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Lu L, Zeng LN, Zong QQ, Rao WW, Ng CH, Ungvari GS, Li J, An FR, Xiang YT. Quality of life in Chinese patients with schizophrenia: A meta-analysis. Psychiatry Res 2018; 268:392-399. [PMID: 30125870 DOI: 10.1016/j.psychres.2018.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/27/2018] [Accepted: 07/04/2018] [Indexed: 12/19/2022]
Abstract
The impact of schizophrenia on quality of life (QOL) is significantly influenced by sociocultural factors. This meta-analysis systematically compared QOL between patients with schizophrenia and healthy controls in China. PubMed, PsycINFO, Embase, Chinese National Knowledge Infrastructure (CNKI), SinoMed and WanFang databases were searched to identify case-control studies. Standardized mean differences (SMDs) and 95% confidence interval (CI) were calculated using random effect models. Eighteen case-control studies comparing QOL between schizophrenia patients (n = 2,425) and healthy controls (n = 2,072) were included in the analyses. Compared with healthy controls, schizophrenia patients had significantly poorer overall QOL [11 studies; SMD:-1.07 (95%CI:-1.44, -0.70), P < 0.001] as well as in the physical, psychological, social and environmental QOL domains. Subgroup analyses revealed that poorer QOL was significantly associated with diagnostic criteria, study location, female gender, older age and inpatient status. Older schizophrenia patients had lower physical and psychological QOL, while inpatients had lower psychological QOL. In conclusion, compared with healthy controls, schizophrenia patients in China have significantly lower QOL.
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Affiliation(s)
- Li Lu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Liang-Nan Zeng
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qian-Qian Zong
- School of Nursing, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Gabor S Ungvari
- University of Notre Dame Australia & Graylands Hospital, Perth, Australia
| | - Jun Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China.
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Balint B, Killaspy H, Marston L, Barnes T, Latorre A, Joyce E, Clarke CS, De Micco R, Edwards MJ, Erro R, Foltynie T, Hunter RM, Nolan F, Schrag A, Freemantle N, Foreshaw Y, Green N, Bhatia KP, Martino D. Development and clinimetric assessment of a nurse-administered screening tool for movement disorders in psychosis. BJPsych Open 2018; 4:404-410. [PMID: 30294450 PMCID: PMC6171333 DOI: 10.1192/bjo.2018.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed. AIMS To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses. METHOD Item selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales. RESULTS Interreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia. CONCLUSIONS The ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia. DECLARATION OF INTEREST None.
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Affiliation(s)
- Bettina Balint
- Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, UK and Department of Neurology, University of Heidelberg, Germany
| | - Helen Killaspy
- Psychiatrist, Division of Psychiatry, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK
| | - Louise Marston
- Research Associate, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK
| | - Thomas Barnes
- Psychiatrist, Department of Psychiatry, Imperial College London, UK
| | - Anna Latorre
- Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK and Department of Neurology and Psychiatry, Sapienza, University of Rome, Italy
| | - Eileen Joyce
- Psychiatrist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK
| | - Caroline S Clarke
- Research Associate, Department of Primary Care and Population Health and Priment Clinical Trials Unit, University College London, UK
| | - Rosa De Micco
- Neurologist, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences and MRI Research Center SUN-FISM, University of Campania 'Luigi Vanvitelli', Italy
| | - Mark J Edwards
- Neurologist, Institute of Cardiovascular and Cell Sciences, St George's University, UK
| | - Roberto Erro
- Neurologist, Neurodegenerative Diseases Center (CEMAND) Department of Medicine, Surgery and Dentistry, University of Salerno, Italy
| | - Thomas Foltynie
- Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK
| | - Rachael M Hunter
- Research Associate, Department of Primary Care and Population Health, and Priment Clinical Trials Unit, University College London, UK
| | - Fiona Nolan
- Research Nurse, School of Health and Social Care, University of Essex, UK
| | - Anette Schrag
- Neurologist, Department of Clinical Neurosciences, Royal Free Campus, UCL Institute of Neurology, University College London, UK
| | - Nick Freemantle
- Statistician, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK
| | - Yvonne Foreshaw
- Research Nurse, Camden and Islington NHS Foundation Trust, St Pancras Hospital, UK
| | - Nicholas Green
- Research Nurse, Camden and Islington NHS Foundation Trust, St Pancras Hospital, UK
| | - Kailash P Bhatia
- Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, UK
| | - Davide Martino
- Neurologist, Department of Clinical Neurosciences, University of Calgary, Canada
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Tominaga T, Tomotake M, Takeda T, Ueoka Y, Tanaka T, Watanabe SY, Kameoka N, Nakataki M, Numata S, Izaki Y, Sumitani S, Kubo H, Kaneda Y, Ohmori T. Relationship between social and cognitive functions in people with schizophrenia. Neuropsychiatr Dis Treat 2018; 14:2215-2224. [PMID: 30214211 PMCID: PMC6121750 DOI: 10.2147/ndt.s171207] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
PURPOSE The purpose of the present study was to examine clinical factors related to social function in people with schizophrenia. PATIENTS AND METHODS The participants were 55 stabilized outpatients with schizophrenia. Their mean age was 39.36 (SD =10.65) years. Social function was assessed using the Quality of Life Scale (QLS). Cognitive function was evaluated with the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia, and the Drug-Induced Extrapyramidal Symptoms Scale. RESULTS Neither the MCCB cognitive domain score nor composite score was correlated with the QLS scores. However, of the 10 MCCB subtests, the Trail Making Test Part A and the Brief Assessment of Cognition in Schizophrenia-Symbol Coding (BACS-SC) scores were positively correlated with the QLS scores. Among clinical variables, especially the PANSS negative syndrome scale score had a strong negative correlation with the QLS scores. Stepwise regression analyses showed that the PANSS negative syndrome scale score was an independent predictor of the QLS scores, and although the BACS-SC score predicted the QLS common objects and activities subscale score, the association was not so strong compared to the PANSS negative syndrome scale score. CONCLUSION These results indicate that speed of processing evaluated by BACS-SC could predict some aspect of social function but negative symptoms have a much stronger impact on global social function in people with schizophrenia.
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Affiliation(s)
- Takeo Tominaga
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan,
| | - Masahito Tomotake
- Department of Mental Health, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Tomoya Takeda
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan,
| | - Yoshinori Ueoka
- Field of Psychology, Department of Human Sciences, Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
| | - Tsunehiko Tanaka
- Faculty of Education, Specialized Courses Educational Psychology, Niigata University, Niigata, Japan
| | - Shin-Ya Watanabe
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan,
| | - Naomi Kameoka
- Department of Psychiatry, Tokushima University Hospital, Tokushima, Japan
| | - Masahito Nakataki
- Department of Psychiatry, Tokushima University Hospital, Tokushima, Japan
| | - Shusuke Numata
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan,
| | - Yumiko Izaki
- Health Service and Counseling Center, Tokushima University, Tokushima, Japan
| | - Satsuki Sumitani
- Academic Support Office for Students with Special Needs, Tokushima University, Tokushima, Japan
| | - Hiroko Kubo
- Department of Psychiatry, Aizato Hospital, Itano-gun, Tokushima, Japan
| | - Yasuhiro Kaneda
- Department of Psychiatry, Iwaki Clinic, Anan, Tokushima, Japan
| | - Tetsuro Ohmori
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan,
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Diviant JP, Vigil JM, Stith SS. The Role of Cannabis within an Emerging Perspective on Schizophrenia. MEDICINES 2018; 5:medicines5030086. [PMID: 30096776 PMCID: PMC6164121 DOI: 10.3390/medicines5030086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 07/06/2018] [Accepted: 07/31/2018] [Indexed: 12/15/2022]
Abstract
Background: Approximately 0.5% of the population is diagnosed with some form of schizophrenia, under the prevailing view that the pathology is best treated using pharmaceutical medications that act on monoamine receptors. Methods: We briefly review evidence on the impact of environmental forces, particularly the effect of autoimmune activity, in the expression of schizophrenic profiles and the role of Cannabis therapy for regulating immunological functioning. Results: A review of the literature shows that phytocannabinoid consumption may be a safe and effective treatment option for schizophrenia as a primary or adjunctive therapy. Conclusions: Emerging research suggests that Cannabis can be used as a treatment for schizophrenia within a broader etiological perspective that focuses on environmental, autoimmune, and neuroinflammatory causes of the disorder, offering a fresh start and newfound hope for those suffering from this debilitating and poorly understood disease.
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Affiliation(s)
- Jegason P Diviant
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA.
| | - Jacob M Vigil
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA.
| | - Sarah S Stith
- Department of Economics, University of New Mexico, Albuquerque, NM 87131, USA.
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Abstract
BACKGROUND Patients with schizophrenia hold a variety of explanatory models of illness that influence different aspects of their life including their understanding of the disease, ability to cope and sense of well-being. AIM To study the association of explanatory models and quality of life in patients with schizophrenia. MATERIALS AND METHODS One hundred and thirty consecutive patients with schizophrenia attending a psychiatric outpatient clinic were recruited in the study and administered the Positive and Negative Symptom Scale (PANSS), the modified Short Explanatory Model Interview (SEMI) and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) Scale to assess severity of psychosis, explanatory models of illness, and quality of life. Sociodemographic and clinical details of patients were also recorded. Standard bivariate and multivariable statistics were employed. RESULTS Higher quality of life scores were associated with better socioeconomic conditions and lower scores on negative and general psychopathology subscales of PANSS. Quality-of-life scores were significantly higher in patients who did not perceive their illness to have negative effects on the different domains of their functioning. CONCLUSION Explanatory models of illness are associated with perceived quality of life in patients with schizophrenia. There is a need to focus on attitudes, perceptions and functioning, rather than symptom reduction alone, to enhance the quality of life in schizophrenia.
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Affiliation(s)
- Jibi A. Jacob
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anju Kuruvilla
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
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Rotstein A, Roe D, Gelkopf M, Levine SZ. Age of onset and quality of life among males and females with schizophrenia: A national study. Eur Psychiatry 2018; 53:100-106. [DOI: 10.1016/j.eurpsy.2018.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 01/26/2023] Open
Abstract
AbstractBackground:Age of onset is considered central to understanding the course of schizophrenia, yet little is known regarding its association with quality of life in general, and specifically among males and females.Aims:To examine the association between the age of schizophrenia onset and quality of life, in general, and among males and females, using data from a national sample and competing statistical models.Methods:Participants with a diagnosis of schizophrenia (N = 1624) completed the Manchester Short Assessment of Quality of Life (MSA-QoL) and were rated on a parallel measure by their professional caregivers (N = 578). Multiple regression analysis models were computed for self-appraised quality of life, and mixed models with random intercepts were used for caregivers. Six competing models were tested for parsimony for each rating source. Three models without adjustment and three models adjusted for confounding variables. Sensitivity analyses were conducted for males and females separately.Results:Age of onset was statistically significantly (P <.05) negatively associated with self-appraised and caregiver-appraised quality of life on aggregate and among females. Among males, a significant (P <.01) quadratic effect of onset age on self-appraised quality of life demonstrated a negative association up to onset age of 36.67 years, after which the association was positive.ConclusionsAn earlier age of onset is associated with a better quality of life in schizophrenia which is tentatively explained by social decline. Specific trends in psychiatric symptom severity may account for this association among females while social advantages may account for the particular results found among males.
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Quality of Life-a Goal for Schizophrenia's Therapy. CURRENT HEALTH SCIENCES JOURNAL 2018; 44:122-128. [PMID: 30746158 PMCID: PMC6320457 DOI: 10.12865/chsj.44.02.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/27/2018] [Indexed: 12/03/2022]
Abstract
Quality of Life (QOL) assessment represents a good instrument to monitor the evolution of schizophrenia and the treatment’s outcomes. The present study has evaluated the relationship between the level of the QOL and different socio-demographical and clinical factors. Lower QOL for schizophrenic persons was influenced by the severity of symptoms and cognitive deficits, while same low level of QOL could be considered an indicator for suicidal behavior. The correct therapeutically management of individuals with schizophrenia could lead to better outcomes in terms of life satisfaction of patients and response to the treatment’s strategies.
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Health-related quality of life in outpatients with schizophrenia: factors that determine changes over time. Soc Psychiatry Psychiatr Epidemiol 2018; 53:239-248. [PMID: 29340780 DOI: 10.1007/s00127-018-1483-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 01/02/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE The objective of this study was to analyze the clinical factors associated with changes in HRQoL in outpatients with schizophrenia using both generic and condition-specific HRQoL scales. METHODS Adult outpatients with schizophrenia at least 18 years of age who did not have an acute psychotic exacerbation in the 3 months prior to baseline were recruited. PANSS dimensions were calculated based on Lindenmayer et al.'s five factors. HRQoL data were assessed by patients using the Schizophrenia Quality of Life Scale (SQLS), the Short Form-36 (SF-36), and the EuroQol-5 Dimension (EQ-5D) questionnaires. RESULTS Out of the 1345 patients included at baseline, 1196 (89%) were evaluated at 12 months. Regression models showed that the factor most consistently associated with HRQoL at endpoint was change in the PANSS negative symptoms score. A decrease in the PANSS negative symptoms score from baseline to 1 year was associated with a decrease in HRQoL during the same period. There were also significant associations of the change in PANSS excitatory factor with all the HRQoL scales except the SF-36 PCS. Female gender was associated with a decrease in all HRQoL ratings. There was also a relationship between years since onset and HRQoL. The longer the time since illness onset, the larger the decrease in HRQoL. CONCLUSIONS This study has found that, in outpatients with schizophrenia, changes in negative and excitement symptoms may have a greater an association with HRQoL than changes in positive, cognitive and depressive symptoms.
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Solmi M, Pigato G, Kane JM, Correll CU. Clinical risk factors for the development of tardive dyskinesia. J Neurol Sci 2018; 389:21-27. [PMID: 29439776 DOI: 10.1016/j.jns.2018.02.012] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 02/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Tardive dyskinesia (TD) is a severe condition that can affect almost 1 out of 4 patients on current or previous antipsychotic treatment, including both first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs). While two novel vesicular monoamine transporter inhibitors, deutetrabenazine and valbenazine, have shown acute efficacy for TD, the majority of patients do not remit, and TD appears to recur once treatment is withdrawn. Hence, prevention of TD remains a crucial goal. METHODS We provide a clinically oriented overview of risk factors for TD, dividing them into patient-, illness- and treatment-related variables, as well as nonmodifiable and modifiable factors. RESULTS Unmodifiable patient-related and illness-related risk factors for TD include older age, female sex, white and African descent, longer illness duration, intellectual disability and brain damage, negative symptoms in schizophrenia, mood disorders, cognitive symptoms in mood disorders, and gene polymorphisms involving antipsychotic metabolism and dopamine functioning. Modifiable comorbidity-related and treatment-related factors include diabetes, smoking, and alcohol and substance abuse, FGA vs SGA treatment, higher cumulative and current antipsychotic dose or antipsychotic plasma levels, early parkinsonian side effects, anticholinergic co-treatment, akathisia, and emergent dyskinesia. DISCUSSION Clinicians using dopamine antagonists need to consider risk factors for TD to minimize TD and its consequences.
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Affiliation(s)
- Marco Solmi
- University of Padua, Neuroscience Department, Psychiatry Unit, Padua, Italy; University Hospital of Padua, Azienda Ospedaliera di Padova, Psychiatry Unit, Padua, Italy
| | - Giorgio Pigato
- University Hospital of Padua, Azienda Ospedaliera di Padova, Psychiatry Unit, Padua, Italy
| | - John M Kane
- The Zucker Hillside Hospital, Department of Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; Hofstra Northwell School of Medicine, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA
| | - Christoph U Correll
- The Zucker Hillside Hospital, Department of Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; Hofstra Northwell School of Medicine, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany.
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Caroff SN, Ungvari GS, Cunningham Owens DG. Historical perspectives on tardive dyskinesia. J Neurol Sci 2018; 389:4-9. [PMID: 29454494 DOI: 10.1016/j.jns.2018.02.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/26/2017] [Accepted: 02/02/2018] [Indexed: 11/27/2022]
Abstract
Tardive dyskinesia (TD) is a persistent hyperkinetic movement disorder associated with dopamine receptor blocking agents including antipsychotic medications. Although uncertainty and concern about this drug side effect have vacillated since its initial recognition 60 years ago, recent commercial interest in developing effective treatments has rekindled scientific and clinical interest after a protracted period of neglect. Although substantial research has advanced knowledge of the clinical features and epidemiology of TD, many fundamental questions raised by early investigators remain unresolved. In this paper, we review the early clinical reports that led to the acceptance of TD as an iatrogenic disorder and the lingering controversies that emerged thereafter. Continued research on TD as a serious adverse reaction to treatment may not only enhance patient outcomes and recovery efforts but may also provide insights into both the mechanism of action of antipsychotic drugs and the nosology and pathophysiology of idiopathic psychomotor disorders.
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Affiliation(s)
- Stanley N Caroff
- Corporal Michael J. Cresencz Veterans Affairs Medical Center and the Perelman School of Medicine at the University of Pennsylvania, University Avenue, Philadelphia, PA 19104, USA.
| | - Gabor S Ungvari
- University of Notre Dame Australia/Marian Centre, 200 Cambridge Street, Perth 6014, Australia.
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Caqueo-Urízar A, Alessandrini M, Boyer L. Calidad de vida en pacientes con esquizofrenia de origen Aymara en la zona Centro-Sur de los Andes. UNIVERSITAS PSYCHOLOGICA 2018. [DOI: 10.11144/javeriana.upsy16-5.qlap] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
El objetivo de este estudio consistió en comparar la calidad de vida (CV) de pacientes con esquizofrenia pertenecientes al grupo étnico aymara de los Andes Centro-Sur, con pacientes no Aymara. En este estudio transversal participaron 253 pacientes de tres clínicas de salud mental en Chile, Perú y Bolivia. Se recogieron datos sociodemográficos y características clínicas. La calidad de vida se evaluó utilizando el Cuestionario S-QoL18. Los análisis comparativos exploraron las diferencias de QoL entre los pacientes Aymara y no Aymara. Los participantes de origen Aymara tuvieron puntuaciones de CV más bajos en comparación con los pacientes no Aymara para el Índice total, las relaciones familiares y la dimensión de vida sentimental. Los ingresos familiares mensuales y la duración del trastorno fueron significativamente más bajos en los pacientes Aymara. Nuestro estudio soporta la hipótesis de una peor CV en pacientes aymaras con esquizofrenia.
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Gervin M, Barnes TR. Assessment of drug-related movement disorders in schizophrenia. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.6.5.332] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Conventional antipsychotic drugs remain one of the mainstays of treatment of schizophrenia and related psychotic disorders. The therapeutic efficacy of these drugs is well established, both for treatment of acute symptoms and in relapse prevention. Unfortunately, they are associated with a broad range of side-effects, the most prominent of which is the development of a variety of movement disorders (see Box 1). Compared with the conventional antipsychotic agents, the newer, atypical antipsychotics have a lower liability for the acute extrapyramidal side-effects (EPS) and, for a few of the new drugs, there is some evidence of a lower risk of tardive dyskinesia (Barnes & McPhillips, 1999). Nevertheless, even with these newer agents, movement disorders are seen in a significant proportion of patients.
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Lim MWZ, Lee J. Determinants of Health-Related Quality of Life in Schizophrenia: Beyond the Medical Model. Front Psychiatry 2018; 9:712. [PMID: 30618882 PMCID: PMC6305274 DOI: 10.3389/fpsyt.2018.00712] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 12/04/2018] [Indexed: 01/05/2023] Open
Abstract
Background: Improving Quality of Life (QoL) in Schizophrenia is an important treatment objective in the shift toward person-centered and recovery-oriented care. Health-Related Quality of Life (HRQoL) is a focused aspect of QoL that is directly impacted by healthcare intervention. This aim of the current study was to ascertain the clinical determinants of HRQoL in Schizophrenia and their collective contribution to HRQoL. Methods: 157 stable outpatients with schizophrenia were recruited for this study. Data collected included sociodemographic information and clinical characteristics. HRQoL was assessed on the RAND-36. Psychopathology was assessed on the Positive and Negative Syndrome Scale (PANSS) and functioning measured on the Global Assessment Scale (GAS). Findings: Multiple regression revealed that the Physical Health Component (PHC) of the RAND-36 was associated with positive symptoms (beta = -0.218, p = 0.005) and presence of psychiatric comorbidity (beta = -0.215, p = 0.003). The Mental Health Component (MHC) was associated with depressive (beta = -0.364, p < 0.001) and positive (beta = -0.175, p = 0.021,) symptoms. Symptoms, functioning, presence of psychiatric comorbidities, gender and age account for 20.3% of the total variance observed in HRQoL. Conclusion: Depressive and positive symptoms are key clinical determinants of HRQoL in people with schizophrenia. However, the medical model-looking solely at clinical determinants-could not account for a large proportion of variance in HRQoL. Hence, future research beyond the medical model is required to uncover the determinants of HRQoL in Schizophrenia. Identifying these factors will contribute toward developing a holistic and person-centered management plan for people with schizophrenia.
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Affiliation(s)
- Madeline W Z Lim
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore.,Department of Psychosis, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Cohen L, Khoramshahi M, Salesse RN, Bortolon C, Słowiński P, Zhai C, Tsaneva-Atanasova K, Di Bernardo M, Capdevielle D, Marin L, Schmidt RC, Bardy BG, Billard A, Raffard S. Influence of facial feedback during a cooperative human-robot task in schizophrenia. Sci Rep 2017; 7:15023. [PMID: 29101325 PMCID: PMC5670132 DOI: 10.1038/s41598-017-14773-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/05/2017] [Indexed: 01/28/2023] Open
Abstract
Rapid progress in the area of humanoid robots offers tremendous possibilities for investigating and improving social competences in people with social deficits, but remains yet unexplored in schizophrenia. In this study, we examined the influence of social feedbacks elicited by a humanoid robot on motor coordination during a human-robot interaction. Twenty-two schizophrenia patients and twenty-two matched healthy controls underwent a collaborative motor synchrony task with the iCub humanoid robot. Results revealed that positive social feedback had a facilitatory effect on motor coordination in the control participants compared to non-social positive feedback. This facilitatory effect was not present in schizophrenia patients, whose social-motor coordination was similarly impaired in social and non-social feedback conditions. Furthermore, patients' cognitive flexibility impairment and antipsychotic dosing were negatively correlated with patients' ability to synchronize hand movements with iCub. Overall, our findings reveal that patients have marked difficulties to exploit facial social cues elicited by a humanoid robot to modulate their motor coordination during human-robot interaction, partly accounted for by cognitive deficits and medication. This study opens new perspectives for comprehension of social deficits in this mental disorder.
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Affiliation(s)
- Laura Cohen
- Learning Algorithms and Systems Laboratory, School of Engineering, EPFL, Lausanne, Switzerland
| | - Mahdi Khoramshahi
- Learning Algorithms and Systems Laboratory, School of Engineering, EPFL, Lausanne, Switzerland
| | | | - Catherine Bortolon
- University Department of Adult Psychiatry, CHU, Montpellier, France
- Laboratory Epsylon, EA 4556, University Montpellier 3 Paul Valery, Montpellier, France
| | - Piotr Słowiński
- Department of Mathematics, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - Chao Zhai
- Department of Engineering Mathematics, University of Bristol, Bristol, United Kingdom
| | - Krasimira Tsaneva-Atanasova
- Department of Mathematics, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - Mario Di Bernardo
- Department of Engineering Mathematics, University of Bristol, Bristol, United Kingdom
| | | | - Ludovic Marin
- EuroMov, Montpellier University, Montpellier, France
| | - Richard C Schmidt
- Psychology Department, College of the Holy Cross, Worcester, MA, USA
| | - Benoit G Bardy
- EuroMov, Montpellier University, Montpellier, France
- Institut Universitaire de France, Paris, France
| | - Aude Billard
- Learning Algorithms and Systems Laboratory, School of Engineering, EPFL, Lausanne, Switzerland
| | - Stéphane Raffard
- University Department of Adult Psychiatry, CHU, Montpellier, France.
- Laboratory Epsylon, EA 4556, University Montpellier 3 Paul Valery, Montpellier, France.
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Pinho LGD, Pereira A, Chaves C. Influence of sociodemographic and clinical characteristics on the quality of life of patients with schizophrenia. Rev Esc Enferm USP 2017; 51:e03244. [PMID: 28902324 DOI: 10.1590/s1980-220x2016031903244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 03/28/2017] [Indexed: 11/21/2022] Open
Abstract
Abstract OBJECTIVE Evaluating the quality of life of Portuguese patients with schizophrenia and linking it to sociodemographic and clinical aspects. METHOD A quantitative cross-sectional study carried out with individuals affected by schizophrenia, living in the entire continental territory of Portugal, through application of a sociodemographic and clinical questionnaire and the Quality of Life Scale short version (QLS7PT). Parametric and non-parametric tests were performed to evaluate the correlation between variables. RESULTS The sample consisted of 282 participants. The results point to a better quality of life for individuals living in autonomous residences or with their parents, who are employed/students, who have had the disorder for less time and are younger, who have completed the 12th grade of schooling and who are not medicated with first-generation neuroleptics. CONCLUSION The results indicate that some sociodemographic and clinical characteristics influence the quality of life of patients with schizophrenia and should be considered in the patient evaluation and in planning appropriate and effective strategies for their psychosocial rehabilitation.
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66
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Li Y, Hou CL, Ma XR, Zhong BL, Zang Y, Jia FJ, Lin YQ, Lai KYC, Chiu HFK, Ungvari GS, Hall BJ, Cai MY, Ng CH, Xiang YT. Quality of life in Chinese patients with schizophrenia treated in primary care. Psychiatry Res 2017; 254:80-84. [PMID: 28456026 DOI: 10.1016/j.psychres.2017.04.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/26/2017] [Accepted: 04/23/2017] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Yan Li
- The National Clinical Research Center for Mental Disorders, China & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Xin-Rong Ma
- Ningxia Mental Health Center, Ningxia Ning-An Hospital, Ningxia Province, China
| | - Bao-Liang Zhong
- The Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Yu Zang
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Kelly Y C Lai
- Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao SAR, China; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mei-Ying Cai
- Guangzhou Yuexiu Center for Disease Control and Prevention, Guangdong Province, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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Grigoriadis DE, Smith E, Hoare SRJ, Madan A, Bozigian H. Pharmacologic Characterization of Valbenazine (NBI-98854) and Its Metabolites. J Pharmacol Exp Ther 2017; 361:454-461. [DOI: 10.1124/jpet.116.239160] [Citation(s) in RCA: 213] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 04/10/2017] [Indexed: 11/22/2022] Open
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Vrbova K, Prasko J, Ociskova M, Kamaradova D, Marackova M, Holubova M, Grambal A, Slepecky M, Latalova K. Quality of life, self-stigma, and hope in schizophrenia spectrum disorders: a cross-sectional study. Neuropsychiatr Dis Treat 2017; 13:567-576. [PMID: 28260904 PMCID: PMC5328600 DOI: 10.2147/ndt.s122483] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
GOALS The aim of this study was to explore the quality of life, self-stigma, personality traits, and hope in patients with schizophrenia spectrum disorders. PATIENTS AND METHODS A total of 52 outpatients participated in this cross-sectional study. The attending psychiatrist assessed each patient with Mini International Neuropsychiatric Interview (MINI). The patients then completed Quality of Life Satisfaction and Enjoyment Questionnaire (Q-LES-Q), Internalized Stigma of Mental Illness (ISMI) Scale, Temperament and Character Inventory - Revised (TCI-R), Adult Dispositional Hope Scale (ADHS), Drug Attitude Inventory 10 (DAI-10), and Liebowitz Social Anxiety Scale (LSAS)-Self-report. The psychiatrist evaluated Clinical Global Impression Severity - the objective version (objCGI-S), and the patients completed the Clinical Global Impression Severity - the subjective version (subjCGI-S). Each participant also completed Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI). RESULTS The quality of life was significantly higher in employed patients and individuals with higher hope, self-directedness (SD), and persistence (PS). The quality of life was lower among patients with higher number of psychiatric hospitalizations, those with higher severity of the disorder, and individuals who were taking higher doses of antipsychotics. Patients with more pronounced symptoms of depression, anxiety, and social anxiety had a lower quality of life. Finally, the quality of life was lower among individuals with higher harm avoidance (HA) and self-stigmatization (ISMI). Backward stepwise regression was applied to identify the most significant factors connected to self-stigma. The regression analysis showed that occupation, level of depression (BDI-II), attitude to using medication (DAI-10), social anxiety (LSAS), and antipsychotic index were the most relevant factors associated with lower quality of life. CONCLUSION Detection of the quality of life in the context of personality traits, hope, self-stigma, and demographic and clinical factors may be an important part of the assessment of the patient with schizophrenia.
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Affiliation(s)
- Kristyna Vrbova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc
| | - Dana Kamaradova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc
| | - Marketa Marackova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc
| | - Michaela Holubova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc; Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic
| | - Ales Grambal
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc
| | - Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovakia
| | - Klara Latalova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital Olomouc, Olomouc
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Monitoring of extrapyramidal side effects in patients on antipsychotic treatment: a completed audit cycle. Ir J Psychol Med 2016; 33:165-169. [PMID: 30115186 DOI: 10.1017/ipm.2015.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Movement disorders are a common problem in those receiving antipsychotic medication. Clinical guidelines recommend that these side-effects are monitored regularly throughout treatment. However, due to a lack of training, clinician confidence levels in assessment are often low and regular monitoring may be neglected. Aims To audit current practice in our services regarding monitoring of extrapyramidal side effects (EPSE) and improve monitoring through education of clinicians. METHOD The clinical records of patients receiving antipsychotic treatment, seen in the outpatient clinic over a 2-week period, were reviewed. Data were collected on whether or not EPSE had been assessed. A re-audit was undertaken following a teaching session. RESULTS Documentation regarding EPSE was present in only 14% of patient records. Following a teaching session, the overall level of documentation of EPSE rose to 42%, with rates of assessment dramatically improving in non-consultant hospital doctors. CONCLUSION In our practice, clinicians are generally poor to assess and record EPSE. However, rates of assessment improved significantly following a teaching session, especially in NCHDs.
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Alptekin K, Akdede BB, Akvardar Y, Celikgün S, Dilşen NS, Durak G, Türk A, Fidaner H. Quality of Life Assessment in Turkish Patients with Schizophrenia and Their Relatives. Psychol Rep 2016; 95:197-206. [PMID: 15460376 DOI: 10.2466/pr0.95.1.197-206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Quality of life of first-degree relatives living in the same household with patients having schizophrenia has not been sufficiently explored. 30 patients with schizophrenia (16 women, 14 men), diagnosed using DSM–IV criteria, 31 of their relatives (15 women, 16 men), and 34 control subjects (21 women, 13 men) were included in the study. The mean age of the patients, their relatives, and the control subjects were 39.8 ± 10.9, 58.1 ± 12.5 and 37.3 ± 17.0, respectively. The World Health Organization Quality of Life–Brief Form was administered to all subjects. Quality of life was worse for the patient group than for their relatives and control subjects, but relatives of the patients and control subjects were not significantly different on Quality of life. Quality of life was negatively correlated with the severity of psychopathology and extrapyramidal side effects induced by antipsychotic drugs in the patients.
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Affiliation(s)
- Köksal Alptekin
- Department of Psychiatry, Adnan Menderes University Medical School, Aydin, Turkey.
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Tomotake M, Kaneda Y, Iga JI, Kinouchi S, Tayoshi S, Motoki I, Sumitani S, Yamauchi K, Taniguchi T, Ishimoto Y, Ueno SI, Ohmori T. Subjective and Objective Measures of Quality of Life Have Different Predictors for People with Schizophrenia. Psychol Rep 2016; 99:477-87. [PMID: 17153817 DOI: 10.2466/pr0.99.2.477-487] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the relationship between subjective and objective quality of life and assessed predictors in people with schizophrenia. The study population consisted of 99 stabilized outpatients with schizophrenia (DSM-IV) who had been regularly receiving outpatient treatment at the Department of Psychiatry, The Tokushima University Hospital. Subjective and objective quality of life were estimated using the Schizophrenia Quality of Life Scale and the Quality of Life Scale, respectively. Psychiatric symptoms were also measured with the Brief Psychiatric Rating Scale and the Calgary Depression Scale for Schizophrenia. Scores on the Schizophrenia Quality of Life Scale Motivation and Energy scales significantly correlated with the Quality of Life Scale total scores –.40 ( p <.001), and with the scores on Interpersonal Relations subscale –.42 ( p <.001), Instrumental Role subscale –.28 ( p = .005), Intrapsychic Foundations subscale –.39 ( p <.001), and Common Objects and Activities subscale –.25 ( p = .014). The Schizophrenia Quality of Life Scale Psychosocial scale significantly correlated with only the Quality of Life Scale total score –.20 ( p = .05), and there was no significant correlation between the scores on the Schizophrenia Quality of Life Scale Symptoms and Side-effects scales and the Quality of Life Scale. Stepwise regression analyses showed that the Calgary Depression Scale for Schizophrenia score was the most important predictor of each scale of the Schizophrenia Quality of Life Scale, and the Brief Psychiatric Rating Scale Negative Symptoms score was the most important predictor of the Quality of Life Scale total score and each subscale. These results suggest that subjective and objective quality of life have different predictors and should be considered as separate and complementary outcome variables.
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Affiliation(s)
- Masahito Tomotake
- Department of Psychiatry, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15, Kuramoto-cho, Tokushimashi, Tokushima 770-8503, Japan.
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Abstract
Taking into account findings in the literature, the author aimed to test whether specific graphical characteristics of handwriting can distinguish patients diagnosed with schizophrenic disorders from healthy controls. Handwriting samples (one sample from each person) from 60 outpatients (29 women, 31 men; age M = 28.5, SD = 5.4) with paranoid schizophrenia were analyzed by three documents examiners and were compared to samples from 60 controls (30 men, 30 women, age M = 28.0, SD = 3.0) without psychiatric disorders. Document examiners assessed 32 graphical features potentially related to schizophrenia. The comparisons between groups revealed that only 7 out of 32 handwriting properties were significantly different in the handwriting of schizophrenic outpatients from controls: the calligraphic forms of letters, loops in ovals, lacking of dots, tremor, sinusoidal baseline, and irregularities size of lower zone. These findings are discussed in terms of motor disturbances in schizophrenia and in relation to the previous research on handwriting of other mental disorders. Similarities between the graphical patterns of handwriting of schizophrenic patients and those of other mental disorders and/or other mental states have been demonstrated.
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Affiliation(s)
- Barbara Gawda
- Department of Psychology, Maria Curie-Sklodowska University, Lublin, Poland
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Holubova M, Prasko J, Latalova K, Ociskova M, Grambal A, Kamaradova D, Vrbova K, Hruby R. Are self-stigma, quality of life, and clinical data interrelated in schizophrenia spectrum patients? A cross-sectional outpatient study. Patient Prefer Adherence 2016; 10:265-74. [PMID: 27019596 PMCID: PMC4786060 DOI: 10.2147/ppa.s96201] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Current research attention has been moving toward the needs of patients and their consequences for the quality of life (QoL). Self-stigma is a maladaptive psychosocial phenomenon disturbing the QoL in a substantial number of psychiatric patients. In our study, we examined the relationship between demographic data, the severity of symptoms, self-stigma, and QoL in patients with schizophrenia spectrum disorder. METHODS Probands who met International Classification of Diseases-10 criteria for schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder, or delusional disorder) were recruited in the study. We studied the correlations between the QoL measured by the QoL Satisfaction and Enjoyment Questionnaire, self-stigma assessed by the Internalized Stigma of Mental Illness, and severity of the disorder measured by the objective and subjective Clinical Global Impression severity scales in this cross-sectional study. RESULTS A total of 109 psychotic patients and 91 healthy controls participated in the study. Compared with the control group, there was a lower QoL and a higher score of self-stigmatization in psychotic patients. We found the correlation between an overall rating of self-stigmatization, duration of disorder, and QoL. The level of self-stigmatization correlated positively with total symptom severity score and negatively with the QoL. Multiple regression analysis revealed that the overall rating of objective symptom severity and the score of self-stigma were significantly associated with the QoL. CONCLUSION Our study suggests a negative impact of self-stigma level on the QoL in patients suffering from schizophrenia spectrum disorders.
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Affiliation(s)
- Michaela Holubova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
- Correspondence: Michaela Holubova, Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, IP Pavlova 6, 77520 Olomouc, Czech Republic, Email
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Klara Latalova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Aleš Grambal
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Dana Kamaradova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Kristyna Vrbova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Radovan Hruby
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
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Uwatoko T, Yoshizumi M, Miyata J, Ubukata S, Fujiwara H, Kawada R, Kubota M, Sasamoto A, Sugihara G, Aso T, Urayama S, Fukuyama H, Murai T, Takahashi H. Insular Gray Matter Volume and Objective Quality of Life in Schizophrenia. PLoS One 2015; 10:e0142018. [PMID: 26544607 PMCID: PMC4636237 DOI: 10.1371/journal.pone.0142018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/15/2015] [Indexed: 12/21/2022] Open
Abstract
Improving quality of life has been recognized as an important outcome for schizophrenia treatment, although the fundamental determinants are not well understood. In this study, we investigated the association between brain structural abnormalities and objective quality of life in schizophrenia patients. Thirty-three schizophrenia patients and 42 age-, sex-, and education-matched healthy participants underwent magnetic resonance imaging. The Quality of Life Scale was used to measure objective quality of life in schizophrenia patients. Voxel-based morphometry was performed to identify regional brain alterations that correlate with Quality of Life Scale score in the patient group. Schizophrenia patients showed gray matter reductions in the frontal, temporal, limbic, and subcortical regions. We then performed voxel-based multiple regression analysis in these regions to identify any correlations between regional gray matter volume and Quality of Life Scale scores. We found that among four subcategories of the scale, the Instrumental Role category score correlated with gray matter volume in the right anterior insula in schizophrenia patients. In addition, this correlation was shown to be mediated by negative symptoms. Our findings suggest that the neural basis of objective quality of life might differ topographically from that of subjective QOL in schizophrenia.
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Affiliation(s)
- Teruhisa Uwatoko
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Kyoto University Health Service, Kyoto, Japan
| | - Miho Yoshizumi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shiho Ubukata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hironobu Fujiwara
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Kyoto University Hospital Integrated Clinical Education Center, Kyoto, Japan
| | - Ryosaku Kawada
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Manabu Kubota
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
| | - Akihiko Sasamoto
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Genichi Sugihara
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshihiko Aso
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichi Urayama
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidenao Fukuyama
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Pu S, Nakagome K, Itakura M, Yamanashi T, Sugie T, Miura A, Satake T, Iwata M, Nagata I, Kaneko K. Self-reported social functioning and prefrontal hemodynamic responses during a cognitive task in schizophrenia. Psychiatry Res 2015; 234:121-9. [PMID: 26382107 DOI: 10.1016/j.pscychresns.2015.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 08/10/2015] [Accepted: 09/02/2015] [Indexed: 10/23/2022]
Abstract
Impaired social functioning is a characteristic of schizophrenia that affects patients' quality of life. The aim of the study was to assess prefrontal hemodynamic responses during a cognitive task and establish its influence on psychiatric symptoms, cognitive function, global functioning, and self-reported social functioning in patients with schizophrenia. Thirty-three patients with schizophrenia and 30 age-and sex-matched healthy controls participated in the study. We measured hemodynamic responses in the prefrontal and superior temporal cortical surface areas with 52-channel near-infrared spectroscopy (NIRS) during a verbal fluency task (VFT). Self-reported social functioning was assessed using the Social Functioning Scale (SFS). Regional hemodynamic responses were significantly smaller in the prefrontal and temporal regions in subjects with schizophrenia than in the controls, and prefrontal hemodynamic responses during the VFT showed a strong correlation with SFS total scores. These results suggest an association between self-reported social functioning and prefrontal activation in subjects with schizophrenia. The present study provides evidence that NIRS imaging could be helpful in understanding the neural basis of social functioning.
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Affiliation(s)
- Shenghong Pu
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan.
| | - Kazuyuki Nakagome
- National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Masashi Itakura
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Takehiko Yamanashi
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Takuya Sugie
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Akehiko Miura
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Takahiro Satake
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Masaaki Iwata
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Izumi Nagata
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Koichi Kaneko
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
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Li G, Ren J, Wang G, Gu G, Ren H, Chen J, Wu Q, Wu X, Anjum N, Guo K, Li R, Li Y, Liu S, Hong Z, Li J. Impact of Crohn's Disease on Marital Quality of Life: A Preliminary Cross-Sectional Study. J Crohns Colitis 2015; 9:873-80. [PMID: 26142464 DOI: 10.1093/ecco-jcc/jjv121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 06/30/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Quality of marriage exerts a great effect on quality of life [QOL] and health outcomes. Few data are available on the effects of Crohn's disease [CD] on quality of marriage. We aimed to clarify whether and how CD affected the marital relationship. METHODS Web-based questionnaires were created including an ENRICH marital inventory, a general QOL survey [SF12], a short Inflammatory Bowel Disease Questionnaire [SIBDQ] and a modified Harvey-Bradshaw Index [HBI]. Married patients were enrolled through the outpatient registration system and diverse social media websites. Controls were subsequently enrolled and matched with the ratio of 1:1 through invitation emails and internet advertising. RESULTS A total of 243 patients completed valid questionnaires and then 243 matched individuals were enrolled. Male patients were more affected, representing a significantly reduced total marital score. CD impaired the dimensions of idealistic distortion and marital satisfaction in both genders. There were correlations between quality of marriage, SF12, SIBDQ and HBI. Mental scale of SF12 correlated best with the marital relationship, indicating more significant involvement of mental adjustment. Multiple linear regression demonstrated that spouse's educational background, duration of marriage from disease onset, enteral nutrition, hospitalisation in past 12 months, and number of previous hospitalisations, independently impacted on quality of marriage. CONCLUSIONS Certain aspects of the marital relationship were impaired in CD patients, especially in male subjects. In addition to medication, mental interventions should be given attention to improve the marriage of CD patients. Despite some novel findings in this study, this research orientation deserves more attention.
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Affiliation(s)
- Guanwei Li
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Jianan Ren
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Gefei Wang
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Guosheng Gu
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Huajian Ren
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Jun Chen
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Qin Wu
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Xiuwen Wu
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Nadeem Anjum
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Kun Guo
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Ranran Li
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Yuan Li
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Song Liu
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Zhiwu Hong
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
| | - Jieshou Li
- Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, P.R. China
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77
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Farag AM, Mier RW, Correa LP. Utilizing the concept of geste antagoniste for conservative management of oro-mandibular tardive dyskinesia: a case report and mini-review. Cranio 2015; 34:338-42. [PMID: 26293144 DOI: 10.1179/2151090315y.0000000022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This case report highlights the implication of the concept of "geste antagoniste" in conservatively managing oromotor dysfunction and its complications. CLINICAL PRESENTATION A 66-year-old female with a 1-year history of tardive dyskinesia (TD) was referred to the Craniofacial Pain Department (CPC) at Tufts University School of Dental Medicine for management of sore labial/lingual mucosa secondary to excessive daytime involuntary activity of the tongue, lips, and mandible. A detailed head/neck examination revealed excessive involuntary movements of the tongue, lips, and mandible with generalized tenderness of her masticatory muscles. No TMJ or bone pathology was evident in a panoramic radiograph. INTERVENTION A lower daytime appliance with bilateral posterior contacts was fabricated to protect her oral mucosa. On reevaluation, excessive movement of the jaw/tongue was significantly reduced with the presence of the appliance in her mouth. Face/neck muscle tenderness was also greatly reduced. CONCLUSION The use of oral appliance therapy in TD patients plays an important role in protecting the teeth/oral mucosa. The subsequent inhibition of excessive motor activity is proposed and should be further investigated.
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Affiliation(s)
- Arwa M Farag
- a Department of Maxillofacial Pathology, Oral Medicine and Orofacial Pain , Tufts University School of Dental Medicine , Boston , MA , USA.,b Department of Oral Medicine, Faculty of Dentistry , King AbdulAziz University , Saudi Arabia
| | - Robert W Mier
- a Department of Maxillofacial Pathology, Oral Medicine and Orofacial Pain , Tufts University School of Dental Medicine , Boston , MA , USA
| | - Leopoldo P Correa
- a Department of Maxillofacial Pathology, Oral Medicine and Orofacial Pain , Tufts University School of Dental Medicine , Boston , MA , USA
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Abstract
BACKGROUND An increasing number of studies identifies the duration of illness (DI) as an important predictor of outcome in patients affected by major psychoses (MP). The aim of the present paper was to revise medical literature about DI and its effects on MP, focusing in particular on the relationship between DI and outcome with particular reference to treatment response, suicidal risk, cognitive impairment and social functioning. METHODS A search in the main database sources has been performed to obtain a comprehensive overview. Studies with different methodologies (open and double-blinded) have been included, while papers considering other variables such as duration of untreated episode/illness were excluded. MP included the diagnoses of schizophrenia, bipolar disorder and major depressive disorder. RESULTS Available data show that DI influences treatment response, suicidal risk and loss of social functioning in schizophrenic patients, while results are more controversial with regard to cognitive impairment. In bipolar disorder, a long DI has been associated with less treatment response, more suicidal risk and cognitive impairment, but more data are needed to draw definitive conclusions. Finally, studies, regarding DI of illness and its predictive value of outcome in major depressive disorder show contradictory results. CONCLUSIONS DI appears a negative outcome factor particularly for schizophrenia, while with regard to mood disorders, more data are needed to draw definitive sound conclusions.
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Affiliation(s)
- Alfredo Carlo Altamura
- Alfredo C Altamura, Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico , Via F. Sforza 35, 20122, Milan , Italy
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79
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Domínguez-Martínez T, Kwapil TR, Barrantes-Vidal N. Subjective quality of life in At-Risk Mental State for psychosis patients: relationship with symptom severity and functional impairment. Early Interv Psychiatry 2015; 9:292-9. [PMID: 24354647 DOI: 10.1111/eip.12111] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 10/25/2013] [Indexed: 11/30/2022]
Abstract
AIMS The understanding of factors related to poor subjective quality of life (sQoL) in early psychosis patients is important for both research and treatment efforts. This study examined how sQoL is associated with age at onset of prodromal symptoms, duration of untreated illness (DUI), symptom severity, premorbid functioning and current functional impairment in At-Risk Mental State (ARMS) for psychosis patients. METHODS Forty ARMS patients were assessed for sQoL, symptom severity, premorbid functioning, and social and role functioning. RESULTS As expected, a large number of significant and negative correlations between sQoL domains and several symptom dimensions emerged, especially for negative symptoms, behavioural change and depression. Poor premorbid functioning in late adolescence was associated with impairments in the psychological health and social relationship domains of sQoL. Current functional impairment was associated with all sQoL domains. Neither age at onset of prodromal symptoms nor DUI was related with sQoL. CONCLUSIONS Findings indicate that different domains of sQoL are differentially and meaningfully associated with symptom severity and functional impairment, suggesting that greater symptom severity and poor functioning are already related with decreased sQoL in the ARMS for psychosis stage. Furthermore, findings highlight the importance of examining functional impairment and affective-motivational symptoms in future research on sQoL in ARMS populations due to their strong relationship with poor sQoL. Finally, findings underscore the importance of addressing the social and occupational dysfunctions already present in early psychosis with psychosocial interventions.
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Affiliation(s)
| | - Thomas R Kwapil
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.,Departament de Salut Mental, Sant Pere Claver- Fundació Sanitària, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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80
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Lerner PP, Miodownik C, Lerner V. Tardive dyskinesia (syndrome): Current concept and modern approaches to its management. Psychiatry Clin Neurosci 2015; 69:321-34. [PMID: 25556809 DOI: 10.1111/pcn.12270] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 11/15/2014] [Accepted: 12/22/2014] [Indexed: 12/31/2022]
Abstract
Tardive dyskinesia is a serious, disabling and potentially permanent, neurological hyperkinetic movement disorder that occurs after months or years of taking psychotropic drugs. The pathophysiology of tardive dyskinesia is complex, multifactorial and still not fully understood. A number of drugs were tried for the management of this motor disturbance, yet until now no effective and standard treatment has been found. It is very disappointing to realize that the introduction of antipsychotics from the second generation has not significantly decreased the prevalence and incidence of tardive dyskinesia. Therefore, the management of this motor disturbance remains an actual topic as well as a challenge for clinicians. This review summarizes recent relevant publications concerning the treatment of tardive dyskinesia.
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Affiliation(s)
- Paul P Lerner
- Faculty of Medicine, Bar-Ilan University, Tsfat, Israel
| | - Chanoch Miodownik
- Be'er-Sheva Mental Health Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Vladimir Lerner
- Be'er-Sheva Mental Health Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
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81
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Lasebikan VO, Owoaje ET. Quality of life in psychosis: prevalence and associated factors in a Nigerian clinical population. Community Ment Health J 2015; 51:491-6. [PMID: 25701078 DOI: 10.1007/s10597-015-9842-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 02/06/2015] [Indexed: 11/25/2022]
Abstract
Aim of the study was to assess sociodemographic and clinical determinants of quality of life in psychotic patients in a general hospital population in Nigeria. Information was obtained on demography, duration of untreated illness (DUI) and functioning among Schizophrenia (368), schizoaffective disorder (70), and 214 patients with affective psychosis. Functioning was assessed using GAF, severity of psychopathology with PANSS and quality of life using WHOQoL-BREF. In general, the differences in the QoL across the three psychotic disorders were small. Linear regression analysis, showed that high GAF p < 0.001, medication adherence, p = 0.007 were associated with good QoL in schizophrenia, low PANSS p < 0.001 and short DUI p = 0.001 in schizoaffective disorder and low PANSS, high GAF p < 0.001 respectively in affective psychosis. QoL and its determinants in psychosis are not absolutely different. More research is required in this area.
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Affiliation(s)
- V O Lasebikan
- Department of Psychiatry, College of Medicine, University of Ibadan, PMB 5116, Ibadan, Nigeria,
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82
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Abstract
BACKGROUND Tardive dyskinesia is a chronic and disabling abnormal movement disorder affecting the muscles of the face, neck, tongue and the limbs. It is a common side effect of long-term antipsychotic medication use in individuals with schizophrenia and other related psychotic disorders. While there are no known effective treatments for tardive dyskinesia to date, some reports suggest that pyridoxal 5 phosphate may be effective in reducing the severity of tardive dyskinesia symptoms. OBJECTIVES To determine the effectiveness of pyridoxal 5 phosphate (vitamin B6 or Pyridoxine or Pyridoxal phosphate) in the treatment of neuroleptic-induced tardive dyskinesia among people with schizophrenia and other related psychotic disorders. SEARCH METHODS The Cochrane schizophrenia group's register of clinical trials was searched (January 2013) using the phrase: [*Pyridoxal* OR *Pyridoxine* OR *P5P* OR *PLP* OR *tardoxal* OR *Vitamin B6* O *Vitamin B 6* R in title, abstract or index terms of REFERENCE, or interventions of STUDY. References of relevant identified studies were handsearched and where necessary, the first authors of relevant studies were contacted. SELECTION CRITERIA Studies described as randomised controlled trials comparing the effectiveness pyridoxal 5 phosphate with placebo in the treatment of neuroleptic-induced tardive dyskinesia among patients with schizophrenia. DATA COLLECTION AND ANALYSIS The review authors independently extracted data from each selected study. For dichotomous data, we calculated risk ratios (RR) and their 95% confidence intervals (CIs) on an intention-to-treat basis based on a fixed-effect model. For continuous data, we calculated mean differences (MD) with 95% CIs, again based on a fixed-effect model. We assessed risk of bias for each included study and used GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to rate quality of evidence. MAIN RESULTS Of the 12 records retrieved by the search, three trials published in 2001, 2003 and 2007, involving 80 inpatients with schizophrenia, aged 18 to 71 years, admitted in a psychiatric facility and followed up for a period nine weeks to 26 weeks, were included. Overall, pyridoxal 5 phosphate produced a significant improvement in tardive dyskinesia symptoms when compared with placebo, assessed by a change in Extrapyramidal Symptoms Rating Scale (ESRS) scores from baseline to the end of the first phase of the included studies (2 RCTs n = 65, RR 19.97, CI 2.87 to 139.19, low quality evidence). The endpoint tardive dyskinesia score (a measure of its severity) assessed with the ESRS, was significantly lower among participants on pyridoxal 5 phosphate compared to those on placebo (2 RCTs n = 60, MD -4.07, CI -6.36 to -1.79, low quality evidence).It was unclear whether pyridoxal 5 phosphate led to more side effects (n = 65, 2 RCTs, RR 3.97, CI 0.20 to 78.59, low quality evidence) or caused deterioration in tardive dyskinesia symptoms when compared to placebo (n = 65, 2 RCTs, RR 0.16, CI 0.01 to 3.14, low quality evidence). Five participants taking pyridoxal 5 phosphate withdrew from the study because they were not willing to take more medications while none of the participants taking placebo discontinued their medications (n = 65, 2 RCTs, RR 8.72, CI 0.51 to 149.75, low quality evidence).There was no significant difference in the endpoint positive and negative psychiatric symptoms scores, measured using the Positive and Negative symptoms Scale (PANSS) between participants taking pyridoxal 5 phosphate and those taking placebo. For the positive symptoms: (n = 15, 1 RCT, MD -1.50, CI -4.80 to 1.80, low quality evidence). For negative the symptoms: (n = 15, 1 RCT, MD -1.10, CI -5.92 to 3.72, low quality evidence). AUTHORS' CONCLUSIONS Pyridoxal 5 phosphate may have some benefits in reducing the severity of tardive dyskinesia symptoms among individuals with schizophrenia. However, the quality of evidence supporting the effectiveness of pyridoxal 5 phosphate in treating tardive dyskinesia is low, based on few studies, short follow-up periods, small sample sizes and inadequate adherence to standardised reporting guidelines for randomised controlled trials among the included studies.
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Affiliation(s)
| | - Olukayode Abayomi
- Ladoke Akintola University Teaching HospitalPsychiatryP.M.B 4007OgbomosoOyoNigeria210214
| | - Tunde Massey‐Ferguson Ojo
- Neuropsychiatric HospitalClinicial Sciences (Resident Doctors Office)PMB 2002ARO, Abeokuta,Ogun StateNigeria234
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83
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Mihanović M, Restek-Petrović B, Bogović A, Ivezić E, Bodor D, Požgain I. Quality of life of patients with schizophrenia treated in foster home care and in outpatient treatment. Neuropsychiatr Dis Treat 2015; 11:585-95. [PMID: 25784813 PMCID: PMC4356698 DOI: 10.2147/ndt.s73582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Sveti Ivan Psychiatric Hospital in Zagreb, Croatia, offers foster home care treatment that includes pharmacotherapy, group psychodynamic psychotherapy, family therapy, and work and occupational therapy. The aim of this study is to compare the health-related quality of life of patients with schizophrenia treated in foster home care with that of patients in standard outpatient treatment. METHODS The sample consisted of 44 patients with schizophrenia who, upon discharge from the hospital, were included in foster home care treatment and a comparative group of 50 patients who returned to their families and continued receiving outpatient treatment. All patients completed the Short Form 36 Health Survey Questionnaire on the day they completed hospital treatment, 6 months later, and 1 year after they participated in the study. The research also included data on the number of hospitalizations for both groups of patients. RESULTS Though directly upon discharge from the hospital, patients who entered foster home care treatment assessed their health-related quality of life as poorer than patients who returned to their families, their assessments significantly improved over time. After 6 months of treatment, these patients even achieved better results in several dimensions than did patients in the outpatient program, and they also had fewer hospitalizations. These effects remained the same at the follow-up 1 year after the inclusion in the study. CONCLUSION Notwithstanding the limitations of this study, it can be concluded that treatment in foster home care is associated with an improvement in the quality of life of patients with schizophrenia, but the same was not observed for the patients in standard outpatient treatment. We hope that these findings will contribute to an improved understanding of the influence of psychosocial factors on the functioning of patients and the development of more effective therapeutic methods aimed at improving the patients' quality of life.
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Affiliation(s)
- Mate Mihanović
- Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Branka Restek-Petrović
- Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | | | - Ena Ivezić
- Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
| | - Davor Bodor
- Psychiatric Hospital “Sveti Ivan”, Zagreb, Croatia
| | - Ivan Požgain
- Department of Psychiatry, University Hospital Center Osijek, Osijek, Croatia
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Abstract
PURPOSE The study reported here aimed to evaluate both biological and psychosocial factors as predictors for quality of life as well as to examine the associations between the factors and quality of life in individuals with schizophrenia. METHODS Eighty individuals with schizophrenia were recruited to the study. The Thai version of the World Health Organization Quality of Life-BREF was utilized to measure the quality of life. The five Marder subscales of the Positive and Negative Syndrome Scale were applied. Other tools for measurement included the Calgary Depression Scale for Schizophrenia and six social support deficits (SSDs). Pearson/Spearman correlation coefficients and the independent t-test were used for the statistical analysis to determine the associations of variables and the overall quality of life and the four domain scores. A multiple linear regression analysis of the overall quality of life and four domain scores was applied to determine their predictors. RESULTS The Positive and Negative Syndrome Scale total score, positive symptoms, negative symptoms, disorganized thought, and anxiety/depression showed a significant correlation with the overall quality of life and most of the four domain scores. Depression, SSDs, and adverse drug events showed a significant correlation with a poorer overall quality of life. The multiple linear regression model revealed that negative symptoms, depression, and seeing a relative less often than once per week were predictors for the overall quality of life (adjusted R (2)=0.472). Negative symptoms were also found to be the main factors predicting a decrease in the four domains of quality of life - physical health, psychological, social relationships, and environment. CONCLUSION Negative symptoms, depression, and poor contact with relatives were the foremost predictors of poor quality of life in individuals with schizophrenia. Positive symptoms, negative symptoms, disorganized thought, anxiety/depression, SSDs, and adverse events were also found to be correlated with quality of life.
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Affiliation(s)
- Sirijit Suttajit
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sutrak Pilakanta
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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de Araújo AA, de Araújo Dantas D, do Nascimento GG, Ribeiro SB, Chaves KM, de Lima Silva V, de Araújo RF, de Souza DLB, de Medeiros CACX. Quality of life in patients with schizophrenia: the impact of socio-economic factors and adverse effects of atypical antipsychotics drugs. Psychiatr Q 2014; 85:357-67. [PMID: 24789610 DOI: 10.1007/s11126-014-9290-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This cross-sectional study compared the effects of treatment with atypical antipsychotic drugs on quality of life (QoL) and side effects in 218 patients with schizophrenia attending the ambulatory services of psychiatric in Rio Grande do Norte, Brazil. Socio-economic variables were compared. The five-dimension EuroQoL (EQ-5D) was used to evaluate QoL, and side effects were assessed using the Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale and the Simpson-Angus Scale. Data were analysed using the χ (2) test and Student's t test, with a significance level of 5 %. Average monthly household incomes in the medication groups were 1.1-2.1 minimum wages ($339-$678). UKU Scale scores showed significant differences in side effects, mainly, clozapine, quetiapine and ziprasidone (p < 0.05). EQ-5D scores showed that all drugs except olanzapine significantly impacted mobility (p < 0.05), and proportions of individuals reporting problems in other dimensions were high: 63.6 % of clozapine users reported mobility problems, 63.7 and 56.3 % of clozapine and ziprasidone users, respectively, had difficulties with usual activities, 68.8 and 54.5 % of ziprasidone and clozapine users, respectively, experienced pain and/or discomfort, and 72.8 % of clozapine users reported anxiety and/or depression. Psychiatric, neurological, and autonomous adverse effects, as well as other side effects, were prevalent in users of atypical antipsychotic drugs, especially clozapine and ziprasidone. Olanzapine had the least side effects. QoL was impacted by side effects and economic conditions in all groups. Thus, the effects of these antipsychotic agents appear to have been masked by aggravating social and economic situations.
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Affiliation(s)
- Aurigena Antunes de Araújo
- Department of Biophysical and Pharmacology, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil,
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86
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Abstract
AbstractObjectives:To outline the limitations of traditional studies of outcome in schizophrenia and to review the findings arising from ‘first episode’ psychosis studies.Method:An extensive literature search was performed and relevant papers were examined and analysed.Results:Current knowledge regarding outcome predictors in schizophrenia has primarily been derived from a series of ‘consecutive admission’ and ‘long-term follow-back’ studies. However, methodological considerations may limit the generalisability of these studies' findings. The prospective evaluation of first episode cohorts has advanced our knowledge regarding the relative importance of premorbid and intercurrent factors in determining outcome in schizophrenia.Conclusions:To date, the ‘first episode’ strategy has highlighted some potentially clinically modifiable outcome predictors. These findings may open the way for targeted introduction of measures aimed at preventing poor outcomes in schizophrenia.
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87
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Miura I, Zhang JP, Nitta M, Lencz T, Kane JM, Malhotra AK, Yabe H, Correll CU. BDNF Val66Met polymorphism and antipsychotic-induced tardive dyskinesia occurrence and severity: a meta-analysis. Schizophr Res 2014; 152:365-72. [PMID: 24411528 PMCID: PMC4010225 DOI: 10.1016/j.schres.2013.12.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/13/2013] [Accepted: 12/18/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Tardive dyskinesia (TD) is a serious long-term consequence of antipsychotic treatment. Since brain-derived neurotrophic factor (BDNF) has potent neurotrophic activity, genetic alterations in the BDNF gene may affect antipsychotic-induced TD. METHODS Searching PubMed and Web of Science until 05/31/13, we conducted a systematic review and a meta-analysis of the effects of BDNF Val66Met polymorphism on antipsychotic-induced TD. Pooled odds ratio was calculated to assess the effects of BDNF Val66Met polymorphism on TD occurrence. Additionally, pooled standardized mean differences (Hedges' g) were calculated to assess the effects on Abnormal Involuntary Movement Scale (AIMS) total score. RESULTS Out of 699 potentially eligible hits, 6 studies (N=1740, mean age=46.0±10.4years; males=73.1%; Asians=80.5%, Caucasians=19.5%; schizophrenia=96.2%) were included in this meta-analysis. Pooling data from all studies, no significant associations were found between BDNF Val66Met polymorphism and TD (p=0.82) or AIMS total scores (p=0.11). However, in studies including only Caucasians (n=339), Met allele carriers had significantly higher AIMS total scores (Hedges' g=0.253, 95% confidence interval=0.030 to 0.476, p=0.026) and non-significantly higher TD occurrence (p=0.127). Conversely, there was no association between BDNF and AIMS scores (p=0.57) or TD (p=0.65) in Asians. CONCLUSION Although there was no significant association between BDNF Val66Met polymorphism and TD or AIMS scores across all patients, our results suggest that BDNF Val66Met polymorphism affects severity and, possibly, TD development in Caucasians. Since the number of studies and patients was still small, additional data are needed to confirm genotype-racial interactions. Furthermore, BDNF enhancing treatments for TD may require further study, especially in Caucasians.
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Affiliation(s)
- Itaru Miura
- The Zucker Hillside Hospital, Psychiatry Research, North Shore — Long Island Jewish Health System, Glen Oaks, NY, USA,Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Jian-Ping Zhang
- The Zucker Hillside Hospital, Psychiatry Research, North Shore — Long Island Jewish Health System, Glen Oaks, NY, USA,Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Masahiro Nitta
- The Zucker Hillside Hospital, Psychiatry Research, North Shore — Long Island Jewish Health System, Glen Oaks, NY, USA,Dainippon Sumitomo Pharma Co., Ltd., Tokyo, Japan
| | - Todd Lencz
- The Zucker Hillside Hospital, Psychiatry Research, North Shore — Long Island Jewish Health System, Glen Oaks, NY, USA,Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA,Albert Einstein College of Medicine, Bronx, NY, USA
| | - John M. Kane
- The Zucker Hillside Hospital, Psychiatry Research, North Shore — Long Island Jewish Health System, Glen Oaks, NY, USA,Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA,Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anil K. Malhotra
- The Zucker Hillside Hospital, Psychiatry Research, North Shore — Long Island Jewish Health System, Glen Oaks, NY, USA,Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA,Albert Einstein College of Medicine, Bronx, NY, USA
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Christoph U. Correll
- The Zucker Hillside Hospital, Psychiatry Research, North Shore — Long Island Jewish Health System, Glen Oaks, NY, USA,Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA,Albert Einstein College of Medicine, Bronx, NY, USA,Corresponding author at: Division of Psychiatry Research, The Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY 11004, USA. Tel.: +1 718 470 4812; fax: +1 718 343 1659
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Salokangas RKR, Heinimaa M, From T, Löyttyniemi E, Ilonen T, Luutonen S, Hietala J, Svirskis T, von Reventlow HG, Juckel G, Linszen D, Dingemans P, Birchwood M, Patterson P, Schultze-Lutter F, Ruhrmann S, Klosterkötter J. Short-term functional outcome and premorbid adjustment in clinical high-risk patients. Results of the EPOS project. Eur Psychiatry 2013; 29:371-80. [PMID: 24315804 DOI: 10.1016/j.eurpsy.2013.10.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 09/24/2013] [Accepted: 10/07/2013] [Indexed: 11/16/2022] Open
Abstract
PURPOSE In patients with schizophrenia, premorbid psychosocial adjustment is an important predictor of functional outcome. We studied functional outcome in young clinical high-risk (CHR) patients and how this was predicted by their childhood to adolescence premorbid adjustment. METHODS In all, 245 young help-seeking CHR patients were assessed with the Premorbid Adjustment Scale, the Structured Interview for Prodromal Syndromes (SIPS) and the Schizophrenia Proneness Instrument (SPI-A). The SIPS assesses positive, negative, disorganised, general symptoms, and the Global Assessment of Functioning (GAF), the SPI-A self-experienced basic symptoms; they were carried out at baseline, at 9-month and 18-month follow-up. Transitions to psychosis were identified. In the hierarchical linear model, associations between premorbid adjustment, background data, symptoms, transitions to psychosis and GAF scores were analysed. RESULTS During the 18-month follow-up, GAF scores improved significantly, and the proportion of patients with poor functioning decreased from 74% to 37%. Poor premorbid adjustment, single marital status, poor work status, and symptoms were associated with low baseline GAF scores. Low GAF scores were predicted by poor premorbid adjustment, negative, positive and basic symptoms, and poor baseline work status. The association between premorbid adjustment and follow-up GAF scores remained significant, even when baseline GAF and transition to psychosis were included in the model. CONCLUSION A great majority of help-seeking CHR patients suffer from deficits in their functioning. In CHR patients, premorbid psychosocial adjustment, baseline positive, negative, basic symptoms and poor working/schooling situation predict poor short-term functional outcome. These aspects should be taken into account when acute intervention and long-term rehabilitation for improving outcome in CHR patients are carried out.
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Affiliation(s)
- R K R Salokangas
- Department of Psychiatry, University of Turku, 70, Kunnallissairaalantie, 20700 Turku, Finland; Psychiatric Clinic, Turku University Central Hospital, Turku, Finland; Turku Psychiatric Clinic, Turku Mental Health Centre, Turku, Finland.
| | - M Heinimaa
- Department of Psychiatry, University of Turku, 70, Kunnallissairaalantie, 20700 Turku, Finland
| | - T From
- Department of Psychiatry, University of Turku, 70, Kunnallissairaalantie, 20700 Turku, Finland
| | - E Löyttyniemi
- Department of Biostatistics, University of Turku, Turku, Finland
| | - T Ilonen
- Department of Psychiatry, University of Turku, 70, Kunnallissairaalantie, 20700 Turku, Finland
| | - S Luutonen
- Department of Psychiatry, University of Turku, 70, Kunnallissairaalantie, 20700 Turku, Finland; Psychiatric Clinic, Turku University Central Hospital, Turku, Finland
| | - J Hietala
- Department of Psychiatry, University of Turku, 70, Kunnallissairaalantie, 20700 Turku, Finland; Psychiatric Clinic, Turku University Central Hospital, Turku, Finland; Turku Psychiatric Clinic, Turku Mental Health Centre, Turku, Finland
| | - T Svirskis
- Department of Psychiatry, University of Helsinki, Helsinki, Finland; Peijas Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - H G von Reventlow
- Department of Psychiatry, Ruhr-University Bochum, LWL University Hospital, Bochum, Germany
| | - G Juckel
- Department of Psychiatry, Ruhr-University Bochum, LWL University Hospital, Bochum, Germany
| | - D Linszen
- Department of Psychiatry and Psychology, University of Maastricht, Maastricht, Netherlands
| | | | - M Birchwood
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - P Patterson
- Youthspace - Birmingham & Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
| | - F Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
| | - S Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - J Klosterkötter
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
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Tardive dyskinesia is associated with greater cognitive impairment in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2013; 46:71-7. [PMID: 23827756 DOI: 10.1016/j.pnpbp.2013.06.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 06/21/2013] [Accepted: 06/24/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Schizophrenia is a psychiatric disorder diagnosed by the presence of a number of symptoms with cognitive impairment as a core feature. Long-term antipsychotic treatment is often associated with the emergence of tardive dyskinesia (TD) and the presence of TD is linked to cognitive impairment. This study examined the relationship between TD and cognitive deficits in Chinese patients with schizophrenia. METHODS We recruited 206 chronic patients with TD (n=102) and without TD (n=104) meeting DSM-IV criteria for schizophrenia and 104 control subjects who were matched on age, gender, and education. All the patients completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Positive and Negative Symptom Scale (PANSS), and the Abnormal Involuntary Movement Scale (AIMS). RESULTS The PANSS total score (p=0.01), N subscore (p=0.006), and AIMS total score (p<0.001) were significantly higher in patients with TD compared to patients without TD. Patients with TD scored lower for visuospatial/constructional, attention, and total index scores (all p<0.001) on the RBANS. AIMS orofacial scores were identified as an independent contributor to RBANS total scores and attention index (p<0.05), whereas AIMS limb and truncal scores were an independent determinant to the visuospatial/constructional index of RBANS (p<0.05). CONCLUSION TD was associated with greater cognitive impairment in patients with schizophrenia compared to those without TD. The orofacial and limb-trunk TD specifically appeared to be a risk factor or contributor to the different aspects of cognitive deficits in schizophrenia. The association between schizophrenia and TD may be explained in part by oxidative stress.
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The interaction of polymorphisms of IL10 and DBH was associated with general symptoms of PANSS with TD in Chinese Han schizophrenic patients. PLoS One 2013; 8:e70963. [PMID: 23951054 PMCID: PMC3737228 DOI: 10.1371/journal.pone.0070963] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 06/24/2013] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Tardive dyskinesia (TD) is a human hyperkinetic movement disorder as a result of potentially irreversible long-term chronic first-generation antipsychotic medications. Unfortunately, mechanisms involved in the development of TD have been poorly understood. Previous studies have indicated that some genetic polymorphisms of immune system and dopamine beta-hydroxylase (DBH) genes may be involved in the pathogenesis of TD. Rs1800872 and rs72393728 are located on the promoter of interleukin-10 (IL10) and DBH gene, respectively. The genetic association between the rs1800872 and TD is unclear. Previous studies have indicated that genetic variations of IL 10 and DBH are implicated in the positive and negative symptoms in schizophrenia. However, the interaction of two variations with severity of TD and symptoms of schizophrenic patients with TD has not been reported. The present study investigated whether these variations and their interaction were associated with clinical phenotypes of TD with schizophrenia in a genetically homogeneous northern Chinese Han population. METHODS Rs1800872 and rs72393728 were genotyped in schizophrenic patients with TD (n = 372) and without TD (NTD; n = 412). The Abnormal Involuntary Movement Scale (AIMS) and Positive and Negative Syndrome Scale (PANSS) were applied to assess the severity of TD and psychopathology of schizophrenia, respectively. RESULTS The allele and genotype frequencies of rs1800872 and rs72393728 did not significantly differ between TD and NTD patients (p>0.05). No significant difference was found in the AIMS total score among the genotypes of two loci (p>0.05). Interestingly, the interaction of rs1800872 and rs72393728 showed a significant association with the PANSS general score (p = 0.011), and a trend toward to the PANSS total score (p = 0.055). CONCLUSION These findings suggest that the interaction of rs1800872 and rs72393728 variants may play a role in psychopathology of the general symptoms on PANSS in schizophrenic patients with TD in a northern Chinese Han population.
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91
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Chugh PK, Rehan HS, Unni KES, Sah RK. Predictive value of symptoms for quality of life in first-episode schizophrenia. Nord J Psychiatry 2013; 67:153-8. [PMID: 22587635 DOI: 10.3109/08039488.2012.687768] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Management of the disease symptomatology impacts the long-term functioning and quality of life (QOL) in psychotic patients. AIM The aim of this research was to study the association between psychiatric symptoms (positive, negative and general psychopathology symptoms) and QOL in first-episode schizophrenia patients. METHODS Fifty-five first-episode drug-naïve schizophrenia outpatients were recruited from a tertiary care hospital in New Delhi, India. WHOQOL-Bref (World Health Organization Quality of Life) Scale was used to assess multi-dimensional domains of QOL (physical, psychological, social and environmental health). The patients were evaluated clinically using PANSS and followed up for 6 months. Multivariate analyses were carried out to outline the symptoms which are predictive of QOL in these patients. RESULTS Physical well-being as assessed with WHOQOL-Bref is significantly impacted by the positive, negative and general psychopathology symptoms of the disease. General psychopathology symptoms demonstrated a strong relationship with different facets of QOL. These symptoms are predictive of physical (P=0.025) and psychological health (P=0.026), social relationships (P=0.009) and environmental QOL (P=0.022). CONCLUSIONS The general psychopathology symptoms significantly impact QOL in a diverse manner. Negative symptoms have a greater influence than positive symptoms on subjective QOL. CLINICAL IMPLICATIONS The antipsychotics focus on primary positive and negative disease symptoms. There is a need to develop a holistic approach (target non-psychotic symptoms intensively) in the disease management to prevent further long-term impairment of QOL.
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Affiliation(s)
- Preeta Kaur Chugh
- Lady Hardinge Medical College, Department of Psychiatry of Children, Adolescents and Adults, New Delhi-1, India.
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Tas C, Brown E, Cubukcuoglu Z, Aydemir O, Danaci AE, Brüne M. Towards an integrative approach to understanding quality of life in schizophrenia: the role of neurocognition, social cognition, and psychopathology. Compr Psychiatry 2013; 54:262-8. [PMID: 22998842 DOI: 10.1016/j.comppsych.2012.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 08/02/2012] [Indexed: 12/28/2022] Open
Abstract
UNLABELLED The term "schizophrenia" refers to a debilitating group of disorders that usually results in a severely impaired quality of life (QoL). Symptomatology appears to have a substantial role in determining QoL, although the relationship between QoL and specific psychotic symptoms is still unclear and has demonstrated mixed results. Due to the intrinsic importance of social functioning in QoL, and the mediating effect of social cognition on social functioning, the aim of this study was to try to investigate QoL in schizophrenia, not only in terms of symptomatology, but also in consideration of potential neurocognitive and social cognitive contributing factors. METHODS Twenty-eight clinically stable patients with schizophrenia performed a broad range of neurocognitive and social cognitive assessments, and also participated in a semi-structured interview of QoL, assessing four partially independent subdomains of QoL. A stepwise regression model was used to determine the best predictors of QoL, and additionally a mediator analysis was performed to test for the mediating power of social cognition on QoL. RESULTS Negative symptoms, intelligence, executive functioning and social cognition all had some power in predicting QoL in schizophrenia. Though most interestingly, mental state reasoning was specifically found to be most strongly related with the Intrapsychic Foundation subdomain of QoL, whereas neurocognition and symptom severity were associated with other subdomains of QoL. CONCLUSIONS The association between mental state reasoning and the more "internal" aspects of QoL in schizophrenia may reflect a specific role for social cognition in introspective and subjective judgments of one's own QoL, whereas neurocognition and negative symptomatology may be more predictive of the external or extrinsic aspects of QoL. In conclusion, social cognitive skills appear to play a crucial role in the experience of one's own subjective well-being, which could help to explain previous inconsistencies in the literature investigating QoL in schizophrenia.
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Affiliation(s)
- Cumhur Tas
- International Graduate School of Neuroscience, Ruhr-University Bochum, Germany.
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Sejil I, Oumaya A, Bouguerra C, Mehdi F, Bellaaj R, Gallali S. [Tardive dyskinesia induced by classical antipsychotic drugs: a Tunisian sample of schizophrenics]. Encephale 2012; 39 Suppl 1:S36-41. [PMID: 23219594 DOI: 10.1016/j.encep.2012.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 08/08/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The term tardive dyskinesia (TD) is used to describe abnormal movement, primarily associated with typical antipsychotic drugs, which are used to treat psychotic states such as schizophrenia. TD is characterised by repetitive involuntary purposeless muscle contractions that force parts of the body into abnormal, and sometimes painful, movements or postures. These movements are involuntary and are difficult or impossible to control. TD usually begins with the face, mouth, lips and tongue, and includes grimacing, lip-smacking, tongue movements and rapid blinking. It may also involve the rest of the body and produce involuntary gestures, tics and writhing movements. TD is severe physically and socially disabling. Schizophrenia is thought to be the psychiatric diagnosis the most frequently associated with TD. MATERIALS AND METHODS The purpose of this article is to study the characteristics of TD in a Tunisian sample of 157 schizophrenics. A variety of demographic and clinical information was obtained by a questionnaire. Diagnoses of schizophrenia and TD were determined by using DSM-VI-R criteria. TD was assessed using the Abnormal Involuntary Movements Scale (AIMS). RESULTS The average age in this sample was 37 ± 6 years. The intermediate duration of evolution of the disease was 8 ± 3 years with a medium full number of hospitalizations of 4 ± 3. We found 58% of the paranoid sub-type. The intermediate duration of exposure to classical neuroleptics was 7 ± 3 years. The average of daily neuroleptic amount was 572.9 ± 145.3 equivalent milligrams of chlorpromazine. Extended release antipsychotics were used in 64.3% of cases, with fluphenazine deaconate in 90% and haloperidol deaconate in 10%. Anticholinergics were used by 74.5% of patients, with use of biperidene in 96% of cases. Therapeutic observance was good in 89.2% of patients. The prevalence of TD was an estimated 35%. The average of AIMS score was 17 ± 9, with a minimal score of 3 and a maximal one of 34. The distribution of patients according to severity found a prevalence of 52.7% of subjects with moderate TD, 38.2% with light TD and 9.1% with severe TD. The distribution of patients according to type, according to DSM-IV criteria, found 78.4% of cases with choreiform TD, 17.5% of cases with athetosic TD and 4.1% of cases with rhythmic TD. The intermediate duration of evolution of TD was estimated at 18 ± 6 months with a minimal duration of 3 months and a maximum of 72 months. The distribution of subjects according to duration of evolution of TD found that approximately three quarter of patients presented with TD that had evolved since one duration, lower or equal to one year. The average age of patients at the moment of installation of TD was estimated at 36 ± 6 years with 22 years as a minimal and 46 years as a maximal age. Among them, 81.8% of patients were aged over 30 at the time of the installation of TD. CONCLUSION The majority of patients with schizophrenia in Tunisia are still treated with typical antipsychotic drugs, and that's why the prevalence of TD remains relatively high.
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Affiliation(s)
- I Sejil
- Service de psychiatrie générale, faculté de médecine de Tunis, université Tunis El Manar, hôpital militaire principal d'instruction de Tunis, Le Mont Fleury, 1008 Tunis, Tunisie.
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Guo X, Zhang Z, Zhai J, Fang M, Hu M, Wu R, Liu Z, Zhao J. Effects of antipsychotic medications on quality of life and psychosocial functioning in patients with early-stage schizophrenia: 1-year follow-up naturalistic study. Compr Psychiatry 2012; 53:1006-12. [PMID: 22516246 DOI: 10.1016/j.comppsych.2012.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 02/28/2012] [Accepted: 03/12/2012] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The relative effects of the atypical antipsychotic drugs and conventional agent on quality of life and psychosocial functioning in patients with early-stage schizophrenia is still uncertain because of an insufficient number of studies examining this issue. METHODS In a 12 months open-label, prospective observational, multicenter study, 1029 subjects with schizophrenia or schizophreniform disorder within 5 years of onset were monotherapy with chlorpromazine, sulpiride, clozapine, risperidone, olanzapine, quetiapine or aripiprazole. The health-related quality of life and psychosocial functioning were assessed using Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), the Global Assessment Scale (GAS) and the Activities of Daily Living Scale (ADL), respectively. RESULTS At 12 months, treatment resulted in significant improvements in all 8 domain scores of SF-36, GAS and ADL score (all P-values< .001). However, only olanzapine and quetiapine groups demonstrated greater improvement in the role-psychical score of SF-36 and GAS score than did the chlorpromazine group (all P-values ≤ .002). CONCLUSIONS All antipsychotics may improve quality of life and social function in patients with early-stage schizophrenia, but further studies are needed to determine whether atypical antipsychotics are superior to conventional agents.
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Affiliation(s)
- Xiaofeng Guo
- Institute of Mental Health, the Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan, PR China
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Patra S, Mishra A. Association of psychopathology with quality of life in acute phase of schizophrenia; an experience from east India. Ind Psychiatry J 2012; 21:104-8. [PMID: 24250041 PMCID: PMC3830157 DOI: 10.4103/0972-6748.119595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To find the association of patient characteristic and psychopathology with quality of life in acute phase of schizophrenia. MATERIALS AND METHODS Socio-demographic variables of patient, psychopathology and quality of life were assessed. Spearman's Correlation coefficients were measured using SPSS version 15.0. RESULTS Quality of life of the patients varied in different domains. Male gender, unmarried status and higher educational status predicted a poorer quality of life. The domains of physical and psychological well-being of WHO-QOL were correlated with PANSS general and total scores whereas environmental and social health showed no correlation with PANSS scores. CONCLUSION Domains of subjective quality of life in acute phase of schizophrenia are associated variedly with socio-demographic variables and symptomatology.
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Affiliation(s)
- Suravi Patra
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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96
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Quality of life among Egyptian patients with schizophrenia disorder, impact of psychopathology. MIDDLE EAST CURRENT PSYCHIATRY 2012. [DOI: 10.1097/01.xme.0000415298.98046.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
The aim of this study was to assess Chinese schizophrenia patients' quality of life (QOL) and identify its demographic and clinical correlates. A random sample of 540 community-dwelling schizophrenia patients was interviewed using standardized assessment instruments. The patients' basic sociodemographic and clinical data and QOL were collected. Compared with the general population, patients had significantly lower scores in the physical and psychological QOL domains. Multivariate analyses showed that better social support independently predicted higher QOL in all domains, whereas more severe positive symptoms predicted worse psychological and environmental domains. Overall psychopathology predicted both worse physical and psychological domains; depressive symptoms and being married predicted worse physical and social QOL, respectively. Our results suggest that therapeutic and psychosocial interventions alleviating positive and depressive symptoms and improving poor social support and marriage-related problems in Chinese patients with schizophrenia might be of considerable benefit in improving their QOL.
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98
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Fujimaki K, Morinobu S, Yamashita H, Takahashi T, Yamawaki S. Predictors of quality of life in inpatients with schizophrenia. Psychiatry Res 2012; 197:199-205. [PMID: 22370148 DOI: 10.1016/j.psychres.2011.10.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 10/31/2011] [Indexed: 10/28/2022]
Abstract
Shortening hospital stays has become a key focus in psychiatric care in recent years. However, patients with schizophrenia account for about 60% of inpatients in psychiatry departments in Japan. This study was designed to investigate the relationship between quality of life (QOL) and key indicators for long-term hospital stays among schizophrenia inpatients. A further aim was to elucidate the clinical determinants of QOL among long-stay inpatients. The study sample consisted of 217 inpatients with schizophrenia. Age, duration of illness, duration of hospitalization, years of education, body mass index, neurocognitive function, drug-induced extrapyramidal symptoms, involuntary movements, psychiatric symptoms, and dose equivalents of antipsychotics and anticholinergic agents were used as index factors. Pearson linear correlation and regression analyses were performed to examine the associations between QOL and the above-mentioned factors. Negative symptoms, psychological discomfort, and resistance as rated on the Brief Psychiatric Rating Scale (BPRS) were correlated with all subscale scores of the Japanese version of the Schizophrenia Quality of Life Scale (JSQLS). Stepwise regression showed that negative symptoms, psychological discomfort, and resistance predicted the dysfunction of psycho-social activity score and the dysfunction of motivation and energy score on the JSQLS. This study shows that active treatment for negative symptoms, psychological discomfort, and resistance should be recommended to improve QOL among inpatients with schizophrenia.
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Affiliation(s)
- Koichiro Fujimaki
- Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara, Japan.
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99
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Zouari L, Thabet JB, Elloumi Z, Elleuch M, Zouari N, Maâlej M. [Quality of life in patients with schizophrenia: a study of 100 cases]. Encephale 2012; 38:111-7. [PMID: 22516268 DOI: 10.1016/j.encep.2011.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 11/22/2010] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The aim of the present study was to evaluate the quality of life (QOL) in outpatients with schizophrenia, and to identify factors correlated to an impaired QOL among them. SUBJECTS AND METHODS A transversal study, in the form of an inquiry, was conducted in 100 outpatients, during seven months, in the psychiatric department of the Hedi Chaker teaching hospital in Sfax - Tunisia. We used the "36 item Short-Form Health Survey" (SF-36) to assess the QOL; this has been considered as impaired when the global medium score was inferior to 66.7. For the global assessment of functioning and the global assessment of the interference by existing side effects with the patient's daily performance, we have used respectively the Global Assessment of Functioning scale (GAF) and the Udvalg of Kliniske Undersogelser (UKU) side effect rating scale. The positive and negative symptoms added to the general psychopathology were assessed using the Positive and Negative syndrome scale (PANSS). RESULTS The QOL was impaired in 34% of the cases. The analysis of the scores of the eight dimensions by the scale SF-36 has shown that the most affected dimensions were, in decreasing order: mental health (MH), general health perceptions (GH), vitality (VT), role limitations due to physical health problems (RP) and role limitations due to emotional problems (RE). The standardization revealed that six dimensions were impaired; these were, in decreasing order: mental health (MH), social functioning (SF), role limitations due to emotional problems (RE), role limitations due to physical health problems (RP), general health perceptions (GH) and physical functioning (PF). The standardization has also revealed an impairment of the psychological component, while the physical component has been conserved. After analysis by multiple linear regression, four factors appeared strongly correlated with the impaired QOL: the professional inactivity, the episodic course with interepisode residual symptoms, the presence of side effects moderately influencing the daily performance, and a general psychopathology score for 26 at least. These four factors affected, in decreasing order of importance, social functioning (SF) (related to two factors), general health perceptions (GH) and role limitations due to emotional problems (RE) (each related to one factor). None of the factors appeared to affect the other dimensions: physical functioning (PF), role limitations due to the physical health problems (RP), bodily pain (BP), mental health (MH) and vitality (VT). The bivariate analysis revealed three other factors correlated, to a lesser degree, to the impairment of the QOL: the disorganized sub-type, a score of (GAF) inferior or equal to 30 and the negative type of schizophrenia. CONCLUSION Management of schizophrenic patients should go beyond the remission of the symptoms; it has also to target the improvement in QOL. This needs an action over the factors that affect the QOL, among which residual symptoms and side effects. The atypical antipsychotics would contribute preciously in this way, due to their efficacy on negative symptoms and their better tolerance than the conventional ones.
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Affiliation(s)
- L Zouari
- Service de psychiatrie « C », CHU Hédi Chaker, route El Aïn km 1, Sfax 3029, Tunisie.
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100
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Kao YC, Liu YP, Cheng TH, Chou MK. Subjective quality of life and suicidal behavior among Taiwanese schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol 2012; 47:523-32. [PMID: 21390511 DOI: 10.1007/s00127-011-0361-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 02/21/2011] [Indexed: 12/18/2022]
Abstract
PURPOSE 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. METHODS 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. RESULTS 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. CONCLUSIONS 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 such as depression.
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Affiliation(s)
- Yu-Chen Kao
- Department of Psychiatry, Songshan Armed Forces General Hospital, No. 131, Jiankang RD., Songshan District, Taipei 10581, Taiwan, Republic of China.
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