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Yıldız E, Yıldırım Ö. The mediating role of psychological flexibility in the relationship between psychotic symptom severity and depression in individuals diagnosed with schizophrenia. J Psychiatr Ment Health Nurs 2024; 31:869-882. [PMID: 38469987 DOI: 10.1111/jpm.13040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 01/12/2024] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Psychotic symptoms and depression are common problems in people diagnosed with schizophrenia. Psychological flexibility is a skill that facilitates coping with difficulties. There is limited research on the role of psychological flexibility in the relationship between psychotic symptoms and depression in people diagnosed with schizophrenia. WHAT DOES THE ARTICLE ADD TO EXISTING KNOWLEDGE?: This article investigates the role of psychological flexibility in the link between psychotic symptom severity and depression in people diagnosed with schizophrenia. The article shows that psychological flexibility partially mediates the relationship between psychotic symptom severity and depression. The article suggests that interventions aimed at improving psychological flexibility may be beneficial in reducing depressive symptoms in people diagnosed with schizophrenia. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses should consider psychotic symptom severity and psychological flexibility when assessing and intervening for depressive symptoms in people diagnosed with schizophrenia. Mental health nurses should receive training to improve psychological flexibility and pass this skill on to their patients. Mental health nurses should continue to research the effectiveness and outcomes of interventions aimed at improving psychological flexibility. ABSTRACT INTRODUCTION: Psychological flexibility may help people diagnosed with schizophrenia (PWS) cope with their psychotic symptoms and reduce their depressive symptoms, but the mechanism of this effect is unclear. AIM To investigate whether psychological flexibility mediates the relationship between psychotic symptom severity and depression in PWS. METHOD A cross-sectional study was conducted, in which a total of 111 PWS were assessed with DSM-5 Clinician-Rated Dimensions of Psychosis Symptom Severity, Calgary Depression Scale for Schizophrenia and Acceptance and Action Questionnaire. Data analysis was performed using SPSS 25 and PROCESS macro. RESULTS Significant correlations were found between psychotic symptoms, depression and psychological flexibility. Psychological flexibility partially mediated the relationship between psychotic symptom severity and depression. DISCUSSION Psychological flexibility could weaken the impact of psychotic symptom severity on depression in PWS. Higher psychotic symptoms were associated with lower psychological flexibility and higher depression. IMPLICATIONS FOR PRACTICE Interventions to improve psychological flexibility may prevent depressive symptoms in PWS. Psychiatric nurses can use psychological flexibility as a goal for evaluation and intervention.
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Affiliation(s)
- Erman Yıldız
- Department of Psychiatric Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
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Li Z, Liu X, Xu H, Zhao L, Zhou Y, Wu X, Huang X, Lang X, Wu F, Zhang X. Sex Difference in Comorbid Depression in First-Episode and Drug-Naive Patients With Schizophrenia: Baseline Results From the Depression in Schizophrenia in China Study. Psychosom Med 2021; 83:1082-1088. [PMID: 34419998 DOI: 10.1097/psy.0000000000000998] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Comorbid depression is common in schizophrenia, and sex differences are prominent in many aspects of schizophrenia. However, few studies have investigated sex difference in comorbid depression in schizophrenia. This large sample study aimed to investigate sex differences in first-episode drug-naive (FEDN) patients with schizophrenia comorbid major depressive episode (SZ-MDE). METHODS A total of 996 FEDN patients with schizophrenia (472 males/524 females) were recruited. The 17-item Hamilton Depression Rating Scale and Positive and Negative Syndrome Scale (PANSS) were applied. RESULTS There was no difference in the prevalence of comorbid MDE between male and female patients with schizophrenia. Among SZ-MDE patients, men had more severe psychotic symptoms (scores of PANSS total scale, negative scale, and general psychopathology scale), more severe depressive symptoms, and higher proportion of severe depression than women (all p < .001). The early onset age of schizophrenia, smoking, and PANSS positive score were the risk factors for comorbid MDE only in female patients with schizophrenia (all p < .05). Furthermore, in female patients with SZ-MDE, smoking was associated with the severity category of depression (p = .001, odds ratio = 2.70). Multiple variable regression demonstrated that the Hamilton Depression Rating Scale score correlated with PANSS general psychopathology (p = .01) and total scores (p = .04) in female SZ-MDE. CONCLUSIONS Our results indicate sex differences in proportion of severe depression, clinical symptoms, and factors of comorbid MDE in FEDN patients with schizophrenia. These sex differences have clinical implications for the treatment of depression as related to the nature and severity of psychopathological symptoms in patients with schizophrenia.
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Affiliation(s)
- Zezhi Li
- From the Department of Psychiatry (Li), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou; Qingdao Mental Health Center (Liu, Xu, Zhao), Qingdao University, Qingdao; Shenzhen Kangning Hospital (Zhou), Shenzhen, Guangdong; Department of Neurosurgery (X. Wu), Shanghai Changhai Hospital; Shanghai Mental Health Center (Huang), Shanghai; Department of Psychiatry, The First Clinical Medical College (Lang), Shanxi Medical University, Taiyuan; Department of Psychiatry (F. Wu, Zhang), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou; and Department of Psychology (Zhang), University of Chinese Academy of Sciences, Beijing, China
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Li Z, Xue M, Zhao L, Zhou Y, Wu X, Xie X, Lang X, Zhang X. Comorbid major depression in first-episode drug-naïve patients with schizophrenia: Analysis of the Depression in Schizophrenia in China (DISC) study. J Affect Disord 2021; 294:33-38. [PMID: 34265669 DOI: 10.1016/j.jad.2021.06.075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Depression is very common in patients with schizophrenia, but few studies have investigated the diagnosed major depressive episode (MDE) in first episode and drug naive (FEDN) schizophrenia. To our best knowledge, this is the first large sample study to examine the prevalence, clinical correlates and associated factors of diagnosed MDE in FEDN schizophrenia, as well as the relationship between depressive symptoms and psychopathological symptoms in these schizophrenia patients. METHODS A total of 996 FEDN schizophrenia patients were recruited. The 17-item Hamilton Depression Rating Scale (HAMD17) and Positive and Negative Syndrome Scale (PANSS) were used to assess the severity of depression and psychopathology, respectively. RESULTS Our results demonstrated that MDE coexisted in nearly half (49.30%) of FEDN schizophrenia patients. Male gender, smoking, PANSS general psychopathology and early age of onset were associated with MDE in patients with FEDN schizophrenia (all p<0.05). In schizophrenia patients with MDE, oridinal logistic regression showed that men (OR=6.65, 95%CI: 4.12-10.45, p<0.001) and smoking (OR=1.94, 95%CI: 1.25-3.01, p=0.003) were positively associated with severity category of depression (all p<0.05), while multivariate regression showed that HAMD17 total score was significantly associated with the PANSS general psychopathology (B=0.06, t=2.72, p=0.007) and total scores (B=0.04, t=2.57, p=0.01). CONCLUSION Our study shows that the prevalence of comorbid MDE is high in FEDN schizophrenia patients. Some demographic and clinical variables are associated with the severity of depression in these schizophrenia patients.
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Affiliation(s)
- Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mei Xue
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | - Lei Zhao
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | | | - Xi Wu
- Department of Neurosurgery, Shanghai Changhai Hospital, Shanghai, China
| | - Xiaoxian Xie
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Xiaoe Lang
- Department of Psychiatry, The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Thorup A, Albert N, Bertelsen M, Petersen L, Jeppesen P, Le Quack P, Krarup G, Jørgensen P, Nordentoft M. Gender differences in first-episode psychosis at 5-year follow-up – two different courses of disease? Results from the OPUS study at 5-year follow-up. Eur Psychiatry 2020; 29:44-51. [DOI: 10.1016/j.eurpsy.2012.11.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 11/14/2012] [Accepted: 11/23/2012] [Indexed: 10/27/2022] Open
Abstract
AbstractObjectiveGender differences in psychosis have been investigated, and the results have contributed to a better understanding of the disease, but many questions are unanswered. In clinical terms, women and men with psychosis differ in terms of access to social support, tendency of substance abuse, level of functioning and symptom patterns. We aimed to investigate how gender differences at onset of psychosis develop during the first 5 years of treatment.MethodA total of 578 patients with a first-episode psychosis in the schizophrenia spectrum were included in the Danish OPUS trial – a randomized clinical trial comparing 2 years of intensive early-intervention programme with standard treatment. All patients were assessed with validated instruments at inclusion, and after 2 and 5 years. Data were analysed for significant gender differences.ResultsMales have significantly higher levels of negative symptoms at all times, and are more likely to live alone and suffer from substance abuse. Females reach higher levels of social functioning at follow-up, and show a greater tendency to be employed or in education than males. Markedly more women than men live with children. More women than men reach a state of recovery and are more compliant with medication.ConclusionThere are significant gender differences at 2- and 5-year follow-up in this large cohort of first-episode psychotic patients. Males and females show different symptomatology and different levels of social functioning.
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Dai J, Du X, Yin G, Zhang Y, Xia H, Li X, Cassidy R, Tong Q, Chen D, Teixeira AL, Zheng Y, Ning Y, Soares JC, He MX, Zhang XY. Prevalence, demographic and clinical features of comorbid depressive symptoms in drug naïve patients with schizophrenia presenting with first episode psychosis. Schizophr Res 2018; 193:182-187. [PMID: 28651908 DOI: 10.1016/j.schres.2017.06.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 06/17/2017] [Accepted: 06/18/2017] [Indexed: 01/04/2023]
Abstract
Depressive symptoms are common in first episode schizophrenia. However, the prevalence and its associations of comorbid depressive symptoms with clinical variables are less well characterized in Chinese Han patients with schizophrenia. In this cross-sectional study, we recruited 240 first-episode and drug naïve (FEDN) inpatients with schizophrenia. All patients were rated on the 17-item Hamilton Depression Rating Scale (HAMD-17) to measure depressive symptoms, and also on the Positive and Negative Syndrome Scale (PANSS) for psychopathology. Our results showed that 131 patients had a total score of 8 or more points on HAMD-17, making the prevalence of comorbid depressive symptoms 54.6%. Fewer women (48.1%, 62 of 129) than men (62.2%, 69 of 111) had comorbid depressive symptoms. Compared to those patients without depressive symptoms, those with depressive symptoms showed higher PANSS total, general psychopathology, cognitive factor and negative symptom scores (all p<0.05). Further stepwise multiple logistic regression analysis indicated that the PANSS general psychopathology, the PANSS total score and gender (all p<0.05) remained significantly associated with depressive symptoms. In addition, correlation analysis showed significant correlations between HAMD total score and the following parameters: the PANSS general psychopathology, total score, and cognitive factor (Bonferroni corrected p's<0.05). Our results suggest that depressive symptoms occur with high prevalence in FEND schizophrenia in a Chinese Han population, and show association with general psychopathology, as well as with cognitive impairment.
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Affiliation(s)
- Jing Dai
- The Fourth People's Hospital of Chengdu, Chengdu Mental Health Center, Chengdu, China
| | - Xiangdong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Guangzhong Yin
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Yingyang Zhang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Haishen Xia
- Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Xiaosi Li
- Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Rylan Cassidy
- Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases of McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Qingchun Tong
- Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases of McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dachun Chen
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Antonio Lucio Teixeira
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Yingjun Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Man-Xi He
- The Fourth People's Hospital of Chengdu, Chengdu Mental Health Center, Chengdu, China.
| | - Xiang Yang Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
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Personal resources and depression in schizophrenia: The role of self-esteem, resilience and internalized stigma. Psychiatry Res 2017; 256:359-364. [PMID: 28686933 DOI: 10.1016/j.psychres.2017.06.079] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 05/03/2017] [Accepted: 06/25/2017] [Indexed: 11/22/2022]
Abstract
Depression in schizophrenia represents a challenge from a diagnostic, psychopathological and therapeutic perspective. The objective of this study is to test the hypothesis that resilience and self-stigma affect depression severity and to evaluate the strength of their relations in 921 patients with schizophrenia. A structural equation model was tested where depression is hypothesized as affected by resilience, internalized stigma, gender and negative symptoms, with the latter two variables used as exogenous covariates and the former two as mediators. The analysis reveals that low resilience, high negative symptoms, female gender were directly associated with depression severity, and internalized stigma acted only as a mediator between avolition and resilience, with similar magnitude. The cross-sectional study design and the variable selection limit the generalizability of the study results. The model supports a complex interaction between personal resources and negative symptoms in predicting depression in schizophrenia. The clinical implication of these findings is that personal resources could be a significant target of psychosocial treatments.
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An der Heiden W, Leber A, Häfner H. Negative symptoms and their association with depressive symptoms in the long-term course of schizophrenia. Eur Arch Psychiatry Clin Neurosci 2016; 266:387-96. [PMID: 27107764 DOI: 10.1007/s00406-016-0697-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 04/11/2016] [Indexed: 12/31/2022]
Abstract
Depressive symptoms abound in schizophrenia and even in subclinical states of the disorder. We studied the frequency of these symptoms and their relationship to negative symptoms from the first psychotic episode on over a long-term course of 134 months on data for 107 patients in our ABC Schizophrenia Study. Prevalence rates of 90 % for presenting at least one negative symptom and of 60 % for presenting at least one depressive symptom in the first psychotic episode illustrate the frequency of these syndromes. After the remission of psychosis the rates fell to 50 % (negative symptoms) and 40 % (depressive symptoms) over a period of 5 years, remaining stable thereafter. After we broke the negative syndrome down into (SANS) subsyndromes, a positive association emerged between anhedonia and depressive symptoms and remained stable over the entire period studied. In contrast, the association between abulia and depression grew increasingly pronounced over the illness course. However, a more detailed look revealed this to be the case in female patients only, whereas male patients showed no such association of these symptom dimensions. We have no explanation at hand for this sex difference yet.
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Affiliation(s)
- Wolfram An der Heiden
- Schizophrenia Research Group, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
| | - Anne Leber
- Schizophrenia Research Group, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
| | - Heinz Häfner
- Schizophrenia Research Group, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany.
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Abstract
Women's mental health is closely linked to their status in society. This paper outlines the clinical features of women with schizophrenia and highlights the interpersonal and social ramifications on their lives. There is no significant gender difference in the incidence and prevalence of schizophrenia. There is no clear trend in mortality, although suicides seem to be more in women with schizophrenia. In India, women face a lot of problems, especially in relation to marriage, pregnancy, childbirth, and menopause. Most studies have shown better premorbid functioning, and social adjustment for women compared with men. There is a great need to plan for gender-sensitive mental health services targeting the special needs of these women. Women caregivers also deserve due attention.
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Affiliation(s)
- R. Thara
- Schizophrenia Research Foundation, Chennai, Tamil Nadu, India
| | - Shantha Kamath
- Schizophrenia Research Foundation, Chennai, Tamil Nadu, India
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Gender differences in 353 inpatients with acute psychosis: The experience of one Psychiatric Emergency Service of Turin. Psychiatry Res 2015; 227:192-7. [PMID: 25890692 DOI: 10.1016/j.psychres.2015.03.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 02/07/2015] [Accepted: 03/30/2015] [Indexed: 11/21/2022]
Abstract
The aim of the study is to evaluate gender-related socio-demographic and clinical differences in a large sample of inpatients with schizophrenia spectrum disorder. A sample of 353 acute patients, consecutively hospitalized between January 2007 and December 2008 in the Psychiatric Emergency Service of the San Giovanni Battista Hospital, was recruited. Psychiatric assessment included the Clinical Global Impression Scale-Severity (CGI-S), the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). Differences between the groups were tested using chi-square test and ANOVA. Data were analyzed using a three-way MANOVA with the six BPRS scales with repeated measures for admission/discharge and BPRS total score baseline and independent groups for men and women. A two-way ANOVA for repeated measures was performed for CGI-S and GAF. Men were younger, more likely to be never married, more often substance abusers. Male patients showed both lower anxious-depressive and anergia symptom scores and higher activation symptom scores than female patients. Brief hospitalization was shown to be highly effective in both groups. Females showed a significantly better improvement in anergia and activation than males. The present evidence suggests that management of acute psychosis should target specific gender differences which should influence therapeutic approach in all its modalities.
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Deligiannidis KM, Rothschild AJ, Barton BA, Kroll-Desrosiers AR, Meyers BS, Flint AJ, Whyte EM, Mulsant BH. A gender analysis of the study of pharmacotherapy of psychotic depression (STOP-PD): gender and age as predictors of response and treatment-associated changes in body mass index and metabolic measures. J Clin Psychiatry 2013; 74:1003-9. [PMID: 24229753 PMCID: PMC3966190 DOI: 10.4088/jcp.13m08400] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Gender differences exist in psychiatric disorders; however, gender has not been well studied in psychotic depression. This analysis of the largest clinical trial in psychotic depression examined the effects of age and gender on clinical characteristics and predictors of treatment outcome and treatment-associated changes in body mass index (BMI) and metabolic measures. METHOD Secondary analyses were performed on data from 259 subjects with major depressive disorder with psychotic features (DSM-IV-TR) aged 18-93 years in the double-blind randomized controlled trial of olanzapine plus sertraline versus olanzapine plus placebo for psychotic depression (Study of Pharmacotherapy of Psychotic Depression). Sociodemographic factors, clinical characteristics, treatment outcome, and treatment-associated changes in BMI and metabolic measures were analyzed by gender and age. Subjects were enrolled from December 2002 to June 2007. RESULTS Female gender was associated with divorced (χ(2)(1) = 5.3, P = .03) or widowed (χ(2)(1) = 8.1, P ≤ .01) marital status. Comorbid anxiety disorders were more common in women than in men (χ(2)(1) = 4.9, P = .03). Hallucinations (χ(2)(1) = 7.8, P = .005) and delusions with disorganization (t(257) = -2.10, P = .04) were significantly associated with female gender, as were higher cholesterol measures (χ(2)(1) = 7.15, P = .008). There were no significant interactions between treatment and gender in terms of change in BMI. Gender was not associated with treatment response. DISCUSSION This study is the first analysis of gender and age as predictors of treatment outcome and treatment-associated changes in BMI and metabolic adverse effects in psychotic depression. Gender differences exist in patients with psychotic depression, most notably with regard to the presence of hallucinations. Female gender was associated with metabolic measures. Future studies with larger sample sizes may detect small gender differences in treatment outcome and treatment-associated changes in BMI and metabolic measures in psychotic depression. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT00056472.
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Affiliation(s)
| | - Anthony J. Rothschild
- University of Massachusetts Medical School and University of Massachusetts Memorial Health Care
| | - Bruce A. Barton
- University of Massachusetts Medical School and University of Massachusetts Memorial Health Care
| | | | - Barnett S. Meyers
- Weill Medical College of Cornell University and New York Presbyterian Hospital
| | - Alastair J. Flint
- University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto
| | - Ellen M. Whyte
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Benoit H. Mulsant
- Department of Psychiatry, University of Toronto
- Centre for Addiction and Mental Health, Toronto, Canada
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Suchanek R, Owczarek A, Kowalski J. Association study between BDNF C-281A polymorphism and paranoid schizophrenia in Polish population. J Mol Neurosci 2011; 46:217-22. [PMID: 21710362 DOI: 10.1007/s12031-011-9582-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 06/13/2011] [Indexed: 01/21/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) is one of the candidate genes for schizophrenia. Polymorphism C-281A (rs28383487) in BDNF gene leads to the reduction of promoter activity in the hippocampal neurons in vitro. To our knowledge, this is the first study to examine the influence of alleles and genotypes of BDNF C-281A polymorphism on development, as well as the clinical course (age of onset, suicidal behaviour and psychopathology) of paranoid schizophrenia. The psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) as subscale scores and also single-item scores. We have also performed the haplotype analysis with val66met BDNF polymorphism, which is known to be involved in the pathogenesis of schizophrenia. We have not found significant differences in the distribution of genotypes and alleles between schizophrenic patients and controls in both the overall analysis, as well as sex stratified. Also, we have not shown statistically significant differences between genotype groups and PANSS scale. However, an association between C-281A polymorphism and time of the first episode of paranoid schizophrenia was revealed. Genotype C/A had been connected with later age of onset of paranoid schizophrenia in men but not in women (p < 0.01). The C-281A and val66met polymorphisms have been in a strong linkage disequilibrium (D' = 0.9875; p < 0.05). The haplotype analysis has shown a tendency to a significantly lower frequency of the Met-C haplotype in the schizophrenia group compared to the controls.
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Affiliation(s)
- Renata Suchanek
- Department of Medical Genetics, Medical University of Silesia, Ostrogorska 30 Street, 41-200, Sosnowiec, Poland.
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Lako IM, Taxis K, Bruggeman R, Knegtering H, Burger H, Wiersma D, Slooff CJ. The course of depressive symptoms and prescribing patterns of antidepressants in schizophrenia in a one-year follow-up study. Eur Psychiatry 2011; 27:240-4. [PMID: 21292455 DOI: 10.1016/j.eurpsy.2010.10.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Revised: 10/19/2010] [Accepted: 10/22/2010] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Antidepressants are frequently prescribed in patients with psychotic disorders, but little is known about their effects in routine clinical practice. The objective was to investigate the prescribing patterns of antidepressants in relation to the course of depressive symptoms in patients with psychotic disorders. METHODS A cohort of 214 Dutch patients with psychotic disorders received two assessments of somatic and psychiatric health, including a clinician-rated screening for depressive symptoms, as part of annual routine outcome monitoring. RESULTS Depressive symptoms were prevalent among 43% (93) of the patients. Antidepressants were prescribed for 40% (86) of the patients and the majority 83% (71) continued this therapy after one year. Multivariable analysis showed that patients with more severe psychopathology had a higher risk to develop depressive symptoms the following year (OR [95% CI]=0.953 [0.912-0.995]). For patients with depressive symptoms at baseline, polypharmacy was a potential risk factor to keep having depressive symptoms (OR [95% CI]=1.593 [1.123-2.261]). Antidepressant use was not an independent predictor in both analyses. CONCLUSIONS Routine outcome monitoring in patients with psychotic disorders revealed a high prevalence of depressive symptoms. Antidepressants were frequently prescribed and continued in routine clinical practice.
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Affiliation(s)
- I M Lako
- Rob Giel Research Center (RGOc), Department of Psychiatry (UCP), University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
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Lecardeur L, Mendrek A, Stip E. Sexual dimorphism of spatial working memory profiles in schizophrenia. Cogn Neuropsychiatry 2010; 15:397-405. [PMID: 20094930 DOI: 10.1080/13546800903399183] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The aim of the present study was to compare spatial working memory performance of females and males schizophrenia patients to verify whether the sexual dimorphism of spatial abilities present in the general population is found also in schizophrenia. METHODS We analysed different types of errors committed by each gender on the spatial working memory test of the Cambridge Neuropsychological Test Automated Battery to determine potential differences between them. RESULTS Despite the lack of difference in the number of errors between men and women, different profiles of errors were associated with the strategy used according to gender. The men's strategy was better compared to women. Specifically, for women strategy score correlated positively with searches in previously visited boxes, whereas for men it correlated with both previously visited boxes and never visited ones. However, men's strategy is more impaired by the number of revisits in boxes in which tokens have previously been found than female's one. CONCLUSIONS These results suggested impaired either central executive and/or visuospatial sketchpad of working memory in patients with schizophrenia. We demonstrated also that the worsening of strategy in men is principally due to central executive deficits compared to women with schizophrenia. The study of sex differences in cognitive performances could help in delineating partially different endophenotypes of schizophrenia in men and women.
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Affiliation(s)
- Laurent Lecardeur
- Department of Psychiatry, Centre de Recherche Fernand-Seguin, Hôpital Louis-H Lafontaine, Université de Montreal, Montreal, Quebec, Canada.
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Lee SH, Kim EY, Kim S, Bae SM. Event-related potential patterns and gender effects underlying facial affect processing in schizophrenia patients. Neurosci Res 2010; 67:172-80. [DOI: 10.1016/j.neures.2010.03.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 02/28/2010] [Accepted: 03/01/2010] [Indexed: 11/25/2022]
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McMillan KA, Enns MW, Cox BJ, Sareen J. Comorbidity of Axis I and II mental disorders with schizophrenia and psychotic disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2009; 54:477-86. [PMID: 19660170 DOI: 10.1177/070674370905400709] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the comorbidity of Axis I and II disorders within a community-based sample of adults with schizophrenia. METHODS The study was conducted using data from the National Epidemiologic Survey of Alcohol and Related Conditions. A diagnosis of schizophrenia was based on respondents' self-report that they had been diagnosed by a health professional with schizophrenia or a psychotic illness or episode (SPIE). Axis I disorders and Axis II personality disorders (PDs) were assessed using the Alcohol Use Disorders and Associated Disabilities Interview Schedule. Mental and physical quality of life were assessed using the Medical Outcomes Study Short Form 12 questionnaire. RESULTS The prevalence of SPIE was 0.9%. We used multiple logistic regression to examine the association between the presence and absence of SPIE in Axis I and II mental disorders. Each of the Axis I and II mental disorders examined were significantly associated with a diagnosis of SPIE after controlling for age, sex, education, marital status, and household income. CONCLUSIONS Clinicians should be aware of the patterns and extent of psychiatric comorbidities that may exist in schizophrenia. Possible mechanisms of these associations are discussed.
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Køster A, Lajer M, Lindhardt A, Rosenbaum B. Gender differences in first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 2008; 43:940-6. [PMID: 18574541 DOI: 10.1007/s00127-008-0384-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 05/22/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND In the description of 1 episode schizophrenia patients, female gender is associated with better social function and a higher degree of compliance, while males exhibit more negative symptoms and a higher degree of abuse. The question is raised whether gender specific differences exist which should be taken into consideration in order to provide optimal treatment for the patients. METHODS AND MATERIAL Data from 269 persons (181 men and 88 women), included in the Danish national schizophrenia project (DNS), were registered at inclusion and year 2, and were analyzed according to gender, social functioning, psychopathology, drug consumption and abuse during the course of 2 years treatment. RESULTS Women had longer duration of illness before treatment and exhibited more affective symptoms while men were more socially isolated and had more negative symptoms. Alcohol and drug abuse appeared significantly more among men. Women were comparatively more heavily medicated than men. Social function, PANSS negative, drug consumption, affective symptomatology and abuse improved significantly after 2 years follow-up. CONCLUSION The gender differences demonstrated in the study suggest gender specific treatment interventions in order to provide optimal treatment for both male and female patients.
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Affiliation(s)
- Anne Køster
- Center of Psychiatry at Rigshospitalet, University of Copenhagen, Faculty of Health Sciences, Copenhagen, Denmark.
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