutic alliance, at the end of treatment. Additionally, the number of behavioral health sessions completed was tracked. No significant differences in WAI scores were found for those receiving behavioral health care via Skype versus in-clinic. Youth WAI goal and total scores were significantly associated with the number of sessions completed for those in the clinic group. Behavioral health can be delivered to youth with T1DM via Internet-based videoconferencing without significantly impacting the therapeutic relationship. Thus, for those adolescents with T1DM who require specialized behavioral health care that targets T1DM management, Internet-based teleconferencing represents a viable alternative to clinic-based care. © 2013 Diabetes Technology Society.

  12. Diagnostic specificity of poor premorbid adjustment: comparison of schizophrenia, schizoaffective disorder, and mood disorder with psychotic features.

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    Tarbox, Sarah I; Brown, Leslie H; Haas, Gretchen L

    2012-10-01

    Individuals with schizophrenia have significant deficits in premorbid social and academic adjustment compared to individuals with non-psychotic diagnoses. However, it is unclear how severity and developmental trajectory of premorbid maladjustment compare across psychotic disorders. This study examined the association between premorbid functioning (in childhood, early adolescence, and late adolescence) and psychotic disorder diagnosis in a first-episode sample of 105 individuals: schizophrenia (n=68), schizoaffective disorder (n=22), and mood disorder with psychotic features (n=15). Social and academic maladjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. Worse social functioning in late adolescence was associated with higher odds of schizophrenia compared to odds of either schizoaffective disorder or mood disorder with psychotic features, independently of child and early adolescent maladjustment. Greater social dysfunction in childhood was associated with higher odds of schizoaffective disorder compared to odds of schizophrenia. Premorbid decline in academic adjustment was observed for all groups, but did not predict diagnosis at any stage of development. Results suggest that social functioning is disrupted in the premorbid phase of both schizophrenia and schizoaffective disorder, but remains fairly stable in mood disorders with psychotic features. Disparities in the onset and time course of social dysfunction suggest important developmental differences between schizophrenia and schizoaffective disorder. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Schizophrenia.

    Science.gov (United States)

    Kahn, René S; Sommer, Iris E; Murray, Robin M; Meyer-Lindenberg, Andreas; Weinberger, Daniel R; Cannon, Tyrone D; O'Donovan, Michael; Correll, Christoph U; Kane, John M; van Os, Jim; Insel, Thomas R

    2015-11-12

    Schizophrenia is a chronic psychiatric disorder with a heterogeneous genetic and neurobiological background that influences early brain development, and is expressed as a combination of psychotic symptoms - such as hallucinations, delusions and disorganization - and motivational and cognitive dysfunctions. The mean lifetime prevalence of the disorder is just below 1%, but large regional differences in prevalence rates are evident owing to disparities in urbanicity and patterns of immigration. Although gross brain pathology is not a characteristic of schizophrenia, the disorder involves subtle pathological changes in specific neural cell populations and in cell-cell communication. Schizophrenia, as a cognitive and behavioural disorder, is ultimately about how the brain processes information. Indeed, neuroimaging studies have shown that information processing is functionally abnormal in patients with first-episode and chronic schizophrenia. Although pharmacological treatments for schizophrenia can relieve psychotic symptoms, such drugs generally do not lead to substantial improvements in social, cognitive and occupational functioning. Psychosocial interventions such as cognitive-behavioural therapy, cognitive remediation and supported education and employment have added treatment value, but are inconsistently applied. Given that schizophrenia starts many years before a diagnosis is typically made, the identification of individuals at risk and those in the early phases of the disorder, and the exploration of preventive approaches are crucial.

  14. Interview Investigation of Insecure Attachment Styles as Mediators between Poor Childhood Care and Schizophrenia-Spectrum Phenomenology.

    Directory of Open Access Journals (Sweden)

    Tamara Sheinbaum

    Full Text Available Insecure attachment styles have received theoretical attention and some initial empirical support as mediators between childhood adverse experiences and psychotic phenomena; however, further specificity needs investigating. The present interview study aimed to examine (i whether two forms of poor childhood care, namely parental antipathy and role reversal, were associated with subclinical positive and negative symptoms and schizophrenia-spectrum personality disorder (PD traits, and (ii whether such associations were mediated by specific insecure attachment styles.A total of 214 nonclinical young adults were interviewed for subclinical symptoms (Comprehensive Assessment of At-Risk Mental States, schizophrenia-spectrum PDs (Structured Clinical Interview for DSM-IV Axis II Disorders, poor childhood care (Childhood Experience of Care and Abuse Interview, and attachment style (Attachment Style Interview. Participants also completed the Beck Depression Inventory-II and all the analyses were conducted partialling out the effects of depressive symptoms.Both parental antipathy and role reversal were associated with subclinical positive symptoms and with paranoid and schizotypal PD traits. Role reversal was also associated with subclinical negative symptoms. Angry-dismissive attachment mediated associations between antipathy and subclinical positive symptoms and both angry-dismissive and enmeshed attachment mediated associations of antipathy with paranoid and schizotypal PD traits. Enmeshed attachment mediated associations of role reversal with paranoid and schizotypal PD traits.Attachment theory can inform lifespan models of how adverse developmental environments may increase the risk for psychosis. Insecure attachment provides a promising mechanism for understanding the development of schizophrenia-spectrum phenomenology and may offer a useful target for prophylactic intervention.

  15. Rethinking Schizophrenia

    OpenAIRE

    Insel, Thomas R.

    2010-01-01

    How will we view schizophrenia in 2030? Schizophrenia today is a chronic, frequently disabling mental disorder that affects about one per cent of the world's population. After a century of studying schizophrenia, the cause of the disorder remains unknown. Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia. These current uns...

  16. High serum soluble tumor necrosis factor receptor 1 predicts poor treatment response in acute-stage schizophrenia.

    Science.gov (United States)

    Nishimon, Shohei; Ohnuma, Tohru; Takebayashi, Yuto; Katsuta, Narimasa; Takeda, Mayu; Nakamura, Toru; Sannohe, Takahiro; Higashiyama, Ryoko; Kimoto, Ayako; Shibata, Nobuto; Gohda, Tomohito; Suzuki, Yusuke; Yamagishi, Sho-Ichi; Tomino, Yasuhiko; Arai, Heii

    2017-06-02

    Inflammation may be involved in the pathophysiology of schizophrenia. However, few cross-sectional or longitudinal studies have examined changes in biomarker expression to evaluate diagnostic and prognostic efficacy in acute-stage schizophrenia. We compared serum inflammatory biomarker concentrations in 87 patients with acute-stage schizophrenia on admission to 105 age-, sex-, and body mass index (BMI)-matched healthy controls. The measured biomarkers were soluble tumor necrosis factor receptor 1 (sTNFR1) and adiponectin, which are associated with inflammatory responses, and pigment epithelium-derived factor (PEDF), which has anti-inflammatory properties. We then investigated biomarker concentrations and associations with clinical factors in 213 patients (including 42 medication-free patients) and 110 unmatched healthy controls to model conditions typical of clinical practice. Clinical symptoms were assessed using the Brief Psychiatric Rating Scale and Global Assessment of Function. In 121 patients, biomarker levels and clinical status were evaluated at both admission and discharge. Serum sTNFR1 was significantly higher in patients with acute-stage schizophrenia compared to matched controls while no significant group differences were observed for the other markers. Serum sTNFR1 was also significantly higher in the 213 patients compared to unmatched controls. The 42 unmedicated patients had significantly lower PEDF levels compared to controls. Between admission and discharge, sTNFR1 levels decreased significantly; however, biomarker changes did not correlate with clinical symptoms. The discriminant accuracy of sTNFR1 was 93.2% between controls and patients, showing no symptom improvement during care. Inflammation and a low-level anti-inflammatory state may be involved in both schizophrenia pathogenesis and acute-stage onset. High serum sTNFR1 in the acute stage could be a useful prognostic biomarker for treatment response in clinical practice. Copyright © 2017

  17. Low levels of vitamin D poorly responsive to daylight exposure in patients with therapy-resistant schizophrenia.

    Science.gov (United States)

    Bogers, Jan P.A.M.; Bostoen, Tijmen; Broekman, Theo G.

    2016-01-01

    Low vitamin D levels are associated with schizophrenia, but the possible association between vitamin D levels and illness severity or duration of exposure to daylight has barely been investigated. To compare vitamin D levels in therapy-refractory severely ill schizophrenia patients and members of staff. To investigate the influence of daylight exposure on vitamin D levels in patients. Vitamin D was measured in patients with therapy-resistant schizophrenia in April, after the winter, and in patients and staff members in June, after an exceptionally sunny spring. Vitamin D levels in April and June were compared in patients, and levels in June were compared in patients and staff. The influence of daylight was taken into account by comparing the time patients spent outdoors during the day with the recommended minimum time for adequate vitamin D synthesis, and by comparing time spent outdoors in patients and staff. Patients had high rates of vitamin D deficiency (79-90%) and lower levels of vitamin D than staff members (p vitamin D levels did not normalize, despite the considerably longer than recommended exposure of the skin to daylight (p vitamin D deficiency of therapy-resistant schizophrenia patients is pronounced and cannot be explained by differences in skin pigmentation or by an inactive, indoor lifestyle on the ward. Even theoretically sufficient exposure of the patients to daylight did not ameliorate the low vitamin D levels. While vitamin D deficiency probably plays a role in somatic health problems, it may also play a role in schizophrenia. Interestingly, exposure to daylight during an unusually sunny spring was not sufficient to correct the vitamin D deficiency seen in the patients. This emphasizes the need to measure and correct vitamin D levels in these patients.

  18. [Attributable risk of co-morbid substance use disorder in poor observance to pharmacological treatment and the occurrence of relapse in schizophrenia].

    Science.gov (United States)

    Ameller, A; Gorwood, P

    2015-04-01

    There are numerous risk factors involved in poor (incomplete) compliance to pharmacological treatment, and the associated relapse risk, for patients with schizophrenia. Comorbid substance use disorders are considered as among the most important ones, although how much their presence increase the risk of poorer observance (and higher risk of relapse) has not been yet assessed. This measure would be important, especially if the published literature on the topic provides sufficient material to perform a meta-analysis and to assess different potential biases such as those related to time (new studies are easier to publish when positive) or sample size (small samples might drive the global positive conclusion). A PubMed(®) search was made, screening the following terms between 1996 and august 2014 "Addiction AND (Observance OR Adherence) AND schizophrenia AND (French OR English [Language])" and "(Substance Abuse OR substance dependance) AND Outcome AND schizophrenia AND (French OR English [Language])". Studies were included if they describe two patients groups (schizophrenia with and without present substance use disorder) and assess the studied outcome. MetaWin(®) version 2 was used for the meta-analysis, while publication time bias relied on non-parametric correlation and the one linked to sample size was assessed through normal quantile plots. An attributable risk was also computered, on the basis of the odds-ratio derived from the meta-analysis and the prevalence of the analyzed trait (associated substance use disorder). Eight studies could be included in the meta-analysis, showing that the presence of a substance use disorder significantly increases the risk of poor observance to pharmacological treatment (OR=2.18 [1.84-2.58]), no significant bias being detected, either linked to time (rho=0.287, P=0.490) or sample size (Kendall's Tau=-0.286, P=0.322). The related attributable risk is 18.50%. Only three studies could be used for the meta-analysis of the risk of

  19. Rethinking schizophrenia.

    Science.gov (United States)

    Insel, Thomas R

    2010-11-11

    How will we view schizophrenia in 2030? Schizophrenia today is a chronic, frequently disabling mental disorder that affects about one per cent of the world's population. After a century of studying schizophrenia, the cause of the disorder remains unknown. Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia. These current unsatisfactory outcomes may change as we approach schizophrenia as a neurodevelopmental disorder with psychosis as a late, potentially preventable stage of the illness. This 'rethinking' of schizophrenia as a neurodevelopmental disorder, which is profoundly different from the way we have seen this illness for the past century, yields new hope for prevention and cure over the next two decades.

  20. Genetic variations of PIP4K2A confer vulnerability to poor antipsychotic response in severely ill schizophrenia patients.

    Directory of Open Access Journals (Sweden)

    Harpreet Kaur

    Full Text Available Literature suggests that disease severity and neurotransmitter signaling pathway genes can accurately identify antipsychotic response in schizophrenia patients. However, putative role of signaling molecules has not been tested in schizophrenia patients based on severity of illness, despite its biological plausibility. In the present study we investigated the possible association of polymorphisms from five candidate genes RGS4, SLC6A3, PIP4K2A, BDNF, PI4KA with response to antipsychotic in variably ill schizophrenia patients. Thus in present study, a total 53 SNPs on the basis of previous reports and functional grounds were examined for their association with antipsychotic response in 423 schizophrenia patients segregated into low and high severity groups. Additionally, haplotype, diplotype, multivariate logistic regression and multifactor-dimensionality reduction (MDR analyses were performed. Furthermore, observed associations were investigated in atypical monotherapy (n = 355 and risperidone (n = 260 treated subgroups. All associations were estimated as odds ratio (OR and 95% confidence interval (CI and test for multiple corrections was applied. Single locus analysis showed significant association of nine variants from SLC6A3, PIP4K2A and BDNF genes with incomplete antipsychotic response in schizophrenia patients with high severity. We identified significant association of six marker diplotype ATTGCT/ATTGCT (rs746203-rs10828317-rs7094131-rs2296624-rs11013052-rs1409396 of PIP4K2A gene in incomplete responders (corrected p-value = 0.001; adjusted-OR = 3.19, 95%-CI = 1.46-6.98 with high severity. These associations were further observed in atypical monotherapy and risperidone sub-groups. MDR approach identified gene-gene interaction among BDNF_rs7103411-BDNF_rs1491851-SLC6A3_rs40184 in severely ill incomplete responders (OR = 7.91, 95%-CI = 4.08-15.36. While RGS4_rs2842026-SLC6A3_rs2975226 interacted synergistically in

  1. Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST)

    NARCIS (Netherlands)

    Pijnenborg, G. H. M.; Timmerman, M. E.; Derks, E. M.; Fleischhacker, W. W.; Kahn, R. S.; Aleman, A.

    2015-01-01

    Although antipsychotics are widely prescribed, their effect of on improving poor illness insight in schizophrenia has seldom been investigated and therefore remains uncertain. This paper examines the effects of low dose haloperidol, amisulpride, olanzapine, quetiapine, and ziprasidone on insight in

  2. Differential effects of antipsychotic drugs on insight in first episode schizophrenia : Data from the European First-Episode Schizophrenia Trial (EUFEST)

    NARCIS (Netherlands)

    Pijnenborg, G. H. M.; Timmerman, Marieke; Derks, E.M.; Fleischhacker, W. W.; Kahn, R. S.; Aleman, A.

    Although antipsychotics are widely prescribed, their effect of on improving poor illness insight in schizophrenia has seldom been investigated and therefore remains uncertain. This paper examines the effects of low dose haloperidol, amisulpride, olanzapine, quetiapine, and ziprasidone on insight in

  3. Notwithstanding High Prevalence of Overweight and Obesity, Smoking Remains the Most Important Factor in Poor Self-rated Health and Hospital Use in an Australian Regional Community

    Directory of Open Access Journals (Sweden)

    Helen Mary Haines

    2017-08-01

    Full Text Available Objective: To classify a rural community sample by their modifiable health behaviours and identify the prevalence of chronic conditions, poor self-rated health, obesity and hospital use. Method: Secondary analysis of a cross- sectional self-report questionnaire in the Hume region of Victoria, Australia. Cluster analysis using the two-step method was applied to responses to health behaviour items. Results: 1,259 questionnaires were completed. Overall 63% were overweight or obese. Three groups were identified: ‘Healthy Lifestyle’ (63%, ‘Non Smoking, Unhealthy Lifestyle’ (25% and ‘Smokers’ (12%. ‘Healthy lifestyle’ were older and more highly educated than the other two groups while ‘Non Smoking, Unhealthy Lifestyle’ were more likely to be obese. ‘Smokers’ had the highest rate of poor self-rated health. Prevalence of chronic conditions was similar in each group (>20%. ‘Smokers’ were twice as likely to have had two or more visits to hospital in the preceding year even after adjustment for age, gender and education. Conclusion: High rates of overweight and obesity were identified but ‘Smokers’ were at the greatest risk for poor self-rated health and hospitalisation. Implications for Public Health: Within an environment of high rates of chronic ill health and obesity, primary care clinicians and public health policy makers must maintain their vigilance in encouraging people to quit smoking.

  4. Vulnerable self, poor understanding of others' minds, threat anticipation and cognitive biases as triggers for delusional experience in schizophrenia: a theoretical model.

    Science.gov (United States)

    Salvatore, Giampaolo; Lysaker, Paul H; Popolo, Raffaele; Procacci, Michele; Carcione, Antonino; Dimaggio, Giancarlo

    2012-01-01

    It remains unclear what processes lead to the establishment of persecutory delusions in acute phases of schizophrenia. Recently, it has been argued that persecutory delusions arise from an interaction among a range of emotional, cognitive and social factors. In this work, we explored this possibility by first discussing the relevant aspects of recent theoretical models of the causes of persecutory delusions. Then, we offered an analysis of the literature, illustrated with clinical observations suggesting that persecutory delusions are triggered during stressful intersubjective transactions by the interactions of (a) an alteration in empathetic perspective taking and in pragmatic understanding of others' minds; (b) a perception/representation of the self as vulnerable or subordinate and of the other as dominant and threatening; and (c) a hyperfunctioning of the threat/self-protection system when faced with perceived danger. Implications for future research and treatment of people suffering from this symptom are discussed. Copyright © 2011 John Wiley & Sons, Ltd.

  5. Toward a Holistic Approach to Spiritual Health Care for People With Schizophrenia.

    Science.gov (United States)

    Ho, Rainbow T H; Wan, Adrian H Y; Chan, Caitlin K P

    2016-01-01

    Medical and behavioral treatments are the predominant types of rehabilitation services for people with schizophrenia. Spirituality in people with schizophrenia remains poorly conceptualized, thereby limiting knowledge advancement in the area of spiritual health care services. To provide a framework for better clinical and research practices, we advocate a holistic approach to investigating spirituality and its application in spiritual health care services of people with schizophrenia.

  6. Does abnormal sleep impair memory consolidation in schizophrenia?

    Directory of Open Access Journals (Sweden)

    Dara S Manoach

    2009-09-01

    Full Text Available Although disturbed sleep is a prominent feature of schizophrenia, its relation to the pathophysiology, signs, and symptoms of schizophrenia remains poorly understood. Sleep disturbances are well known to impair cognition in healthy individuals. Yet, in spite of its ubiquity in schizophrenia, abnormal sleep has generally been overlooked as a potential contributor to cognitive deficits. Amelioration of cognitive deficits is a current priority of the schizophrenia research community, but most efforts to define, characterize, and quantify cognitive deficits focus on cross-sectional measures. While this approach provides a valid snapshot of function, there is now overwhelming evidence that critical aspects of learning and memory consolidation happen offline, both over time and with sleep. Initial memory encoding is followed by a prolonged period of consolidation, integration, and reorganization, that continues over days or even years. Much of this evolution of memories is mediated by sleep. This article briefly reviews (i abnormal sleep in schizophrenia, (ii sleep-dependent memory consolidation in healthy individuals, (iii recent findings of impaired sleep-dependent memory consolidation in schizophrenia, and (iv implications of impaired sleep-dependent memory consolidation in schizophrenia. This literature suggests that abnormal sleep in schizophrenia disrupts attention and impairs sleep-dependent memory consolidation and task automation. We conclude that these sleep-dependent impairments may contribute substantially to generalized cognitive deficits in schizophrenia. Understanding this contribution may open new avenues to ameliorating cognitive dysfunction and thereby improve outcome in schizophrenia.

  7. Subjective experience and suicidal ideation in schizophrenia

    DEFF Research Database (Denmark)

    Skodlar, Borut; Tomori, Martina; Parnas, Josef

    2008-01-01

    ideation and intentions, followed by a qualitative phenomenological analysis of the material. Solitude with inability to participate in human interactions and feelings of inferiority were found to be the main sources of suicidal ideation. These experiences seem to resemble ordinary depressive reactions......Suicidal ideation and behavior are a frequent complication of schizophrenia. Although a number of risk factors have been identified, specific features of suicidality in schizophrenia remain poorly understood. In this study, 19 patients with schizophrenia were interviewed in depth on their suicidal......, yet we found them to be reflective of a more basic self-alienation and incapacity for immersion in the shared world. Ignoring this experiential level of patients' disturbances may lead to trivialization (and misjudgment) of the experiences at the root of suicidality in schizophrenia....

  8. Remission and Recovery in Schizophrenia: Practitioner and Patient Perspectives

    OpenAIRE

    Davidson, Larry; Schmutte, Timothy; Dinzeo, Thomas; Andres-Hyman, Raquel

    2007-01-01

    Schizophrenia remains a complex, dynamic, multi-dimensional, and poorly understood condition. Although the concept of heterogeneity in outcome has conceptually overturned the post Kraepelinian legacy of progressive deterioration, a number of factors appear to contribute to perpetuating a pessimistic attitude toward outcome within the field. These include the limited access people with schizophrenia have to effective interventions and the phenomenon of the “clinician's illusion,” which refers ...

  9. Eating Disorders in Schizophrenia: Implications for Research and Management

    Directory of Open Access Journals (Sweden)

    Youssef Kouidrat

    2014-01-01

    Full Text Available Objective. Despite evidence from case series, the comorbidity of eating disorders (EDs with schizophrenia is poorly understood. This review aimed to assess the epidemiological and clinical characteristics of EDs in schizophrenia patients and to examine whether the management of EDs can be improved. Methods. A qualitative review of the published literature was performed using the following terms: “schizophrenia” in association with “eating disorders,” “anorexia nervosa,” “bulimia nervosa,” “binge eating disorder,” or “night eating syndrome.” Results. According to our literature review, there is a high prevalence of comorbidity between schizophrenia and EDs. EDs may occur together with or independent of psychotic symptoms in these patients. Binge eating disorders and night eating syndromes are frequently found in patients with schizophrenia, with a prevalence of approximately 10%. Anorexia nervosa seems to affect between 1 and 4% of schizophrenia patients. Psychopathological and neurobiological mechanisms, including effects of antipsychotic drugs, should be more extensively explored. Conclusions. The comorbidity of EDs in schizophrenia remains relatively unexplored. The clearest message of this review is the importance of screening for and assessment of comorbid EDs in schizophrenia patients. The management of EDs in schizophrenia requires a multidisciplinary approach to attain maximized health outcomes. For clinical practice, we propose some recommendations regarding patient-centered care.

  10. Patients with poor response to antipsychotics have a more severe pattern of frontal atrophy: a voxel-based morphometry study of treatment resistance in schizophrenia.

    Science.gov (United States)

    Quarantelli, Mario; Palladino, Olga; Prinster, Anna; Schiavone, Vittorio; Carotenuto, Barbara; Brunetti, Arturo; Marsili, Angela; Casiello, Margherita; Muscettola, Giovanni; Salvatore, Marco; de Bartolomeis, Andrea

    2014-01-01

    Approximately 30% of schizophrenia patients do not respond adequately to the therapy. Previous MRI studies have suggested that drug treatment resistance is associated with brain morphological abnormalities, although region-of-interest analysis of MR studies from nonresponder and responder patients failed to demonstrate a statistically significant difference between these two schizophrenia subgroups. We have used a voxel-based analysis of segmented MR studies to assess structural cerebral differences in 20 nonresponder and 15 responder patients and 16 age-matched normal volunteers. Differences between the three groups emerged bilaterally mainly at the level of the superior and middle frontal gyri, primarily due to reduced grey matter volumes in nonresponders, as compared to both normal volunteers and responder patients. Post hoc direct comparison between the two schizophrenia subgroups demonstrated significantly reduced grey matter volumes in middle frontal gyrus bilaterally, in the dorsolateral aspects of left superior frontal gyrus extending into postcentral gyrus and in the right medial temporal cortex. Our results extend and integrate previous findings suggesting a more severe atrophy in nonresponder schizophrenia patients, compared to responder patients, mainly at the level of the superior and middle frontal gyri. Longitudinal studies in drug-naïve patients are needed to assess the role of these associations.

  11. Targeting Functional Biomarkers in Schizophrenia with Neuroimaging

    OpenAIRE

    Wylie, Korey P.; Smucny, Jason; Legget, Kristina T.; Tregellas, Jason R.

    2016-01-01

    Many of the most debilitating symptoms for psychiatric disorders such as schizophrenia remain poorly treated. As such, the development of novel treatments is urgently needed. Unfortunately, the costs associated with high failure rates for investigational compounds as they enter clinical trials has led to pharmaceutical companies downsizing or eliminating research programs needed to develop these drugs. One way of increasing the probability of success for investigational compounds is to incorp...

  12. Effects of sports participation on psychiatric symptoms and brain activations during sports observation in schizophrenia

    OpenAIRE

    Takahashi, H; Sassa, T; Shibuya, T; Kato, M; Koeda, M; Murai, T; Matsuura, M; Asai, K; Suhara, T; Okubo, Y

    2012-01-01

    Weight gain has been identified as being responsible for increased morbidity and mortality rates of schizophrenia patients. For the management of weight gain, exercise is one of the most acknowledged interventions. At the same time, exercise and sports have been recognized for their positive impact on psychiatric symptoms of schizophrenia. However, the neurobiological basis for this remains poorly understood. We aimed to examine the effect of sports participation on weight gain, psychiatric s...

  13. Family matters : The influence of family history on phenomenology and IQ in patients with schizophrenia and their relatives

    NARCIS (Netherlands)

    Verweij, K.H.W.

    2014-01-01

    Although the exact aetiology of schizophrenia remains unknown, multiple genetic and environmental factors influence the development and expression of schizophrenia. The strongest risk factor to develop schizophrenia is the familial risk, thus having a family member with schizophrenia. The

  14. [Mineralization of the basal ganglia as the supposed cause of poor tolerance of zuclopenthixol in a patient with long-term untreated paranoid schizophrenia].

    Science.gov (United States)

    Wichowicz, Hubert M; Wilkowska, Alina; Banecka-Majkutewicz, Zyta; Kummer, Łukasz; Konarzewska, Joanna; Raczak, Alicja

    2013-01-01

    Formations described as intracranial calcifications can appear in the course of diseases of the central nervous system, other systems and organs (e.g. endocrine), but also as a disorder of idiopathic character. They are frequently located in subcortical nuclei and usually constitute an incidental finding. This report presents the case of a patient suffering from paranoid schizophrenia for approximately 40 years, who did not agree to any treatment and was hospitalized against her will because she was the threat to the lives of others. She was treated with zuklopentixol resulting in positive symptoms reduction and considerable improvement in social functioning. Unfortunately neurological symptoms appeared: bradykinesis, rigidity--of the type of the lead pipe, balance, posture and gait abnormalities, disturbances in precise hands movements, double-sided Rossolimo's sign, plantar reflex without the participation of the big toe on the left. Neuroimaging studies have demonstrated changes in the form of lenticular nuclei calcification and reduction of signal intensity in posterior parts of both putamens. Neurological symptoms decreased significantly after switching to atypical neuroleptic (olanzapine), and the patient did not require any additional treatment. Mineralization of the basal ganglia can often be associated with psychiatric disorders and it shouldn't be neglected because it can require modification of pharmacotherapy or additional neurological treatment.

  15. Motivation and Social Cognition in Patients with Schizophrenia.

    Science.gov (United States)

    Fervaha, Gagan; Siddiqui, Ishraq; Foussias, George; Agid, Ofer; Remington, Gary

    2015-07-01

    Social cognition, referring to one's ability to perceive and process social cues, is an important domain in schizophrenia. Numerous studies have demonstrated that patients with schizophrenia have poorer performance on tests assessing social cognition relative to healthy comparison participants. However, whether variables such as motivation are related to performance on these tests in patients with schizophrenia is unclear. One thousand three-hundred and seventy-eight patients with schizophrenia completed the Facial Emotion Discrimination Task as a measure of emotional processing, a key facet of social cognition. Level of motivation was also evaluated in these patients using a derived measure from the Quality of Life Scale. The relationship between motivation and task performance was examined using bivariate correlations and logistic regression modeling, controlling for the impact of age and overall severity of psychopathology, the latter evaluated using the Positive and Negative Syndrome Scale. Motivation was positively related to performance on the social cognition test, and this relationship remained significant after controlling for potential confounding variables such as age and illness severity. Social cognition was also related to functioning, and the relationship was mediated by level of motivation. The present study found a significant relationship between motivation and performance on a test of social cognition in a large sample of patients with schizophrenia. These findings suggest that amotivation undermines task performance, or alternatively that poor social cognitive ability impedes motivation. Future studies evaluating social cognition in patients with schizophrenia should concurrently assess for variables such as effort and motivation.

  16. [Schizophrenia and informed consent to research].

    Science.gov (United States)

    Fovet, T; Amad, A; Thomas, P; Jardri, R

    2015-10-01

    Informed consent to research remains a complex issue, while sometimes staying difficult to obtain, even in the general population. This problem may be maximized with patients suffering from schizophrenia. This paper summarizes available data in the literature about informed consent for research involving patients suffering from schizophrenia. Medline and Google Scholar searches were conducted using the following MESH terms: schizophrenia, informed consent and research. Studies using dedicated standardized scales (e.g. MacCAT-CR) revealed a decrease in the capacity to consent of patients with schizophrenia when compared with healthy individuals. Keeping in mind that schizophrenia is an heterogeneous disorder, patients with the lowest insight as well as those with the most severe cognitive symptoms appeared more impaired in their capacity to consent. Such a poor capacity to understand and consent to trials was shown linked with alterations in decision-making. For these specific patients, interventions may be set up to increase their capacity to consent. Various strategies were proposed: enhanced consent forms, extended discussion, test/feedback method or multimedia interventions. Among them, interventions relying on communication and the growing field of information technologies (e.g. web-based tools) seem promising. Finally, associations grouping families and patients (like the French Association UNAFAM) may facilitate the involvement of patients in research programs with safer conditions. Patients suffering from schizophrenia appear able to consent to research programs when suitable interventions are proposed. Further studies are now needed to optimize and individualize such interventions. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  17. Differential Patterns of Dysconnectivity in Mirror Neuron and Mentalizing Networks in Schizophrenia

    NARCIS (Netherlands)

    Schilbach, Leonhard; Derntl, Birgit; Aleman, Andre; Caspers, Svenja; Clos, Mareike; Diederen, Kelly M J; Gruber, Oliver; Kogler, Lydia; Liemburg, Edith J; Sommer, Iris E; Müller, Veronika I; Cieslik, Edna C; Eickhoff, Simon B

    Impairments of social cognition are well documented in patients with schizophrenia (SCZ), but the neural basis remains poorly understood. In light of evidence that suggests that the "mirror neuron system" (MNS) and the "mentalizing network" (MENT) are key substrates of intersubjectivity and joint

  18. Remission and recovery in schizophrenia: practitioner and patient perspectives.

    Science.gov (United States)

    Davidson, Larry; Schmutte, Timothy; Dinzeo, Thomas; Andres-Hyman, Raquel

    2008-01-01

    Schizophrenia remains a complex, dynamic, multi-dimensional, and poorly understood condition. Although the concept of heterogeneity in outcome has conceptually overturned the post Kraepelinian legacy of progressive deterioration, a number of factors appear to contribute to perpetuating a pessimistic attitude toward outcome within the field. These include the limited access people with schizophrenia have to effective interventions and the phenomenon of the "clinician's illusion," which refers to the tendency of practitioners to assume that patients remain seriously ill when outside of the clinical care settings in which they are typically seen. Longitudinal studies, however, continue to point to a large number of people who experience improvements in their condition over time. Pressure from patients and their families, who experience periods of symptomatic relief and enhanced functioning first-hand, has led to the introduction of such concepts as "remission" and being "in" recovery with schizophrenia, in addition to the conventional notion of recovering "from" schizophrenia. These developments are consistent with recent policy initiatives by the U.S. and other governments around the world and aim to re-orient research and clinical practice from a traditional focus on effecting cure to exploring ways to encourage and assist people with schizophrenia to live meaningful lives in the face of an enduring illness.

  19. GABA transporter-1 deficiency confers schizophrenia-like behavioral phenotypes.

    Directory of Open Access Journals (Sweden)

    Zhe Yu

    Full Text Available The mechanism underlying the pathogenesis of schizophrenia remains poorly understood. The hyper-dopamine and hypo-NMDA receptor hypotheses have been the most enduring ideas. Recently, emerging evidence implicates alterations of the major inhibitory system, GABAergic neurotransmission in the schizophrenic patients. However, the pathophysiological role of GABAergic system in schizophrenia still remains dubious. In this study, we took advantage of GABA transporter 1 (GAT1 knockout (KO mouse, a unique animal model with elevated ambient GABA, to study the schizophrenia-related behavioral abnormalities. We found that GAT1 KO mice displayed multiple behavioral abnormalities related to schizophrenic positive, negative and cognitive symptoms. Moreover, GAT1 deficiency did not change the striatal dopamine levels, but significantly enhanced the tonic GABA currents in prefrontal cortex. The GABA(A receptor antagonist picrotoxin could effectively ameliorate several behavioral defects of GAT1 KO mice. These results identified a novel function of GAT1, and indicated that the elevated ambient GABA contributed critically to the pathogenesis of schizophrenia. Furthermore, several commonly used antipsychotic drugs were effective in treating the locomotor hyperactivity in GAT1 KO mice, suggesting the utility of GAT1 KO mice as an alternative animal model for studying schizophrenia pathogenesis and developing new antipsychotic drugs.

  20. Schizophrenia and chromosomal deletions

    Energy Technology Data Exchange (ETDEWEB)

    Lindsay, E.A.; Baldini, A. [Baylor College of Medicine, Houston, TX (United States); Morris, M. A. [Univ. of Geneva School of Medicine, NY (United States)] [and others

    1995-06-01

    Recent genetic linkage analysis studies have suggested the presence of a schizophrenia locus on the chromosomal region 22q11-q13. Schizophrenia has also been frequently observed in patients affected with velo-cardio-facial syndrome (VCFS), a disorder frequently associated with deletions within 22q11.1. It has been hypothesized that psychosis in VCFS may be due to deletion of the catechol-o-methyl transferase gene. Prompted by these observations, we screened for 22q11 deletions in a population of 100 schizophrenics selected from the Maryland Epidemiological Sample. Our results show that there are schizophrenic patients carrying a deletion of 22q11.1 and a mild VCFS phenotype that might remain unrecognized. These findings should encourage a search for a schizophrenia-susceptibility gene within the deleted region and alert those in clinical practice to the possible presence of a mild VCFS phenotype associated with schizophrenia. 9 refs.

  1. The schizophrenia risk gene ZNF804A influences the antipsychotic response of positive schizophrenia symptoms

    OpenAIRE

    Mössner, R; Schumacher, A; Wagner, M; Lennertz, L; Steinbrecher, A; Quednow, Boris B; Rujescu, D; Rietschel, M; Maier, W

    2012-01-01

    Genetic factors determining the response to antipsychotic treatment in schizophrenia are poorly understood. A new schizophrenia susceptibility gene, the zinc-finger gene ZNF804A, has recently been identified. To assess the pharmacogenetic importance of this gene, we treated 144 schizophrenia patients and assessed the response of positive and negative symptoms by PANSS. Patients homozygous for the ZNF804A risk allele for schizophrenia (rs1344706 AA) showed poorer improvement of positive sympto...

  2. Token economy for schizophrenia.

    LENUS (Irish Health Repository)

    McMonagle, T

    2000-01-01

    A token economy is a behavioural therapy technique in which the desired change is achieved by means of tokens administered for the performance of predefined behaviours according to a program. Though token economy programmes were widespread in the 1970s they became largely restricted to wards where long-stay patients from institutions are prepared for transfer into the community and were particularly aimed at changing negative symptoms of schizophrenia - poor motivation, poor attention and social withdrawal.

  3. Schizophrenia : Current concepts in aetiology

    Directory of Open Access Journals (Sweden)

    P S Bhat

    2014-01-01

    Full Text Available Schizophrenia is perhaps the most devastating neuropsychiatric illness. Worldwide, its prevalence rate is about 1%. Schizophrenia is considered a neurodevelopmental disorder involving the interplay of susceptibility genes and environmental factors. There is a wide range of pathologic findings, but there is no specific or diagnostic laboratory abnormality. Till date, the aetiology, neuropathology, and pathophysiology of schizophrenia remain elusive. Over the last forty years, the dopaminergic model has been the leading neurochemical hypothesis of schizophrenia. Yet it remains unlikely that dopaminergic dysfunction, on its own. Glutamatergic models provide an alternate approach for conceptualizing the brain abnormalities associated with schizophrenia. New pharmacological and behavioral approaches aimed at potentiating glutamatergic neurotransmission, offer new hopeforfuture clinical development

  4. Clozapine for severe ("kraepelinian" schizophrenia: Sustained improvement over 5 years

    Directory of Open Access Journals (Sweden)

    Ricardo de Oliveira-Souza

    Full Text Available Abstract Clozapine has become a keystone in the treatment of schizophrenia because of its efficacy as an antipsychotic with negligible neuroleptic effects. The long-term stability of its effects, however, is poorly understood, because most studies have probed the usefulness of clozapine over a period of weeks to several months at the most. Knowing whether clozapine's benefits are sustained over the very long-term, i.e., more than 5 years, may be critical for cost-benefit analyses. Objective: To report the results of an open study on the efficacy of clozapine over the very long-term. Methods: Thirty-three adults (26 men with severe (kraepelinian schizophrenia were assessed at regular intervals using a brief neuropsychiatric battery over a 5-year period. Results: A significant improvement was observed between the pre-clozapine and the first "on-clozapine" evaluation. This improvement was paralleled by a remarkable conversion of schizophrenia from "active" (mostly paranoid into "residual" in 70% of all patients. Eight patients became functionally productive to the point of being capable of living an independent life. Roughly one-third of our cases showed no improvement. Conclusions: Clozapine is a safe and effective drug for patients with severe schizophrenia who have failed to improve on other antipsychotic drugs. Clozapine's maximal benefit is established by the end of the first year of treatment and continues unabated for many years thereafter. Clozapine-resistant patients remain a major challenge calling for the discovery of new treatments for schizophrenia.

  5. Gene-environment interaction and covariation in schizophrenia: the role of obstetric complications.

    Science.gov (United States)

    Mittal, Vijay A; Ellman, Lauren M; Cannon, Tyrone D

    2008-11-01

    While genetic factors account for a significant proportion of liability to schizophrenia, a body of evidence attests to a significant environmental contribution. Understanding the mechanisms through which genetic and environmental factors coalesce in influencing schizophrenia is critical for elucidating the pathways underlying psychotic illness and for developing primary prevention strategies. Although obstetric complications (OCs) remain among the most well-documented environmental indicators of risk for schizophrenia, the pathogenic role they play in the etiology of schizophrenia continues to remain poorly understood. A question of major importance is do these factors result from a genetic diathesis to schizophrenia (as in gene-environment covariation), act additively or interactively with predisposing genes for the disorder in influencing disease risk, or independently cause disease onset? In this review, we evaluate 3 classes of OCs commonly related to schizophrenia including hypoxia-associated OCs, maternal infection during pregnancy, and maternal stress during pregnancy. In addition, we discuss several mechanisms by which OCs impact on genetically susceptible brain regions, increasing constitutional vulnerability to neuromaturational events and stressors later in life (ie, adolescence), which may in turn contribute to triggering psychosis.

  6. Bleuler and the Neurobiology of Schizophrenia

    OpenAIRE

    Heckers, Stephan

    2011-01-01

    Schizophrenia remains a major challenge for psychiatry. One hundred years after the publication of Eugen Bleuler’s monograph, we are still debating the nosology and mechanisms of schizophrenia. We have stalled in the development of more effective treatments, after success with the introduction of antipsychotic medication. Cure and prevention remain in the distance. This article reviews the importance of Bleuler’s monograph for the neuroscientific exploration of schizophrenia. While Bleuler as...

  7. [Prevention of schizophrenia: a review].

    Science.gov (United States)

    Balhara, Yatan Pal Singh

    2013-01-01

    Research over the years has introduced multiple interventions for schizophrenia. Notwithstanding the nature of intervention pharmacological or psychological a complete cure for the condition remains a much-desired, yet unachieved goal. What is required is an exploration of alternative intervention strategies for treating schizophrenia a preventive approach is such an option. The chronic nature of schizophrenia and its associated disabilities have a tremendously negative affect the quality of life of patients, their families, and communities. Among the preferred approaches to reducing the negative consequences associated with the disorder is the prevention of its emergence. This review aimed to present the available data on the prevention of schizophrenia data that suggest some pharmacological and non-pharmacological interventions have a potential role in the prevention of schizophrenia. Nonetheless, the findings are restricted to a few sites and are at best preliminary; as such, the findings must be replicated in new studies that include large samples and different settings.

  8. Mysticism and schizophrenia

    DEFF Research Database (Denmark)

    Parnas, Josef; Henriksen, Mads Gram

    2016-01-01

    Mysticism and schizophrenia are different categories of human existence and experience. Nonetheless, they exhibit important phenomenological affinities, which, however, remain largely unaddressed. In this study, we explore structural analogies between key features of mysticism and major clinical......-phenomenological aspects of the schizophrenia spectrum disorders-i.e. attitudes, the nature of experience, and the 'other', mystical or psychotic reality. Not only do these features gravitate around the issue of the basic dimensions of consciousness, they crucially seem to implicate and presuppose a specific alteration...

  9. Bleuler and the neurobiology of schizophrenia.

    Science.gov (United States)

    Heckers, Stephan

    2011-11-01

    Schizophrenia remains a major challenge for psychiatry. One hundred years after the publication of Eugen Bleuler's monograph, we are still debating the nosology and mechanisms of schizophrenia. We have stalled in the development of more effective treatments, after success with the introduction of antipsychotic medication. Cure and prevention remain in the distance. This article reviews the importance of Bleuler's monograph for the neuroscientific exploration of schizophrenia. While Bleuler assumed that schizophrenia has a neural basis, he remained agnostic on possible mechanisms and skeptical about the value of pathological diagnosis. He preferred psychological understanding over neural explanation. He gave hope by making schizophrenia dimensional and less predictive of course and outcome. To make progress now, we need to redefine schizophrenia at the level of the brain.

  10. Schizophrenia and city life.

    Science.gov (United States)

    Lewis, G; David, A; Andréasson, S; Allebeck, P

    1992-07-18

    Prevalence of schizophrenia and rates of first admission to hospital for this disorder are higher in most modern industrialised cities, and in urban compared with rural areas. The "geographical drift" hypothesis (ie, most schizophrenics tend to drift into city areas because of their illness or its prodrome) has remained largely unchallenged. We have investigated the association between place of upbringing and the incidence of schizophrenia with data from a cohort of 49,191 male Swedish conscripts linked to the Swedish National Register of Psychiatric Care. The incidence of schizophrenia was 1.65 times higher (95% confidence interval 1.19-2.28) among men brought up in cities than in those who had had a rural upbringing. The association persisted despite adjustment for other factors associated with city life such as cannabis use, parental divorce, and family history of psychiatric disorder. This finding cannot be explained by the widely held notion that people with schizophrenia drift into cities at the beginning of their illness. We conclude that undetermined environmental factors found in cities increase the risk of schizophrenia.

  11. [Poor insight and psychosis].

    Science.gov (United States)

    Giotakos, O

    2017-01-01

    A variety of phenomena might be considered as reflecting impaired insight in psychosis, like failure to recognize signs, symptoms or disease, failure to derive appropriate cognitive representations, despite recognition of the disease, and misattribution of the source or cause of the disease. The unawareness of tardive dyskinesia symptoms in schizophrenic patients points that self-awareness deficits in schizophrenia may be domain specific. Poor insight is an independent phenomenological and a prevalent feature in psychotic disorders in general, and in schizophrenia in particular, but we don't know yet if delusions in schizophrenia are the result of an entirely normal attempt to account for abnormal perceptual experiences or a product of abnormal experience but of normal reasoning. The theoretical approaches regarding impaired insight include the disturbed perceptual input, the impaired linkage between thought and emotion and the breakdown of the process of self-monitoring and error checking. The inability to distinguish between internally and externally generated mental events has been described by the metarepresentation theory. This theory includes the awareness of ones' goals, which leads to disorders of willed action, the awareness of intention, which leads to movement disorders, and the awareness of intentions of others, which leads to paranoid delusions. The theory of metarepresentation implies mainly output mechanisms, like the frontal cortex, while the input mechanism implies posterior brain systems, including the parietal lobe. There are many similarities between the disturbances of awareness seen in schizophrenia and those seen as a result of known neurological impairment. Neuropsychological models of impaired insight typically attribute the disturbance to any of a variety of core deficits in the processing of information. In this respect, lack of insight is on conceptual par with alogia, apraxia or aphasia in reflecting disturbed cognitive processing. In

  12. The personal impact of schizophrenia in Europe

    NARCIS (Netherlands)

    Thornicroft, Graham; Tansella, Michele; Becker, Thomas; Knapp, Martin; Leese, Morven; Schene, Aart; Vazquez-Barquero, José Luis

    2004-01-01

    The personal impact of schizophrenia is poorly described in the scientific literature. The European Psychiatric Set-vices: Inputs Linked to Outcome Domains and Needs (EPSILON) study compared representative treated prevalence cohorts of patients with schizophrenia in five European countries, to

  13. Sugarcane outgrowers in Ethiopia: ’Forced’ to remain poor?

    OpenAIRE

    Mengistu Assefa Wendimu; Arne Henningsen; Peter Gibbon

    2015-01-01

    Contract farming is often seen as a panacea to many of the challenges faced by agricultural production in developing countries. Given the large heterogeneity of contract farming arrangements, it is debatable whether all kinds of contract farming arrangements offer benefits to participating smallholders. We apply matching methods to analyze the effects of a public sugarcane outgrower scheme in Ethiopia. Participation in the outgrower scheme significantly reduces the income and asset stocks of ...

  14. Care seeking for maternal health: challenges remain for poor women

    African Journals Online (AJOL)

    Data were analysed using Nudist software. Important findings: The location of childbirth involves retaining control of the process and outcome, and securing a safe delivery. The pregnant woman is influenced by her attendants; families only seek care for complications if local or herbal, remedies and prayer are defeated.

  15. Care seeking for maternal health: challenges remain for poor women

    African Journals Online (AJOL)

    Bernt Lindtjorn

    Timely care seeking is reliant on the knowledge, understanding and financial ... on the relative heterogeneity and security situation of that region. ... adolescent girls and boys, newly delivered mothers, older ... such as the mother in-law or older sister in-laws. The main overriding factors that contribute to the decisions and ...

  16. Altered excitatory-inhibitory balance in the NMDA-hypofunction model of schizophrenia

    Directory of Open Access Journals (Sweden)

    Colin Kehrer

    2008-04-01

    Full Text Available Schizophrenia is a common psychiatric disorder of high incidence, affecting approximately 1% of the world population. The essential neurotransmitter pathology of schizophrenia remains poorly defined, despite huge advances over the past half-century in identifying neurochemical and pathological abnormalities in the disease. The dopamine/serotonin hypothesis has originally provided much of the momentum for neurochemical research in schizophrenia. In recent years, the attention has, however, shifted to the glutamate system, the major excitatory neurotransmitter in the CNS and towards a concept of functional imbalance between excitatory and inhibitory transmission at the network level in various brain regions in schizophrenia. The evidence indicating a central role for the NMDAreceptor subtype in the etiology of schizophrenia has led to the NMDA-hypofunction model of this disease and the use of phencyclidines as a means to induce the NMDA-hypofunction state in animal models. The purpose of this review is to discuss recent findings highlighting the importance of the NMDA-hypofunction model of schizophrenia, both from a clinical perspective, as well as in opening a line of research, which enables electrophysiological studies at the cellular and network level in vitro. In particular, changes in excitation-inhibition (E/I balance in the NMDA-hypofunction model of the disease and the resulting changes in network behaviours, particularly in gamma frequency oscillatory activity, will be discussed.

  17. Cognitive behaviour therapy for schizophrenia

    OpenAIRE

    Addington, Jean; Lecomte, Tania

    2012-01-01

    Schizophrenia is one of the major and potentially severe mental illnesses. Even with best practices, there are limitations to the effectiveness of treatments that include medications for this disorder. Relapse rates are high and often those with the illness remain symptomatic and functionally impaired. All the evidence suggests that individuals with schizophrenia do best with a combination of pharmacological and psychosocial intervention. One psychosocial treatment that has received much atte...

  18. Motivational deficits and cognitive test performance in schizophrenia.

    Science.gov (United States)

    Fervaha, Gagan; Zakzanis, Konstantine K; Foussias, George; Graff-Guerrero, Ariel; Agid, Ofer; Remington, Gary

    2014-09-01

    Motivational and cognitive deficits are core features of schizophrenia, both closely linked with functional outcomes. Although poor effort and decreased motivation are known to affect performance on cognitive tests, the extent of this relationship is unclear in patients with schizophrenia. To evaluate the association between intrinsic motivation and cognitive test performance in patients with schizophrenia. Cross-sectional and 6-month prospective follow-up study performed at 57 sites in the United States, including academic and community medical treatment centers, participating in the Clinical Antipsychotic Trials of Intervention Effectiveness study. The primary sample included 431 stable patients with a DSM-IV diagnosis of schizophrenia currently receiving a stable medication regimen. Cognitive performance and intrinsic motivation were evaluated using a comprehensive neuropsychological test battery and a derived measure from the Heinrichs-Carpenter Quality of Life Scale, respectively. Symptom severity and functional status were also assessed. The primary outcome variable was global neurocognition. Individual domains of cognition were also evaluated for their association with motivation. Level of intrinsic motivation was significantly and positively correlated with global cognitive test performance, a relationship that held for each domain of cognition evaluated (correlation range, 0.20-0.34; P motivation and cognitive performance also remained significant after controlling for antipsychotic dose (P motivation during the 6-month follow-up was also found to be significantly related to improvement in global cognitive performance (P motivation and cognitive performance and suggest that test performance is not purely a measure of ability. Future studies assessing cognition in patients with schizophrenia should consider potential moderating variables such as effort and motivation. Implications for the assessment and interpretation of cognitive impairment based on

  19. Childhood Schizophrenia

    Science.gov (United States)

    ... Trouble sleeping Irritability or depressed mood Lack of motivation Strange behavior Substance use Compared with schizophrenia symptoms ... may neglect personal hygiene or appear to lack emotion ― doesn't make eye contact, doesn't change ...

  20. [Epigenetics of schizophrenia: a review].

    Science.gov (United States)

    Rivollier, F; Lotersztajn, L; Chaumette, B; Krebs, M-O; Kebir, O

    2014-10-01

    Schizophrenia is a frequent and disabling disease associated with heterogeneous psychiatric phenotypes. It emerges during childhood, adolescence or young adulthood and has dramatic consequences for the affected individuals, causing considerable familial and social burden, as well as increasing health expenses. Although some progress has been made in the understanding of their physiopathology, many questions remain unsolved, and the disease is still poorly understood. The prevailing hypothesis regarding psychotic disorders proposes that a combination of genetic and/or environmental factors, during critical periods of brain development increases the risk for these illnesses. Epigenetic regulations, such as DNA methylation, can mediate gene x environment interactions at the level of the genome and may provide a potential substrate to explain the variability in symptom severity and family heritability. Initially, epigenetics was used to design mitotic and meiotic changes in gene transcription that could not be attributed to genetic mutations. It referred later to changes in the epigenome not transmitted through the germline. Thus, epigenetics refers to a wide range of molecular mechanisms including DNA methylation of cytosine residues in CpG dinucleotides and post-translational histone modifications. These mechanisms alter the way the transcriptional factors bind the DNA, modulating its expression. Prenatal and postnatal environmental factors may affect these epigenetics factors, having responsability in long-term DNA transcription, and influencing the development of psychiatric disorders. The object of this review is to present the state of knowledge in epigenetics of schizophrenia, outlining the most recent findings in the matter. We did so using Pubmed, researching words such as 'epigenetics', 'epigenetic', 'schizophrenia', 'psychosis', 'psychiatric'. This review summarizes evidences mostly for two epigenetic mechanisms: DNA methylation and post

  1. Is dietary pattern of schizophrenia patients different from healthy subjects?

    Directory of Open Access Journals (Sweden)

    Amani Reza

    2007-05-01

    Full Text Available Abstract Background There are limited findings about dietary patterns and food preferences among patients suffering from schizophrenia. The main objective of this study was therefore to compare the nutritional pattern of schizophrenia patients with that of matched healthy subjects. Methods The dietary pattern of 30 hospitalized 16–67 years old schizophrenic patients (11 female was compared with that of 30 healthy age and sex matched individuals as control group. Subjects' anthropometric measurements including weight, height and body mass index (BMI, semi-quantitative food frequency (FFQ, medical and food history questionnaires were also collected and FFQs were then scored using Food Guide Pyramid to obtain the dietary scores. Percent body fat (%BF was measured using bioelectrical impedance analysis (BIA method. Results Female patients had more %BF and lower dietary pattern scores than that of their controls (32 ± 3.6 vs 27.7 ± 4.6 percent and 43.2 ± 11.9 vs 54.5 ± 10.7 points; respectively, p Conclusion Schizophrenia patients have poor nutritional patterns. In particular, female patients have more percent body fat and lower dietary pattern scores compared with their healthy controls. All patients used to consume more fats and sweet drinks frequently. The findings of this study suggest that schizophrenia patients need specific medical nutrition therapies through limiting dietary fats and sugars intakes and weight control. Whether obesity is the consequence of disease, dietary preference or medications used remains to be cleared.

  2. Swallowing Disorders in Schizophrenia.

    Science.gov (United States)

    Kulkarni, Deepika P; Kamath, Vandan D; Stewart, Jonathan T

    2017-08-01

    Disorders of swallowing are poorly characterized but quite common in schizophrenia. They are a source of considerable morbidity and mortality in this population, generally as a result of either acute asphyxia from airway obstruction or more insidious aspiration and pneumonia. The death rate from acute asphyxia may be as high as one hundred times that of the general population. Most swallowing disorders in schizophrenia seem to fall into one of two categories, changes in eating and swallowing due to the illness itself and changes related to psychotropic medications. Behavioral changes related to the illness are poorly understood and often involve eating too quickly or taking inappropriately large boluses of food. Iatrogenic problems are mostly related to drug-induced extrapyramidal side effects, including drug-induced parkinsonism, dystonia, and tardive dyskinesia, but may also include xerostomia, sialorrhea, and changes related to sedation. This paper will provide an overview of common swallowing problems encountered in patients with schizophrenia, their pathophysiology, and management. While there is a scarcity of quality evidence in the literature, a thorough history and examination will generally elucidate the predominant problem or problems, often leading to effective management strategies.

  3. The biochemical womb of schizophrenia: A review.

    Science.gov (United States)

    Gaur, N; Gautam, S; Gaur, M; Sharma, P; Dadheech, G; Mishra, S

    2008-10-01

    The conclusive identification of specific etiological factors or pathogenic processes in the illness of schizophrenia has remained elusive despite great technological progress. The convergence of state-of-art scientific studies in molecular genetics, molecular neuropathophysiology, in vivo brain imaging and psychopharmacology, however, indicates that we may be coming much closer to understanding the genesis of schizophrenia. In near future, the diagnosis and assessment of schizophrenia using biochemical markers may become a "dream come true" for the medical community as well as for the general population. An understanding of the biochemistry/ visa vis pathophysiology of schizophrenia is essential to the discovery of preventive measures and therapeutic intervention.

  4. Insight in schizophrenia: a review.

    Science.gov (United States)

    Dam, Jesper

    2006-01-01

    The issue of insight in schizophrenia must be assumed to be one of the most important aspects of the clinical examination. Comprehensive studies have shown that between 50% and 80% of all patients suffering from schizophrenia do not believe that they have a disorder. In recent years, poor insight in schizophrenia has been the subject of increasing interest, as manifested in a number of studies discussed in the present review. Some of these studies focus on insight correlated to various parameters such as psychopathology, neuropsychology, clinical relevance and compliance. Other studies refer to more theoretical implications, among these the issue of defining the concept of insight: whether insight can be seen as a "primary" phenomenon in schizophrenia, and whether insight may be graduated, dimensioned or increased. Several authors have developed rating scales in an attempt to obtain a measure for the degree or dimension of insight. Here, the range of parameters employed gives an excellent impression of the complexity of the concept of insight. In the concluding discussion, a phenomenological aspect is brought in, in an attempt to place the concept of insight in relation to disturbances of the self in schizophrenia and to primary symptoms in schizophrenia, amongst these autism.

  5. Febrile seizures and risk of schizophrenia

    DEFF Research Database (Denmark)

    Vestergaard, Mogens; Pedersen, Carsten Bøcker; Christensen, Jakob

    2005-01-01

    BACKGROUND: Febrile seizure is a benign condition for most children, but experiments in animals and neuroimaging studies in humans suggest that some febrile seizures may damage the hippocampus, a brain area of possible importance in schizophrenia. METHODS: A population-based cohort of all children...... with schizophrenia. A history of febrile seizures was associated with a 44% increased risk of schizophrenia [relative risk (RR)=1.44; 95% confidence interval (CI), 1.07-1.95] after adjusting for confounding factors. The association between febrile seizures and schizophrenia remained virtually unchanged when...... restricting the analyses to people with no history of epilepsy. A history of both febrile seizures and epilepsy was associated with a 204% increased risk of schizophrenia (RR=3.04; 95% CI, 1.36-6.79) as compared with people with no such history. CONCLUSIONS: We found a slightly increased risk of schizophrenia...

  6. Effects of environmental noise on cognitive (dys)functions in schizophrenia: A pilot within-subjects experimental study

    OpenAIRE

    Wright, Bernice; Peters, Emmanuelle; Ettinger, Ulrich; Kuipers, Elizabeth; Kumari, Veena

    2016-01-01

    Cognitive impairment, particularly in attention, memory and executive function domains, is commonly present and associated with poor functional outcomes in schizophrenia. In healthy adults, environmental noise adversely affects many cognitive domains, including those known to be compromised in schizophrenia. This pilot study examined whether environmental noise causes further cognitive deterioration in a small sample of people with schizophrenia. Eighteen outpatients with schizophrenia on sta...

  7. Genetics Home Reference: schizophrenia

    Science.gov (United States)

    ... Share: Email Facebook Twitter Home Health Conditions Schizophrenia Schizophrenia Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Schizophrenia is a brain disorder classified as a psychosis, ...

  8. Systematic Prioritization and Integrative Analysis of Copy Number Variations in Schizophrenia Reveal Key Schizophrenia Susceptibility Genes

    Science.gov (United States)

    Luo, Xiongjian; Huang, Liang; Han, Leng; Luo, Zhenwu; Hu, Fang; Tieu, Roger; Gan, Lin

    2014-01-01

    Schizophrenia is a common mental disorder with high heritability and strong genetic heterogeneity. Common disease-common variants hypothesis predicts that schizophrenia is attributable in part to common genetic variants. However, recent studies have clearly demonstrated that copy number variations (CNVs) also play pivotal roles in schizophrenia susceptibility and explain a proportion of missing heritability. Though numerous CNVs have been identified, many of the regions affected by CNVs show poor overlapping among different studies, and it is not known whether the genes disrupted by CNVs contribute to the risk of schizophrenia. By using cumulative scoring, we systematically prioritized the genes affected by CNVs in schizophrenia. We identified 8 top genes that are frequently disrupted by CNVs, including NRXN1, CHRNA7, BCL9, CYFIP1, GJA8, NDE1, SNAP29, and GJA5. Integration of genes affected by CNVs with known schizophrenia susceptibility genes (from previous genetic linkage and association studies) reveals that many genes disrupted by CNVs are also associated with schizophrenia. Further protein-protein interaction (PPI) analysis indicates that protein products of genes affected by CNVs frequently interact with known schizophrenia-associated proteins. Finally, systematic integration of CNVs prioritization data with genetic association and PPI data identifies key schizophrenia candidate genes. Our results provide a global overview of genes impacted by CNVs in schizophrenia and reveal a densely interconnected molecular network of de novo CNVs in schizophrenia. Though the prioritized top genes represent promising schizophrenia risk genes, further work with different prioritization methods and independent samples is needed to confirm these findings. Nevertheless, the identified key candidate genes may have important roles in the pathogenesis of schizophrenia, and further functional characterization of these genes may provide pivotal targets for future therapeutics and

  9. [PALEOPATHOLOGY OF HUMAN REMAINS].

    Science.gov (United States)

    Minozzi, Simona; Fornaciari, Gino

    2015-01-01

    Many diseases induce alterations in the human skeleton, leaving traces of their presence in ancient remains. Paleopathological examination of human remains not only allows the study of the history and evolution of the disease, but also the reconstruction of health conditions in the past populations. This paper describes the most interesting diseases observed in skeletal samples from the Roman Imperial Age necropoles found in urban and suburban areas of Rome during archaeological excavations in the last decades. The diseases observed were grouped into the following categories: articular diseases, traumas, infections, metabolic or nutritional diseases, congenital diseases and tumours, and some examples are reported for each group. Although extensive epidemiological investigation in ancient skeletal records is impossible, the palaeopathological study allowed to highlight the spread of numerous illnesses, many of which can be related to the life and health conditions of the Roman population.

  10. A review of schizophrenia research in malaysia.

    Science.gov (United States)

    Chee, K Y; Salina, A A

    2014-08-01

    Research in schizophrenia has advanced tremendously. One hundred and seventy five articles related to Schizophrenia were found from a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. This project aims to examine published research articles, in local and international journals in order to provide a glimpse of the research interest in Malaysia with regards to schizophrenia. Single case study, case series report, reviews and registry reports were not included in this review. Medication trial, unless it concerned a wider scope of psychopharmacology was also excluded from this review. A total of 105 articles were included in this review. Despite numerous genetics studies conducted and published, a definitive conclusion on the aetiology or mechanism underlying schizophrenia remains elusive. The National Mental Health - Schizophrenia Registry (NMHR) proved to be an important platform for many studies and publications. Studies stemmed from NMHR have provided significant insight into the baseline characteristic of patients with schizophrenia, pathway to care, and outcomes of the illness. International and regional collaborations have also encouraged important work involving stigma and discrimination in schizophrenia. Ministry of Health's hospitals (MOH) are the main research sites in the country with regards to schizophrenia research. Numbers of schizophrenia research are still low in relation to the number of universities and hospitals in the country. Some of the weaknesses include duplication of studies, over-emphasising clinical trials and ignoring basic clinical research, and the lack of publications in international and regional journals.

  11. Symptomatology and social inference: a theory of mind study of schizophrenia and psychotic affective disorder.

    Science.gov (United States)

    Marjoram, Dominic; Gardner, Clare; Burns, Jonathan; Miller, Patrick; Lawrie, Stephen M; Johnstone, Eve C

    2005-11-01

    There is evidence that certain patients with schizophrenia have deficits in theory of mind (ToM) capabilities. It is, however, unclear whether these are symptom or diagnosis-specific. A ToM hinting task was given to 15 patients with a DSM-IV diagnosis of schizophrenia, 15 patients with affective disorder and 15 healthy controls. Severity of the current psychopathology was measured using the Krawiecka standardised scale of psychotic symptoms (Krawiecka, Goldberg, & Vaughan, 1977); IQ was estimated via the Ammons and Ammons Quick Test (Ammons & Ammons, 1962). The group with schizophrenia performed significantly worse than the affective and control groups. Poor performance on the hinting task was found to be significantly related to the presence of positive symptoms (instead of negative ones) and specifically related to delusions and hallucinations. These findings remained when covariance for potentially confounding variables was applied. Individuals with high levels of delusions and hallucinations performed significantly worse on this ToM task, regardless of diagnosis, implying ToM impairment is not exclusive to schizophrenia but is evident in other forms of psychosis. Between-group analyses showed the schizophrenia group had a significantly poorer performance on this task than the others.

  12. Cannabis abuse is associated with better emotional memory in schizophrenia: a functional magnetic resonance imaging study.

    Science.gov (United States)

    Bourque, Josiane; Mendrek, Adrianna; Durand, Myriam; Lakis, Nadia; Lipp, Olivier; Stip, Emmanuel; Lalonde, Pierre; Grignon, Sylvain; Potvin, Stéphane

    2013-10-30

    In schizophrenia cannabis abuse/dependence is associated with poor compliance and psychotic relapse. Despite this, the reasons for cannabis abuse remain elusive, but emotions may play a critical role in this comorbidity. Accordingly, we performed a functional magnetic resonance imaging study of emotional memory in schizophrenia patients with cannabis abuse (dual-diagnosis, DD). Participants comprised 14 DD patients, 14 non-abusing schizophrenia patients (SCZ), and 21 healthy controls (HC) who had to recognize positive and negative pictures while being scanned. Recognition of positive and negative emotions was prominently impaired in SCZ patients, relative to HC, while differences between DD and HC were smaller. For positive and negative stimuli, we observed significant activations in frontal, limbic, temporal and occipital regions in HC; in frontal, limbic and temporal regions in DD; and in temporal, parietal, limbic and occipital regions in the SCZ group. Our results suggest that emotional memory and prefrontal lobe functioning are preserved in DD relative to SCZ patients. These results are consistent with previous findings showing that cannabis abuse is associated with fewer negative symptoms and better cognitive functioning in schizophrenia. Longitudinal studies will need to determine whether the relative preservation of emotional memory is primary or secondary to cannabis abuse in schizophrenia. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. Do schizophrenia patients age early?

    Science.gov (United States)

    Shivakumar, Venkataram; Kalmady, Sunil V; Venkatasubramanian, Ganesan; Ravi, Vasanthapuram; Gangadhar, Bangalore N

    2014-08-01

    The etiopathogenesis of schizophrenia is poorly understood. Within the proposed "neurodegeneration paradigm", observations have been put forth for "accelerated aging" in this disorder. This proposition is largely based on the neuroscience research that demonstrates progressive changes in brain as well as other systemic abnormalities supportive of faster aging process in patients with this disorder. In this review, we have summarized the literature related to the concept of early aging in schizophrenia. These studies include P300 abnormalities & visual motion discrimination, neuroimaging findings, telomere dynamics as well as neuropathology of related brain regions. We also propose a role of vitamin D, neuroimmunological changes and elevated oxidative stress as well as mitochondrial dysfunction in addition to the above factors with 'vitamin-D deficiency' as the central paradox. Put together, the evidence supporting early aging in schizophrenia is compelling and this requires further systematic studies. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Effects of sports participation on psychiatric symptoms and brain activations during sports observation in schizophrenia.

    Science.gov (United States)

    Takahashi, H; Sassa, T; Shibuya, T; Kato, M; Koeda, M; Murai, T; Matsuura, M; Asai, K; Suhara, T; Okubo, Y

    2012-03-20

    Weight gain has been identified as being responsible for increased morbidity and mortality rates of schizophrenia patients. For the management of weight gain, exercise is one of the most acknowledged interventions. At the same time, exercise and sports have been recognized for their positive impact on psychiatric symptoms of schizophrenia. However, the neurobiological basis for this remains poorly understood. We aimed to examine the effect of sports participation on weight gain, psychiatric symptoms and brain activation during sports observation in schizophrenia patients. Thirteen schizophrenia patients who participated in a 3-month program, including sports participation and 10 control schizophrenia patients were studied. In both groups, body mass index (BMI), Positive and Negative Syndrome Scale (PANSS), and brain activation during observation of sports-related actions measured by functional magnetic resonance imaging were accessed before and after a 3-month interval. BMI and general psychopathology scale of PANSS were significantly reduced in the program group but not in the control group after a 3-month interval. Compared with baseline, activation of the body-selective extrastriate body area (EBA) in the posterior temporal-occipital cortex during observation of sports-related actions was increased in the program group. In this group, increase in EBA activation was associated with improvement in the general psychopathology scale of PANSS. Sports participation had a positive effect not only on weight gain but also on psychiatric symptoms in schizophrenia. EBA might mediate these beneficial effects of sports participation. Our findings merit further investigation of neurobiological mechanisms underlying the therapeutic effect of sports for schizophrenia.

  15. Vitamin supplementation in the treatment of schizophrenia.

    Science.gov (United States)

    Brown, Hannah E; Roffman, Joshua L

    2014-07-01

    This article reviews the current literature addressing the treatment of schizophrenia with vitamin supplementation. It describes the important roles that vitamins play in normal metabolism, and reviews the evidence pertaining to vitamin deficiency and supplementation in patients with schizophrenia. There is mounting evidence suggesting that vitamin supplementation, in particular with folic acid, vitamin B12 and vitamin D, may be important in treatment within certain subgroups of patients. There is a need for larger randomized controlled trials, and further studies examining the incidence of schizophrenia in countries with poor prenatal care and malnutrition, as well as in countries that have adopted mandatory folic acid fortification of grain products, are recommended.

  16. Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality.

    Science.gov (United States)

    Burns, Jonathan K; Tomita, Andrew; Kapadia, Amy S

    2014-03-01

    Income inequality is associated with numerous negative health outcomes. There is evidence that ecological-level socio-environmental factors may increase risk for schizophrenia. The aim was to investigate whether measures of income inequality are associated with incidence of schizophrenia at the country level. We conducted a systematic review of incidence rates for schizophrenia, reported between 1975 and 2011. For each country, national measures of income inequality (Gini coefficient) along with covariate risk factors for schizophrenia were obtained. Multi-level mixed-effects Poisson regression was performed to investigate the relationship between Gini coefficients and incidence rates of schizophrenia controlling for covariates. One hundred and seven incidence rates (from 26 countries) were included. Mean incidence of schizophrenia was 18.50 per 100,000 (SD = 11.9; range = 1.7-67). There was a significant positive relationship between incidence rate of schizophrenia and Gini coefficient (β = 1.02; Z = 2.28; p = .02; 95% CI = 1.00, 1.03). Countries characterized by a large rich-poor gap may be at increased risk of schizophrenia. We suggest that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.

  17. The management of schizophrenia: focus on extended-release quetiapine fumarate

    Directory of Open Access Journals (Sweden)

    Peuskens J

    2011-09-01

    Full Text Available Joseph Peuskens Universitair Psychiatrisch Centrum KU Leuven, Campus St Jozef Kortenberg, Kortenberg, Belgium Abstract: Effective management of schizophrenia remains a significant clinical challenge. While antipsychotic medications have proven efficacy in this disease, there remains an opportunity to further improve symptom control and long-term relapse prevention. Also, a number of factors, including tolerability and complex dosing regimens, can result in nonadherence to medication. Quetiapine is an atypical antipsychotic with proven efficacy and an established tolerability profile in schizophrenia. The once-daily extended-release formulation (quetiapine XR offers a simplified dosing regimen and titration schedule. Short-term clinical studies have shown that quetiapine XR (400–800 mg/d is efficacious in the acute treatment of schizophrenia, while a long-term study has shown that quetiapine XR was significantly more effective than placebo at preventing relapse. Furthermore, an investigation in which stable patients switched from the immediate-release formulation (quetiapine IR to quetiapine XR showed that quetiapine XR is generally well tolerated and has no loss of efficacy compared with quetiapine IR. In patients who experienced insufficient efficacy or poor tolerability on their previous antipsychotic, switching to quetiapine XR significantly improved efficacy compared with the previous treatment. In conclusion, quetiapine XR is an effective and generally well tolerated treatment for schizophrenia. Furthermore, once-daily dosing may improve patient adherence, which may impact positively on patient outcomes. Keywords: adherence, atypical antipsychotics, adverse events

  18. Left nucleus accumbens atrophy in deficit schizophrenia: A preliminary study.

    Science.gov (United States)

    De Rossi, Pietro; Dacquino, Claudia; Piras, Fabrizio; Caltagirone, Carlo; Spalletta, Gianfranco

    2016-08-30

    A question that remains to be answered is whether schizophrenia can be characterized by a single etiopathophysiology or whether separate sub-syndromes should be differentiated to define specific mechanisms for each sub-type. Individuals affected by the deficit subtype of schizophrenia (DSZ) display avolitional/amotivational features that respond poorly to conventional treatments. Characterizing DSZ from a neuroanatomical point of view may help clarify this issue and develop new treatment strategies. To determine if DSZ is associated with structural alterations in specific deep grey matter structures linked to its key clinical features, 22 DSZ patients, 22 non-deficit schizophrenia (NDSZ) patients and 22 healthy controls (HC) were recruited for a case-control cross-sectional study. High-resolution magnetic resonance imaging was performed in all subjects and volumes of deep grey matter structures were measured using FreeSurfer. DSZ patients displayed smaller left accumbens volumes compared to both NDSZ patients and HC. Moreover, age and duration of illness were significantly associated with lower volume of the left accumbens in DSZ but not in NDSZ. Findings indicate that DSZ is associated with lower volume of the nucleus accumbens in the dominant hemisphere. This is consistent with the psychopathological features and functional impairments present in DSZ and thus indicates a potential mechanism. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. [Decision-making and schizophrenia].

    Science.gov (United States)

    Adida, M; Maurel, M; Kaladjian, A; Fakra, E; Lazerges, P; Da Fonseca, D; Belzeaux, R; Cermolacce, M; Azorin, J-M

    2011-12-01

    Abnormalities involving the prefrontal cortex (PFC) have long been postulated to underpin the pathophysiology of schizophrenia. Investigations of PFC integrity have focused mainly on the dorsolateral PFC (DLPFC) and abnormalities in this region have been extensively documented. However, defects in schizophrenia may extend to other prefrontal regions, including the ventromedial PFC (VMPFC), and evidence of VMPFC abnormalities comes from neuropathological, structural and functional studies. Patients with acquired brain injury to the VMPFC display profound disruption of social behaviour and poor judgment in their personal lives. The Iowa Gambling Task (IGT) was developed to assess decision-making in these neurological cases : it presents a series of 100 choices from four card decks that differ in the distribution of rewarding and punishing outcomes. Whilst healthy volunteers gradually develop a preference for the two "safe" decks over the course of the task, patients with VMPFC lesions maintain a preference for the two "risky" decks which are associated with high reinforcement in the short term, but significant long-term debt. Interestingly, damage to VMPFC may cause both poor performance on the IGT and lack of insight concerning the acquired personality modification. Recently, our group reported a trait-related decisionmaking impairment in the three phases of bipolar disorder. In a PET study, VMPFC dysfunction was shown in bipolar manic patients impaired on a decision-making task and an association between decision-making cognition and lack of insight was described in mania. A quantitative association between grey matter volume of VMPFC and memory impairment was previously reported in schizophrenia. Research suggests that lack of insight is a prevalent feature in schizophrenia patients, like auditory hallucinations, paranoid or bizarre delusions, and disorganized speech and thinking. Because schizophrenia is associated with significant social or occupational

  20. Reduced Context Effects on Retrieval in First-Episode Schizophrenia

    NARCIS (Netherlands)

    Talamini, Lucia M.; de Haan, Lieuwe; Nieman, Dorien H.; Linszen, Don H.; Meeter, Martijn

    2010-01-01

    Background: A recent modeling study by the authors predicted that contextual information is poorly integrated into episodic representations in schizophrenia, and that this is a main cause of the retrieval deficits seen in schizophrenia. Methodology/Principal Findings: We have tested this prediction

  1. Reduced context effects on retrieval in first-episode schizophrenia

    NARCIS (Netherlands)

    Talamini, L.M.; de Haan, L.; Nieman, D.H.; Linszen, D.H.; Meeter, M.

    2010-01-01

    Background: A recent modeling study by the authors predicted that contextual information is poorly integrated into episodic representations in schizophrenia, and that this is a main cause of the retrieval deficits seen in schizophrenia. Methodology/Principal Findings: We have tested this prediction

  2. Reduced context effects on retrieval in first-episode schizophrenia

    NARCIS (Netherlands)

    Talamini, L.M.; Haan, L.; Nieman, D.H.; Linszen, D.H.; Meeter, M.

    2010-01-01

    Background: A recent modeling study by the authors predicted that contextual information is poorly integrated into episodic representations in schizophrenia, and that this is a main cause of the retrieval deficits seen in schizophrenia. & Methodology/Principal Findings: We have tested this

  3. The care needs of elderly patients with schizophrenia spectrum disorders

    NARCIS (Netherlands)

    Meesters, P.D.; Comijs, H.C.; Dröes, R.M.; de Haan, L.; Smit, J.H.; Eikelenboom, P.; Beekman, A.T.F.; Stek, M.L.

    2013-01-01

    Objective: Elderly patients constitute the fastest growing segment of the schizophrenia population. Still, their needs for care are poorly understood. This study aimed to gain insight into the care needs of older patients with schizophrenia spectrum disorders. Setting and Participants: Patients,

  4. Social cognition and quality of life in schizophrenia

    NARCIS (Netherlands)

    Maat, A.; Fett, A.J.; Kahn, R.S.; Linszen, D.H.; van Os, J.; Wiersma, D.; Bruggeman, R.; Cahn, W.; de Haan, L.; Krabbendam, A.C.; Myin-Germeys, I.

    2012-01-01

    Schizophrenia is associated with poor quality of life (QOL). Whereas the effects of neurocognitive deficits and psychopathology on QOL of schizophrenia patients have recently been elucidated, little is known about social cognitive deficits in this regard. This study investigated the influence of

  5. Drama therapy for schizophrenia or schizophrenia-like illnesses.

    Science.gov (United States)

    Ruddy, R A; Dent-Brown, K

    2007-01-24

    drama interventions and inpatient care in the other included studies. There were no significant findings about the value of drama interventions for keeping inpatients engaged in treatment. Due to poor reporting very little data from the five studies could be used and there were no conclusive findings about the harms or benefits of drama therapy for inpatients with schizophrenia. Randomised studies are possible in this field. The use of drama therapy for schizophrenia and schizophrenia-like illnesses should continue to be under evaluation as its benefits, or harms, are unclear.

  6. Reduced context effects on retrieval in first-episode schizophrenia.

    Directory of Open Access Journals (Sweden)

    Lucia M Talamini

    Full Text Available BACKGROUND: A recent modeling study by the authors predicted that contextual information is poorly integrated into episodic representations in schizophrenia, and that this is a main cause of the retrieval deficits seen in schizophrenia. METHODOLOGY/PRINCIPAL FINDINGS: We have tested this prediction in patients with first-episode schizophrenia and matched controls. The benefit from contextual cues in retrieval was strongly reduced in patients. On the other hand, retrieval based on item cues was spared. CONCLUSIONS/SIGNIFICANCE: These results suggest that reduced integration of context information into episodic representations is a core deficit in schizophrenia and one of the main causes of episodic memory impairment.

  7. Identifying Gene-Environment Interactions in Schizophrenia

    DEFF Research Database (Denmark)

    van Os, Jim; Rutten, Bart P; Myin-Germeys, Inez

    2014-01-01

    Recent years have seen considerable progress in epidemiological and molecular genetic research into environmental and genetic factors in schizophrenia, but methodological uncertainties remain with regard to validating environmental exposures, and the population risk conferred by individual...... of G × E in schizophrenia. While such investigations are now well underway, new challenges emerge for G × E research from late-breaking evidence that genetic variation and environmental exposures are, to a significant degree, shared across a range of psychiatric disorders, with potential overlap...

  8. Comorbidities and risk factors among patients with schizophrenia.

    Science.gov (United States)

    Harrison, Christopher; Charles, Janice; Britt, Helena

    2015-01-01

    General practitioners (GPs) are charged with maintaining a holistic approach to their patients' health. While most patients with schizophrenia attend public mental health services and/or non-government organisations supporting people with mental illness, 88.2% of people with a psychotic illness (the majority being schizophrenia or schizoaffective disorder) had visited a GP in the previous year. For at least 30-40% of people living with schizophrenia in Australia, ongoing management is provided by their GP alone. Moreover, there is evidence that patients with schizophrenia value the help provided by GPs. Patients with schizophrenia have reduced life expectancy. Overseas research (primarily from the UK and US) has found that the poor physical health of patients with schizophrenia can be attributed to a number of factors such as modifiable lifestyle risk factors and side effects of medication, compounded by causes intrinsic to the illness such as mental stress and loss of initiative.

  9. In vivo measurements of glutamate, GABA, and NAAG in schizophrenia.

    Science.gov (United States)

    Rowland, Laura M; Kontson, Kimberly; West, Jeffrey; Edden, Richard A; Zhu, He; Wijtenburg, S Andrea; Holcomb, Henry H; Barker, Peter B

    2013-09-01

    The major excitatory and inhibitory neurotransmitters, glutamate (Glu) and gamma-aminobutyric acid (GABA), respectively, are implicated in the pathophysiology of schizophrenia. N-acetyl-aspartyl-glutamate (NAAG), a neuropeptide that modulates the Glu system, may also be altered in schizophrenia. This study investigated GABA, Glu + glutamine (Glx), and NAAG levels in younger and older subjects with schizophrenia. Forty-one subjects, 21 with chronic schizophrenia and 20 healthy controls, participated in this study. Proton magnetic resonance spectroscopy ((1)H-MRS) was used to measure GABA, Glx, and NAAG levels in the anterior cingulate (AC) and centrum semiovale (CSO) regions. NAAG in the CSO was higher in younger schizophrenia subjects compared with younger control subjects. The opposite pattern was observed in the older groups. Glx was reduced in the schizophrenia group irrespective of age group and brain region. There was a trend for reduced AC GABA in older schizophrenia subjects compared with older control subjects. Poor attention performance was correlated to lower AC GABA levels in both groups. Higher levels of CSO NAAG were associated with greater negative symptom severity in schizophrenia. These results provide support for altered glutamatergic and GABAergic function associated with illness course and cognitive and negative symptoms in schizophrenia. The study also highlights the importance of studies that combine MRS measurements of NAAG, GABA, and Glu for a more comprehensive neurochemical characterization of schizophrenia.

  10. Recent advances in understanding schizophrenia.

    Science.gov (United States)

    Haller, Chiara S; Padmanabhan, Jaya L; Lizano, Paulo; Torous, John; Keshavan, Matcheri

    2014-01-01

    Schizophrenia is a highly disabling disorder whose causes remain to be better understood, and treatments have to be improved. However, several recent advances have been made in diagnosis, etiopathology, and treatment. Whereas reliability of diagnosis has improved with operational criteria, including Diagnostic and Statistical Manual of Mental Disorders, (DSM) Fifth Edition, validity of the disease boundaries remains unclear because of substantive overlaps with other psychotic disorders. Recent emphasis on dimensional approaches and translational bio-behavioral research domain criteria may eventually help move toward a neuroscience-based definition of schizophrenia. The etiology of schizophrenia is now thought to be multifactorial, with multiple small-effect and fewer large-effect susceptibility genes interacting with several environmental factors. These factors may lead to developmentally mediated alterations in neuroplasticity, manifesting in a cascade of neurotransmitter and circuit dysfunctions and impaired connectivity with an onset around early adolescence. Such etiopathological understanding has motivated a renewed search for novel pharmacological as well as psychotherapeutic targets. Addressing the core features of the illness, such as cognitive deficits and negative symptoms, and developing hypothesis-driven early interventions and preventive strategies are high-priority goals for the field. Schizophrenia is a severe, chronic mental disorder and is among the most disabling disorders in all of medicine. It is estimated by the National Institute of Mental Health (NIMH) that 2.4 million people over the age of 18 in the US suffer from schizophrenia. This illness typically begins in adolescence and derails the formative goals of school, family, and work, leading to considerable suffering and disability and reduced life expectancy by about 20 years. Treatment outcomes are variable, and some people are successfully treated and reintegrated (i.e. go back to work

  11. An extended cost-effectiveness analysis of schizophrenia treatment in India under universal public finance.

    Science.gov (United States)

    Raykar, Neha; Nigam, Aditi; Chisholm, Dan

    2016-01-01

    Schizophrenia remains a priority condition in mental health policy and service development because of its early onset, severity and consequences for affected individuals and households. This paper reports on an 'extended' cost-effectiveness analysis (ECEA) for schizophrenia treatment in India, which seeks to evaluate through a modeling approach not only the costs and health effects of intervention but also the consequences of a policy of universal public finance (UPF) on health and financial outcomes across income quintiles. Using plausible values for input parameters, we conclude that health gains from UPF are concentrated among the poorest, whereas the non-health gains in the form of out-of-pocket private expenditures averted due to UPF are concentrated among the richest income quintiles. Value of insurance is the highest for the poorest quintile and declines with income. Universal public finance can play a crucial role in ameliorating the adverse economic and social consequences of schizophrenia and its treatment in resource-constrained settings where health insurance coverage is generally poor. This paper shows the potential distributional and financial risk protection effects of treating schizophrenia.

  12. SCHIZOPHRENIA: A REVIEW

    OpenAIRE

    Parle Milind; Sharma Kailash

    2013-01-01

    Schizophrenia continues to be a mysterious disease fascinating the minds of psychiatrists, pharmacologists and neuroscientists all over the world for more than a century. The crucial welfare of the millions afflicted with schizophrenia is at stake. The cause of schizophrenia is not yet identified. However, it appears from the available reports that schizophrenia results from genetic, occupational and environmental risk factors, which act independently or combine synergistically to develop sch...

  13. Cost of schizophrenia in England.

    Science.gov (United States)

    Mangalore, Roshni; Knapp, Martin

    2007-03-01

    variety of secondary sources and some official data publicly available was not the latest. Schizophrenia continues to be a high cost illness because of the range of health needs that people have. Despite the shifting balance of care away from hospital-based care, the health care costs of treating and supporting people with schizophrenia remain high. Decision-makers need to recognise the breadth of economic impacts, well beyond the health system as conventionally defined. For example, as nearly 80% of schizophrenia patients remain unemployed, the cost of lost productivity is especially large. Better measurement of criminal justice services costs, private expenditures borne by families and valuation of lost quality of life could improve the estimates further.

  14. Horticultural therapy for schizophrenia.

    Science.gov (United States)

    Liu, Yan; Bo, Li; Sampson, Stephanie; Roberts, Samantha; Zhang, Guoyou; Wu, Weiping

    2014-05-19

    n = 24,RR 5.00 95% CI 0.27 to 94.34, very low quality evidence). There was no clear evidence of a difference in Personal Wellbeing Index (PWI-C) change scores between groups, however confidence intervals were wide (1 RCT n = 22, MD -0.90 95% CI -10.35 to 8.55, very low quality evidence). At the end of treatment, the Depression Anxiety Stress Scale (DASS21) change scores in horticultural therapy group were greater than that in the control group (1 RCT n = 22, MD -23.70 CI -35.37 to - 12.03, very low quality evidence). The only included study did not report on adverse effects of interventions. Based on the current very low quality data, there is insufficient evidence to draw any conclusions on benefits or harms of horticultural therapy for people with schizophrenia. This therapy remains unproven and more and larger randomised trials are needed to increase high quality evidence in this area.

  15. Dreaming and Schizophrenia.

    Science.gov (United States)

    Stickney, Jeffrey L.

    Parallels between dream states and schizophrenia suggest that the study of dreams may offer some information about schizophrenia. A major theoretical assumption of the research on dreaming and schizophrenia is that, in schizophrenics, the dream state intrudes on the awake state creating a dreamlike symptomatology. This theory, called the REM…

  16. First episode schizophrenia

    African Journals Online (AJOL)

    with schizophrenia present clinically with psychotic, negative and cognitive ... changes in their emotions, cognition or behaviour which may indicate a ... contribute 80% to the risk of schizophrenia developing. A number of .... Positive symptoms ... Depression ... treatment of first episode schizophrenia is of critical importance.

  17. Disrupted Olfactory Integration in Schizophrenia: Functional Connectivity Study.

    Science.gov (United States)

    Kiparizoska, Sara; Ikuta, Toshikazu

    2017-09-01

    Evidence for olfactory dysfunction in schizophrenia has been firmly established. However, in the typical understanding of schizophrenia, olfaction is not recognized to contribute to or interact with the illness. Despite the solid presence of olfactory dysfunction in schizophrenia, its relation to the rest of the illness remains largely unclear. Here, we aimed to examine functional connectivity of the olfactory bulb, olfactory tract, and piriform cortices and isolate the network that would account for the altered olfaction in schizophrenia. We examined the functional connectivity of these specific olfactory regions in order to isolate other brain regions associated with olfactory processing in schizophrenia. Using the resting state functional MRI data from the Center for Biomedical Research Excellence in Brain Function and Mental Illness, we compared 84 patients of schizophrenia and 90 individuals without schizophrenia. The schizophrenia group showed disconnectivity between the anterior piriform cortex and the nucleus accumbens, between the posterior piriform cortex and the middle frontal gyrus, and between the olfactory tract and the visual cortices. The current results suggest functional disconnectivity of olfactory regions in schizophrenia, which may account for olfactory dysfunction and disrupted integration with other sensory modalities in schizophrenia. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  18. Prevalence of schizophrenia in patients with psoriasis: a nationwide study

    Directory of Open Access Journals (Sweden)

    Hung-Pin Tu

    2017-03-01

    Conclusion: Schizophrenia is more prevalent in patients with psoriasis. Although the exact mechanisms remain to be clarified, the finding that psoriatic patients with comorbid cerebrovascular disease or chronic pulmonary disease have higher odds for schizophrenia may imply psoriatic patients with those comorbidities are likely to have higher inflammatory burden, which would contribute to the development of schizophrenia if a disruption of the blood–brain barrier is present. Further investigations are indicated to validate the hypothesis explaining the association between known comorbidies of psoriasis and schizophrenia.

  19. Exploring the nature of facial affect processing deficits in schizophrenia

    NARCIS (Netherlands)

    Wout, Mascha van 't; Aleman, Andre; Kessels, Roy P. C.; Cahn, Wiepke; Haan, Edward H. F. de; Kahn, Rene S.

    2007-01-01

    Schizophrenia has been associated with deficits in facial affect processing, especially negative emotions. However, the exact nature of the deficit remains unclear. The aim of the present study was to investigate whether schizophrenia patients have problems in automatic allocation of attention as

  20. Exploring the nature of facial affect processing deficits in schizophrenia.

    NARCIS (Netherlands)

    Wout, M. van 't; Aleman, A.; Kessels, R.P.C.; Cahn, W.; Haan, E.H.F. de; Kahn, R.S.

    2007-01-01

    Schizophrenia has been associated with deficits in facial affect processing, especially negative emotions. However, the exact nature of the deficit remains unclear. The aim of the present study was to investigate whether schizophrenia patients have problems in automatic allocation of attention as

  1. Caregiver burden among relatives of patients with schizophrenia in ...

    African Journals Online (AJOL)

    Background. Caring for patients with schizophrenia places an enormous burden on the caregivers. The magnitude of this problem remains largely unknown in sub-Saharan Africa. Objective. The objective of this study was to determine the nature of the burden reported by caregiving relatives of patients with schizophrenia.

  2. Candidate CSPG4 mutations and induced pluripotent stem cell modeling implicate oligodendrocyte progenitor cell dysfunction in familial schizophrenia

    NARCIS (Netherlands)

    F.M.S. Vrij (Femke); C.G. Bouwkamp (Christian); N. Gunhanlar (Nilhan); G. Shpak (Guy); B. Lendemeijer (Bert); Baghdadi, M. (Maarouf); Gopalakrishna, S. (Shreekara); M. Ghazvini (Mehrnaz); T. Li (Tracy); M. Quadri (Marialuisa); S. Olgiati (Simone); G.J. Breedveld (Guido); M.P.H. Coesmans (Michiel); E.J. Mientjes (Edwin); de Wit, T. (Ton); F.W. Verheijen (Frans); H.B. Beverloo (Berna); Cohen, D. (Dan); Kok, R.M. (Rob M.); P.R. Bakker (Roberto); Nijburg, A. (Aviva); A.T. Spijker (Anne); P.M.J. Haffmans (P.M. Judith); Hoencamp, E. (Erik); V. Bergink (Veerle); J.A.S. Vorstman; Wu, T. (Timothy); L.M. Olde Loohuis (Loes M.); Amin, N. (Najaf); C.D. Langen (Carolyn); Hofman, A. (Albert); W.J.G. Hoogendijk (Witte); van Duijn, C.M. (Cornelia M.); Ikram, M.A. (M. A.); M.W. Vernooij (Meike); H.W. Tiemeier (Henning); Uitterlinden, A.G. (André G.); Y. Elgersma (Ype); B. Distel (Ben); J.H. Gribnau (Joost); T.J.H. White (Tonya); V. Bonifati (Vincenzo); Kushner, S.A. (Steven A.)

    2018-01-01

    textabstractSchizophrenia is highly heritable, yet its underlying pathophysiology remains largely unknown. Among the most well-replicated findings in neurobiological studies of schizophrenia are deficits in myelination and white matter integrity; however, direct etiological genetic and cellular

  3. Implicit motor sequence learning in schizophrenia and in old age: reduced performance only in the third session

    NARCIS (Netherlands)

    Cornelis, Claudia; de Picker, Livia J.; de Boer, Peter; Dumont, Glenn; Coppens, Violette; Morsel, Anne; Janssens, Luc; Timmers, Maarten; Sabbe, Bernard G. C.; Morrens, Manuel; Hulstijn, Wouter

    2016-01-01

    Although there still is conflicting evidence whether schizophrenia is a neurodegenerative disease, cognitive changes in schizophrenia resemble those observed during normal aging. In contrast to extensively demonstrated deficits in explicit learning, it remains unclear whether implicit sequence

  4. [Theory of mind in schizophrenia spectrum disorders].

    Science.gov (United States)

    Bora, Emre

    2009-01-01

    To review studies that investigated theory of mind (ToM) deficits in schizophrenia spectrum disorders. After a thorough literature search, 71 studies were included in this review. Data regarding the relationship between ToM, and other cognitive skills, symptoms, and the impact of the state of illness were reviewed. ToM instruments used in schizophrenia spectrum disorders have some major psychometric limitations; however, previous research was still able to provide some important findings regarding mentalizing impairments in schizophrenia. While ToM deficits are more pronounced in the acute phase of illness, it seems to persist during periods of remission. There is also evidence of ToM deficits in the healthy relatives of schizophrenics, patients with delusional disorder and bipolar disorder (BD), and individuals with high schizotypy scores. ToM dysfunction might be secondary to other cognitive deficits in patients with schizophrenia that have a good prognosis, asymptomatic schizophrenia, delusional disorder, and BD. Other cognitive deficits do not seem to explain ToM dysfunction in patients with psychosis and severe negative symptoms. These findings support the contribution of impairment in both domain-general and domain-specific mechanisms to ToM deficits in schizophrenia spectrum disorders. ToM deficits may be important for understanding poor social functioning and poor insight in psychotic disorders. While ToM is influenced by state variables, it might be an endophenotype of schizophrenia; however, ToM is likely to be an indicator of other frontal lobe-related endophenotypes. Longitudinal studies conducted with high-risk individuals are particularly important.

  5. Psychoeducation for schizophrenia

    Science.gov (United States)

    Xia, Jun; Merinder, Lars Bertil; Belgamwar, Madhvi R

    2014-01-01

    Background Schizophrenia can be a severe and chronic illness characterised by lack of insight and poor compliance with treatment. Psychoeducational approaches have been developed to increase patients’ knowledge of, and insight into, their illness and its treatment. It is supposed that this increased knowledge and insight will enable people with schizophrenia to cope in a more effective way with their illness, thereby improving prognosis. Objectives To assess the effects of psychoeducational interventions compared with standard levels of knowledge provision. Search methods We searched the Cochrane Schizophrenia Group Trials Register (February 2010). We updated this search November 2012 and added 27 new trials to the awaiting assessment section. Selection criteria All relevant randomised controlled trials focusing on psychoeducation for schizophrenia and/or related serious mental illnesses involving individuals or groups. We excluded quasi-randomised trials. Data collection and analysis At least two review authors extracted data independently from included papers. We contacted authors of trials for additional and missing data. We calculated risk ratios (RR) and 95% confidence intervals (CI) of homogeneous dichotomous data. We used a fixed-effects model for heterogeneous dichotomous data. Where possible we also calculated the numbers needed to treat (NNT), as well as weighted means for continuous data. Main results This review includes a total of 5142 participants (mostly inpatients) from 44 trials conducted between 1988 and 2009 (median study duration ~ 12 weeks, risk of bias - moderate). We found that incidences of non-compliance were lower in the psychoeducation group in the short term (n = 1400, RR 0.52 CI 0.40 to 0.67, NNT 11 CI 9 to 16). This finding holds for the medium and long term. Relapse appeared to be lower in psychoeducation group (n = 1214, RR 0.70 CI 0.61 to 0.81, NNT 9 CI 7 to 14) and this also applied to readmission (n = 206, RR 0.71 CI 0.56 to 0

  6. Revised associative inference paradigm confirms relational memory impairment in schizophrenia.

    Science.gov (United States)

    Armstrong, Kristan; Williams, Lisa E; Heckers, Stephan

    2012-07-01

    Patients with schizophrenia have widespread cognitive impairments, with selective deficits in relational memory. We previously reported a differential relational memory deficit in schizophrenia using the Associative Inference Paradigm (AIP), a task suggested by the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) initiative to examine relational memory. However, the AIP had limited feasibility for testing in schizophrenia because of high attrition of schizophrenia patients during training. Here we developed and tested a revised version of the AIP to improve feasibility. 30 healthy control and 37 schizophrenia subjects received 3 study-test sessions on 3 sets of paired associates: H-F1 (house paired with face), H-F2 (same house paired with new face), and F3-F4 (two novel faces). After training, subjects were tested on the trained, noninferential Face-Face pairs (F3-F4) and novel, inferential Face-Face pairs (F1-F2), constructed from the faces of the trained House-Face pairs. Schizophrenia patients were significantly more impaired on the inferential F1-F2 pairs than the noninferential F3-F4 pairs, providing evidence for a differential relational memory deficit. Only 8% of schizophrenia patients were excluded from testing because of poor training performance. The revised AIP confirmed the previous finding of a relational memory deficit in a larger and more representative sample of schizophrenia patients.

  7. Electroconvulsive therapy for schizophrenia.

    Science.gov (United States)

    Tharyan, P; Adams, C E

    2005-04-18

    that ECT, combined with treatment with antipsychotic drugs, may be considered an option for people with schizophrenia, particularly when rapid global improvement and reduction of symptoms is desired. This is also the case for those with schizophrenia who show limited response to medication alone. Even though this initial beneficial effect may not last beyond the short term, there is no clear evidence to refute its use for people with schizophrenia. The research base for the use of ECT in people with schizophrenia continues to expand, but even after more than five decades of clinical use, there remain many unanswered questions regarding its role in the management of people with schizophrenia.

  8. Mental correlates of neuromotoric deviation in 6-year-olds at heightened risk for schizophrenia.

    Science.gov (United States)

    McNeil, Thomas F; Cantor-Graae, Elizabeth; Blennow, Gösta

    2003-04-01

    The meaning and relevance of the increased rates of neuromotoric deviation (ND) observed in patients with schizophrenia and their biological relatives remain unclear. ND could represent free-floating, independent characteristics of individuals in these families vs. signs of an increased risk for current or future mental disorder. The co-temporaneous relationship between ND and mental disorder at 6 years of age was investigated among 31 children with an increased risk for schizophrenia and similar psychoses, defined as having a mother with a history of schizophrenia or unspecified functional psychosis. As compared with high-risk cases with a low level of ND, the subgroup of 10 high-risk offspring showing notably increased rates of ND had significantly more frequent psychiatric diagnoses (typically language disorders and enuresis), poor functioning on global assessment, poor interpersonal competency and high anxiety proneness. Neuromotoric items representing "overflow" (e.g., choreatic movements, tremor) were significantly positively related to each of these mental characteristics. Among high-risk offspring, an increased rate of ND is very clearly associated with increased rates of current mental disorder, and might potentially identify a subgroup with an especially high risk for serious mental disorder in the future.

  9. First rank symptoms for schizophrenia.

    Science.gov (United States)

    Soares-Weiser, Karla; Maayan, Nicola; Bergman, Hanna; Davenport, Clare; Kirkham, Amanda J; Grabowski, Sarah; Adams, Clive E

    2015-01-25

    - a situation which applies to the initial screening of most people with suspected schizophrenia. FRS remain a simple, quick and useful clinical indicator for an illness of enormous clinical variability.

  10. Neuroimaging of affect processing in schizophrenia

    International Nuclear Information System (INIS)

    Habel, U.; Kircher, T.; Schneider, F.

    2005-01-01

    Functional imaging of normal and dysfunctional emotional processes is an important tool for a better understanding of the pathophysiology of affective symptoms in schizophrenia patients. These symptoms are still poorly characterized with respect to their neural correlates. Comparisons of cerebral activation during emotional paradigms offered the possibility for a better characterization of cerebral dysfunctions during emotional processing in schizophrenia. Abnormal activation patterns reveal a complex dysfunctional subcortical-cortical network. This is modulated by respective genotypes as well as psycho- and pharmacotherapy. (orig.) [de

  11. Measuring motivation in people with schizophrenia.

    Science.gov (United States)

    Fervaha, Gagan; Foussias, George; Takeuchi, Hiroyoshi; Agid, Ofer; Remington, Gary

    2015-12-01

    Motivational deficits are a key determinant of poor functional outcomes in schizophrenia. These impairments are typically evaluated using various clinical rating scales; however, the degree of convergence between motivation scores derived from different instruments is not clear. In the present study, we measured motivational deficits in 62 patients with schizophrenia using 5 scores derived from 3 different instruments. We found that the scores from these different instruments were highly inter-correlated, and largely independent of severity of other symptom domains (e.g., depression). Our findings suggest that clinical ratings scales evaluating motivational deficits are tapping into a similar underlying construct. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Subjective quality of life and suicidal behavior among Taiwanese schizophrenia patients.

    Science.gov (United States)

    Kao, Yu-Chen; Liu, Yia-Ping; Cheng, Tsung-Hsing; Chou, Ming-Kuen

    2012-04-01

    Research of suicidal behavior in individuals with schizophrenia has often suggested that clinical characteristics and symptoms likely influence a patient's suicidal risk. However, there is a lack of research describing the link between patients' subjective quality of life (SQOL) and suicidal behavior in non-Western countries. Therefore, the current study attempts to explore how schizophrenia patients' SQOL and their suicidal behavior are related in a Taiwanese sample. In this study, 102 schizophrenia outpatients were investigated using the Taiwanese World Health Organization Quality of Life Schedule-Brief Version (WHO-QOL-BREF-TW), several Beck-Related symptom rating scales, and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. These patients were also evaluated for suicidal risk using the critical items of the Scale for Suicide Ideation (SSI) and lifetime suicide attempts. Statistical analyses, including independent sample t tests, analysis of covariance (ANCOVA) and logistic stepwise regression models were completed. Compared with the non-suicidal group, suicidal patients had significantly lower scores in SQOL domains. The differences in social domain remained significant after adjusting for depressive symptoms. In multiple logistic regression analyses, level of depressive and psychotic symptoms increased and poor social and psychological SQOL were significant contributors to suicidal behavior. Having removed depressive symptoms from the model, only dissatisfaction with social SQOL was associated with heightened suicidal risk. Schizophrenia is associated with a high suicidal risk, of which depressive and psychotic symptoms are the major correlates. Again, the present study confirms and extends previous research showing that dissatisfied SQOL, particularly dissatisfaction with social relationships, should be considered in the assessment of suicidal risk in outpatients with schizophrenia, even when accounting other possible confounding factor

  13. Relative risk of probabilistic category learning deficits in patients with schizophrenia and their siblings

    Science.gov (United States)

    Weickert, Thomas W.; Goldberg, Terry E.; Egan, Michael F.; Apud, Jose A.; Meeter, Martijn; Myers, Catherine E.; Gluck, Mark A; Weinberger, Daniel R.

    2010-01-01

    Background While patients with schizophrenia display an overall probabilistic category learning performance deficit, the extent to which this deficit occurs in unaffected siblings of patients with schizophrenia is unknown. There are also discrepant findings regarding probabilistic category learning acquisition rate and performance in patients with schizophrenia. Methods A probabilistic category learning test was administered to 108 patients with schizophrenia, 82 unaffected siblings, and 121 healthy participants. Results Patients with schizophrenia displayed significant differences from their unaffected siblings and healthy participants with respect to probabilistic category learning acquisition rates. Although siblings on the whole failed to differ from healthy participants on strategy and quantitative indices of overall performance and learning acquisition, application of a revised learning criterion enabling classification into good and poor learners based on individual learning curves revealed significant differences between percentages of sibling and healthy poor learners: healthy (13.2%), siblings (34.1%), patients (48.1%), yielding a moderate relative risk. Conclusions These results clarify previous discrepant findings pertaining to probabilistic category learning acquisition rate in schizophrenia and provide the first evidence for the relative risk of probabilistic category learning abnormalities in unaffected siblings of patients with schizophrenia, supporting genetic underpinnings of probabilistic category learning deficits in schizophrenia. These findings also raise questions regarding the contribution of antipsychotic medication to the probabilistic category learning deficit in schizophrenia. The distinction between good and poor learning may be used to inform genetic studies designed to detect schizophrenia risk alleles. PMID:20172502

  14. Antipsychotic use is a risk factor for hyponatremia in patients with schizophrenia: a 15-year follow-up study.

    Science.gov (United States)

    Yang, Hang-Ju; Cheng, Wan-Ju

    2017-03-01

    Hyponatremia affects 10% of patients with chronic schizophrenia and can lead to severe consequences. However, the role of antipsychotics and other risk factors in hyponatremia occurrence has remained inconsistent. This study examined the association between antipsychotic use and hyponatremia occurrence in patients with schizophrenia. We utilized the National Health Insurance Research Database to follow 2051 patients with schizophrenia from 1998 to 2013. Among them, 137 (6.7%) developed hyponatremia. Sociodemographic characteristics, physical comorbidities, and psychiatric treatment experiences were compared between those who had hyponatremia and those who did not. A Cox proportional hazards model was used to examine the hazard ratios (HRs) of these characteristics. In patients with hyponatremia, the mean age at first hyponatremia occurrence was 54.7 ± 13.9 years, an average of 9.5 ± 4.0 years after schizophrenia diagnosis, and 32.9% of them were off antipsychotics before hyponatremia occurrences. Age at schizophrenia diagnosis (HR = 1.1), low-income household (HR = 2.4), comorbidities (HR = 1.2), and psychiatric admissions (HR = 1.04) were associated with the risks of hyponatremia. Compared with no antipsychotic use, atypical (HR = 2.1) and typical antipsychotics (HR = 3.1) were associated with an elevated risk of hyponatremia, after adjustment for age, sex, and physical comorbidities. Carbamazepine use (HR = 2.9) was also a significant risk factor for hyponatremia (p schizophrenia with polypharmacy should be monitored for hyponatremia occurrences. Clinicians should pay attention to the impact of poor living conditions on hyponatremia occurrence.

  15. Reduced hippocampal and parahippocampal volumes in murderers with schizophrenia.

    Science.gov (United States)

    Yang, Yaling; Raine, Adrian; Han, Chen-Bo; Schug, Robert A; Toga, Arthur W; Narr, Katherine L

    2010-04-30

    Evidence has accumulated to suggest that individuals with schizophrenia are at increased risk for violent offending. Furthermore, converging evidence suggests that abnormalities in the fronto-limbic system, including the prefrontal cortex, the hippocampus, and the parahippocampal gyrus, may contribute towards both neuropsychological disturbances in schizophrenia and violent behavior. Since the behavioral and clinical consequences of disturbed fronto-limbic circuitry appear to differ in schizophrenia and violence, it may be argued that patients with schizophrenia who exhibit violent behavior would demonstrate different structural abnormalities compared to their non-violent counterparts. However, the neurobiological basis underlying homicide offenders with schizophrenia remains unclear and little is known regarding the cross-cultural applicability of the findings. Using a 2 x 2 factorial design on a total Chinese sample of 92 males and females, we found reduced gray matter volume in the hippocampus and parahippocampal gyrus in murderers with schizophrenia, in the parahippocampal gyrus in murderers without schizophrenia, and in the prefrontal cortex in non-violent schizophrenia compared to normal controls. Results provide initial evidence demonstrating cross-cultural generalizability of prior fronto-limbic findings on violent schizophrenia. Future studies examining subtle morphological changes in frontal and limbic structures in association with clinical and behavioral characteristics may help further clarify the neurobiological basis of violent behavior. Copyright @ 2009 Elsevier Ireland Ltd. All rights reserved.

  16. Altered Cerebral Blood Flow Covariance Network in Schizophrenia.

    Science.gov (United States)

    Liu, Feng; Zhuo, Chuanjun; Yu, Chunshui

    2016-01-01

    Many studies have shown abnormal cerebral blood flow (CBF) in schizophrenia; however, it remains unclear how topological properties of CBF network are altered in this disorder. Here, arterial spin labeling (ASL) MRI was employed to measure resting-state CBF in 96 schizophrenia patients and 91 healthy controls. CBF covariance network of each group was constructed by calculating across-subject CBF covariance between 90 brain regions. Graph theory was used to compare intergroup differences in global and nodal topological measures of the network. Both schizophrenia patients and healthy controls had small-world topology in CBF covariance networks, implying an optimal balance between functional segregation and integration. Compared with healthy controls, schizophrenia patients showed reduced small-worldness, normalized clustering coefficient and local efficiency of the network, suggesting a shift toward randomized network topology in schizophrenia. Furthermore, schizophrenia patients exhibited altered nodal centrality in the perceptual-, affective-, language-, and spatial-related regions, indicating functional disturbance of these systems in schizophrenia. This study demonstrated for the first time that schizophrenia patients have disrupted topological properties in CBF covariance network, which provides a new perspective (efficiency of blood flow distribution between brain regions) for understanding neural mechanisms of schizophrenia.

  17. Vitamin Supplementation in the Treatment of Schizophrenia

    Science.gov (United States)

    Brown, Hannah E.; Roffman, Joshua L.

    2014-01-01

    In this article we review the current literature addressing the treatment of schizophrenia with vitamin supplementation. We first describe the important roles that vitamins play in normal metabolism, then review the evidence pertaining to vitamin deficiency and supplementation in patients with schizophrenia. We then describe mounting evidence suggesting that vitamin supplementation, in particular with folic acid, vitamin B12 and vitamin D, may be important in treatment within certain subgroups of patients. We highlight the need for larger, randomized controlled trials, and recommend further studies examining the incidence of schizophrenia in countries with poor prenatal care and malnutrition, as well as in countries that have adopted mandatory folic acid fortification of grain products. PMID:24846474

  18. Premorbid adjustment and neuropsychological performance in schizophrenia.

    Science.gov (United States)

    Silverstein, Marshall L; Mavrolefteros, George; Close, David

    2002-01-01

    To examine the relationship between premorbid adjustment and neuropsychological deficit in schizophrenia, this report examined retrospective ratings of social and school adjustment during three age epochs (childhood, early adolescence, and late adolescence) as predictors of neurocognitive performance in 61 clinically and pharmacologically stabilized schizophrenia outpatients. Results indicated greater cognitive deficits when premorbid adjustment was unfavorable, particularly for measures of attention and executive functions. Premorbid number and quality of peer relationships and psychosocial adaptation to the school environment were more closely related to neuropsychological performance during adulthood than were premorbid withdrawal and premorbid academic performance. Early onset of poor premorbid adjustment rather than deterioration from childhood to adolescence was associated with greater neuropsychological disturbance in adulthood. It is suggested that childhood onset of premorbid deficits in selective areas of social and academic adjustment appears to influence the cognitive performance seen in adult schizophrenia. This study is consistent with findings from other related reports; it extends these findings to a larger and clinically stabilized sample.

  19. Exploring rationality in schizophrenia

    DEFF Research Database (Denmark)

    Revsbech, Rasmus; Mortensen, Erik Lykke; Owen, Gareth

    2015-01-01

    Background Empirical studies of rationality (syllogisms) in patients with schizophrenia have obtained different results. One study found that patients reason more logically if the syllogism is presented through an unusual content. Aims To explore syllogism-based rationality in schizophrenia. Meth...... differences became non-significant. Conclusions When taking intelligence and neuropsychological performance into account, patients with schizophrenia and controls perform similarly on syllogism tests of rationality.......Background Empirical studies of rationality (syllogisms) in patients with schizophrenia have obtained different results. One study found that patients reason more logically if the syllogism is presented through an unusual content. Aims To explore syllogism-based rationality in schizophrenia. Method...... Thirty-eight first-admitted patients with schizophrenia and 38 healthy controls solved 29 syllogisms that varied in presentation content (ordinary v. unusual) and validity (valid v. invalid). Statistical tests were made of unadjusted and adjusted group differences in models adjusting for intelligence...

  20. Occipital bending in schizophrenia.

    Science.gov (United States)

    Maller, Jerome J; Anderson, Rodney J; Thomson, Richard H; Daskalakis, Zafiris J; Rosenfeld, Jeffrey V; Fitzgerald, Paul B

    2017-01-01

    To investigate the prevalence of occipital bending (an occipital lobe crossing or twisting across the midline) in subjects with schizophrenia and matched healthy controls. Occipital bending prevalence was investigated in 37 patients with schizophrenia and 44 healthy controls. Ratings showed that prevalence was nearly three times higher among schizophrenia patients (13/37 [35.1%]) than in control subjects (6/44 [13.6%]). Furthermore, those with schizophrenia had greater normalized gray matter volume but less white matter volume and had larger brain-to-cranial ratio. The results suggest that occipital bending is more prevalent among schizophrenia patients than healthy subjects and that schizophrenia patients have different gray matter-white matter proportions. Although the cause and clinical ramifications of occipital bending are unclear, the results infer that occipital bending may be a marker of psychiatric illness.

  1. Differential effects of antipsychotic drugs on insight in first episode schizophrenia: Data from the European First-Episode Schizophrenia Trial (EUFEST).

    Science.gov (United States)

    Pijnenborg, G H M; Timmerman, M E; Derks, E M; Fleischhacker, W W; Kahn, R S; Aleman, A

    2015-06-01

    Although antipsychotics are widely prescribed, their effect of on improving poor illness insight in schizophrenia has seldom been investigated and therefore remains uncertain. This paper examines the effects of low dose haloperidol, amisulpride, olanzapine, quetiapine, and ziprasidone on insight in first-episode schizophrenia, schizoaffective disorder, or schizophreniform disorder. The effects of five antipsychotic drugs in first episode psychosis on insight were compared in a large scale open randomized controlled trial conducted in 14 European countries: the European First-Episode Schizophrenia Trial (EUFEST). Patients with at least minimal impairments in insight were included in the present study (n=455). Insight was assessed with item G12 of the Positive and Negative Syndrome Scale (PANSS), administered at baseline and at 1, 3, 6, 9, and 12 months after randomization. The use of antipsychotics was associated with clear improvements in insight over and above improvements in other symptoms. This effect was most pronounced in the first three months of treatment, with quetiapine being significantly less effective than other drugs. Effects of spontaneous improvement cannot be ruled out due to the lack of a placebo control group, although such a large spontaneous improvement of insight would seem unlikely. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  2. Neurodevelopmental Animal Models Reveal the Convergent Role of Neurotransmitter Systems, Inflammation, and Oxidative Stress as Biomarkers of Schizophrenia: Implications for Novel Drug Development.

    Science.gov (United States)

    Möller, M; Swanepoel, T; Harvey, B H

    2015-07-15

    Schizophrenia is a life altering disease with a complex etiology and pathophysiology, and although antipsychotics are valuable in treating the disorder, certain symptoms and/or sufferers remain resistant to treatment. Our poor understanding of the underlying neuropathological mechanisms of schizophrenia hinders the discovery and development of improved pharmacological treatment, so that filling these gaps is of utmost importance for an improved outcome. A vast amount of clinical data has strongly implicated the role of inflammation and oxidative insults in the pathophysiology of schizophrenia. Preclinical studies using animal models are fundamental in our understanding of disease development and pathology as well as the discovery and development of novel treatment options. In particular, social isolation rearing (SIR) and pre- or postnatal inflammation (PPNI) have shown great promise in mimicking the biobehavioral manifestations of schizophrenia. Furthermore, the "dual-hit" hypothesis of schizophrenia states that a first adverse event such as genetic predisposition or a prenatal insult renders an individual susceptible to develop the disease, while a second insult (e.g., postnatal inflammation, environmental adversity, or drug abuse) may be necessary to precipitate the full-blown syndrome. Animal models that emphasize the "dual-hit" hypothesis therefore provide valuable insight into understanding disease progression. In this Review, we will discuss SIR, PPNI, as well as possible "dual-hit" animal models within the context of the redox-immune-inflammatory hypothesis of schizophrenia, correlating such changes with the recognized monoamine and behavioral alterations of schizophrenia. Finally, based on these models, we will review new therapeutic options, especially those targeting immune-inflammatory and redox pathways.

  3. Cognition-Emotion Dysinteraction in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Alan eAnticevic

    2012-10-01

    Full Text Available Evolving theories of schizophrenia emphasize a ‘disconnection’ in distributed fronto-striatal-limbic neural systems, which may give rise to breakdowns in cognition and emotional function. We discuss these diverse domains of function from the perspective of disrupted neural circuits involved in ‘cold’ cognitive vs. ‘hot’ affective operations and the interplay between these processes. We focus on three research areas that highlight cognition-emotion dysinteractions in schizophrenia: First, we discuss the role of cognitive deficits in the ‘maintenance’ of emotional information. We review recent evidence suggesting that motivational abnormalities in schizophrenia may in part arise due to a disrupted ability to ‘maintain’ affective information over time. Here, dysfunction in a prototypical ‘cold’ cognitive operation may result in ‘affective’ deficits in schizophrenia. Second, we discuss abnormalities in the detection and ascription of salience, manifest as excessive processing of non-emotional stimuli and inappropriate distractibility. We review emerging evidence suggesting deficits in some, but not other, specific emotional processes in schizophrenia – namely an intact ability to perceive emotion ‘in the moment’ but poor prospective valuation of stimuli and heightened reactivity to stimuli that ought to be filtered. Third, we discuss abnormalities in learning mechanisms that may give rise to delusions, the fixed, false and often emotionally charged beliefs that accompany psychosis. We discuss the role of affect in aberrant belief formation, mostly ignored by current theoretical models. Together, we attempt to provide a consilient overview for how breakdowns in neural systems underlying affect and cognition in psychosis interact across symptom domains. We conclude with a brief treatment of the neurobiology of schizophrenia and the need to close our explanatory gap between cellular-level hypotheses and complex

  4. Toxoplasma gondii and schizophrenia

    OpenAIRE

    Mokhtari Mohammadreza; Mokhtari Mojgan

    2006-01-01

    Recent epidemiologic studies indicate that infectious agents may contribute to some cases of schizophrenia. In animals, infection with Toxoplasma gondii can alter behavior and neurotransmitter function. In humans, acute infection with T. gondii can produce psychotic symptoms similar to those displayed by persons with schizophrenia. Since 1953, a total of 19 studies of T. gondii antibodies in persons with schizophrenia and other severe psychiatric disorders and in controls have been reported; ...

  5. Women and schizophrenia

    OpenAIRE

    Thara, R.; Kamath, Shantha

    2015-01-01

    Women's mental health is closely linked to their status in society. This paper outlines the clinical features of women with schizophrenia and highlights the interpersonal and social ramifications on their lives. There is no significant gender difference in the incidence and prevalence of schizophrenia. There is no clear trend in mortality, although suicides seem to be more in women with schizophrenia. In India, women face a lot of problems, especially in relation to marriage, pregnancy, child...

  6. Biological study in schizophrenia

    International Nuclear Information System (INIS)

    Kasai, Kiyoto; Yoshikawa, Akane; Natsubori, Takanobu; Koike, Shinsuke; Nagai, Tatsuya; Araki, Tsuyoshi; Nishimura, Yukika; Iwamoto, Kazuya

    2012-01-01

    Schizophrenia is associated with enormous morbidity, mortality, personal disability, and social cost. Although considerable research on schizophrenia has been performed, the etiology of this disease has not been fully elucidated. In recent years, imaging and genetic technologies have been developed dramatically. Disturbances in glutamate and gamma-aminobutyric acid (GABA)ergic neurotransmission may underlie the pathophysiology of schizophrenia. We attempted an integrative review, of studies pertaining to recent advances of schizophrenia research with a focus on neuroimaging and genetic studies. Additionally, we present the preliminary findings of the clinical research in our outpatient unit, specialized for early intervention, at the University of Tokyo Hospital. (author)

  7. The Danish Schizophrenia Registry

    DEFF Research Database (Denmark)

    Baandrup, Lone; Cerqueira, Charlotte; Haller, Lea

    2016-01-01

    Aim of database: To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research. Study population: Patients diagnosed with schizophrenia and receiving mental health care...... to the data for use in specific research projects by applying to the steering committee. Conclusion: The Danish Schizophrenia Registry represents a valuable source of informative data to monitor and improve the quality of care of patients with schizophrenia in Denmark. However, continuous resources and time...

  8. Impaired strategic decision making in schizophrenia.

    Science.gov (United States)

    Kim, Hyojin; Lee, Daeyeol; Shin, Young-Min; Chey, Jeanyung

    2007-11-14

    Adaptive decision making in dynamic social settings requires frequent re-evaluation of choice outcomes and revision of strategies. This requires an array of multiple cognitive abilities, such as working memory and response inhibition. Thus, the disruption of such abilities in schizophrenia can have significant implications for social dysfunctions in affected patients. In the present study, 20 schizophrenia patients and 20 control subjects completed two computerized binary decision-making tasks. In the first task, the participants played a competitive zero-sum game against a computer in which the predictable choice behavior was penalized and the optimal strategy was to choose the two targets stochastically. In the second task, the expected payoffs of the two targets were fixed and unaffected by the subject's choices, so the optimal strategy was to choose the target with the higher expected payoff exclusively. The schizophrenia patients earned significantly less money during the first task, even though their overall choice probabilities were not significantly different from the control subjects. This was mostly because patients were impaired in integrating the outcomes of their previous choices appropriately in order to maintain the optimal strategy. During the second task, the choices of patients and control subjects displayed more similar patterns. This study elucidated the specific components in strategic decision making that are impaired in schizophrenia. The deficit, which can be characterized as strategic stiffness, may have implications for the poor social adjustment in schizophrenia patients.

  9. Insight in Schizophrenia: Relationship to Positive, Negative and Neurocognitive Dimensions

    Science.gov (United States)

    Joseph, Boban; Narayanaswamy, Janardhanan C.; Venkatasubramanian, Ganesan

    2015-01-01

    Impairment of insight is considered as the hallmark of schizophrenia. Substantial proportion of patients with schizophrenia has either poor or absent insight. Insight is a multidimensional and dynamic construct which appears to have intricate links with other symptom dimensions of the psychotic illness. A better appreciation of the association that insight shares with other symptom clusters in psychosis could help us in gaining knowledge about aetiology, prognosis and treatment-related facets of the disorder. This is likely to have critical implications in the understanding and therapeutics of schizophrenia. PMID:25722504

  10. Prospective memory in schizophrenia: relationship to medication management skills, neurocognition, and symptoms in individuals with schizophrenia.

    Science.gov (United States)

    Raskin, Sarah A; Maye, Jacqueline; Rogers, Alexandra; Correll, David; Zamroziewicz, Marta; Kurtz, Matthew

    2014-05-01

    Impaired adherence to medication regimens is a serious concern for individuals with schizophrenia linked to relapse and poorer outcomes. One possible reason for poor adherence to medication is poor ability to remember future intentions, labeled prospective memory skills. It has been demonstrated in several studies that individuals with schizophrenia have impairments in prospective memory that are linked to everyday life skills. However, there have been no studies, to our knowledge, examining the relationship of a clinical measure of prospective memory to medication management skills, a key element of successful adherence. In this Study 41 individuals with schizophrenia and 25 healthy adults were administered a standardized test battery that included measures of prospective memory, medication management skills, neurocognition, and symptoms. Individuals with schizophrenia demonstrated impairments in prospective memory (both time and event-based) relative to healthy controls. Performance on the test of prospective memory was correlated with the standardized measure of medication management in individuals with schizophrenia. Moreover, the test of prospective memory predicted skills in medication adherence even after measures of neurocognition were accounted for. This suggests that prospective memory may play a key role in medication management skills and thus should be a target of cognitive remediation programs.

  11. Factor Structure of Social Cognition in Schizophrenia: Is Empathy Preserved?

    OpenAIRE

    Corbera, Silvia; Wexler, Bruce E.; Ikezawa, Satoru; Bell, Morris D.

    2013-01-01

    Social cognitive impairments are core features of schizophrenia and are closely associated with poor functional outcome. This study sought to identify specific aspects of social cognition and their relationships to measures of social function, quality of life, and neurocognition. Principal component analysis was performed using social cognitive measures in patients with schizophrenia and healthy matched controls and revealed three factors: Interpersonal Discomfort, Basic Social Cognition, and...

  12. Schizophrenia and Parkinson's disease: Selected therapeutic ...

    African Journals Online (AJOL)

    Both Schizophrenia and Parkinson's disease are very much linked to the dopaminergic system, yet a larger understanding that goes behind this ''simplified explanation'' of the linked phenomena remains important to further novel advances. The description of factors related to both disorders including implicated receptors, ...

  13. Amotivation and functional outcomes in early schizophrenia.

    Science.gov (United States)

    Fervaha, Gagan; Foussias, George; Agid, Ofer; Remington, Gary

    2013-12-15

    Negative symptoms, particularly amotivation/apathy, are intimately tied to functional outcomes. In the present study, apathy strongly predicted psychosocial functioning in a sample of early course schizophrenia patients. This relationship remained robust even after controlling for other clinical variables. These data suggest amotivation is core to functioning across the disease course. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Genetic correlates of insight in schizophrenia.

    Science.gov (United States)

    Xavier, Rose Mary; Vorderstrasse, Allison; Keefe, Richard S E; Dungan, Jennifer R

    2018-05-01

    Insight in schizophrenia is clinically important as it is associated with several adverse outcomes. Genetic contributions to insight are unknown. We examined genetic contributions to insight by investigating if polygenic risk scores (PRS) and candidate regions were associated with insight. Schizophrenia case-only analysis of the Clinical Antipsychotics Trials of Intervention Effectiveness trial. Schizophrenia PRS was constructed using Psychiatric Genomics Consortium (PGC) leave-one out GWAS as discovery data set. For candidate regions, we selected 105 schizophrenia-associated autosomal loci and 11 schizophrenia-related oligodendrocyte genes. We used regressions to examine PRS associations and set-based testing for candidate analysis. We examined data from 730 subjects. Best-fit PRS at p-threshold of 1e-07 was associated with total insight (R 2 =0.005, P=0.05, empirical P=0.054) and treatment insight (R 2 =0.005, P=0.048, empirical P=0.048). For models that controlled for neurocognition, PRS significantly predicted treatment insight but at higher p-thresholds (0.1 to 0.5) but did not survive correction. Patients with highest polygenic burden had 5.9 times increased risk for poor insight compared to patients with lowest burden. PRS explained 3.2% (P=0.002, empirical P=0.011) of variance in poor insight. Set-based analyses identified two variants associated with poor insight- rs320703, an intergenic variant (within-set P=6e-04, FDR P=0.046) and rs1479165 in SOX2-OT (within-set P=9e-04, FDR P=0.046). To the best of our knowledge, this is the first study examining genetic basis of insight. We provide evidence for genetic contributions to impaired insight. Relevance of findings and necessity for replication are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Self-reported empathy and neural activity during action imitation and observation in schizophrenia

    OpenAIRE

    Horan, William P.; Iacoboni, Marco; Cross, Katy A.; Korb, Alex; Lee, Junghee; Nori, Poorang; Quintana, Javier; Wynn, Jonathan K.; Green, Michael F.

    2014-01-01

    Introduction: Although social cognitive impairments are key determinants of functional outcome in schizophrenia their neural bases are poorly understood. This study investigated neural activity during imitation and observation of finger movements and facial expressions in schizophrenia, and their correlates with self-reported empathy. Methods: 23 schizophrenia outpatients and 23 healthy controls were studied with functional magnetic resonance imaging (fMRI) while they imitated, executed, o...

  16. Toxoplasma Infection in Schizophrenia Patients: A Comparative Study with Control Group

    OpenAIRE

    Alipour, A; Shojaee, S; Mohebali, M; Tehranidoost, M; Abdi Masoleh, F; Keshavarz, H

    2011-01-01

    Background: Schizophrenia is a serious, chronic, and often debilitating neuropsychiatric disor­der. Its causes are still poorly understood. Besides genetic and non-genetic (environmental) fac­tors are thought to be important as the cause of the structural and functional deficits that character­ize schizophrenia. This study aimed to compare Toxoplasma gondii infection between schizo­phrenia patients and non-schizophrenia individuals as control group.Methods: A case-control study was designed i...

  17. [Fratricide and Schizophrenia].

    Science.gov (United States)

    Rezende Leal, Juliana; Martins Valença, Alexandre

    2016-01-01

    Fratricide is the killing of one's own bother. It's a type of homicide rarely seen on psychiatric practice. This is still a theme which is poorly studied, and not well understood by the scientific literature. To report a case of a men, with paranoid schizophrenia that murdered his own bother and had a psychiatric forensic evaluation to establish his penal responsibility. A psychiatric interview was carried out and the psychiatric diagnosis was established based on the interview and analysis of forensic and medical records, using the DSM-IV-TR criteria. Literature review was held about the theme. The examinee was considered not guilty by reason of insanity, due to the presence of a mental disorder that affected her entire understanding and volition of the practiced act. The study of such cases may illustrate and identify motivating factors related to homicidal behavior in individuals with severe mental disorders. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Genetic Markers of Human Evolution Are Enriched in Schizophrenia

    DEFF Research Database (Denmark)

    Srinivasan, Saurabh; Bettella, Francesco; Mattingsdal, Morten

    2016-01-01

    BACKGROUND: Why schizophrenia has accompanied humans throughout our history despite its negative effect on fitness remains an evolutionary enigma. It is proposed that schizophrenia is a by-product of the complex evolution of the human brain and a compromise for humans' language, creative thinking...... and ancillary information on genetic variants. We used information from the evolutionary proxy measure called the Neanderthal selective sweep (NSS) score. RESULTS: Gene loci associated with schizophrenia are significantly (p = 7.30 × 10(-9)) more prevalent in genomic regions that are likely to have undergone...... phenotypes. The false discovery rate conditional on the evolutionary proxy points to 27 candidate schizophrenia susceptibility loci, 12 of which are associated with schizophrenia and other psychiatric disorders or linked to brain development. CONCLUSIONS: Our results suggest that there is a polygenic overlap...

  19. Structural and psychosocial correlates of birth order anomalies in schizophrenia and homicide.

    Science.gov (United States)

    Schug, Robert A; Yang, Yaling; Raine, Adrian; Han, Chenbo; Liu, Jianghong

    2010-12-01

    Birth order--a unique index of both neurodevelopmental and/or psychosocial factors in the pathogenesis of psychiatric disorder--remains largely unexplored in violent schizophrenia. We examined whether murderers with schizophrenia would demonstrate birth order anomalies, distinguishing them from both nonviolent schizophrenia patients and murderers without schizophrenia. Self-report birth order, psychosocial history data (i.e., maternal birth age, family size, parental criminality, parental SES), and structural magnetic resonance imaging data were collected from normal controls, nonviolent schizophrenia patients, murderers with schizophrenia, murderers without schizophrenia, and murderers with psychiatric conditions other than schizophrenia at a brain hospital in Nanjing, China. Results indicated that murderers with schizophrenia were characterized by significantly increased (i.e., later) birth order compared with both nonviolent schizophrenia patients and murderers without schizophrenia. Additionally, birth order was negatively correlated with gray matter volume in key frontal subregions for schizophrenic murderers, and was negatively correlated with parental SES. Findings may suggest biological, psychosocial, or interactional trajectories which may lead to a homicidally violent outcome in schizophrenia.

  20. Proton magnetic resonance spectroscopy in schizophrenia

    International Nuclear Information System (INIS)

    Bertolino, Alessandro; Weinberger, Daniel R.

    1999-01-01

    Proton magnetic resonance spectroscopy (MRS) has become an important tool to study in vivo certain biochemical aspects of brain disorders. In the last decade this technique has been applied to the in vivo investigation of pathophysiological aspects of psychiatric disorders, extending knowledge of the related brain alterations. This review will focus on providing some background to clarify technical and biochemical issues and it will describe the studies that have been performed in schizophrenia. The results will be framed in a more general context to highlight what we have learned and what remains to be understood from the application of this technique to schizophrenia

  1. Potential Value of Genomic Copy Number Variations in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Chuanjun Zhuo

    2017-06-01

    Full Text Available Schizophrenia is a devastating neuropsychiatric disorder affecting approximately 1% of the global population, and the disease has imposed a considerable burden on families and society. Although, the exact cause of schizophrenia remains unknown, several lines of scientific evidence have revealed that genetic variants are strongly correlated with the development and early onset of the disease. In fact, the heritability among patients suffering from schizophrenia is as high as 80%. Genomic copy number variations (CNVs are one of the main forms of genomic variations, ubiquitously occurring in the human genome. An increasing number of studies have shown that CNVs account for population diversity and genetically related diseases, including schizophrenia. The last decade has witnessed rapid advances in the development of novel genomic technologies, which have led to the identification of schizophrenia-associated CNVs, insight into the roles of the affected genes in their intervals in schizophrenia, and successful manipulation of the target CNVs. In this review, we focus on the recent discoveries of important CNVs that are associated with schizophrenia and outline the potential values that the study of CNVs will bring to the areas of schizophrenia research, diagnosis, and therapy. Furthermore, with the help of the novel genetic tool known as the Clustered Regularly Interspaced Short Palindromic Repeats-associated nuclease 9 (CRISPR/Cas9 system, the pathogenic CNVs as genomic defects could be corrected. In conclusion, the recent novel findings of schizophrenia-associated CNVs offer an exciting opportunity for schizophrenia research to decipher the pathological mechanisms underlying the onset and development of schizophrenia as well as to provide potential clinical applications in genetic counseling, diagnosis, and therapy for this complex mental disease.

  2. Schizophrenia and Metacognition

    DEFF Research Database (Denmark)

    Austin, Stephen F.; Mors, Ole; Nordentoft, Merete

    2014-01-01

    tested for relationships between course of illness and levels of specific metacognitions in schizophrenia spectrum disorders. A large cohort of people with first episode psychosis (n = 578) recruited as part the OPUS trial (1998–2000) were tested. Information about course of illness (remitted, episodic...... beliefs may also impact on positive symptoms and course of illness within schizophrenia....

  3. Self-experience in the early phases of schizophrenia: 5-year follow-up of the Copenhagen Prodromal Study

    DEFF Research Database (Denmark)

    Parnas, Josef; Raballo, Andrea; Handest, Peter

    2011-01-01

    Despite the avalanche of empirical data on prodromal/"at risk" conditions, the essential aspects of the vulnerability to the schizophrenia spectrum remain largely unaddressed. We report here the results of the Copenhagen Schizophrenia Prodromal Study, a prospective, observational study of first a......-disorders baseline scores yielded the best prediction of the subsequent development of schizophrenia spectrum disorders. Escalating transitions within the spectrum (i.e., from schizotypal disorder to schizophrenia) were not associated to any candidate psychopathological predictor....

  4. Development of the Positive Emotions Program for Schizophrenia (PEPS: an intervention to improve pleasure and motivation in schizophrenia

    Directory of Open Access Journals (Sweden)

    Alexandra eNguyen

    2016-02-01

    Full Text Available Objectives: The efficacy of drug-based treatments and psychological interventions on the primary negative symptoms of schizophrenia remains limited. Recent literature has distinguished negative symptoms associated with a diminished capacity to experience, from those associated with a limited capacity for expression. The Positive Emotions Program for Schizophrenia (PEPS is a new method that specifically aims to reduce the syndrome of a diminished capacity to experience. Methods: The intervention’s vital ingredients were identified through a literature review of emotion in schizophrenia and positive psychology. The program has been beta-tested on various groups of healthcare professionals. Results: A detailed description of the final version of PEPS is presented here. The French version of the program is freely downloadable. Conclusions: PEPS is a specific, short, easy to use, group-based intervention to improve pleasure and motivation in schizophrenia. It was built considering a recovery-oriented approach to schizophrenia.

  5. Asthma, corticosteroid use and schizophrenia: A nationwide population-based study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Wei-Chen Wang

    Full Text Available Asthma and corticosteroid use have been implicated as possible risk factors for schizophrenia. The retrospective cohort study herein aimed to investigate the association between asthma, corticosteroid use, and schizophrenia.Longitudinal data (2000 to 2007 from adults with asthma (n = 50,046 and without asthma (n = 50,046 were compared on measures of schizophrenia incidence using Taiwan's National Health Insurance Research Database (NHIRD. Incidence of schizophrenia diagnosis (ICD-9 codes 295.XX between 2000 and 2007 were compared between groups. Competing risk-adjusted Cox regression analyses were conducted, adjusting for sex, age, residence, socioeconomic status, corticosteroid use, outpatient and emergency room visit frequency, Charlson comorbidity index, and total length of hospital stays days for any disorder.Of the 75,069 subjects, 238 received a diagnosis of schizophrenia. The mean (SD follow-up interval for all subjects was 5.8 (2.3 years. After adjusting for potential confounding factors, asthma was associated with significantly greater hazard ratio for incident schizophrenia 1.40 (95% CI = 1.05, 1.87. Additional factors associated with greater incidence of schizophrenia were rural residence, lower economic status, and poor general health. Older age (i.e. ≥65 years was negatively associated with schizophrenia incidence. Corticosteroid use was not associated with increased risk for schizophrenia.Asthma was associated with increased risk for schizophrenia. The results herein suggest that a convergent disturbance in the immune-inflammatory system may contribute to the pathoetiology of asthma and schizophrenia.

  6. GABAergic Mechanisms in Schizophrenia

    DEFF Research Database (Denmark)

    de Jonge, Jeroen C; Vinkers, Christiaan H; Hulshoff Pol, Hilleke E

    2017-01-01

    Schizophrenia is a psychiatric disorder characterized by hallucinations, delusions, disorganized thinking, and impairments in cognitive functioning. Evidence from postmortem studies suggests that alterations in cortical γ-aminobutyric acid (GABAergic) neurons contribute to the clinical features...... of schizophrenia. In vivo measurement of brain GABA levels using magnetic resonance spectroscopy (MRS) offers the possibility to provide more insight into the relationship between problems in GABAergic neurotransmission and clinical symptoms of schizophrenia patients. This study reviews and links alterations...... in the GABA system in postmortem studies, animal models, and human studies in schizophrenia. Converging evidence implicates alterations in both presynaptic and postsynaptic components of GABAergic neurotransmission in schizophrenia, and GABA may thus play an important role in the pathophysiology...

  7. Cognitive Remediation in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Joana Vieira

    2014-06-01

    Full Text Available Several reviews of the literature support the idea that cognitive deficits observed in a large percentage of patients with schizophrenia are responsible for the cognitive performance deficit and functional disability associated with the disease. The grow- ing importance of neurocognition in Psychiatry, especially with regard to planning strategies and rehabilitative therapies to improve the prognosis of patients contrib- utes to the interest of achieving this literature review on cognitive rehabilitation in schizophrenia. In this work, drawn from research in the areas of schizophrenia, cog- nition, cognitive rehabilitation and cognitive remediation (2000-2012 through PubMed and The Cochrane Collaboration, it is intended, to describe the types of psychological and behavioral therapies recommended in the treatment of cognitive disabilities in patients diagnosed with schizophrenia. This review will also highlight the clinical and scientific evidence of each of these therapies, as their effect on cognitive performance, symptoms and functionality in patients with schizophrenia.

  8. Schizophrenia and Suicide

    Directory of Open Access Journals (Sweden)

    Ozlem Cetin

    2011-12-01

    Full Text Available Suicide is one of the major causes of premature death among patients with schizophrenia. Follow-up studies have estimated that 4-5% of these patients die by suicide. Reducing the high rates of suicide in schizophrenia is possible with understanding of predictive risk factors. Various studies have identified risk factors for suicide in schizophrenia patients. Clinical risk factors include previous suicide attempts, comorbid depression, feelings of hopelessness, concept of insight and substance abuse. Biopsychosocial factors, such as a high intelligence quotient and high level of premorbid functioning, have also been associated with an increased risk of suicide in patients with schizophrenia. The risk of suicide is considered to be highest in the early course of illness. Antipsychotic drugs, in particular clozapine and antidepressants may be helpful in reducing the risk of suicide in schizophrenia.

  9. Proverb comprehension reconsidered--'theory of mind' and the pragmatic use of language in schizophrenia.

    Science.gov (United States)

    Brüne, Martin; Bodenstein, Luise

    2005-06-15

    For decades, impaired proverb comprehension has been regarded as typical of schizophrenic thought disorder. Testing patients' proverb understanding has widely been abandoned, however, due to poor reliability and validity of the assessment procedures. Since the underlying cognitive deficit of impaired proverb interpretation remained obscure, this study sought to determine the relation of proverb understanding with other cognitive domains, particularly 'theory of mind' or 'mindreading', in schizophrenia. 31 patients diagnosed with schizophrenia were assessed using a novel German Proverb Test [Barth, A., Küfferle, B., 2001. Die Entwicklung eines Sprichworttests zur Erfassung konkretistischer Denkstörungen bei schizophrenen Patienten. Nervenarzt 72, 853-858.], a 'theory of mind' test battery, a variety of executive functioning tests and verbal intelligence. Psychopathology was measured using the PANSS [Kay, S.R., Opler, L.A., Lindenmayer, J.P., 1989. The Positive and Negative Syndrome Scale (PANSS): rationale and standardisation. Br. J. Psychiatry 158 (suppl. 7), 59-67.]. Patients' task performance was compared to a group of healthy control persons. 'Theory of mind', executive functioning and intelligence were strongly correlated with patients' ability to interpret proverbs correctly. In a regression analysis 'theory of mind' performance predicted, conservatively estimated, about 39% of the variance of proverb comprehension in the patient group. The ability to interpret such metaphorical speech that is typical of many proverbs crucially depends on schizophrenic patients' ability to infer mental states. Future studies may further address differences between schizophrenia subtypes or the relation to specific symptom clusters.

  10. The Effects of Music Intervention on Functional Connectivity Strength of the Brain in Schizophrenia.

    Science.gov (United States)

    Yang, Mi; He, Hui; Duan, Mingjun; Chen, Xi; Chang, Xin; Lai, Yongxiu; Li, Jianfu; Liu, Tiejun; Luo, Cheng; Yao, Dezhong

    2018-01-01

    Schizophrenia is often associated with behavior abnormality in the cognitive and affective domain. Music intervention is used as a complementary treatment for improving symptoms in patients with schizophrenia. However, the neurophysiological correlates of these remissions remain poorly understood. Here, we investigated the effects of music intervention in neural circuits through functional magnetic resonance imaging (fMRI) study in schizophrenic subjects. Under the standard care, patients were randomly assigned to music and non-music interventions (MTSZ, UMTSZ) for 1 month. Resting-state fMRI were acquired over three time points (baseline, 1 month, and 6 months later) in patients and analyzed using functional connectivity strength (FCS) and seed-based functional connection (FC) approaches. At baseline, compared with healthy controls, decreased FCS in the right middle temporal gyrus (MTG) was observed in patients. However, after music intervention, the functional circuitry of the right MTG, which was related with the function of emotion and sensorimotor, was improved in MTSZ. Furthermore, the FC increments were significantly correlated with the improvement of symptoms, while vanishing 6 months later. Together, these findings provided evidence that music intervention might positively modulate the functional connectivity of MTG in patients with schizophrenia; such changes might be associated with the observed therapeutic effects of music intervention on neurocognitive function. This trial is registered with ChiCTR-OPC-14005339.

  11. Revisiting the Suitability of Antisaccade Performance as an Endophenotype in Schizophrenia

    Science.gov (United States)

    Mazhari, Shahrzad; Price, Greg; Dragovic, Milan; Waters, Flavie A.; Clissa, Peter; Jablensky, Assen

    2011-01-01

    Poor performance on the antisaccade task has been proposed as a candidate endophenotype in schizophrenia. Caveats to this proposal, however, include inconsistent findings in first-degree relatives of individuals with schizophrenia, and substantial heterogeneity in individuals with the disorder. In this study, we examined antisaccade performance in…

  12. Associations between HIV and schizophrenia and their effect on HIV treatment outcomes

    DEFF Research Database (Denmark)

    Helleberg, Marie; Pedersen, Marianne G; Pedersen, Carsten B

    2015-01-01

    BACKGROUND: Associations between HIV and schizophrenia in people with and without substance use disorders and the effect on timeliness of HIV diagnosis, antiretroviral therapy (ART), and treatment outcomes are poorly understood. We aimed to assess the association between HIV and schizophrenia and...

  13. Cessation of cannabis use by patients with recent-onset schizophrenia and related disorders

    NARCIS (Netherlands)

    Dekker, Nienke; de Haan, Lieuwe; van den Berg, Sake; de Gier, Martin; Becker, Hiske; Linzen, Don H.

    2008-01-01

    Cannabis abuse has been found to be a component risk factor for the onset and poor outcome during the early course of schizophrenia and related disorders. Cannabis use has become a target for prevention and treatment of schizophrenia patients. Therefore, knowledge of factors that influence

  14. Cognition-emotion dysinteraction in schizophrenia.

    Science.gov (United States)

    Anticevic, Alan; Corlett, Philip R

    2012-01-01

    Evolving theories of schizophrenia emphasize a "disconnection" in distributed fronto-striatal-limbic neural systems, which may give rise to breakdowns in cognition and emotional function. We discuss these diverse domains of function from the perspective of disrupted neural circuits involved in "cold" cognitive vs. "hot" affective operations and the interplay between these processes. We focus on three research areas that highlight cognition-emotion dysinteractions in schizophrenia: First, we discuss the role of cognitive deficits in the "maintenance" of emotional information. We review recent evidence suggesting that motivational abnormalities in schizophrenia may in part arise due to a disrupted ability to "maintain" affective information over time. Here, dysfunction in a prototypical "cold" cognitive operation may result in "affective" deficits in schizophrenia. Second, we discuss abnormalities in the detection and ascription of salience, manifest as excessive processing of non-emotional stimuli and inappropriate distractibility. We review emerging evidence suggesting deficits in some, but not other, specific emotional processes in schizophrenia - namely an intact ability to perceive emotion "in-the-moment" but poor prospective valuation of stimuli and heightened reactivity to stimuli that ought to be filtered. Third, we discuss abnormalities in learning mechanisms that may give rise to delusions, the fixed, false, and often emotionally charged beliefs that accompany psychosis. We highlight the role of affect in aberrant belief formation, mostly ignored by current theoretical models. Together, we attempt to provide a consilient overview for how breakdowns in neural systems underlying affect and cognition in psychosis interact across symptom domains. We conclude with a brief treatment of the neurobiology of schizophrenia and the need to close our explanatory gap between cellular-level hypotheses and complex behavioral symptoms observed in this illness.

  15. Defending the unabomber: anosognosia in schizophrenia.

    Science.gov (United States)

    Amador, X F; Paul-Odouard, R

    2000-01-01

    The use of recent psychiatric research in the defense of the 'Unabomber' (United States vs. Theodore Kaczynski) is a compelling example of how the gap between research and practice can have profound consequences on the practice of forensic psychiatry, psychology and the judicial process. In this case, educating the lawyers and the court about the research on poor insight in schizophrenia changed the defense strategy and ultimately the course of the trial.

  16. First-episode schizophrenia: characterization and clinical correlates

    Directory of Open Access Journals (Sweden)

    Robert M. Bilder

    2007-11-01

    Full Text Available Neuropsychological impairments are well documented in schizophrenia and are important targets of treatment. Information about the severity and pattern of deficits after treatment for the first psychotic episode and about relationships between these deficits and syndromal characteristics remains limited. Comprehensive neuropsychological assessments including 41 individual tests were given to 94 patients with first-episode schizophrenia after initial stabilization of psychosis and to a comparison group of 36 healthy volunteers. Profiles of neuropsychological deficits and the relationship of deficits to sex and handedness were examined. Correlations of neuropsychological deficit with a broad range of historical and clinical characteristics, including outcome, were explored. Patients had a large generalized neuropsychological deficit. Patients also had, superimposed on the generalized deficit, subtle relative deficits in memory and executive functions. Learning/memory dysfunction best distinguished patients from healthy individuals; after accounting for this difference, only motor deficits further distinguished the groups. Patients with higher neuropsychological ability had only memory deficits, and patients with lower ability had both memory and executive deficits. Dextral patients had less severe generalized deficit. Severity of residual symptoms was associated with greater generalized deficit. Executive and attentional deficits were most linked to global functional impairment and poor outcome. The results document a large generalized deficit, and more subtle differential deficits, in clinically stabilized first-episode patients. Learning/memory deficits were observed even in patients with less severe generalized deficit, but the pattern was unlike the amnestic syndrome and probably reflects different mechanisms. Executive and attentional deficits marked the more severe ly disabled patients, and may portend relatively poor outcome. Failure to

  17. Nonverbal expressive behaviour in schizophrenia and social phobia.

    Science.gov (United States)

    Del-Monte, Jonathan; Raffard, Stéphane; Salesse, Robin N; Marin, Ludovic; Schmidt, Richard C; Varlet, Manuel; Bardy, Benoît G; Philippe Boulenger, Jean; Christine Gély-Nargeot, Marie; Capdevielle, Delphine

    2013-11-30

    Expressive behaviour plays a crucial role in the success of social interactions. Abnormality of expressive behaviour has been reported in interpersonal interactions of patients suffering from schizophrenia and social phobia, two debilitating mental disorders with important social deficits. However, no study has compared the expressive behaviour in these two disorders. Thirty schizophrenia patients, 21 social phobia patients and 30 healthy controls were evaluated and compared on expressive, cognitive and clinical dimensions. Expressive behaviour was assessed using the Motor Affective subscale of the Motor-Affective-Social-Scale (MASS). Covariables include the Positive and Negative Syndrome Scale (PANSS), the anxiety level Liebowitz-Social-Anxiety-Scale (LSAS) and cognitive tasks. After controlling for depression, schizophrenia and social phobia patients both exhibited significantly fewer expressive behaviours compared to healthy controls. Moreover, our results showed specific signatures: schizophrenia patients performed fewer spontaneous gestures (hand gestures and smiles) whereas social phobia patients had an impaired ability to produce voluntary smiles in comparison to healthy controls. Interestingly, poor social functioning was significantly correlated with a decrease of expressive behaviour for schizophrenia patients. Expressive behaviour is impaired in different ways in social phobia and schizophrenia and is associated in schizophrenia with poorer social functioning. The Motor Affective subscale of the MASS is an interesting tool for assessing the dysfunction of interpersonal expressive behaviour in mental disorders. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Role of perceived family environment in the pathogenesis of schizophrenia

    Directory of Open Access Journals (Sweden)

    Roshan Lal Dewangan

    2018-01-01

    Full Text Available Background: Family plays an important role in mental health of its member, thus its contribution can also be discerned in pathogenesis. Maintenance and relapse of several mental illnesses have been also attributed to the family environment (FE. This study explores FE as perceived by schizophrenia patients. Methodology: A case–control study was conducted in Chhattisgarh, India, to measure the association of perceived FE with schizophrenia. Between February 2014 and January 2015, 100 paranoid schizophrenia patients and 100 neighborhood-based healthy (based on 28-item General Health Questionnaire controls were recruited. Minimum school-educated individuals aged 20–35 years were eligible if they/their caregivers provided consent. Interpersonal relationships and FE were assessed by an interviewer-administered 69-item FE scale. Results: The odds of suffering from schizophrenia increased with age, decreased with education, income, and found to be less among married. Schizophrenia risk was negatively associated with mean scores for cohesion, acceptance/caring, active-recreational orientation, and organization. Negative symptoms of schizophrenia were less pronounced among patients belonging to joint families. Conclusion: Thus, to minimize the burden and morbidity associated with schizophrenia, interventions to improve FE by minimizing conflict and improving cohesion, acceptance/caring, active-recreational orientation, and organization, and specifically targeting older, less-educated, poor, and married individuals in nuclear families seemed necessary.

  19. Geographical and temporal variations in clozapine prescription for schizophrenia

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Røge, Rasmus; Schjerning, Ole

    2012-01-01

    Despite its unsurpassed efficacy in treatment-resistant schizophrenia, clozapine remains underutilized. Trends in the prescription of clozapine in patients with ICD-10 F20.x schizophrenia were assessed using data from Danish national registers. Three substudies were carried out: (i) an assessment...... of differences in national prescription patterns between 1996 and 2007 using a cross-sectional design; (ii) a comparison of time from first schizophrenia diagnosis to first prescription of clozapine in a five-year cohort study, using the Cox regression model, of two patient groups who were first diagnosed...

  20. Visual masking & schizophrenia

    Directory of Open Access Journals (Sweden)

    Michael H. Herzog

    2015-06-01

    Full Text Available Visual masking is a frequently used tool in schizophrenia research. Visual masking has a very high sensitivity and specificity and masking paradigms have been proven to be endophenotypes. Whereas masking is a powerful technique to study schizophrenia, the underlying mechanisms are discussed controversially. For example, for more than 25 years, masking deficits of schizophrenia patients were mainly attributed to a deficient magno-cellular system (M-system. Here, we show that there is very little evidence that masking deficits are magno-cellular deficits. We will discuss the magno-cellular and other approaches in detail and highlight their pros and cons.

  1. Effects of cariprazine, a novel antipsychotic, on cognitive deficit and negative symptoms in a rodent model of schizophrenia symptomatology.

    Science.gov (United States)

    Neill, Jo C; Grayson, Ben; Kiss, Béla; Gyertyán, István; Ferguson, Paul; Adham, Nika

    2016-01-01

    Negative symptoms and cognitive impairment associated with schizophrenia are strongly associated with poor functional outcome and reduced quality of life and remain an unmet clinical need. Cariprazine is a dopamine D3/D2 receptor partial agonist with preferential binding to D3 receptors, recently approved by the FDA for the treatment of schizophrenia and manic or mixed episodes associated with bipolar I disorder. The aim of this study is to evaluate effects of cariprazine in an animal model of cognitive deficit and negative symptoms of schizophrenia. Following sub-chronic PCP administration (2mg/kg, IP for 7 days followed by 7 days drug-free), female Lister Hooded rats were administered cariprazine (0.05, 0.1, or 0.25mg/kg, PO) or risperidone (0.16 or 0.1mg/kg, IP) before testing in novel object recognition (NOR), reversal learning (RL), and social interaction (SI) paradigms. As we have consistently demonstrated, sub-chronic PCP significantly impaired behavior in these tests. Deficits were significantly improved by cariprazine, in a dose dependent manner in the operant RL test with efficacy at lower doses in the NOR and SI tests. Locomotor activity was reduced at the highest doses of 0.1mg/kg and 0.25mg/kg in NOR and SI. Risperidone also reversed the PCP-induced deficit in all tests. In conclusion, cariprazine was effective to overcome PCP-induced deficits in cognition and social behavior in a thoroughly validated rat model in tests representing specific symptom domains in schizophrenia patients. These findings support very recent results showing efficacy of cariprazine in the treatment of negative symptoms in schizophrenia patients. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  2. Convergence and divergence of neurocognitive patterns in schizophrenia and depression.

    Science.gov (United States)

    Liang, Sugai; Brown, Matthew R G; Deng, Wei; Wang, Qiang; Ma, Xiaohong; Li, Mingli; Hu, Xun; Juhas, Michal; Li, Xinmin; Greiner, Russell; Greenshaw, Andrew J; Li, Tao

    2018-02-01

    Neurocognitive impairments are frequently observed in schizophrenia and major depressive disorder (MDD). However, it remains unclear whether reported neurocognitive abnormalities could objectively identify an individual as having schizophrenia or MDD. The current study included 220 first-episode patients with schizophrenia, 110 patients with MDD and 240 demographically matched healthy controls (HC). All participants performed the short version of the Wechsler Adult Intelligence Scale-Revised in China; the immediate and delayed logical memory of the Wechsler Memory Scale-Revised in China; and seven tests from the computerized Cambridge Neurocognitive Test Automated Battery to evaluate neurocognitive performance. The three-class AdaBoost tree-based ensemble algorithm was employed to identify neurocognitive endophenotypes that may distinguish between subjects in the categories of schizophrenia, depression and HC. Hierarchical cluster analysis was applied to further explore the neurocognitive patterns in each group. The AdaBoost algorithm identified individual's diagnostic class with an average accuracy of 77.73% (80.81% for schizophrenia, 53.49% for depression and 86.21% for HC). The average area under ROC curve was 0.92 (0.96 in schizophrenia, 0.86 in depression and 0.92 in HC). Hierarchical cluster analysis revealed for MDD and schizophrenia, convergent altered neurocognition patterns related to shifting, sustained attention, planning, working memory and visual memory. Divergent neurocognition patterns for MDD and schizophrenia related to motor speed, general intelligence, perceptual sensitivity and reversal learning were identified. Neurocognitive abnormalities could predict whether the individual has schizophrenia, depression or neither with relatively high accuracy. Additionally, the neurocognitive features showed promise as endophenotypes for discriminating between schizophrenia and depression. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Updating the mild encephalitis hypothesis of schizophrenia.

    Science.gov (United States)

    Bechter, K

    2013-04-05

    Schizophrenia seems to be a heterogeneous disorder. Emerging evidence indicates that low level neuroinflammation (LLNI) may not occur infrequently. Many infectious agents with low overall pathogenicity are risk factors for psychoses including schizophrenia and for autoimmune disorders. According to the mild encephalitis (ME) hypothesis, LLNI represents the core pathogenetic mechanism in a schizophrenia subgroup that has syndromal overlap with other psychiatric disorders. ME may be triggered by infections, autoimmunity, toxicity, or trauma. A 'late hit' and gene-environment interaction are required to explain major findings about schizophrenia, and both aspects would be consistent with the ME hypothesis. Schizophrenia risk genes stay rather constant within populations despite a resulting low number of progeny; this may result from advantages associated with risk genes, e.g., an improved immune response, which may act protectively within changing environments, although they are associated with the disadvantage of increased susceptibility to psychotic disorders. Specific schizophrenic symptoms may arise with instances of LLNI when certain brain functional systems are involved, in addition to being shaped by pre-existing liability factors. Prodrome phase and the transition to a diseased status may be related to LLNI processes emerging and varying over time. The variability in the course of schizophrenia resembles the varying courses of autoimmune disorders, which result from three required factors: genes, the environment, and the immune system. Preliminary criteria for subgrouping neurodevelopmental, genetic, ME, and other types of schizophrenias are provided. A rare example of ME schizophrenia may be observed in Borna disease virus infection. Neurodevelopmental schizophrenia due to early infections has been estimated by others to explain approximately 30% of cases, but the underlying pathomechanisms of transition to disease remain in question. LLNI (e.g. from

  4. Using human brain imaging studies as a guide towards animal models of schizophrenia

    Science.gov (United States)

    BOLKAN, Scott S.; DE CARVALHO, Fernanda D.; KELLENDONK, Christoph

    2015-01-01

    Schizophrenia is a heterogeneous and poorly understood mental disorder that is presently defined solely by its behavioral symptoms. Advances in genetic, epidemiological and brain imaging techniques in the past half century, however, have significantly advanced our understanding of the underlying biology of the disorder. In spite of these advances clinical research remains limited in its power to establish the causal relationships that link etiology with pathophysiology and symptoms. In this context, animal models provide an important tool for causally testing hypotheses about biological processes postulated to be disrupted in the disorder. While animal models can exploit a variety of entry points towards the study of schizophrenia, here we describe an approach that seeks to closely approximate functional alterations observed with brain imaging techniques in patients. By modeling these intermediate pathophysiological alterations in animals, this approach offers an opportunity to (1) tightly link a single functional brain abnormality with its behavioral consequences, and (2) to determine whether a single pathophysiology can causally produce alterations in other brain areas that have been described in patients. In this review we first summarize a selection of well-replicated biological abnormalities described in the schizophrenia literature. We then provide examples of animal models that were studied in the context of patient imaging findings describing enhanced striatal dopamine D2 receptor function, alterations in thalamo-prefrontal circuit function, and metabolic hyperfunction of the hippocampus. Lastly, we discuss the implications of findings from these animal models for our present understanding of schizophrenia, and consider key unanswered questions for future research in animal models and human patients. PMID:26037801

  5. Cognitive-perceptual deficits and symptom correlates in first-episode schizophrenia

    Directory of Open Access Journals (Sweden)

    Riaan M. Olivier

    2017-08-01

    Full Text Available Background: Thought disorder and visual-perceptual deficits have been well documented, but their relationships with clinical symptoms and cognitive function remain unclear. Cognitive-perceptual deficits may underscore clinical symptoms in schizophrenia patients. Aim: This study aimed to explore how thought disorder and form perception are related with clinical symptoms and cognitive dysfunction in first-episode schizophrenia. Setting: Forty-two patients with a first-episode of schizophrenia, schizophreniform or schizoaffective disorder were recruited from community clinics and state hospitals in the Cape Town area. Methods: Patients were assessed at baseline with the Rorschach Perceptual Thinking Index (PTI, the Positive and Negative Syndrome Scale (PANSS and the MATRICS Cognitive Consensus Battery (MCCB. Spearman correlational analyses were conducted to investigate relationships between PTI scores, PANSS factor analysis-derived domain scores and MCCB composite and subscale scores. Multiple regression models explored these relationships further. Results: Unexpectedly, poor form perception (X- % was inversely correlated with the severity of PANSS positive symptoms (r = -0.42, p = 0.02. Good form perception (XA% correlated significantly with speed of processing (r = 0.59, p < 0.01, working memory (r = 0.48, p < 0.01 and visual learning (r = 0.55, p < 0.01. PTI measures of thought disorder did not correlate significantly with PANSS symptom scores or cognitive performance. Conclusions: Form perception is associated with positive symptoms and impairment in executive function during acute psychosis. These findings suggest that there may be clinical value in including sensory-perceptual processing tasks in cognitive remediation and social cognitive training programmes for schizophrenia patients.

  6. Social skills programmes for schizophrenia.

    Science.gov (United States)

    Almerie, Muhammad Qutayba; Okba Al Marhi, Muhammad; Jawoosh, Muhammad; Alsabbagh, Mohamad; Matar, Hosam E; Maayan, Nicola; Bergman, Hanna

    2015-06-09

    . Global state was measured in one trial by numbers not experiencing a clinical improvement, results favoured social skills (1 RCT, n = 67, RR 0.29 CI 0.12 to 0.68, very low quality evidence). Quality of life was also improved in the social skills programme compared to standard care (1 RCT, n = 112, MD -7.60 CI -12.18 to -3.02, very low quality evidence). However, when social skills programmes were compared to a discussion group control, we found no significant differences in the participants social functioning, relapse rates, mental state or quality of life, again the quality of evidence for these outcomes was very low. Compared to standard care, social skills training may improve the social skills of people with schizophrenia and reduce relapse rates, but at present, the evidence is very limited with data rated as very low quality. When social skills training was compared to discussion there was no difference on patients outcomes. Cultural differences might limit the applicability of the current results, as most reported studies were conducted in China. Whether social skills training can improve social functioning of people with schizophrenia in different settings remains unclear and should be investigated in a large multi-centre randomised controlled trial.

  7. Identifying aspects of neighbourhood deprivation associated with increased incidence of schizophrenia.

    Science.gov (United States)

    Bhavsar, Vishal; Boydell, Jane; Murray, Robin; Power, Paddy

    2014-06-01

    Several studies have found an association between area deprivation and incidence of schizophrenia. However, not all studies have concurred and definitions of deprivation have varied between studies. Relative deprivation and inequality seem to be particularly important, but which aspects of deprivation or how this effect might operate is not known. The Lambeth Early Onset case register is a database of all cases of first episode psychosis aged 16 to 35years from the London Borough of Lambeth, a highly urban area. We identified 405 people with first onset schizophrenia who presented between 2000 and 2007. We calculated the overall incidence of first onset schizophrenia and tested for an association with area-level deprivation, using a multi-domain index of deprivation (IMD 2004). Specific analyses into associations with individual sub-domains of deprivation were then undertaken. Incidence rates, directly standardized for age and gender, were calculated for Lambeth at two geographical levels (small and large neighbourhood level). The Poisson regression model predicting incidence rate ratios for schizophrenia using overall deprivation score was statistically significant at both levels after adjusting for ethnicity, ethnic density, population density and population turnover. The incidence rate ratio for electoral ward deprivation was 1.03 (95% CI=1.004-1.04) and for the super output area deprivation was 1.04 (95% CI=1.02-1.06). The individual domains of crime, employment deprivation and educational deprivation were statistically significant predictors of incidence but, after adjusting for the other domains as well as age, gender, ethnicity and population density, only crime and educational deprivation, remained statistically significant. Low income, poor housing and deprived living environment did not predict incidence. In a highly urban area, an association was found between area-level deprivation and incidence of schizophrenia, after controlling for age, gender

  8. Treatment-Resistant Schizophrenia

    DEFF Research Database (Denmark)

    Howes, Oliver D; McCutcheon, Rob; Agid, Ofer

    2017-01-01

    OBJECTIVE: Research and clinical translation in schizophrenia is limited by inconsistent definitions of treatment resistance and response. To address this issue, the authors evaluated current approaches and then developed consensus criteria and guidelines. METHOD: A systematic review of randomize...

  9. [Risk factors of schizophrenia].

    Science.gov (United States)

    Suvisaari, Jaana

    2010-01-01

    Schizophrenia is a multifactorial, neurodevelopmental disorder caused by a combination of genetic and environmental risk factors. Disturbances of brain development begin prenatally, while different environmental insults further affect postnatal brain maturation during childhood and adolescence. Genome-wide association studies (GWAS) have succeeded in identifying hundreds of new risk variants for common, multifactorial diseases. In schizophrenia research, GWAS have found several rare copy number variants that considerably increase the risk of schizophrenia, and have shown an association between schizophrenia and the major histocompatibility complex. Research on environmental risk factors in recent years has provided new information particularly on risk factors related to pregnancy and childhood rearing environment. Gene-environment interactions have become a central research topic. There is evidence that genetically susceptible children are more vulnerable to the effects of unstable childhood rearing environment and other environmental risk factors.

  10. And the Dead Remain Behind

    Directory of Open Access Journals (Sweden)

    Peter Read

    2013-08-01

    Full Text Available In most cultures the dead and their living relatives are held in a dialogic relationship. The dead have made it clear, while living, what they expect from their descendants. The living, for their part, wish to honour the tombs of their ancestors; at the least, to keep the graves of the recent dead from disrepair. Despite the strictures, the living can fail their responsibilities, for example, by migration to foreign countries. The peripatetic Chinese are one of the few cultures able to overcome the dilemma of the wanderer or the exile. With the help of a priest, an Australian Chinese migrant may summon the soul of an ancestor from an Asian grave to a Melbourne temple, where the spirit, though removed from its earthly vessel, will rest and remain at peace. Amongst cultures in which such practices are not culturally appropriate, to fail to honour the family dead can be exquisitely painful. Violence is the cause of most failure.

  11. Oxytocin, Dopamine, and the Amygdala: A Neurofunctional Model of Social Cognitive Deficits in Schizophrenia

    OpenAIRE

    Rosenfeld, Andrew J.; Lieberman, Jeffrey A.; Jarskog, L. Fredrik

    2010-01-01

    Until recently, the social cognitive impairment in schizophrenia has been underappreciated and remains essentially untreated. Deficits in emotional processing, social perception and knowledge, theory of mind, and attributional bias may contribute to functional social cognitive impairments in schizophrenia. The amygdala has been implicated as a key component of social cognitive circuitry in both animal and human studies. In addition, structural and functional studies of schizophrenia reproduci...

  12. NEUROPSYCHOLOGY OF SCHIZOPHRENIA

    OpenAIRE

    Hugo Selma Sánchez

    2008-01-01

    Neuropsychology has had an explosive grow in the last decades. It contributions to the fields of Psychiatry are growing in an exponential rate. Research related to schizophrenia has bringing new views of the nature of the disease, at the same time offering contradictions and questions pending to resolve. The present article exposes the most relevant discoveries in the neuropshychology of schizophrenia neuroanatomy dysfunctions, development neurofuntionality, alterations in neurotransmitters a...

  13. Finding Genes for Schizophrenia

    OpenAIRE

    Åberg, Karolina

    2005-01-01

    Schizophrenia is one of our most common psychiatric diseases. It severely affects all aspects of psychological functions and results in loss of contact with reality. No cure exists and the treatments available today produce only partial relief for disease symptoms. The aim of this work is to better understand the etiology of schizophrenia by identification of candidate genes and gene pathways involved in the development of the disease. In a preliminarily study, the effects of medication and g...

  14. NEUROPSYCHOLOGY OF SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Hugo Selma Sánchez

    2008-11-01

    Full Text Available Neuropsychology has had an explosive grow in the last decades. It contributions to the fields of Psychiatry are growing in an exponential rate. Research related to schizophrenia has bringing new views of the nature of the disease, at the same time offering contradictions and questions pending to resolve. The present article exposes the most relevant discoveries in the neuropshychology of schizophrenia neuroanatomy dysfunctions, development neurofuntionality, alterations in neurotransmitters and cognitive deficiencies and areas for exploring.

  15. Loss aversion in schizophrenia.

    Science.gov (United States)

    Trémeau, Fabien; Brady, Melissa; Saccente, Erica; Moreno, Alexis; Epstein, Henry; Citrome, Leslie; Malaspina, Dolores; Javitt, Daniel

    2008-08-01

    Loss aversion in decision-making refers to a higher sensitivity to losses than to gains. Loss aversion is conceived as an affective interference in cognitive processes such as judgment and decision-making. Loss aversion in non-risky choices has not been studied in schizophrenia. Forty-two individuals with schizophrenia and 42 non-patient control subjects, matched by gender and age, were randomized to two different scenarios (a buying scenario and a selling scenario). Subjects were asked to evaluate the price of a decorated mug. Schizophrenia subjects were re-tested four weeks later with the other scenario. Contrary to non-patient controls, schizophrenia subjects did not show loss aversion. In the schizophrenia group, absence of loss aversion was correlated with age, duration of illness, number of months in State hospitals, and poorer performance in the Wisconsin Card Sorting Test, but not with current psychopathology and two domains of emotional experience. Absence of loss aversion in schizophrenia represents a deficit in the processing of emotional information during decision-making. It can be interpreted as a lack of integration between the emotional and the cognitive systems, or to a more diffuse and de-differentiated impact of emotional information on decision-making. Future studies should bring more clarity to this question.

  16. Red Assembly: the work remains

    Directory of Open Access Journals (Sweden)

    Leslie Witz

    installed. What to do at this limit, at the transgressive encounter between saying yes and no to history, remains the challenge. It is the very challenge of what insistently remains.

  17. Green business will remain green

    International Nuclear Information System (INIS)

    Marcan, P.

    2008-01-01

    It all started with two words. Climate change. The carbon dioxide trading scheme, which was the politicians' idea on solving the number one global problem, followed. Four years ago, when the project was begun, there was no data for project initiation. Quotas for polluters mainly from energy production and other energy demanding industries were distributed based on spreadsheets, maximum output and expected future development of economies. Slovak companies have had a chance to profit from these arrangements since 2005. Many of them took advantage of the situation and turned the excessive quotas into an extraordinary profit which often reached hundreds of million Sk. The fact that the price of free quotas offered for sale dropped basically to 0 in 2006 only proved that the initial distribution was too generous. And the market reacted to the first official measurements of emissions. Slovak companies also contributed to this development. However, when planning the maximum emission volumes for 2008-2012 period, in spite of the fact that actual data were available, their expectations were not realistic. A glance at the figures in the proposal of the Ministry of Environment is sufficient to realize that there will be no major change in the future. And so for many Slovak companies business with a green future will remain green for the next five years. The state decided to give to selected companies even more free space as far as emissions are concerned. The most privileged companies can expect quotas increased by tens of percent. (author)

  18. BACE1-Dependent Neuregulin-1 Signaling: An Implication for Schizophrenia

    Directory of Open Access Journals (Sweden)

    Zhengrong Zhang

    2017-09-01

    Full Text Available Schizophrenia is a chronic psychiatric disorder with a lifetime prevalence of about 1% in the general population. Recent studies have shown that Neuregulin-1 (Nrg1 is a candidate gene for schizophrenia. At least 15 alternative splicing of NRG1 isoforms all contain an extracellular epidermal growth factor (EGF-like domain, which is sufficient for Nrg1 biological activity including the formation of myelin sheaths and the regulation of synaptic plasticity. It is known that Nrg1 can be cleaved by β-secretase (BACE1 and the resulting N-terminal fragment (Nrg1-ntf binds to receptor tyrosine kinase ErbB4, which activates Nrg1/ErbB4 signaling. While changes in Nrg1 expression levels in schizophrenia still remain controversial, understanding the BACE1-cleaved Nrg1-ntf and Nrg1/ErbB4 signaling in schizophrenia neuropathogenesis is essential and important. In this review paper, we included three major parts: (1 Nrg1 structure and cleavage pattern by BACE1; (2 BACE1-dependent Nrg1 cleavage associated with schizophrenia in human studies; and (3 Animal studies of Nrg1 and BACE1 mutations with behavioral observations. Our review will provide a better understanding of Nrg1 in schizophrenia and a potential strategy for using BACE1 cleavage of Nrg1 as a unique biomarker for diagnosis, as well as a new therapeutic target, of schizophrenia.

  19. Korean sibling caregivers of individuals diagnosed with schizophrenia

    Directory of Open Access Journals (Sweden)

    Mijung Park

    2017-12-01

    Full Text Available Siblings of individuals diagnosed with schizophrenia are an important source of family caregiving. Unfortunately, limited information is available about sibling caregivers because existing studies have focused on other family relationships such as parents, spouses, and children. To fill the knowledge gap, the purpose of this study is to describe Korean sibling caregivers’ experience with individuals diagnosed with schizophrenia. Guided by Colaizzi’s descriptive phenomenological methodology, we conducted in-depth, semi-structured, face-to-face interviews with eight individuals who have a sibling (1 diagnosed with schizophrenia and (2 hospitalized in an inpatient psychiatric unit. We discerned six key themes: sorrow, burnout, shame, different perspectives in life, acceptance, and responsibility. We categorized these themes into three groups: suffering, hope, and responsibility and obligation. Sibling caregivers of individuals with schizophrenia experience a mixture of several emotions. Participants loved their brother or sister with schizophrenia, but at the same time they felt shame and fear. While they were burdened by the responsibilities of caregiving, they remained loyal to their sibling with schizophrenia, continuing to help their siblings reach their full potential. Although participants were confused about the symptoms of schizophrenia, they were committed to learning more about the illness. Because we conducted the current study in Korea, the findings of this study may be unique to Korea culture. Further studies are needed to compare and contrast nuanced differences in sibling caregivers’ experience among different cultural groups.

  20. An investigation into the drivers of avolition in schizophrenia.

    Science.gov (United States)

    Suri, Gaurav; Lavaysse, Lindsey M; Young, Gerald; Moodie, Craig; Tersakyan, Alen; Gross, James J; Gard, David E

    2018-03-01

    Over a century of research has documented that avolition is a core symptom in schizophrenia. However, the drivers of avolition remain unclear. Conceptually, there are at least two potential mutually compatible drivers that could cause avolition in schizophrenia. First, people with schizophrenia might have differences in preferences that result in less goal-directed behavior than non-clinical populations (preference-differences). Second, people with schizophrenia might have difficulty translating their preferences into manifest behavior at rates similar to non-clinical populations (psychological-inertia). In the present work, we modified and validated a well-validated paradigm from the motivation/decision making literature to compare levels of preference-differences and psychological-inertia. To measure preference-differences, people with and without schizophrenia choose between a lower-valenced and higher-valenced image. We measured the rate at which the normatively lower-valenced image was preferred. To measure psychological-inertia, both groups were given the opportunity to volitionally switch from a lower-valenced image and view a higher-valenced image. Contrary to expectations, people with schizophrenia did not differ on either preference-differences or psychological-inertia. Statistical analysis revealed that the possibility of a Type II error for even a weak effect was small. The present data suggest new avenues for research investigating mechanisms underlying avolition and clinical interventions targeting avolition in schizophrenia. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Silicon photonics: some remaining challenges

    Science.gov (United States)

    Reed, G. T.; Topley, R.; Khokhar, A. Z.; Thompson, D. J.; Stanković, S.; Reynolds, S.; Chen, X.; Soper, N.; Mitchell, C. J.; Hu, Y.; Shen, L.; Martinez-Jimenez, G.; Healy, N.; Mailis, S.; Peacock, A. C.; Nedeljkovic, M.; Gardes, F. Y.; Soler Penades, J.; Alonso-Ramos, C.; Ortega-Monux, A.; Wanguemert-Perez, G.; Molina-Fernandez, I.; Cheben, P.; Mashanovich, G. Z.

    2016-03-01

    This paper discusses some of the remaining challenges for silicon photonics, and how we at Southampton University have approached some of them. Despite phenomenal advances in the field of Silicon Photonics, there are a number of areas that still require development. For short to medium reach applications, there is a need to improve the power consumption of photonic circuits such that inter-chip, and perhaps intra-chip applications are viable. This means that yet smaller devices are required as well as thermally stable devices, and multiple wavelength channels. In turn this demands smaller, more efficient modulators, athermal circuits, and improved wavelength division multiplexers. The debate continues as to whether on-chip lasers are necessary for all applications, but an efficient low cost laser would benefit many applications. Multi-layer photonics offers the possibility of increasing the complexity and effectiveness of a given area of chip real estate, but it is a demanding challenge. Low cost packaging (in particular, passive alignment of fibre to waveguide), and effective wafer scale testing strategies, are also essential for mass market applications. Whilst solutions to these challenges would enhance most applications, a derivative technology is emerging, that of Mid Infra-Red (MIR) silicon photonics. This field will build on existing developments, but will require key enhancements to facilitate functionality at longer wavelengths. In common with mainstream silicon photonics, significant developments have been made, but there is still much left to do. Here we summarise some of our recent work towards wafer scale testing, passive alignment, multiplexing, and MIR silicon photonics technology.

  2. [Schizophrenia: neurodevelopmental disorder or degenerative brain process?].

    Science.gov (United States)

    Gross, G; Huber, G

    2008-05-01

    In the last two decades schizophrenia is viewed increasingly as a neurodevelopmental (ND) disorder; as indicators are discussed f.e. premorbid personality, behaviour anomalies, premorbid somatic signs, deviations shown by brain imaging methods, neuropathological findings or neuropsychological deficits. Premorbid personality and behaviour anomalies have to be distinguished from precursor syndromes (prodromes and outpost syndromes), preceding the first psychotic episode many years. Moreover, only a minority of patients, later developing schizophrenia, reveal abnormal premorbid personality traits. Explanations why clinical expression of the disorder is delayed until adult life or at least adolescence, remain speculative. Findings of neocortical and limbic maldevelopment, e.g. in parahippocampal cortex, are hitherto not yet conclusive. As an argument for the ND hypothesis is claimed that ventricular enlargement already is present at the onset of positive symptoms and does not progress on follow-ups. But, if a ND disorder would have caused the ventricular enlargement, cranial volume and head size must be decreased, what is not the case in schizophrenia. Furtheron, there are findings of progressive increase in ventricular size and also of gliosis, especially in subcortical and periventricular areas. Anomalies of cerebral asymmetry; also distinct ND brain anomalies such as cavum septi pellucidi or dysgenesis of corpus callosum do not occur more frequently than expected in schizophrenia. As to the rate of obstetric complications (OCs) and viral infections sufficiently reliable data are missing; the great majority of schizophrenics have no OCs. Altogether, attempts to correlate brain findings, regarded as expression of an aberrant brain development with clinical subgroups of schizophrenia, were not very successful. This is also valid for ND concepts confined to male, early onset or sporadic schizophrenias. Only a distinct psychopathological remission type with the component

  3. Relationship between insight and theory of mind in schizophrenia: A meta-analysis.

    Science.gov (United States)

    Bora, Emre

    2017-12-01

    Poor insight in schizophrenia has been associated with executive dysfunction and deficits in general cognitive ability. The overall outcome of available neurocognitive studies suggests that there is a significant but modest relationship between cognitive deficits and poor insight in schizophrenia. However, social cognitive abilities, particularly, theory of mind (ToM), might also play a role in poor insight in schizophrenia. A novel meta-analysis of the relationship between ToM and insight in schizophrenia was conducted. Current meta-analysis included 16 studies including 1085 patients with schizophrenia-spectrum disorders. There was a significant association between ToM and clinical insight (r=0.28, CI=0.20-0.36). By contrast, there was no significant relationship between ToM and cognitive insight. Current findings suggest that there is a small but significant relationship between ToM and clinical insight in schizophrenia. ToM impairment is one of the factors contributing to poor insight in schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Neurodevelopmental correlates in schizophrenia

    Directory of Open Access Journals (Sweden)

    Ivković Maja

    2003-01-01

    Full Text Available Contemporary aetiopathogenetic considerations, based on neuro-imaging genetic and developmental neurobiology studies, suggest neurodevelopmental origin of schizophrenia. Several lines of evidence including structural abnormalities on in vivo brain imaging, the excess of prenatal and obstetric complications and the association of congenital and minor physical anomalies with schizophrenia, strongly indicate the neurodevelopmental pathogenesis of schizophrenia. On the other hand, controversial concept of psychotic continuum suggests schizophrenia and depression sharing the same genetic contribution to the pathogenesis. If this would be the case, depression could also be considered as neuro developmental disorder. The aims of the study were to investigate the association between: a pregnancy and birth complications (PBC, and b minor physical anomalies (MPA and schizophrenia or depression. Experimental groups consisted of 60 schizophrenic, 28 major depression patients and 30 healthy controls. All patients were diagnosed according to DSM-IV. Schizophrenic group was divided with regard to PANSS score into positive (n=32 and negative form (n=28 subgroups. PBC information were gathered from maternal recall while MPA were examined by using Waldrop scale for adults. The results showed that negative and positive schizophrenic subgroups had significantly more PBC than depressive group (p<0,05, as well than controls (p<0,001; p<0,05; respectively. There was no significant trend for more PBC in negative than in positive subgroup. All schizophrenic patients had higher rates of MPA than depressives (p<0,05. This trend for more MPA was not significant in comparison with healthy controls. These findings suggest that schizophrenia, especially its negative forms, could be considered as a member of the spectrum of neuro developmental disorders, which does not seem to be the case with depression. PBC and MPA could also be valuable in evaluation of risks for

  5. Fetal programming of schizophrenia: select mechanisms.

    Science.gov (United States)

    Debnath, Monojit; Venkatasubramanian, Ganesan; Berk, Michael

    2015-02-01

    Mounting evidence indicates that schizophrenia is associated with adverse intrauterine experiences. An adverse or suboptimal fetal environment can cause irreversible changes in brain that can subsequently exert long-lasting effects through resetting a diverse array of biological systems including endocrine, immune and nervous. It is evident from animal and imaging studies that subtle variations in the intrauterine environment can cause recognizable differences in brain structure and cognitive functions in the offspring. A wide variety of environmental factors may play a role in precipitating the emergent developmental dysregulation and the consequent evolution of psychiatric traits in early adulthood by inducing inflammatory, oxidative and nitrosative stress (IO&NS) pathways, mitochondrial dysfunction, apoptosis, and epigenetic dysregulation. However, the precise mechanisms behind such relationships and the specificity of the risk factors for schizophrenia remain exploratory. Considering the paucity of knowledge on fetal programming of schizophrenia, it is timely to consolidate the recent advances in the field and put forward an integrated overview of the mechanisms associated with fetal origin of schizophrenia. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Predicting severity of paranoid schizophrenia

    OpenAIRE

    Kolesnichenko Elena Vladimirovna

    2015-01-01

    Clinical symptoms, course and outcomes of paranoid schizophrenia are polymorphic. 206 cases of paranoid schizophrenia were investigated. Clinical predictors were collected from hospital records and interviews. Quantitative assessment of the severity of schizophrenia as special indexes was used. Schizoid, epileptoid, psychasthenic and conformal accentuation of personality in the premorbid, early onset of psychosis, paranoid and hallucinatory-paranoid variants of onset predicted more expressed ...

  7. Cognitive control components and speech symptoms in people with schizophrenia.

    Science.gov (United States)

    Becker, Theresa M; Cicero, David C; Cowan, Nelson; Kerns, John G

    2012-03-30

    Previous schizophrenia research suggests poor cognitive control is associated with schizophrenia speech symptoms. However, cognitive control is a broad construct. Two important cognitive control components are poor goal maintenance and poor verbal working memory storage. In the current research, people with schizophrenia (n=45) performed three cognitive tasks that varied in their goal maintenance and verbal working memory storage demands. Speech symptoms were assessed using clinical rating scales, ratings of disorganized speech from typed transcripts, and self-reported disorganization. Overall, alogia was associated with both goal maintenance and verbal working memory tasks. Objectively rated disorganized speech was associated with poor goal maintenance and with a task that included both goal maintenance and verbal working memory storage demands. In contrast, self-reported disorganization was unrelated to either amount of objectively rated disorganized speech or to cognitive control task performance, instead being associated with negative mood symptoms. Overall, our results suggest that alogia is associated with both poor goal maintenance and poor verbal working memory storage and that disorganized speech is associated with poor goal maintenance. In addition, patients' own assessment of their disorganization is related to negative mood, but perhaps not to objective disorganized speech or to cognitive control task performance. Published by Elsevier Ireland Ltd.

  8. Treating schizophrenia during menopause.

    Science.gov (United States)

    Brzezinski, Amnon; Brzezinski-Sinai, Noa A; Seeman, Mary V

    2017-05-01

    The aim of this review is to examine three questions: What are the risks and benefits of treating women with schizophrenia with hormone therapy (HT) at menopause? Should the antipsychotic regimen be changed at menopause? Do early- and late-onset women with schizophrenia respond differently to HT at menopause? MEDLINE databases for the years 1990 to 2016 were searched using the following interactive terms: schizophrenia, gender, menopause, estrogen, and hormones. The selected articles (62 out of 800 abstracts) were chosen on the basis of their applicability to the objectives of this targeted narrative review. HT during the perimenopause in women with schizophrenia ameliorates psychotic and cognitive symptoms, and may also help affective symptoms. Vasomotor, genitourinary, and sleep symptoms are also reduced. Depending on the woman's age and personal risk factors and antipsychotic side effects, the risk of breast cancer and cardiovascular disease may be increased. Antipsychotic types and doses may need to be adjusted at menopause, as may be the mode of administration. Both HT and changes in antipsychotic management should be considered for women with schizophrenia at menopause. The question about differences in response between early- and late-onset women cannot yet be answered.

  9. The neuroproteomics of schizophrenia.

    LENUS (Irish Health Repository)

    English, Jane A

    2011-01-15

    Proteomics is the study of global gene expression of an organ, body system, fluid, or cellular compartment at the protein level. Proteomic findings are reflective of complex gene × environment interactions, and the importance of this is increasingly appreciated in schizophrenia research. In this review, we outline the main proteomic methods available to researchers in this area and summarize, for the first time, the findings of the main quantitative neuroproteomic investigations of schizophrenia brain. Our review of these data revealed 16 gray matter proteins, and eight white matter proteins that were differentially expressed in the same direction in two or more investigations. Pathway analysis identified cellular assembly and organization as particularly disrupted in both gray and white matter, whereas the glycolysis-gluconeogenesis pathway was the major signaling pathway significantly altered in both. Reassuringly, these findings show remarkable convergence with functional pathways and positional candidate genes implicated from genomic studies. The specificity of schizophrenia proteomic findings are also addressed in the context of neuroproteomic investigations of neurodegenerative disorders and bipolar disorder. Finally, we discuss the major challenges in the field of neuroproteomics, such as the need for high throughput validation methods and optimal sample preparation. Future directions in the neuroproteomics of schizophrenia, including the use of blood-based biomarker work, the need to focus on subproteomes, and the increasing use of mass spectrometry-based methods are all discussed. This area of research is still in its infancy and offers huge potential to our understanding of schizophrenia on a cellular level.

  10. Autism and Schizophrenia in High Functioning Adults: Behavioral Differences and Overlap

    Science.gov (United States)

    Spek, Annelies A.; Wouters, Saskia G. M.

    2010-01-01

    Several recent studies have demonstrated a genetical overlap between autism and schizophrenia. However, at a behavioral level it remains unclear which features can validly distinguish adults with autism from an adult schizophrenia group. To this end, the present study compared 21 individuals with the autistic disorder and 21 individuals with…

  11. Autism and Schizophrenia in high functioning adults: Behavioral differences and overlap

    NARCIS (Netherlands)

    Spek, Annelies A; Wouters, Saskia G.M.

    2011-01-01

    Several recent studies have demonstrated a genetical overlap between autism and schizophrenia. However, at a behavioral level it remains unclear which features can validly distinguish adults with autism from an adult schizophrenia group. To this end, the present study compared 21 individuals with

  12. Delineating psychomotor slowing from reduced processing speed in schizophrenia

    NARCIS (Netherlands)

    Morrens, M.; Hulstijn, W.; Matton, C.; Madani, Y.; Bouwel, L. van; Peuskens, J.; Sabbe, B.G.C.

    2008-01-01

    Introduction. Psychomotor slowing is an intrinsic feature of schizophrenia that is poorly delineated from generally reduced processing speed. Although the Symbol Digit Substitution Test (SDST) is widely used to assess psychomotor speed, the task also taps several higher-order cognitive processes.

  13. Outcome of first-episode schizophrenia and the new antipsychotics

    African Journals Online (AJOL)

    associated w~h poor outcome ard predictors of relapse, and the use ... Although a muttitude of clinical trials has been conducted, no ... negative symptoms and side-effects, are alienated from society ... development of chronic or secondary symptoms are .... psychotropic drugs on negative symptoms in schizophrenia. J Clin.

  14. Development and preliminary testing of the Schizophrenia Hope Scale, a brief scale to measure hope in people with schizophrenia.

    Science.gov (United States)

    Choe, Kwisoon

    2014-06-01

    Hope has received attention as a central component of recovery from mental illness; however, most instruments measuring hope were developed outside the mental health field. To measure the effects of mental health programs on hope in people with schizophrenia, a specialized scale is needed. This study examined the psychometric properties of the newly developed 9-item Schizophrenia Hope Scale (SHS-9) designed to measure hope in individuals with schizophrenia. A descriptive survey design. Participants were recruited from three psychiatric hospitals and two community mental health centers in South Korea. A total of 347 individuals over age 18 with a DSM-IV diagnosis of schizophrenia, schizoaffective, or schizophrenia spectrum disorders (competent to provide written informed consent) participated in this study; 149 (94 men, 55 women) completed a preliminary scale consisting of 40 revised items, and 198 (110 men, 88 women) completed the second scale of 17 items. Scale items were first selected from extensive literature reviews and a qualitative study on hope in people with schizophrenia; the validity and reliability of a preliminary scale was then evaluated by an expert panel and exploratory factor analysis. The remaining 9 items forming the Schizophrenia Hope Scale (SHS-9) were evaluated through confirmatory factor analysis. The SHS-9 demonstrates promising psychometric integrity. The internal consistency alpha coefficient was 0.92 with a score range of 0-18 and a mean total score of 12.06 (SD=4.96), with higher scores indicating higher levels of hope. Convergent validity was established by correlating the SHS-9 to the State-Trait Hope Inventory, r=0.61 (phope accounting for 61.77% of the total item variance. As hope has been shown to facilitate recovery from mental illness, the accurate assessment of hope provided by the short, easy-to-use Schizophrenia Hope Scale (SHS-9) may aid clinicians in improving the quality of life of individuals with schizophrenia. Copyright

  15. Quality of Care and Outcomes of Heart Failure Among Patients With Schizophrenia in Denmark

    DEFF Research Database (Denmark)

    Jorgensen, Mette; Mainz, Jan; Egstrup, Kenneth

    2017-01-01

    care among patients with schizophrenia included patient-specific factors (age, gender, Global Assessment of Functioning [GAF] score, alcohol or drug abuse, duration of schizophrenia); provider-specific factors (quality of schizophrenia care); and system-specific factors (patient-volume defined......Research on the association between schizophrenia and the quality of care and clinical outcomes of heart failure (HF) remains sparse. This nationwide study compared the quality of care and clinical outcomes of HF among Danish patients with and without schizophrenia. In a population-based cohort...... study, we identified 36,718 patients with incident HF with hospital contacts, including 108 with schizophrenia, using Danish registries between 2004 and 2013. High quality of HF care was defined as receiving ≥ 80% guideline-recommended process-performance measures of care. Potential predictors of HF...

  16. An Overview of Diabetes Management in Schizophrenia Patients: Office Based Strategies for Primary Care Practitioners and Endocrinologists

    Science.gov (United States)

    Annamalai, Aniyizhai; Tek, Cenk

    2015-01-01

    Diabetes is common and seen in one in five patients with schizophrenia. It is more prevalent than in the general population and contributes to the increased morbidity and shortened lifespan seen in this population. However, screening and treatment for diabetes and other metabolic conditions remain poor for these patients. Multiple factors including genetic risk, neurobiologic mechanisms, psychotropic medications, and environmental factors contribute to the increased prevalence of diabetes. Primary care physicians should be aware of adverse effects of psychotropic medications that can cause or exacerbate diabetes and its complications. Management of diabetes requires physicians to tailor treatment recommendations to address special needs of this population. In addition to behavioral interventions, medications such as metformin have shown promise in attenuating weight loss and preventing hyperglycemia in those patients being treated with antipsychotic medications. Targeted diabetes prevention and treatment is critical in patients with schizophrenia and evidence-based interventions should be considered early in the course of treatment. This paper reviews the prevalence, etiology, and treatment of diabetes in schizophrenia and outlines office based interventions for physicians treating this vulnerable population. PMID:25878665

  17. An Overview of Diabetes Management in Schizophrenia Patients: Office Based Strategies for Primary Care Practitioners and Endocrinologists

    Directory of Open Access Journals (Sweden)

    Aniyizhai Annamalai

    2015-01-01

    Full Text Available Diabetes is common and seen in one in five patients with schizophrenia. It is more prevalent than in the general population and contributes to the increased morbidity and shortened lifespan seen in this population. However, screening and treatment for diabetes and other metabolic conditions remain poor for these patients. Multiple factors including genetic risk, neurobiologic mechanisms, psychotropic medications, and environmental factors contribute to the increased prevalence of diabetes. Primary care physicians should be aware of adverse effects of psychotropic medications that can cause or exacerbate diabetes and its complications. Management of diabetes requires physicians to tailor treatment recommendations to address special needs of this population. In addition to behavioral interventions, medications such as metformin have shown promise in attenuating weight loss and preventing hyperglycemia in those patients being treated with antipsychotic medications. Targeted diabetes prevention and treatment is critical in patients with schizophrenia and evidence-based interventions should be considered early in the course of treatment. This paper reviews the prevalence, etiology, and treatment of diabetes in schizophrenia and outlines office based interventions for physicians treating this vulnerable population.

  18. The When and Where of Working Memory Dysfunction in Early-Onset Schizophrenia-A Functional Magnetic Resonance Imaging Study.

    Science.gov (United States)

    Bittner, Robert A; Linden, David E J; Roebroeck, Alard; Härtling, Fabian; Rotarska-Jagiela, Anna; Maurer, Konrad; Goebel, Rainer; Singer, Wolf; Haenschel, Corinna

    2015-09-01

    Behavioral evidence indicates that working memory (WM) in schizophrenia is already impaired at the encoding stage. However, the neurophysiological basis of this primary deficit remains poorly understood. Using event-related fMRI, we assessed differences in brain activation and functional connectivity during the encoding, maintenance and retrieval stages of a visual WM task with 3 levels of memory load in 17 adolescents with early-onset schizophrenia (EOS) and 17 matched controls. The amount of information patients could store in WM was reduced at all memory load levels. During encoding, activation in left ventrolateral prefrontal cortex (VLPFC) and extrastriate visual cortex, which in controls positively correlated with the amount of stored information, was reduced in patients. Additionally, patients showed disturbed functional connectivity between prefrontal and visual areas. During retrieval, right inferior VLPFC hyperactivation was correlated with hypoactivation of left VLPFC in patients during encoding. Visual WM encoding is disturbed by a failure to adequately engage a visual-prefrontal network critical for the transfer of perceptual information into WM. Prefrontal hyperactivation appears to be a secondary consequence of this primary deficit. Isolating the component processes of WM can lead to more specific neurophysiological markers for translational efforts seeking to improve the treatment of cognitive dysfunction in schizophrenia. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Alterações cognitivas na esquizofrenia: atualização Cognitive impairment in schizophrenia: an update

    Directory of Open Access Journals (Sweden)

    Breno de Castro Ferreira Junior

    2010-01-01

    Full Text Available As alterações cognitivas são características centrais na esquizofrenia. Elas permanecem relativamente estáveis durante todo o curso da doença, não sendo secundárias a outros sintomas ou a efeitos colaterais de psicofármacos. Estão diretamente ligadas a prejuízo funcional e a pior qualidade de vida dos pacientes. Diversos estudos vêm sendo realizados no sentido de caracterizar as principais alterações cognitivas na esquizofrenia, identificar suas bases neurobiológicas e padronizar instrumentos de pesquisa, fundamentais para o advento de novos alvos para intervenções farmacológicas na esquizofrenia. O objetivo deste trabalho foi fazer uma atualização sobre o assunto.Cognitive dysfunctions are among the core features of schizophrenia. They remain relatively stable throughout the course of the disease, and are secondary neither to other symptoms nor to side effects of psychotropic drugs. Cognitive deficits are directly associated with functional impairment and poor quality of life. Many studies have been conducted to describe the main cognitive abnormalities observed in schizophrenia, to identify their neurobiological bases, and to standardize research instruments, which are of paramount importance for the identification of new targets for pharmacological interventions in schizophrenia. The main objective of this paper was to provide an updated review of the subject.

  20. Stigma, schizophrenia and the media: exploring changes in the reporting of schizophrenia in major U.S. newspapers.

    Science.gov (United States)

    Vahabzadeh, Arshya; Wittenauer, Justine; Carr, Erika

    2011-11-01

    Newspaper media are a major source of information about mental illness in the United States. Previous research has shown that some printed material has been both negative and stigmatizing, which can have a detrimental impact on individuals with mental illnesses. Such perceptions represented in the media may cause those with mental illnesses to internalize a negative and stigmatizing stereotype and hinder the public's understanding of mental illness. In recent years, advocacy groups have increased their efforts to combat stigmatization of those with mental illnesses. This study focused specifically on the use of stigmatizing language concerning schizophrenia in U.S. newspapers. Because advocacy to decrease stigmatization of mental illness has increased in recent years, this study compared media depictions of schizophrenia in 2000 and 2010 to determine if there had been a reduction in reporting of dangerousness and perpetration of crime by people with schizophrenia or in stigmatizing language. All articles published in five high-circulation newspapers from diverse urban geographical regions between January 1 and June 1 in 2000 and 2010 that contained the words "schizophrenia" or "schizophrenic" were reviewed. Articles were categorized under the categories of education, incidental reference, medical and pharmaceutical news, metaphorical use, charity, obituary, medically inappropriate, and human interest. Human interest articles were further subcategorized into advocacy, crimes committed by people with schizophrenia, crimes committed against those suffering from schizophrenia, and issues related to poor mental health care. There was a statistically significant decrease in reporting of crime committed by people with schizophrenia in 2010 compared with 2000. However, no significant difference was found in metaphorical usage of the terms schizophrenia and schizophrenic between 2000 and 2010.

  1. Schizophrenia and smoking: impact on negative symptoms

    Directory of Open Access Journals (Sweden)

    Miriam Saliba

    2017-06-01

    Full Text Available Introduction: it has been hypothesized that individuals with schizophrenia use nicotine to reduce negative symptoms and improve cognitive function. There is an inconsistency in the literature suggesting that nicotine could help decrease negative symptoms in schizophrenic patients. Objective: to investigate the effects of nicotine on the expression of the negative symptoms in smokers and non-smokers with schizophrenia. Methods: a cross sectional study, conducted between April and August 2016, 100 inpatients with schizophrenia (54 smokers and 46 non-smokers diagnosed according to DSM-V, at Psychiatric Hospital of the Cross Lebanon, were compared to changes in clinical parameters using CDSS, PANSS, and nicotine dependence using FTND. The Student’s t-test was used to compare between 2 groups, while the ANOVA test was used to compare between 3 or more groups. For categorical variables, the chi-2 test was used. Results: the mean age was 47.16 years (SD = 7.14 for smokers compared to 47.02 years (SD = 7.92 for non-smokers. 64.8% of smokers were males versus 45.7% of non-smokers. Smoking (high nicotine dependence significantly decreases the PANSS negative symptoms score between the 2 groups (p .05 for both variables. Discussion and conclusion: this study is the first to investigate the relationship between the expression of negative symptoms in individuals with schizophrenia and smoking in Lebanon. Cigarette smoking rates remain remarkably high in patients with schizophrenia. Smoking is a complex process which involves psychopathological, biochemical and neuropharmacological aspects among schizophrenic patients. Further studies are needed to acknowledge these findings and the reasons behind it.

  2. "We're Not Just Sitting on the Periphery": A Staff Perspective of Physical Activity in Older Adults with Schizophrenia

    Science.gov (United States)

    Leutwyler, Heather; Hubbard, Erin M.; Jeste, Dilip V.; Vinogradov, Sophia

    2013-01-01

    Targeted physical activity interventions to improve the poor physical function of older adults with schizophrenia are necessary but currently not available. Given disordered thought processes and institutionalization, it is likely that older adults with schizophrenia have unique barriers and facilitators to physical activity. It is necessary to…

  3. Low dietary intake of n-3 fatty acids, niacin, folate, and vitamin C in Korean patients with schizophrenia and the development of dietary guidelines for schizophrenia.

    Science.gov (United States)

    Kim, Eun Jin; Lim, So Young; Lee, Hee Jae; Lee, Ju-Yeon; Choi, Seunggi; Kim, Seon-Young; Kim, Jae-Min; Shin, Il-Seon; Yoon, Jin-Sang; Yang, Soo Jin; Kim, Sung-Wan

    2017-09-01

    Inappropriate dietary intake and poor nutritional status are reported to be associated with metabolic syndrome and psychopathology in patients with schizophrenia. We hypothesized that inappropriate dietary habits and insufficient dietary intake of specific nutrients are associated with schizophrenia. To test the hypothesis, we assessed the dietary habits and nutritional intake of patients with schizophrenia and then developed suitable dietary guidelines. In total, 140 subjects (73 controls and 67 patients with schizophrenia from community mental health centers) were included, and dietary intakes were analyzed using a semi-quantitative food frequency questionnaire. As a result, the proportion of overweight or obese patients was significantly higher in schizophrenia subjects (64.2%) compared with control subjects (39.7%) (P=.004). The male schizophrenia patients had significantly lower dietary intakes of protein, polyunsaturated fatty acids (PUFAs), vitamin K, niacin, folate, and vitamin C than the male control subjects. In all multiple logistic regression models, subjects with the "low" dietary intake of protein, n-3 PUFAs, niacin, folate, and vitamin C had a significantly higher odds ratios for schizophrenia compared with those with the "high" dietary intake category of each nutrient. Therefore, maintenance of a healthy body weight and sufficient dietary intake of protein, PUFAs, niacin, folate, and vitamin C are recommended for Korean patients with schizophrenia. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment.

    Science.gov (United States)

    Ganguly, Pronab; Soliman, Abdrabo; Moustafa, Ahmed A

    2018-01-01

    Individuals with schizophrenia lead a poor quality of life, due to poor medical attention, homelessness, unemployment, financial constraints, lack of education, and poor social skills. Thus, a review of factors associated with the holistic management of schizophrenia is of paramount importance. The objective of this review is to improve the quality of life of individuals with schizophrenia, by addressing the factors related to the needs of the patients and present them in a unified manner. Although medications play a role, other factors that lead to a successful holistic management of schizophrenia include addressing the following: financial management, independent community living, independent living skill, relationship, friendship, entertainment, regular exercise for weight gained due to medication administration, co-morbid health issues, and day-care programmes for independent living. This review discusses the relationship between different symptoms and problems individuals with schizophrenia face (e.g., homelessness and unemployment), and how these can be managed using pharmacological and non-pharmacological methods. Thus, the target of this review is the carers of individuals with schizophrenia, public health managers, counselors, case workers, psychiatrists, and clinical psychologists aiming to enhance the quality of life of individuals with schizophrenia.

  5. Social cognition and neurocognitive deficits in first-episode schizophrenia

    DEFF Research Database (Denmark)

    Bliksted, Vibeke Fuglsang; Fagerlund, Birgitte; Weed, Ethan

    2014-01-01

    BACKGROUND: Recent research has shown a significant impact of social cognitive domains on real world functioning and prognosis in schizophrenia. However, the correlations between specific aspects of social cognition, neurocognition, IQ and clinical symptoms remain unclear in first-episode schizop...... are comparable to the implicit and explicit mentalising discussed in the developmental literature. The two forms of social cognitive deficits are likely to require quite different social cognitive interventions.......BACKGROUND: Recent research has shown a significant impact of social cognitive domains on real world functioning and prognosis in schizophrenia. However, the correlations between specific aspects of social cognition, neurocognition, IQ and clinical symptoms remain unclear in first...

  6. Eating Disorders in Schizophrenia: Implications for Research and Management

    OpenAIRE

    Kouidrat, Youssef; Amad, Ali; Lalau, Jean-Daniel; Loas, Gwenole

    2014-01-01

    Objective. Despite evidence from case series, the comorbidity of eating disorders (EDs) with schizophrenia is poorly understood. This review aimed to assess the epidemiological and clinical characteristics of EDs in schizophrenia patients and to examine whether the management of EDs can be improved. Methods. A qualitative review of the published literature was performed using the following terms: “schizophrenia” in association with “eating disorders,” “anorexia nervosa,” “bulimia nervosa,” “b...

  7. Does hypertension remain after kidney transplantation?

    Directory of Open Access Journals (Sweden)

    Gholamreza Pourmand

    2015-05-01

    Full Text Available Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61% patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8% the cause of end-stage renal disease (ESRD was unknown followed by HTN (26.3%. A total of 166 (41.5% patients had been hypertensive before transplantation and 234 (58.5% had normal blood pressure. Among these 234 individuals, 94 (40.2% developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8% remained hypertensive after transplantation. Totally 180 (45% patients had post-transplantation HTN and 220 patients (55% didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

  8. Disruption of structure–function coupling in the schizophrenia connectome

    Directory of Open Access Journals (Sweden)

    Luca Cocchi

    2014-01-01

    Full Text Available Neuroimaging studies have demonstrated that the phenomenology of schizophrenia maps onto diffuse alterations in large-scale functional and structural brain networks. However, the relationship between structural and functional deficits remains unclear. To answer this question, patients with established schizophrenia and matched healthy controls underwent resting-state functional and diffusion weighted imaging. The network-based statistic was used to characterize between-group differences in whole-brain functional connectivity. Indices of white matter integrity were then estimated to assess the structural correlates of the functional alterations observed in patients. Finally, group differences in the relationship between indices of functional and structural brain connectivity were determined. Compared to controls, patients with schizophrenia showed decreased functional connectivity and impaired white matter integrity in a distributed network encompassing frontal, temporal, thalamic, and striatal regions. In controls, strong interregional coupling in neural activity was associated with well-myelinated white matter pathways in this network. This correspondence between structure and function appeared to be absent in patients with schizophrenia. In two additional disrupted functional networks, encompassing parietal, occipital, and temporal cortices, the relationship between function and structure was not affected. Overall, results from this study highlight the importance of considering not only the separable impact of functional and structural connectivity deficits on the pathoaetiology of schizophrenia, but also the implications of the complex nature of their interaction. More specifically, our findings support the core nature of fronto-striatal, fronto-thalamic, and fronto-temporal abnormalities in the schizophrenia connectome.

  9. Brain neurodevelopmental markers related to the deficit subtype of schizophrenia.

    Science.gov (United States)

    Takahashi, Tsutomu; Takayanagi, Yoichiro; Nishikawa, Yumiko; Nakamura, Mihoko; Komori, Yuko; Furuichi, Atsushi; Kido, Mikio; Sasabayashi, Daiki; Noguchi, Kyo; Suzuki, Michio

    2017-08-30

    Deficit schizophrenia is a homogeneous subtype characterized by a trait-like feature of primary and prominent negative symptoms, but the etiologic factors related to this specific subtype remain largely unknown. This magnetic resonance imaging study aimed to examine gross brain morphology that probably reflects early neurodevelopment in 38 patients with deficit schizophrenia, 37 patients with non-deficit schizophrenia, and 59 healthy controls. Potential brain neurodevelopmental markers investigated in this study were the adhesio interthalamica (AI), cavum septi pellucidi (CSP), and surface morphology (i.e., olfactory sulcus depth, sulcogyral pattern, and number of orbital sulci) of the orbitofrontal cortex (OFC). The subtype classification of schizophrenia patients was based on the score of Proxy for the Deficit Syndrome. The deficit schizophrenia group had a significantly shorter AI compared with the non-deficit group and controls. The deficit group, but not the non-deficit group, was also characterized by an altered distribution of the OFC sulcogyral pattern, as well as fewer posterior orbital sulcus compared with controls. Other neurodevelopmental markers did not differentiate the deficit and non-deficit subgroups. These results suggest that the deficit subtype of schizophrenia and its clinical manifestation may be at least partly related to prominent neurodevelopmental pathology. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  10. Functioning in early and late stages of schizophrenia

    Directory of Open Access Journals (Sweden)

    Leonardo Gazzi Costa

    2014-12-01

    Full Text Available INTRODUCTION: Schizophrenia is frequently associated with a debilitating course and prominent impairment in social and occupational functioning. Although the criteria for classification into stages have not been defined in the literature, illness duration and functioning seem to be good candidates.OBJECTIVE:To compare functioning of patients with schizophrenia at different stages of the disease (early vs. late and healthy sex- and age-matched controls.METHODS: This double-blinded, case-controlled study included 79 individuals: 23 patients with schizophrenia diagnosed up to 5 years earlier; 19 patients with schizophrenia diagnosed at least 20 years earlier; and healthy matched controls. Diagnoses were established using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV Axis I Disorder. Functioning was assessed using the Functioning Assessment Short Test (FAST.RESULTS: Patients in the early stage had significantly higher scores than healthy controls in total FAST and in autonomy, occupational functioning, cognitive functioning and interpersonal relationships. Individuals in the late stage had significantly poorer functioning than controls in all domains. The comparison of functioning between the two groups of patients revealed no significant differences, except in occupational functioning, in which late stage patients had a poorer performance.CONCLUSION: Functioning impairment in schizophrenia tends to remain stable despite illness duration. Therefore, functioning should be effectively assessed at an early stage, as illness duration alone may not be the most reliable criterion to stage patients with schizophrenia.

  11. Intrinsic and Antipsychotic Drug-Induced Metabolic Dysfunction in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Zachary Freyberg

    2017-07-01

    Full Text Available For decades, there have been observations demonstrating significant metabolic disturbances in people with schizophrenia including clinically relevant weight gain, hypertension, and disturbances in glucose and lipid homeostasis. Many of these findings pre-date the use of antipsychotic drugs (APDs which on their own are also strongly associated with metabolic side effects. The combination of APD-induced metabolic changes and common adverse environmental factors associated with schizophrenia have made it difficult to determine the specific contributions of each to the overall metabolic picture. Data from drug-naïve patients, both from the pre-APD era and more recently, suggest that there may be an intrinsic metabolic risk associated with schizophrenia. Nevertheless, these findings remain controversial due to significant clinical variability in both psychiatric and metabolic symptoms throughout patients' disease courses. Here, we provide an extensive review of classic and more recent literature describing the metabolic phenotype associated with schizophrenia. We also suggest potential mechanistic links between signaling pathways associated with schizophrenia and metabolic dysfunction. We propose that, beyond its symptomatology in the central nervous system, schizophrenia is also characterized by pathophysiology in other organ systems directly related to metabolic control.

  12. Schizophrenia, Sleep and Acupuncture

    NARCIS (Netherlands)

    Bosch, M.P.C.; Noort, M.W.M.L. van den

    2008-01-01

    This book is an introduction for professionals in Western medicine and for acupuncturists on the use of acupuncture in treatment of schizophrenia and sleep disorders. Acupuncture has long been used in Traditional Chinese Medicine (TCM) in mental health and sleep disorders. This book aims to build a

  13. Depression in Kraepelinian schizophrenia

    African Journals Online (AJOL)

    related problems and poorer social and family relationships, show a lower level of ... Furthermore, suicide terminates the lives of an estimated 10 - 15% ... deterioration of functioning in social, work and self-care domains. .... quality of life in outpatients with schizophrenia spectrum disorders? ... Acta Psychiatr Scand 2002;.

  14. Neural chaos and schizophrenia

    Czech Academy of Sciences Publication Activity Database

    Bob, P.; Chládek, Jan; Šusta, M.; Glaslová, K.; Jagla, F.; Kukleta, M.

    2007-01-01

    Roč. 26, č. 4 (2007), s. 298-305 ISSN 0231-5882 Institutional research plan: CEZ:AV0Z20650511 Keywords : EDA * Lyapunov exponent * schizophrenia * chaos Subject RIV: FL - Psychiatry, Sexuology Impact factor: 1.286, year: 2007

  15. Glutamatergic System and Schizophrenia

    Directory of Open Access Journals (Sweden)

    Osman Ozdemir

    2016-12-01

    Full Text Available Glutamate is the major excitatory neurotransmitter in the brain. It has a role several cognitive functions including learning, memory and perception. Glutamatergic neurotransmission is also involved in regulating neuronal migration, synaptogenesis, and the pruning neurons. Glutamatergic exci-totoxicity has been implicated in various neuropsychiatric disorders. Accumulating evidence suggests that glutamatergic dysfunction may contribute to the pathogenesis of schizophrenia. The N-methyl-D-aspartic acid (NMDA receptor antagonists such as phencyclidine and ketamine can cause both the positive and negative symptoms psychotic symptoms in normal humans, and worsen these symptoms in persons with schizophrenia. Hence, it has been hypotesized that schizophrenia may be associated with decreased NMDA-receptor activity. According to the hypothesis, NMDA reseptor hypofunction can lead to decreased inhibition of glutamatergic neurons and excessive glutamate release. Finally, the reduction of gray matter in several brain regions seen in patients with schizophrenia has been suggested to be the result of neurotoxicity mediated by NMDA receptors. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(4.000: 394-405

  16. Social cognition in schizophrenia

    NARCIS (Netherlands)

    Maat, A.

    2014-01-01

    Schizophrenia is a chronic psychiatric disorder, incorporating a wide range of symptoms that may occur at certain stages of the disease. The core symptoms can largely be divided into positive symptoms, e.g. hallucinations and delusions, and negative symptoms, e.g. apathia and emotional flattening.

  17. Iconic decay in schizophrenia.

    Science.gov (United States)

    Hahn, Britta; Kappenman, Emily S; Robinson, Benjamin M; Fuller, Rebecca L; Luck, Steven J; Gold, James M

    2011-09-01

    Working memory impairment is considered a core deficit in schizophrenia, but the precise nature of this deficit has not been determined. Multiple lines of evidence implicate deficits at the encoding stage. During encoding, information is held in a precategorical sensory store termed iconic memory, a literal image of the stimulus with high capacity but rapid decay. Pathologically increased iconic decay could reduce the number of items that can be transferred into working memory before the information is lost and could thus contribute to the working memory deficit seen in the illness. The current study used a partial report procedure to test the hypothesis that patients with schizophrenia (n = 37) display faster iconic memory decay than matched healthy control participants (n = 28). Six letters, arranged in a circle, were presented for 50 ms. Following a variable delay of 0-1000 ms, a central arrow cue indicated the item to be reported. In both patients and control subjects, recall accuracy decreased with increasing cue delay, reflecting decay of the iconic representation of the stimulus array. Patients displayed impaired memory performance across all cue delays, consistent with an impairment in working memory, but the rate of iconic memory decay did not differ between patients and controls. This provides clear evidence against faster loss of iconic memory representations in schizophrenia, ruling out iconic decay as an underlying source of the working memory impairment in this population. Thus, iconic decay rate can be added to a growing list of unimpaired cognitive building blocks in schizophrenia.

  18. A dynamical systems hypothesis of schizophrenia.

    Directory of Open Access Journals (Sweden)

    Marco Loh

    2007-11-01

    Full Text Available We propose a top-down approach to the symptoms of schizophrenia based on a statistical dynamical framework. We show that a reduced depth in the basins of attraction of cortical attractor states destabilizes the activity at the network level due to the constant statistical fluctuations caused by the stochastic spiking of neurons. In integrate-and-fire network simulations, a decrease in the NMDA receptor conductances, which reduces the depth of the attractor basins, decreases the stability of short-term memory states and increases distractibility. The cognitive symptoms of schizophrenia such as distractibility, working memory deficits, or poor attention could be caused by this instability of attractor states in prefrontal cortical networks. Lower firing rates are also produced, and in the orbitofrontal and anterior cingulate cortex could account for the negative symptoms, including a reduction of emotions. Decreasing the GABA as well as the NMDA conductances produces not only switches between the attractor states, but also jumps from spontaneous activity into one of the attractors. We relate this to the positive symptoms of schizophrenia, including delusions, paranoia, and hallucinations, which may arise because the basins of attraction are shallow and there is instability in temporal lobe semantic memory networks, leading thoughts to move too freely round the attractor energy landscape.

  19. Moderating factors for the effectiveness of group art therapy for schizophrenia: secondary analysis of data from the MATISSE randomised controlled trial.

    Science.gov (United States)

    Leurent, Baptiste; Killaspy, Helen; Osborn, David P; Crawford, Mike J; Hoadley, Angela; Waller, Diane; King, Michael

    2014-11-01

    Although some studies suggest that art therapy may be useful in the treatment of negative symptoms of schizophrenia, a recent large trial of group art therapy found no clinical advantage over standard care, but the study population was heterogeneous and uptake of the intervention was poor. This study aimed to investigate whether art therapy was more effective for specific subgroups of patients. Secondary analysis of data from a randomised controlled trial of group art therapy as an adjunctive treatment for schizophrenia (n = 140) versus standard care alone (n = 137). Positive and Negative Syndrome Scale scores at 12 months were compared between trial arms. Interaction between intervention effect and different subgroups, including those with more severe negative symptoms of schizophrenia, and those who expressed a preference for art therapy prior to randomisation, was tested using a linear mixed model. The clinical effectiveness of group art therapy did not significantly differ between participants with more or less severe negative symptoms [interaction for difference in PANSS = 1.7, 95 % CI (-8.6 to 12.1), P = 0.741], or between those who did and did not express a preference for art therapy [interaction = 3.9, 95 % CI (-6.7 to 14.5), P = 0.473]. None of the other exploratory subgroups suggested differences in intervention effect. There was no evidence of greater improvement in clinical symptoms of schizophrenia for those with more severe negative symptoms or those with a preference for art therapy. Identification of patients with schizophrenia who may benefit most from group art therapy remains elusive.

  20. Molindone for schizophrenia and severe mental illness.

    Science.gov (United States)

    Bagnall, A; Fenton, M; Kleijnen, J; Lewis, R

    2007-01-24

    Antipsychotic therapy is the mainstay of treatment for people with schizophrenia. In recent years new or atypical antipsychotics have been introduced. These are less likely to produce movement disorders and raise serum prolactin. Researchers have suggested that molindone should be classified as an atypical antipsychotic. To determine the effects of molindone compared with placebo, typical and other atypical antipsychotic drugs for schizophrenia and related psychoses. For the original search we searched the following databases: Biological Abstracts (1980-1999), The Cochrane Library CENTRAL (Issue 1, 1999), The Cochrane Schizophrenia Group's Register (January 1999), CINAHL (1982-1999), EMBASE (1980-1999), MEDLINE (1966-1999), LILACS (1982-1999), PSYNDEX (1977-1999), and PsycLIT (1974-1999). We also searched pharmaceutical databases on the Dialog Corporation Datastar and Dialog and the references of all identified studies for further trials. Finally, we contacted the manufacturer of molindone and the authors of any relevant trials. For the update of this review, we searched The Cochrane Schizophrenia Group's Trials Register (August 2005). We included all randomised controlled trials that compared molindone to other treatments for schizophrenia and schizophrenia-like psychoses. We extracted data independently and analysed on an intention to treat basis calculating, for binary data, the fixed effect relative risk (RR), their 95% confidence intervals (CI), and the number needed to treat or harm (NNT or NNH). We excluded data if loss to follow up was greater than 50%. We included fourteen studies. Duration ranged from very short (10 days) studies of the intramuscular preparation, to trials lasting over three months. For measures of global assessment, available data do not justify any conclusions on the comparative efficacy of molindone and placebo. When compared to other typical antipsychotics we found no evidence of a difference in effectiveness (doctors' 4 RCTs n=150

  1. Association study between the Taq1A (rs1800497 polymorphism and schizophrenia in a Brazilian sample

    Directory of Open Access Journals (Sweden)

    Quirino Cordeiro

    2014-08-01

    Full Text Available Schizophrenia is a severe psychotic disorder with recurrent relapse and functional impairment. It results from a poorly understood gene-environment interaction. The Taq1A polymorphism (located in the gene cluster NTAD is a likely candidate for schizophrenia. Its rs1800497 polymorphism was shown to be associated with DRD2 gene expression. Therefore the present work aims to investigate a possible association between schizophrenia and such polymorphism. The compared distribution of the alleles and genotypes of the studied polymorphism was investigated in a Brazilian sample of 235 patients and 834 controls. Genotypic frequencies were in Hardy-Weinberg equilibrium. There was a trend of allelic association between the Taq1A polymorphism (rs1800497 with schizophrenia in the studied sample. However no statistically differences were found between cases and controls when analyzed by gender or schizophrenia subtypes.

  2. Schizophrenia and the immune system: pathophysiology, prevention, and treatment.

    Science.gov (United States)

    Richard, Michelle D; Brahm, Nancy C

    2012-05-01

    Published evidence on established and theoretical connections between immune system dysfunction and schizophrenia is reviewed, with a discussion of developments in the search for immunologically-targeted treatments. A growing body of evidence indicates that immunologic influences may play an important role in the etiology and course of schizophrenia. A literature search identified more than 100 articles pertaining to suspected immunologic influences on schizophrenia published over the past 15 years. Schizophrenia researchers have explored a wide range of potential immune system-related causal or contributory factors, including neurobiological and neuroanatomical disorders, genetic abnormalities, and environmental influences such as maternal perinatal infection. Efforts to establish an immunologic basis for schizophrenia and identify reliable immune markers continue to be hindered by sampling challenges and methodological problems. In aggregate, the available evidence indicates that at least some cases of schizophrenia have an immunologic component, suggesting that immune-focused prevention strategies (e.g., counseling of pregnant women to avoid immune stressors) and close monitoring of at-risk children are appropriate. While antipsychotics remain the standard treatments for schizophrenia, a variety of drugs with immunologic effects have been investigated as adjunctive therapies, with variable and sometimes conflicting results; these include the cyclooxygenase-2 inhibitor celecoxib, immune-modulating agents (e.g., azathioprine and various anticytokine agents such as atlizumab, anakinra, and tumor necrosis factor-α blockers), and an investigational anti-interferon-γ agent. The published evidence indicates that immune system dysfunction related to genetic, environmental, and neurobiological influences may play a role in the etiology of schizophrenia in a subset of patients.

  3. Characteristics of homicide offenders with Schizophrenia from the Russian Federation.

    Science.gov (United States)

    Golenkov, Andrei; Large, Matthew; Nielssen, Olav; Tsymbalova, Alla

    2011-12-01

    It has been suggested that the characteristics of homicides committed by people with schizophrenia from regions with a high total homicide rate differ from the characteristics of homicides by people with schizophrenia from regions with low rates of homicide. Homicide offenders in the Chuvash Republic of the Russian Federation have been systematically examined for over 30 years. This study reports on a review of the documents from pre-trial psychiatric assessments and legal proceedings of all people charged with homicide offenses between 1981 and 2010 who were found to have schizophrenia. There were 133 people (120 men, 13 women) with an ICD-10 diagnosis of schizophrenia who committed a homicide offense in the 30 years of the study, including 15 repeat homicide offenders and 9 homicides with multiple victims. The odds ratio (OR) for homicide associated with schizophrenia was 13.5, 95% confidence interval (CI) (11.4-16.0). The mean age of the offenders was 34.8 (SD 9.6) and most had the paranoid subtype of schizophrenia (78%). The majority of victims were family members (51%) or acquaintances (43%). Delusions of persecution, auditory hallucinations and other positive symptoms were present in 58% of offenders at the time of the homicide. The remaining 42% exhibited negative symptoms such as emotional deficits, had antisocial attitudes or were regarded as having impaired self-control. Alcohol intoxication was reported at the time of 45% of homicides. Stabbing was the most common method and few of the homicides involved firearms. The characteristics of homicide offenders with schizophrenia from Chuvashia do not appear to differ greatly from those of homicide offenders with schizophrenia from regions with far lower rates of homicide. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. The Human Remains from HMS Pandora

    Directory of Open Access Journals (Sweden)

    D.P. Steptoe

    2002-04-01

    Full Text Available In 1977 the wreck of HMS Pandora (the ship that was sent to re-capture the Bounty mutineers was discovered off the north coast of Queensland. Since 1983, the Queensland Museum Maritime Archaeology section has carried out systematic excavation of the wreck. During the years 1986 and 1995-1998, more than 200 human bone and bone fragments were recovered. Osteological investigation revealed that this material represented three males. Their ages were estimated at approximately 17 +/-2 years, 22 +/-3 years and 28 +/-4 years, with statures of 168 +/-4cm, 167 +/-4cm, and 166cm +/-3cm respectively. All three individuals were probably Caucasian, although precise determination of ethnicity was not possible. In addition to poor dental hygiene, signs of chronic diseases suggestive of rickets and syphilis were observed. Evidence of spina bifida was seen on one of the skeletons, as were other skeletal anomalies. Various taphonomic processes affecting the remains were also observed and described. Compact bone was observed under the scanning electron microscope and found to be structurally coherent. Profiles of the three skeletons were compared with historical information about the 35 men lost with the ship, but no precise identification could be made. The investigation did not reveal the cause of death. Further research, such as DNA analysis, is being carried out at the time of publication.

  5. Early and sustained dynamic intervention in schizophrenia

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Rosenbaum, Bent

    2009-01-01

    This paper is based on the Danish National Schizophrenia Project manual for psychodynamic individual psychotherapy with persons in states of schizophrenia. The methods for engaging with and treating a patient with schizophrenia in a supportive, psychodynamic way are described....

  6. The Schizophrenia-Associated BRD1 Gene Regulates Behavior, Neurotransmission, and Expression of Schizophrenia Risk Enriched Gene Sets in Mice.

    Science.gov (United States)

    Qvist, Per; Christensen, Jane Hvarregaard; Vardya, Irina; Rajkumar, Anto Praveen; Mørk, Arne; Paternoster, Veerle; Füchtbauer, Ernst-Martin; Pallesen, Jonatan; Fryland, Tue; Dyrvig, Mads; Hauberg, Mads Engel; Lundsberg, Birgitte; Fejgin, Kim; Nyegaard, Mette; Jensen, Kimmo; Nyengaard, Jens Randel; Mors, Ole; Didriksen, Michael; Børglum, Anders Dupont

    2017-07-01

    The schizophrenia-associated BRD1 gene encodes a transcriptional regulator whose comprehensive chromatin interactome is enriched with schizophrenia risk genes. However, the biology underlying the disease association of BRD1 remains speculative. This study assessed the transcriptional drive of a schizophrenia-associated BRD1 risk variant in vitro. Accordingly, to examine the effects of reduced Brd1 expression, we generated a genetically modified Brd1 +/- mouse and subjected it to behavioral, electrophysiological, molecular, and integrative genomic analyses with focus on schizophrenia-relevant parameters. Brd1 +/- mice displayed cerebral histone H3K14 hypoacetylation and a broad range of behavioral changes with translational relevance to schizophrenia. These behaviors were accompanied by striatal dopamine/serotonin abnormalities and cortical excitation-inhibition imbalances involving loss of parvalbumin immunoreactive interneurons. RNA-sequencing analyses of cortical and striatal micropunches from Brd1 +/- and wild-type mice revealed differential expression of genes enriched for schizophrenia risk, including several schizophrenia genome-wide association study risk genes (e.g., calcium channel subunits [Cacna1c and Cacnb2], cholinergic muscarinic receptor 4 [Chrm4)], dopamine receptor D 2 [Drd2], and transcription factor 4 [Tcf4]). Integrative analyses further found differentially expressed genes to cluster in functional networks and canonical pathways associated with mental illness and molecular signaling processes (e.g., glutamatergic, monoaminergic, calcium, cyclic adenosine monophosphate [cAMP], dopamine- and cAMP-regulated neuronal phosphoprotein 32 kDa [DARPP-32], and cAMP responsive element binding protein signaling [CREB]). Our study bridges the gap between genetic association and pathogenic effects and yields novel insights into the unfolding molecular changes in the brain of a new schizophrenia model that incorporates genetic risk at three levels: allelic

  7. Identifying gene-environment interactions in schizophrenia: contemporary challenges for integrated, large-scale investigations

    NARCIS (Netherlands)

    van Os, Jim; Rutten, Bart P.; Myin-Germeys, Inez; Delespaul, Philippe; Viechtbauer, Wolfgang; van Zelst, Catherine; Bruggeman, Richard; Reininghaus, Ulrich; Morgan, Craig; Murray, Robin M.; Di Forti, Marta; McGuire, Philip; Valmaggia, Lucia R.; Kempton, Matthew J.; Gayer-Anderson, Charlotte; Hubbard, Kathryn; Beards, Stephanie; Stilo, Simona A.; Onyejiaka, Adanna; Bourque, Francois; Modinos, Gemma; Tognin, Stefania; Calem, Maria; O'Donovan, Michael C.; Owen, Michael J.; Holmans, Peter; Williams, Nigel; Craddock, Nicholas; Richards, Alexander; Humphreys, Isla; Meyer-Lindenberg, Andreas; Leweke, F. Markus; Tost, Heike; Akdeniz, Ceren; Rohleder, Cathrin; Bumb, J. Malte; Schwarz, Emanuel; Alptekin, Köksal; Üçok, Alp; Saka, Meram Can; Atbaşoğlu, E. Cem; Gülöksüz, Sinan; Gumus-Akay, Guvem; Cihan, Burçin; Karadağ, Hasan; Soygür, Haldan; Cankurtaran, Eylem Şahin; Ulusoy, Semra; Akdede, Berna; Binbay, Tolga; Ayer, Ahmet; Noyan, Handan; Karadayı, Gülşah; Akturan, Elçin; Ulaş, Halis; Arango, Celso; Parellada, Mara; Bernardo, Miguel; Sanjuán, Julio; Bobes, Julio; Arrojo, Manuel; Santos, Jose Luis; Cuadrado, Pedro; Rodríguez Solano, José Juan; Carracedo, Angel; García Bernardo, Enrique; Roldán, Laura; López, Gonzalo; Cabrera, Bibiana; Cruz, Sabrina; Díaz Mesa, Eva Ma; Pouso, María; Jiménez, Estela; Sánchez, Teresa; Rapado, Marta; González, Emiliano; Martínez, Covadonga; Sánchez, Emilio; Olmeda, Ma Soledad; de Haan, Lieuwe; Velthorst, Eva; van der Gaag, Mark; Selten, Jean-Paul; van Dam, Daniella; van der Ven, Elsje; van der Meer, Floor; Messchaert, Elles; Kraan, Tamar; Burger, Nadine; Leboyer, Marion; Szoke, Andrei; Schürhoff, Franck; Llorca, Pierre-Michel; Jamain, Stéphane; Tortelli, Andrea; Frijda, Flora; Vilain, Jeanne; Galliot, Anne-Marie; Baudin, Grégoire; Ferchiou, Aziz; Richard, Jean-Romain; Bulzacka, Ewa; Charpeaud, Thomas; Tronche, Anne-Marie; de Hert, Marc; van Winkel, Ruud; Decoster, Jeroen; Derom, Catherine; Thiery, Evert; Stefanis, Nikos C.; Sachs, Gabriele; Aschauer, Harald; Lasser, Iris; Winklbaur, Bernadette; Schlögelhofer, Monika; Riecher-Rössler, Anita; Borgwardt, Stefan; Walter, Anna; Harrisberger, Fabienne; Smieskova, Renata; Rapp, Charlotte; Ittig, Sarah; Soguel-Dit-Piquard, Fabienne; Studerus, Erich; Klosterkötter, Joachim; Ruhrmann, Stephan; Paruch, Julia; Julkowski, Dominika; Hilboll, Desiree; Sham, Pak C.; Cherny, Stacey S.; Chen, Eric Y. H.; Campbell, Desmond D.; Li, Miaoxin; Romeo-Casabona, Carlos María; Emaldi Cirión, Aitziber; Urruela Mora, Asier; Jones, Peter; Kirkbride, James; Cannon, Mary; Rujescu, Dan; Tarricone, Ilaria; Berardi, Domenico; Bonora, Elena; Seri, Marco; Marcacci, Thomas; Chiri, Luigi; Chierzi, Federico; Storbini, Viviana; Braca, Mauro; Minenna, Maria Gabriella; Donegani, Ivonne; Fioritti, Angelo; La Barbera, Daniele; La Cascia, Caterina Erika; Mulè, Alice; Sideli, Lucia; Sartorio, Rachele; Ferraro, Laura; Tripoli, Giada; Seminerio, Fabio; Marinaro, Anna Maria; McGorry, Patrick; Nelson, Barnaby; Amminger, G. Paul; Pantelis, Christos; Menezes, Paulo R.; del-Ben, Cristina M.; Gallo Tenan, Silvia H.; Shuhama, Rosana; Ruggeri, Mirella; Tosato, Sarah; Lasalvia, Antonio; Bonetto, Chiara; Ira, Elisa; Nordentoft, Merete; Krebs, Marie-Odile; Barrantes-Vidal, Neus; Cristóbal, Paula; Kwapil, Thomas R.; Brietzke, Elisa; Bressan, Rodrigo A.; Gadelha, Ary; Maric, Nadja P.; Andric, Sanja; Mihaljevic, Marina; Mirjanic, Tijana

    2014-01-01

    Recent years have seen considerable progress in epidemiological and molecular genetic research into environmental and genetic factors in schizophrenia, but methodological uncertainties remain with regard to validating environmental exposures, and the population risk conferred by individual molecular

  8. The efficacy of SMS text messages to compensate for the effects of cognitive impairments in schizophrenia

    NARCIS (Netherlands)

    Pijnenborg, G. H. M.; Withaar, F. K.; Brouwer, W. H.; Timmerman, M. E.; van den Bosch, R. J.; Evans, J. J.

    Background and aims. Many people with schizophrenia have severe cognitive impairments that hamper their activities. The effect of pharmacological and behavioural interventions on cognitive functioning has been demonstrated, but even after successful intervention considerable impairments can remain.

  9. Identifying Gene-Environment Interactions in Schizophrenia : Contemporary Challenges for Integrated, Large-scale Investigations

    NARCIS (Netherlands)

    van Os, Jim; Rutten, Bart P.; Myin-Germeys, Inez; Delespaul, Philippe; Viechtbauer, Wolfgang; van Zelst, Catherine; Bruggeman, Richard; Reininghaus, Ulrich; Morgan, Craig; Murray, Robin M.; Di Forti, Marta; McGuire, Philip; Valmaggia, Lucia R.; Kempton, Matthew J.; Gayer-Anderson, Charlotte; Hubbard, Kathryn; Beards, Stephanie; Stilo, Simona A.; Onyejiaka, Adanna; Bourque, Francois; Modinos, Gemma; Tognin, Stefania; Calem, Maria; O'Donovan, Michael C.; Owen, Michael J.; Holmans, Peter; Williams, Nigel; Craddock, Nicholas; Richards, Alexander; Humphreys, Isla; Meyer-Lindenberg, Andreas; Leweke, F. Markus; Tost, Heike; Akdeniz, Ceren; Rohleder, Cathrin; Bumb, J. Malte; Schwarz, Emanuel; Alptekin, Koksal; Ucok, Alp; Saka, Meram Can; Atbasoglu, E. Cem; Guloksuz, Sinan; Gumus-Akay, Guvem; Cihan, Burin; Karadag, Hasan; Soygur, Haldan; Cankurtaran, Eylem Sahin; Ulusoy, Semra; Akdede, Berna; Binbay, Tolga

    Recent years have seen considerable progress in epidemiological and molecular genetic research into environmental and genetic factors in schizophrenia, but methodological uncertainties remain with regard to validating environmental exposures, and the population risk conferred by individual molecular

  10. Identifying Gene-Environment interactions in schizophrenia: Contemporary challenges for integrated, large-scale investigations

    NARCIS (Netherlands)

    European Network authors, o.a.; van der Gaag, M.

    2014-01-01

    Recent years have seen considerable progress in epidemiological and molecular genetic research into environmental and genetic factors in schizophrenia, but methodological uncertainties remain with regard to validating environmental exposures, and the population risk conferred by individual molecular

  11. Advancing paternal age and schizophrenia: the impact of delayed fatherhood.

    Science.gov (United States)

    Ek, Mats; Wicks, Susanne; Svensson, Anna C; Idring, Selma; Dalman, Christina

    2015-05-01

    It is well known that advancing paternal age is associated with an increased risk of schizophrenia in offspring, but the mechanism behind this association remains unknown. This study investigates if delayed fatherhood rather than advancing paternal age per se might explain the increased risk of schizophrenia in offspring associated with advancing paternal age. This is a register-based study of the Swedish population looking at people born 1955-1985 who have 1 or 2 siblings (n = 2 589 502). The main analysis investigated whether the association between advancing paternal age and schizophrenia was explained by delayed fatherhood. Possible confounding factors were taken into account. Cox regression was used throughout. In the main analysis the association between advancing paternal age and increased risk of schizophrenia in offspring disappeared after controlling for delayed fatherhood (hazard ratio [HR] = 0.93, 95% CI = 0.72-1.21 comparing 45+ years old fathers to those 25-29), whereas delayed fatherhood showed an association with increased risk of schizophrenia in offspring comparing 35-39 and 40-44 years old fathers to 25-29 year olds (HR = 1.37, 95% CI = 1.18-1.58; HR = 1.81, 95% CI = 1.44-2.28, respectively). The results remained when controlling for possible confounders. This study suggests that the association between paternal age and schizophrenia is not due to paternal age per se, but rather to an unknown factor associated with both delayed fatherhood and schizophrenia. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  12. Gamma-Aminobutyric Acid Concentration is Reduced in Visual Cortex in Schizophrenia and Correlates with Orientation-Specific Surround Suppression

    OpenAIRE

    Yoon, Jong H.; Maddock, Richard J.; Rokem, Ariel; Silver, Michael A.; Minzenberg, Michael J.; Ragland, J. Daniel; Carter, Cameron S.

    2010-01-01

    The neural mechanisms underlying cognitive deficits in schizophrenia remain largely unknown. The gamma-aminobutyric acid (GABA) hypothesis proposes that reduced neuronal GABA concentration and neurotransmission results in cognitive impairments in schizophrenia. However, few in vivo studies have directly examined this hypothesis. We employed magnetic resonance spectroscopy (MRS) at high field to measure visual cortical GABA levels in 13 subjects with schizophrenia and 13 demographically matche...

  13. Nanosuspension Technology for Solubilizing Poorly Soluble Drugs

    OpenAIRE

    Deoli Mukesh

    2012-01-01

    Poor water solubility for many drugs and drug candidates remains a major obstacle to their development and clinical application. It is estimated that around 40% of drugs in the pipeline cannot be delivered through the preferred route or in some cases, at all owing to poor water solubility. Conventional formulations to improve solubility suffer from low bioavailability and poor pharmacokinetics, with some carriers rendering systemic toxicities (e.g. Cremophor1 EL). To date, nanoscale systems f...

  14. Cure or curse? Ambivalent attitudes towards neuroleptic medication in schizophrenia and non-schizophrenia patients.

    Science.gov (United States)

    Moritz, Steffen; Peters, Maarten J V; Karow, Anne; Deljkovic, Azra; Tonn, Peter; Naber, Dieter

    2009-10-30

    Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis patients. As direct questioning is notoriously prone to social desirability biases, we conducted an anonymous survey. After a strict selection process blind to results, 95 psychiatric patients were retained for the final analyses (69 participants with a presumed diagnosis of schizophrenia psychosis, 26 without psychosis). Self-reported neuroleptic non-compliance was more prevalent in psychosis patients than non-psychosis patients. Apart from side effects and illness insight, main reasons for non-compliance in both groups were forgetfulness, distrust in therapist, and no subjective need for treatment. Other notable reasons were stigma and advice of relatives/acquaintances against neuroleptic medication. Gain from illness was a reason for non-compliance in 11-18% of the psychosis patients. Only 9% of all patients reported no side effects and full compliance and at the same time acknowledged that neuroleptics worked well for them. While pills were preferred over depot injections by the majority of patients, depot was judged as an alternative by a substantial subgroup. Although many patients acknowledge the need and benefits of neuroleptic medication, non-compliance was the norm rather than the exception in our samples.

  15. Cure or curse? Ambivalent attitudes towards neuroleptic medication in schizophrenia and non-schizophrenia patients

    Directory of Open Access Journals (Sweden)

    Dieter Naber

    2009-10-01

    Full Text Available Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis patients. As direct questioning is notoriously prone to social desirability biases, we conducted an anonymous survey. After a strict selection process blind to results, 95 psychiatric patients were retained for the final analyses (69 participants with a presumed diagnosis of schizophrenia psychosis, 26 without psychosis. Self-reported neuroleptic non-compliance was more prevalent in psychosis patients than non-psychosis patients. Apart from side effects and illness insight, main reasons for non-compliance in both groups were forgetfulness, distrust in therapist, and no subjective need for treatment. Other notable reasons were stigma and advice of relatives/acquaintances against neuroleptic medication. Gain from illness was a reason for non-compliance in 11-18% of the psychosis patients. Only 9% of all patients reported no side effects and full compliance and at the same time acknowledged that neuroleptics worked well for them. While pills were preferred over depot injections by the majority of patients, depot was judged as an alternative by a substantial subgroup. Although many patients acknowledge the need and benefits of neuroleptic medication, non-compliance was the norm rather than the exception in our samples.

  16. Improving psychology students' attitudes toward people with schizophrenia: A quasi-randomized controlled study.

    Science.gov (United States)

    Magliano, Lorenza; Rinaldi, Angela; Costanzo, Regina; De Leo, Renata; Schioppa, Giustina; Petrillo, Miriam; Read, John

    2016-01-01

    Despite scientific evidence that the majority of people with schizophrenia (PWS) have personal histories of traumatic life events and adversities, their needs for psychological support often remain unmet. Poor availability of nonpharmacological therapies in schizophrenia may be partly because of professionals' attitudes toward people diagnosed with this disorder. As future health professionals, psychology students represent a target population for efforts to increase the probability that PWS will be offered effective psychological therapies. This quasi-randomized controlled study investigated the effect of an educational intervention, addressing common prejudices via scientific evidence and prerecorded audio-testimony from PWS, on the attitudes of psychology students toward PWS. Students in their fifth year of a master's degree in Psychology at the Second University of Naples, Italy were randomly assigned to an experimental group-which attended two 3-hr sessions a week apart-or to a control group. Compared with their baseline assessment, at 1-month reassessment the 76 educated students endorsed more psychosocial causes and more of them recommended psychologists in the treatment of schizophrenia. They were also more optimistic about recovery, less convinced that PWS are recognizable and unpredictable, and more convinced that treatments, pharmacological and psychological, are useful. No significant changes were found, from baseline to 1-month reassessment, in the 112 controls. At 1-month reassessment, educated students were more optimistic about recovery and less convinced that PWS are unpredictable than controls. These findings suggest that psychology students' attitudes toward PWS can be improved by training initiatives including education and indirect contact with users. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  17. Self- and other-agency in people with passivity (first rank) symptoms in schizophrenia.

    Science.gov (United States)

    Graham-Schmidt, Kyran T; Martin-Iverson, Mathew T; Waters, Flavie A V

    2018-02-01

    Individuals with passivity (first-rank) symptoms report that their actions, thoughts and sensations are influenced or controlled by an external (non-self) agent. Passivity symptoms are closely linked to schizophrenia and related disorders yet they remain poorly understood. One dominant framework posits a role for deficits in the sense of agency. An important question is whether deficits in self-agency can be differentiated from other-agency in schizophrenia and passivity symptoms. This study aimed to evaluate self- and other-agency in 51 people with schizophrenia (n=20 current, 10 past, 21 no history of passivity symptoms), and 48 healthy controls. Participants completed the projected hand illusion (PHI) with active and passive movements, as well as immediate and delayed visual feedback. Experiences of agency and loss of agency over the participant's hand and the image ('the other hand') were assessed with a self-report questionnaire. Those with passivity symptoms (current and past) reported less difference in agency between active and passive movements on items assessing agency over their own hand (but not agency over the other hand). Relative to the healthy controls, the current and never groups continued to experience the illusion with delayed visual feedback suggesting impaired timing mechanisms regardless of symptom profile. These findings are consistent with a reduced contribution of proprioceptive predictive cues to agency judgements specific to self representations in people with passivity symptoms, and a subsequent reliance on external visual cues in these judgements. Altogether, these findings emphasise the multifactorial nature of agency and the contribution of multiple impairments to passivity symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Impaired glutathione synthesis in schizophrenia

    DEFF Research Database (Denmark)

    Gysin, René; Kraftsik, Rudolf; Sandell, Julie

    2007-01-01

    Schizophrenia is a complex multifactorial brain disorder with a genetic component. Convergent evidence has implicated oxidative stress and glutathione (GSH) deficits in the pathogenesis of this disease. The aim of the present study was to test whether schizophrenia is associated with a deficit...... of GSH synthesis. Cultured skin fibroblasts from schizophrenia patients and control subjects were challenged with oxidative stress, and parameters of the rate-limiting enzyme for the GSH synthesis, the glutamate cysteine ligase (GCL), were measured. Stressed cells of patients had a 26% (P = 0.......002) decreased GCL activity as compared with controls. This reduction correlated with a 29% (P schizophrenia in two...

  19. Social trait judgment and affect recognition from static faces and video vignettes in schizophrenia.

    Science.gov (United States)

    McIntosh, Lindsey G; Park, Sohee

    2014-09-01

    Social impairment is a core feature of schizophrenia, present from the pre-morbid stage and predictive of outcome, but the etiology of this deficit remains poorly understood. Successful and adaptive social interactions depend on one's ability to make rapid and accurate judgments about others in real time. Our surprising ability to form accurate first impressions from brief exposures, known as "thin slices" of behavior has been studied very extensively in healthy participants. We sought to examine affect and social trait judgment from thin slices of static or video stimuli in order to investigate the ability of schizophrenic individuals to form reliable social impressions of others. 21 individuals with schizophrenia (SZ) and 20 matched healthy participants (HC) were asked to identify emotions and social traits for actors in standardized face stimuli as well as brief video clips. Sound was removed from videos to remove all verbal cues. Clinical symptoms in SZ and delusional ideation in both groups were measured. Results showed a general impairment in affect recognition for both types of stimuli in SZ. However, the two groups did not differ in the judgments of trustworthiness, approachability, attractiveness, and intelligence. Interestingly, in SZ, the severity of positive symptoms was correlated with higher ratings of attractiveness, trustworthiness, and approachability. Finally, increased delusional ideation in SZ was associated with a tendency to rate others as more trustworthy, while the opposite was true for HC. These findings suggest that complex social judgments in SZ are affected by symptomatology. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Thirty Days without a Bite: Wernicke's Encephalopathy in a Patient with Paranoid Schizophrenia.

    Science.gov (United States)

    Langlois, Mélanie; Doré, Marie-Claire; Laforce, Robert

    2014-09-25

    Wernicke's Encephalopathy (WE) is a preventable neurologic condition characterized by altered mental status, ophthalmoplegia, and ataxia. Although historically associated with alcoholism, a few authors have described WE in patients with non-alcohol related psychiatric disorders. We report herein the case of a 36-year-old young man with paranoid schizophrenia who was brought to hospital for confusion and difficulties with his vision. His roommate said he had gone about thirty days without eating '…because he was on a slimming cure'. History and physical examination suggested WE as a result of isolation and poor diet leading to nutritional deficiency. This was confirmed by brain magnetic resonance imaging showing classic thalamic, mammillary bodies and brainstem lesions. Of note, his cognitive profile was far more heterogeneous than what had classically been described in the literature and involved both cortical and subcortical pathology, generating memory but also significant executive deficits. Intravenous treatment with thiamine was given and our patient showed mild improvements in visual acuity and nystagmus. However, persistent cognitive and physical disabilities consistent with Korsakoff syndrome remained, and he now lives in a supervised home. This case illustrates the tragic consequences of nutritional deficiencies in a patient with paranoid schizophrenia. The threshold to suspect WE in schizophrenic patients should be lowered and in doubt prophylactic parenteral thiamine should be administered.

  1. The role of neurexins in schizophrenia and autistic spectrum disorder.

    Science.gov (United States)

    Reichelt, A C; Rodgers, R J; Clapcote, S J

    2012-03-01

    Schizophrenia and autistic spectrum disorder (ASD) are common, chronic mental conditions with both genetic and environmental components to their aetiology. The identification of genes influencing susceptibility to these disorders offers a rational route towards a clearer understanding of the neurobiology, and with this the prospect of treatment and prevention strategies tailored towards the remediation of the altered pathways. Copy number variants (CNVs) underlie many serious illnesses, including neurological and neurodevelopmental syndromes. Recent studies assessing copy number variation in ASD and schizophrenia have repeatedly observed heterozygous deletions eliminating exons of the neurexin-1α gene (but not the neurexin-1β gene) in patients with ASD and schizophrenia. The neurexins are synaptic adhesion proteins that are known to play a key role in synaptic formation and maintenance. The functional significance of the recurrent deletion is poorly understood, but the availability of mice with deletion of the promoter and first exon of neurexin-1α provides direct access to the biological effects of neurexin-1α disruption on phenotypes relevant to ASD and schizophrenia. We review the evidence for the role of neurexin-1α in schizophrenia and ASD, and consider how genetic disruption of neurexin-1α may underpin the neuropathology contributing to these distinct neurodevelopmental disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Indirect self-destructiveness in individuals with schizophrenia

    Directory of Open Access Journals (Sweden)

    Konstantinos Tsirigotis

    2017-06-01

    Full Text Available Objective: To explore the indirect self-destructiveness syndrome in patients with schizophrenia. Methods: Two hundred individuals with paranoid schizophrenia (117 men and 83 women, mean age 37.15 years, all in remission, were examined using the Polish version of the Chronic Self-Destructiveness Scale. Two hundred well-matched healthy individuals served as a control group. Results: The intensity of indirect self-destructiveness was greater in the schizophrenia group than in controls. The intensity of each manifestation was as follows (in decreasing order: helplessness and passiveness in the face of difficulties (A5, personal and social neglects (A3, lack of planfulness (A4, poor health maintenance (A2, transgression and risk (A1. Conclusion: Patients with schizophrenia displayed more behaviors that were indirectly self-destructive than healthy controls; they scored better than healthy controls only on caring for their own health. The patients showed the lowest intensity of behaviors connected with the active form of indirect self-destructiveness, and the highest intensity of behaviors connected with the passive form. These findings may enable delivery of more effective forms of pharmacological and psychosocial help to patients with schizophrenia.

  3. Working memory dysfunctions predict social problem solving skills in schizophrenia.

    Science.gov (United States)

    Huang, Jia; Tan, Shu-ping; Walsh, Sarah C; Spriggens, Lauren K; Neumann, David L; Shum, David H K; Chan, Raymond C K

    2014-12-15

    The current study aimed to examine the contribution of neurocognition and social cognition to components of social problem solving. Sixty-seven inpatients with schizophrenia and 31 healthy controls were administrated batteries of neurocognitive tests, emotion perception tests, and the Chinese Assessment of Interpersonal Problem Solving Skills (CAIPSS). MANOVAs were conducted to investigate the domains in which patients with schizophrenia showed impairments. Correlations were used to determine which impaired domains were associated with social problem solving, and multiple regression analyses were conducted to compare the relative contribution of neurocognitive and social cognitive functioning to components of social problem solving. Compared with healthy controls, patients with schizophrenia performed significantly worse in sustained attention, working memory, negative emotion, intention identification and all components of the CAIPSS. Specifically, sustained attention, working memory and negative emotion identification were found to correlate with social problem solving and 1-back accuracy significantly predicted the poor performance in social problem solving. Among the dysfunctions in schizophrenia, working memory contributed most to deficits in social problem solving in patients with schizophrenia. This finding provides support for targeting working memory in the development of future social problem solving rehabilitation interventions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Inference in `poor` languages

    Energy Technology Data Exchange (ETDEWEB)

    Petrov, S.

    1996-10-01

    Languages with a solvable implication problem but without complete and consistent systems of inference rules (`poor` languages) are considered. The problem of existence of finite complete and consistent inference rule system for a ``poor`` language is stated independently of the language or rules syntax. Several properties of the problem arc proved. An application of results to the language of join dependencies is given.

  5. On incomprehensibility in schizophrenia

    DEFF Research Database (Denmark)

    Henriksen, Mads Gram

    2013-01-01

    the notion of understanding that deems these delusions incomprehensible and to see if it is possible to comprehend these delusions if we apply another notion of understanding. First, I discuss the contemporary schizophrenia definitions and their inherent problems, and I argue that the notion...... of incomprehensibility in these definitions rests heavily on Jaspers’ notions of understanding and empathy. Secondly, I discuss two Wittgensteinian attempts to comprehend bizarre delusions: (a) Campbell’s proposal to conceive delusions as framework propositions and (b) Sass’s suggestion to interpret delusions...... in the light of solipsism. Finally, I discuss the phenomenological conception of schizophrenia, which conceives delusion formation as resulting from alterations of the structure of experiencing and from underlying self-disorders. I argue that although a psychological understanding that seeks to grasp meaning...

  6. Schizophrenia: A Systemic Disorder

    Science.gov (United States)

    Kirkpatrick, Brian; Miller, Brian; García-Rizo, Clemente; Fernandez-Egea, Emilio

    2015-01-01

    The concept of schizophrenia that is most widely taught is that it is a disorder in which psychotic symptoms are the main problem, and a dysregulation of dopamine signaling is the main feature of pathophysiology. However, this concept limits clinical assessment, the treatments offered to patients, research, and the development of therapeutics. A more appropriate conceptual model is that: 1) schizophrenia is not a psychotic disorder, but a disorder of essentially every brain function in which psychosis is present; 2) it is not a brain disease, but a disorder with impairments throughout the body; 3) for many patients, neuropsychiatric problems other than psychosis contribute more to impairment in function and quality of life than does psychosis; and, 4) some conditions that are considered to be comorbid are integral parts of the illness. In conclusion, students, patients, and family members should be taught this model, along with its implications for assessment, research, and therapeutics. PMID:23518782

  7. Epigenetic mechanisms in schizophrenia.

    Science.gov (United States)

    Akbarian, Schahram

    2014-09-01

    Schizophrenia is a major psychiatric disorder that lacks a unifying neuropathology, while currently available pharmacological treatments provide only limited benefits to many patients. This review will discuss how the field of neuroepigenetics could contribute to advancements of the existing knowledge on the neurobiology and treatment of psychosis. Genome-scale mapping of DMA methylation, histone modifications and variants, and chromosomal loopings for promoter-enhancer interactions and other epigenetic determinants of genome organization and function are likely to provide important clues about mechanisms contributing to dysregulated expression of synaptic and metabolic genes in schizophrenia brain, including the potential links to the underlying genetic risk architecture and environmental exposures. In addition, studies in animal models are providing a rapidly increasing list of chromatin-regulatory mechanisms with significant effects on cognition and complex behaviors, thereby pointing to the therapeutic potential of epigenetic drug targets in the nervous system.

  8. [Schizophrenia, environment and epigenetics].

    Science.gov (United States)

    Must, Anita; Janka, Zoltan; Horvath, Szatmar

    2011-12-01

    Psychotic, cognitive and affective symptoms defining schizophrenia may, though much less severe, manifest themselves in up to 10 to 20% of the general population. What explains the fact that in certain cases the symptoms require even constant medical supervision, while others are capable of living a normal life within social conventions? Which factors lead to the transition of mild, subclinical manifestations and vulnerability indicators towards the outburst of one of the most severe and depriving mental disorders? Genetic susceptibility is undoubtedly crucial. More recent research findings emphasize the modifying effect of specific environmental factors on gene expression. The gene-environment interplay may induce so-called epigenetic alterations which may manifest themselves over several generations. Future integrative, multi-dimensional and flexible schizophrenia research approaches focusing on the identification of neurobiological and cognitive outcomes are much needed to understand disease vulnerability, susceptibility mechanisms, periods and interactions. Research methods may differ, but our aim is common - establishing more effective diagnostic and therapeutic interventions.

  9. The Future is The Past: Methylation QTLs in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Anke Hoffmann

    2016-11-01

    Full Text Available Genome-wide association studies (GWAS have remarkably advanced insight into the genetic basis of schizophrenia (SCZ. Still, most of the functional variance in disease risk remains unexplained. Hence, there is a growing need to map genetic variability-to-genes-to-functions for understanding the pathophysiology of SCZ and the development of better treatments. Genetic variation can regulate various cellular functions including DNA methylation, an epigenetic mark with important roles in transcription and the mediation of environmental influences. Methylation quantitative trait loci (meQTLs are derived by mapping levels of DNA methylation in genetically different, genotyped individuals and define loci at which DNA methylation is influenced by genetic variation. Recent evidence points to an abundance of meQTLs in brain tissues whose functional contributions to development and mental diseases are still poorly understood. Interestingly, fetal meQTLs reside in regulatory domains affecting methylome reconfiguration during early brain development and are enriched in loci identified by GWAS for SCZ. Moreover, fetal meQTLs are preserved in the adult brain and could trace early epigenomic deregulation during vulnerable periods. Overall, these findings highlight the role of fetal meQTLs in the genetic risk for and in the possible neurodevelopmental origin of SCZ.

  10. Accelerated brain aging in schizophrenia : A longitudinal pattern recognition study

    NARCIS (Netherlands)

    Schnack, Hugo G.; Van Haren, Neeltje E M; Nieuwenhuis, Mireille; Pol, Hilleke E Hulshoff; Cahn, Wiepke; Kahn, René S.

    2016-01-01

    OBJECTIVE: Despite the multitude of longitudinal neuroimaging studies that have been published, a basic question on the progressive brain loss in schizophrenia remains unaddressed: Does it reflect accelerated aging of the brain, or is it caused by a fundamentally different process? The authors used

  11. Accelerated Brain Aging in Schizophrenia : A Longitudinal Pattern Recognition Study

    NARCIS (Netherlands)

    Schnack, Hugo G; van Haren, Neeltje E M; Nieuwenhuis, Mireille; Hulshoff Pol, Hilleke E; Cahn, Wiepke; Kahn, René S

    2016-01-01

    OBJECTIVE: Despite the multitude of longitudinal neuroimaging studies that have been published, a basic question on the progressive brain loss in schizophrenia remains unaddressed: Does it reflect accelerated aging of the brain, or is it caused by a fundamentally different process? The authors used

  12. Amusia and protolanguage impairments in schizophrenia.

    Science.gov (United States)

    Kantrowitz, J T; Scaramello, N; Jakubovitz, A; Lehrfeld, J M; Laukka, P; Elfenbein, H A; Silipo, G; Javitt, D C

    2014-10-01

    Both language and music are thought to have evolved from a musical protolanguage that communicated social information, including emotion. Individuals with perceptual music disorders (amusia) show deficits in auditory emotion recognition (AER). Although auditory perceptual deficits have been studied in schizophrenia, their relationship with musical/protolinguistic competence has not previously been assessed. Musical ability was assessed in 31 schizophrenia/schizo-affective patients and 44 healthy controls using the Montreal Battery for Evaluation of Amusia (MBEA). AER was assessed using a novel battery in which actors provided portrayals of five separate emotions. The Disorganization factor of the Positive and Negative Syndrome Scale (PANSS) was used as a proxy for language/thought disorder and the MATRICS Consensus Cognitive Battery (MCCB) was used to assess cognition. Highly significant deficits were seen between patients and controls across auditory tasks (p amusia and intact music-perceiving groups, which remained significant after controlling for group status and education. Correlations with AER were specific to the melody domain, and correlations between protolanguage (melody domain) and language were independent of overall cognition. This is the first study to document a specific relationship between amusia, AER and thought disorder, suggesting a shared linguistic/protolinguistic impairment. Once amusia was considered, other cognitive factors were no longer significant predictors of AER, suggesting that musical ability in general and melodic discrimination ability in particular may be crucial targets for treatment development and cognitive remediation in schizophrenia.

  13. MRI anatomy of schizophrenia

    OpenAIRE

    McCarley, Robert William; Wible, Cynthia Gayle; Frumin, Melissa; Hirayasu, Yoshio; Levitt, James Jonathan; Fischer, Iris A.; Shenton, Martha Elizabeth

    1999-01-01

    Structural magnetic resonance imaging (MRI) data have provided much evidence in support of our current view that schizophrenia is a brain disorder with altered brain structure, and consequently involving more than a simple disturbance in neurotransmission. This review surveys 118 peer–reviewed studies with control group from 1987 to May 1998. Most studies (81%) do not find abnormalities of whole brain/intracranial contents, while lateral ventricle enlargement is reported in 77%, and third ven...

  14. Iconic Decay in Schizophrenia

    OpenAIRE

    Hahn, Britta; Kappenman, Emily S.; Robinson, Benjamin M.; Fuller, Rebecca L.; Luck, Steven J.; Gold, James M.

    2010-01-01

    Working memory impairment is considered a core deficit in schizophrenia, but the precise nature of this deficit has not been determined. Multiple lines of evidence implicate deficits at the encoding stage. During encoding, information is held in a precategorical sensory store termed iconic memory, a literal image of the stimulus with high capacity but rapid decay. Pathologically increased iconic decay could reduce the number of items that can be transferred into working memory before the info...

  15. [Environmental risk factors for schizophrenia: a review].

    Science.gov (United States)

    Vilain, J; Galliot, A-M; Durand-Roger, J; Leboyer, M; Llorca, P-M; Schürhoff, F; Szöke, A

    2013-02-01

    . Others, such as obstetrical complications, are grouped (or "composed") in that they include various sub-factors that can influence the development of schizophrenia. The data reviewed clearly demonstrates that environmental factors have an influence on the risk of developing schizophrenia. For certain factors - cannabis, migration, urbanicity, obstetrical complications, seasonality - there is enough evidence to establish an association with the risk of schizophrenia. This association, however, remains weak (especially for seasonality). With the exception of cannabis, no direct link can yet be established. Concerning the three remaining factors - childhood traumas, infectious agents, socio-demographic factors - the available proof is insufficient. One main limitation concerning all environmental factors is the generalization of results due to the fact that the studies were conducted on geographically limited populations. The current state of knowledge does not allow us to determine the mechanisms by which these factors may act. Further research is needed to fill the gaps in our understanding of the subject. In response to this need, a collaborative European project (European Study of Gene-Environment Interactions [EU GEI]) was set-up. This study proposes the analysis of those environmental factors that influence the incidence of schizophrenia in various European countries, in both rural and urban settings, migrant and native populations, as well as their interaction with genetic factors. Copyright © 2011 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  16. Aging women with schizophrenia.

    Science.gov (United States)

    Pentland, Wendy; Miscio, Gina; Eastabrook, Shirley; Krupa, Terry

    2003-01-01

    The purpose of this study was to describe the aging experiences of women with schizophrenia. The research focused on how participants viewed their own aging with schizophrenia, their perceived worries and concerns and how they were coping with aging with the disorder. Using a qualitative approach, data were collected using multiple in-depth interviews with six participants selected purposefully from the client list of a community mental health center. Interview transcriptions were coded and analyzed according to the study questions using QSR Nudist 4 software. Several categories and sub-categories emerged. These included the improvement in the illness over time; physical and daily living activity limitations; specific positive and negative changes that the women report have accompanied aging; the profound losses experienced by the participants when they were younger as a result of having schizophrenia; and how these losses have affected their present lives in terms of limiting available informal support, creating dependency on formal programs and services, and participants' fears of the future. Based on the study findings, implications for mental health practice and services are considered and suggestions are made to guide future research.

  17. [Psychoeducation in schizophrenia].

    Science.gov (United States)

    Zapata Ospina, Juan Pablo; Rangel Martínez-Villalba, Andrés Mauricio; García Valencia, Jenny

    2015-01-01

    The treatment of schizophrenia includes the use of psychotropic drugs, psychotherapy, and psychosocial interventions that include psychoeducation. This strategy has been defined as the delivery of information about the disorder and its treatment in a systematic and structured way. To review the literature on the efficacy of psychoeducation in schizophrenia. A search in PubMed, SciELO, EMBASE and PsycINFO was made with the terms "psychoeducation", "schizophrenia" and "psychosocial intervention". Articles in Spanish and English language were reviewed. Psychoeducation can be applied to patients, family or both, and individually or in groups. The number of sessions can vary. There have been many studies that seek to determine the efficacy of psychoeducation in the clinical course, family dynamics and stigma, with results that favor its implementation, but so far it has not been possible to determine exactly how best to apply psychoeducation, mainly because of the great variability of designs. The studies on psychoeducation have shown efficacy. However, this might be an overestimation, as there is a high risk of bias. Consequently, there is not enough evidence. At least for now, it is reasonable to complement pharmacotherapy with psycoeducation. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Scene construction in schizophrenia.

    Science.gov (United States)

    Raffard, Stéphane; D'Argembeau, Arnaud; Bayard, Sophie; Boulenger, Jean-Philippe; Van der Linden, Martial

    2010-09-01

    Recent research has revealed that schizophrenia patients are impaired in remembering the past and imagining the future. In this study, we examined patients' ability to engage in scene construction (i.e., the process of mentally generating and maintaining a complex and coherent scene), which is a key part of retrieving past experiences and episodic future thinking. 24 participants with schizophrenia and 25 healthy controls were asked to imagine new fictitious experiences and described their mental representations of the scenes in as much detail as possible. Descriptions were scored according to various dimensions (e.g., sensory details, spatial reference), and participants also provided ratings of their subjective experience when imagining the scenes (e.g., their sense of presence, the perceived similarity of imagined events to past experiences). Imagined scenes contained less phenomenological details (d = 1.11) and were more fragmented (d = 2.81) in schizophrenia patients compared to controls. Furthermore, positive symptoms were positively correlated to the sense of presence (r = .43) and the perceived similarity of imagined events to past episodes (r = .47), whereas negative symptoms were negatively related to the overall richness of the imagined scenes (r = -.43). The results suggest that schizophrenic patients' impairments in remembering the past and imagining the future are, at least in part, due to deficits in the process of scene construction. The relationships between the characteristics of imagined scenes and positive and negative symptoms could be related to reality monitoring deficits and difficulties in strategic retrieval processes, respectively. Copyright 2010 APA, all rights reserved.

  19. Exploiting the Poor

    DEFF Research Database (Denmark)

    Kamp Justesen, Mogens; Bjørnskov, Christian

    2014-01-01

    While extant research has focused on the causes and consequences of corruption at the macro-level, less effort has been devoted to understanding the micro-foundation of corruption. We argue that poor people are more likely to be victims of corrupt behavior by street-level bureaucrats as the poor...... often rely heavily on services provided by governments. We test this proposition using micro-level survey data from the Afrobaromenter. Multilevel regressions across 18 countries show that poor people are much more prone to experience having to pay bribes to government officials....

  20. Accelerated Brain Aging in Schizophrenia: A Longitudinal Pattern Recognition Study.

    Science.gov (United States)

    Schnack, Hugo G; van Haren, Neeltje E M; Nieuwenhuis, Mireille; Hulshoff Pol, Hilleke E; Cahn, Wiepke; Kahn, René S

    2016-06-01

    Despite the multitude of longitudinal neuroimaging studies that have been published, a basic question on the progressive brain loss in schizophrenia remains unaddressed: Does it reflect accelerated aging of the brain, or is it caused by a fundamentally different process? The authors used support vector regression, a supervised machine learning technique, to address this question. In a longitudinal sample of 341 schizophrenia patients and 386 healthy subjects with one or more structural MRI scans (1,197 in total), machine learning algorithms were used to build models to predict the age of the brain and the presence of schizophrenia ("schizophrenia score"), based on the gray matter density maps. Age at baseline ranged from 16 to 67 years, and follow-up scans were acquired between 1 and 13 years after the baseline scan. Differences between brain age and chronological age ("brain age gap") and between schizophrenia score and healthy reference score ("schizophrenia gap") were calculated. Accelerated brain aging was calculated from changes in brain age gap between two consecutive measurements. The age prediction model was validated in an independent sample. In schizophrenia patients, brain age was significantly greater than chronological age at baseline (+3.36 years) and progressively increased during follow-up (+1.24 years in addition to the baseline gap). The acceleration of brain aging was not constant: it decreased from 2.5 years/year just after illness onset to about the normal rate (1 year/year) approximately 5 years after illness onset. The schizophrenia gap also increased during follow-up, but more pronounced variability in brain abnormalities at follow-up rendered this increase nonsignificant. The progressive brain loss in schizophrenia appears to reflect two different processes: one relatively homogeneous, reflecting accelerated aging of the brain and related to various measures of outcome, and a more variable one, possibly reflecting individual variation and

  1. Premorbid self-disorders and lifetime diagnosis in the schizophrenia spectrum

    DEFF Research Database (Denmark)

    Parnas, Josef; Carter, John; Frederiksen, Julie E Nordgaard

    2016-01-01

    assessment, we hypothesized that a proxy scale drawn from the Minnesota Multiphasic Personality Inventory (MMPI) could distinguish those who later developed a schizophrenia-spectrum disorder (N = 68) from those who remained healthy (N = 64). The Self-Disorder Scale comprised 32 items whose content suggested......AIM: The notion of a disordered self as a core disturbance of schizophrenia was proposed in many foundational texts. Recent studies, spurred by the development of the Examination of Anomalous Self-Experience (EASE), seem to indicate that self-disorders are a specific manifestation of schizophrenia......), the overlap did not account for the Self-Disorder Scale's predictive efficacy. CONCLUSION: The results support the notion of self-disorders as a core vulnerability feature in schizophrenia, detectable premorbidly in those developing later schizophrenia-spectrum disorders....

  2. Family intervention for schizophrenia.

    Science.gov (United States)

    Pharoah, F M; Mari, J J; Streiner, D

    2000-01-01

    It has been showed that people with schizophrenia from families that express high levels of criticism, hostility, or over involvement, have more frequent relapses than people with similar problems from families that tend to be less expressive of their emotions. Psychosocial interventions designed to reduce these levels of expressed emotions within families now exist for mental health workers. These interventions are proposed as adjuncts rather than alternatives to drug treatments, and their main purpose is to decrease the stress within the family and also the rate of relapse. To estimate the effects of family psychosocial interventions in community settings for the care of those with schizophrenia or schizophrenia-like conditions compared to standard care. Electronic searches of the Cochrane Library (Issue 2, 1998), the Cochrane Schizophrenia Group's Register (June 1998), EMBASE (1981-1995) and MEDLINE (1966-1995) were undertaken and supplemented with reference searching of the identified literature. Randomised or quasi-randomised studies were selected if they focused on families of people with schizophrenia or schizoaffective disorder and compared community-orientated family-based psychosocial intervention of more than five sessions to standard care. Data were reliably extracted, and, where appropriate and possible, summated. Peto odds ratios (OR), their 95% confidence intervals (CI) and number needed to treat (NNT) were estimated. The reviewers assume that people who died or dropped out had no improvement and tested the sensitivity of the final results to this assumption. Family intervention may decrease the frequency of relapse (one year OR 0.57 CI 0.4-0.8, NNT 6.5 CI 4-14). The trend over time of this main finding is towards the null and some small but negative studies may not have been identified by the search. Family intervention may decrease hospitalisation and encourage compliance with medication but data are few and equivocal. Family intervention does not

  3. Neuropsychological Impairments in Schizophrenia and Psychotic Bipolar Disorder: Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) Study

    Science.gov (United States)

    Hill, S. Kristian; Reilly, James L.; Keefe, Richard S.E.; Gold, James M.; Bishop, Jeffrey R.; Gershon, Elliot S.; Tamminga, Carol A.; Pearlson, Godfrey D.; Keshavan, Matcheri S.; Sweeney, John A.

    2017-01-01

    Objective Familial neuropsychological deficits are well established in schizophrenia but remain less well characterized in other psychotic disorders. This study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium 1) compares cognitive impairment in schizophrenia and bipolar disorder with psychosis, 2) tests a continuum model of cognitive dysfunction in psychotic disorders, 3) reports familiality of cognitive impairments across psychotic disorders, and 4) evaluates cognitive impairment among nonpsychotic relatives with and without cluster A personality traits. Method Participants included probands with schizophrenia (N=293), psychotic bipolar disorder (N=227), schizoaffective disorder (manic, N=110; depressed, N=55), their first-degree relatives (N=316, N=259, N=133, and N=64, respectively), and healthy comparison subjects (N=295). All participants completed the Brief Assessment of Cognition in Schizophrenia (BACS) neuropsychological battery. Results Cognitive impairments among psychotic probands, compared to healthy comparison subjects, were progressively greater from bipolar disorder (z=−0.77) to schizoaffective disorder (manic z=−1.08; depressed z=−1.25) to schizophrenia (z=−1.42). Profiles across subtests of the BACS were similar across disorders. Familiality of deficits was significant and comparable in schizophrenia and bipolar disorder. Of particular interest were similar levels of neuropsychological deficits in relatives with elevated cluster A personality traits across proband diagnoses. Nonpsychotic relatives of schizophrenia probands without these personality traits exhibited significant cognitive impairments, while relatives of bipolar probands did not. Conclusions Robust cognitive deficits are present and familial in schizophrenia and psychotic bipolar disorder. Severity of cognitive impairments across psychotic disorders was consistent with a continuum model, in which more prominent affective features and less

  4. Zotepine versus other atypical antipsychotics for schizophrenia

    Science.gov (United States)

    Subramanian, Selvizhi; Rummel-Kluge, Christine; Hunger, Heike; Schmid, Franziska; Schwarz, Sandra; Kissling, Werner; Leucht, Stefan; Komossa, Katja

    2014-01-01

    Background In many parts of the world, particularly in industrialised countries, second generation (atypical) antipsychotic drugs have become first line treatment for people suffering from schizophrenia. The question as to whether the effects of various second generation antipsychotic drugs differ is a matter of debate. Objectives To evaluate the effects of zotepine compared with other second generation antipsychotic drugs for people suffering from schizophrenia and schizophrenia-like psychoses. Search methods We searched the Cochrane Schizophrenia Group Trials Register (November 2009), inspected references of all identified studies for further trials and contacted authors of trials for additional information. Selection criteria We included only randomised clinical controlled trials that compared zotepine with any forms of amisulpride, aripiprazole, clozapine, olanzapine, risperidone, sertindole or ziprasidone in people suffering from only schizophrenia or schizophrenia-like psychoses. Data collection and analysis SS and KK extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random-effects model. For continuous data, we calculated weighted mean differences (MD) again based on a random-effects model. Main results We included three studies (total n=289; 2 RCTs zotepine vs clozapine; 1 RCT zotepine vs clozapine vs risperidone (at 4 mg, 8 mg doses) vs remoxipride. All studies were of limited methodological quality. When zotepine was compared with clozapine, it was clozapine that was found to be more effective in terms of global state (n=59, 1 RCT, RR No clinically significant response 8.23 CI 1.14 to 59.17). Mental state scores also favoured clozapine (n=59, 1 RCT, MD average score (BPRS total, high = poor) 6.00 CI 2.17 to 9.83) and there was less use of antiparkinson medication in the clozapine group (n=116, 2 RCTs, RR 20.96 CI 2.89 to 151.90). In the

  5. Accounting for the Poor

    OpenAIRE

    Robert M. Townsend

    2013-01-01

    Economists and other social scientists have long tried to understand the nature of poverty and how poor people make decisions. For example, T.W. Schultz, a Nobel Laureate, former professor of economics at the University of Chicago, and former president of the American Economic Association, spent his career working in development and agricultural economics. In his 1980 Nobel Prize acceptance speech, Schultz suggests that there is some accounting for the behavior of the poor in agriculture. "Fa...

  6. Diagnostic profile and suicide risk in schizophrenia spectrum disorder.

    Science.gov (United States)

    Reutfors, Johan; Bahmanyar, Shahram; Jönsson, Erik G; Ekbom, Anders; Nordström, Peter; Brandt, Lena; Ösby, Urban

    2010-11-01

    Earlier studies of patients with schizophrenia have investigated suicide risk in relation to specific psychiatric symptoms, but it remains to be better understood how suicide risk relates to the diagnostic profile in these patients. We identified all patients with a first clinical ICD-diagnosis of schizophrenia, schizophreniform or schizoaffective disorder in Stockholm County between 1984 and 2000. Patients who died by suicide within five years from diagnosis were defined as cases (n=84) and were individually matched with a similar number of living controls from the same population. Sociodemographic and clinical variables were retrieved from hospital records through a blind process. DSM-IV lifetime diagnoses for cases and controls were derived using the OPCRIT algorithm. A schizophrenia spectrum diagnosis (i.e. schizophrenia, schizophreniform or schizoaffective disorder) was assigned by OPCRIT to 50% of the suicide cases and 62% of the controls. Criteria for schizophrenia were met by 41% of the cases and 51% of the controls; for schizoaffective disorder by 8% of the cases and 10% of the controls; for other psychosis by 23% of the cases and 25% of the controls; and for mood disorder by 26% of the cases and 12% of the controls. Using the schizophrenia diagnosis as a reference, suicide risk was significantly higher in patients meeting criteria for a mood disorder diagnosis with an adjusted odds ratio of 3.3 (95% CI 1.2-9.0). In patients with a clinical schizophrenia spectrum diagnosis, a DSM-IV mood disorder diagnosis increases the suicide risk more than three-fold. Copyright © 2010 Elsevier B.V. All rights reserved.

  7. Altered cortical processing of motor inhibition in schizophrenia.

    Science.gov (United States)

    Lindberg, Påvel G; Térémetz, Maxime; Charron, Sylvain; Kebir, Oussama; Saby, Agathe; Bendjemaa, Narjes; Lion, Stéphanie; Crépon, Benoît; Gaillard, Raphaël; Oppenheim, Catherine; Krebs, Marie-Odile; Amado, Isabelle

    2016-12-01

    Inhibition is considered a key mechanism in schizophrenia. Short-latency intracortical inhibition (SICI) in the motor cortex is reduced in schizophrenia and is considered to reflect locally deficient γ-aminobutyric acid (GABA)-ergic modulation. However, it remains unclear how SICI is modulated during motor inhibition and how it relates to neural processing in other cortical areas. Here we studied motor inhibition Stop signal task (SST) in stabilized patients with schizophrenia (N = 28), healthy siblings (N = 21) and healthy controls (n = 31) matched in general cognitive status and educational level. Transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) were used to investigate neural correlates of motor inhibition. SST performance was similar in patients and controls. SICI was modulated by the task as expected in healthy controls and siblings but was reduced in patients with schizophrenia during inhibition despite equivalent motor inhibition performance. fMRI showed greater prefrontal and premotor activation during motor inhibition in schizophrenia. Task-related modulation of SICI was higher in subjects who showed less inhibition-related activity in pre-supplementary motor area (SMA) and cingulate motor area. An exploratory genetic analysis of selected markers of inhibition (GABRB2, GAD1, GRM1, and GRM3) did not explain task-related differences in SICI or cortical activation. In conclusion, this multimodal study provides direct evidence of a task-related deficiency in SICI modulation in schizophrenia likely reflecting deficient GABA-A related processing in motor cortex. Compensatory activation of premotor areas may explain similar motor inhibition in patients despite local deficits in intracortical processing. Task-related modulation of SICI may serve as a useful non-invasive GABAergic marker in development of therapeutic strategies in schizophrenia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Systems-level analysis of risk genes reveals the modular nature of schizophrenia.

    Science.gov (United States)

    Liu, Jiewei; Li, Ming; Luo, Xiong-Jian; Su, Bing

    2018-05-19

    Schizophrenia (SCZ) is a complex mental disorder with high heritability. Genetic studies (especially recent genome-wide association studies) have identified many risk genes for schizophrenia. However, the physical interactions among the proteins encoded by schizophrenia risk genes remain elusive and it is not known whether the identified risk genes converge on common molecular networks or pathways. Here we systematically investigated the network characteristics of schizophrenia risk genes using the high-confidence protein-protein interactions (PPI) from the human interactome. We found that schizophrenia risk genes encode a densely interconnected PPI network (P = 4.15 × 10 -31 ). Compared with the background genes, the schizophrenia risk genes in the interactome have significantly higher degree (P = 5.39 × 10 -11 ), closeness centrality (P = 7.56 × 10 -11 ), betweeness centrality (P = 1.29 × 10 -11 ), clustering coefficient (P = 2.22 × 10 -2 ), and shorter average shortest path length (P = 7.56 × 10 -11 ). Based on the densely interconnected PPI network, we identified 48 hub genes and 4 modules formed by highly interconnected schizophrenia genes. We showed that the proteins encoded by schizophrenia hub genes have significantly more direct physical interactions. Gene ontology (GO) analysis revealed that cell adhesion, cell cycle, immune system response, and GABR-receptor complex categories were enriched in the modules formed by highly interconnected schizophrenia risk genes. Our study reveals that schizophrenia risk genes encode a densely interconnected molecular network and demonstrates the modular nature of schizophrenia. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Prevalence of schizophrenia: recent developments

    African Journals Online (AJOL)

    The long held view that schizophrenia affects about 1% of the population has been shown to be an overestimate and in fact derived from incorrect data.1 Also, for many years, it was believed that the prevalence of schizophrenia varied little between sites.2,3 It is in fact the case that the estimates of the prevalence of ...

  10. [Negative Symptoms Revisited--Toward the Recovery of Persons with Schizophrenia].

    Science.gov (United States)

    Ikebuchi, Emi

    2015-01-01

    The negative symptoms of schizophrenia are usually treatment-refractory, and considered to be a major cause of a poor outcome. Recently, it has become an important issue to elucidate the etiology of and develop treatment for negative symptoms in order to improve the outcome of schizophrenia patients. Firstly, the history of negative symptoms was reviewed. Several lines of factor-analysis studies have suggested that negative symptoms are independent from other symptoms of schizophrenia, and consist of two factors, the poverty of expression and avolition, while the results depend upon the assessment scale employed in each analysis. Anhedonia, a part of avolition, may be considered as the impairment of pleasure-seeking behavior, the impairment of remembering non-current feelings, and a person's belief that he/she cannot experience pleasure, rather than the loss of pleasure itself. As neurological bases for avolition, decreases in reward expectancy, value representation, and the behavior to seek uncertain reward were observed, which resulted in poor social functioning due to the difficulties of initiating adaptive behaviors for the future. These impairments are the bases of decreased intrinsic motivation. The negative symptoms were considered to result in poor social functioning mediated by neuro-and social cognitive dysfunction and dysfunctional cognition, such as low self-efficacy and self-stigma. Pharmacotherapy for negative symptoms remains to be established due to a lack of evidence. Several psycho-social interventions in self-efficacy, self-stigma, intrinsic motivation, and environmental contexts are now being developed, while their effects are rather limited. The principles of psychiatric rehabilitation, i.e., respecting one's own value system and preference, self-determination, and motivation, are worth revisiting from the viewpoint of neuro-cognitive science. Furthermore, a hope-oriented approach, the presence of peers, and reconstructing social values as

  11. Pharmacotherapy of Schizophrenia: Ploypharmacy Approaches

    Directory of Open Access Journals (Sweden)

    Fatemeh Rahiminejad

    2010-07-01

    Full Text Available "nSchizophrenia is a debilitating illness, rating as one of the leading causes of lost years of quality of life. The illness imposes a disproportionate burden on patients and their families, healthcare systems and society. Pharmacological management is the cornerstone of treatment of schizophrenia, and antipsychotics, both first generation of antipsychotics and second generation of antipsychotics, are efficacious in reducing levels of psychopathology in acute episodes of schizophrenia. Clearly a need for innovative treatment strategies in schizophrenia that will ensure increased effectiveness against negative symptoms and cognitive dysfunction dysfunction. Therefore, in majority of cases polypharmacy is one of the effective approaches. This review focused on polypharmacy in the treatment of schizophrenia and in particular negative symptoms.

  12. Schizophrenia: a review of neuropharmacology.

    Science.gov (United States)

    Lyne, J; Kelly, B D; O'Connor, W T

    2004-01-01

    The last few decades have seen significant advances in our understanding of the neurochemical basis of schizophrenia. To describe the neurotransmitter systems and nerve circuits implicated in schizophrenia; to compare the neuropharmacology of typical and atypical anti-psychotic agents; and to describe recent developments in the pharmacological treatment of schizophrenia. Relevant pharmacological, neurophysiological and psychiatric literature was examined and reviewed. Schizophrenia is associated with abnormalities of multiple neurotransmitter systems, including dopamine, serotonin, gamma-aminobutyric acid and glutamate. Typical and atypical antipsychotic agents differ in their receptor-binding affinities, which are related to their differing side-effect profiles. Novel therapeutic strategies include normalisation of synaptic dopamine or serotonin levels, serotonin receptor antagonism and modulation of cerebral protein synthesis. The ideal treatment for schizophrenia may not be a single pharmacological agent but several agents that match the different expressions of the illness, in combination with psycho-social interventions.

  13. Impaired coupling of local and global functional feedbacks underlies abnormal synchronization and negative symptoms of schizophrenia.

    Science.gov (United States)

    Noh, Kyungchul; Shin, Kyung Soon; Shin, Dongkwan; Hwang, Jae Yeon; Kim, June Sic; Jang, Joon Hwan; Chung, Chun Kee; Kwon, Jun Soo; Cho, Kwang-Hyun

    2013-04-10

    Abnormal synchronization of brain oscillations is found to be associated with various core symptoms of schizophrenia. However, the underlying mechanism of this association remains yet to be elucidated. In this study, we found that coupled local and global feedback (CLGF) circuits in the cortical functional network are related to the abnormal synchronization and also correlated to the negative symptom of schizophrenia. Analysis of the magnetoencephalography data obtained from patients with chronic schizophrenia during rest revealed an increase in beta band synchronization and a reduction in gamma band power compared to healthy controls. Using a feedback identification method based on non-causal impulse responses, we constructed functional feedback networks and found that CLGF circuits were significantly reduced in schizophrenia. From computational analysis on the basis of the Wilson-Cowan model, we unraveled that the CLGF circuits are critically involved in the abnormal synchronization and the dynamical switching between beta and gamma bands power in schizophrenia. Moreover, we found that the abundance of CLGF circuits was negatively correlated with the development of negative symptoms of schizophrenia, suggesting that the negative symptom is closely related to the impairment of this circuit. Our study implicates that patients with schizophrenia might have the impaired coupling of inter- and intra-regional functional feedbacks and that the CLGF circuit might serve as a critical bridge between abnormal synchronization and the negative symptoms of schizophrenia.

  14. NMDA hypofunction as a convergence point for progression and symptoms of schizophrenia

    Directory of Open Access Journals (Sweden)

    Wen-Jun eGao

    2013-03-01

    Full Text Available Schizophrenia is a disabling mental illness that is now recognized as a neurodevelopmental disorder. It is likely that genetic risk factors interact with environmental perturbations to affect normal brain development and that this altered trajectory results in a combination of positive, negative, and cognitive symptoms. Although the exact pathophysiology of schizophrenia is unknown, the N-methyl-D-aspartate receptor (NMDAR, a major glutamate receptor subtype, has received great attention. Proper expression and regulation of NMDARs in the brain is critical for learning and memory processes as well as cortical plasticity and maturation. Evidence from both animal models and human studies implicates a dysfunction of NMDARs both in disease progression and symptoms of schizophrenia. Furthermore, mutations in many of the known genetic risk factors for schizophrenia suggest that NMDAR hypofunction is a convergence point for schizophrenia. In this review, we discuss how disrupted NMDAR function leads to altered neurodevelopment that may contribute to the progression and development of symptoms for schizophrenia, particularly cognitive deficits. We review the shared signaling pathways among the schizophrenia susceptibility genes DISC1, neuregulin1, and dysbindin, focusing on the AKT/GSK3β pathway, and how their mutations and interactions can lead to NMDAR dysfunction during development. Additionally, we explore what open questions remain and suggest where schizophrenia research needs to move in order to provide mechanistic insight into the cause of NMDAR dysfunction, as well as generate possible new avenues for therapeutic intervention.

  15. Reading impairment in schizophrenia: dysconnectivity within the visual system.

    Science.gov (United States)

    Vinckier, Fabien; Cohen, Laurent; Oppenheim, Catherine; Salvador, Alexandre; Picard, Hernan; Amado, Isabelle; Krebs, Marie-Odile; Gaillard, Raphaël

    2014-01-01

    Patients with schizophrenia suffer from perceptual visual deficits. It remains unclear whether those deficits result from an isolated impairment of a localized brain process or from a more diffuse long-range dysconnectivity within the visual system. We aimed to explore, with a reading paradigm, the functioning of both ventral and dorsal visual pathways and their interaction in schizophrenia. Patients with schizophrenia and control subjects were studied using event-related functional MRI (fMRI) while reading words that were progressively degraded through word rotation or letter spacing. Reading intact or minimally degraded single words involves mainly the ventral visual pathway. Conversely, reading in non-optimal conditions involves both the ventral and the dorsal pathway. The reading paradigm thus allowed us to study the functioning of both pathways and their interaction. Behaviourally, patients with schizophrenia were selectively impaired at reading highly degraded words. While fMRI activation level was not different between patients and controls, functional connectivity between the ventral and dorsal visual pathways increased with word degradation in control subjects, but not in patients. Moreover, there was a negative correlation between the patients' behavioural sensitivity to stimulus degradation and dorso-ventral connectivity. This study suggests that perceptual visual deficits in schizophrenia could be related to dysconnectivity between dorsal and ventral visual pathways. © 2013 Published by Elsevier Ltd.

  16. Associating schizophrenia, long non-coding RNAs and neurostructural dynamics

    Science.gov (United States)

    Merelo, Veronica; Durand, Dante; Lescallette, Adam R.; Vrana, Kent E.; Hong, L. Elliot; Faghihi, Mohammad Ali; Bellon, Alfredo

    2015-01-01

    Several lines of evidence indicate that schizophrenia has a strong genetic component. But the exact nature and functional role of this genetic component in the pathophysiology of this mental illness remains a mystery. Long non-coding RNAs (lncRNAs) are a recently discovered family of molecules that regulate gene transcription through a variety of means. Consequently, lncRNAs could help us bring together apparent unrelated findings in schizophrenia; namely, genomic deficiencies on one side and neuroimaging, as well as postmortem results on the other. In fact, the most consistent finding in schizophrenia is decreased brain size together with enlarged ventricles. This anomaly appears to originate from shorter and less ramified dendrites and axons. But a decrease in neuronal arborizations cannot explain the complex pathophysiology of this psychotic disorder; however, dynamic changes in neuronal structure present throughout life could. It is well recognized that the structure of developing neurons is extremely plastic. This structural plasticity was thought to stop with brain development. However, breakthrough discoveries have shown that neuronal structure retains some degree of plasticity throughout life. What the neuroscientific field is still trying to understand is how these dynamic changes are regulated and lncRNAs represent promising candidates to fill this knowledge gap. Here, we present evidence that associates specific lncRNAs with schizophrenia. We then discuss the potential role of lncRNAs in neurostructural dynamics. Finally, we explain how dynamic neurostructural modifications present throughout life could, in theory, reconcile apparent unrelated findings in schizophrenia. PMID:26483630

  17. Associating schizophrenia, long non-coding RNAs and neurostructural dynamics

    Directory of Open Access Journals (Sweden)

    Veronica eMerelo

    2015-09-01

    Full Text Available Several lines of evidence indicate that schizophrenia has a strong genetic component. But the exact nature and functional role of this genetic component in the pathophysiology of this mental illness remains a mystery. Long non-coding RNAs (lncRNAs are a recently discovered family of molecules that regulate gene transcription through a variety of means. Consequently, lncRNAs could help us bring together apparent unrelated findings in schizophrenia; namely, genomic deficiencies on one side and neuroimaging, as well as postmortem results on the other. In fact, the most consistent finding in schizophrenia is decreased brain size together with enlarged ventricles. This anomaly appears to originate from shorter and less ramified dendrites and axons. But a decrease in neuronal arborizations cannot explain the complex pathophysiology of this psychotic disorder; however, dynamic changes in neuronal structure present throughout life could. It is well recognized that the structure of developing neurons is extremely plastic. This structural plasticity was thought to stop with brain development. However, breakthrough discoveries have shown that neuronal structure retains some degree of plasticity throughout life. What the neuroscientific field is still trying to understand is how these dynamic changes are regulated and lncRNAs represent promising candidates to fill this knowledge gap. Here, we present evidence that associates specific lncRNAs with schizophrenia. We then discuss the potential role of lncRNAs in neurostructural dynamics. Finally, we explain how dynamic neurostructural modifications present throughout life could, in theory, reconcile apparent unrelated findings in schizophrenia.

  18. Genetic Basis of Positive and Negative Symptom Domains in Schizophrenia.

    Science.gov (United States)

    Xavier, Rose Mary; Vorderstrasse, Allison

    2017-10-01

    Schizophrenia is a highly heritable disorder, the genetic etiology of which has been well established. Yet despite significant advances in genetics research, the pathophysiological mechanisms of this disorder largely remain unknown. This gap has been attributed to the complexity of the polygenic disorder, which has a heterogeneous clinical profile. Examining the genetic basis of schizophrenia subphenotypes, such as those based on particular symptoms, is thus a useful strategy for decoding the underlying mechanisms. This review of literature examines the recent advances (from 2011) in genetic exploration of positive and negative symptoms in schizophrenia. We searched electronic databases PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature using key words schizophrenia, symptoms, positive symptoms, negative symptoms, cognition, genetics, genes, genetic predisposition, and genotype in various combinations. We identified 115 articles, which are included in the review. Evidence from these studies, most of which are genetic association studies, identifies shared and unique gene associations for the symptom domains. Genes associated with neurotransmitter systems and neuronal development/maintenance primarily constitute the shared associations. Needed are studies that examine the genetic basis of specific symptoms within the broader domains in addition to functional mechanisms. Such investigations are critical to developing precision treatment and care for individuals afflicted with schizophrenia.

  19. The neural correlates of apathy in schizophrenia: An exploratory investigation.

    Science.gov (United States)

    Caravaggio, Fernando; Fervaha, Gagan; Menon, Mahesh; Remington, Gary; Graff-Guerrero, Ariel; Gerretsen, Philip

    2017-10-25

    Motivational deficits represent a core negative symptom in patients with schizophrenia. Previous morphology studies have demonstrated that apathy in patients with schizophrenia is associated with reduced frontal grey matter (GM). We attempted to replicate this previous finding, and explored whether it was distinct from potential associations with a distinct subdomain of negative symptoms, namely Affective Flattening, and GM. Twenty medicated patients with schizophrenia provided structural T1-weighted images acquired on a 3-Tesla MRI scanner and negative symptoms were evaluated using the Scale for the Assessment of Negative Symptoms. Voxel-based morphometry (VBM) was used to explore the correlations between whole-brain GM and i) Apathy, and ii) Affective Flattening, respectively. Apathy scores were negatively correlated with several GM clusters in frontal regions, including the frontal inferior operculum and the left dorsal anterior cingulate cortex. Only positive correlations with GM clusters were observed for Affective Flattening, particularly in the inferior temporal lobe. Notably, the regions associated with apathy scores were distinct from those associated with Affective Flattening, and these findings remained after controlling for antipsychotic medication dosage. We replicated previous associations between reduced frontal GM and apathy in patients with schizophrenia. Moreover, we demonstrated that these GM associations are distinct from those with Affective Flattening. The present findings set the stage for future larger-scale studies confirming the structural and neurochemical substrates of apathy in schizophrenia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Ethics of the early intervention in the treatment of schizophrenia.

    Science.gov (United States)

    Filaković, Pavo; Degmecić, Dunja; Koić, Elvira; Benić, Domagoj

    2007-09-01

    When second generation antipsychotics were introduced in the mid 1990-s they offered the possibility of early psychopharmacological interventions in the treatment of schizophrenia. The idea applying antipsychotics in the prodromal phase of schizophrenia today is an realistic option. However ethical dilemmas about offering antipsychotics to the adolescents with at risk mental states, of whom only a few are real prodromes of schizophrenia remain for clinicians. In the literature about the ethics of the early interventions in psychiatry there are still many ethical questions which call for caution because of the low predictive value of at risk mental states, of which only 40% turn out to be a real prodrome of schizophrenia. These ethical questions can be addressed in three categories: - how to best identify who should receive early pharmacological intervention? - what this intervention should consist of? - how to evaluate treatment efficacy in the absence of illness base rates in the adolescents with a real prodrome of schizophrenia? Besides, arguing against the concept of early psychopharmacological interventions in the adolescent population are the fact of the unknown effect of antipsychotics on the developing brain as well as negative effects of stigma on those adolescents who receive them. The authors in the article analyse these ethical questions and take the side of those clinicians who think that caution and careful ethical judgment are needed before the prescribing of antipsychotics to adolescents with at risk mental states.

  1. Altered amygdala-prefrontal connectivity during emotion perception in schizophrenia.

    Science.gov (United States)

    Bjorkquist, Olivia A; Olsen, Emily K; Nelson, Brady D; Herbener, Ellen S

    2016-08-01

    Individuals with schizophrenia evidence impaired emotional functioning. Abnormal amygdala activity has been identified as an etiological factor underlying affective impairment in this population, but the exact nature remains unclear. The current study utilized psychophysiological interaction analyses to examine functional connectivity between the amygdala and medial prefrontal cortex (mPFC) during an emotion perception task. Participants with schizophrenia (SZ) and healthy controls (HC) viewed and rated positive, negative, and neutral images while undergoing functional neuroimaging. Results revealed a significant group difference in right amygdala-mPFC connectivity during perception of negative versus neutral images. Specifically, HC participants demonstrated positive functional coupling between the amygdala and mPFC, consistent with co-active processing of salient information. In contrast, SZ participants evidenced negative functional coupling, consistent with top-down inhibition of the amygdala by the mPFC. A significant positive correlation between connectivity strength during negative image perception and clinician-rated social functioning was also observed in SZ participants, such that weaker right amygdala-mPFC coupling during negative compared to neutral image perception was associated with poorer social functioning. Overall, results suggest that emotional dysfunction and associated deficits in functional outcome in schizophrenia may relate to abnormal interactions between the amygdala and mPFC during perception of emotional stimuli. This study adds to the growing literature on abnormal functional connections in schizophrenia and supports the functional disconnection hypothesis of schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. [Cognition, schizophrenia and the effect of antipsychotics].

    Science.gov (United States)

    Stip, E

    2006-01-01

    in patients receiving clozapine, while haloperidol was associated with deleterious effects in both tasks. Risperidone, however, produced different effects depending on the task performed. Another 6-month double-blind Canadian study confirmed the beneficial effect of olanzapine on PL compared to haloperidol and risperidone. The differential effects of drugs on the striatal D(2) receptors, -irrespective of their classification as conventional or atypical neuroleptics and the specific process implicated in each of these PL tasks may explain these results. Tracer studies using radioactive benzamides (IBZM) specific to striatal D receptors determined a relationship between striatal D(2) receptor occupancy and PL performance such as the mirror drawing task. Using this method, data obtained in Montreal on schizophrenia patients receiving olanzapine and haloperidol have shown that the coefficient of determination in a visuomotor PL task varied inversely with D2 receptor saturation. This review probes the effect of impaired cognitive functions on schizophrenia patients' quality of life. Cognitive deficits found in schizophrenia affect planning, along with the aptitude to initiate and -regulate a goal-directed behaviour. These impairments have been repeatedly, yet inconclusively, attributed to frontal lobe dysfunction. Morphological findings obtained from neuroimaging studies remain inconsistent, some noting no differences between patients and controls while others observing reduced prefrontal volumes in schizophrenia patients. Conversely, functional neuroimaging (fMRI) demonstrated reduced frontal blood flow relative to global cerebral perfusion in schizophrenia patients. Overall, neuroimaging literature provides reliable evidence of frontal impairments in schizophrenia, although the average magnitude of difference between patients and controls is insufficient to defend a frontal lobe dysfunction hypo-thesis, as far as brain volume, resting cerebral metabolism or blood flow

  3. Factor Structure of Social Cognition in Schizophrenia: Is Empathy Preserved?

    Directory of Open Access Journals (Sweden)

    Silvia Corbera

    2013-01-01

    Full Text Available Social cognitive impairments are core features of schizophrenia and are closely associated with poor functional outcome. This study sought to identify specific aspects of social cognition and their relationships to measures of social function, quality of life, and neurocognition. Principal component analysis was performed using social cognitive measures in patients with schizophrenia and healthy matched controls and revealed three factors: Interpersonal Discomfort, Basic Social Cognition, and Empathy. Patients had higher scores on Interpersonal Discomfort and lower scores on Basic Social Cognition than controls, but the two groups were the same on Empathy. Lower social performance was significantly correlated with poor Basic Social Cognition in patients and with high Interpersonal Discomfort in controls. While neurocognition was significantly associated with Basic Social Cognition in both groups, it was not associated with Empathy. Social cognitive interventions should emphasize improving basic social cognitive processing deficits, managing Interpersonal Discomfort, and utilizing preserved capacity for empathy as a potential strength in social interactions.

  4. The beneficial influence of inattention on visual interference in schizophrenia.

    Science.gov (United States)

    Brodeur, Mathieu B; Kiang, Michael; Christensen, Bruce K

    2016-09-01

    Schizophrenia is associated with poor spatial attention. However, although this deficit undermines the perception of target information, it may be helpful for ignoring irrelevant inputs. The present study examined whether event-related brain potential (ERP) indices of visual spatial attention predicted the magnitude of the brain response to interference in schizophrenia. ERPs were recorded in 16 schizophrenia patients and 20 healthy control participants who had to indicate whether the target E was global or local in compound letter stimuli. The nontarget could be either highly similar to the target (i.e., a global E composed of local Ss and vice versa) and thus produce more interference, or it could be dissimilar (i.e., a global E composed of local Hs and vice versa) and generate less interference. Both groups' responses were slowed by interference. Voltage amplitudes of the P1, and of ERP interference effects from 300-500 ms after stimulus onset, were significantly smaller in schizophrenia patients than in healthy participants when the target was global. In patients, larger P1 amplitudes were correlated with larger interference effects and with more severe symptoms of attentional deficits and conceptual disorganization. Schizophrenia participants thus exhibited abnormal ERPs to interference despite normal behavioral performance. Schizophrenia patients likely pay less attention to stimuli in general; however, the impact of this impairment on target detection is compensated by relatively greater inattention to irrelevant components of the stimuli, and this explains why they are not more influenced by interference than healthy participants at the behavioral level. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  5. EXECUTIVE FUNCTIONING IN SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Gricel eOrellana

    2013-06-01

    Full Text Available The executive function (EF is a set of abilities, which allows us to invoke voluntary control of our behavioral responses. These functions enable human beings to develop and carry out plans, make up analogies, obey social rules, solve problems, adapt to unexpected circumstances, do many tasks simultaneously and locate episodes in time and place. EF includes divided attention and sustained attention, working memory, set-shifting, flexibility, planning and the regulation of goal directed behavior and can be defined as a brain function underlying the human faculty to act or think not only in reaction to external events but also in relation with internal goals and states. EF is mostly associated with dorsolateral prefrontal cortex (PFC. Besides EF, PFC is involved in self-regulation of behavior, i.e. the ability to regulate behavior according to internal goals and constraints, particularly in less structured situations. Self-regulation of behavior is subtended by ventral medial /orbital PFC. Impairment of EF is one of the most commonly observed deficits in schizophrenia through the various disease stages. Impairment in tasks measuring conceptualization, planning, cognitive flexibility, verbal fluency, ability to solve complex problems and working memory occur in schizophrenia. Disorders detected by executive tests are consistent with evidence from functional neuroimaging, which have shown PFC dysfunction in patients while performing these kinds of tasks. Schizophrenics also exhibit deficit in odor identifying, decision-making and self-regulation of behavior suggesting dysfunction of the orbital PFC. However, impairment in executive tests is explained by dysfunction of prefronto-striato-thalamic, prefronto-parietal and prefronto-temporal neural networks mainly. Disorders in executive functions may be considered central facts with respect to schizophrenia and it has been suggested that negative symptoms may be explained by that executive dysfunction.

  6. MRI anatomy of schizophrenia.

    Science.gov (United States)

    McCarley, R W; Wible, C G; Frumin, M; Hirayasu, Y; Levitt, J J; Fischer, I A; Shenton, M E

    1999-05-01

    Structural magnetic resonance imaging (MRI) data have provided much evidence in support of our current view that schizophrenia is a brain disorder with altered brain structure, and consequently involving more than a simple disturbance in neurotransmission. This review surveys 118 peer-reviewed studies with control group from 1987 to May 1998. Most studies (81%) do not find abnormalities of whole brain/intracranial contents, while lateral ventricle enlargement is reported in 77%, and third ventricle enlargement in 67%. The temporal lobe was the brain parenchymal region with the most consistently documented abnormalities. Volume decreases were found in 62% of 37 studies of whole temporal lobe, and in 81% of 16 studies of the superior temporal gyrus (and in 100% with gray matter separately evaluated). Fully 77% of the 30 studies of the medial temporal lobe reported volume reduction in one or more of its constituent structures (hippocampus, amygdala, parahippocampal gyrus). Despite evidence for frontal lobe functional abnormalities, structural MRI investigations less consistently found abnormalities, with 55% describing volume reduction. It may be that frontal lobe volume changes are small, and near the threshold for MRI detection. The parietal and occipital lobes were much less studied; about half of the studies showed positive findings. Most studies of cortical gray matter (86%) found volume reductions were not diffuse, but more pronounced in certain areas. About two thirds of the studies of subcortical structures of thalamus, corpus callosum and basal ganglia (which tend to increase volume with typical neuroleptics), show positive findings, as do almost all (91%) studies of cavum septi pellucidi (CSP). Most data were consistent with a developmental model, but growing evidence was compatible also with progressive, neurodegenerative features, suggesting a "two-hit" model of schizophrenia, for which a cellular hypothesis is discussed. The relationship of clinical

  7. Outpatient management of schizophrenia.

    Science.gov (United States)

    Martin, R L

    1991-03-01

    As effective antipsychotic pharmacotherapy has become available, patients with schizophrenia are increasingly managed in an outpatient setting by primary care physicians. Pharmacotherapy is generally effective in treating "positive," or psychotic, symptoms and lessening the risks of relapse, but ineffective in improving "negative," or deficit, symptoms. Aggressive attempts to totally control positive symptoms and to ameliorate negative symptoms tend to increase side effects and may be detrimental to the patient. Intensive psychotherapeutic and rehabilitative approaches are generally unproductive. Attempting to obtain a cure is unrealistic. A moderate approach is recommended, taking into consideration the limitations of existing treatments, achieving control of extreme symptoms and minimizing social and occupational limitations.

  8. [Medicamental treatment of schizophrenia].

    Science.gov (United States)

    Lotstra, F; Lestienne, S; De Nayer, A

    2010-09-01

    Antipsychotics play a key role in biologic therapy of schizophrenia. Following the first-generation neuroleptics, associated with many extrapyramidal side effects (severe dystonias, parkinsonian syndrome, akatisia and late dyskinesia) altering patients' compliance to the treatment, one can now find a new generation of molecules considered as atypical antipsychotics because they rarely cause neurological complications. This propriety provides a better compliance, along with a clear decrease of late dyskinesia risk but the effectiveness compared to ordinary molecules is still questioned. However, some of them can cause an increased risk of metabolic syndrome. Some molecules such as benzodiazepines and some antidepressants can also be prescribed to cure schizophrenic patients.

  9. Schizophrenia and violent behavior

    Directory of Open Access Journals (Sweden)

    Alexandre Martins Valença

    2011-12-01

    Full Text Available The aim of this study is to report the case of a woman who killed a child. After a forensic psychiatric appraisal to evaluate penal responsibility, she was considered not guilty by reason of insanity and mandatorily committed to the central forensic psychiatric hospital in the State of Rio de Janeiro, Brazil. The patient received a diagnosis of paranoid schizophrenia, based on DSM-IV-TR. She was not in psychiatric treatment and showed psychotic symptoms before the violent behavior became manifest. The study of motivational factors in homicidal behavior may provide further knowledge for understanding, preventing and treating it in such cases.

  10. The association between season of birth, age at onset, and clozapine use in schizophrenia.

    Science.gov (United States)

    Kim, J S; Park, C M; Choi, J A; Park, E; Tchoe, H J; Choi, M; Suh, J K; Kim, Y H; Won, S H; Chung, Y C; Bae, K Y; Lee, S K; Park, S C; Lee, S H

    2017-11-01

    This study aimed to determine whether the rate of clozapine use, an indicator of refractoriness in schizophrenia, is associated with the season of birth and age at onset in patients with schizophrenia based on nationwide data. Patients with schizophrenia (n = 114 749) who received prescriptions for antipsychotic medication between 2008 and 2014 were retrospectively identified from the Korean National Health Insurance Service database. The study population was divided into three groups based on their age at the onset of schizophrenia (early, middle, and late onset). We assessed differences in the month of birth between patients and the general population. In addition, the cumulative clozapine use was calculated. Compared to the late-onset schizophrenia group, the early- and middle-onset groups showed a higher probability of birth during the winter season. In addition, the early-onset group showed the highest cumulative clozapine use rate. In the middle-onset group, the initiation of clozapine use was significantly earlier for patients born in winter compared to those born in summer. Our results indicate that the age at onset is an important factor in predicting the prognosis of schizophrenia patients. The season of birth also affects the prognosis, but with less robustness. Specifically, it appears that early disease onset and winter birth might be associated with poor outcomes in Korean patients with schizophrenia. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Cognitive endophenotypes, gene-environment interactions and experience-dependent plasticity in animal models of schizophrenia.

    Science.gov (United States)

    Burrows, Emma L; Hannan, Anthony J

    2016-04-01

    Schizophrenia is a devastating brain disorder caused by a complex and heterogeneous combination of genetic and environmental factors. In order to develop effective new strategies to prevent and treat schizophrenia, valid animal models are required which accurately model the disorder, and ideally provide construct, face and predictive validity. The cognitive deficits in schizophrenia represent some of the most debilitating symptoms and are also currently the most poorly treated. Therefore it is crucial that animal models are able to capture the cognitive dysfunction that characterizes schizophrenia, as well as the negative and psychotic symptoms. The genomes of mice have, prior to the recent gene-editing revolution, proven the most easily manipulable of mammalian laboratory species, and hence most genetic targeting has been performed using mouse models. Importantly, when key environmental factors of relevance to schizophrenia are experimentally manipulated, dramatic changes in the phenotypes of these animal models are often observed. We will review recent studies in rodent models which provide insight into gene-environment interactions in schizophrenia. We will focus specifically on environmental factors which modulate levels of experience-dependent plasticity, including environmental enrichment, cognitive stimulation, physical activity and stress. The insights provided by this research will not only help refine the establishment of optimally valid animal models which facilitate development of novel therapeutics, but will also provide insight into the pathogenesis of schizophrenia, thus identifying molecular and cellular targets for future preclinical and clinical investigations. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Theory of mind in schizophrenia: exploring neural mechanisms of belief attribution.

    Science.gov (United States)

    Lee, Junghee; Quintana, Javier; Nori, Poorang; Green, Michael F

    2011-01-01

    Although previous behavioral studies have shown that schizophrenia patients have impaired theory of mind (ToM), the neural mechanisms associated with this impairment are poorly understood. This study aimed to identify the neural mechanisms of ToM in schizophrenia, using functional magnetic resonance imaging (fMRI) with a belief attribution task. In the scanner, 12 schizophrenia patients and 13 healthy control subjects performed the belief attribution task with three conditions: a false belief condition, a false photograph condition, and a simple reading condition. For the false belief versus simple reading conditions, schizophrenia patients showed reduced neural activation in areas including the temporoparietal junction (TPJ) and medial prefrontal cortex (MPFC) compared with controls. Further, during the false belief versus false photograph conditions, we observed increased activations in the TPJ and the MPFC in healthy controls, but not in schizophrenia patients. For the false photograph versus simple reading condition, both groups showed comparable neural activations. Schizophrenia patients showed reduced task-related activation in the TPJ and the MPFC during the false belief condition compared with controls, but not for the false photograph condition. This pattern suggests that reduced activation in these regions is associated with, and specific to, impaired ToM in schizophrenia.

  13. 9. Poor medication

    African Journals Online (AJOL)

    Sitwala

    Majority (60%) of the patients were reviewed at least twice in the last 6 months at the time of the interview. 195 (83%) patients reported that drugs prescribed were not available at the hospital pharmacy, but 186 (79%) of. Factors Associated With Poor Medication Adherence. In Hypertensive Patients In Lusaka, Zambia. 1,4. 1.

  14. Social Cognition in Schizophrenia: An NIMH Workshop on Definitions, Assessment, and Research Opportunities

    Science.gov (United States)

    Green, Michael F.; Penn, David L.; Bentall, Richard; Carpenter, William T.; Gaebel, Wolfgang; Gur, Ruben C.; Kring, Ann M.; Park, Sohee; Silverstein, Steven M.; Heinssen, Robert

    2008-01-01

    Social cognition has become a high priority area for the study of schizophrenia. However, despite developments in this area, progress remains limited by inconsistent terminology and differences in the way social cognition is measured. To address these obstacles, a consensus-building meeting on social cognition in schizophrenia was held at the National Institute of Mental Health in March 2006. Agreement was reached on several points, including definitions of terms, the significance of social cognition for schizophrenia research, and suggestions for future research directions. The importance of translational interdisciplinary research teams was emphasized. The current article presents a summary of these discussions. PMID:18184635

  15. Is it me? Verbal self-monitoring neural network and clinical insight in schizophrenia.

    Science.gov (United States)

    Sapara, Adegboyega; Ffytche, Dominic H; Cooke, Michael A; Williams, Steven C R; Kumari, Veena

    2015-12-30

    Self-monitoring, defined as the ability to distinguish between self-generated stimuli from other-generated ones, is known to be impaired in schizophrenia. This impairment has been theorised as the basis for many of the core psychotic symptoms, in particular, poor clinical insight. This study aimed to investigate verbal self-monitoring related neural substrates of preserved and poor clinical insight in schizophrenia. It involved 40 stable schizophrenia outpatients, 20 with preserved and 20 with poor insight, and 20 healthy participants. All participants underwent functional magnetic resonance imaging with brain coverage covering key areas in the self-monitoring network during a verbal self-monitoring task. Healthy participants showed higher performance accuracy and greater thalamic activity than both preserved and poor insight patient groups. Preserved insight patients showed higher activity in the putamen extending into the caudate, insula and inferior frontal gyrus, compared to poor insight patients, and in the anterior cingulate and medial frontal gyrus, compared to healthy participants. Poor insight patients did not show greater activity in any brain area compared to preserved insight patients or healthy participants. Future studies may pursue therapeutic avenues, such as meta-cognitive therapies to promote self-monitoring or targeted stimulation of relevant brain areas, as means of enhancing insight in schizophrenia. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  16. Schizophrenia on YouTube.

    Science.gov (United States)

    Nour, Matthew M; Nour, Murraih H; Tsatalou, Olga-Maria; Barrera, Alvaro

    2017-01-01

    YouTube ( www.youtube.com ) is the most popular video-sharing Web site on the Internet and is used by medical students as a source of information regarding mental health conditions, including schizophrenia. The accuracy and educational utility of schizophrenia presentations on YouTube are unknown. The purpose of this study was to analyze the accuracy of depictions of psychosis in the context of a diagnosis of schizophrenia (referred to in this article as "acute schizophrenia") on YouTube and to assess the utility of these videos as educational tools for teaching medical students to recognize the clinical features of acute schizophrenia. YouTube was searched for videos purporting to show acute schizophrenia. Eligible videos were independently rated by two consultant psychiatrists on two separate occasions 22 days apart for diagnostic accuracy, psychopathology, and educational utility. Videos (N=4,200) were assessed against predefined inclusion and exclusion criteria. The majority were not eligible for further analysis, mostly because they did not claim to show a patient with schizophrenia (74%) or contained duplicated content (11%). Of 35 videos that met the eligibility and adequacy criteria, only 12 accurately depicted acute schizophrenia. Accurate videos were characterized by persecutory delusions (83%), inappropriate affect (75%), and negative symptoms (83%). Despite the fact that 83% of accurate videos were deemed to have good educational utility compared with 15% of inaccurate videos, accurate and inaccurate videos had similar view counts (290,048 versus 186,124). Schizophrenia presentations on YouTube offer a distorted picture of the condition.

  17. Unipolar Depression in Paroxysmal Schizophrenia

    Directory of Open Access Journals (Sweden)

    Alexander S. Bobrov

    2013-12-01

    Full Text Available Based on the current study, the clinical characteristics of unipolar depression in the clinical picture of schizophrenia with the paroxysmal type of disease course are presented. Given the concomitant depression with phobic symptoms, the following clinical variants are marked: depression with generalized social phobia and/or anthropophobia and depression with generalized pathological body sensations and hypochondriacal phobias. In other words, we are talking about a necessity to allocate a special type of schizophrenia with affective structure episodes and comorbid neurosis-like symptoms. Information on the basic treatment strategy of schizophrenia with depressive structure episodes and comorbid neurosis-like symptoms in everyday psychiatric practice is also provided.

  18. Schizophrenia: breaking down the barriers.

    Science.gov (United States)

    Haghighat, R

    1997-01-01

    This paper reviews the key issues presented during the Fourth International Conference on Schizophrenia, which was held in October 1996 in Vancouver, Canada. The main emphasis was placed on the problem of stigma, loneliness and work as well as on the necessity to further elucidate the physiopathology of schizophrenia. Some of the barriers discussed are unlikely to disappear from human societies in the short term with any possible cure for schizophrenia as they are part of any major long-term illness, of which there is a long and ever increasing list.

  19. Gesture Imitation in Schizophrenia

    Science.gov (United States)

    Matthews, Natasha; Gold, Brian J.; Sekuler, Robert; Park, Sohee

    2013-01-01

    Recent evidence suggests that individuals with schizophrenia (SZ) are impaired in their ability to imitate gestures and movements generated by others. This impairment in imitation may be linked to difficulties in generating and maintaining internal representations in working memory (WM). We used a novel quantitative technique to investigate the relationship between WM and imitation ability. SZ outpatients and demographically matched healthy control (HC) participants imitated hand gestures. In Experiment 1, participants imitated single gestures. In Experiment 2, they imitated sequences of 2 gestures, either while viewing the gesture online or after a short delay that forced the use of WM. In Experiment 1, imitation errors were increased in SZ compared with HC. Experiment 2 revealed a significant interaction between imitation ability and WM. SZ produced more errors and required more time to imitate when that imitation depended upon WM compared with HC. Moreover, impaired imitation from WM was significantly correlated with the severity of negative symptoms but not with positive symptoms. In sum, gesture imitation was impaired in schizophrenia, especially when the production of an imitation depended upon WM and when an imitation entailed multiple actions. Such a deficit may have downstream consequences for new skill learning. PMID:21765171

  20. Gesture imitation in schizophrenia.

    Science.gov (United States)

    Matthews, Natasha; Gold, Brian J; Sekuler, Robert; Park, Sohee

    2013-01-01

    Recent evidence suggests that individuals with schizophrenia (SZ) are impaired in their ability to imitate gestures and movements generated by others. This impairment in imitation may be linked to difficulties in generating and maintaining internal representations in working memory (WM). We used a novel quantitative technique to investigate the relationship between WM and imitation ability. SZ outpatients and demographically matched healthy control (HC) participants imitated hand gestures. In Experiment 1, participants imitated single gestures. In Experiment 2, they imitated sequences of 2 gestures, either while viewing the gesture online or after a short delay that forced the use of WM. In Experiment 1, imitation errors were increased in SZ compared with HC. Experiment 2 revealed a significant interaction between imitation ability and WM. SZ produced more errors and required more time to imitate when that imitation depended upon WM compared with HC. Moreover, impaired imitation from WM was significantly correlated with the severity of negative symptoms but not with positive symptoms. In sum, gesture imitation was impaired in schizophrenia, especially when the production of an imitation depended upon WM and when an imitation entailed multiple actions. Such a deficit may have downstream consequences for new skill learning.

  1. Out of touch with reality? Social perception in first-episode schizophrenia

    OpenAIRE

    Ebisch, Sjoerd J. H.; Salone, Anatolia; Ferri, Francesca; De Berardis, Domenico; Romani, Gian Luca; Ferro, Filippo M.; Gallese, Vittorio

    2013-01-01

    Social dysfunction has been recognized as an elementary feature of schizophrenia, but it remains a crucial issue whether social deficits in schizophrenia concern the inter-subjective domain or primarily have their roots in disturbances of self-experience. Social perception comprises vicarious processes grounding an experiential inter-relationship with others as well as self-regulation processes allowing to maintain a coherent sense of self. The present study investigated whether the functiona...

  2. Cortical thickness and low insight into symptoms in enduring schizophrenia.

    Science.gov (United States)

    Emami, Seema; Guimond, Synthia; Mallar Chakravarty, M; Lepage, Martin

    2016-01-01

    Poor insight is a common, multidimensional phenomenon in patients with schizophrenia, associated with poorer outcomes and treatment non-adherence. Yet scant research has investigated the neuronal correlates of insight into symptoms (IS), a dimension of insight that may be particularly significant in enduring schizophrenia. Sixty-six patients with enduring schizophrenia (duration >4years) and 33 healthy controls completed MRI scanning and IQ, depression, and anxiety assessments. The Scale to Assess Insight-Expanded (SAI-E) measured insight into patients' four most prominent symptoms and patients were classified into two groups: low IS (0-2; n=33), and high IS (>2; n=33). We evaluated the association between cortical thickness (CT) and insight into symptoms using two methods: (1) a between-patients region-of-interest analysis in the insula, superior temporal gyrus (STG) and frontal lobe; and (2) a whole-brain exploratory regression between patient and controls. Brain regions were segmented using a neuroanatomical atlas and vertex-wise CT analyses were conducted with CIVET, covaried for age and sex. ROI analysis revealed thinner insula cortex in patients with low IS (pinsight-related differences in CT that has been previously unexplored in enduring schizophrenia. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Exploring social cognition in schizophrenia

    DEFF Research Database (Denmark)

    Revsbech, Rasmus; Mortensen, Erik Lykke; Frederiksen, Julie Elisabeth Nordgaard

    2017-01-01

    The aim of the study was to compare social cognition between groups of patients diagnosed with schizophrenia and healthy controls and to replicate two previous studies using tests of social cognition that may be particularly sensitive to social cognitive deficits in schizophrenia. Thirty......-eight first-admitted patients with schizophrenia and 38 healthy controls solved 11 “imaginary conversation (i.e., theory of mind)” items, 10 “psychological understanding” items, and 10 “practical understanding” items. Statistical tests were made of unadjusted and adjusted group differences in models adjusting...... nonsignificant. When intelligence and global cognitive functioning is taken into account, schizophrenia patients and healthy controls perform similarly on social cognitive tests. © 2016 Springer-Verlag Berlin Heidelberg...

  4. Excess Early Mortality in Schizophrenia

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk; Nordentoft, Merete; Mortensen, Preben Bo

    2014-01-01

    Schizophrenia is often referred to as one of the most severe mental disorders, primarily because of the very high mortality rates of those with the disorder. This article reviews the literature on excess early mortality in persons with schizophrenia and suggests reasons for the high mortality...... as well as possible ways to reduce it. Persons with schizophrenia have an exceptionally short life expectancy. High mortality is found in all age groups, resulting in a life expectancy of approximately 20 years below that of the general population. Evidence suggests that persons with schizophrenia may...... not have seen the same improvement in life expectancy as the general population during the past decades. Thus, the mortality gap not only persists but may actually have increased. The most urgent research agenda concerns primary candidates for modifiable risk factors contributing to this excess mortality...

  5. GWAS, Cytomegalovirus Infection, and Schizophrenia

    DEFF Research Database (Denmark)

    Grove, Jakob; Børglum, Anders; Pearce, Brad D

    2014-01-01

    In recent years, good progress has been made in uncovering the genetic underpinnings of schizophrenia. Even so, as a polygenic disorder, schizophrenia has a complex etiology that is far from understood. Meanwhile, data are being collected enabling the study of interactions between genes...... and the environment. A confluence of data from genetic and environmental exposure studies point to the role of infections and immunity in the pathophysiology of schizophrenia. In a recent study by Børglum et al., a single nucleotide polymorphism (SNP) in the gene CTNNA3 was identified that may provide clues to gene......-environment interactions. The carriers of the minor allele for the SNP had a fivefold risk of later developing schizophrenia if their mothers were CMV positive, while the children not carrying the allele had no excess risk from maternal CMV. In the current paper, we summarize recent advances to clarify a possible...

  6. Neural complexity, dissociation, and schizophrenia

    Czech Academy of Sciences Publication Activity Database

    Bob, P.; Šusta, M.; Chládek, Jan; Glaslová, K.; Fedor-Ferybergh, P.

    2007-01-01

    Roč. 13, č. 10 (2007), HY1-5 ISSN 1234-1010 Institutional research plan: CEZ:AV0Z20650511 Keywords : neural complexity * dissociation * schizophrenia Subject RIV: FH - Neurology Impact factor: 1.607, year: 2007

  7. Management of treatment resistant schizophrenia

    African Journals Online (AJOL)

    Adele

    Whilst gains have been made in recent years in the pharmacological treatment of schizophrenia, a number of ... pharmacotherapy to include psychological and occupational ... outcome studies suggesting that only 20-30% of people with.

  8. Schizophrenia and second language acquisition.

    Science.gov (United States)

    Bersudsky, Yuly; Fine, Jonathan; Gorjaltsan, Igor; Chen, Osnat; Walters, Joel

    2005-05-01

    Language acquisition involves brain processes that can be affected by lesions or dysfunctions in several brain systems and second language acquisition may depend on different brain substrates than first language acquisition in childhood. A total of 16 Russian immigrants to Israel, 8 diagnosed schizophrenics and 8 healthy immigrants, were compared. The primary data for this study were collected via sociolinguistic interviews. The two groups use language and learn language in very much the same way. Only exophoric reference and blocking revealed meaningful differences between the schizophrenics and healthy counterparts. This does not mean of course that schizophrenia does not induce language abnormalities. Our study focuses on those aspects of language that are typically difficult to acquire in second language acquisition. Despite the cognitive compromises in schizophrenia and the manifest atypicalities in language of speakers with schizophrenia, the process of acquiring a second language seems relatively unaffected by schizophrenia.

  9. Spouse with schizophrenia and risk of dementia.

    Science.gov (United States)

    Rohde, Christopher; Agerbo, Esben; Nielsen, Philip Rising

    2016-12-01

    Increased prevalence of lifestyle risk factors or shared etiology may underlie the association between schizophrenia and the subsequent risk of dementia. We explored the association between having a spouse with schizophrenia and the risk of dementia. We found a positive relationship between having a spouse with schizophrenia and vascular dementia in individuals without a mental disorder themselves but no association between having a spouse with schizophrenia and Alzheimer's dementia. As spouses share environmental risk factors and lifestyle, this might suggest that the excess risk of dementia in probands with schizophrenia could be ascribed to the unhealthy living environment among individuals with schizophrenia.

  10. Evaluation of shared genetic susceptibility loci between autoimmune diseases and schizophrenia based on genome-wide association studies

    DEFF Research Database (Denmark)

    Hoeffding, Louise K E; Rosengren, Anders; Thygesen, Johan H

    2017-01-01

    Background: Epidemiological studies have documented higher than expected comorbidity (or, in some cases, inverse comorbidity) between schizophrenia and several autoimmune disorders. It remains unknown whether this comorbidity reflects shared genetic susceptibility loci.  Aims: The present study a...

  11. Schizophrenia: Hope on the Horizon

    OpenAIRE

    Sullivan, Patrick F.

    2015-01-01

    Editor?s Note: In July 2014, an international consortium of schizophrenia researchers co-founded by the author mounted the largest biological experiment in the history of psychiatry and found eighty new regions in the genome associated with the illness. With many more avenues for exploring the biological underpinnings of schizophrenia now available to neuroscientists, hope may be on the way for the estimated 2.4 million Americans and 1 in 100 people worldwide affected by the illness, one in w...

  12. Towards a geography of schizophrenia

    International Nuclear Information System (INIS)

    Frith, Ch.

    1996-01-01

    The schizophrenia is one of the more severe and the more frequent mental diseases. It cannot be explained by a structural anomaly of the brain but by a cerebral functioning disorder. With the imagery (NMR imaging, positron computed tomography) the searchers have particularly studied two sorts of schizophrenia: the lack of will and the pseudo hallucinations. In these two cases, an alteration of the affected cerebral areas activity compared with healthy persons is observed. (O.M.)

  13. Factors Moderating the Relationship Between Childhood Trauma and Premorbid Adjustment in First-Episode Schizophrenia.

    Science.gov (United States)

    Kilian, S; Burns, J K; Seedat, S; Asmal, L; Chiliza, B; Du Plessis, S; Olivier, M R; Kidd, M; Emsley, R

    2017-01-01

    Childhood trauma is a recognised risk factor for schizophrenia. It has been proposed that childhood trauma interferes with normal neurodevelopment, thereby establishing a biological vulnerability to schizophrenia. Poor premorbid adjustment is frequently a precursor to schizophrenia, and may be a manifestation of neurodevelopmental compromise. We investigated the relationship between childhood trauma and premorbid adjustment in 77 patients with first-episode schizophrenia spectrum disorders. We also investigated possible mediating roles for other selected risk factors in the relationship. We found several significant correlations between different trauma types and both social and academic premorbid adjustment from childhood to late adolescence. There were no significant moderating effects for family history of schizophrenia or family history of psychiatric disorder. History of obstetric complications, substance abuse and poor motor coordination weakened some of the associations between childhood trauma and premorbid adjustment, while poor sequencing of motor acts strengthened the association. Our results confirm previous studies indicating an association between childhood trauma and premorbid adjustment. Results indicate a general rather than specific association, apparent with different types of trauma, and affecting both social and academic components of premorbid adjustment across childhood, early and late adolescence. Further, our results suggest a complex interplay of various risk factors, supporting the notion of different pathways to psychosis.

  14. GABA(B) receptors, schizophrenia and sleep dysfunction: a review of the relationship and its potential clinical and therapeutic implications.

    Science.gov (United States)

    Kantrowitz, Joshua; Citrome, Leslie; Javitt, Daniel

    2009-08-01

    Evidence for an intrinsic relationship between sleep, cognition and the symptomatic manifestations of schizophrenia is accumulating. This review presents evidence for the possible utility of GABA(B) receptor agonists for the treatment of subjective and objective sleep abnormalities related to schizophrenia. At the phenotypic level, sleep disturbance occurs in 16-30% of patients with schizophrenia and is related to reduced quality of life and poor coping skills. On the neurophysiological level, studies suggest that sleep deficits reflect a core component of schizophrenia. Specifically, slow-wave sleep deficits, which are inversely correlated with cognition scores, are seen. Moreover, sleep plays an increasingly well documented role in memory consolidation in schizophrenia. Correlations of slow-wave sleep deficits with impaired reaction time and declarative memory have also been reported. Thus, both behavioural insomnia and sleep architecture are critical therapeutic targets in patients with schizophrenia. However, long-term treatment with antipsychotics often results in residual sleep dysfunction and does not improve slow-wave sleep, and adjunctive GABA(A) receptor modulators, such as benzodiazepines and zolpidem, can impair sleep architecture and cognition in schizophrenia. GABA(B) receptor agonists have therapeutic potential in schizophrenia. These agents have minimal effect on rapid eye movement sleep while increasing slow-wave sleep. Preclinical associations with increased expression of genes related to slow-wave sleep production and circadian rhythm function have also been reported. GABA(B) receptor deficits result in a sustained hyperdopaminergic state and can be reversed by a GABA(B) receptor agonist. Genetic, postmortem and electrophysiological studies also associate GABA(B) receptors with schizophrenia. While studies thus far have not shown significant effects, prior focus on the use of GABA(B) receptor agonists has been on the positive symptoms of

  15. Correlates of adverse childhood events among adults with schizophrenia spectrum disorders.

    Science.gov (United States)

    Rosenberg, Stanley D; Lu, Weili; Mueser, Kim T; Jankowski, Mary Kay; Cournos, Francine

    2007-02-01

    Multiple studies have found that childhood adversity is related to a range of poor mental health, substance abuse, poor physical health, and poor social functioning outcomes in the general population of adults. However, despite the high rates of childhood adversity in schizophrenia, the clinical correlates of these events have not been systematically evaluated. This study evaluated the relationship between adverse experiences in childhood and functional, clinical, and health outcomes among adults with schizophrenia. The authors surveyed 569 adults with schizophrenia regarding adverse childhood events (including physical abuse, sexual abuse, parental mental illnesses, loss of a parent, parental separation or divorce, witnessing domestic violence, and foster or kinship care). The relationships between cumulative exposure to these events and psychiatric, physical, and functional outcomes were evaluated. Increased exposure to adverse childhood events was strongly related to psychiatric problems (suicidal thinking, hospitalizations, distress, and posttraumatic stress disorder), substance abuse, physical health problems (HIV infection), medical service utilization (physician visits), and poor social functioning (homelessness or criminal justice involvement). The findings extend the results of research in the general population by suggesting that childhood adversity contributes to worse mental health, substance abuse, worse physical health, and poor functional outcomes in schizophrenia.

  16. Structural brain alterations associated with schizophrenia preceded by conduct disorder: a common and distinct subtype of schizophrenia?

    Science.gov (United States)

    Schiffer, Boris; Leygraf, Norbert; Müller, Bernhard W; Scherbaum, Norbert; Forsting, Michael; Wiltfang, Jens; Gizewski, Elke R; Hodgins, Sheilagh

    2013-09-01

    Conduct disorder (CD) prior to age 15 is a precursor of schizophrenia in a minority of cases and is associated with violent behavior through adulthood, after taking account of substance misuse. The present study used structural magnetic imaging to examine gray matter (GM) volumes among 27 men with schizophrenia preceded by CD (SZ+CD), 23 men with schizophrenia but without CD (SZ-CD), 27 men with CD only (CD), and 25 healthy (H) men. The groups with schizophrenia were similar in terms of age of onset and duration of illness, levels of psychotic symptoms, and medication. The 2 groups with CD were similar as to number of CD symptoms, lifelong aggressive behavior, and number of criminal convictions. Men with SZ+CD, relative to those with SZ-CD, displayed (1) increased GM volumes in the hypothalamus, the left putamen, the right cuneus/precuneus, and the right inferior parietal cortex after controlling for age, alcohol, and drug misuse and (2) decreased GM volumes in the inferior frontal region. Men with SZ+CD (relative to the SZ-CD group) and CD (relative to the H group) displayed increased GM volumes of the hypothalamus and the inferior and superior parietal lobes, which were not associated with substance misuse. Aggressive behavior, both prior to age 15 and lifetime tendency, was positively correlated with the GM volume of the hypothalamus. Thus, among males, SZ+CD represents a distinct subtype of schizophrenia. Although differences in behavior emerge in childhood and remain stable through adulthood, further research is needed to determine whether the differences in GM volumes result from abnormal neural development distinct from that of other males developing schizophrenia.

  17. Marital adjustment of patients with substance dependence, schizophrenia and bipolar affective disorder

    Directory of Open Access Journals (Sweden)

    Shital S Muke

    2014-01-01

    Full Text Available Background: Marital adjustment is considered as a part of social well-being. Disturbed marital relationship can directly affect the disease adjustment and the way they face disease outcomes and complications. It may adversely affect physical health, mental health, the quality-of-life and even economic status of individuals. Aim: The aim of this study was to compare the marital adjustment among patients with substance dependence, schizophrenia and bipolar affective disorder. Materials and Methods: The sample consisted of each 30 patients with substance dependence, bipolar affective disorder and schizophrenia, diagnosed as per international classification of diseases-10 diagnostic criteria for research with a minimum duration of illness of 1 year were evaluated using marital adjustment questionnaire. The data was analyzed using parametric and non-parametric statistics. Results: Prevalence of poor marital adjustment in patients with schizophrenia, bipolar affective disorder and substance dependence was 60%, 70% and 50% respectively. There was a significant difference on overall marital adjustment among substance dependence and bipolar affective disorder patients. There was no significant difference on overall marital adjustment among patients with substance dependence and schizophrenia as well as among patients with schizophrenia and bipolar affective disorder. On marital adjustment domains, schizophrenia patients had significantly poor sexual adjustment than substance dependence patients while bipolar affective disorder patients had significantly poor sexual and social adjustment compared with substance dependence patients. Conclusion: Patients with substance dependence have significant better overall marital adjustment compared with bipolar affective disorder patients. Patients with substance dependence have significantly better social and sexual adjustment than patients with bipolar affective disorder as well as significantly better sexual

  18. Esquizofrenia refratária Refractory schizophrenia

    Directory of Open Access Journals (Sweden)

    Helio Elkis

    2007-10-01

    Full Text Available OBJETIVO: O propósito deste artigo é o de revisar vários aspectos da esquizofrenia refratária levando em conta questões relacionadas à definição, aspectos clínicos, correlatos psicobiológicos, tratamentos farmacológicos e não farmacológicos, assim como preditores de resposta terapêutica. MÉTODO: Pesquisa no Medline, assim como artigos dos autores. RESULTADOS E CONCLUSÕES: Pelo menos um terço dos pacientes com esquizofrenia são refratários a tratamento com antipsicóticos e as evidências apontam a clozapina em monoterapia como a principal opção nesses casos. A politerapia com antipsicóticos não tem apoio em evidências. Ensaios clínicos recentes mostraram que a potencialização da clozapina com outros antipsicóticos não é superior ao placebo.OBJECTIVE: The aim of the present paper is to review the various aspects of refractory schizophrenia regarding issues such as definitions, clinical aspects, psychobiological correlates, pharmacological and non-pharmacological treatment options and predictors of treatment response. METHOD: Medline search as well as articles of the authors. RESULTS AND CONCLUSIONS: Refractory schizophrenia affects at least one third of patients with schizophrenia and the best evidence shows that is monotherapy with clozapine remains the mainstay for the treatment of such condition. Antipsychotic polipharmacy is not supported by current evidence and recent clinical trials have shown that clozapine augmentation with antipsychotics has no benefit over placebo.

  19. A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia.

    Science.gov (United States)

    Harrow, Martin; Jobe, Thomas H; Faull, Robert N; Yang, Jie

    2017-10-01

    To assess the long-term effectiveness of antipsychotic medications in facilitating work functioning in patients with schizophrenia we conducted longitudinal multifollowup research on 139 initially psychotic patients. The 70 patients with schizophrenia and 69 initially psychotic mood disordered control patients were followed up 6 times over 20 years. We compared the influence on work functioning of patients with schizophrenia continuously prescribed antipsychotics with patients with schizophrenia not prescribed antipsychotics, using statistical controls for inter-subject differences. While antipsychotics reduce or eliminate flagrant psychosis for most patients with schizophrenia at acute hospitalizations, four years later and continually until the 20 year followups, patients with schizophrenia not prescribed antipsychotics had significantly better work functioning. The work performance of the patients who were continuously prescribed antipsychotics was at a low rate and did not improve over time. Multiple other factors also interfere with work functioning. The data suggest that some patients with schizophrenia not prescribed antipsychotics for prolonged periods can function relatively well. Multiple other factors are associated with poor post-hospital work performance. The longitudinal data raise questions about prolonged treatment of schizophrenia with antipsychotic medications. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Savings for the Poor

    OpenAIRE

    Ignacio Mas

    2010-01-01

    This paper reviews the relevance of formal financial services – in particular, savings – to poor people, the economic factors that have hindered the mass-scale delivery of such services in developing countries, and the technology-based opportunities that exist today to make massive gains in financial inclusion. It also highlights the benefits to government from universal financial access, as well as the key policy enablers that would need to be put in place to allow the necessary innovati...

  1. Poorly Differentiated Thyroid Carcinoma.

    Science.gov (United States)

    Setia, Namrata; Barletta, Justine A

    2014-12-01

    Poorly differentiated thyroid carcinoma (PDTC) has been recognized for the past 30 years as an entity showing intermediate differentiation and clinical behavior between well-differentiated thyroid carcinomas (ie, papillary thyroid carcinoma and follicular thyroid carcinoma) and anaplastic thyroid carcinoma; however, there has been considerable controversy around the definition of PDTC. In this review, the evolution in the definition of PDTC, current diagnostic criteria, differential diagnoses, potentially helpful immunohistochemical studies, and molecular alterations are discussed with the aim of highlighting where the diagnosis of PDTC currently stands. Published by Elsevier Inc.

  2. The Associations between Visual Attention and Facial Expression Identification in Patients with Schizophrenia.

    Science.gov (United States)

    Lin, I-Mei; Fan, Sheng-Yu; Huang, Tiao-Lai; Wu, Wan-Ting; Li, Shi-Ming

    2013-12-01

    Visual search is an important attention process that precedes the information processing. Visual search also mediates the relationship between cognition function (attention) and social cognition (such as facial expression identification). However, the association between visual attention and social cognition in patients with schizophrenia remains unknown. The purposes of this study were to examine the differences in visual search performance and facial expression identification between patients with schizophrenia and normal controls, and to explore the relationship between visual search performance and facial expression identification in patients with schizophrenia. Fourteen patients with schizophrenia (mean age=46.36±6.74) and 15 normal controls (mean age=40.87±9.33) participated this study. The visual search task, including feature search and conjunction search, and Japanese and Caucasian Facial Expression of Emotion were administered. Patients with schizophrenia had worse visual search performance both in feature search and conjunction search than normal controls, as well as had worse facial expression identification, especially in surprised and sadness. In addition, there were negative associations between visual search performance and facial expression identification in patients with schizophrenia, especially in surprised and sadness. However, this phenomenon was not showed in normal controls. Patients with schizophrenia who had visual search deficits had the impairment on facial expression identification. Increasing ability of visual search and facial expression identification may improve their social function and interpersonal relationship.

  3. Ultrastructural Alterations of Von Economo Neurons in the Anterior Cingulate Cortex in Schizophrenia.

    Science.gov (United States)

    Krause, Martin; Theiss, Carsten; Brüne, Martin

    2017-11-01

    Von Economo neurons (VENs) are large bipolar projection neurons mainly located in layer Vb of anterior cingulate cortex (ACC) and anterior insula. Both regions are involved in cognitive and emotional procedures and are functionally and anatomically altered in schizophrenia. Although the detailed function of VEN remains unclear, it has been suggested that these neurons are involved in the pathomechanism of schizophrenia. Here, we were interested in the question whether or not the VEN of schizophrenia patients would show abnormalities at the ultrastructural level. Accordingly, we examined the amount of lysosomal aggregations of the VEN in post-mortem tissue of patients with schizophrenia, bipolar disorder and psychologically unaffected individuals, and compared the findings with aggregations in adjacent pyramidal cells in layer Vb of the ACC. VEN of patients with schizophrenia, and to a lesser degree individuals with bipolar disorder contained significantly more lysosomal aggregations compared with tissue from unaffected controls. Specifically, the larger amount of lysosomal aggregations in schizophrenia seemed to be selective for VEN, with no differences occurring in pyramidal cells. These findings may indicate that the VEN of schizophrenia patients are selectively vulnerable to neuronal damage. Anat Rec, 2017. © 2017 Wiley Periodicals, Inc. Anat Rec, 300:2017-2024, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  4. Gray Matter Volume Decrease Distinguishes Schizophrenia From Bipolar Offspring During Childhood and Adolescence.

    Science.gov (United States)

    Sugranyes, Gisela; de la Serna, Elena; Romero, Soledad; Sanchez-Gistau, Vanessa; Calvo, Anna; Moreno, Dolores; Baeza, Inmaculada; Diaz-Caneja, Covadonga M; Sanchez-Gutierrez, Teresa; Janssen, Joost; Bargallo, Nuria; Castro-Fornieles, Josefina

    2015-08-01

    There is increasing support toward the notion that schizophrenia and bipolar disorder share neurodevelopmental underpinnings, although areas of divergence remain. We set out to examine gray matter volume characteristics of child and adolescent offspring of patients with schizophrenia or bipolar disorder comparatively. In this 2-center study, magnetic resonance structural neuroimaging data were acquired in 198 children and adolescents (aged 6-17 years): 38 offspring of patients with schizophrenia, 77 offspring of patients with bipolar disorder, and 83 offspring of community controls. Analyses of global brain volumes and voxel-based morphometry (using familywise error correction) were conducted. There was an effect of group on total cerebral gray matter volume (F = 3.26, p = .041), driven by a decrease in offspring of patients with schizophrenia relative to offspring of controls (p = .035). At a voxel-based level, we observed an effect of group in the left inferior frontal cortex/anterior insula (F = 14.7, p bipolar disorder (p bipolar disorder and offspring of controls in either global or voxel-based gray matter volumes. This first comparative study between offspring of patients with schizophrenia and bipolar disorder suggests that gray matter volume reduction in childhood and adolescence may be specific to offspring of patients with schizophrenia; this may index a greater neurodevelopmental impact of risk for schizophrenia relative to bipolar disorder during youth. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  5. Elevated maternal C-reactive protein and increased risk of schizophrenia in a national birth cohort.

    Science.gov (United States)

    Canetta, Sarah; Sourander, Andre; Surcel, Heljä-Marja; Hinkka-Yli-Salomäki, Susanna; Leiviskä, Jaana; Kellendonk, Christoph; McKeague, Ian W; Brown, Alan S

    2014-09-01

    The objective of the present study was to investigate an association between early gestational C-reactive protein, an established inflammatory biomarker, prospectively assayed in maternal sera, and schizophrenia in a large, national birth cohort with an extensive serum biobank. A nested case-control design from the Finnish Prenatal Study of Schizophrenia cohort was utilized. A total of 777 schizophrenia cases (schizophrenia, N=630; schizoaffective disorder, N=147) with maternal sera available for C-reactive protein testing were identified and matched to 777 control subjects in the analysis. Maternal C-reactive protein levels were assessed using a latex immunoassay from archived maternal serum specimens. Increasing maternal C-reactive protein levels, classified as a continuous variable, were significantly associated with schizophrenia in offspring (adjusted odds ratio=1.31, 95% confidence interval=1.10-1.56). This finding remained significant after adjusting for potential confounders, including maternal and parental history of psychiatric disorders, twin/singleton birth, urbanicity, province of birth, and maternal socioeconomic status. This finding provides the most robust evidence to date that maternal inflammation may play a significant role in schizophrenia, with possible implications for identifying preventive strategies and pathogenic mechanisms in schizophrenia and other neurodevelopmental disorders.

  6. Mismatch negativity in chronic schizophrenia and first-episode schizophrenia.

    Science.gov (United States)

    Salisbury, Dean F; Shenton, Martha E; Griggs, Carlye B; Bonner-Jackson, Aaron; McCarley, Robert W

    2002-08-01

    Mismatch negativity (MMN) is an event-related brain potential that is sensitive to stimulus deviation from a repetitive pattern. The MMN is thought primarily to reflect the activity of sensory memory, with, at most, moderate influences of higher-level cognitive processes, such as attention. The MMN is reported to be reduced in patients with chronic schizophrenia. However, it is unknown whether MMN is reduced in patients with first-episode schizophrenia (at first hospitalization). Subject groups comprised patients with chronic schizophrenia (n = 16) and older control subjects (n = 13), and patients with first-episode schizophrenia (n = 21) and younger control subjects (n = 27). The MMN was visualized by subtracting the averaged event-related brain potential to standard tones (1 kHz [95% of all tones]) from the event-related brain potential to pitch-deviant tones (1.2 kHz [5% of all tones]). The MMN voltage was the mean voltage from 100 to 200 milliseconds. Pitch-deviant MMN was reduced by approximately 47% in patients with chronic illness along the sagittal midline relative to controls. The MMN was not reduced in patients with first-episode schizophrenia. All 4 groups showed approximately 64% larger MMN to pitch-deviant tones over the right hemisphere compared with the left hemisphere. The pitch-deviant MMN reductions present in patients with chronic schizophrenia are not present at first hospitalization. The sensory, echoic memory functions indexed by MMN seem unaffected early in the schizophrenia disease process. Reductions in MMN amplitude may develop over time and index the progression of the disorder, although that can only be definitively determined by longitudinal assessments.

  7. Cognitive behavioral therapy in 22q11.2 microdeletion with psychotic symptoms: What do we learn from schizophrenia?

    Science.gov (United States)

    Demily, Caroline; Franck, Nicolas

    2016-11-01

    The 22q11.2 deletion syndrome (22q11.2DS) is one of the most common microdeletion syndromes, with a widely underestimated prevalence between 1 per 2000 and 1 per 6000. Since childhood, patients with 22q11.2DS are described as having difficulties to initiate and maintain peer relationships. This lack of social skills has been linked to attention deficits/hyperactivity disorder, anxiety and depression. A high incidence of psychosis and positive symptoms is observed in patients with 22q11.2DS and remains correlated with poor social functioning, anxiety and depressive symptoms. Because 22q11.2DS and schizophrenia share several major clinical features, 22q11.2DS is sometimes considered as a genetic model for schizophrenia. Surprisingly, almost no study suggests the use of cognitive and behavioral therapy (CBT) in this indication. We reviewed what should be learned from schizophrenia to develop specific intervention for 22q11.2DS. In our opinion, the first step of CBT approach in 22q11.2DS with psychotic symptoms is to identify precisely which tools can be used among the already available ones. Cognitive behavioral therapy (CBT) targets integrated disorders, i.e. reasoning biases and behavior disorders. In 22q11.2DS, CBT-targeted behavior disorders may take the form of social avoidance and withdrawal or, in the contrary, a more unusual disinhibition and aggressiveness. In our experience, other negative symptoms observed in 22q11.2DS, such as motivation deficit or anhedonia, may also be reduced by CBT. Controlled trials have been studying the benefits of CBT in schizophrenia and several meta-analyses proved its effectiveness. Therefore, it is legitimate to propose this tool in 22q11.2DS, considering symptoms similarities. Overall, CBT is the most effective psychosocial intervention on psychotic symptoms and remains a relevant complement to pharmacological treatments such as antipsychotics. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Premorbid teacher-rated social functioning predicts adult schizophrenia-spectrum disorder: A high-risk prospective investigation

    DEFF Research Database (Denmark)

    Tsuji, Thomas; Kline, Emily; Sorensen, Holger J.

    2013-01-01

    Social functioning deficits are a core component of schizophrenia spectrum disorders, and may emerge years prior to the onset of diagnosable illness. The current study prospectively examines the relation between teacher-rated childhood social dysfunction and later mental illness among participants...... who were at genetic high-risk for schizophrenia and controls (n=244). The teacher-rated social functioning scale significantly predicted psychiatric outcomes (schizophrenia-spectrum vs. other psychiatric disorder vs. no mental illness). Poor premorbid social functioning appears to constitute a marker...

  9. A Danish Twin Study of Schizophrenia Liability

    DEFF Research Database (Denmark)

    Kläning, Ulla; Trumbetta, Susan L; Gottesman, Irving I

    2016-01-01

    whether variance in schizophrenia liability attributable to environmental factors may have decreased with successive cohorts exposed to improvements in public health. ICD-10 diagnoses were determined by clinical interview. Although the best-fitting, most parsimonious biometric model of schizophrenia...

  10. Researchers Find a Mechanism for Schizophrenia

    Science.gov (United States)

    ... issue Health Capsule Researchers Find a Mechanism for Schizophrenia En español Send us your comments Scientists uncovered a mechanism behind genetic variations previously linked to schizophrenia. The findings may lead to new clinical approaches. ...

  11. Family Matters: imaging the vulnerability for schizophrenia

    NARCIS (Netherlands)

    Leeuw, M. de

    2015-01-01

    Schizophrenia is a highly heritable psychiatric disorder that is characterized by impairments in the fronto-striatal network underlying cognitive deficits. Subjects who are at increased familial risk such as siblings and offspring of schizophrenia patients, also show cognitive impairments

  12. Antipsychotic switching for people with schizophrenia who have neuroleptic-induced weight or metabolic problems.

    Science.gov (United States)

    Mukundan, Anitha; Faulkner, Guy; Cohn, Tony; Remington, Gary

    2010-12-08

    changes, rather than means with standard deviation.People are less likely to leave the study early if they remain on olanzapine compared to switching to quetiapine or aripiprazole.There was no significant difference in outcomes of mental state, global state, and adverse events between groups which switched medications and those that remained on previous medication. Three different switching strategies were compared and no strategy was found to be superior to the others for outcomes of weight gain, mental state and global state. Evidence from this review suggests that switching antipsychotic medication to one with lesser potential for causing weight gain or metabolic problems could be an effective way to manage these side effects, but the data were weak due to the limited number of trials in this area and small sample sizes. Poor reporting of data also hindered using some trials and outcomes. There was no difference in mental state, global state and other treatment related adverse events between switching to another medication and continuing on the previous one. When the three switching strategies were compared none of them had an advantage over the others in their effects on the primary outcomes considered in this review. Better designed trials with adequate power would provide more convincing evidence for using medication switching as an intervention strategy.

  13. Impairments in action-outcome learning in schizophrenia.

    Science.gov (United States)

    Morris, Richard W; Cyrzon, Chad; Green, Melissa J; Le Pelley, Mike E; Balleine, Bernard W

    2018-03-03

    Learning the causal relation between actions and their outcomes (AO learning) is critical for goal-directed behavior when actions are guided by desire for the outcome. This can be contrasted with habits that are acquired by reinforcement and primed by prevailing stimuli, in which causal learning plays no part. Recently, we demonstrated that goal-directed actions are impaired in schizophrenia; however, whether this deficit exists alongside impairments in habit or reinforcement learning is unknown. The present study distinguished deficits in causal learning from reinforcement learning in schizophrenia. We tested people with schizophrenia (SZ, n = 25) and healthy adults (HA, n = 25) in a vending machine task. Participants learned two action-outcome contingencies (e.g., push left to get a chocolate M&M, push right to get a cracker), and they also learned one contingency was degraded by delivery of noncontingent outcomes (e.g., free M&Ms), as well as changes in value by outcome devaluation. Both groups learned the best action to obtain rewards; however, SZ did not distinguish the more causal action when one AO contingency was degraded. Moreover, action selection in SZ was insensitive to changes in outcome value unless feedback was provided, and this was related to the deficit in AO learning. The failure to encode the causal relation between action and outcome in schizophrenia occurred without any apparent deficit in reinforcement learning. This implies that poor goal-directed behavior in schizophrenia cannot be explained by a more primary deficit in reward learning such as insensitivity to reward value or reward prediction errors.

  14. Psychosis among "healthy" siblings of schizophrenia patients

    OpenAIRE

    Arajärvi, Ritva; Ukkola, Jonna; Haukka, Jari; Suvisaari, Jaana; Hintikka, Jukka; Partonen, Timo; Lönnqvist, Jouko

    2006-01-01

    Abstract Background Schizophrenia aggregates in families and accurate diagnoses are essential for genetic studies of schizophrenia. In this study, we investigated whether siblings of patients with schizophrenia can be identified as free of any psychotic disorder using only register information. We also analyzed the emergence of psychotic disorders among siblings of patients with schizophrenia during seven to eleven years of follow-up. Methods A genetically homogenous population isolate in no...

  15. Registered criminality and sanctioning of schizophrenia patients

    DEFF Research Database (Denmark)

    Munkner, Runa; Haastrup, Soeren; Joergensen, Torben

    2009-01-01

    BACKGROUND: Patients with schizophrenia have been shown to have an increased risk of criminality, especially violent crimes. AIMS: The aim of the current study was to describe the pattern of crimes committed by Danish patients with schizophrenia and examine the sanctions given for crimes in relat...... than imprison, individuals with schizophrenia. CONCLUSION: The findings suggest that greater alertness is needed in the judicial system for individuals diagnosed with schizophrenia....

  16. Fish remains and humankind: part two

    Directory of Open Access Journals (Sweden)

    Andrew K G Jones

    1998-07-01

    Full Text Available The significance of aquatic resources to past human groups is not adequately reflected in the published literature - a deficiency which is gradually being acknowledged by the archaeological community world-wide. The publication of the following three papers goes some way to redress this problem. Originally presented at an International Council of Archaeozoology (ICAZ Fish Remains Working Group meeting in York, U.K. in 1987, these papers offer clear evidence of the range of interest in ancient fish remains across the world. Further papers from the York meeting were published in Internet Archaeology 3 in 1997.

  17. Community pharmacy loyalty among individuals with schizophrenia.

    Science.gov (United States)

    Lauzier, Sophie; Grégoire, Jean-Pierre; Lesage, Alain; Moisan, Jocelyne

    2013-01-01

    Community pharmacists can use medication records to assist individuals who are loyal to their pharmacy in better managing their pharmacotherapy. However, the extent of community pharmacy loyalty among individuals with severe mental illness such as schizophrenia remains unknown. To assess the extent of community pharmacy loyalty among individuals with schizophrenia and identify factors associated with loyalty. Using the Quebec Health Insurance Board databases, a cohort study of individuals with schizophrenia who claimed an antipsychotic drug for the first time between January 1, 2001 and December 31, 2005 was conducted. Such individuals were considered loyal to their community pharmacy if they filled all their prescriptions for any drug at the same community pharmacy during the second year after antipsychotics initiation. Logistic regression models were used to identify factors associated with community pharmacy loyalty (measured in the first year after antipsychotics initiation). Of the 6159 individuals in the study, 57.8% were loyal to one pharmacy. Men were more likely to be loyal (Adjusted OR = 1.29; 95% CI = 1.16-1.44), as were individuals aged 30-64 years and those aged ≥65 years, when compared to individuals 20-29 years (1.70; 1.48-1.95 and 2.39; 1.97-2.90, respectively). Individuals who filled their antipsychotics on a weekly basis were also more likely to be loyal (1.39; 1.18-1.63). Factors associated with non-loyalty were welfare beneficiary status (0.79; 0.70-0.89), having substance-use disorder (0.69; 0.60-0.80), a greater number of different types of drugs (5-8 types = 0.76; 0.66-0.87; 9-51 = 0.59; 0.50-0.69), and emergency department visits (0.71; 0.60-0.82). Results suggest that medication records in community pharmacies are incomplete for 42.2% of individuals with schizophrenia. Individuals more likely to experience more severe illness were also those less likely to be loyal. Given the potentially severe consequences of medication-related problems

  18. The 'poor man's laryngogram'

    International Nuclear Information System (INIS)

    Bartelt, D.

    1991-01-01

    This paper is reassessment of an old method improved by well-directed application of well-known maneuvers of laryngo-pharyngeal function. Although not as visually attractive as a dedicated laryngogram (now hardly ever requested), it does render similarly reliable diagnostic information, which, supported, as occasionally necessary, by conventional tomography, can even surpass that given by the older technique. Its main advantage lies in providing cheap, quick, noninvasive studies with minimal descomfort for the patient. Should further investigation be necessary, for analysis of deep extension, modern cross-sectional imaging methods (especially MR) far surpass even dedicated laryngography in diagnostic value and can be based adequately on 'poor mans's laryngography'. Ways in which this method may be optimised, especially those involving laryngopharyngeal function, are briefly presented - with emphasis on relevant practical aspects - as are normal and abnormal findings. (orig.) [de

  19. Schizophrenia: an integrated sociodevelopmental-cognitive model

    Science.gov (United States)

    Howes, Oliver D; Murray, Robin M

    2014-01-01

    Schizophrenia remains a major burden1. The dopamine (DA) and neurodevelopmental hypotheses attempt to explain the pathogenic mechanisms and origins of the disorder respectively2-4. Recently an alternative, the cognitive model, has gained popularity5. However the first two theories have not been satisfactorily integrated, and the most influential iteration of the cognitive model makes no mention of DA, neurodevelopment, or indeed the brain5. Here we show that developmental alterations secondary to variant genes, early hazards to the brain and childhood adversity, sensitise the DA system, and result in excessive presynaptic DA synthesis and DA release. Social adversity biases the cognitive schema that the individual uses to interpret experiences towards paranoid interpretations. Subsequent stress results in dysregulated DA release, causing the misattribution of salience to stimuli, which are then misinterpreted by the biased cognitive processes. The resulting paranoia and hallucinations in turn cause further stress, and eventually repeated DA dysregulation hard-wires the psychotic beliefs. Finally we consider the implications of this model for understanding and treating schizophrenia. PMID:24315522

  20. REMO poor man's reanalysis

    Science.gov (United States)

    Ries, H.; Moseley, C.; Haensler, A.

    2012-04-01

    Reanalyses depict the state of the atmosphere as a best fit in space and time of many atmospheric observations in a physically consistent way. By essentially solving the data assimilation problem in a very accurate manner, reanalysis results can be used as reference for model evaluation procedures and as forcing data sets for different model applications. However, the spatial resolution of the most common and accepted reanalysis data sets (e.g. JRA25, ERA-Interim) ranges from approximately 124 km to 80 km. This resolution is too coarse to simulate certain small scale processes often associated with extreme events. In addition, many models need higher resolved forcing data ( e.g. land-surface models, tools for identifying and assessing hydrological extremes). Therefore we downscaled the ERA-Interim reanalysis over the EURO-CORDEX-Domain for the time period 1989 to 2008 to a horizontal resolution of approximately 12 km. The downscaling is performed by nudging REMO-simulations to lower and lateral boundary conditions of the reanalysis, and by re-initializing the model every 24 hours ("REMO in forecast mode"). In this study the three following questions will be addressed: 1.) Does the REMO poor man's reanalysis meet the needs (accuracy, extreme value distribution) in validation and forcing? 2.) What lessons can be learned about the model used for downscaling? As REMO is used as a pure downscaling procedure, any systematic deviations from ERA-Interim result from poor process modelling but not from predictability limitations. 3.) How much small scale information generated by the downscaling model is lost with frequent initializations? A comparison to a simulation that is performed in climate mode will be presented.

  1. Identification of Genetic Factors in the Etiology of Schizophrenia

    Directory of Open Access Journals (Sweden)

    Argel Aguilar Valles

    2011-09-01

    Full Text Available ABSTRACT Schizophrenia is a mental disorder that affects approximately 1% of the worldwide population. It is characterized by psychotic episodes in which individuals have hallucinations or delusions. This disorder also involves a strong element of social dysfunction, lack of motivation and profound cognitive deficits. The causes of this disorder remain largely unknown, but evidence indicates that arises from changes in the development of the central nervous system. Among the identified risk factors for this disorder are several environmental events, including prenatal infections and malnutrition, and complications during childbirth. However, the most important factor seems to be genetics. Despite this, the identification of genes involved in the development of this disorder has emerged as one of the most difficult tasks facing modern genetics and genomics. The development of techniques for studying the human genome has allowed a more systematic approach to determine variations in the genome sequence and structure that area casually involved in schizophrenia. These studies suggest the participation hundreds of genes in schizophrenia development. In addition, it has been suggested that many of these genes are involved in various mental illnesses that today are diagnosed as separate entities, but whose biological substrate may be shared. Key words: schizophrenia, deletions, development, duplications, polymorphisms.

  2. Functional hierarchy underlies preferential connectivity disturbances in schizophrenia.

    Science.gov (United States)

    Yang, Genevieve J; Murray, John D; Wang, Xiao-Jing; Glahn, David C; Pearlson, Godfrey D; Repovs, Grega; Krystal, John H; Anticevic, Alan

    2016-01-12

    Schizophrenia may involve an elevated excitation/inhibition (E/I) ratio in cortical microcircuits. It remains unknown how this regulatory disturbance maps onto neuroimaging findings. To address this issue, we implemented E/I perturbations within a neural model of large-scale functional connectivity, which predicted hyperconnectivity following E/I elevation. To test predictions, we examined resting-state functional MRI in 161 schizophrenia patients and 164 healthy subjects. As predicted, patients exhibited elevated functional connectivity that correlated with symptom levels, and was most prominent in association cortices, such as the fronto-parietal control network. This pattern was absent in patients with bipolar disorder (n = 73). To account for the pattern observed in schizophrenia, we integrated neurobiologically plausible, hierarchical differences in association vs. sensory recurrent neuronal dynamics into our model. This in silico architecture revealed preferential vulnerability of association networks to E/I imbalance, which we verified empirically. Reported effects implicate widespread microcircuit E/I imbalance as a parsimonious mechanism for emergent inhomogeneous dysconnectivity in schizophrenia.

  3. Molecular Imaging in Schizophrenia Spectrum Disorders

    NARCIS (Netherlands)

    Klein, H.C.; Doorduin, J.; van Berckel, B.N.M.

    2014-01-01

    In this chapter, we aim to shed light on the schizophrenia spectrum disorders using molecular imaging. Schizophrenia spectrum disorders consist primarily of the disorders with full-blown psychosis in their course and are grouped in the DSM-IV category of schizophrenia and other psychotic disorders.

  4. Poison or cure: meanings of medication in schizophrenia.

    Science.gov (United States)

    Rosenfield, Paul J

    2007-01-01

    Antipsychotic medications provide tremendous relief to many individuals with schizophrenia, but can have significant costs, including adverse metabolic, neurological, and psychological effects. Prescribers and consumers of these medications often have different perceptions of the safety and utility of medications, ranging from "poison" to "cure." While much of the literature on the meaning of medication in schizophrenia discusses patients' negative perceptions of medication, poor insight, and other risk factors for nonadherence, a variety of additional factors should be considered, including both doctors' and patients' perspectives. Historical, cultural, and scientific, as well as individual factors, influence both the prescribing and taking of antipsychotic medications. The relationship between doctors and patients, as informed by these factors, plays a central role in the creation of the meanings of medications. An understanding of this relationship can help to establish more collaborative treatment relationships, beyond the dichotomy of poison or cure.

  5. Temperament and substance abuse in schizophrenia: is there a relationship?

    Science.gov (United States)

    Van Ammers, E C; Sellman, J D; Mulder, R T

    1997-05-01

    The influence of temperament on substance abuse in schizophrenia is poorly understood, whereas it is known to play an important role in other clinical populations. In a sample of 28 male schizophrenics, Cloninger's dimensions of temperament were measured with the use of the Tridimensional Personality Questionnaire (TPQ). Levels of four commonly used substances were recorded. There was a significant correlation between the novelty-seeking dimension and past use of alcohol, cannabis, and caffeine and current use of caffeine and nicotine. There was no relationship between substance use and clinical symptoms or demographic variables. The possible implications of abnormal mean TPQ scores in the sample as well as a weak correlation between symptom patterns and TPQ scores are discussed. The findings suggest that novelty-seeking type behaviors contribute to substance use in schizophrenia.

  6. Neurocognitive pattern analysis reveals classificatory hierarchy of attention deficits in schizophrenia.

    Science.gov (United States)

    Shen, Christina; Popescu, Florin C; Hahn, Eric; Ta, Tam T M; Dettling, Michael; Neuhaus, Andres H

    2014-07-01

    Attention deficits, among other cognitive deficits, are frequently observed in schizophrenia. Although valid and reliable neurocognitive tasks have been established to assess attention deficits in schizophrenia, the hierarchical value of those tests as diagnostic discriminants on a single-subject level remains unclear. Thus, much research is devoted to attention deficits that are unlikely to be translated into clinical practice. On the other hand, a clear hierarchy of attention deficits in schizophrenia could considerably aid diagnostic decisions and may prove beneficial for longitudinal monitoring of therapeutic advances. To propose a diagnostic hierarchy of attention deficits in schizophrenia, we investigated several facets of attention in 86 schizophrenia patients and 86 healthy controls using a set of established attention tests. We applied state-of-the-art machine learning algorithms to determine attentive test variables that enable an automated differentiation between schizophrenia patients and healthy controls. After feature preranking, hypothesis building, and hypothesis validation, the polynomial support vector machine classifier achieved a classification accuracy of 90.70% ± 2.9% using psychomotor speed and 3 different attention parameters derived from sustained and divided attention tasks. Our study proposes, to the best of our knowledge, the first hierarchy of attention deficits in schizophrenia by identifying the most discriminative attention parameters among a variety of attention deficits found in schizophrenia patients. Our results offer a starting point for hierarchy building of schizophrenia-associated attention deficits and contribute to translating these concepts into diagnostic and therapeutic practice on a single-subject level. © The Author 2013. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Composition, taxonomy and functional diversity of the oropharynx microbiome in individuals with schizophrenia and controls

    Directory of Open Access Journals (Sweden)

    Eduardo Castro-Nallar

    2015-08-01

    Full Text Available The role of the human microbiome in schizophrenia remains largely unexplored. The microbiome has been shown to alter brain development and modulate behavior and cognition in animals through gut-brain connections, and research in humans suggests that it may be a modulating factor in many disorders. This study reports findings from a shotgun metagenomic analysis of the oropharyngeal microbiome in 16 individuals with schizophrenia and 16 controls. High-level differences were evident at both the phylum and genus levels, with Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria dominating both schizophrenia patients and controls, and Ascomycota being more abundant in schizophrenia patients than controls. Controls were richer in species but less even in their distributions, i.e., dominated by fewer species, as opposed to schizophrenia patients. Lactic acid bacteria were relatively more abundant in schizophrenia, including species of Lactobacilli and Bifidobacterium, which have been shown to modulate chronic inflammation. We also found Eubacterium halii, a lactate-utilizing species. Functionally, the microbiome of schizophrenia patients was characterized by an increased number of metabolic pathways related to metabolite transport systems including siderophores, glutamate, and vitamin B12. In contrast, carbohydrate and lipid pathways and energy metabolism were abundant in controls. These findings suggest that the oropharyngeal microbiome in individuals with schizophrenia is significantly different compared to controls, and that particular microbial species and metabolic pathways differentiate both groups. Confirmation of these findings in larger and more diverse samples, e.g., gut microbiome, will contribute to elucidating potential links between schizophrenia and the human microbiota.

  8. Impaired early visual response modulations to spatial information in chronic schizophrenia

    Science.gov (United States)

    Knebel, Jean-François; Javitt, Daniel C.; Murray, Micah M.

    2011-01-01

    Early visual processing stages have been demonstrated to be impaired in schizophrenia patients and their first-degree relatives. The amplitude and topography of the P1 component of the visual evoked potential (VEP) are both affected; the latter of which indicates alterations in active brain networks between populations. At least two issues remain unresolved. First, the specificity of this deficit (and suitability as an endophenotype) has yet to be established, with evidence for impaired P1 responses in other clinical populations. Second, it remains unknown whether schizophrenia patients exhibit intact functional modulation of the P1 VEP component; an aspect that may assist in distinguishing effects specific to schizophrenia. We applied electrical neuroimaging analyses to VEPs from chronic schizophrenia patients and healthy controls in response to variation in the parafoveal spatial extent of stimuli. Healthy controls demonstrated robust modulation of the VEP strength and topography as a function of the spatial extent of stimuli during the P1 component. By contrast, no such modulations were evident at early latencies in the responses from patients with schizophrenia. Source estimations localized these deficits to the left precuneus and medial inferior parietal cortex. These findings provide insights on potential underlying low-level impairments in schizophrenia. PMID:21764264

  9. Does Schizophrenia in Offspring Increase the Risk of Developing Alzheimer's Dementia

    Directory of Open Access Journals (Sweden)

    Christopher Rohde

    2016-08-01

    Full Text Available Background/Aims: Prior studies have consistently found a higher risk of dementia in individuals with schizophrenia, but whether this is due to a common etiology between the disorders remains obscure. We wanted to elucidate this association by investigating whether schizophrenia in offspring increases the risk of Alzheimer's dementia. Methods: All individuals born between 1930 and 1953 were identified through national registers and followed from their 50th birthday until the date of Alzheimer's dementia, death or end of the study. Regressions were performed to evaluate the association between offspring with schizophrenia and Alzheimer's dementia. Results: Individuals with offspring with schizophrenia did not have an increased risk of Alzheimer's dementia [incidence rate ratio (IRR, 0.97; 95% CI, 0.88-1.07] compared to individuals with offspring without psychiatric contact. This finding remained stable when evaluating early-onset (IRR, 1.10; 95% CI, 0.91-1.31 and late-onset Alzheimer's dementia (IRR, 0.92; 95% CI, 0.88-1.07. Similar findings were made for vascular and unspecified dementia. Conclusion: The finding of no familial coaggregation between schizophrenia and Alzheimer's dementia may suggest that no common etiology between the disorders exists. This may indicate that the excess risk of dementia in individuals with schizophrenia is a by-product of the higher rates of somatic comorbidity and adverse health risk factors among these individuals.

  10. Why Agricultural Educators Remain in the Classroom

    Science.gov (United States)

    Crutchfield, Nina; Ritz, Rudy; Burris, Scott

    2013-01-01

    The purpose of this study was to identify and describe factors that are related to agricultural educator career retention and to explore the relationships between work engagement, work-life balance, occupational commitment, and personal and career factors as related to the decision to remain in the teaching profession. The target population for…

  11. Juveniles' Motivations for Remaining in Prostitution

    Science.gov (United States)

    Hwang, Shu-Ling; Bedford, Olwen

    2004-01-01

    Qualitative data from in-depth interviews were collected in 1990-1991, 1992, and 2000 with 49 prostituted juveniles remanded to two rehabilitation centers in Taiwan. These data are analyzed to explore Taiwanese prostituted juveniles' feelings about themselves and their work, their motivations for remaining in prostitution, and their difficulties…

  12. Kadav Moun PSA (:60) (Human Remains)

    Centers for Disease Control (CDC) Podcasts

    2010-02-18

    This is an important public health announcement about safety precautions for those handling human remains. Language: Haitian Creole.  Created: 2/18/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/18/2010.

  13. The Annuity Puzzle Remains a Puzzle

    NARCIS (Netherlands)

    Peijnenburg, J.M.J.; Werker, Bas; Nijman, Theo

    We examine incomplete annuity menus and background risk as possible drivers of divergence from full annuitization. Contrary to what is often suggested in the literature, we find that full annuitization remains optimal if saving is possible after retirement. This holds irrespective of whether real or

  14. An analysis of the cognitive deficit of schizophrenia based on the Piaget developmental theory.

    Science.gov (United States)

    Torres, Alejandro; Olivares, Jose M; Rodriguez, Angel; Vaamonde, Antonio; Berrios, German E

    2007-01-01

    The objective of the study was to evaluate from the perspective of the Piaget developmental model the cognitive functioning of a sample of patients diagnosed with schizophrenia. Fifty patients with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and 40 healthy matched controls were evaluated by means of the Longeot Logical Thought Evaluation Scale. Only 6% of the subjects with schizophrenia reached the "formal period," and 70% remained at the "concrete operations" stage. The corresponding figures for the control sample were 25% and 15%, respectively. These differences were statistically significant. The samples were specifically differentiable on the permutation, probabilities, and pendulum tests of the scale. The Longeot Logical Thought Evaluation Scale can discriminate between subjects with schizophrenia and healthy controls.

  15. Left globus pallidus abnormality in never-medicated patients with schizophrenia

    International Nuclear Information System (INIS)

    Early, T.S.; Reiman, E.M.; Raichle, M.E.; Spitznagel, E.L.

    1987-01-01

    Schizophrenia is a severe psychiatric disorder characterized by onset in young adulthood, the occurrence of hallucinations and delusions, and the development of enduring psychosocial disability. The pathophysiology of this disorder remains unknown. Studies of cerebral blood flow and metabolism designed to identify brain abnormalities in schizophrenia have been limited by inadequate methods of anatomical localization and the possibility of persistent medication effects. The authors have now used positron emission tomography and a validated method of anatomical localization in an attempt to identify abnormalities of regional cerebral blood flow in newly diagnosed never-medicated patients with schizophrenia. An exploratory study of 5 patients and 10 normal control subjects identified abnormally high blood flow in the left globus pallidus of patients with schizophrenia. A replication study of 5 additional patients and 10 additional control subjects confirmed this finding. No other abnormalities were found

  16. Soluble Urokinase-Type Plasminogen Activator Receptor Levels in Patients With Schizophrenia

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Røge, Rasmus; Pristed, Sofie Gry

    2015-01-01

    PAR) is a protein that can be measured in blood samples and reflects the levels of inflammatory activity. It has been associated with mortality and the development of type 2 diabetes and cardiovascular disease. METHODS: suPAR levels in patients with schizophrenia were compared to healthy controls from the Danish......BACKGROUND: The etiology of schizophrenia remains largely unknown but alterations in the immune system may be involved. In addition to the psychiatric symptoms, schizophrenia is also associated with up to 20 years reduction in life span. Soluble urokinase-type plasminogen activator receptor (su...... Blood Donor Study. SuPAR levels were dichotomized at >4.0 ng/ml, which is considered the threshold for low grade inflammation. A multiple logistic regression model was used and adjusted for age, sex, and current smoking. RESULTS: In total we included 1009 subjects, 105 cases with schizophrenia (10...

  17. Antidepressant Controlled Trial For Negative Symptoms In Schizophrenia (ACTIONS): a double-blind, placebo-controlled, randomised clinical trial.

    Science.gov (United States)

    Barnes, Thomas R E; Leeson, Verity C; Paton, Carol; Costelloe, Céire; Simon, Judit; Kiss, Noemi; Osborn, David; Killaspy, Helen; Craig, Tom K J; Lewis, Shôn; Keown, Patrick; Ismail, Shajahan; Crawford, Mike; Baldwin, David; Lewis, Glyn; Geddes, John; Kumar, Manoj; Pathak, Rudresh; Taylor, Simon

    2016-04-01

    Negative symptoms of schizophrenia represent deficiencies in emotional responsiveness, motivation, socialisation, speech and movement. When persistent, they are held to account for much of the poor functional outcomes associated with schizophrenia. There are currently no approved pharmacological treatments. While the available evidence suggests that a combination of antipsychotic and antidepressant medication may be effective in treating negative symptoms, it is too limited to allow any firm conclusions. To establish the clinical effectiveness and cost-effectiveness of augmentation of antipsychotic medication with the antidepressant citalopram for the management of negative symptoms in schizophrenia. A multicentre, double-blind, individually randomised, placebo-controlled trial with 12-month follow-up. Adult psychiatric services, treating people with schizophrenia. Inpatients or outpatients with schizophrenia, on continuing, stable antipsychotic medication, with persistent negative symptoms at a criterion level of severity. Eligible participants were randomised 1 : 1 to treatment with either placebo (one capsule) or 20 mg of citalopram per day for 48 weeks, with the clinical option at 4 weeks to increase the daily dosage to 40 mg of citalopram or two placebo capsules for the remainder of the study. The primary outcomes were quality of life measured at 12 and 48 weeks assessed using the Heinrich's Quality of Life Scale, and negative symptoms at 12 weeks measured on the negative symptom subscale of the Positive and Negative Syndrome Scale. No therapeutic benefit in terms of improvement in quality of life or negative symptoms was detected for citalopram over 12 weeks or at 48 weeks, but secondary analysis suggested modest improvement in the negative symptom domain, avolition/amotivation, at 12 weeks (mean difference -1.3, 95% confidence interval -2.5 to -0.09). There were no statistically significant differences between the two treatment arms over 48-week

  18. Temporal lobe structures and facial emotion recognition in schizophrenia patients and nonpsychotic relatives.

    Science.gov (United States)

    Goghari, Vina M; Macdonald, Angus W; Sponheim, Scott R

    2011-11-01

    Temporal lobe abnormalities and emotion recognition deficits are prominent features of schizophrenia and appear related to the diathesis of the disorder. This study investigated whether temporal lobe structural abnormalities were associated with facial emotion recognition deficits in schizophrenia and related to genetic liability for the disorder. Twenty-seven schizophrenia patients, 23 biological family members, and 36 controls participated. Several temporal lobe regions (fusiform, superior temporal, middle temporal, amygdala, and hippocampus) previously associated with face recognition in normative samples and found to be abnormal in schizophrenia were evaluated using volumetric analyses. Participants completed a facial emotion recognition task and an age recognition control task under time-limited and self-paced conditions. Temporal lobe volumes were tested for associations with task performance. Group status explained 23% of the variance in temporal lobe volume. Left fusiform gray matter volume was decreased by 11% in patients and 7% in relatives compared with controls. Schizophrenia patients additionally exhibited smaller hippocampal and middle temporal volumes. Patients were unable to improve facial emotion recognition performance with unlimited time to make a judgment but were able to improve age recognition performance. Patients additionally showed a relationship between reduced temporal lobe gray matter and poor facial emotion recognition. For the middle temporal lobe region, the relationship between greater volume and better task performance was specific to facial emotion recognition and not age recognition. Because schizophrenia patients exhibited a specific deficit in emotion recognition not attributable to a generalized impairment in face perception, impaired emotion recognition may serve as a target for interventions.

  19. The puzzle of processing speed, memory, and executive function impairments in schizophrenia: fitting the pieces together.

    Science.gov (United States)

    Knowles, Emma E M; Weiser, Mark; David, Anthony S; Glahn, David C; Davidson, Michael; Reichenberg, Abraham

    2015-12-01

    Substantial impairment in performance on the digit-symbol substitution task in patients with schizophrenia is well established, which has been widely interpreted as denoting a specific impairment in processing speed. However, other higher order cognitive functions might be more critical to performance on this task. To date, this idea has not been rigorously investigated in patients with schizophrenia. Neuropsychological measures of processing speed, memory, and executive functioning were completed by 125 patients with schizophrenia and 272 control subjects. We implemented a series of confirmatory factor and structural regression modeling to build an integrated model of processing speed, memory, and executive function with which to deconstruct the digit-symbol substitution task and characterize discrepancies between patients with schizophrenia and control subjects. The overall structure of the processing speed, memory, and executive function model was the same across groups (χ(2) = 208.86, p > .05), but the contribution of the specific cognitive domains to coding task performance differed significantly. When completing the task, control subjects relied on executive function and, indirectly, on working memory ability, whereas patients with schizophrenia used an alternative set of cognitive operations whereby they relied on the same processes required to complete verbal fluency tasks. Successful coding task performance relies predominantly on executive function, rather than processing speed or memory. Patients with schizophrenia perform poorly on this task because of an apparent lack of appropriate executive function input; they rely instead on an alternative cognitive pathway. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Intrinsic motivation and metacognition as predictors of learning potential in patients with remitted schizophrenia.

    Science.gov (United States)

    Tas, Cumhur; Brown, Elliot C; Esen-Danaci, Aysen; Lysaker, Paul H; Brüne, Martin

    2012-08-01

    Previous research has suggested that neurocognitive functioning predicts best the potential of patients with schizophrenia to acquire newly learned material, which, in turn may impact patients' social functioning. Recent studies have also shown that intrinsic motivation and metacognitive abilities play a decisive role in social functioning in schizophrenia. Accordingly, the present study sought to examine the relationship between intelligence, motivation, metacognition, and learning during a cognitive remediation experimental training. We hypothesized that metacognition and intrinsic motivation would have a strong relationship and independently predict learning potential. Thirty-two patients with schizophrenia who fulfilled the criteria of functional remission were recruited. In a pre-training-post experimental design, patients' learning potential was assessed using previously defined cognitive remediation training for WCST. Intrinsic motivation was examined using Intrinsic Motivation Inventory for schizophrenia; mastery, a domain of metacognition, was measured using the Metacognitive Assessment Scale. Metacognition significantly correlated with subdomains of intrinsic motivation. Patients with higher intrinsic motivation and preserved metacognition improved more in the learning paradigm compared to poorly motivated patients and patients with reduced metacognitive abilities. In particular, "mastery" was determined as an independent predictor of learning potential. Motivation and metacognition are important predictors of learning in schizophrenia. Psychological interventions in schizophrenia may therefore consider incorporating techniques to stimulate metacognitive and motivational abilities as well as developing individualized training programs. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. LORETA current source density for duration mismatch negativity and neuropsychological assessment in early schizophrenia.

    Directory of Open Access Journals (Sweden)

    Tomohiro Miyanishi

    Full Text Available INTRODUCTION: Patients with schizophrenia elicit cognitive decline from the early phase of the illness. Mismatch negativity (MMN has been shown to be associated with cognitive function. We investigated the current source density of duration mismatch negativity (dMMN, by using low-resolution brain electromagnetic tomography (LORETA, and neuropsychological performance in subjects with early schizophrenia. METHODS: Data were obtained from 20 patients meeting DSM-IV criteria for schizophrenia or schizophreniform disorder, and 20 healthy control (HC subjects. An auditory odd-ball paradigm was used to measure dMMN. Neuropsychological performance was evaluated by the brief assessment of cognition in schizophrenia Japanese version (BACS-J. RESULTS: Patients showed smaller dMMN amplitudes than those in the HC subjects. LORETA current density for dMMN was significantly lower in patients compared to HC subjects, especially in the temporal lobes. dMMN current density in the frontal lobe was positively correlated with working memory performance in patients. CONCLUSIONS: This is the first study to identify brain regions showing smaller dMMN current density in early schizophrenia. Further, poor working memory was associated with decreased dMMN current density in patients. These results are likely to help understand the neural basis for cognitive impairment of schizophrenia.

  2. Characteristics of the tree-drawing test in chronic schizophrenia.

    Science.gov (United States)

    Kaneda, Ayako; Yasui-Furukori, Norio; Saito, Manabu; Sugawara, Norio; Nakagami, Taku; Furukori, Hanako; Kaneko, Sunao

    2010-04-01

    A tree-drawing test acts as both a projective psychological examination as well as a supplementary psychodiagnostic tool. There is little information relating the characteristics of schizophrenia and the tree-drawing test. The present study compared the structural and morphological differences in the results of the tree-drawing test between schizophrenic patients and healthy individuals, as well as between schizophrenic patients who responded well to treatment and those who responded poorly. The subjects included 202 chronic schizophrenic patients and 113 healthy individuals. The schizophrenic patients were categorized as 'good responders' or 'poor responders' based on their response to medical treatments. The tree-drawing test was performed on all subjects. The tree drawn by each subject was analyzed structurally and morphologically. There were significant differences between the trunk and branches drawn by schizophrenic patients and those drawn by healthy controls. There were no significant differences between the good responders and the poor responders in any aspect of the tree drawings. Multiple regression models showed that the ratio of the tree area to the total area of the drawing paper, the width of the trunk, the trunk base opening, and the size of the branch ends were significantly associated with schizophrenia. The present study suggests that the trees drawn by schizophrenic patients are significantly different from those drawn by healthy individuals, but among schizophrenic patients, it is difficult to distinguish between good responders and poor responders using the tree-drawing test.

  3. Co-morbid anxiety disorders in patients with schizophrenia in a ...

    African Journals Online (AJOL)

    Background: Anxiety disorders occur commonly in schizophrenia but are often overlooked by psychiatrists. Their presence may compound the challenges faced by these patients and may contribute to poor outcome. Objectives: The purpose of this study was to determine the prevalence of anxiety disorders among the ...

  4. Medications Used for Cognitive Enhancement in Patients With Schizophrenia, Bipolar Disorder, Alzheimer's Disease, and Parkinson's Disease.

    Science.gov (United States)

    Hsu, Wen-Yu; Lane, Hsien-Yuan; Lin, Chieh-Hsin

    2018-01-01

    Cognitive impairment, which frequently occurs in patients with schizophrenia, bipolar disorder, Alzheimer's disease, and Parkinson's disease, has a significant impact on the daily lives of both patients and their family. Furthermore, since the medications used for cognitive enhancement have limited efficacy, the issue of cognitive enhancement still remains a clinically unsolved challenge. We reviewed the clinical studies (published between 2007 and 2017) that focused on the efficacy of medications used for enhancing cognition in patients with schizophrenia, bipolar disorder, Alzheimer's disease, and Parkinson's disease. Acetylcholinesterase inhibitors and memantine are the standard treatments for Alzheimer's disease and Parkinson's disease. Some studies have reported selective cognitive improvement in patients with schizophrenia following galantamine treatment. Newer antipsychotics, including paliperidone, lurasidone, aripiprazole, ziprasidone, and BL-1020, have also been reported to exert cognitive benefits in patients with schizophrenia. Dopaminergic medications were found to improve language function in patients with Parkinson's disease. However, no beneficial effects on cognitive function were observed with dopamine agonists in patients with schizophrenia. The efficacies of nicotine and its receptor modulators in cognitive improvement remain controversial, with the majority of studies showing that varenicline significantly improved the cognitive function in schizophrenic patients. Several studies have reported that N -methyl-d-aspartate glutamate receptor (NMDAR) enhancers improved the cognitive function in patients with chronic schizophrenia. NMDAR enhancers might also have cognitive benefits in patients with Alzheimer's disease or Parkinson's disease. Raloxifene, a selective estrogen receptor modulator, has also been demonstrated to have beneficial effects on attention, processing speed, and memory in female patients with schizophrenia. Clinical trials with

  5. Childhood exposure to green space - A novel risk-decreasing mechanism for schizophrenia?

    Science.gov (United States)

    Engemann, Kristine; Pedersen, Carsten Bøcker; Arge, Lars; Tsirogiannis, Constantinos; Mortensen, Preben Bo; Svenning, Jens-Christian

    2018-03-21

    Schizophrenia risk has been linked to urbanization, but the underlying mechanism remains unknown. Green space is hypothesized to positively influence mental health and might mediate risk of schizophrenia by mitigating noise and particle pollution exposure, stress relief, or other unknown mechanisms. The objectives for this study were to determine if green space are associated with schizophrenia risk, and if different measures of green space associate differently with risk. We used satellite data from the Landsat program to quantify green space in a new data set for Denmark at 30×30m resolution for the years 1985-2013. The effect of green space at different ages and within different distances from each person's place of residence on schizophrenia risk was estimated using Cox regression on a very large longitudinal population-based sample of the Danish population (943,027 persons). Living at the lowest amount of green space was associated with a 1.52-fold increased risk of developing schizophrenia compared to persons living at the highest level of green space. This association remained after adjusting for known risk factors for schizophrenia: urbanization, age, sex, and socioeconomic status. The strongest protective association was observed during the earliest childhood years and closest to place of residence. This is the first nationwide population-based study to demonstrate a protective association between green space during childhood and schizophrenia risk; suggesting limited green space as a novel environmental risk factor for schizophrenia. This study supports findings from other studies highlighting positive effects of exposure to natural environments for human health. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Explosives remain preferred methods for platform abandonment

    International Nuclear Information System (INIS)

    Pulsipher, A.; Daniel, W. IV; Kiesler, J.E.; Mackey, V. III

    1996-01-01

    Economics and safety concerns indicate that methods involving explosives remain the most practical and cost-effective means for abandoning oil and gas structures in the Gulf of Mexico. A decade has passed since 51 dead sea turtles, many endangered Kemp's Ridleys, washed ashore on the Texas coast shortly after explosives helped remove several offshore platforms. Although no relationship between the explosions and the dead turtles was ever established, in response to widespread public concern, the US Minerals Management Service (MMS) and National Marine Fisheries Service (NMFS) implemented regulations limiting the size and timing of explosive charges. Also, more importantly, they required that operators pay for observers to survey waters surrounding platforms scheduled for removal for 48 hr before any detonations. If observers spot sea turtles or marine mammals within the danger zone, the platform abandonment is delayed until the turtles leave or are removed. However, concern about the effects of explosives on marine life remains

  7. Diet, smoking and cardiovascular risk in schizophrenia in high and low care supported housing.

    Science.gov (United States)

    Gupta, Avirup; Craig, Tom K J

    2009-01-01

    People suffering from schizophrenia have markedly increased physical morbidity and mortality. A poor diet and sedentary lifestyle make a significant contribution to this ill health. Healthcare professionals need to include assessments of diet and to promote a 'healthy living' lifestyle. To describe the dietary habits and cardiovascular risk factors of people with chronic schizophrenia living in supported accommodation and to audit the provision of cardiovascular health screening in this population. The dietary habits of 69 people with chronic schizophrenia living in community settings were assessed. Tobacco smoking, body mass indices and waist circumference were also measured. The dietary behaviour of patients living in high care settings with care staff present every day was compared with those in low care settings. Residents in both levels of care made poor dietary choices. Patients in high care were consuming more fast food than those in low care. The dietary habits of men and women in both levels of care were worse than reported by surveys of the general population in England. All patients had seen their GP in the previous year though only 3 had received diabetes screening and fewer than half had lipid profiles. People with schizophrenia do not improve their diet just by the provision of healthy food as was the case in high care settings. Secondary care services must address physical health monitoring as well as mental health if the increased mortality of patients with schizophrenia is to be addressed effectively. More effective interventions are necessary to improve and sustain a healthy diet.

  8. Association of impaired facial affect recognition with basic facial and visual processing deficits in schizophrenia.

    Science.gov (United States)

    Norton, Daniel; McBain, Ryan; Holt, Daphne J; Ongur, Dost; Chen, Yue

    2009-06-15

    Impaired emotion recognition has been reported in schizophrenia, yet the nature of this impairment is not completely understood. Recognition of facial emotion depends on processing affective and nonaffective facial signals, as well as basic visual attributes. We examined whether and how poor facial emotion recognition in schizophrenia is related to basic visual processing and nonaffective face recognition. Schizophrenia patients (n = 32) and healthy control subjects (n = 29) performed emotion discrimination, identity discrimination, and visual contrast detection tasks, where the emotionality, distinctiveness of identity, or visual contrast was systematically manipulated. Subjects determined which of two presentations in a trial contained the target: the emotional face for emotion discrimination, a specific individual for identity discrimination, and a sinusoidal grating for contrast detection. Patients had significantly higher thresholds (worse performance) than control subjects for discriminating both fearful and happy faces. Furthermore, patients' poor performance in fear discrimination was predicted by performance in visual detection and face identity discrimination. Schizophrenia patients require greater emotional signal strength to discriminate fearful or happy face images from neutral ones. Deficient emotion recognition in schizophrenia does not appear to be determined solely by affective processing but is also linked to the processing of basic visual and facial information.

  9. nAChR dysfunction as a common substrate for schizophrenia and comorbid nicotine addiction: current trends and perspectives

    Science.gov (United States)

    Parikh, Vinay; Kutlu, Munir Gunes; Gould, Thomas J.

    2016-01-01

    Introduction The prevalence of tobacco use in the population with schizophrenia is enormously high. Moreover, nicotine dependence is found to be associated with symptom severity and poor outcome in patients with schizophrenia. The neurobiological mechanisms that explain schizophrenia-nicotine dependence comorbidity are not known. This study systematically reviews the evidence highlighting the contribution of nicotinic acetylcholine receptors (nAChRs) to nicotine abuse in schizophrenia. Methods Electronic data bases (Medline, Google Scholar, and Web of Science) were searched using the selected key words that match the aims set forth for this review. A total of 275 articles were used for the qualitative synthesis of this review. Results Substantial evidence from preclinical and clinical studies indicated that dysregulation of α7 and β2-subunit containing nAChRs account for the cognitive and affective symptoms of schizophrenia and nicotine use may represent a strategy to remediate these symptoms. Additionally, recent meta-analyses proposed that early tobacco use may itself increase the risk of developing schizophrenia. Genetic studies demonstrating that nAChR dysfunction that may act as a shared vulnerability factor for comorbid tobacco dependence and schizophrenia were found to support this view. The development of nAChR modulators was considered an effective therapeutic strategy to ameliorate psychiatric symptoms and to promote smoking cessation in schizophrenia patients. Conclusions The relationship between schizophrenia and smoking is complex. While the debate for the self-medication versus addiction vulnerability hypothesis continues, it is widely accepted that a dysfunction in the central nAChRs represent a common substrate for various symptoms of schizophrenia and comorbid nicotine dependence. PMID:26803692

  10. Understanding Autism in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Arnaldo Ballerini

    2012-01-01

    Full Text Available Detachment from external reality, distancing from others, closure into a sort of virtual hermitage, and prevalence of inner fantasies, are the descriptive aspects of autism. However, from an anthropological-phenomenological point of view, in schizophrenia, the autistic mode of life can arise from a person’s being confronted with a pathological crisis in the obviousness of the intersubjective world, essentially a crisis in the intersubjective foundation of human presence. The “condition of possibility” of the autistic way of being is the deficiency of the operation that phenomenology call empathetic-intuitive constitution of the Other, an Other which is the naturalness of evidence of being a subject like me. The theme of the Other, of intersubjectivity, has become so central in the psychopathological analysis of schizophrenic disorders because the modifications of interhuman encounter cannot be seen as the secondary consequences of symptoms but constitute the fundamental disorder of schizophrenic alienation. Revision of the concept of autism from the original definition, centered on the prevalence of inner fantasies, leads to the profound change with the vision of autism as “loss” and “void.” I call attention to possibility of phenomenological research to understand autistic world starting from this “void.”

  11. [Chronical care of schizophrenia].

    Science.gov (United States)

    Lustygier, V

    2010-09-01

    Schizophrenia is a complex mental disease leading to many deficits that needs a broad range of therapeutic interventions. The recent data raises the importance of the cognitive revalidation even though other interventions are also necessary in the treatment. The asylums of the former century have experienced a slow and continuous process of patient's deinstitutionalization. The global knowledge of the disorder having progressed, new multidisciplinary and multidimensional models of managing are now proposed. The psychiatric rehabilitation is one of those models having as goal the global taking charge of the disease, from the managing of the symptoms to the return to a life with good quality. The great specificity of this rehabilitation work is that it's multidisciplinary and involves a strong collaboration between the medical and the psychosocial intervening party's around a common therapeutic project. This model brings up the notion of recovery witch is, not the cure but, the experience that a patient acquires as he accepts the situation and as he recovers the feeling of being able to get going again.

  12. Understanding autism in schizophrenia.

    Science.gov (United States)

    Ballerini, Arnaldo

    2012-01-01

    Detachment from external reality, distancing from others, closure into a sort of virtual hermitage, and prevalence of inner fantasies, are the descriptive aspects of autism. However, from an anthropological-phenomenological point of view, in schizophrenia, the autistic mode of life can arise from a person's being confronted with a pathological crisis in the obviousness of the intersubjective world, essentially a crisis in the intersubjective foundation of human presence. The "condition of possibility" of the autistic way of being is the deficiency of the operation that phenomenology call empathetic-intuitive constitution of the Other, an Other which is the naturalness of evidence of being a subject like me. The theme of the Other, of intersubjectivity, has become so central in the psychopathological analysis of schizophrenic disorders because the modifications of interhuman encounter cannot be seen as the secondary consequences of symptoms but constitute the fundamental disorder of schizophrenic alienation. Revision of the concept of autism from the original definition, centered on the prevalence of inner fantasies, leads to the profound change with the vision of autism as "loss" and "void." I call attention to possibility of phenomenological research to understand autistic world starting from this "void."

  13. Prefrontal cortical gamma-aminobutyric acid transmission and cognitive function: drawing links to schizophrenia from preclinical research.

    Science.gov (United States)

    Tse, Maric T; Piantadosi, Patrick T; Floresco, Stan B

    2015-06-01

    Cognitive dysfunction in schizophrenia is one of the most pervasive and debilitating aspects of the disorder. Among the numerous neural abnormalities that may contribute to schizophrenia symptoms, perturbations in markers for the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), particularly within the frontal lobes, are some of the most reliable alterations observed at postmortem examination. However, how prefrontal GABA dysfunction contributes to cognitive impairment in schizophrenia remains unclear. We provide an overview of postmortem GABAergic perturbations in the brain affected by schizophrenia and describe circumstantial evidence linking these alterations to cognitive dysfunction. In addition, we conduct a survey of studies using neurodevelopmental, genetic, and pharmacologic rodent models that induce schizophrenia-like cognitive impairments, highlighting the convergence of these mechanistically distinct approaches to prefrontal GABAergic disruption. We review preclinical studies that have directly targeted prefrontal cortical GABAergic transmission using local application of GABAA receptor antagonists. These studies have provided an important link between GABA transmission and cognitive dysfunction in schizophrenia because they show that reducing prefrontal inhibitory transmission induces various cognitive, emotional, and dopaminergic abnormalities that resemble aspects of the disorder. These converging clinical and preclinical findings provide strong support for the idea that perturbations in GABA signaling drive certain forms of cognitive dysfunction in schizophrenia. Future studies using this approach will yield information to refine further a putative "GABA hypothesis" of schizophrenia. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. Predicting risk and the emergence of schizophrenia.

    LENUS (Irish Health Repository)

    Clarke, Mary C

    2012-09-01

    This article gives an overview of genetic and environmental risk factors for schizophrenia. The presence of certain molecular, biological, and psychosocial factors at certain points in the life span, has been linked to later development of schizophrenia. All need to be considered in the context of schizophrenia as a lifelong brain disorder. Research interest in schizophrenia is shifting to late childhood\\/early adolescence for screening and preventative measures. This article discusses those environmental risk factors for schizophrenia for which there is the largest evidence base.

  15. Christianity and Schizophrenia Redux: An Empirical Study.

    Science.gov (United States)

    Kéri, Szabolcs; Kelemen, Oguz

    2016-04-09

    This paper explores the relationship among schizophrenia, spirituality, and Christian religiosity. We interviewed 120 patients with schizophrenia and 120 control individuals (74.2 % of individuals with self-reported Christian religions). Patients with schizophrenia showed increases in positive spirituality and decreases in positive congregational support, as measured by the Brief Multidimensional Measure of Religiousness/Spirituality. There was no significant difference in Christian religiosity. Higher positive spirituality was predicted by more severe self-disorder, perceptual disorder, and positive clinical symptoms. Schizophrenia patients with religious delusions did not exhibit enhanced Christian beliefs and rituals. These results do not confirm the hypothesis of general hyper-religiosity in schizophrenia.

  16. Long-term Risk of Dementia in Persons With Schizophrenia: A Danish Population-Based Cohort Study.

    Science.gov (United States)

    Ribe, Anette Riisgaard; Laursen, Thomas Munk; Charles, Morten; Katon, Wayne; Fenger-Grøn, Morten; Davydow, Dimitry; Chwastiak, Lydia; Cerimele, Joseph M; Vestergaard, Mogens

    2015-11-01

    Although schizophrenia is associated with several age-related disorders and considerable cognitive impairment, it remains unclear whether the risk of dementia is higher among persons with schizophrenia compared with those without schizophrenia. To determine the risk of dementia among persons with schizophrenia compared with those without schizophrenia in a large nationwide cohort study with up to 18 years of follow-up, taking age and established risk factors for dementia into account. This population-based cohort study of more than 2.8 million persons aged 50 years or older used individual data from 6 nationwide registers in Denmark. A total of 20 683 individuals had schizophrenia. Follow-up started on January 1, 1995, and ended on January 1, 2013. Analysis was conducted from January 1, 2015, to April 30, 2015. Incidence rate ratios (IRRs) and cumulative incidence proportions (CIPs) of dementia for persons with schizophrenia compared with persons without schizophrenia. During 18 years of follow-up, 136 012 individuals, including 944 individuals with a history of schizophrenia, developed dementia. Schizophrenia was associated with a more than 2-fold higher risk of all-cause dementia (IRR, 2.13; 95% CI, 2.00-2.27) after adjusting for age, sex, and calendar period. The estimates (reported as IRR; 95% CI) did not change substantially when adjusting for medical comorbidities, such as cardiovascular diseases and diabetes mellitus (2.01; 1.89-2.15) but decreased slightly when adjusting for substance abuse (1.71; 1.60-1.82). The association between schizophrenia and dementia risk was stable when evaluated in subgroups characterized by demographics and comorbidities, although the IRR was higher among individuals younger than 65 years (3.77; 3.29-4.33), men (2.38; 2.13-2.66), individuals living with a partner (3.16; 2.71-3.69), those without cerebrovascular disease (2.23; 2.08-2.39), and those without substance abuse (1.96; 1.82-2.11). The CIPs (95% CIs) of developing

  17. Exploring social cognition in schizophrenia

    DEFF Research Database (Denmark)

    Revsbech, R.; Mortensen, E. L.; Nordgaard, J.

    2017-01-01

    The aim of the study was to compare social cognition between groups of patients diagnosed with schizophrenia and healthy controls and to replicate two previous studies using tests of social cognition that may be particularly sensitive to social cognitive deficits in schizophrenia. Thirty......-eight first-admitted patients with schizophrenia and 38 healthy controls solved 11 “imaginary conversation (i.e., theory of mind)” items, 10 “psychological understanding” items, and 10 “practical understanding” items. Statistical tests were made of unadjusted and adjusted group differences in models adjusting...... for intelligence and neuropsychological test performance. Healthy controls performed better than patients on all types of social cognitive tests, particularly on “psychological understanding.” However, after adjusting for intelligence and neuropsychological test performance, all group differences became...

  18. Schizophrenia as a human process.

    Science.gov (United States)

    Corradi, Richard B

    2011-01-01

    The patient with schizophrenia often appears to be living in an alien world, one of strange voices, bizarre beliefs, and disorganized speech and behavior. It is difficult to empathize with someone suffering from symptoms so remote from one's ordinary experience. However, examination of the disorder reveals not only symptoms of the psychosis itself but also an intensely human struggle against the disintegration of personality it can produce. Furthermore, examination of the individual's attempts to cope with a devastating psychotic process reveals familiar psychodynamic processes and defense mechanisms, however unsuccessful they may be. Knowing that behind the seemingly alien diagnostic features of schizophrenia is a person attempting to preserve his or her self-identity puts a human face on the illness. This article utilizes clinical material to describe some of the psychodynamic processes of schizophrenia. Its purpose is to facilitate understanding of an illness that requires comprehensive biopsychosocial treatment in which a therapeutic doctor-patient relationship is as necessary as antipsychotic medication.

  19. Serving the world's poor, profitably.

    Science.gov (United States)

    Prahalad, C K; Hammond, Allen

    2002-09-01

    By stimulating commerce and development at the bottom of the economic pyramid, multi-nationals could radically improve the lives of billions of people and help create a more stable, less dangerous world. Achieving this goal does not require MNCs to spearhead global social-development initiatives for charitable purposes. They need only act in their own self-interest. How? The authors lay out the business case for entering the world's poorest markets. Fully 65% of the world's population earns less than $2,000 per year--that's 4 billion people. But despite the vastness of this market, it remains largely untapped. The reluctance to invest is easy to understand, but it is, by and large, based on outdated assumptions of the developing world. While individual incomes may be low, the aggregate buying power of poor communities is actually quite large, representing a substantial market in many countries for what some might consider luxury goods like satellite television and phone services. Prices, and margins, are often much higher in poor neighborhoods than in their middle-class counterparts. And new technologies are already steadily reducing the effects of corruption, illiteracy, inadequate infrastructure, and other such barriers. Because these markets are in the earliest stages of economic development, revenue growth for multi-nationals entering them can be extremely rapid. MNCs can also lower costs, not only through low-cost labor but by transferring operating efficiencies and innovations developed to serve their existing operations. Certainly, succeeding in such markets requires MNCs to think creatively. The biggest change, though, has to come from executives: Unless business leaders confront their own preconceptions--particularly about the value of high-volume, low-margin businesses--companies are unlikely to master the challenges or reap the rewards of these developing markets.

  20. Schizophrenia patients and 22q11.2 deletion syndrome adolescents at risk express the same deviant patterns of resting state EEG microstates: A candidate endophenotype of schizophrenia

    Directory of Open Access Journals (Sweden)

    Miralena I. Tomescu

    2015-09-01

    Full Text Available Schizophrenia is a complex psychiatric disorder and many of the factors contributing to its pathogenesis are poorly understood. In addition, identifying reliable neurophysiological markers would improve diagnosis and early identification of this disease. The 22q11.2 deletion syndrome (22q11DS is one major risk factor for schizophrenia. Here, we show further evidence that deviant temporal dynamics of EEG microstates are a potential neurophysiological marker by showing that the resting state patterns of 22q11DS are similar to those found in schizophrenia patients. The EEG microstates are recurrent topographic distributions of the ongoing scalp potential fields with temporal stability of around 80 ms that are mapping the fast reconfiguration of resting state networks. Five minutes of high-density EEG recordings was analysed from 27 adult chronic schizophrenia patients, 27 adult controls, 30 adolescents with 22q11DS, and 28 adolescent controls. In both patient groups we found increased class C, but decreased class D presence and high transition probabilities towards the class C microstates. Moreover, these aberrant temporal dynamics in the two patient groups were also expressed by perturbations of the long-range dependency of the EEG microstates. These findings point to a deficient function of the salience and attention resting state networks in schizophrenia and 22q11DS as class C and class D microstates were previously associated with these networks, respectively. These findings elucidate similarities between individuals at risk and schizophrenia patients and support the notion that abnormal temporal patterns of EEG microstates might constitute a marker for developing schizophrenia.

  1. Resting EEG deficits in accused murderers with schizophrenia.

    Science.gov (United States)

    Schug, Robert A; Yang, Yaling; Raine, Adrian; Han, Chenbo; Liu, Jianghong; Li, Liejia

    2011-10-31

    Empirical evidence continues to suggest a biologically distinct violent subtype of schizophrenia. The present study examined whether murderers with schizophrenia would demonstrate resting EEG deficits distinguishing them from both non-violent schizophrenia patients and murderers without schizophrenia. Resting EEG data were collected from five diagnostic groups (normal controls, non-murderers with schizophrenia, murderers with schizophrenia, murderers without schizophrenia, and murderers with psychiatric conditions other than schizophrenia) at a brain hospital in Nanjing, China. Murderers with schizophrenia were characterized by increased left-hemispheric fast-wave EEG activity relative to non-violent schizophrenia patients, while non-violent schizophrenia patients instead demonstrated increased diffuse slow-wave activity compared to all other groups. Results are discussed within the framework of a proposed left-hemispheric over-processing hypothesis specific to violent individuals with schizophrenia, involving left hemispheric hyperarousal deficits, which may lead to a homicidally violent schizophrenia outcome. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  2. Schizophrenia: Hope on the Horizon.

    Science.gov (United States)

    Sullivan, Patrick F

    2015-01-01

    In July 2014, an international consortium of schizophrenia researchers co-founded by the author mounted the largest biological experiment in the history of psychiatry and found eighty new regions in the genome associated with the illness. With many more avenues for exploring the biological underpinnings of schizophrenia now available to neuroscientists, hope may be on the way for the estimated 2.4 million Americans and 1 in 100 people worldwide affected by the illness, one in which drugs have limited impact and there is no known cure.

  3. Schizophrenia: management and family burden.

    Science.gov (United States)

    Sebit, M B

    2007-01-01

    To explore schizophrenia with respect to its management, causes, risk factors as well as the impact it has in families regarding the burden and social networks support. Desk literature reviews. The findings are that patients with schizophrenia typically have great difficulty following a medication regimen, but they also have the greatest potential for benefiting from adherence. As with other chronic diseases that lack a definitive cure, the individual's service/recovery plan must include treatment interventions directed towards decreasing manifestations of the illness, rehabilitative services, enhancing adaptive skills, and social support mobilization aimed at optimizing function and quality of life. Finally, this paper is not exhaustive, but a pointer for further readings.

  4. [Dissociative identity disorder or schizophrenia?].

    Science.gov (United States)

    Tschöke, S; Steinert, T

    2010-01-01

    We present a case of dissociative identity disorder in which Schneiderian first rank symptoms were present besides of various states of consciousness. Thus the diagnosis of schizophrenia had to be considered. Formally, the symptoms met ICD-10 criteria for schizophrenia. However, taking into account the lack of formal thought disorder and of negative symptoms as well as a typical history of severe and prolonged traumatisation, we did not diagnose a co-morbid schizophrenic disorder. There is good evidence for the existence of psychotic symptoms among patients with dissociative disorders. However, in clinical practice this differential diagnosis is rarely considered.

  5. Where now for schizophrenia research?

    Science.gov (United States)

    Nutt, David J; Need, Anna C

    2014-08-01

    Schizophrenia continues to pose a serious challenge to neuroscience and psychiatry as well as to health care systems and to the patients and families who suffer this terrible and disabling illness. Major developments in the past few months in both genetics and drug development oblige us to consider novel drug discovery tactics for future schizophrenia research. Here we review what we consider to be the key issues and some suggested solutions. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  6. Prefrontal activity and impaired memory encoding strategies in schizophrenia.

    Science.gov (United States)

    Guimond, Synthia; Hawco, Colin; Lepage, Martin

    2017-08-01

    Schizophrenia patients have significant memory difficulties that have far-reaching implications in their daily life. These impairments are partly attributed to an inability to self-initiate effective memory encoding strategies, but its core neurobiological correlates remain unknown. The current study addresses this critical gap in our knowledge of episodic memory impairments in schizophrenia. Schizophrenia patients (n = 35) and healthy controls (n = 23) underwent a Semantic Encoding Memory Task (SEMT) during an fMRI scan. Brain activity was examined for conditions where participants were a) prompted to use semantic encoding strategies, or b) not prompted but required to self-initiate such strategies. When prompted to use semantic encoding strategies, schizophrenia patients exhibited similar recognition performance and brain activity as healthy controls. However, when required to self-initiate these strategies, patients had significant reduced recognition performance and brain activity in the left dorsolateral prefrontal cortex, as well as in the left temporal gyrus, left superior parietal lobule, and cerebellum. When patients were divided based on performance on the SEMT, the subgroup with more severe deficits in self-initiation also showed greater reduction in left dorsolateral prefrontal activity. These results suggest that impaired self-initiation of elaborative encoding strategies is a driving feature of memory deficits in schizophrenia. We also identified the neural correlates of impaired self-initiation of semantic encoding strategies, in which a failure to activate the left dorsolateral prefrontal cortex plays a key role. These findings provide important new targets in the development of novel treatments aiming to improve memory and ultimately patients' outcome. Copyright © 2017. Published by Elsevier Ltd.

  7. Modelling approaches - The case of schizophrenia : the case of schizophrenia

    NARCIS (Netherlands)

    Heeg, Bart M.S.; Damen, Joep; Buskens, Erik; Caleo, Sue; de Charro, F.; van Hout, B.A.

    2008-01-01

    Schizophrenia is a chronic disease characterized by periods of relative stability interrupted by acute episodes (or relapses). The course of the disease may vary considerably between patients. Patient histories show considerable inter- and even intra-individual variability. We provide a critical

  8. Decomposition Technique for Remaining Useful Life Prediction

    Science.gov (United States)

    Saha, Bhaskar (Inventor); Goebel, Kai F. (Inventor); Saxena, Abhinav (Inventor); Celaya, Jose R. (Inventor)

    2014-01-01

    The prognostic tool disclosed here decomposes the problem of estimating the remaining useful life (RUL) of a component or sub-system into two separate regression problems: the feature-to-damage mapping and the operational conditions-to-damage-rate mapping. These maps are initially generated in off-line mode. One or more regression algorithms are used to generate each of these maps from measurements (and features derived from these), operational conditions, and ground truth information. This decomposition technique allows for the explicit quantification and management of different sources of uncertainty present in the process. Next, the maps are used in an on-line mode where run-time data (sensor measurements and operational conditions) are used in conjunction with the maps generated in off-line mode to estimate both current damage state as well as future damage accumulation. Remaining life is computed by subtracting the instance when the extrapolated damage reaches the failure threshold from the instance when the prediction is made.

  9. Industry remains stuck in a transitional mode

    International Nuclear Information System (INIS)

    Garb, F.A.

    1991-01-01

    The near future for industry remains foggy for several obvious reasons. The shake-up of the Soviet Union and how the pieces will reform remains unclear. How successful efforts are to privatize government oil company operations around the world has yet to be determined. A long sought peace in the Middle East seems to be inching closer, but will this continue? If it does continue, what impact will it have on world energy policy? Will American companies, which are now transferring their attention to foreign E and P, also maintain an interest in domestic activities? Is the U.S. economy really on the upswing? We are told that the worst of the recession is over, but try telling this to thousands of workers in the oil patch who are being released monthly by the big players in domestic operations. This paper reports that 1992 should be a better year than 1991, if measured in opportunity. There are more exploration and acquisition options available, both domestically and internationally, than there have been in years. Probably more opportunities exist than there are players-certainly more than can be funded with current financial resources

  10. Zuclopenthixol dihydrochloride for schizophrenia.

    Science.gov (United States)

    Bryan, Edward J; Purcell, Marie Ann; Kumar, Ajit

    2017-11-16

    Oral zuclopenthixol dihydrochloride (Clopixol) is an anti-psychotic treatment for people with psychotic symptoms, especially those with schizophrenia. It is associated with neuroleptic malignant syndrome, a prolongation of the QTc interval, extra-pyramidal reactions, venous thromboembolism and may modify insulin and glucose responses. To determine the effects of zuclopenthixol dihydrochloride for treatment of schizophrenia. We searched the Cochrane Schizophrenia Group's Trials Register (latest search 09 June 2015). There were no language, date, document type, or publication status limitations for inclusion of records in the register. All randomised controlled trials (RCTs) focusing on zuclopenthixol dihydrochloride for schizophrenia. We included trials meeting our inclusion criteria and reporting useable data. We extracted data independently. For binary outcomes, we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. We employed a random-effect model for analyses. We assessed risk of bias for included studies and created 'Summary of findings' tables using GRADE. We included 20 trials, randomising 1850 participants. Data were reported for 12 comparisons, predominantly for the short term (up to 12 weeks) and inpatient populations. Overall risk of bias for included studies was low to unclear.Data were unavailable for many of our pre-stated outcomes of interest. No data were available, across all comparisons, for death, duration of stay in hospital and general functioning.Zuclopenthixol dihydrochloride versus: 1. placeboMovement disorders (EPSEs) were similar between groups (1 RCT, n = 28, RR 6.07 95% CI 0.86 to 43.04 very low-quality evidence). There was no clear difference in numbers leaving the study early (2 RCTs, n = 100, RR 0.29, 95% CI 0.01 to 6.60, very low-quality evidence). 2. chlorpromazineNo clear differences were found for

  11. Dual-modality impairment of implicit learning of letter-strings versus color-patterns in patients with schizophrenia.

    Science.gov (United States)

    Chiu, Ming-Jang; Liu, Kristina; Hsieh, Ming H; Hwu, Hai-Gwo

    2005-12-12

    Implicit learning was reported to be intact in schizophrenia using artificial grammar learning. However, emerging evidence indicates that artificial grammar learning is not a unitary process. The authors used dual coding stimuli and schizophrenia clinical symptom dimensions to re-evaluate the effect of schizophrenia on various components of artificial grammar learning. Letter string and color pattern artificial grammar learning performances were compared between 63 schizophrenic patients and 27 comparison subjects. Four symptom dimensions derived from a Chinese Positive and Negative Symptom Scale ratings were correlated with patients' artificial grammar implicit learning performances along the two stimulus dimensions. Patients' explicit memory performances were assessed by verbal paired associates and visual reproduction subtests of the Wechsler Memory Scales Revised Version to provide a contrast to their implicit memory function. Schizophrenia severely hindered color pattern artificial grammar learning while the disease affected lexical string artificial grammar learning to a lesser degree after correcting the influences from age, education and the performance of explicit memory function of both verbal and visual modalities. Both learning performances correlated significantly with the severity of patients' schizophrenic clinical symptom dimensions that reflect poor abstract thinking, disorganized thinking, and stereotyped thinking. The results of this study suggested that schizophrenia affects various mechanisms of artificial grammar learning differently. Implicit learning, knowledge acquisition in the absence of conscious awareness, is not entirely intact in patients with schizophrenia. Schizophrenia affects implicit learning through an impairment of the ability of making abstractions from rules and at least in part decreasing the capacity for perceptual learning.

  12. Lack of cardinal symptoms of meningitis in a hospitalized patient with chronic schizophrenia: lessons to be learned.

    Science.gov (United States)

    So, Ryuhei; Hirota, Tomoya; Yamamoto, Yuki; Hishimoto, Akitoyo; Correll, Christoph U

    2015-01-01

    There are prior reports describing a diagnostic delay in medical emergencies in patients with schizophrenia. To our knowledge, this is the first case report demonstrating the risk of diagnostic delay of acute meningitis due to reduced pain perception as well as other factors related to schizophrenia and its treatment. We report a case of meningitis in a patient suffering from chronic schizophrenia and poor treatment response despite high doses of antipsychotics. Potential difficulties and pitfalls when suspecting or diagnosing meningitis as a physical comorbidity in patients with schizophrenia are discussed. A 33-year-old man with chronic and treatment-resistant schizophrenia developed acute meningitis. The definite diagnosis was delayed because the cardinal symptoms other than fever were not clearly elicited by physical examination. The characteristic symptoms of meningitis were concealed by reduced pain perception, rigidity due to the administration of antipsychotics, disorganized thinking and potentially diminished communication with health care professionals as commonly seen in patients with schizophrenia. Meningitis should not be dismissed as a possibility in patients with fever of unknown origin just because a patient with schizophrenia does not present with cardinal features of meningitis other than fever. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Shotgun microbial profiling of fossil remains

    DEFF Research Database (Denmark)

    Der Sarkissian, Clio; Ermini, Luca; Jónsson, Hákon

    2014-01-01

    the specimen of interest, but instead reflect environmental organisms that colonized the specimen after death. Here, we characterize the microbial diversity recovered from seven c. 200- to 13 000-year-old horse bones collected from northern Siberia. We use a robust, taxonomy-based assignment approach...... to identify the microorganisms present in ancient DNA extracts and quantify their relative abundance. Our results suggest that molecular preservation niches exist within ancient samples that can potentially be used to characterize the environments from which the remains are recovered. In addition, microbial...... community profiling of the seven specimens revealed site-specific environmental signatures. These microbial communities appear to comprise mainly organisms that colonized the fossils recently. Our approach significantly extends the amount of useful data that can be recovered from ancient specimens using...

  14. Some remaining problems in HCDA analysis

    International Nuclear Information System (INIS)

    Chang, Y.W.

    1981-01-01

    The safety assessment and licensing of liquid-metal fast breeder reactors (LMFBRs) requires an analysis on the capability of the reactor primary system to sustain the consequences of a hypothetical core-disruptive accident (HCDA). Although computational methods and computer programs developed for HCDA analyses can predict reasonably well the response of the primary containment system, and follow up the phenomena of HCDA from the start of excursion to the time of dynamic equilibrium in the system, there remain areas in the HCDA analysis that merit further analytical and experimental studies. These are the analysis of fluid impact on reactor cover, three-dimensional analysis, the treatment of the perforated plates, material properties under high strain rates and under high temperatures, the treatment of multifield flows, and the treatment of prestressed concrete reactor vessels. The purpose of this paper is to discuss the structural mechanics of HCDA analysis in these areas where improvements are needed

  15. Political, energy events will remain interwoven

    International Nuclear Information System (INIS)

    Jones, D.P.

    1991-01-01

    This paper reports that it is possible to discuss the significance of political and energy events separately, but, in truth, they are intricately interwoven. Furthermore, there are those who will argue that since the two are inseparable, the future is not predictable; so why bother in the endeavor. It is possible that the central point of the exercise may have been missed-yes, the future is unpredictable exclamation point However, the objective of prediction is secondary. The objective of understanding the dynamic forces of change is primary exclamation point With this view of recent history, it is perhaps appropriate to pause and think about the future of the petroleum industry. The future as shaped by political, energy, economic, environmental and technological forces will direct our lives and markets during this decade. Most importantly, what will be the direction that successful businesses take to remain competitive in a global environment? These are interesting issues worthy of provocative thoughts and innovative ideas

  16. Nuclear remains an economic and ecologic asset

    International Nuclear Information System (INIS)

    Le Ngoc, Boris

    2015-01-01

    The author herein outlines the several benefits of nuclear energy and nuclear industry for France. He first outlines that France possesses 97 per cent of de-carbonated electricity thanks to nuclear energy (77 pc) and renewable energies (20 pc, mainly hydraulic), and that renewable energies must be developed in the building and transport sectors to be able to get rid of the environmentally and financially costly fossil energies. He outlines that reactor maintenance and the nuclear fuel cycle industry are fields of technological leadership for the French nuclear industry which is, after motor industry and aircraft industry, the third industrial sector in France. He indicates that nuclear electricity is to remain the most competitive one, and that nuclear energy and renewable energies must not be opposed to it but considered as complementary in the struggle against climate change, i.e. to reduce greenhouse gas emissions and to get rid of the prevalence of fossil energies

  17. Population cycles: generalities, exceptions and remaining mysteries

    Science.gov (United States)

    2018-01-01

    Population cycles are one of nature's great mysteries. For almost a hundred years, innumerable studies have probed the causes of cyclic dynamics in snowshoe hares, voles and lemmings, forest Lepidoptera and grouse. Even though cyclic species have very different life histories, similarities in mechanisms related to their dynamics are apparent. In addition to high reproductive rates and density-related mortality from predators, pathogens or parasitoids, other characteristics include transgenerational reduced reproduction and dispersal with increasing-peak densities, and genetic similarity among populations. Experiments to stop cyclic dynamics and comparisons of cyclic and noncyclic populations provide some understanding but both reproduction and mortality must be considered. What determines variation in amplitude and periodicity of population outbreaks remains a mystery. PMID:29563267

  18. Design of a Virtual Reality System for Affect Analysis in Facial Expressions (VR-SAAFE); Application to Schizophrenia.

    Science.gov (United States)

    Bekele, E; Bian, D; Peterman, J; Park, S; Sarkar, N

    2017-06-01

    Schizophrenia is a life-long, debilitating psychotic disorder with poor outcome that affects about 1% of the population. Although pharmacotherapy can alleviate some of the acute psychotic symptoms, residual social impairments present a significant barrier that prevents successful rehabilitation. With limited resources and access to social skills training opportunities, innovative technology has emerged as a potentially powerful tool for intervention. In this paper, we present a novel virtual reality (VR)-based system for understanding facial emotion processing impairments that may lead to poor social outcome in schizophrenia. We henceforth call it a VR System for Affect Analysis in Facial Expressions (VR-SAAFE). This system integrates a VR-based task presentation platform that can minutely control facial expressions of an avatar with or without accompanying verbal interaction, with an eye-tracker to quantitatively measure a participants real-time gaze and a set of physiological sensors to infer his/her affective states to allow in-depth understanding of the emotion recognition mechanism of patients with schizophrenia based on quantitative metrics. A usability study with 12 patients with schizophrenia and 12 healthy controls was conducted to examine processing of the emotional faces. Preliminary results indicated that there were significant differences in the way patients with schizophrenia processed and responded towards the emotional faces presented in the VR environment compared with healthy control participants. The preliminary results underscore the utility of such a VR-based system that enables precise and quantitative assessment of social skill deficits in patients with schizophrenia.

  19. [The fragmentation of representational space in schizophrenia].

    Science.gov (United States)

    Plagnol, A; Oïta, M; Montreuil, M; Granger, B; Lubart, T

    2003-01-01

    Existent neurocognitive models of schizophrenia converge towards a core of impairments involving working memory, context processing, action planning, controlled and intentional processing. However, the emergence of this core remains itself difficult to explain and more specific hypotheses do not explain the heterogeneity of schizophrenia. To overcome these limits, we propose a new paradigm based on representational theory from cognitive science. Some recent developments of this theory enable us to describe a subjective universe as a representational space which is displayed from memory. We outline a conceptual framework to construct such a representational space from analogical -representations that can be activated in working memory and are connected to a network of symbolic structures. These connections are notably made through an analytic process of the analogical fragments, which involves the attentional focus. This framework allows us to define rigorously some defense processes in response to traumatic tensions that are expressed on the representational space. The fragmentation of representational space is a consequence of a defensive denial based on an impairment of the analytic process. The fragmentation forms some parasitic areas in memory which are excluded from the main part of the representational space and disturb information processing. The key clinical concepts of paranoid syndromes can be defined in this conceptual framework: mental automatism, delusional intuition, acute destructuration, psychotic dissociation, and autistic withdrawal. We show that these syndromes imply each other, which in return increases the fragmentation of the representational space. Some new concepts emerge naturally in this framework, such as the concept of "suture" which is defined as a link between a parasitic area and the main representational space. Schizophrenia appears as a borderline case of fragmentation of the representational space. This conceptual framework is

  20. Differentiation of schizophrenia patients from healthy subjects by mismatch negativity and neuropsychological tests.

    Directory of Open Access Journals (Sweden)

    Yi-Ting Lin

    Full Text Available BACKGROUND: Schizophrenia is a heterogeneous disorder with diverse presentations. The current and the proposed DSM-V diagnostic system remains phenomenologically based, despite the fact that several neurobiological and neuropsychological markers have been identified. A multivariate approach has better diagnostic utility than a single marker method. In this study, the mismatch negativity (MMN deficit of schizophrenia was first replicated in a Han Chinese population, and then the MMN was combined with several neuropsychological measurements to differentiate schizophrenia patients from healthy subjects. METHODOLOGY/PRINCIPAL FINDINGS: 120 schizophrenia patients and 76 healthy controls were recruited. Each subject received examinations for duration MMN, Continuous Performance Test, Wisconsin Card Sorting Test, and Wechsler Adult Intelligence Scale Third Edition (WAIS-III. The MMN was compared between cases and controls, and important covariates were investigated. Schizophrenia patients had significantly reduced MMN amplitudes, and MMN decreased with increasing age in both patient and control groups. None of the neuropsychological indices correlated with MMN. Predictive multivariate logistic regression models using the MMN and neuropsychological measurements as predictors were developed. Four predictors, including MMN at electrode FCz and three scores from the WAIS-III (Arithmetic, Block Design, and Performance IQ were retained in the final predictive model. The model performed well in differentiating patients from healthy subjects (percentage of concordant pairs: 90.5%. CONCLUSIONS/SIGNIFICANCE: MMN deficits were found in Han Chinese schizophrenia patients. The multivariate approach combining biomarkers from different modalities such as electrophysiology and neuropsychology had a better diagnostic utility.

  1. Abnormal prefrontal and parietal activity linked to deficient active binding in working memory in schizophrenia.

    Science.gov (United States)

    Grot, Stéphanie; Légaré, Virginie Petel; Lipp, Olivier; Soulières, Isabelle; Dolcos, Florin; Luck, David

    2017-10-01

    Working memory deficits have been widely reported in schizophrenia, and may result from inefficient binding processes. These processes, and their neural correlates, remain understudied in schizophrenia. Thus, we designed an FMRI study aimed at investigating the neural correlates of both passive and active binding in working memory in schizophrenia. Nineteen patients with schizophrenia and 23 matched controls were recruited to perform a working memory binding task, in which they were instructed to memorize three letters and three spatial locations. In the passive binding condition, letters and spatial locations were directly presented as bound. Conversely, in the active binding condition, words and spatial locations were presented as separated, and participants were instructed to intentionally create associations between them. Patients exhibited a similar performance to the controls for the passive binding condition, but a significantly lower performance for the active binding. FMRI analyses revealed that this active binding deficit was related to aberrant activity in the posterior parietal cortex and the ventrolateral prefrontal cortex. This study provides initial evidence of a specific deficit for actively binding information in schizophrenia, which is linked to dysfunctions in the neural networks underlying attention, manipulation of information, and encoding strategies. Together, our results suggest that all these dysfunctions may be targets for neuromodulation interventions known to improve cognitive deficits in schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Functional Implications of the IL-23/IL-17 Immune Axis in Schizophrenia.

    Science.gov (United States)

    Debnath, Monojit; Berk, Michael

    2017-12-01

    The aetiology of schizophrenia seems to stem from complex interactions amongst environmental, genetic, metabolic, immunologic and oxidative components. Chronic low-grade inflammation has been persistently linked to schizophrenia, and this has primarily been based on the findings derived from Th1/Th2 cytokine balance. While the IL-23/IL-17 axis plays crucial role in the pathogenesis of several immune-mediated disorders, it has remained relatively unexplored in neuropsychiatric disorders. Altered levels of cytokines related to IL-23/IL-17 axis have been observed in schizophrenia patients in a few studies. In addition, other indirect factors known to confer schizophrenia risk like complement activation and altered gut microbiota are shown to modulate the IL-23/IL-17 axis. These preliminary observations provide crucial clues about the functional implications of IL-23/IL-17 axis in schizophrenia. In this review, an attempt has been made to highlight the biology of IL-23/IL-17 axis and its relevance to schizophrenia risk and pathogenesis. Given the pathogenic potential of the IL-23/IL-17 axis, therapeutic targeting of this axis may be a promising approach to benefit patients suffering from this devastating disorder.

  3. Predictors of employment in schizophrenia: The importance of intrinsic and extrinsic motivation.

    Science.gov (United States)

    Reddy, L Felice; Llerena, Katiah; Kern, Robert S

    2016-10-01

    Unemployment is a primary functional deficit for the majority of adults with schizophrenia. Research indicates that over two-thirds of adults living in the community with schizophrenia are unemployed. Despite effective programs to assist with job identification and placement, the ability to attain and maintain employment remains a pressing concern. A contributing factor that may be relevant but has received little attention in the work rehabilitation literature is motivation. People with schizophrenia show marked deficits in both intrinsic and extrinsic motivation but these deficits have not been directly examined in relation to work outcomes. The present study sought to examine the relationship between intrinsic and extrinsic motivation and work outcome among a sample of 65 adults with schizophrenia enrolled in a supported employment program. One-third of the participants in the study obtained work. Intrinsic motivation related to valuing and feeling useful in a work role significantly predicted who would obtain employment. Extrinsic motivation related to gaining rewards and avoiding obstacles showed a non-significant trend-level relationship such that workers had higher extrinsic motivation than nonworkers. These findings highlight the importance of considering both intrinsic and extrinsic motivation in work-related interventions and supported employment for individuals with schizophrenia. The results are discussed in terms of clinical implications for improving rehabilitation and occupational outcomes in schizophrenia. Published by Elsevier B.V.

  4. Evidence that hippocampal-parahippocampal dysfunction is related to genetic risk for schizophrenia.

    Science.gov (United States)

    Di Giorgio, A; Gelao, B; Caforio, G; Romano, R; Andriola, I; D'Ambrosio, E; Papazacharias, A; Elifani, F; Bianco, L Lo; Taurisano, P; Fazio, L; Popolizio, T; Blasi, G; Bertolino, A

    2013-08-01

    Abnormalities in hippocampal-parahippocampal (H-PH) function are prominent features of schizophrenia and have been associated with deficits in episodic memory. However, it remains unclear whether these abnormalities represent a phenotype related to genetic risk for schizophrenia or whether they are related to disease state. We investigated H-PH-mediated behavior and physiology, using blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI), during episodic memory in a sample of patients with schizophrenia, clinically unaffected siblings and healthy subjects. Patients with schizophrenia and unaffected siblings displayed abnormalities in episodic memory performance. During an fMRI memory encoding task, both patients and siblings demonstrated a similar pattern of reduced H-PH engagement compared with healthy subjects. Our findings suggest that the pathophysiological mechanism underlying the inability of patients with schizophrenia to properly engage the H-PH during episodic memory is related to genetic risk for the disorder. Therefore, H-PH dysfunction can be assumed as a schizophrenia susceptibility-related phenotype.

  5. Enhanced temporal variability of amygdala-frontal functional connectivity in patients with schizophrenia.

    Science.gov (United States)

    Yue, Jing-Li; Li, Peng; Shi, Le; Lin, Xiao; Sun, Hong-Qiang; Lu, Lin

    2018-01-01

    The "dysconnectivity hypothesis" was proposed 20 years ago. It characterized schizophrenia as a disorder with dysfunctional connectivity across a large range of distributed brain areas. Resting-state functional magnetic resonance imaging (rsfMRI) data have supported this theory. Previous studies revealed that the amygdala might be responsible for the emotion regulation-related symptoms of schizophrenia. However, conventional methods oversimplified brain activities by assuming that it remained static throughout the entire scan duration, which may explain why inconsistent results have been reported for the same brain region. An emerging technique is sliding time window analysis, which is used to describe functional connectivity based on the temporal variability of regions of interest (e.g., amygdala) in patients with schizophrenia. Conventional analysis of the static functional connectivity between the amygdala and whole brain was also conducted. Static functional connectivity between the amygdala and orbitofrontal region was impaired in patients with schizophrenia. The variability of connectivity between the amygdala and medial prefrontal cortex was enhanced (i.e., greater dynamics) in patients with schizophrenia. A negative relationship was found between the variability of connectivity and information processing efficiency. A positive correlation was found between the variability of connectivity and symptom severity. The findings suggest that schizophrenia was related to abnormal patterns of fluctuating communication among brain areas that are involved in emotion regulations. Unveiling the temporal properties of functional connectivity could disentangle the inconsistent results of previous functional connectivity studies.

  6. Altered Coupling Between Resting-State Cerebral Blood Flow and Functional Connectivity in Schizophrenia.

    Science.gov (United States)

    Zhu, Jiajia; Zhuo, Chuanjun; Xu, Lixue; Liu, Feng; Qin, Wen; Yu, Chunshui

    2017-10-21

    Respective changes in resting-state cerebral blood flow (CBF) and functional connectivity in schizophrenia have been reported. However, their coupling alterations in schizophrenia remain largely unknown. 89 schizophrenia patients and 90 sex- and age-matched healthy controls underwent resting-state functional MRI to calculate functional connectivity strength (FCS) and arterial spin labeling imaging to compute CBF. The CBF-FCS coupling of the whole gray matter and the CBF/FCS ratio (the amount of blood supply per unit of connectivity strength) of each voxel were compared between the 2 groups. Whole gray matter CBF-FCS coupling was decreased in schizophrenia patients relative to healthy controls. In schizophrenia patients, the decreased CBF/FCS ratio was predominantly located in cognitive- and emotional-related brain regions, including the dorsolateral prefrontal cortex, insula, hippocampus and thalamus, whereas an increased CBF/FCS ratio was mainly identified in the sensorimotor regions, including the putamen, and sensorimotor, mid-cingulate and visual cortices. These findings suggest that the neurovascular decoupling in the brain may be a possible neuropathological mechanism of schizophrenia. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com

  7. Neurological signs and involuntary movements in schizophrenia: intrinsic to and informative on systems pathobiology.

    LENUS (Irish Health Repository)

    Whitty, Peter F

    2012-02-01

    While it has long been considered whether the pathobiology of schizophrenia extends beyond its defining symptoms to involve diverse domains of abnormality, in the manner of a systemic disease, studies of neuromotor dysfunction have been confounded by treatment with antipsychotic drugs. This challenge has been illuminated by a new generation of studies on first-episode schizophrenia before initiation of antipsychotic treatment and by opportunities in developing countries to study chronically ill patients who have remained antipsychotic naive due to limitations in provision of psychiatric care. Building from studies in antipsychotic-naive patients, this article reviews 2 domains of neuromotor dysfunction in schizophrenia: neurological signs and involuntary movements. The presence and characteristics of neurological signs in untreated vis-a-vis treated psychosis indicate a vulnerability marker for schizophrenia and implicate disruption to neuronal circuits linking the basal ganglia, cerebral cortex, and cerebellum. The presence and characteristics of involuntary movements in untreated vis-a-vis treated psychosis indicate an intrinsic feature of the disease process and implicate dysfunction in cortical-basal ganglia-cortical circuitry. These neuromotor disorders of schizophrenia join other markers of subtle but pervasive cerebral and extracerebral, systemic dysfunction, and complement current concepts of schizophrenia as a disorder of developmentally determined cortical-basal ganglia-thalamo-cortical\\/cerebellar network disconnectivity.

  8. Attention/vigilance in schizophrenia: performance results from a large multi-site study of the Consortium on the Genetics of Schizophrenia (COGS).

    Science.gov (United States)

    Nuechterlein, Keith H; Green, Michael F; Calkins, Monica E; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Light, Gregory A; Radant, Allen D; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Sprock, Joyce; Stone, William S; Sugar, Catherine A; Swerdlow, Neal R; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Braff, David L

    2015-04-01

    Attention/vigilance impairments are present in individuals with schizophrenia across psychotic and remitted states and in their first-degree relatives. An important question is whether deficits in attention/vigilance can be consistently and reliably measured across sites varying in many participant demographic, clinical, and functional characteristics, as needed for large-scale genetic studies of endophenotypes. We examined Continuous Performance Test (CPT) data from phase 2 of the Consortium on the Genetics of Schizophrenia (COGS-2), the largest-scale assessment of cognitive and psychophysiological endophenotypes relevant to schizophrenia. The CPT data from 2251 participants from five sites were examined. A perceptual-load vigilance task (the Degraded Stimulus CPT or DS-CPT) and a memory-load vigilance task (CPT-Identical Pairs or CPT-IP) were utilized. Schizophrenia patients performed more poorly than healthy comparison subjects (HCS) across sites, despite significant site differences in participant age, sex, education, and racial distribution. Patient-HCS differences in signal/noise discrimination (d') in the DS-CPT varied significantly across sites, but averaged a medium effect size. CPT-IP performance showed large patient-HCS differences across sites. Poor CPT performance was independent of or weakly correlated with symptom severity, but was significantly associated with lower educational achievement and functional capacity. Current smoking was associated with poorer CPT-IP d'. Patients taking both atypical and typical antipsychotic medication performed more poorly than those on no or atypical antipsychotic medications, likely reflecting their greater severity of illness. We conclude that CPT deficits in schizophrenia can be reliably detected across sites, are relatively independent of current symptom severity, and are related to functional capacity. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Imaging dopamine transmission in schizophrenia

    International Nuclear Information System (INIS)

    Laruelle, M.

    1998-01-01

    Over the last ten years, several positron emission tomography (PET) and single photon computerized tomography (SPECT) studies of the dopamine (DA) system in patients with schizophrenia were performed to test the hypothesis that DA hyperactivity is associated with this illness. In this paper are reviewed the results of fifteen brain imaging studies comparing indices of DA function in drug naive or drug free patients with schizophrenia and healthy controls: thirteen studies included measurements of Da D 2 receptor density, two studies compared amphetamine-induced DA release, and two studies measured DOPA decarboxylase activity, an enzyme involved in DA synthesis. It was conducted a meta-analysis of the studies measuring D 2 receptor density parameters, under the assumption that all tracers labeled the same population of D 2 receptors. This analysis revealed that, compared to healthy controls, patients with schizophrenia present a significant but mild elevation of D 2 receptor density parameters and a significant larger variability of these indices. It was found no statistical evidence that studies performed with radiolabeled butyrophenones detected a larger increase in D 2 receptor density parameters than studies performed with other radioligands, such as benzamides. Studies of presynaptic activity revealed an increase in DA transmission response to amphetamine challenge, and an increase in DOPA decarboxylase activity. Together, these data are compatible with both pre- and post-synaptic alterations of DA transmission in schizophrenia. Future studies should aim at a better characterization of these alterations, and at defining their role in the pathophysiology of the illness

  10. Second Language Acquisition and Schizophrenia

    Science.gov (United States)

    Dugan, James E.

    2014-01-01

    Schizophrenia is a complex mental disorder that results in language-related symptoms at various discourse levels, ranging from semantics (e.g. inventing words and producing nonsensical strands of similar-sounding words) to pragmatics and higher-level functioning (e.g. too little or too much information given to interlocutors, and tangential…

  11. [Theory of mind in schizophrenia].

    Science.gov (United States)

    Bonshtein, Udi

    2006-12-01

    The term "theory of mind" (ToM) refers to the capacity to infer one's own and other persons' mental states (e.g. their beliefs, feelings, intentions or knowledge). It was found that children in the autistic spectrum have deficits in ToM. One of the suggestions was that unlike autistic people, ToM skills are normally developed in schizophrenia patients, but "lost" in the first psychotic episode. The deficit may disappear on remission from the acute phase, as described in some studies. A substantial body of research has highlighted the impaired ToM in schizophrenia. There is good empirical evidence that ToM is specifically impaired in schizophrenia and that many psychotic symptoms--for instance, delusions of alien control and persecution, the presence of thought and language disorganization, and other behavioral symptoms--may best be understood in light of a disturbed capacity in patients to relate their own intentions to executing behavior, and to monitor others' intentions. However, it is still under debate how an impaired ToM in schizophrenia is associated with other aspects of cognition, how the impairment fluctuates with acuity or chronicity of the schizophrenic disorder, and if it is a state or trate marker. The paper reviews the current literature and suggests potential implications and future research areas.

  12. Glutamate and GABA in schizophrenia

    NARCIS (Netherlands)

    Marsman, A.

    2013-01-01

    Schizophrenia is characterized by a loss of brain tissue, which may represent an ongoing pathophysiological process. Possible mechanisms that may be involved are the glutamatergic and GABAergic (gamma-aminobutyric acid) systems. Particularly hypofunction of the N-methyl-D-aspartate (NMDA) type of

  13. Imbalanced Kynurenine Pathway in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Magdalena E. Kegel

    2014-01-01

    Full Text Available Several studies suggest a role for kynurenic acid (KYNA in the pathophysiology of schizophrenia. It has been proposed that increased brain KYNA levels in schizophrenia result from a pathological shift in the kynurenine pathway toward enhanced KYNA formation, away from the other branch of the pathway leading to quinolinic acid (QUIN. Here we investigate the levels of QUIN in cerebrospinal fluid (CSF of patients with schizophrenia and healthy controls, and relate those to CSF levels of KYNA and other kynurenine metabolites from the same individuals. CSF QUIN levels from stable outpatients treated with olanzapine (n = 22 and those of controls (n = 26 were analyzed using liquid chromatography-mass spectrometry. No difference in CSF QUIN levels between patients and controls was observed (20.6 ± 1.5 nM vs. 18.2 ± 1.1 nM, P = 0.36. CSF QUIN was positively correlated to CSF kynurenine and CSF KYNA in patients but not in controls. The CSF QUIN/KYNA ratio was lower in patients than in controls ( P = 0.027. In summary, the present study offers support for an over-activated and imbalanced kynurenine pathway, favoring the production of KYNA over QUIN in patients with schizophrenia.

  14. Influence of cognition and symptoms of schizophrenia on IADL performance.

    Science.gov (United States)

    Lipskaya, Lena; Jarus, Tal; Kotler, Moshe

    2011-09-01

    People with schizophrenia experience difficulties with instrumental activities of daily living (IADL), which are required for independent living. Yet, factors that influence IADL performance are still poorly understood. Identification of such factors will contribute to the rehabilitation process and recovery. The present study aimed to examine the influence of cognitive abilities, schizophrenia symptoms, and demographic variables on IADL functioning during acute hospital admission. The participants were 81 adults with DSM-IV chronic schizophrenia. They were assessed on the Revised Observed Tasks of Daily Living (OTDL-R), the Positive and Negative Syndrome Scale (PANSS), the Neurobehavioral Cognitive Status Examination (Cognistat), and the Kitchen Task Assessment (KTA) at acute hospitalization. The prediction model of IADL performance at this time consists of executive functioning (explained 21% of variance), memory and abstract thinking (explained 13.5%), negative symptoms (explained 13%), age of illness onset and years of education (explained 8%). The total explained variance is 53.5%. These results provide evidence-based guidelines for the evaluation process in inpatient settings. Such guidelines are important since planning of intervention processes and appropriate community integration programs often occurs during acute hospitalization, while the structured nature of inpatient settings limits natural variability in occupational performance.

  15. INSIGHT AND SELF-STIGMA IN PATIENTS WITH SCHIZOPHRENIA.

    Science.gov (United States)

    Vidović, Domagoj; Brecić, Petrana; Vilibić, Maja; Jukić, Vlado

    2016-03-01

    Poor insight and high level of self-stigma are often present among patients with schizophrenia and are related to poorer treatment adherence, poorer social function and rehabilitation, aggressive behavior, higher level of depression, social anxiety, lower quality of life and self-esteem. Reports on a relationship between insight and stigma are controversial. We examined the relationship of the level of insight and self-stigma in a sample of 149 patients with schizophrenia. Insight was measured with the Scale to assess Unawareness of Mental Disorder and self-stigma with the Internalized Stigma of Mental Illness. Results showed 88.6% of the patients to have high or moderate insight, with a mean value of 2.73. General insight showed the highest level (2.58) and insight in positive symptoms the lowest level (2.9). The self-stigma score in general was 2.13, with stereotype endorsement being lowest (1.98). According to study results, 77.1% of patients felt minimal or low self-stigma across all subscales, except for stigma resistance subscale. Statistically significant correlation was found between insight and four subscales of self-stigma, while no correlation was found for the stigma resistance subscale only. These results imply the need of individually tailored antistigma and insight promoting programs for patients with schizophrenia.

  16. Problem solving skills for schizophrenia.

    Science.gov (United States)

    Xia, J; Li, Chunbo

    2007-04-18

    The severe and long-lasting symptoms of schizophrenia are often the cause of severe disability. Environmental stress such as life events and the practical problems people face in their daily can worsen the symptoms of schizophrenia. Deficits in problem solving skills in people with schizophrenia affect their independent and interpersonal functioning and impair their quality of life. As a result, therapies such as problem solving therapy have been developed to improve problem solving skills for people with schizophrenia. To review the effectiveness of problem solving therapy compared with other comparable therapies or routine care for those with schizophrenia. We searched the Cochrane Schizophrenia Group's Register (September 2006), which is based on regular searches of BIOSIS, CENTRAL, CINAHL, EMBASE, MEDLINE and PsycINFO. We inspected references of all identified studies for further trials. We included all clinical randomised trials comparing problem solving therapy with other comparable therapies or routine care. We extracted data independently. For homogenous dichotomous data we calculated random effects, relative risk (RR), 95% confidence intervals (CI) and, where appropriate, numbers needed to treat (NNT) on an intention-to-treat basis. For continuous data, we calculated weighted mean differences (WMD) using a random effects statistical model. We included only three small trials (n=52) that evaluated problem solving versus routine care, coping skills training or non-specific interaction. Inadequate reporting of data rendered many outcomes unusable. We were unable to undertake meta-analysis. Overall results were limited and inconclusive with no significant differences between treatment groups for hospital admission, mental state, behaviour, social skills or leaving the study early. No data were presented for global state, quality of life or satisfaction. We found insufficient evidence to confirm or refute the benefits of problem solving therapy as an additional

  17. Heterogeneity of schizophrenia: Genetic and symptomatic factors.

    Science.gov (United States)

    Takahashi, Sakae

    2013-10-01

    Schizophrenia may have etiological heterogeneity, and may reflect common symptomatology caused by many genetic and environmental factors. In this review, we show the potential existence of heterogeneity in schizophrenia based on the results of our previous studies. In our study of the NOTCH4 gene, there were no significant associations between any single nucleotide polymorphisms (SNPs) of NOTCH4 and schizophrenia. However, exploratory analyses suggested that the SNP, rs3134928 may be associated with early-onset schizophrenia, and that rs387071 may be associated with schizophrenia characterized by negative symptoms. In our highly familial schizophrenia study, the African-American cohort without environmental exposure showed a possible linkage at marker 8p23.1 in the dominant model and in the European-American cohort, a marker at 22q13.32 showed a probable linkage in the recessive model. In the less familial schizophrenia families, these linkages were not shown. Based on our eye movement study, a putative subtype of schizophrenia with severe symptoms related to excitement/hostility, negative symptoms and disorganization may be associated with chromosome 22q11. We consider that a sample stratification approach may clarify the heterogeneity of schizophrenia. Therefore, this approach may lead to a more straightforward way of identifying susceptibility genes of schizophrenia. © 2013 Wiley Periodicals, Inc.

  18. Hypothesis: grandiosity and guilt cause paranoia; paranoid schizophrenia is a psychotic mood disorder; a review.

    Science.gov (United States)

    Lake, Charles Raymond

    2008-11-01

    Delusional paranoia has been associated with severe mental illness for over a century. Kraepelin introduced a disorder called "paranoid depression," but "paranoid" became linked to schizophrenia, not to mood disorders. Paranoid remains the most common subtype of schizophrenia, but some of these cases, as Kraepelin initially implied, may be unrecognized psychotic mood disorders, so the relationship of paranoid schizophrenia to psychotic bipolar disorder warrants reevaluation. To address whether paranoia associates more with schizophrenia or mood disorders, a selected literature is reviewed and 11 cases are summarized. Comparative clinical and recent molecular genetic data find phenotypic and genotypic commonalities between patients diagnosed with schizophrenia and psychotic bipolar disorder lending support to the idea that paranoid schizophrenia could be the same disorder as psychotic bipolar disorder. A selected clinical literature finds no symptom, course, or characteristic traditionally considered diagnostic of schizophrenia that cannot be accounted for by psychotic bipolar disorder patients. For example, it is hypothesized here that 2 common mood-based symptoms, grandiosity and guilt, may underlie functional paranoia. Mania explains paranoia when there are grandiose delusions that one's possessions are so valuable that others will kill for them. Similarly, depression explains paranoia when delusional guilt convinces patients that they deserve punishment. In both cases, fear becomes the overwhelming emotion but patient and physician focus on the paranoia rather than on underlying mood symptoms can cause misdiagnoses. This study uses a clinical, case-based, hypothesis generation approach that warrants follow-up with a larger representative sample of psychotic patients followed prospectively to determine the degree to which the clinical course observed herein is typical of all such patients. Differential diagnoses, nomenclature, and treatment implications are

  19. Genome-wide association study with the risk of schizophrenia in a Korean population.

    Science.gov (United States)

    Kim, Lyoung Hyo; Park, Byung Lae; Cheong, Hyun Sub; Namgoong, Suhg; Kim, Ji On; Kim, Jeong-Hyun; Shin, Joong-Gon; Park, Chul Soo; Kim, Bong-Jo; Kim, Jae Won; Choi, Ihn-Geun; Hwang, Jaeuk; Shin, Hyoung Doo; Woo, Sung-Il

    2016-03-01

    Schizophrenia is regarded as a multifactorial and polygenic brain disorder that is attributed to different combinations of genetic and environmental risk factors. Recently, several genome-wide association studies (GWASs) of schizophrenia have identified numerous risk factors, but the replication results remain controversial and ambiguous. To identify schizophrenia susceptibility loci in the Korean population, we performed a GWAS using the Illumina HumanOmni1-Quad V1.0 Microarray. We genotyped 1,140,419 single nucleotide polymorphisms (SNPs) in 350 Korea schizophrenia patients and 700 control subjects, and approximately 620,001 autosomal SNPs were passed our quality control. In the case-control analysis, the rs9607195 A>G on intergenic area 250 kb away from the ISX gene and the rs12738007 A>G on the intron of the MECR gene were the most strongly associated SNPs with the risk of schizophrenia (P = 6.2 × 10(-8) , OR = 0.50 and P = 3.7 × 10(-7) , OR = 2.39, respectively). In subsequent fine-mapping analysis, 6 SNPs of MECR were genotyped with 310 schizophrenia patients and 604 control subjects. The association of the MECR rs12738007, a top ranked-SNP in GWAS, was replicated (P = 1.5 × 10(-2) , OR = 1.53 in fine mapping analysis, P = 1.5 × 10(-6) , OR = 1.90 in combined analysis). The identification of putative schizophrenia susceptibility loci could provide new insights into genetic factors related with schizophrenia and clues for the development of diagnosis strategies. © 2015 Wiley Periodicals, Inc.

  20. Rare Genome-Wide Copy Number Variation and Expression of Schizophrenia in 22q11.2 Deletion Syndrome.

    Science.gov (United States)

    Bassett, Anne S; Lowther, Chelsea; Merico, Daniele; Costain, Gregory; Chow, Eva W C; van Amelsvoort, Therese; McDonald-McGinn, Donna; Gur, Raquel E; Swillen, Ann; Van den Bree, Marianne; Murphy, Kieran; Gothelf, Doron; Bearden, Carrie E; Eliez, Stephan; Kates, Wendy; Philip, Nicole; Sashi, Vandana; Campbell, Linda; Vorstman, Jacob; Cubells, Joseph; Repetto, Gabriela M; Simon, Tony; Boot, Erik; Heung, Tracy; Evers, Rens; Vingerhoets, Claudia; van Duin, Esther; Zackai, Elaine; Vergaelen, Elfi; Devriendt, Koen; Vermeesch, Joris R; Owen, Michael; Murphy, Clodagh; Michaelovosky, Elena; Kushan, Leila; Schneider, Maude; Fremont, Wanda; Busa, Tiffany; Hooper, Stephen; McCabe, Kathryn; Duijff, Sasja; Isaev, Karin; Pellecchia, Giovanna; Wei, John; Gazzellone, Matthew J; Scherer, Stephen W; Emanuel, Beverly S; Guo, Tingwei; Morrow, Bernice E; Marshall, Christian R

    2017-11-01

    Chromosome 22q11.2 deletion syndrome (22q11.2DS) is associated with a more than 20-fold increased risk for developing schizophrenia. The aim of this study was to identify additional genetic factors (i.e., "second hits") that may contribute to schizophrenia expression. Through an international consortium, the authors obtained DNA samples from 329 psychiatrically phenotyped subjects with 22q11.2DS. Using a high-resolution microarray platform and established methods to assess copy number variation (CNV), the authors compared the genome-wide burden of rare autosomal CNV, outside of the 22q11.2 deletion region, between two groups: a schizophrenia group and those with no psychotic disorder at age ≥25 years. The authors assessed whether genes overlapped by rare CNVs were overrepresented in functional pathways relevant to schizophrenia. Rare CNVs overlapping one or more protein-coding genes revealed significant between-group differences. For rare exonic duplications, six of 19 gene sets tested were enriched in the schizophrenia group; genes associated with abnormal nervous system phenotypes remained significant in a stepwise logistic regression model and showed significant interactions with 22q11.2 deletion region genes in a connectivity analysis. For rare exonic deletions, the schizophrenia group had, on average, more genes overlapped. The additional rare CNVs implicated known (e.g., GRM7, 15q13.3, 16p12.2) and novel schizophrenia risk genes and loci. The results suggest that additional rare CNVs overlapping genes outside of the 22q11.2 deletion region contribute to schizophrenia risk in 22q11.2DS, supporting a multigenic hypothesis for schizophrenia. The findings have implications for understanding expression of psychotic illness and herald the importance of whole-genome sequencing to appreciate the overall genomic architecture of schizophrenia.

  1. The poorly explored impact of uncontrolled asthma

    DEFF Research Database (Denmark)

    O'Byrne, Paul M; Pedersen, Søren; Schatz, Michael

    2013-01-01

    The goal of asthma management is to achieve disease control; however, despite the availability of effective and safe medications, for many patients asthma remains uncontrolled. One reason for this is the fear of long-term side effects from the regular use of inhaled corticosteroids (ICSs). Adverse...... effects of poorly controlled asthma (for example, obesity, pneumonia, and risks to the fetus) can be perceived as side effects of ICSs. Poorly controlled asthma adversely affects children's cardiovascular fitness, while children with well-controlled asthma perform at the same level as their peers....... Children with uncontrolled asthma also have a higher frequency of obesity than children with controlled asthma. Stress can affect asthma control, and children with poorly controlled asthma are more likely to have learning disabilities compared with those with good control. In adults, focused attention...

  2. Impaired reward responsiveness in schizophrenia.

    Science.gov (United States)

    Taylor, Nicholas; Hollis, Jeffrey P; Corcoran, Sarah; Gross, Robin; Cuthbert, Bruce; Swails, Lisette W; Duncan, Erica

    2018-03-08

    Anhedonia is a core negative symptom of schizophrenia. Schizophrenia patients report largely intact pleasure in consuming rewards, but have impairments in generating motivated behavior to pursue rewards, and show reduced fMRI activation of the reward pathway during presentation of rewarded stimuli. A computer based task measuring the development of a response bias in favor of rewarded stimuli permits assessment of reward-induced motivation. We hypothesized that subjects with schizophrenia would be impaired on this task. 58 schizophrenia subjects (SCZ) and 52 healthy controls (CON) were studied with a signal detection task to assess reward responsiveness. In multiple trials over three blocks subjects were asked to correctly identify two stimuli that were paired with unequal chance of monetary reward. The critical outcome variable was response bias, the development of a greater percent correct identification of the stimulus that was rewarded more often. An ANOVA on response bias with Block as a repeated-measures factor and Diagnosis as a between-group factor indicated that SCZ subjects achieved a lower bias to rewarded stimuli than CON subjects (F(1,105)=8.82, p=0.004, η 2 =0.078). Post hoc tests indicated that SCZ subjects had significantly impaired bias in Block 1 (p=0.002) and Block 2 (p=0.05), indicating that SCZ were slower to achieve normal levels of bias during the session. SCZ subjects were slower to develop response bias to rewarded stimuli than CON subjects. This finding is consonant with the hypothesis that people with schizophrenia have a blunted capacity to modify behavior in response to reward. Copyright © 2018. Published by Elsevier B.V.

  3. SMART POINT CLOUD: DEFINITION AND REMAINING CHALLENGES

    Directory of Open Access Journals (Sweden)

    F. Poux

    2016-10-01

    Full Text Available Dealing with coloured point cloud acquired from terrestrial laser scanner, this paper identifies remaining challenges for a new data structure: the smart point cloud. This concept arises with the statement that massive and discretized spatial information from active remote sensing technology is often underused due to data mining limitations. The generalisation of point cloud data associated with the heterogeneity and temporality of such datasets is the main issue regarding structure, segmentation, classification, and interaction for an immediate understanding. We propose to use both point cloud properties and human knowledge through machine learning to rapidly extract pertinent information, using user-centered information (smart data rather than raw data. A review of feature detection, machine learning frameworks and database systems indexed both for mining queries and data visualisation is studied. Based on existing approaches, we propose a new 3-block flexible framework around device expertise, analytic expertise and domain base reflexion. This contribution serves as the first step for the realisation of a comprehensive smart point cloud data structure.

  4. Why all the confusion? Experimental task explains discrepant semantic priming effects in schizophrenia under "automatic" conditions: evidence from Event-Related Potentials.

    Science.gov (United States)

    Kreher, Donna A; Goff, Donald; Kuperberg, Gina R

    2009-06-01

    The schizophrenia research literature contains many differing accounts of semantic memory function in schizophrenia as assessed through the semantic priming paradigm. Most recently, Event-Related Potentials (ERPs) have been used to demonstrate both increased and decreased semantic priming at a neural level in schizophrenia patients, relative to healthy controls. The present study used ERPs to investigate the role of behavioral task in determining neural semantic priming effects in schizophrenia. The same schizophrenia patients and healthy controls completed two experiments in which word stimuli were identical, and the time between the onset of prime and target remained constant at 350 ms: in the first, participants monitored for words within a particular semantic category that appeared only in filler items (implicit task); in the second, participants explicitly rated the relatedness of word-pairs (explicit task). In the explicit task, schizophrenia patients showed reduced direct and indirect semantic priming in comparison with healthy controls. In contrast, in the implicit task, schizophrenia patients showed normal or, in positively thought-disordered patients, increased direct and indirect N400 priming effects compared with healthy controls. These data confirm that, although schizophrenia patients with positive thought disorder may show an abnormally increased automatic spreading activation, the introduction of semantic decision-making can result in abnormally reduced semantic priming in schizophrenia, even when other experimental conditions bias toward automatic processing.

  5. Influence of contact with schizophrenia on implicit attitudes towards schizophrenia patients held by clinical residents

    Directory of Open Access Journals (Sweden)

    Omori Ataru

    2012-11-01

    Full Text Available Abstract Background Patients with schizophrenia and their families have suffered greatly from stigmatizing effects. Although many efforts have been made to eradicate both prejudice and stigma, they still prevail even among medical professionals, and little is known about how contact with schizophrenia patients affects their attitudes towards schizophrenia. Methods We assessed the impact of the renaming of the Japanese term for schizophrenia on clinical residents and also evaluated the influence of contact with schizophrenia patients on attitudes toward schizophrenia by comparing the attitudes toward schizophrenia before and after a one-month clinical training period in psychiatry. Fifty-one clinical residents participated. Their attitudes toward schizophrenia were assessed twice, before and one month after clinical training in psychiatry using the Implicit Association Test (IAT as well as Link’s devaluation-discrimination scale. Results The old term for schizophrenia, “Seishin-Bunretsu-Byo”, was more congruent with criminal than the new term for schizophrenia, “Togo-Shitcho-Sho”, before clinical training. However, quite opposite to our expectation, after clinical training the new term had become even more congruent with criminal than the old term. There was no significant correlation between Link's scale and IAT effect. Conclusions Renaming the Japanese term for schizophrenia still reduced the negative images of schizophrenia among clinical residents. However, contact with schizophrenia patients unexpectedly changed clinical residents’ attitudes towards schizophrenia negatively. Our results might contribute to an understanding of the formation of negative attitudes about schizophrenia and assist in developing appropriate clinical training in psychiatry that could reduce prejudice and stigma concerning schizophrenia.

  6. Treatment with Ziprasidone for schizophrenia patients with OCD.

    Science.gov (United States)

    Juven-Wetzler, Alzbeta; Fostick, Leah; Cwikel-Hamzany, Shlomit; Balaban, Evgenya; Zohar, Joseph

    2014-09-01

    Comorbidity of obsessive-compulsive disorder (OCD) has been observed in about 15% of schizophrenic patients and has been associated with poor prognosis. Therefore, there is a need for specific treatment options for these patients (schizo-obsessive, ScOCD). This is an open, prospective study, aiming to test the efficacy of Ziprasidone (80-200mg/d) in ScOCD patients and comparing the response to the treatment between stable schizophrenic (N=16) and stable ScOCD (N=29) patients. Treatment effect with Ziprasidone was different in schizophrenic patients when stratified based on OCD comorbidity. Overall, the effect on OCD symptoms (as measured by the Yale Brown Obsessive Compulsive Scale, YBOCS) was found to be bimodal-either no response or exacerbation (for 45% of the patients, n=13) or significant improvement of symptoms (55%, n=16). Those who improved in OCD symptoms, improved also in negative and general schizophrenia symptoms, while ScOCD-unimproved group worsened in all symptoms. Whereas schizophrenic patients without OCD responded in a modest Gaussian distribution, they improved in schizophrenia negative symptoms and in general anxiety. This data suggests that schizo-obsessive disorder is a distinct and complex condition with more than one underlying pathogenesis. Definition of these ScOCD subgroups defined by their response to Ziprasidone might contribute to personalized medicine within the OCD-schizophrenia spectrum. Moreover, this finding suggests that ScOCD may be considered as a special schizophrenic subtype and its inclusion in schizophrenia treatment studies need to be further explored due to its divergent response. Copyright © 2014. Published by Elsevier B.V.

  7. What remains of the Arrow oil?

    International Nuclear Information System (INIS)

    Sergy, G.; Owens, E.

    1993-01-01

    In February 1970, the tanker Arrow became grounded 6.5 km off the north shore of Chedabucto Bay, Nova Scotia, and nearly 72,000 bbl of Bunker C fuel oil were released from the vessel during its subsequent breakup and sinking. The oil was washed ashore in various degrees over an estimated 305 km of the bay's 604-km shoreline, of which only 48 km were cleaned. In addition, the tanker Kurdistan broke in two in pack ice in March 1979 in the Cabot Strait area, spilling ca 54,000 bbl of Bunker C, some of which was later found at 16 locations along the northeast and east shorelines of Chedabucto Bay. In summer 1992, a systematic ground survey of the bay's shorelines was conducted using Environment Canada Shoreline Cleanup Assessment Team (SCAT) procedures. Standard observations were made of oil distribution and width, thickness, and character of the oil residues in 419 coastal segments. Results from the survey are summarized. Oil was found to be present on 13.3 km of the shoreline, with heavy oiling restricted to 1.3 km primarily in the areas of Black Duck Cove and Lennox Passage. Some of this residual oil was identified as coming from the Arrow. Natural weathering processes account for removal of most of the spilled oil from the bay. Oil remaining on the shore was found in areas outside of the zone of physical wave action, in areas of nearshore mixing where fine sediments are not present to weather the oil through biophysical processes, or in crusts formed by oil weathered on the surface. The systematic description of oiled shorelines using the SCAT methodology proved very successful, even for such an old spill. 6 refs

  8. Ghost Remains After Black Hole Eruption

    Science.gov (United States)

    2009-05-01

    NASA's Chandra X-ray Observatory has found a cosmic "ghost" lurking around a distant supermassive black hole. This is the first detection of such a high-energy apparition, and scientists think it is evidence of a huge eruption produced by the black hole. This discovery presents astronomers with a valuable opportunity to observe phenomena that occurred when the Universe was very young. The X-ray ghost, so-called because a diffuse X-ray source has remained after other radiation from the outburst has died away, is in the Chandra Deep Field-North, one of the deepest X-ray images ever taken. The source, a.k.a. HDF 130, is over 10 billion light years away and existed at a time 3 billion years after the Big Bang, when galaxies and black holes were forming at a high rate. "We'd seen this fuzzy object a few years ago, but didn't realize until now that we were seeing a ghost", said Andy Fabian of the Cambridge University in the United Kingdom. "It's not out there to haunt us, rather it's telling us something - in this case what was happening in this galaxy billions of year ago." Fabian and colleagues think the X-ray glow from HDF 130 is evidence for a powerful outburst from its central black hole in the form of jets of energetic particles traveling at almost the speed of light. When the eruption was ongoing, it produced prodigious amounts of radio and X-radiation, but after several million years, the radio signal faded from view as the electrons radiated away their energy. HDF 130 Chandra X-ray Image of HDF 130 However, less energetic electrons can still produce X-rays by interacting with the pervasive sea of photons remaining from the Big Bang - the cosmic background radiation. Collisions between these electrons and the background photons can impart enough energy to the photons to boost them into the X-ray energy band. This process produces an extended X-ray source that lasts for another 30 million years or so. "This ghost tells us about the black hole's eruption long after

  9. Visual binding abilities in the initial and advanced stages of schizophrenia

    DEFF Research Database (Denmark)

    Parnas, Josef; Vianin, P; Saebye, D

    2001-01-01

    OBJECTIVE: The study tests the hypothesis that intramodal visual binding is disturbed in schizophrenia and should be detectable in all illness stages as a stable trait marker. METHOD: Three groups of patients (rehospitalized chronic schizophrenic, first admitted schizophrenic and schizotypal...... to schizophrenic patients and to healthy subjects. Furthermore, chronic schizophrenia was associated with a poor performance on cortical tests of SWM, global local and on Raven. This association appears to be mediated by or linked to the chronicity of the illness. CONCLUSION: The study confirms a variety...... of neurocognitive deficits in schizophrenia which, however, in this sample seem to be linked to chronicity of illness. However, certain aspects of visual processing concerned with Gestalt extraction deserve attention as potential vulnerability- or prodrome- indicators. The initial hypothesis of the study...

  10. Negative attitude towards medication is associated with working memory impairment in schizophrenia patients.

    Science.gov (United States)

    Goodman, Craig; Knoll, Gabriella; Isakov, Victoria; Silver, Henry

    2005-03-01

    A lack of insight into illness and negative attitudes towards medication are common among individuals with schizophrenia and impact clinical outcomes. This study aimed to examine the relationships between attitudes towards medication and cognitive function in schizophrenia patients. Thirty-five male forensic inpatients who were suffering from chronic schizophrenia participated in the study. A drug attitude inventory was used to evaluate the attitudes of the patients towards medication. Neuropsychological function was assessed with a comprehensive battery of tests. Patients with positive attitudes towards medication performed significantly better than those with negative attitudes on tests of verbal working memory (digit span forwards and backwards), inhibition and set shifting (Penn Inhibition test), delayed object memory and overall mental status (Mini Mental State Examination). There were no differences in age, education, hospitalizations or clinical symptoms between the groups. Our findings support an association between negative attitudes towards medication and poor cognitive performance, particularly of working memory.

  11. Neural Basis of Anhedonia and Amotivation in Patients with Schizophrenia: The Role of Reward System.

    Science.gov (United States)

    Lee, Jung Suk; Jung, Suwon; Park, Il Ho; Kim, Jae-Jin

    2015-01-01

    Anhedonia, the inability to feel pleasure, and amotivation, the lack of motivation, are two prominent negative symptoms of schizophrenia, which contribute to the poor social and occupational behaviors in the patients. Recently growing evidence shows that anhedonia and amotivation are tied together, but have distinct neural correlates. It is important to note that both of these symptoms may derive from deficient functioning of the reward network. A further analysis into the neuroimaging findings of schizophrenia shows that the neural correlates overlap in the reward network including the ventral striatum, anterior cingulate cortex and orbitofrontal cortex. Other neuroimaging studies have demonstrated the involvement of the default mode network in anhedonia. The identification of aspecific deficit in hedonic and motivational capacity may help to elucidate the mechanisms behind social functioning deficits in schizophrenia, and may also lead to more targeted treatment of negative symptoms.

  12. New genetic findings in schizophrenia: is there still room for the dopamine hypothesis of schizophrenia?

    Directory of Open Access Journals (Sweden)

    Vanessa Nieratschker

    2010-05-01

    Full Text Available Schizophrenia is a highly heritable disorder, but the identification of specific genes has proven to be a difficult endeavour. Genes involved in the dopaminergic system are considered to be major candidates since the “dopamine hypothesis” of impairment in dopaminergic neurotransmission is one of the most widely accepted hypotheses of the aetiology of schizophrenia. The overall findings from candidate studies do provide some support for the “dopamine hypothesis”. However, results from the first systematic genome-wide association (GWA studies have implicated variants within ZNF804A, NRGN, TCF4, and variants in the MHC region on chromosome 6p22.1. Although these genes may not immediately impact on dopaminergic neurotransmission, it remains possible that downstream impairments in dopaminergic function are caused. Furthermore, only a very small fraction of all truly associated genetic variants have been detected and many more associated variants will be identified in the future by GWA studies and alternative approaches. The results of these studies may allow a more comprehensive re-evaluation of the dopamine hypothesis.

  13. Observational study of outpatients with schizophrenia in the Middle ...

    African Journals Online (AJOL)

    Observational study of outpatients with schizophrenia in the Middle East and Africa — 3- and 6-month efficacy and safety results. The Intercontinental Schizophrenia Outpatient Health Outcomes Study.

  14. Reliability of clinical ICD-10 schizophrenia diagnoses

    DEFF Research Database (Denmark)

    Jakobsen, Klaus D; Frederiksen, Julie N; Hansen, Thomas

    2005-01-01

    Concern has been expressed as to the reliability of clinical ICD-10 diagnosis of schizophrenia. This study was designed to assess the diagnostic reliability of the clinical ICD-10 diagnosis of schizophrenia in a random sample of Danish in- and outpatients with a history of psychosis. A sample...... value (87%) of ICD-10 schizophrenia and an overall good agreement between clinical and OPCRIT-derived diagnoses (kappa=0.60). An even higher positive predictive value was obtained when diagnoses were amalgamated into a diagnostic entity of schizophrenia-spectrum disorders (98%). Near perfect agreement...... was seen between OPCRIT-derived ICD-10 and DSM-IV diagnoses (kappa=0.87). Thus, this study demonstrates high reliability of the clinical diagnosis of schizophrenia and even more so of the diagnosis of schizophrenia-spectrum disorder....

  15. Mosaic Turner syndrome associated with schizophrenia.

    Science.gov (United States)

    Jung, Sook Young; Park, Joo Won; Kim, Dong Hyun; Jun, Yong Hoon; Lee, Jeong Seop; Lee, Ji Eun

    2014-03-01

    Turner syndrome is a sex-chromosome disorder; occurring in 1 in 2,500 female births. There are sporadic few case reports of concomitant Turner syndrome with schizophrenia worldwide. Most Turner females had a 45,X monosomy, whereas the majority of comorbidity between Turner syndrome and schizophrenia had a mosaic karyotype (45,X/46,XX). We present a case of a 21-year-old woman with Turner syndrome, mosaic karyotype (45,X/46,XX), showing mental retardation, hypothyroidism, and schizophrenia. HOPA gene within Xq13 is related to mental retardation, hypothyroidism, and schizophrenia. Our case may be a potential clue which supports the hypothesis for involvement of genes on X chromosome in development of schizophrenia. Further studies including comorbid cases reports are need in order to discern the cause of schizophrenia in patients having Turner syndrome.

  16. Trajectories of premorbid childhood and adolescent functioning in schizophrenia-spectrum psychoses: A first-episode study.

    Science.gov (United States)

    Horton, Leslie E; Tarbox, Sarah I; Olino, Thomas M; Haas, Gretchen L

    2015-06-30

    Evidence of social and behavioral problems preceding the onset of schizophrenia-spectrum psychoses is consistent with a neurodevelopmental model of these disorders. Here we predict that individuals with a first episode of schizophrenia-spectrum psychoses will evidence one of three patterns of premorbid adjustment: an early deficit, a deteriorating pattern, or adequate or good social adjustment. Participants were 164 (38% female; 31% black) individuals ages 15-50 with a first episode of schizophrenia-spectrum psychoses. Premorbid adjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. We compared the fit of a series of growth mixture models to examine premorbid adjustment trajectories, and found the following 3-class model provided the best fit with: a "stable-poor" adjustment class (54%), a "stable-good" adjustment class (39%), and a "deteriorating" adjustment class (7%). Relative to the "stable-good" class, the "stable-poor" class experienced worse negative symptoms at 1-year follow-up, particularly in the social amotivation domain. This represents the first known growth mixture modeling study to examine premorbid functioning patterns in first-episode schizophrenia-spectrum psychoses. Given that the stable-poor adjustment pattern was most prevalent, detection of social and academic maladjustment as early as childhood may help identify people at increased risk for schizophrenia-spectrum psychoses, potentially increasing feasibility of early interventions. Published by Elsevier Ireland Ltd.

  17. Neural Mechanisms Underlying Affective Theory of Mind in Violent Antisocial Personality Disorder and/or Schizophrenia.

    Science.gov (United States)

    Schiffer, Boris; Pawliczek, Christina; Müller, Bernhard W; Wiltfang, Jens; Brüne, Martin; Forsting, Michael; Gizewski, Elke R; Leygraf, Norbert; Hodgins, Sheilagh

    2017-10-21

    Among violent offenders with schizophrenia, there are 2 sub-groups, one with and one without, conduct disorder (CD) and antisocial personality disorder (ASPD), who differ as to treatment response and alterations of brain structure. The present study aimed to determine whether the 2 groups also differ in Theory of Mind and neural activations subsuming this task. Five groups of men were compared: 3 groups of violent offenders-schizophrenia plus CD/ASPD, schizophrenia with no history of antisocial behavior prior to illness onset, and CD/ASPD with no severe mental illness-and 2 groups of non-offenders, one with schizophrenia and one without (H). Participants completed diagnostic interviews, the Psychopathy Checklist Screening Version Interview, the Interpersonal Reactivity Index, authorized access to clinical and criminal files, and underwent functional magnetic resonance imaging while completing an adapted version of the Reading-the-Mind-in-the-Eyes Task (RMET). Relative to H, nonviolent and violent men with schizophrenia and not CD/ASPD performed more poorly on the RMET, while violent offenders with CD/ASPD, both those with and without schizophrenia, performed similarly. The 2 groups of violent offenders with CD/ASPD, both those with and without schizophrenia, relative to the other groups, displayed higher levels of activation in a network of prefrontal and temporal-parietal regions and reduced activation in the amygdala. Relative to men without CD/ASPD, both groups of violent offenders with CD/ASPD displayed a distinct pattern of neural responses during emotional/mental state attribution pointing to distinct and comparatively successful processing of social information. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  18. Testosterone is inversely related to brain activity during emotional inhibition in schizophrenia.

    Directory of Open Access Journals (Sweden)

    Ans Vercammen

    Full Text Available Sex steroids affect cognitive function as well as emotion processing and regulation. They may also play a role in the pathophysiology of schizophrenia. However, the effects of sex steroids on cognition and emotion-related brain activation in schizophrenia are poorly understood. Our aim was to determine the extent to which circulating testosterone relates to brain activation in men with schizophrenia compared to healthy men during cognitive-emotional processing. We assessed brain activation in 18 men with schizophrenia and 22 age-matched healthy men during an emotional go/no-go task using fMRI and measured total serum testosterone levels on the same morning. We performed an ROI analysis to assess the relationship between serum testosterone and brain activation, focusing on cortical regions involved the emotional go/no-go task. Slower RT and reduced accuracy was observed when participants responded to neutral stimuli, while inhibiting responses to negative stimuli. Healthy men showed a robust increase in activation of the middle frontal gyrus when inhibiting responses to negative stimuli, but there was no significant association between activation and serum testosterone level in healthy men. Men with schizophrenia showed a less pronounced increase in activation when inhibiting responses to negative stimuli; however, they did show a strong inverse association between serum testosterone level and activation of the bilateral middle frontal gyrus and left insula. Additionally, increased accuracy during inhibition of response to negative words was associated with both higher serum testosterone levels and decreased activation of the middle frontal gyrus in men with schizophrenia only. We conclude that endogenous hormone levels, even within the normal range, may play an enhanced modulatory role in determining the neural and behavioural response during cognitive-emotional processing in schizophrenia.

  19. Abnormal neural hierarchy in processing of verbal information in patients with schizophrenia.

    Science.gov (United States)

    Lerner, Yulia; Bleich-Cohen, Maya; Solnik-Knirsh, Shimrit; Yogev-Seligmann, Galit; Eisenstein, Tamir; Madah, Waheed; Shamir, Alon; Hendler, Talma; Kremer, Ilana

    2018-01-01

    Previous research indicates abnormal comprehension of verbal information in patients with schizophrenia. Yet the neural mechanism underlying the breakdown of verbal information processing in schizophrenia is poorly understood. Imaging studies in healthy populations have shown a network of brain areas involved in hierarchical processing of verbal information over time. Here, we identified critical aspects of this hierarchy, examining patients with schizophrenia. Using functional magnetic resonance imaging, we examined various levels of information comprehension elicited by naturally presented verbal stimuli; from a set of randomly shuffled words to an intact story. Specifically, patients with first episode schizophrenia ( N  = 15), their non-manifesting siblings ( N  = 14) and healthy controls ( N  = 15) listened to a narrated story and randomly scrambled versions of it. To quantify the degree of dissimilarity between the groups, we adopted an inter-subject correlation (inter-SC) approach, which estimates differences in synchronization of neural responses within and between groups. The temporal topography found in healthy and siblings groups were consistent with our previous findings - high synchronization in responses from early sensory toward high order perceptual and cognitive areas. In patients with schizophrenia, stimuli with short and intermediate temporal scales evoked a typical pattern of reliable responses, whereas story condition (long temporal scale) revealed robust and widespread disruption of the inter-SCs. In addition, the more similar the neural activity of patients with schizophrenia was to the average response in the healthy group, the less severe the positive symptoms of the patients. Our findings suggest that system-level neural indication of abnormal verbal information processing in schizophrenia reflects disease manifestations.

  20. Abnormal neural hierarchy in processing of verbal information in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Yulia Lerner

    2018-01-01

    Full Text Available Previous research indicates abnormal comprehension of verbal information in patients with schizophrenia. Yet the neural mechanism underlying the breakdown of verbal information processing in schizophrenia is poorly understood. Imaging studies in healthy populations have shown a network of brain areas involved in hierarchical processing of verbal information over time. Here, we identified critical aspects of this hierarchy, examining patients with schizophrenia. Using functional magnetic resonance imaging, we examined various levels of information comprehension elicited by naturally presented verbal stimuli; from a set of randomly shuffled words to an intact story. Specifically, patients with first episode schizophrenia (N = 15, their non-manifesting siblings (N = 14 and healthy controls (N = 15 listened to a narrated story and randomly scrambled versions of it. To quantify the degree of dissimilarity between the groups, we adopted an inter-subject correlation (inter-SC approach, which estimates differences in synchronization of neural responses within and between groups. The temporal topography found in healthy and siblings groups were consistent with our previous findings – high synchronization in responses from early sensory toward high order perceptual and cognitive areas. In patients with schizophrenia, stimuli with short and intermediate temporal scales evoked a typical pattern of reliable responses, whereas story condition (long temporal scale revealed robust and widespread disruption of the inter-SCs. In addition, the more similar the neural activity of patients with schizophrenia was to the average response in the healthy group, the less severe the positive symptoms of the patients. Our findings suggest that system-level neural indication of abnormal verbal information processing in schizophrenia reflects disease manifestations.

  1. Modifiable risk factors for schizophrenia and autism--shared risk factors impacting on brain development.

    Science.gov (United States)

    Hamlyn, Jess; Duhig, Michael; McGrath, John; Scott, James

    2013-05-01

    Schizophrenia and autism are two poorly understood clinical syndromes that differ in age of onset and clinical profile. However, recent genetic and epidemiological research suggests that these two neurodevelopmental disorders share certain risk factors. The aims of this review are to describe modifiable risk factors that have been identified in both disorders, and, where available, collate salient systematic reviews and meta-analyses that have examined shared risk factors. Based on searches of Medline, Embase and PsycINFO, inspection of review articles and expert opinion, we first compiled a set of candidate modifiable risk factors associated with autism. Where available, we next collated systematic-reviews (with or without meta-analyses) related to modifiable risk factors associated with both autism and schizophrenia. We identified three modifiable risk factors that have been examined in systematic reviews for both autism and schizophrenia. Advanced paternal age was reported as a risk factor for schizophrenia in a single meta-analysis and as a risk factor in two meta-analyses for autism. With respect to pregnancy and birth complications, for autism one meta-analysis identified maternal diabetes and bleeding during pregnancy as risks factors for autism whilst a meta-analysis of eight studies identified obstetric complications as a risk factor for schizophrenia. Migrant status was identified as a risk factor for both autism and schizophrenia. Two separate meta-analyses were identified for each disorder. Despite distinct clinical phenotypes, the evidence suggests that at least some non-genetic risk factors are shared between these two syndromes. In particular, exposure to drugs, nutritional excesses or deficiencies and infectious agents lend themselves to public health interventions. Studies are now needed to quantify any increase in risk of either autism or schizophrenia that is associated with these modifiable environmental factors. Copyright © 2012 Elsevier Inc

  2. Neurodevelopment, GABA System Dysfunction, and Schizophrenia

    OpenAIRE

    Schmidt, Martin J; Mirnics, Karoly

    2014-01-01

    The origins of schizophrenia have eluded clinicians and researchers since Kraepelin and Bleuler began documenting their findings. However, large clinical research efforts in recent decades have identified numerous genetic and environmental risk factors for schizophrenia. The combined data strongly support the neurodevelopmental hypothesis of schizophrenia and underscore the importance of the common converging effects of diverse insults. In this review, we discuss the evidence that genetic and...

  3. Risk factors for development of schizophrenia

    OpenAIRE

    Dunglová, Eva

    2013-01-01

    Schizophrenia is a severe disease. There is a complicity of genetic and environmental factors in schizophrenia onset. Factors with probable influence on development of schizophrenia are rate of urbanization, geographic location, migration, month of birth, maternal nutrition during pregnancy and birth complications, stress during pregnancy, length of lactation period, prenatal and postnatal infection exposure, exposure to a cat during childhood or cannabis abuse. Until now the information on t...

  4. Acute and chronic effects of NMDA receptor antagonists in rodents, relevance to negative symptoms of schizophrenia: a translational link to humans.

    Science.gov (United States)

    Neill, Joanna C; Harte, Michael K; Haddad, Peter M; Lydall, Emma S; Dwyer, Dominic M

    2014-05-01

    Negative symptoms of schizophrenia remain an unmet clinical need as they are common, persistent, respond poorly to existing treatments and lead to disability. Blunted affect, alogia, asociality, anhedonia and avolition are regarded as key negative symptoms despite DSM-IV-TR specifying a more limited range. The key to development of improved therapies is improved animal models that mimic the human condition in terms of behaviour and pathology and that predict efficacy of novel treatments in patients. Accumulating evidence shows that NMDA receptor (NMDAR) antagonists mimic cognitive deficits of relevance to schizophrenia in animals, along with associated pathological changes. This review examines evidence for the ability of NMDAR antagonists to mimic anhedonia and asociality, two negative symptoms of schizophrenia, in animals. The use of various species, paradigms and treatment regimens are reviewed. We conclude that sub-chronic treatment with NMDAR antagonists, typically PCP, induces social withdrawal in animals but not anhedonia. NMDAR antagonists have further effects in paradigms such as motivational salience that may be useful for mimicking other aspects of negative symptoms but these require further development. Sub-chronic treatment regimens of NMDAR antagonists also have some neurobiological effects of relevance to negative symptoms. It is our view that a sub-chronic treatment regime with NMDAR antagonists, particularly PCP, with animals tested following a wash-out period and in a battery of tests to assess certain behaviours of relevance to negative symptoms and social withdrawal (the animal equivalent of asociality) is valuable. This will enhance our understanding of the psycho and neuropathology of specific negative symptom domains and allow early detection of novel pharmacological targets. © 2013 Elsevier B.V. and ECNP All rights reserved.

  5. Drug–drug conditioning between citalopram and haloperidol or olanzapine in a conditioned avoidance response model: implications for polypharmacy in schizophrenia

    Science.gov (United States)

    Sparkman, Nathan L.; Li, Ming

    2016-01-01

    Patients with schizophrenia often have anxiety and depression, and thus are treated with multiple psychotherapeutic medications. This practice of polypharmacy increases the possibility for drug–drug interactions. However, the pharmacological and behavioral mechanisms underlying drug–drug interactions in schizophrenia remain poorly understood. In the present study, we adopted a preclinical approach and examined a less known behavioral mechanism, drug–drug conditioning (DDC) between haloperidol (a typical antipsychotic) or olanzapine (atypical antipsychotic) and citalopram (a selective serotonin reuptake inhibitor). A rat two-way conditioned avoidance response paradigm was used to measure antipsychotic activity and determine how DDC may alter the antipsychotic efficacy in this model. Following acquisition of the avoidance response, rats were then randomly assigned to receive vehicle, citalopram (10.0 mg/kg, intraperitoneally), haloperidol (0.05 mg/kg, subcutaneously), olanzapine (1.0 mg/kg, subcutaneously), combined haloperidol with citalopram, or combined olanzapine with citalopram treatment for seven avoidance test sessions. In comparison with antipsychotic treatment alone, combined treatment with citalopram potentiated the antiavoidance effect of olanzapine or haloperidol (to a lesser extent) during the seven drug-test sessions. In addition, repeated pairing of citalopram with haloperidol or olanzapine caused citalopram to show a newly acquired avoidance-disruptive effect. This effect was context specific because citalopram paired with haloperidol or olanzapine outside the avoidance testing context (i.e. home cages) did not show such an effect. These findings indicate that concurrent antidepressant and antipsychotic treatments may engender a DDC process that follows the general Pavlovian associative conditioning principles. They also indicate that adjunctive citalopram treatment may enhance the antipsychotic efficacy of haloperidol and olanzapine in the

  6. Superior intellectual ability in schizophrenia: neuropsychological characteristics.

    Science.gov (United States)

    MacCabe, James H; Brébion, Gildas; Reichenberg, Abraham; Ganguly, Taposhri; McKenna, Peter J; Murray, Robin M; David, Anthony S

    2012-03-01

    It has been suggested that neurocognitive impairment is a core deficit in schizophrenia. However, it appears that some patients with schizophrenia have intelligence quotients (IQs) in the superior range. In this study, we sought out schizophrenia patients with an estimated premorbid Intelligence Quotient (IQ) of at least 115 and studied their neuropsychological profile. Thirty-four patients meeting diagnostic criteria for schizophrenia or schizoaffective disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV), with mean estimated premorbid IQ of 120, were recruited and divided into two subgroups, according to whether or not their IQ had declined by at least 10 points from their premorbid estimate. Their performance on an extensive neuropsychological battery was compared with that of 19 IQ-matched healthy controls and a group of 16 "typical" schizophrenia patients with estimated premorbid IQ Schizophrenia patients whose estimated premorbid and current IQ both lay in the superior range were statistically indistinguishable from IQ-matched healthy controls on all neurocognitive tests. However, their profile of relative performance in subtests was similar to that of typical schizophrenia patients. Patients with superior premorbid IQ and evidence of intellectual deterioration had intermediate scores. Our results confirm the existence of patients meeting DSM-IV diagnostic criteria for schizophrenia who have markedly superior premorbid intellectual level and appear to be free of gross neuropsychological deficits. We discuss the implications of these findings for the primacy of cognitive deficits in schizophrenia.

  7. Wellness within illness: happiness in schizophrenia.

    Science.gov (United States)

    Palmer, Barton W; Martin, Averria Sirkin; Depp, Colin A; Glorioso, Danielle K; Jeste, Dilip V

    2014-10-01

    Schizophrenia is typically a chronic disorder and among the most severe forms of serious mental illnesses in terms of adverse impact on quality of life. Yet, there have been suggestions that some people with schizophrenia can experience an overall sense of happiness in their lives. We investigated happiness among 72 outpatients with non-remitted chronic schizophrenia with a mean duration of illness of 24.4 years, and 64 healthy comparison subjects (HCs). Despite continued treatment with antipsychotic medications, the individuals with schizophrenia manifested a mild to moderate level of psychopathology. People with schizophrenia reported lower mean levels of happiness than HCs, but there was substantial heterogeneity within the schizophrenia group. Level of happiness in persons with schizophrenia was significantly correlated with higher mental health-related quality of life, and several positive psychosocial factors (lower perceived stress, and higher levels of resilience, optimism, and personal mastery). However, level of happiness was not related to sociodemographic characteristics, duration of illness, severity of positive or negative symptoms, physical function, medical comorbidity, or cognitive functioning. Except for an absence of an association with resilience, the pattern of correlations of happiness with other variables seen among HCs was similar to that in individuals with schizophrenia. Although happiness may be harder to achieve in the context of a serious mental illness, it nonetheless appears to be a viable treatment goal in schizophrenia. Psychotherapies targeting positive coping factors such as resilience, optimism, and personal mastery warrant further investigation. Copyright © 2014. Published by Elsevier B.V.

  8. Neurodevelopment, GABA System Dysfunction, and Schizophrenia

    Science.gov (United States)

    Schmidt, Martin J; Mirnics, Karoly

    2015-01-01

    The origins of schizophrenia have eluded clinicians and researchers since Kraepelin and Bleuler began documenting their findings. However, large clinical research efforts in recent decades have identified numerous genetic and environmental risk factors for schizophrenia. The combined data strongly support the neurodevelopmental hypothesis of schizophrenia and underscore the importance of the common converging effects of diverse insults. In this review, we discuss the evidence that genetic and environmental risk factors that predispose to schizophrenia disrupt the development and normal functioning of the GABAergic system. PMID:24759129

  9. Schizophrenia spectrum and other psychotic disorders

    DEFF Research Database (Denmark)

    Pagsberg, Anne Katrine

    2013-01-01

    The DSM-5 list of diagnoses concerning schizophrenia spectrum and other psychotic disorders is expected to be revised and graduated from mild to severe. The proposed changes for the diagnosis of schizophrenia affect demands for characteristic symptoms, clarify relation to pervasive developmental...... diagnostic reliability and validity, but it is estimated to exclude about 2 % of patients currently diagnosed with DSM-IV schizophrenia from fulfilling criteria for DSM-5 schizophrenia. It might generate a problem for future young patients if the changes concerning demands on characteristic symptoms turn out...

  10. Neurodevelopment, GABA system dysfunction, and schizophrenia.

    Science.gov (United States)

    Schmidt, Martin J; Mirnics, Karoly

    2015-01-01

    The origins of schizophrenia have eluded clinicians and researchers since Kraepelin and Bleuler began documenting their findings. However, large clinical research efforts in recent decades have identified numerous genetic and environmental risk factors for schizophrenia. The combined data strongly support the neurodevelopmental hypothesis of schizophrenia and underscore the importance of the common converging effects of diverse insults. In this review, we discuss the evidence that genetic and environmental risk factors that predispose to schizophrenia disrupt the development and normal functioning of the GABAergic system.

  11. Sensory and cross-network contributions to response inhibition in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Matthew J. Hoptman

    Full Text Available Patients with schizophrenia show response inhibition deficits equal to or greater than those seen in impulse-control disorders, and these deficits contribute to poor outcome. However, little is known about the circuit abnormalities underlying this impairment. To address this, we examined stop signal task performance in 21 patients with schizophrenia and 21 healthy controls using event related potential (ERP and resting state functional connectivity. Patients showed prolonged stop signal reaction time (SSRT and reduced N1, N2, and P3 amplitudes compared to controls. Across groups, P3 amplitudes were maximal after SSRT (i.e., after the time associated with the decision to stop occurred, suggesting that this component indexed response monitoring. Multiple regression analyses showed that longer SSRTs were independently related to 1 patient status, 2 reduced N1 amplitude on successful stop trials and 3 reduced anticorrelated resting state functional connectivity between visual and frontoparietal cortical networks. This study used a combined multimodal imaging approach to better understand the network abnormalities that underlie response inhibition in schizophrenia. It is the first of its kind to specifically assess the brain's resting state functional architecture in combination with behavioral and ERP methods to investigate response inhibition in schizophrenia. Keywords: EEG, Stop signal task, Impulsivity, Schizophrenia, Resting state functional connectivity

  12. The Correlates of Quality of Life Among Jordanian Patients With Schizophrenia.

    Science.gov (United States)

    Rayan, Ahmad; Obiedate, Khaldoon

    Addressing the quality of life (QOL) of patients with schizophrenia is of special importance in the Arab world, where little knowledge is available about their well-being, and most of them experience stigma and living in poverty. The purpose of this study was to examine the association of sociodemographic characteristics, severity of depressive symptoms, and various aspects of public stigma against mental illness, with QOL among Jordanian patients with schizophrenia. In this descriptive correlational study, 160 Jordanian outpatients diagnosed with schizophrenia completed measures of demographic characteristics, perceived public stigma against mental illness, severity of depression, and QOL. Participants had poor QOL. Age, marital status, relapse, education level, stigma against mental illness, and severity of depression were significantly associated with QOL among Jordanian patients with schizophrenia. Data analysis revealed that the severity of depression accounted for an additional 27% of the variance above and beyond the 36.7% accounted for by age of the participants and perceived public stigma against mental illness. Health care professionals should develop culturally competent nursing practice considering the specific factors associated with QOL among Arab patients with schizophrenia.

  13. [Towards an Understanding of Stigma: What is the Stereotype Associated with Schizophrenia].

    Science.gov (United States)

    Yvon, Florence; Prouteau, Antoinette

    Objectives Stigmatization of people suffering from schizophrenia spectrum disorder relies on the existence of a stereotype which is associated with a social category, here schizophrenia. The short report's aim is to briefly synthesize the recent literature about the content of the stereotype associated with schizophrenia, and to suggest some perspectives for future studies, on the basis of recent advances in the domain.Methods First, we present the theoretical concepts of stigma and stereotype. Second, we propose a brief synthesis of the recently published articles focusing on the content of schizophrenia stereotype in the general population, in English and in French.Results The stereotype associated with mental illness is clearly negative. The most common model in the literature assumes 4 factors in the content of stereotype: attribution of responsibility in the condition, dangerousness, poor prognosis, unpredictability and incompetence in social roles. If the stereotype could vary among countries, it is clearly associated with desire for social distance and discrimination. The stereotype also varies among mental illnesses. Compared with bipolar disorders and autism, schizophrenia focuses the most negative aspects of mental illness stereotype, especially in terms of dangerousness and social distance.Conclusion The study of stereotype, though rapidly growing, still raises questions about the validity of commonly used models in the psychiatric literature, and may benefit from further specific studies. Social psychology models and methods appear to be a promising perspective. The production of data, useful for users, families as well as for professionals may require multidisciplinarity for future projects.

  14. Selective, sustained, and shift in attention in patients with diagnoses of schizophrenia.

    Science.gov (United States)

    Hagh-Shenas, H; Toobai, S; Makaremi, A

    2002-12-01

    Attentional deficits are a prominent aspect of cognitive dysfunction in schizophrenia. The present study was designed to investigate attention deficit in a group of patients with diagnosis of schizophrenia. According to the segmental set theory suggested by Hogarty and Flesher, three aspects of attention problems, selective, sustained, and shift in attention, were studied. The 30 patients hospitalized on three psychiatric wards at Shiraz and Isfahan and 30 normal healthy subjects matched for age, sex, and years of education were administered a computerized Continuous Performance Test, Stroop Color-word Test, and Wisconsin Card Sorting test. Analysis showed patients performed more poorly than control subjects on measured aspects of attention. The acute/chronic classification did not predict differences in attention scores between subtypes of schizophrenia, while the positive/negative classification did. Paranoid, undifferentiated, and residual groups by subtypes of schizophrenia showed similar performance on the Continuous Performance Test, but were significantly different on errors on the Wisconsin Card Sorting test and on reaction time to Stroop stimuli in the incongruent color-word condition. Patients with paranoid diagnosis performed better than other subtypes on these tasks. Present results suggest that the Continuous Performance Test is valuable for differentiating of schizophrenia spectrum disorder, while scores on Stroop and Wisconsin card sorting may have better diagnostic value for differentiating subtypes of the disorder.

  15. The Puzzle of Processing Speed, Memory and Executive Function Impairments in Schizophrenia: Fitting the Pieces Together

    Science.gov (United States)

    Knowles, Emma E. M.; Weiser, Mark; David, Anthony S.; Glahn, David; Davidson, Michael; Reichenberg, Abraham

    2015-01-01

    Background Substantial impairment in digit-symbol substitution task performance in schizophrenia is well established, which has been widely interpreted as denoting a specific impairment in processing-speed ability. However, other higher-order cognitive functions might be more critical to performance on this task. To date, this has not been rigorously investigated in schizophrenia. Methods One-hundred and twenty-five schizophrenia cases and 272 controls completed neuropsychological measures of processing speed, memory and executive functioning. We implemented a series of confirmatory factor and structural regression modeling in order to build an integrated model of processing speed, memory and executive function with which to deconstruct digit-symbol substitution task and characterize discrepancies between cases and controls. Results The overall structure of the processing speed, memory and executive function model was the same across groups (χ2 = 208.86, p>.05) but the contribution of the specific cognitive domains to coding task performance differed significantly. When completing the task controls relied on executive function and, indirectly, on working memory ability; while schizophrenia cases utilized an alternative set of cognitive operations whereby they relied on the same processes required to complete verbal fluency tasks. Conclusions Successful coding task performance is predominantly reliant on executive function, rather than processing-speed or memory abilities. Schizophrenia patients perform poorly on this task due to an apparent lack of appropriate executive function input, they rely instead on an alternative cognitive pathway. PMID:25863361

  16. Risk Syndromes and Scales Determining Risk in Schizophrenia and Other Psychoses

    Directory of Open Access Journals (Sweden)

    Soner Cakmak

    2015-12-01

    Full Text Available Schizophrenia is a chronic disorder leading to lifelong deterioration of social and vocational functioning. Prodromal period, designates the time interval starting with emerging nonspecific signs and deficits and extending up to presentation of distinct and ongoing schizophrenic symptoms, is observed in most of schizophrenia patients. In schizophrenia, poor premorbid adjustment leads to a worse prognosis and thus early detection and intervention is required in prodromal period. To this end, under the heading of risk factors for schizophrenia and psychosis, classification and scales to determine the risk are being utilized. Most frequently used scales are; Bonn Scale for the Assessment of Basic Symptoms (BSABS, Comprehensive Assessment of At-Risk Mental States (CAARMS, Structured Interview for Psychosis-Risk Syndromes (SIPS. Through the light of these latest developments, recent edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5 added psychosis risk syndrome or attenuated psychosis syndrome to indicate risk of transition to psychosis. These approaches revealed that the risk of progression to psychosis was not reliably correlated with fulfilled criteria, but abscence of criteria credibly predicted the unlikelihood of psychosis emergence. Evidently, concomitant premorbid features and prodromal symptoms significantly increase the risk of progression to psychosis and schizophrenia in comparison to normal population. Nevertheless, specification and elaboration of risk criteria will enhance reliability of risk determination. [Archives Medical Review Journal 2015; 24(4.000: 494-508

  17. Measuring cognitive insight in schizophrenia and bipolar disorder: a comparative study

    Directory of Open Access Journals (Sweden)

    Jónsdóttir Halldóra

    2007-12-01

    Full Text Available Abstract Background Beck Cognitive Insight Scale (BCIS has been designed for assessment of self-reflection on patients' anomalous experiences and interpretations of own beliefs. The scale has been developed and validated for patients with schizophrenia. We wanted to study the utility of the scale for patients with bipolar disorder. The relationship between the BCIS as a measure of cognitive insight and established methods for assessment of insight of illness was explored in both diagnostic groups. Methods The BCIS self-report inventory was administered to patients with schizophrenia (n = 143, bipolar disorder (n = 92 and controls (n = 64. The 15 items of the inventory form two subscales, self-reflectiveness and self-certainty. Results The internal consistency of the subscales was good for the patient groups and the controls. The mean subscale scores were not significantly different for the three groups. Four items in subscale self-reflectiveness referring to psychotic experiences gave, however, different results in the control subjects. Self-certainty and scores on insight item PANSS correlated significantly in the schizophrenia, but not in the bipolar group. Conclusion BCIS with its two subscales seems applicable for patients with bipolar disorder as well as for patients with schizophrenia. The self-report inventory can also be applied to control subjects if the items referring to psychotic experiences are omitted. In schizophrenia high scores on self-certainty is possibly associated with poor insight of illness. For the bipolar group the subscales are largely independent of traditional insight measures.

  18. Synaptic Effects of Dopamine Breakdown and Their Relation to Schizophrenia-Linked Working Memory Deficits

    Directory of Open Access Journals (Sweden)

    Andrew D. Bolton

    2018-06-01

    Full Text Available Working memory is the ability to hold information “online” over a time delay in order to perform a task. This kind of memory is encoded in the brain by persistent neural activity that outlasts the presentation of a stimulus. Patients with schizophrenia perform poorly in working memory tasks that require the brief memory of a target location in space. This deficit indicates that persistent neural activity related to spatial locations may be impaired in the disease. At the circuit level, many studies have shown that NMDA receptors and the dopamine system are involved in both schizophrenia pathology and working memory-related persistent activity. In this Hypothesis and Theory article, we examine the possible connection between NMDA receptors, the dopamine system, and schizophrenia-linked working memory deficits. In particular, we focus on the dopamine breakdown product homocysteine (HCY, which is consistently elevated in schizophrenia patients. Our previous studies have shown that HCY strongly reduces the desensitization of NMDA currents. Here, we show that HCY likely affects NMDA receptors in brain regions that support working memory; this is because these areas favor dopamine breakdown over transport to clear dopamine from synapses. Finally, within the context of two NMDA-based computational models of working memory, we suggest a mechanism by which HCY could give rise to the working memory deficits observed in schizophrenia patients.

  19. The neuropsychology of cannabis and other substance use in schizophrenia: review of the literature and critical evaluation of methodological issues.

    Science.gov (United States)

    Coulston, Carissa M; Perdices, Michael; Tennant, Christopher C

    2007-11-01

    Research on the neuropsychology of substance use in schizophrenia has been steadily growing over the past decade. However, significant gaps remain in the knowledge of individual substances and their relationship to cognition in the schizophrenia spectrum disorders. Approximately 65 studies to date have directly examined this relationship. Of these, approximately 20 have focused on nicotine, 15 on alcohol, 10 on cocaine, three on stimulants/hallucinogens, one on benzodiazepines, 10 on polydrug abuse, and seven on cannabis. Research on cannabis is especially lacking, given that worldwide it is the most commonly used illicit drug in schizophrenia, is used at higher rates in schizophrenia than in the general population, and makes its own unique contribution to the onset and prognosis of schizophrenia. In the present paper an overview of the neuropsychology literature on substance use in schizophrenia is presented, with special emphasis on cannabis. This incorporates a discussion of the methodological limitations inherent in these studies, and range of potential confounding variables that were not considered or controlled, providing directions for future research into the cognitive correlates of cannabis and other substance use in schizophrenia.

  20. Ambiguity aversion in schizophrenia: An fMRI study of decision-making under risk and ambiguity.

    Science.gov (United States)

    Fujino, Junya; Hirose, Kimito; Tei, Shisei; Kawada, Ryosaku; Tsurumi, Kosuke; Matsukawa, Noriko; Miyata, Jun; Sugihara, Genichi; Yoshihara, Yujiro; Ideno, Takashi; Aso, Toshihiko; Takemura, Kazuhisa; Fukuyama, Hidenao; Murai, Toshiya; Takahashi, Hidehiko

    2016-12-01

    When making decisions in everyday life, we often have to choose between uncertain outcomes. Economic studies have demonstrated that healthy people tend to prefer options with known probabilities (risk) than those with unknown probabilities (ambiguity), which is referred to as "ambiguity aversion." However, it remains unclear how patients with schizophrenia behave under ambiguity, despite growing evidence of their altered decision-making under uncertainty. In this study, combining economic tools and functional magnetic resonance imaging (fMRI), we assessed the attitudes toward risk/ambiguity and investigated the neural correlates during decision-making under risk/ambiguity in schizophrenia. Although no significant difference in attitudes under risk was observed, patients with schizophrenia chose ambiguity significantly more often than the healthy controls. Attitudes under risk and ambiguity did not correlate across patients with schizophrenia. Furthermore, unlike in the healthy controls, activation of the left lateral orbitofrontal cortex was not increased during decision-making under ambiguity compared to under risk in schizophrenia. These results suggest that ambiguity aversion, a well-established subjective bias, is attenuated in patients with schizophrenia, highlighting the need to distinguish between risk and ambiguity when assessing decision-making under these situations. Our findings, comprising important clinical implications, contribute to improved understanding of the mechanisms underlying altered decision-making in patients with schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Transdiagnostic differences in the resting-state functional connectivity of the prefrontal cortex in depression and schizophrenia.

    Science.gov (United States)

    Chen, Xi; Liu, Chang; He, Hui; Chang, Xin; Jiang, Yuchao; Li, Yingjia; Duan, Mingjun; Li, Jianfu; Luo, Cheng; Yao, Dezhong

    2017-08-01

    Depression and schizophrenia are two of the most serious psychiatric disorders. They share similar symptoms but the pathology-specific commonalities and differences remain unknown. This study was conducted to acquire a full picture of the functional alterations in schizophrenia and depression patients. The resting-state fMRI data from 20 patients with schizophrenia, 20 patients with depression and 20 healthy control subjects were collected. A data-driven approach that included local functional connectivity density (FCD) analysis combined with multivariate pattern analysis (MVPA) was used to compare the three groups. Based on the results of the MVPA, the local FCD value in the orbitofrontal cortex (OFC) can differentiate depression patients from schizophrenia patients. The patients with depression had a higher local FCD value in the medial and anterior parts of the OFC than the subjects in the other two groups, which suggested altered abstract and reward reinforces processing in depression patients. Subsequent functional connectivity analysis indicated that the connection in the prefrontal cortex was significantly lower in people with schizophrenia compared to people with depression and healthy controls. The systematically different medications for schizophrenia and depression may have different effects on functional connectivity. These results suggested that the resting-state functional connectivity pattern in the prefrontal cortex may be a transdiagnostic difference between depression and schizophrenia patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Elevated Maternal C-Reactive Protein is Associated with Increased Risk of Schizophrenia in a National Birth Cohort

    Science.gov (United States)

    Canetta, Sarah; Sourander, Andre; Surcel, Helja-Marja; Hinkka-Yli-Salomäki, Susanna; Leiviskä, Jaana; Kellendonk, Christoph; McKeague, Ian W.; Brown, Alan S.

    2014-01-01

    Objective The goal of the present study was to investigate an association between early gestational C-reactive protein (CRP), an established inflammatory biomarker, prospectively assayed in maternal sera, and schizophrenia in a large national birth cohort with an extensive serum biobank. Methods This study utilized a nested case-control design from the Finnish Prenatal Study of Schizophrenia cohort. 777 schizophrenia cases (630 with schizophrenia, 147 with schizoaffective disorder) that had maternal sera available for CRP testing were identified and matched to 777 controls in the analysis. Maternal CRP levels were assessed using a latex immunoassay from archived maternal serum specimens. Results Increasing maternal CRP levels, classified as a continuous variable, were significantly associated with schizophrenia in offspring (adjusted odds ratio (OR)=1.31, 95% confidence interval (CI)=1.10-1.56, p=0.003). This finding remained significant after adjusting for potential confounders including maternal and parental history of psychiatric disorders, twin/singleton birth, urbanicity, province of birth, and maternal socioeconomic status. Conclusion This finding provides the most robust evidence to date that maternal inflammation may play a significant role in schizophrenia, with possible implications for identifying preventive strategies and pathogenic mechanisms in schizophrenia and other neurodevelopmental disorders. PMID:24969261

  3. Right Frontotemporal Cortex Mediates the Relationship between Cognitive Insight and Subjective Quality of Life in Patients with Schizophrenia.

    Science.gov (United States)

    Pu, Shenghong; Nakagome, Kazuyuki; Itakura, Masashi; Ohtachi, Hiroaki; Iwata, Masaaki; Nagata, Izumi; Kaneko, Koichi

    2018-01-01

    Although prior studies identified a relationship between cognitive insight and subjective quality of life (QOL) in patients with schizophrenia, the brain regions mediating this relationship remain unknown. Recent studies have shown that the ventrolateral prefrontal cortex may be particularly important for cognitive insight in individuals with schizophrenia. Here, we examined whether frontotemporal function mediates the relationship between cognitive insight and QOL in 64 participants, including 32 patients with schizophrenia and 32 healthy controls. Cognitive insight was measured using the Beck Cognitive Insight Scale (BCIS), while participants' subjective QOL was assessed using the Medical Outcomes Study 36-item Short-form Health Survey. Frontotemporal function was evaluated during a verbal fluency task using multichannel near-infrared spectroscopy. Consistent with previous findings, we found that frontotemporal function was impaired in patients with schizophrenia. Interestingly, our data also revealed that the right ventrolateral PFC and the right anterior part of the temporal cortex significantly mediated the relationship between the self-reflectiveness (SR) subscale of the BCIS and subjective QOL. These findings suggest that cognitive insight, particularly SR, is associated with subjective QOL in patients with schizophrenia via right frontotemporal function. The findings of this study provide important insight into a QOL model of schizophrenia, which may guide the development of cost-effective interventions that target frontotemporal function in patients with schizophrenia.

  4. Verbal working memory in schizophrenia from the Consortium on the Genetics of Schizophrenia (COGS) study: the moderating role of smoking status and antipsychotic medications.

    Science.gov (United States)

    Lee, Junghee; Green, Michael F; Calkins, Monica E; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Light, Gregory A; Nuechterlein, Keith H; Radant, Allen D; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Sprock, Joyce; Stone, William S; Sugar, Catherine A; Swerdlow, Neal R; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Braff, David L

    2015-04-01

    Working memory impairment has been extensively studied in schizophrenia, but less is known about moderators of the impairment. Using the Consortium on the Genetics of Schizophrenia case-control study (COGS-2), we examined smoking status, types of antipsychotic medication, and history of substance as moderators for working memory impairment in schizophrenia. From 5 sites, 1377 patients with schizophrenia or schizoaffective, depressed type and 1037 healthy controls completed the letter-number span (LNS) task. The LNS uses intermixed letter and digit stimuli that increase from 2 up to 8 stimuli. In the forward condition, participants repeated the letters and numbers in the order they were presented. In the reorder condition, participants repeated the digits in ascending order followed by letters in alphabetical order. Schizophrenia patients performed more poorly than controls, with a larger difference on reorder than forward conditions. Deficits were associated with symptoms, functional capacity, and functional outcome. Patients who smoked showed larger impairment than nonsmoking patients, primarily due to deficits on the reorder condition. The impairing association of smoking was more pronounced among patients taking first-generation than those taking second-generation antipsychotic medications. Correlations between working memory and community functioning were stronger for nonsmokers. History of substance use did not moderate working memory impairment. Results confirm the working memory impairment in schizophrenia, and indicate smoking status as an important moderator for these deficits. The greater impairment in smokers may reflect added burden of smoking on general health or that patients with greater deficits are more likely to smoke. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. A brief intervention to improve exercising in patients with schizophrenia: a controlled pilot study with mental contrasting and implementation intentions (MCII).

    Science.gov (United States)

    Sailer, Pascal; Wieber, Frank; Pröpster, Karl; Stoewer, Steffen; Nischk, Daniel; Volk, Franz; Odenwald, Michael

    2015-09-03

    Regular exercise can have positive effects on both the physical and mental health of individuals with schizophrenia. However, deficits in cognition, perception, affect, and volition make it especially difficult for people with schizophrenia to plan and follow through with their exercising intentions, as indicated by poor attendance and high drop-out rates in prior studies. Mental Contrasting and Implementation Intentions (MCII) is a well-established strategy to support the enactment of intended actions. This pilot study tests whether MCII helps people with schizophrenia in highly structured or autonomy-focused clinical hospital settings to translate their exercising intentions into action. Thirty-six inpatients (eleven women) with a mean age of 30.89 years (SD = 11.41) diagnosed with schizophrenia spectrum disorders from specialized highly structured or autonomy-focused wards were randomly assigned to two intervention groups. In the equal contact goal intention control condition, patients read an informative text about physical activity; they then set and wrote down the goal to attend jogging sessions. In the MCII experimental condition, patients read the same informative text and then worked through the MCII strategy. We hypothesized that MCII would increase attendance and persistence relative to the control condition over the course of four weeks and this will be especially be the case when applied in an autonomy-focused setting compared to when applied in a highly structured setting. When applied in autonomy-focused settings, MCII increased attendance and persistence in jogging group sessions relative to the control condition. In the highly structured setting, no differences between conditions were found, most likely due to a ceiling effect. These results remained even when adjusting for group differences in the pre-intervention scores for the control variables depression (BDI), physical activity (IPAQ), weight (BMI), age, and education. Whereas commitment and

  6. The nature and timing of social deficits in child and adolescent offspring of parents with schizophrenia: preliminary evidence for precursors of negative symptoms?

    Science.gov (United States)

    Horton, Leslie E; Smith, Ashley A; Haas, Gretchen L

    2014-10-01

    Children with social dysfunction and a first-degree relative with schizophrenia are at elevated risk for schizophrenia; however, the nature of this dysfunction is unclear. It was hypothesized that familial high-risk (HR) children and adolescents (n=17) would have social skill deficits relative to healthy controls (HC; n=35). HR participants had a bimodal distribution of social skill scores (47% excellent; 53% poor). HR participants had worse social skills, assertion and empathy scores, suggesting possible developmental precursors to the social amotivation domain of negative symptoms. Characterizing HR children's social deficits could assist identification of those at risk for schizophrenia. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. A self administered executive functions ecological questionnaire (the Behavior Rating Inventory of Executive Function - Adult Version shows impaired scores in a sample of patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Andrei Szöke

    2013-02-01

    Full Text Available Subjective measurements of cognition have seldom been used in schizophrenia. This is mainly due to the assumption that such measurements lack sensitivity in a disorder characterized by poor insight. We investigated the capacity of BRIEF-A (Behavior Rating Inventory of Executive Function - Adult Version: a self-administered, ecological questionnaire to identify executive deficits in adults with schizophrenia. The global score and each domain-specific score was significantly lower in patients than in healthy controls. BRIEF-A could be a useful complement to objective measurements, providing a subjective assessment of everyday consequences of executive dysfunction in patients with schizophrenia.

  8. CHANGES IN VALUES OF CHOLESTEROL AND TRYGLICERIDES AFTER WEIGHT LOSS DURING TREATMENT WITH ARIPIPRAZOLE IN A PATIENT WITH SCHIZOPHRENIA - Case report

    OpenAIRE

    Uzun, Suzana; Kozumplik, Oliver; Sedić, Biserka

    2010-01-01

    Metabolic syndrome can contribute to significant morbidity and premature mortality and should be accounted for in the treatment of mental disorders. Patients with schizophrenia are at risk of undetected somatic comorbidity. Patients with schizophrenia have metabolically unfavorable body composition, comprising abdominal obesity, high fat percentage and low muscle mass, leading to increased risk of metabolic and cardiovascular diseases. Smoking, poor diet, reduced physical activity and a...

  9. A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

    OpenAIRE

    Stip, Emmanuel; Vincent, Philippe D.; Sablier, Juliette; Guevremont, Catherine; Zhornitsky, Simon; Tranulis, Constantin

    2013-01-01

    Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5% in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improved AAR...

  10. A randomized-controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

    OpenAIRE

    Emmanuel eStip; Emmanuel eStip; Emmanuel eStip; Philippe D. Vincent; Philippe D. Vincent; Philippe D. Vincent; Catherine eGuevremont; Simon eZhornitsky; Constantin eTranulis; Constantin eTranulis; Constantin eTranulis; Juliette eSablier; Juliette eSablier

    2013-01-01

    Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5 % in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improv...

  11. Aberrant Network Activity in Schizophrenia.

    Science.gov (United States)

    Hunt, Mark J; Kopell, Nancy J; Traub, Roger D; Whittington, Miles A

    2017-06-01

    Brain dynamic changes associated with schizophrenia are largely equivocal, with interpretation complicated by many factors, such as the presence of therapeutic agents and the complex nature of the syndrome itself. Evidence for a brain-wide change in individual network oscillations, shared by all patients, is largely equivocal, but stronger for lower (delta) than for higher (gamma) bands. However, region-specific changes in rhythms across multiple, interdependent, nested frequencies may correlate better with pathology. Changes in synaptic excitation and inhibition in schizophrenia disrupt delta rhythm-mediated cortico-cortical communication, while enhancing thalamocortical communication in this frequency band. The contrasting relationships between delta and higher frequencies in thalamus and cortex generate frequency mismatches in inter-regional connectivity, leading to a disruption in temporal communication between higher-order brain regions associated with mental time travel. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Proprioceptive information processing in schizophrenia

    DEFF Research Database (Denmark)

    Arnfred, Sidse M H

    of the left somatosensory cortex and it was suggested to be in accordance with two theories of schizophrenic information processing: the theory of deficiency of corollary discharge and the theory of weakening of the influence of past regularities. No gating deficiency was observed and the imprecision...... Rado (1890-1972) suggested that one of two un-reducible deficits in schizophrenia was a disorder of proprioception. Exploration of proprioceptive information processing is possible through the measurement of evoked and event related potentials. Event related EEG can be analyzed as conventional time...... and amplitude attenuation was not a general phenomenon across the entire brain response. Summing up, in support of Rado's hypothesis, schizophrenia spectrum patients demonstrated abnormalities in proprioceptive information processing. Future work needs to extend the findings in larger un-medicated, non...

  13. Neurodevelopmental risk factors in schizophrenia

    Directory of Open Access Journals (Sweden)

    Lobato M.I.

    2001-01-01

    Full Text Available The authors review environmental and neurodevelopmental risk factors for schizophrenic disorders, with emphasis on minor physical anomalies, particularly craniofacial anomalies and dermatoglyphic variations. The high prevalence of these anomalies among schizophrenic subjects supports the neurodevelopmental theory of the etiology of schizophrenia, since they suggest either genetically or epigenetically controlled faulty embryonic development of structures of ectodermal origin like brain and skin. This may disturb neurodevelopment that in turn may cause these subjects to be at increased risk for the development of schizophrenia and related disorders. The precise confirmation of this theory, at least in some cases, will provide further understanding of these illnesses, allowing easy and inexpensive identification of subjects at risk and providing guidelines for the development of new pharmacological interventions for early treatment and even for primary prevention of the illness.

  14. Long-term memory deficits in schizophrenia : Primary or secondary dysfunction?

    NARCIS (Netherlands)

    Holthausen, EAE; Wiersma, D; Sitskoorn, MM; Dingemans, PM; Schene, AH; van den Bosch, RJ

    2003-01-01

    Long-term memory impairment is often found in schizophrenia. The question remains whether this is caused by other cognitive deficits. One hundred eighteen first-episode patients were compared with 45 control participants on several memory tasks. The role of processing speed and central executive

  15. Long-term memory deficits in schizophrenia: Primary or secondary dysfunction?

    NARCIS (Netherlands)

    Holthausen, Esther A. E.; Wiersma, Durk; Sitskoorn, Margriet M.; Dingemans, Peter M.; Schene, Aart H.; van den Bosch, Robert J.

    2003-01-01

    Long-term memory impairment is often found in schizophrenia. The question remains whether this is caused by other cognitive deficits. One hundred eighteen first-episode patients were compared with 45 control participants on several memory tasks. The role of processing speed and central executive

  16. Bodily Experience in Schizophrenia : Factors Underlying a Disturbed Sense of Body Ownership

    NARCIS (Netherlands)

    Klaver, Maayke; Dijkerman, H Chris

    2016-01-01

    Emerging evidence is now challenging the view that patients diagnosed with schizophrenia experience a selective deficit in their sense of agency. Additional disturbances seem to exist in their sense of body ownership. However, the factors underlying this disturbance in body ownership remain elusive.

  17. Rorschach Measures of Cognition Relate to Everyday and Social Functioning in Schizophrenia

    Science.gov (United States)

    Moore, Raeanne C.; Viglione, Donald J.; Rosenfarb, Irwin S.; Patterson, Thomas L.; Mausbach, Brent T.

    2013-01-01

    Neurocognitive impairment and negative symptoms contribute to functional disability in people with schizophrenia. Yet, a high level of unexplained variability remains after accounting for the role of these factors. This study examined the role of thought disorder, psychological complexity, and interpersonal representations, as measured by the…

  18. Symptom dimensions are associated with progressive brain volume changes in schizophrenia

    NARCIS (Netherlands)

    Collin, G.; Derks, E. M.; van Haren, N. E. M.; Schnack, H. G.; Hulshoff Pol, H. E.; Kahn, R. S.; Cahn, W.

    2012-01-01

    Background: There is considerable variation in progressive brain volume changes in schizophrenia. Whether this is related to the clinical heterogeneity that characterizes the illness remains to be determined. This study examines the relationship between change in brain volume over time and

  19. Matricide and schizophrenia in the 21st century: a review and ...

    African Journals Online (AJOL)

    Studies have shown an association between homicidal behaviour and psychiatric disorders although it remains difficult to conclude that definite causal relationships exist between specific mental illnesses and particular forms of homicide. However, matricide has been linked to schizophrenia for several decades with an ...

  20. Evidence for Genetic Overlap Between Schizophrenia and Age at First Birth in Women

    NARCIS (Netherlands)

    Mehta, Divya; Tropf, Felix C.; Gratten, Jacob; Bakshi, Andrew; Zhu, Zhihong; Bacanu, Silviu-Alin; Hemani, Gibran; Magnusson, Patrik K. E.; Barban, Nicola; Esko, Tõnu; Metspalu, Andres; Snieder, Harold; Mowry, Bryan J.; Kendler, Kenneth S.; Yang, Jian; Visscher, Peter M.; McGrath, John J.; Mills, Melinda C.; Wray, Naomi R.; Lee, S. Hong; Andreassen, Ole A.; Bramon, Elvira; Bruggeman, Richard; Buxbaum, Joseph D.; Cairns, Murray J.; Cantor, Rita M.; Cloninger, C. Robert; Cohen, David; Crespo-Facorro, Benedicto; Darvasi, Ariel; DeLisi, Lynn E.; Dinan, Timothy; Djurovic, Srdjan; Donohoe, Gary; Drapeau, Elodie; Escott-Price, Valentina; Freimer, Nelson B.; Georgieva, Lyudmila; de Haan, Lieuwe; Henskens, Frans A.; Joa, Inge; Julià, Antonio; Khrunin, Andrey; Lerer, Bernard; Limborska, Svetlana; Loughland, Carmel M.; Macek, Milan; Marsal, Sara; McCarley, Robert W.; McIntosh, Andrew M.; McQuillin, Andrew; Melegh, Bela; Michie, Patricia T.; Morris, Derek W.; Murphy, Kieran C.; Myin-Germeys, Inez; Olincy, Ann; van Os, Jim; Pantelis, Christos; Posthuma, Danielle; Quested, Digby; Schall, Ulrich; Scott, Rodney J.; Seidman, Larry J.; Toncheva, Draga; Tooney, Paul A.; Waddington, John; Weinberger, Daniel R.; Weiser, Mark; Wu, Jing Qin

    2016-01-01

    A recently published study of national data by McGrath et al in 2014 showed increased risk of schizophrenia (SCZ) in offspring associated with both early and delayed parental age, consistent with a U-shaped relationship. However, it remains unclear if the risk to the child is due to psychosocial

  1. Investigating vision in schizophrenia through responses to humorous stimuli

    Directory of Open Access Journals (Sweden)

    Wolfgang Tschacher

    2015-06-01

    Full Text Available The visual environment of humans contains abundant ambiguity and fragmentary information. Therefore, an early step of vision must disambiguate the incessant stream of information. Humorous stimuli produce a situation that is strikingly analogous to this process: Funniness is associated with the incongruity contained in a joke, pun, or cartoon. Like in vision in general, appreciating a visual pun as funny necessitates disambiguation of incongruous information. Therefore, perceived funniness of visual puns was implemented to study visual perception in a sample of 36 schizophrenia patients and 56 healthy control participants. We found that both visual incongruity and Theory of Mind (ToM content of the puns were associated with increased experienced funniness. This was significantly less so in participants with schizophrenia, consistent with the gestalt hypothesis of schizophrenia, which would predict compromised perceptual organization in patients. The association of incongruity with funniness was not mediated by known predictors of humor appreciation, such as affective state, depression, or extraversion. Patients with higher excitement symptoms and, at a trend level, reduced cognitive symptoms, reported lower funniness experiences. An open question remained whether patients showed this deficiency of visual incongruity detection independent of their ToM deficiency. Humorous stimuli may be viewed as a convenient method to study perceptual processes, but also fundamental questions of higher-level cognition.

  2. A possible contributory mechanism for impaired idiom perception in schizophrenia.

    Science.gov (United States)

    Sela, Tal; Lavidor, Michal; Mitchell, Rachel L C

    2015-09-30

    In this review, we focus on the ability of people with schizophrenia to correctly perceive the meaning of idioms; figurative language expressions in which intended meaning is not derived from the meaning of constituent words. We collate evidence on how idiom perception is impaired, ascertain the clinical relevance of this impairment, and consider possible psychological and neural mechanisms behind the impairment. In reviewing extant literature, we searched the PubMed database, from 1975-2014, focussing on articles that directly concerned schizophrenia and idioms, with follow up searches to explore the viability of possible underlying mechanisms. We learn that there is clear evidence of impairment, with a tendency to err towards literal interpretations unless the figurative meaning is salient, and despite contextual cues to figurative interpretations. Given the importance of idioms in everyday language, the potential impact is significant. Clinically, impaired idiom perception primarily relates to positive symptoms of schizophrenia, but also to negative symptoms. The origins of the impairment remain speculation, with impaired executive function, impaired semantic functions, and impaired context processing all proposed to explain the phenomenon. We conclude that a possible contributory mechanism at the neural level is an impaired dorsolateral prefrontal cortex system for cognitive control over semantic processing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Resilience research in schizophrenia: a review of recent developments.

    Science.gov (United States)

    Mizuno, Yuya; Wartelsteiner, Fabienne; Frajo-Apor, Beatrice

    2016-05-01

    The concept of resilience is expected to be relevant in understanding the heterogeneous outcomes associated with schizophrenia. We reviewed recent developments in clinical studies focusing on the biological and psychological aspects of resilience in this population. We aimed to clarify current concepts of resilience in the field, elucidate gaps in the literature, and provide recommendations for future research. A total of 20 articles published between 2014 and 2015 were included. Six studies were neuroimaging studies, while the remaining studies used various psychological assessments. Most studies were cross-sectional except for three studies with naturalistic follow-up, one single-blind randomized controlled trial, and two published protocols of prospective studies. The following patterns of research were evident among the highly heterogeneous literature: studies focusing on protective factors and others emphasizing dynamic processes, studies investigating 'at-risk but resilient' groups (e.g. nonpsychotic siblings of patients with schizophrenia), and studies using psychological scales to measure resilience. The heterogeneity in how reports conceptualize, assess, and interpret resilience likely reflects the multidimensional nature of the concept itself and the lack of a 'gold standard' in assessing resilience in schizophrenia. Further research is needed to make recommendations on how to facilitate resilience in clinical care.

  4. Identification of genetic factors in the etiology of schizophrenia

    International Nuclear Information System (INIS)

    Aguilar Valles, Argel

    2011-01-01

    Schizophrenia is a mental disorder that affects approximately 1% of the worldwide population. It is characterized by psychotic episodes in which individuals have hallucinations or delusions. This disorder also involves a strong element of social dysfunction, lack of motivation and profound cognitive deficits. The causes of this disorder remain largely unknown, but evidence indicates that arises from changes in the development of the central nervous system. Among the identified risk factors for this disorder are several environmental events, including prenatal infections and malnutrition, and complications during childbirth. However, the most important factor seems to be genetics. Despite this, the identification of genes involved in the development of this disorder has emerged as one of the most difficult tasks facing modern genetics and genomics. The development of techniques for studying the human genome has allowed a more systematic approach to determine variations in the genome sequence and structure that area casually involved in schizophrenia. These studies suggest the participation of hundreds of genes in schizophrenia development. In addition, it has been suggested that many of these genes are involved in various mental illnesses that today are diagnosed as separate entities, but whose biological substrate may be shared.

  5. Quality of life in Chinese patients with schizophrenia treated in primary care.

    Science.gov (United States)

    Li, Yan; Hou, Cai-Lan; Ma, Xin-Rong; Zhong, Bao-Liang; Zang, Yu; Jia, Fu-Jun; Lin, Yong-Qiang; Lai, Kelly Y C; Chiu, Helen F K; Ungvari, Gabor S; Hall, Brian J; Cai, Mei-Ying; Ng, Chee H; Xiang, Yu-Tao

    2017-08-01

    In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. This study examined the quality of life (QOL) in patients with schizophrenia treated in primary care and explored the demographic and clinical characteristics associated with QOL. Altogether, 612 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. QOL, psychotic and depressive symptoms, extra-pyramidal symptoms and insight were assessed using standardized instruments. Data analyses were conducted with the one sample t-test and multiple linear regression analyses. Compared with the normative data for the Chinese general population, significantly lower scores in physical and mental QOL domains were found in the patient group. Older age, being unemployed, major medical conditions, no smoking, more severe depressive and negative symptoms, more frequent insomnia, and suicidality were independently associated with poor physical QOL. Male gender, more severe depressive and anxiety symptoms, more frequent insomnia, and suicidality were independently associated with poor mental QOL. Patients with schizophrenia treated in primary care had lower level of QOL in comparison with general population. Effective measures need to be implemented to improve their QOL. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  6. Are oxidative stress markers useful to distinguish schizoaffective disorder from schizophrenia and bipolar disorder?

    Science.gov (United States)

    Bulbul, Feridun; Virit, Osman; Alpak, Gokay; Unal, Ahmet; Bulut, Mahmut; Kaya, Mehmet Cemal; Altindag, Abdurrahman; Celik, Hakim; Savas, Haluk A

    2014-04-01

    Schizoaffective disorder is a disease with both affective and psychotic symptoms. In this study, we aimed to compare oxidative metabolism markers of schizoaffective disorder, bipolar disorder and schizophrenic patients. Furthermore, we also aimed to investigate whether schizoaffective disorder could be differentiated from schizophrenia and bipolar disorder in terms of oxidative metabolism. Total oxidant status (TOS) and total antioxidant status (TAS) were measured in the blood samples that were collected from schizoaffective patients (n = 30), bipolar disorder patients (n = 30) and schizophrenic patients (n = 30). Oxidative stress index (OSI) was calculated by dividing TOS by TAS. TOS and OSI were found to be higher in patients with schizoaffective disorder compared with those in schizophrenia and bipolar disorder patients. TAS was not significantly different between the groups. Schizoaffective disorder was found to be different from bipolar disorder and schizophrenia in terms of oxidative parameters. This result may indicate that schizoaffective disorder could differ from bipolar disorder and schizophrenia in terms of biochemical parameters. Increased TOS levels observed in schizoaffective disorder may suggest poor clinical course and may be an indicator of poor prognosis.

  7. Verbal memory impairments in schizophrenia associated with cortical thinning

    Directory of Open Access Journals (Sweden)

    S. Guimond

    2016-01-01

    Full Text Available Verbal memory (VM represents one of the most affected cognitive domains in schizophrenia. Multiple studies have shown that schizophrenia is associated with cortical abnormalities, but it remains unclear whether these are related to VM impairments. Considering the vast literature demonstrating the role of the frontal cortex, the parahippocampal cortex, and the hippocampus in VM, we examined the cortical thickness/volume of these regions. We used a categorical approach whereby 27 schizophrenia patients with ‘moderate to severe’ VM impairments were compared to 23 patients with ‘low to mild’ VM impairments and 23 healthy controls. A series of between-group vertex-wise GLM on cortical thickness were performed for specific regions of interest defining the parahippocampal gyrus and the frontal cortex. When compared to healthy controls, patients with ‘moderate to severe’ VM impairments revealed significantly thinner cortex in the left frontal lobe, and the parahippocampal gyri. When compared to patients with ‘low to mild’ VM impairments, patients with ‘moderate to severe’ VM impairments showed a trend of thinner cortex in similar regions. Virtually no differences were observed in the frontal area of patients with ‘low to mild’ VM impairments relative to controls. No significant group differences were observed in the hippocampus. Our results indicate that patients with greater VM impairments demonstrate significant cortical thinning in regions known to be important in VM performance. Treating VM deficits in schizophrenia could have a positive effect on the brain; thus, subgroups of patients with more severe VM deficits should be a prioritized target in the development of new cognitive treatments.

  8. Microglia and Brain Plasticity in Acute Psychosis and Schizophrenia Illness Course: A Meta-Review

    Directory of Open Access Journals (Sweden)

    Livia J. De Picker

    2017-11-01

    Full Text Available ObjectiveSchizophrenia poses a tremendous health, social, and economic burden upon patients and society, indicating current treatment options remain inadequate. Recent findings from several lines of evidence have pointed to the importance of immune system involvement in not only premorbid neurodevelopmental but also subsequent symptom generation and aging processes of brain change in schizophrenia. In this meta-review, we use the summarized evidence from recent quantitative systematic reviews (SRs and meta-analyses of several subspecialties to critically evaluate the hypothesis that immune-related processes shape the symptomatic presentation and illness course of schizophrenia, both directly and indirectly through altered neuroplasticity.MethodsWe performed a data search in PubMed for English language SRs and meta-analyses from 2010 to 2017. The methodological quality of the SRs was assessed with the AMSTAR instrument. In addition, we review in this paper 11 original publications on translocator protein (TSPO positron emission tomography (PET imaging in schizophrenia.ResultsWe reviewed 26 SRs and meta-analyses. Evidence from clinical observational studies of inflammatory or immunological markers and randomized controlled drug trials of immunomodulatory compounds as add-on in the treatment of schizophrenia suggests psychotic exacerbations are accompanied by immunological changes different from those seen in non-acute states, and that the symptoms of schizophrenia can be modified by compounds such as non-steroidal anti-inflammatory drug and minocycline. Information derived from post-mortem brain tissue analysis and PET neuroimaging studies to evaluate microglial activation have added new perspectives to the available evidence, yet these results are very heterogeneous. Each research domain comes with unique opportunities as well as inherent limitations. A better understanding of the (patho-physiology of microglial cells and their role in

  9. Association between neurological soft signs, temperament and character in patients with schizophrenia and non-psychotic relatives

    Directory of Open Access Journals (Sweden)

    Liliana Galindo

    2016-04-01

    Full Text Available The heritability of schizophrenia and most personality traits has been well established, but the role of personality in susceptibility to schizophrenia remains uncertain. The aim of this study was to test for an association between personality traits and Neurological Soft Signs (NSS, a well-known biological marker of schizophrenia, in non-psychotic relatives of patients with schizophrenia. For this purpose, we evaluated the NSS scale and personality measured by the Temperament and Character inventory (TCI-R in three groups of subjects: 29 patients with schizophrenia, 24 unaffected relatives and 37 controls. The results showed that patients with schizophrenia were more asocial (higher harm avoidance and lower reward dependence, more perseverative (higher persistence, and more schizotypal (lower self-directedness and cooperativeness, higher self-transcendence. The unaffected relatives showed higher harm avoidance, lower self-directedness and cooperativeness than the healthy controls. Higher NSS scores and sub-scores were found in patients and non-psychotic relatives compared with the controls. Among all the patients, total NSS scores were positively correlated with harm avoidance but negatively correlated with novelty seeking and persistence. Total NSS were also correlated with low scores on self-directedness and cooperativeness, which are indicators of personality disorder. Our results show that susceptibility to NSS and to schizophrenia are both related to individual differences in the temperament and character features in non-psychotic relatives of patients with schizophrenia. High harm avoidance, low persistence, low self-directedness and low cooperativeness contribute to both the risk of NSS and schizophrenia. These findings highlight the value of using both assessments to study high risk populations.

  10. Disease and genetic contributions toward local tissue volume disturbances in schizophrenia: a tensor-based morphometry study.

    Science.gov (United States)

    Yang, Yaling; Nuechterlein, Keith H; Phillips, Owen R; Gutman, Boris; Kurth, Florian; Dinov, Ivo; Thompson, Paul M; Asarnow, Robert F; Toga, Arthur W; Narr, Katherine L

    2012-09-01

    Structural brain deficits, especially frontotemporal volume reduction and ventricular enlargement, have been repeatedly reported in patients with schizophrenia. However, it remains unclear whether brain structural deformations may be attributable to disease-related or genetic factors. In this study, the structural magnetic resonance imaging data of 48 adult-onset schizophrenia patients, 65 first-degree nonpsychotic relatives of schizophrenia patients, 27 community comparison (CC) probands, and 73 CC relatives were examined using tensor-based morphometry (TBM) to isolate global and localized differences in tissue volume across the entire brain between groups. We found brain tissue contractions most prominently in frontal and temporal regions and expansions in the putamen/pallidum, and lateral and third ventricles in schizophrenia patients when compared with unrelated CC probands. Results were similar, though less prominent when patients were compared with their nonpsychotic relatives. Structural deformations observed in unaffected patient relatives compared to age-similar CC relatives were suggestive of schizophrenia-related genetic liability and were pronounced in the putamen/pallidum and medial temporal regions. Schizophrenia and genetic liability effects for the putamen/pallidum were confirmed by regions-of-interest analysis. In conclusion, TBM findings complement reports of frontal, temporal, and ventricular dysmorphology in schizophrenia and further indicate that putamen/pallidum enlargements, originally linked mainly with medication exposure in early studies, also reflect a genetic predisposition for schizophrenia. Thus, brain deformation profiles revealed in this study may help to clarify the role of specific genetic or environmental risk factors toward altered brain morphology in schizophrenia.

  11. Genetic variants in long non-coding RNA MIAT contribute to risk of paranoid schizophrenia in a Chinese Han population.

    Science.gov (United States)

    Rao, Shu-Quan; Hu, Hui-Ling; Ye, Ning; Shen, Yan; Xu, Qi

    2015-08-01

    The heritability of schizophrenia has been reported to be as high as ~80%, but the contribution of genetic variants identified to this heritability remains to be estimated. Long non-coding RNAs (LncRNAs) are involved in multiple processes critical to normal cellular function and dysfunction of lncRNA MIAT may contribute to the pathophysiology of schizophrenia. However, the genetic evidence of lncRNAs involved in schizophrenia has not been documented. Here, we conducted a two-stage association analysis on 8 tag SNPs that cover the whole MIAT locus in two independent Han Chinese schizophrenia case-control cohorts (discovery sample from Shanxi Province: 1093 patients with paranoid schizophrenia and 1180 control subjects; replication cohort from Jilin Province: 1255 cases and 1209 healthy controls). In discovery stage, significant genetic association with paranoid schizophrenia was observed for rs1894720 (χ(2)=74.20, P=7.1E-18), of which minor allele (T) had an OR of 1.70 (95% CI=1.50-1.91). This association was confirmed in the replication cohort (χ(2)=22.66, P=1.9E-06, OR=1.32, 95%CI 1.18-1.49). Besides, a weak genotypic association was detected for rs4274 (χ(2)=4.96, df=2, P=0.03); the AA carriers showed increased disease risk (OR=1.30, 95%CI=1.03-1.64). No significant association was found between any haplotype and paranoid schizophrenia. The present studies showed that lncRNA MIAT was a novel susceptibility gene for paranoid schizophrenia in the Chinese Han population. Considering that most lncRNAs locate in non-coding regions, our result may explain why most susceptibility loci for schizophrenia identified by genome wide association studies were out of coding regions. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Autoimmune diseases and severe infections as risk factors for schizophrenia: a 30-year population-based register study.

    Science.gov (United States)

    Benros, Michael E; Nielsen, Philip R; Nordentoft, Merete; Eaton, William W; Dalton, Susanne O; Mortensen, Preben B

    2011-12-01

    Autoimmune diseases have been associated with an increased risk of schizophrenia. It has been suggested that brain-reactive autoantibodies are part of the mechanisms behind this association. Furthermore, an increased permeability of the blood-brain barrier has been observed during periods of infection and inflammation. The authors therefore investigated whether autoimmune diseases combined with exposures to severe infections may increase the risk of schizophrenia Nationwide population-based registers in Denmark were linked, and the data were analyzed in a cohort study using survival analysis. All analyses were adjusted for calendar year, age, and sex. Incidence rate ratios and accompanying 95% confidence intervals (CIs) as measures of relative risk were used. A prior autoimmune disease increased the risk of schizophrenia by 29% (incidence rate ratio=1.29; 95% CI=1.18-1.41). Any history of hospitalization with infection increased the risk of schizophrenia by 60% (incidence rate ratio=1.60; 95% CI=1.56-1.64). When the two risk factors were combined, the risk of schizophrenia was increased even further (incidence rate ratio=2.25; 95% CI=2.04-2.46). The risk of schizophrenia was increased in a dose-response relationship, where three or more infections and an autoimmune disease were associated with an incidence rate ratio of 3.40 (95% CI=2.91-3.94). The results remained significant after adjusting for substance use disorders and family history of psychiatric disorders. Hospital contact with infection occurred in nearly 24% of individuals prior to a schizophrenia diagnosis. Autoimmune disease and the number of infections requiring hospitalization are risk factors for schizophrenia. The increased risk is compatible with an immunological hypothesis in subgroups of schizophrenia patients.

  13. Association of GRIN1 and GRIN2A-D With schizophrenia and genetic interaction with maternal herpes simplex virus-2 infection affecting disease risk

    DEFF Research Database (Denmark)

    Demontis, Ditte; Nyegaard, Mette; Buttenschøn, Henriette Nørmølle

    2011-01-01

    in the offspring interacted with maternal herpes simplex virus-2 (HSV-2) seropositivity during pregnancy influencing the risk of schizophrenia later in life. Individuals from three independently collected Danish case control samples were genotyped for 81 tagSNPs (in total 984 individuals diagnosed...... the NMDA receptors are therefore likely to influence the risk of schizophrenia. The aim of this study was to determine (1) whether SNP variation in the genes (GRIN1, GRIN2A, GRIN2B, GRIN2C, and GRIN2D) encoding the NMDA receptor were associated with schizophrenia; (2) whether GRIN gene variation...... with schizophrenia and 1,500 control persons) and antibodies against maternal HSV-2 infection were measured in one of the samples (365 cases and 365 controls). Nine SNPs out of 30 in GRIN2B were significantly associated with schizophrenia. One SNP remained significant after Bonferroni correction (rs1806194, P...

  14. C-reactive protein levels and treatment resistance in schizophrenia - A Danish population-based cohort study

    DEFF Research Database (Denmark)

    Horsdal, Henriette Thisted; Wimberley, Theresa; Benros, Michael Eriksen

    2017-01-01

    -time schizophrenia diagnosis and a baseline C-reactive protein measurement (a commonly available marker of systemic inflammation) from 2000 to 2012. We defined treatment resistance as the earliest observed instance of either clozapine initiation or hospital admission due to schizophrenia after having received......OBJECTIVE: Schizophrenia is associated with increased levels of inflammatory markers. However, it remains unclear whether inflammatory markers are associated with treatment-resistant schizophrenia. METHODS: We conducted a population-based follow-up study among individuals with a first...... (4.0 vs. 3.1 mg/L, p = .13) was observed among the 52 (13.3%) treatment-resistant individuals. Increased levels of C-reactive protein (above 3 mg/L) at baseline were not associated with treatment resistance (adjusted hazard ratio = 0.99, 95% confidence interval [0.56, 1.73]). CONCLUSIONS: C...

  15. Exploring difference and overlap between schizophrenia, schizoaffective and bipolar disorders using resting-state brain functional networks.

    Science.gov (United States)

    Du, Yuhui; Liu, Jingyu; Sui, Jing; He, Hao; Pearlson, Godfrey D; Calhoun, Vince D

    2014-01-01

    Schizophrenia, schizoaffective and bipolar disorders share some common symptoms. However, the biomarkers underlying those disorders remain unclear. In fact, there is still controversy about the schizoaffective disorder with respect to its validity of independent category and its relationship with schizophrenia and bipolar disorders. In this paper, based on brain functional networks extracted from resting-state fMRI using a recently proposed group information guided ICA (GIG-ICA) method, we explore the biomarkers for discriminating healthy controls, schizophrenia patients, bipolar patients, and patients with two symptom defined subsets of schizoaffective disorder, and then investigate the relationship between different groups. The results demonstrate that the discriminating regions mainly including frontal, parietal, precuneus, cingulate, supplementary motor, cerebellar, insular and supramarginal cortices perform well in distinguishing the different diagnostic groups. The results also suggest that schizoaffective disorder may be an independent disorder, although its subtype characterized by depressive episodes shares more similarity with schizophrenia.

  16. Association of the 3′ Region of COMT with Schizophrenia in Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Ling Chien

    2009-04-01

    Conclusion: The SNP rs165599, which has been mapped to the 3′-UTR region of the COMT gene, was significantly associated with schizophrenia in our family study, and possibly associated with the age of onset, delusion/hallucination symptom dimension, and CPT performance. Therefore, COMT may contribute to the genetic risk for schizophrenia not through the Val108/158 Met polymorphism, but through other variants that are situated 3′ to this region, in the Taiwanese population. Nevertheless, the true associated functional variants in our subjects remain to be elucidated.

  17. Disrupted resting-state functional connectivity in minimally treated chronic schizophrenia.

    Science.gov (United States)

    Wang, Xijin; Xia, Mingrui; Lai, Yunyao; Dai, Zhengjia; Cao, Qingjiu; Cheng, Zhang; Han, Xue; Yang, Lei; Yuan, Yanbo; Zhang, Yong; Li, Keqing; Ma, Hong; Shi, Chuan; Hong, Nan; Szeszko, Philip; Yu, Xin; He, Yong

    2014-07-01

    The pathophysiology of chronic schizophrenia may reflect long term brain changes related to the disorder. The effect of chronicity on intrinsic functional connectivity patterns in schizophrenia without the potentially confounding effect of antipsychotic medications, however, remains largely unknown. We collected resting-state fMRI data in 21 minimally treated chronic schizophrenia patients and 20 healthy controls. We computed regional functional connectivity strength for each voxel in the brain, and further divided regional functional connectivity strength into short-range regional functional connectivity strength and long-range regional functional connectivity strength. General linear models were used to detect between-group differences in these regional functional connectivity strength metrics and to further systematically investigate the relationship between these differences and clinical/behavioral variables in the patients. Compared to healthy controls, the minimally treated chronic schizophrenia patients showed an overall reduced regional functional connectivity strength especially in bilateral sensorimotor cortex, right lateral prefrontal cortex, left insula and right lingual gyrus, and these regional functional connectivity strength decreases mainly resulted from disruption of short-range regional functional connectivity strength. The minimally treated chronic schizophrenia patients also showed reduced long-range regional functional connectivity strength in the bilateral posterior cingulate cortex/precuneus, and increased long-range regional functional connectivity strength in the right lateral prefrontal cortex and lingual gyrus. Notably, disrupted short-range regional functional connectivity strength mainly correlated with duration of illness and negative symptoms, whereas disrupted long-range regional functional connectivity strength correlated with neurocognitive performance. All of the results were corrected using Monte-Carlo simulation. This

  18. Multidimensional analysis of the abnormal neural oscillations associated with lexical processing in schizophrenia.

    Science.gov (United States)

    Xu, Tingting; Stephane, Massoud; Parhi, Keshab K

    2013-04-01

    The neural mechanisms of language abnormalities, the core symptoms in schizophrenia, remain unclear. In this study, a new experimental paradigm, combining magnetoencephalography (MEG) techniques and machine intelligence methodologies, was designed to gain knowledge about the frequency, brain location, and time of occurrence of the neural oscillations that are associated with lexical processing in schizophrenia. The 248-channel MEG recordings were obtained from 12 patients with schizophrenia and 10 healthy controls, during a lexical processing task, where the patients discriminated correct from incorrect lexical stimuli that were visually presented. Event-related desynchronization/synchronization (ERD/ERS) was computed along the frequency, time, and space dimensions combined, that resulted in a large spectral-spatial-temporal ERD/ERS feature set. Machine intelligence techniques were then applied to select a small subset of oscillation patterns that are abnormal in patients with schizophrenia, according to their discriminating power in patient and control classification. Patients with schizophrenia showed abnormal ERD/ERS patterns during both lexical encoding and post-encoding periods. The top-ranked features were located at the occipital and left frontal-temporal areas, and covered a wide frequency range, including δ (1-4 Hz), α (8-12 Hz), β (12-32 Hz), and γ (32-48 Hz) bands. These top features could discriminate the patient group from the control group with 90.91% high accuracy, which demonstrates significant brain oscillation abnormalities in patients with schizophrenia at the specific frequency, time, and brain location indicated by these top features. As neural oscillation abnormality may be due to the mechanisms of the disease, the spectral, spatial, and temporal content of the discriminating features can offer useful information for helping understand the physiological basis of the language disorder in schizophrenia, as well as the pathology of the

  19. An odor-specific threshold deficit implicates abnormal intracellular cyclic AMP signaling in schizophrenia.

    Science.gov (United States)

    Turetsky, Bruce I; Moberg, Paul J

    2009-02-01

    Although olfactory deficits are common in schizophrenia, their underlying pathophysiology remains unknown. Recent evidence has suggested that cAMP signaling may be disrupted in schizophrenia. Since cAMP mediates signal transduction in olfactory receptor neurons, this could contribute to the etiology of observed olfactory deficits. This study was designed to test this hypothesis by determining odor detection threshold sensitivities to two odorants that differ in their relative activations of this intracellular cAMP signaling cascade. Thirty schizophrenia patients, 25 healthy comparison subjects, and 19 unaffected first-degree relatives of schizophrenia patients were studied. Odor detection threshold sensitivities wer