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Azaiez C, Chalghaf N, Tannoubi A, Guelmami N, Srem-Sai M, Quansah F, Hagan JE, Sneni H, Boussayala G, Ghalmi I, Lami MI, Bragazzi NL, Mandigout S, Ayed CB, Azaiez F. Psychometric properties of Arabic-translated-related quality of life scales for people with parkinson disease: a scoping review. BMC Public Health 2024; 24:2505. [PMID: 39277745 PMCID: PMC11402201 DOI: 10.1186/s12889-024-20002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/05/2024] [Indexed: 09/17/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) substantially contributes to poor functional outcomes, loss in productivity, and poor health-related quality of life (HRQoL). Despite the existence of various scales, there is a notable gap in existing HRQoL reviews with regard to the availability of Arabic validated scales. As a response to this gap, the aim of our scoping review is to identify validated scales, focusing on their psychometric validation procedures, to contribute valuable insights to the understanding of HRQoL among the Arabic-speaking people with PD. METHODS A scoping review was conducted at the end of December 2022, using the Medline and Embase databases. The focus of this review was on examining the psychometric properties and validation procedures of included scales. Articles were included in the full-text screening process if they focused on people with PD of any age, included a scale measuring HRQoL in Arabic, and were written in English, French, or Arabic. RESULTS After applying inclusion/exclusion criteria, 10 studies were selected to analyze HRQoL scales validated in people with PD. However, the PDQ-39 is the only HRQol PD specific scales validated in the Arabic language. Five studies validated in people with PD were identified in the context of instrument validation (3 generic, 1 specific validated in 2 studies). CONCLUSION There are several HRQoL measurement scales for people with PD. However, only one specific HRQoL instrument has been validated in Arabic for people with PD. For the remaining instruments identified they were just used in people with PD without being validated in this population.
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Affiliation(s)
- Chiraz Azaiez
- Sociological Research Group on Contemporary Societies (GRESCO), University of Limoges, BP 23204, Limoges, 87032, France
- Institute of Sport and Physical Education of Gafsa, University of Gafsa, Gafsa, 2100, Tunisia
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, 3047, Tunisia
| | - Naser Chalghaf
- Institute of Sport and Physical Education of Gafsa, University of Gafsa, Gafsa, 2100, Tunisia
- Ostgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, 16126, Italy
| | - Amayra Tannoubi
- Ostgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, 16126, Italy
- Higher Institute of Sport and Physical Education of Kef, University of Jendouba, Kef, 7100, Tunisia
| | - Noomen Guelmami
- Ostgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, 16126, Italy
- Department of Mathematics and Statistics, York University, Toronto, ON, 4700, Canada
| | - Medina Srem-Sai
- Department of Health, Physical Education, Recreation and Sports, University of Education, P.O. Box 25, Winneba, Ghana
| | - Frank Quansah
- Department of Educational Foundations, University of Education, P.O. Box 25, Winneba, Winneba, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, PMB TF0494, Cape Coast, Ghana.
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Postfach 10 01 31, 33501, Bielefeld, Germany.
| | - Heifa Sneni
- Institute of Sport and Physical Education of Gafsa, University of Gafsa, Gafsa, 2100, Tunisia
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, 3047, Tunisia
| | - Ghada Boussayala
- Institute of Sport and Physical Education of Gafsa, University of Gafsa, Gafsa, 2100, Tunisia
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, 3047, Tunisia
| | - Imane Ghalmi
- Université de Mohamed Cherif Messadia, Souk Ahras, 41000, Algeria
| | - Mazin Inhaier Lami
- College of Physical Education and Sports Sciences, University of Wasit, 52001, Wasit, Iraq
| | - Nicola Luigi Bragazzi
- Ostgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, 16126, Italy
- Department of Mathematics and Statistics, York University, Toronto, ON, 4700, Canada
| | | | - Choukri Ben Ayed
- Sociological Research Group on Contemporary Societies (GRESCO), University of Limoges, BP 23204, Limoges, 87032, France
| | - Fairouz Azaiez
- Institute of Sport and Physical Education of Gafsa, University of Gafsa, Gafsa, 2100, Tunisia
- Ostgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, 16126, Italy
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Fonseca AO, Gomes JS, Novaes RACB, Dias CL, Rodrigues MEDMA, Gadelha A, Noto C. Feuerstein Instrumental Enrichment Program for People With Schizophrenia After the First Episode of Psychosis: Protocol for an Open-Label Intervention Study. JMIR Res Protoc 2024; 13:e57031. [PMID: 39240685 PMCID: PMC11415717 DOI: 10.2196/57031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/22/2024] [Accepted: 07/18/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Schizophrenia is a disorder associated with neurocognitive deficits that adversely affect daily functioning and impose an economic burden. Cognitive rehabilitation interventions, particularly during the early phases of illness, have been shown to improve cognition, functionality, and quality of life. The Feuerstein Instrumental Enrichment (FIE) program, based on the Mediated Learning Experience and the Structural Cognitive Modifiability theory, has been applied in various disorders, but its applicability in schizophrenia has not yet been clarified. OBJECTIVE This study aims to investigate the effects of the FIE program on the functionality of patients with first-episode schizophrenia. METHODS In total, 17 patients will be recruited for an open-label intervention consisting of twice-weekly sessions for 10 weeks. The primary outcome measure will be changes in the Goal Achievement Scale score. Maze task performance from the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) battery will serve as a secondary outcome measure. At the same time, changes in Positive and Negative Syndrome Scale scores and other MATRICS domains will be analyzed as exploratory outcomes. Assessments will be administered before and after the intervention, with a follow-up period of 6 months. RESULTS This trial was preregistered in The Brazilian Registry of Clinical Trials (RBR-4gzhy4s). By February 2024, 11 participants were enrolled in the training. Recruitment is expected to be completed by May 2024. Data analysis will be conducted between May and September 2024. The results are expected to be published in January 2025. CONCLUSIONS This study may establish a protocol for the FIE program that uses mediation techniques for individuals in the early stages of schizophrenia. The results will add to the knowledge about strategies to promote cognitive skills and functional impairment in daily life. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57031.
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Affiliation(s)
- Ana Olivia Fonseca
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - July Silveira Gomes
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - Cíntia Lopes Dias
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - Ary Gadelha
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Cristiano Noto
- First Episode Program, Psychiatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil
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Ye X, Zeng F, Wang Y, Ding R, Zhao M, Zhu D, He P. Effectiveness of Community-Based Rehabilitation Interventions on Symptoms and Functioning for People with Schizophrenia: A Systematic Review and Meta-Analysis. Psychiatr Q 2023; 94:501-529. [PMID: 37249835 DOI: 10.1007/s11126-023-10029-8] [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] [Accepted: 05/09/2023] [Indexed: 05/31/2023]
Abstract
Schizophrenia is a serious mental illness that imposes huge burden of illness on the society. We aimed to conduct a meta-analytic and systematic review of literature on the effectiveness of community-based rehabilitation interventions on symptoms and functioning for people with schizophrenia. The PubMed, Embase, the Cochrane Library, Web of Science, and CINAHL databases were searched through April 16 and 17, 2021, including clinical trial registries and previous Cochrane reviews. We included 24 randomized controlled trials in this review. The content of interventions varied from single-faceted rehabilitation intervention or cognitive retraining, to multi-component rehabilitation interventions or case management. Among 20 studies that reported effects of community-based rehabilitation interventions on symptoms, the pooled SMDs across all interventions was 0.94 (95% CI = 0.11, 1.76; P < 0.001; I2 = 99.1%; n = 3694), representing a strong effect. 21 included studies showed that community-based rehabilitation interventions also had beneficial impacts on functioning (SMD = 1.65; 95% CI = 0.88, 2.43; P < 0.001; I2 = 98.9%; n = 3734). Overall quality of evidence was moderate with a high level of heterogeneity. Community-based rehabilitation interventions have positive effectiveness in improving patients' symptoms and functioning. Community-based rehabilitation interventions should therefore be provided as an adjuvant service in addition to facility-based care for people with schizophrenia.
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Affiliation(s)
- Xin Ye
- Institute for Global Public Policy; LSE-Fudan Research Centre for Global Public Policy, Fudan University, 220 Handan Road, Yangpu District, Shanghai, 200433, China
| | - Fangyi Zeng
- School of Public Health, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Yanshang Wang
- School of Public Health, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Ruoxi Ding
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Miaomiao Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine; Center for Mental Health Management, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Haidian District, 38 Xue Yuan Road, Beijing, 100191, China.
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Housing First for homeless people with severe mental illness: extended 4-year follow-up and analysis of recovery and housing stability from the randomized Un Chez Soi d'Abord trial. Epidemiol Psychiatr Sci 2022; 31:e14. [PMID: 35125129 PMCID: PMC8851060 DOI: 10.1017/s2045796022000026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS Housing First (HF), a recovery-oriented approach, was proven effective in stabilising housing situations of homeless individuals with severe mental disorders, yet had limited effectiveness on recovery outcomes on a short-term basis compared to standard treatment. The objective was to assess the effects of the HF model among homeless people with high support needs for mental and physical health services on recovery, housing stability, quality of life, health care use, mental symptoms and addiction issues on 4 years of data from the Un Chez Soi d'Abord trial. METHODS A multicentre randomised controlled trial was conducted from August 2011 to April 2018 with intent-to-treat analysis in four French cities: Lille, Marseille, Paris and Toulouse. Participants were homeless or precariously-housed patients with a DSM-IV-TR diagnosis of bipolar disorder or schizophrenia. Two groups were compared: the HF group (n = 353) had immediate access to independent housing and support from the assertive community treatment team; the Treatment-As-Usual (TAU) group (n = 350) had access to existing support and services. Main outcomes were personal recovery (Recovery Assessment Scale (RAS) scale), housing stability, quality of life (S-QoL), global physical and mental status (Medical Outcomes Study 36-item Short Form Health Survey (SF-36)), inpatient days, mental symptoms (Modified Colorado Symptom Index (MCSI)) and addictions (Mini International Neuropsychiatric Interview (MINI) and Alcohol Use Disorders Identification Test (AUDIT)). Mixed models using longitudinal and cluster designs were performed and adjusted to first age on the street, gender and mental disorder diagnosis. Models were tested for time × group and site × time interactions. RESULTS The 703 participants [123 (18%) female] had a mean age of 39 years (95% CI 38.0-39.5 years). Both groups improved RAS index from baseline to 48 months, with no statistically significant changes found between the HF and TAU groups over time. HF patients exhibited better autonomy (adjusted β = 2.6, 95% CI 1.2-4.1) and sentimental life (2.3, 95% CI 0.5-4.1), higher housing stability (28.6, 95% CI 25.1-32.1), lower inpatient days (-3.14, 95% CI -5.2 to -1.1) and improved SF-36 mental composite score (-0.8, 95% CI -1.6 to -0.1) over the 4-year follow-up. HF participants experienced higher alcohol consumption between baseline and 48 months. No significant differences were observed for self-reported mental symptoms or substance dependence. CONCLUSION Data at 4 years were consistent with 2-year follow-up data: similar improvement in personal recovery outcomes but higher housing stability, autonomy and lower use of hospital services in the HF group compared to the TAU group, with the exception of an ongoing alcohol issue. These sustained benefits support HF as a valuable intervention for the homeless patients with severe mental illness. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01570712.
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Chang CC, Lin YY, Tzeng NS, Kao YC, Chang HA. Adjunct high-frequency transcranial random noise stimulation over the lateral prefrontal cortex improves negative symptoms of schizophrenia: A randomized, double-blind, sham-controlled pilot study. J Psychiatr Res 2021; 132:151-160. [PMID: 33096356 DOI: 10.1016/j.jpsychires.2020.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/10/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
High-frequency transcranial random noise stimulation (hf-tRNS) is a non-invasive neuromodulatory technique capable of increasing human cortex excitability. There were only published case reports on the use of hf-tRNS targeting the lateral prefrontal cortex in treating negative symptoms of schizophrenia, thus necessitating systematic investigation. We designed a randomized, double-blind, sham-controlled trial in a cohort of stabilized schizophrenia patients to examine the efficacy of add-on hf-tRNS (100-640 Hz; 2 mA; 20 min) using a high definition 4 × 1 electrode montage (anode AF3, cathodes AF4, F2, F6, and FC4) in treating negative symptoms (ClinicalTrials.gov ID: NCT04038788). Participants received either active hf-tRNS or sham twice daily for 5 consecutive weekdays. Primary outcome measure was the change over time in the Positive and Negative Syndrome Scale Factor Score for Negative Symptoms (PANSS-FSNS), which was measured at baseline, after 10-session stimulation, and at one-week and one-month follow-ups. Among 36 randomized patients, 35 (97.2%) completed the trial. Intention-to-treat analysis showed a significantly greater decrease in PANSS-FSNS score after active (-17.11%) than after sham stimulation (-1.68%), with a large effect size (Cohen's d = 2.16, p < 0.001). The beneficial effect lasted for up to one month. In secondary-outcome analyses, the authors observed improvements with hf-tRNS of disorganization symptoms, unawareness of negative symptoms, subjective response to taking antipsychotics, and antipsychotic-induced extrapyramidal symptoms. No effects were observed on the neurocognitive performance and other outcome measures. Overall, hf-tRNS was safe and efficacious in improving negative symptoms. Our promising findings should be confirmed in a larger sample of patients with predominant negative symptoms.
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Affiliation(s)
- Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yen-Yue Lin
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan; Department of Life Sciences, National Central University, Taoyuan, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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Brand BA, de Boer JN, Oude Ophuis SB, Slot MI, De Wilde B, Catthoor KC, Goverde AJ, Bakker PR, Marcelis MC, Grootens KP, Luykx JJ, Heringa SM, Weickert CS, Sommer IE, Weickert TW. Raloxifene augmentation in men and women with a schizophrenia spectrum disorder: A study protocol. Contemp Clin Trials Commun 2020; 20:100681. [PMID: 33364517 PMCID: PMC7750317 DOI: 10.1016/j.conctc.2020.100681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/28/2020] [Accepted: 11/22/2020] [Indexed: 12/14/2022] Open
Abstract
Although acute psychotic symptoms are often reduced by antipsychotic treatment, many patients with schizophrenia are impaired in daily functioning due to the persistence of negative and cognitive symptoms. Raloxifene, a Selective Estrogen Receptor Modulator (SERM) has been shown to be an effective adjunctive treatment in schizophrenia. Yet, there is a paucity in evidence for raloxifene efficacy in men and premenopausal women. We report the design of a study that aims to replicate earlier findings concerning the efficacy of raloxifene augmentation in reducing persisting symptoms and cognitive impairment in postmenopausal women, and to extend these findings to a male and peri/premenopausal population of patients with schizophrenia. The study is a multisite, placebo-controlled, double-blind, randomised clinical trial in approximately 110 adult men and women with schizophrenia. Participants are randomised 1:1 to adjunctive raloxifene 120 mg or placebo daily during 12 weeks. The treatment phase includes measurements at three time points (week 0, 6 and 12), followed by a follow-up period of two years. The primary outcome measure is change in symptom severity, as measured with the Positive and Negative Syndrome Scale (PANSS), and cognition, as measured with the Brief Assessment of Cognition in Schizophrenia (BACS). Secondary outcome measures include social functioning and quality of life. Genetic, hormonal and inflammatory biomarkers are measured to assess potential associations with treatment effects. If it becomes apparent that raloxifene reduces psychotic symptoms and/or improves cognition, social functioning and/or quality of life as compared to placebo, implementation of raloxifene in clinical psychiatric practice can be considered.
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Key Words
- AE, Adverse event
- AF, alkaline phosphatase
- ALAT, alanine aminotransferase
- ANOVA, analysis of variance
- ANSS, positive and negative syndrome scale
- APTT, activated partial thrombin time
- ASAT, aspartate aminotransferase
- Antipsychotic medication
- BACS, Brief Assessment of Cognition in Schizophrenia
- BDI, Beck's Depression Inventory
- BNSS, Brief Negative Symptom scale
- CRP, C-reactive protein
- DHEA, dehydroepiandrosterone
- DNA, Deoxyribonucleic acid
- DSMB, Data Safety Monitoring Board
- EQ-5D-5L, Euro Quality of Life 5 Dimensions 5 Levels
- Estrogen
- FSH, follicle stimulating hormone
- GGZ Centraal, Psychiatric Center Geestelijke Gezondheidszorg Centraal
- GGzE, Geestelijke Gezondheidszorg Eindhoven
- HDL, high-density lipoprotein
- ICH-GCP, the International Conference on Harmonization – Good Clinical Practice
- IMCJE, International Committee of Medical Journal Editors
- LDL, low-density lipoprotein
- LHT, lithium heparin tube
- MINI, Mini International Neuropsychiatric Interview Plus
- PSP, Personal and Social Performance
- QALYs, Quality Adjusted Life Years
- Raloxifene
- Randomised controlled trial
- RvA, Reinier van Arkel Institute for Mental Health Care
- SAE, Serious Adverse Event
- SCT, sodium citrate tube
- SERM, selective estrogen receptor modulator
- SHBG, sex hormone-binding globulin
- SMD, standard mean difference
- SST, serum separator tube
- SUSAR, Suspected Unexpected Serious Adverse Reaction
- Schizophrenia
- TALD, Thought And Language Disorder scale
- ULN, upper limit of normal
- UMCG, University Medical Center Groningen
- UMCU, University Medical Center Utrecht
- WOCBP, Women of child bearing potential
- ZNA, Ziekenhuis Netwerk Antwerpen
- eGFR, estimated glomerular filtration rate
- iMTA-MCQ, institute for Medical Technology Assessment's Medical Consumption Questionnaire
- iMTA-PCQ, institute for Medical Technology Assessment's Productivity Cost Questionnaire
- psychotic disorder NOS, psychotic disorder not otherwise specified
- β-HCG, beta-human chorionic gonadotropin
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Affiliation(s)
- Bodyl A. Brand
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands
- Department of Biomedical Sciences and Systems, Cognitive Neurosciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Janna N. de Boer
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands
- Department of Biomedical Sciences and Systems, Cognitive Neurosciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Sebastianus B.J. Oude Ophuis
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands
| | - Margot I.E. Slot
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands
| | | | - Kirsten C.E.E.R. Catthoor
- Ziekenhuis Netwerk Antwerpen (ZNA), Antwerp, Belgium
- The Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp, Belgium
| | - Angelique J. Goverde
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
| | - P. Roberto Bakker
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Machteld C. Marcelis
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
| | - Koen P. Grootens
- Reinier van Arkel Institute for Mental Health Care (RvA), ‘s Hertogenbosch, the Netherlands
| | - Jurjen J. Luykx
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands
- Ziekenhuis Netwerk Antwerpen (ZNA), Antwerp, Belgium
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center, Utrecht, Utrecht University, Utrecht, the Netherlands
- Outpatient Second Opinion Clinic, GGNet Mental Health, Warnsveld, the Netherlands
| | - Sophie M. Heringa
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands
- Isala, Department of Medical Psychology, Zwolle, the Netherlands
| | - Cynthia Shannon Weickert
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Iris E.C. Sommer
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands
- Department of Biomedical Sciences and Systems, Cognitive Neurosciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Thomas W. Weickert
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- State University of New York, Upstate Medical University, Syracuse, NY, USA
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Caqueo-Urízar A, Ferrer R, Ponce F, Urzúa A, Boyer L. Clinical outcomes of schizophrenia: A differential study among Latin-American countries. Psychiatry Res 2020; 292:113334. [PMID: 32768808 DOI: 10.1016/j.psychres.2020.113334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | - Rodrigo Ferrer
- Escuela de Psicología y Filosofía, Universidad de Tarapacá, Arica, Chile.
| | | | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile.
| | - Laurent Boyer
- Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille Univ, Marseille, France.
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Spironelli C, Romeo Z, Maffei A, Angrilli A. Comparison of automatic visual attention in schizophrenia, bipolar disorder, and major depression: Evidence from P1 event-related component. Psychiatry Clin Neurosci 2019; 73:331-339. [PMID: 30882991 DOI: 10.1111/pcn.12840] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 02/08/2019] [Accepted: 03/10/2019] [Indexed: 01/12/2023]
Abstract
AIM The ability to discern commonalities and differences in the neurobiology of functional psychoses represents a key element to unmasking shared vulnerability across different psychiatric conditions. The present study sought to compare the automatic visual attention mechanisms in three psychiatric disorders considered to distribute along the continuum of psychosis severity: schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD). To this end, the visual P1 event-related potential component, a cortical correlate of automatic visual attention, was measured during an ecological task based on visual word pair presentation. METHODS Four samples of participants, 18 SCZ, 20 BD, 28 MDD, and 30 healthy controls, were recruited and submitted to the same procedure and stimuli. The P1 evoked by visual word presentation was recorded through a 38-electrode electroencephalography cap. Words were presented on a computer screen serially as pairs, and participants had to decide whether they rhymed or not. RESULTS P1 was larger at posterior sites in SCZ compared with BD, healthy control, and MDD participants. BD patients showed the lowest P1 compared with all other groups. Positive Pearson's correlations were found in SCZ patients between P1 amplitude on left posterior sites and both hallucination severity and worse task performance. CONCLUSION The three investigated psychiatric samples showed different automatic visual attention patterns: SCZ patients exhibited the greatest cognitive impairment correlated with the amplitude of P1, MDD patients revealed a normal component, and BD showed a compensated euthymic response different from results of past literature in untreated patients.
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Affiliation(s)
- Chiara Spironelli
- Department of General Psychology, University of Padua, Padua, Italy.,Padua Neuroscience Center, Padua, Italy
| | | | - Antonio Maffei
- Department of General Psychology, University of Padua, Padua, Italy
| | - Alessandro Angrilli
- Department of General Psychology, University of Padua, Padua, Italy.,Padua Neuroscience Center, Padua, Italy.,IN-CNR Institute of Neuroscience CNR, Padua, Italy
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Freitas R, Dos Santos B, Altamura C, Bernasconi C, Corral R, Evans J, Malla A, Krebs MO, Nordstroem AL, Zink M, Haro JM, Elkis H. Can the Positive and Negative Syndrome scale (PANSS) differentiate treatment-resistant from non-treatment-resistant schizophrenia? A factor analytic investigation based on data from the Pattern cohort study. Psychiatry Res 2019; 276:210-217. [PMID: 31108345 DOI: 10.1016/j.psychres.2019.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 02/14/2019] [Accepted: 05/01/2019] [Indexed: 12/25/2022]
Abstract
Treatment-Resistant Schizophrenia (TRS) and Non-Treatment-Resistant Schizophrenia (NTRS) may represent different subtypes of schizophrenia. However, few studies have investigated their PANSS symptom dimensions by Exploratory (EFA) or Confirmatory (CFA). Data from the present study are derived from 1429 patients of the Pattern study. TRS was defined by the use of clozapine in the previous year whereas NTRS by the use of non-clozapine antipsychotics ("by proxy"). Factors were chosen based on the Kaiser criterion and considered valid when loadings were greater than or equal to 0.5. The fit to the data was evaluated by CFA in comparison with well-established PANSS models, using fit indexes. The EFA yielded similar five-factor model in both groups: Negative, Positive, Anxiety/Depression, Cognitive and Excited. CFA showed a satisfactory, but not perfect, fit to the data, as compared with the previous PANSS factor analytic models. Despite the limitations regarding the 'by proxy' definition of TRS, the results of the present study show that there are no differences in the factorial structure of PANSS in patients with TRS and NTRS.
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Affiliation(s)
- Rosana Freitas
- Departamento e Instituto de Psiquiatria-Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bernardo Dos Santos
- Departamento e Instituto de Psiquiatria-Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Carlo Altamura
- University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milano, Italy
| | | | - Ricardo Corral
- Fundación para el Estudio y Tratamiento de las Enfermedades Mentales (FETEM), Cerviño 4634 5th floor Apt. B Buenos Aires, (C1425AHQ), Argentina
| | - Jonathan Evans
- Center for Academic Mental Health, University of Bristol, Bristol BS8 2BN, UK
| | - Ashok Malla
- Douglas Mental Health University Institute, McGill University, Montréal, QC H4H 1R3, Canada
| | - Marie-Odile Krebs
- Service Hospitalo Universitaire, Laboratoire de Physiopathologie des Maladies Psychiatriques, Inserm, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France
| | | | - Mathias Zink
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Universitat de Barcelona, Spain
| | - Helio Elkis
- Departamento e Instituto de Psiquiatria-Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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10
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Domenech C, Bernasconi C, Moneta MV, Nordstroem AL, Cristobal-Narvaez P, Vorstenbosch E, Cobo J, Ochoa S, Haro JM. Health-related quality of life associated with different symptoms in women and in men who suffer from schizophrenia. Arch Womens Ment Health 2019; 22:357-365. [PMID: 30088146 DOI: 10.1007/s00737-018-0896-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/24/2018] [Indexed: 11/29/2022]
Abstract
Health-related quality of life (HRQoL) in patients with schizophrenia is related to the severity of psychiatric symptoms. The objective of this study is to analyze whether the symptoms that influence HRQoL are similar in women and men. Data were part of the Pattern study, an international observational investigation which collected data from 1379 outpatients with schizophrenia. Patients were evaluated with the Mini International Neuropsychiatric Inventory, the Clinical Global Impression-Schizophrenia, and the Positive and Negative Syndrome Scale (PANSS), and reported their quality of life using the Schizophrenia Quality of Life Scale (SQLS), the Short Form-36 (SF-36), and the EuroQol-5 Dimension (EQ-5D). Men reported higher HRQoL on all scales. PANSS total score was 80.6 (SD 23.6) for women and 77.9 (SD 22.1) for men. In women, a higher PANSS negative score and a higher PANSS affective score were associated with a lower SQLS score. In men, a higher PANSS positive score and a higher PANSS affective score were associated with a lower SQLS score. The same pattern appeared with EQ-VAS and EQ-5D tariff. In women, greater age and higher PANSS affective score were associated with a lower SF-36 mental component score. In men, higher PANSS affective, positive, and cognitive scores were associated with a lower SF-36 mental component score. This study shows that HRQoL is influenced by different psychiatric symptoms in women and men. This may have significant implications when deciding the main treatment target in patients with schizophrenia.ClinicalTrials.gov Identifier: https://clinicaltrials.gov/ct2/show/NCT01634542.
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Affiliation(s)
- Cristina Domenech
- Universitat de Barcelona, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Catalonia, Spain
| | | | - Maria Victoria Moneta
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red, CIBERSAM, Madrid, Spain
| | | | - Paula Cristobal-Narvaez
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red, CIBERSAM, Madrid, Spain
| | - Ellen Vorstenbosch
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Catalonia, Spain
| | - Jesus Cobo
- Corporació Sanitària Parc Taulí, Hospital Universitari - UAB Sabadell, Barcelona, Catalonia, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red, CIBERSAM, Madrid, Spain
| | - Josep Maria Haro
- Universitat de Barcelona, Barcelona, Spain. .,Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Catalonia, Spain. .,Centro de Investigación Biomédica en Red, CIBERSAM, Madrid, Spain.
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11
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Affiliation(s)
- Scott Henderson
- Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia
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12
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Domenech C, Pastore A, Altamura AC, Bernasconi C, Corral R, Elkis H, Evans J, Malla A, Margari F, Krebs MO, Nordstroem AL, Zink M, Haro JM. Correlation of Health-Related Quality of Life in Clinically Stable Outpatients with Schizophrenia. Neuropsychiatr Dis Treat 2019; 15:3475-3486. [PMID: 31908462 PMCID: PMC6930014 DOI: 10.2147/ndt.s218578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/09/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Generic health-related quality of life (HRQoL) scales are increasingly being used to assess the effects of new treatments in schizophrenia. The objective of this study is to better understand the usefulness of generic and condition specific HRQoL scales in schizophrenia by analyzing their correlates. METHODS Data formed part of the Pattern study, an international observational study among 1379 outpatients with schizophrenia. Patients were evaluated with the Mini International Neuropsychiatric Inventory, the Clinical Global Impression-Schizophrenia (CGI-SCH) Scale and the Positive and Negative Syndrome Scale (PANSS) and reported their HRQoL using the Schizophrenia Quality of Life Scale (SQLS), the Short Form-36 (SF-36), and the EuroQol-5 Dimension (EQ-5D). The two summary values of the SF-36 (the Mental Component Score and the Physical Component Score, SF-36 MCS and SF-36 PCS) were calculated. RESULTS Higher PANSS positive dimension ratings were associated with worse HRQoL for the SQLS, EQ-5D VAS, SF-36 MCS, and SF-36 PCS. Higher PANSS negative dimension ratings were associated with worse HRQoL for the EQ-5D VAS, SF-36 MCS, and SF-36 PCS, but not for the SQLS or the EQ-5D tariff. PANSS depression ratings were associated with lower HRQoL in all the scales. There was a high correlation between the HRQoL scales. However, in patients with more severe cognitive/disorganized PANSS symptoms, the SQLS score was relatively higher than the EQ-5D tariff and SF-36 PCS scores. CONCLUSION This study has shown substantial agreement between three HRQoL scales, being either generic or condition specific. This supports the use of generic HRQoL measures in schizophrenia. CLINICALTRIALSGOV IDENTIFIER NCT01634542 (July 6, 2012, retrospectively registered).
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Affiliation(s)
- Cristina Domenech
- Universitat de Barcelona, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, CIBERSAM, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Adriana Pastore
- Department of Basic Medical Science, Neuroscience and Sense Organs, 'Policlinico' Hospital, University of Bari 'Aldo Moro', Bari, Italy
| | - A Carlo Altamura
- University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Ricardo Corral
- Fundación para el Estudio y Tratamiento de las Enfermedades Mentales (FETEM), Buenos Aires, Argentina
| | - Helio Elkis
- Departamento e Instituto de Psiquiatria - FMUSP, Sao Paulo, Brazil
| | - Jonathan Evans
- Centre for Academic Mental Health, University of Bristol, Bristol, UK
| | - Ashok Malla
- Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada
| | - Francesco Margari
- Department of Basic Medical Science, Neuroscience and Sense Organs, 'Policlinico' Hospital, University of Bari 'Aldo Moro', Bari, Italy
| | - Marie-Odile Krebs
- Service Hospitalo Universitaire, Laboratoire de Physiopathologie des Maladies Psychiatriques, Inserm, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France
| | | | - Mathias Zink
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany and Regional Clinical Centre, Ansbach, Germany
| | - Josep Maria Haro
- Universitat de Barcelona, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, CIBERSAM, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
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13
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Azaiez C, Millier A, Lançon C, Clay E, Auquier P, Llorca PM, Toumi M. Health related quality of life in patients having schizophrenia negative symptoms - a systematic review. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2018; 6:1517573. [PMID: 30275939 PMCID: PMC6161588 DOI: 10.1080/20016689.2018.1517573] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/14/2018] [Accepted: 08/21/2018] [Indexed: 05/07/2023]
Abstract
Background: Schizophrenia negative symptoms (SNS) contribute substantially to poor functional outcomes, loss in productivity and poor quality of life. It is unclear which instruments may be used for assessing quality of life in patients with SNS. Objective: The objective of this review was to identify instruments assessing health-related quality of life (HRQoL) validated in patients with SNS and to assess their level of validation. Data sources: We conducted a systematic literature review in Medline and the ISPOR database in March 2016 to identify studies on the quality of life in patients with SNS published by March 2016. Data extraction: Psychometric properties and validation steps. Data synthesis: After applying inclusion/exclusion criteria, 49 studies were selected for the analysis of HRQoL instruments; however, none of these instruments only addressed patients with SNS. Of these, 19 HRQoL instruments used in patients with schizophrenia or including patients with SNS among others, in the context of instrument validation, were identified (4 generic, 10 non-specific mental health, 5 schizophrenia-specific). Conclusion: No HRQoL instrument has been validated in patients with SNS only; for the remaining instruments identified, it remains unclear whether they were intended to capture HRQoL in patients with SNS.
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Affiliation(s)
- Chiraz Azaiez
- Public Health Department – Research Unit EA 3279, Aix-Marseille University, Marseille, France
| | | | - Christophe Lançon
- Psychiatry Department, Marseille University Hospital, Marseille, France
| | | | - Pascal Auquier
- Public Health Department – Research Unit EA 3279, Aix-Marseille University, Marseille, France
| | - Pierre-Michel Llorca
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Mondher Toumi
- Public Health Department – Research Unit EA 3279, Aix-Marseille University, Marseille, France
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14
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Altered Small-World Networks in First-Episode Schizophrenia Patients during Cool Executive Function Task. Behav Neurol 2018; 2018:2191208. [PMID: 30254708 PMCID: PMC6145160 DOI: 10.1155/2018/2191208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/15/2018] [Accepted: 07/22/2018] [Indexed: 01/25/2023] Open
Abstract
At present, little is known about brain functional connectivity and its small-world topologic properties in first-episode schizophrenia (SZ) patients during cool executive function task. In this paper, the Trail Making Test-B (TMT-B) task was used to evaluate the cool executive function of first-episode SZ patients and electroencephalography (EEG) data were recorded from 14 first-episode SZ patients and 14 healthy controls during this cool executive function task. Brain functional connectivity between all pairs of EEG channels was constructed based on mutual information (MI) analysis. The constructed brain functional networks were filtered by three thresholding schemes: absolute threshold, mean degree, and a novel data-driven scheme based on orthogonal minimal spanning trees (OMST), and graph theory was then used to study the topographical characteristics of the filtered brain graphs. Results indicated that the graph theoretical measures of the theta band showed obvious difference between SZ patients and healthy controls. In the theta band, the characteristic path length was significantly longer and the cluster coefficient was significantly smaller in the SZ patients for a wide range of absolute threshold T. However, the cluster coefficient showed no significant changes, and the characteristic path length was still significantly longer in SZ patients when calculated as a function of mean degree K. Interestingly, we also found that only the characteristic path length was significantly longer in SZ patients compared with healthy controls after using the OMST scheme. Pearson correlation analysis showed that the characteristic path length was positively correlated with executive time of TMT-B for the combined SZ patients and healthy controls (r = 0.507, P = 0.006), but not for SZ patients alone (r = 0.072, P = 0.612). The above results suggested a less optimal organization of the brain network and could be useful for understanding the pathophysiologic mechanisms underlying cool executive dysfunction in first-episode SZ patients.
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15
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Haro JM, Altamura C, Corral R, Elkis H, Evans J, Krebs MO, Zink M, Malla A, Méndez JI, Bernasconi C, Lalonde J, Nordstroem AL. Understanding the course of persistent symptoms in schizophrenia: Longitudinal findings from the pattern study. Psychiatry Res 2018; 267:56-62. [PMID: 29883861 DOI: 10.1016/j.psychres.2018.04.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 03/31/2018] [Accepted: 04/02/2018] [Indexed: 02/02/2023]
Abstract
The Pattern study was conducted to provide longitudinal observational data for individual patients with persistent symptoms of schizophrenia. Pattern is an international, multicenter, non-interventional, prospective cohort study of schizophrenia outpatients who were not considered to be in recovery. In the longitudinal phase reported herein, patients were assessed over 1 year using different clinical rating scales. Patient management followed routine local clinical practice. Primary outcome was disease state, defined by the Positive and Negative Syndrome Scale (PANSS), Negative Symptom Factor Score (NSFS), Positive Symptom Factor Score (PSFS), and Personal and Social Performance (PSP) Scale. In total, 1344 protocol-compliant patients (70.9% male) were included. Patients showed a high stability in disease state between consecutive study visits. Persistent negative persistent symptoms and symptomatic remission were the most prevalent and stable disease states. Patients in relapse generally transitioned to negative persistent symptoms or to symptomatic remission. PANSS, PSP, and quality of life ratings remained relatively stable. Relapses occurred in 10% of patients; probability of relapse was associated with younger age, extra-pyramidal symptoms, and more antipsychotic medications. Despite treatment, schizophrenia symptoms tend to remain stable over time, without overall improvement. One of the greatest challenges in schizophrenia is attainment of full symptom remission.
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Affiliation(s)
- Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain.
| | - Carlo Altamura
- University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, Milano 20122, Italy
| | - Ricardo Corral
- Fundación para el Estudio y Tratamiento de las Enfermedades Mentales (FETEM), Cerviño 4634 5th floor Apt. B, Buenos Aires C1425AHQ, Argentina
| | - Helio Elkis
- Departamento e Instituto de Psiquiatria-FMUSP, Sao Paulo, Brazil
| | - Jonathan Evans
- Centre for Academic Mental Health, University of Bristol, Bristol BS8 2BN, UK
| | - Marie-Odile Krebs
- Service Hospitalo Universitaire, Laboratoire de Physiopathologie des Maladies Psychiatriques, Inserm, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France
| | - Mathias Zink
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Bezirkskrankenhaus Ansbach, Mannheim, Germany
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16
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de Medeiros HLV, Vasconcelos SC, Elkis H, Martins DR, de Alexandria Leite RM, de Albuquerque ACL, Freitas RR, Scardoelli MA, Di Sarno E, Napolitano I, Oliveira GM, Vizzotto A, da Silva AMP, da Costa Lima MD. The Brief Negative Symptom Scale: Validation in a multicenter Brazilian study. Compr Psychiatry 2018; 85:42-47. [PMID: 29966891 DOI: 10.1016/j.comppsych.2018.06.007] [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: 01/22/2018] [Revised: 06/01/2018] [Accepted: 06/19/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Negative symptoms are a core feature of schizophrenia. The Brief Negative Symptom Scale (BNSS) is a scale developed to measure negative symptoms in schizophrenia. METHODS The present study aimed to examine the construct validity of BNSS, by using convergent and divergent validities as well as factor analysis, in a Brazilian sample of 111 outpatients diagnosed with schizophrenia by DSM-5. Patients were evaluated by the Brazilian version of the BNSS and positive and negative subscales of the Positive and Negative Syndrome Scale (PANSS). RESULTS Assessment of patients by both instruments revealed an excellent internal consistency (Cronbach's alpha = 0.938) or inter-rater reliability (ICC = 0.92), as well as a strong correlation between BNSS and Marder negative PANSS (r = 0.866) and a weak correlation of the instrument with the positive PANSS (r = 0.292), thus characterizing convergent and discriminant validities, respectively. The exploratory factor analysis identified two distinct factors, namely, motivation/pleasure and emotional expressivity, accounting for 68.63% of the total variance. CONCLUSION The study shows that the Brazilian version of the BNSS has adequate psychometric properties and is a reliable instrument for the assessment of negative symptoms in schizophrenia, either for clinical practice or research.
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Affiliation(s)
| | | | - Helio Elkis
- University of São Paulo, 785, Ovídio Pires de Campos ST, São Paulo, SP, Brazil
| | - Diana Rocha Martins
- Federal University of Paraíba, Jardim Universitário STr, João Pessoa, PB, Brazil
| | | | | | | | | | - Elaine Di Sarno
- University of São Paulo, 785, Ovídio Pires de Campos ST, São Paulo, SP, Brazil
| | - Isabel Napolitano
- University of São Paulo, 785, Ovídio Pires de Campos ST, São Paulo, SP, Brazil
| | | | - Adriana Vizzotto
- University of São Paulo, 785, Ovídio Pires de Campos ST, São Paulo, SP, Brazil
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17
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Gomes J, Trevizol A, Ducos D, Gadelha A, Ortiz B, Fonseca A, Akiba H, Azevedo C, Guimaraes L, Shiozawa P, Cordeiro Q, Lacerda A, Dias A. Effects of transcranial direct current stimulation on working memory and negative symptoms in schizophrenia: a phase II randomized sham-controlled trial. Schizophr Res Cogn 2018; 12:20-28. [PMID: 29552509 PMCID: PMC5852322 DOI: 10.1016/j.scog.2018.02.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/01/2018] [Accepted: 02/04/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND The lack of efficacy of pharmacological treatments for cognitive and negative symptoms in schizophrenia highlights the need for new interventions. We investigated the effects of tDCS on working memory and negative symptoms in patients with schizophrenia. METHOD Double-blinded, randomized, sham-controlled clinical trial, investigating the effects of 10 sessions of tDCS in schizophrenia subjects. Stimulation used 2 mA, for 20 min, with electrodes of 25 cm2 wrapped in cotton material soaked in saline solution. Anode was positioned over the left DLPFC and the cathode in the contralateral area. Twenty-four participants were assessed at baseline, after intervention and in a three-months follow-up. The primary outcome was the working memory score from MATRICS and the secondary outcome the negative score from PANSS. Data were analyzed using generalized estimating equations. RESULTS We did not find group ∗ time interaction for the working memory (p = 0.720) score or any other cognitive variable (p > 0.05). We found a significant group ∗ time interaction for PANSS negative (p < 0.001, d = 0.23, CI.95 = -0.59-1.02), general (p = 0.011) and total scores (p < 0.001). Exploratory analysis of PANSS 5 factors suggests tDCS effect on PANSS negative (p = 0.012), cognitive (p = 0.016) and depression factors (p = 0.029). CONCLUSION The results from this trial highlight the therapeutic effects of tDCS for treatment of persistent symptoms in schizophrenia, with reduction of negative symptoms. We were not able to confirm the superiority of active tDCS over sham to improve working memory performance. Larger sample size studies are needed to confirm these findings.
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Affiliation(s)
- J.S. Gomes
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A.P. Trevizol
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
- Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD), Sao Paulo State Secretariat of Health, Sao Paulo, Brazil
| | - D.V. Ducos
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A. Gadelha
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - B.B. Ortiz
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A.O. Fonseca
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - H.T. Akiba
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - C.C. Azevedo
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - L.S.P. Guimaraes
- Epidemiology and Biostatistics Unity, Clinical Hospital of Porto Alegre, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - P. Shiozawa
- Department of Psychiatry, Santa Casa School of Medicine, Sao Paulo, Brazil
| | - Q. Cordeiro
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A. Lacerda
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Research and Clinical Trials Sinapse-Bairral, Instituto Bairral de Psiquiatria, Itapira, Brazil
| | - A.M. Dias
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
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18
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Hui CLM, Honer WG, Lee EHM, Chang WC, Chan SKW, Chen ESM, Pang EPF, Lui SSY, Chung DWS, Yeung WS, Ng RMK, Lo WTL, Jones PB, Sham P, Chen EYH. Long-term effects of discontinuation from antipsychotic maintenance following first-episode schizophrenia and related disorders: a 10 year follow-up of a randomised, double-blind trial. Lancet Psychiatry 2018; 5:432-442. [PMID: 29551618 DOI: 10.1016/s2215-0366(18)30090-7] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The long-term consequences of discontinuing antipsychotic medication after successful treatment of first-episode psychosis are not well studied. We assess the relation between early maintenance therapy decisions in first-episode psychosis and the subsequent clinical outcome at 10 years. METHODS This is a 10 year follow-up study, spanning Sept 5, 2003, to Dec 30, 2014, of a randomised, double-blind trial in seven centres in Hong Kong in which 178 patients with first-episode psychosis with full positive symptom resolution after at least 1 year of antipsychotic treatment were given maintenance treatment (n=89; oral quetiapine 400 mg daily) or early treatment discontinuation (n=89; placebo) for 12 months. After the trial, patients received naturalistic treatment. Overall this cohort of patients will have received about 3 years of treatment before entering the follow-up phase of the study: about 2 years of maintenance treatment before study entry and 1 year of treatment in the trial. The primary outcome of this follow-up was the proportion of patients in each group (including those for whom direct follow-up was not available) with good or poor long-term clinical outcomes at 10 years, with poor outcome defined as a composite of persistent psychotic symptoms, a requirement for clozapine treatment, or death by suicide. The randomised trial was registered with ClinicalTrials.gov, number NCT00334035, and the follow-up study was registered with ClinicalTrials.gov, number NCT01926340. FINDINGS Poor 10 year clinical outcome occurred in 35 (39%) of 89 patients in the discontinuation group and 19 (21%) of 89 patients in the maintenance treatment group (risk ratio 1·84, 95% CI 1·15-2·96; p=0·012). Suicide was the only serious adverse event that occurred in the follow-up phase (four [4%] patients in the early discontinuation group vs two [2%] in the maintenance group). INTERPRETATION In patients with first-episode psychosis with a full initial response to treatment, medication continuation for at least the first 3 years after starting treatment decreases the risk of relapse and poor long-term clinical outcome. FUNDING Food and Health Bureau, Research Grants Council of Hong Kong, and AstraZeneca.
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Affiliation(s)
- Christy L M Hui
- Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Canada
| | - Edwin H M Lee
- Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wing Chung Chang
- Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sherry K W Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Emily S M Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Edwin P F Pang
- Department of Psychiatry, United Christian Hospital, Hong Kong Special Administrative Region, China
| | - Simon S Y Lui
- Department of Psychiatry, Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Dicky W S Chung
- Department of Psychiatry, Tai Po Hospital, Hong Kong Special Administrative Region, China
| | - Wai Song Yeung
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, China
| | - Roger M K Ng
- Department of Psychiatry, Kowloon Hospital, Hong Kong Special Administrative Region, China
| | - William T L Lo
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong Special Administrative Region, China
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Pak Sham
- Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong Special Administrative Region, China; Centre for Genomic Sciences, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong Special Administrative Region, China
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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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Llerena K, Reddy LF, Kern RS. The role of experiential and expressive negative symptoms on job obtainment and work outcome in individuals with schizophrenia. Schizophr Res 2018; 192:148-153. [PMID: 28599750 DOI: 10.1016/j.schres.2017.06.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/08/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
Abstract
Unemployment rates for schizophrenia are high across all age groups compared to the general population. Past studies have focused on neurocognition as a key determinant of unemployment and poor work outcome in schizophrenia. However, several recent studies suggest that clinical symptoms may be equally or more important than cognitive dysfunction for understanding employment difficulties. An enhanced understanding of the domains of negative symptoms that hinder job obtainment and work outcomes in people with schizophrenia is vital for developing treatments that translate into better employment outcomes. The purpose of this study was to determine whether 112 participants with schizophrenia or schizoaffective disorder receiving supported employment services differed on experiential and expressive negative symptoms based on whether they obtained a job or remained unemployed. Further, in a subset of workers, this study examined the relationship of experiential "motivational" negative symptoms with work outcomes (weeks worked, hours worked, wages earned). Neurocognition was assessed using the MATRICS Consensus Cognitive Battery and clinical symptoms were assessed using the Scale for the Assessment of Negative Symptoms and the Brief Psychiatric Rating Scale. Experiential, but not expressive, negative symptoms were related to job obtainment, hours worked, and wages earned. However, these findings were attenuated and non-significant after controlling for age. These results suggest that experiential negative symptoms are potentially key to better understanding employment outcomes of individuals with schizophrenia receiving supported employment services, but further work is needed to untangle its significance vis-à-vis other individual, environmental, and program factors.
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Affiliation(s)
- Katiah Llerena
- Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, 11301 Wilshire Blvd., Bldg. 210, Los Angeles, CA 90073, USA; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, 760 Westwood Plaza, Los Angeles, CA 90095, USA.
| | - L Felice Reddy
- Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, 11301 Wilshire Blvd., Bldg. 210, Los Angeles, CA 90073, USA; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Robert S Kern
- Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, 11301 Wilshire Blvd., Bldg. 210, Los Angeles, CA 90073, USA; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, 760 Westwood Plaza, Los Angeles, CA 90095, USA
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Einarson TR, Bereza BG, Tedouri F, Van Impe K, Denee TR, Dries PJT. Cost-effectiveness of 3-month paliperidone therapy for chronic schizophrenia in the Netherlands. J Med Econ 2017; 20:1187-1199. [PMID: 28762843 DOI: 10.1080/13696998.2017.1363050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND A new depot formulation of paliperidone has been developed that provides effective treatment for schizophrenia for 3 months (PP3M). It has been tested in phase-3 trials, but no data on its cost-effectiveness have been published. PURPOSE To determine the cost-effectiveness of PP3M compared with once-monthly paliperidone (PP1M), haloperidol long-acting therapy (HAL-LAT), risperidone microspheres (RIS-LAT), and oral olanzapine (oral-OLZ) for treating chronic schizophrenia in The Netherlands. METHODS A previous 1-year decision tree was adapted, based on local inputs supplemented with data from published literature. The primary analysis used DRG costs in 2016 euros from the insurer perspective, as derived from official lists. A micro-costing analysis was also conducted. For the costing scenario, official list prices were used. Clinical outcomes included relapses (treated as outpatients, requiring hospitalization, total), and quality-adjusted life-years (QALYs). Rates and utility scores were derived from the literature. Economic outcomes were the incremental cost/QALY-gained or relapse-avoided. Model robustness was examined in scenario, 1-way, and probability sensitivity analyses. RESULTS The expected cost was lowest with PP3M (8,781€), followed by PP1M (10,325€), HAL-LAT (11,278€), RIS-LAT (11,307€), and oral-OLZ (13,556€). PP3M had the fewest total relapses/patient (0.36, 0.94, 1.39, 1.21, and 1.70, respectively), hospitalizations (0.11, 0.46, 0.40, 0.56, and 0.57, respectively), emergency room visits (0.25, 0.48. 0.99, 0.65, and 1.14, respectively) and the most QALYs (0.847, 0.735, 0.709, 0.719, and 0.656, respectively). In both cost-effectiveness and cost-utility analyses, PP3M dominated all other drugs. Sensitivity analyses confirmed base case findings. In the costing analysis, total costs were, on average, 31.9% higher than DRGs. CONCLUSIONS PP3M dominated all commonly used drugs. It is cost-effective for treating chronic schizophrenia in the Netherlands. Results were robust over a wide range of sensitivity analyses. For patients requiring a depot medication, such as those with adherence problems, PP3M appears to be a good alternative anti-psychotic treatment.
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Affiliation(s)
- Thomas R Einarson
- a Leslie Dan Faculty of Pharmacy , University of Toronto , Toronto , ON , Canada
| | - Basil G Bereza
- a Leslie Dan Faculty of Pharmacy , University of Toronto , Toronto , ON , Canada
| | - Fadi Tedouri
- b Janssen Janssen Pharmaceutica NV , Beerse , Belgium
| | | | - Tom R Denee
- c Janssen-Cilag BV , Tilburg , The Netherlands
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Einarson TR, Bereza BG, Garcia Llinares I, González Martín Moro B, Tedouri F, Van Impe K. Cost-effectiveness of 3-month paliperidone treatment for chronic schizophrenia in Spain. J Med Econ 2017; 20:1039-1047. [PMID: 28678566 DOI: 10.1080/13696998.2017.1351370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND A 3-month long treatment of paliperidone palmitate (PP3M) has been introduced as an option for treating schizophrenia. Its cost-effectiveness in Spain has not been established. AIMS To compare the costs and effects of PP3M compared with once-monthly paliperidone (PP1M) from the payer perspective in Spain. METHODS This study used the recently published trial by Savitz et al. as a core model over 1 year. Additional data were derived from the literature. Costs in 2016 Euros were obtained from official lists and utilities from Osborne et al. The authors conducted both cost-utility and cost-effectiveness analyses. For the former, the incremental cost per quality-adjusted life-year (QALY) gained was calculated. For the latter, the outcomes were relapses and hospitalizations avoided. To assure the robustness of the analyses, a series of 1-way and probability sensitivity analyses were conducted. RESULTS The expected cost was lower with PP3M (4,780€) compared with PP1M (5,244€). PP3M had the fewest relapses (0.080 vs 0.161), hospitalizations (0.034 v.s 0.065), and emergency room visits (0.045 v.s 0.096) and the most QALYs (0.677 v.s 0.625). In both cost-effectiveness and cost-utility analyses, PP3M dominated PP1M. Sensitivity analyses confirmed base case findings. For the primary analysis (cost-utility), PP3M dominated PP1M in 46.9% of 10,000 simulations and was cost-effective at a threshold of 30,000€/QALY gained. CONCLUSIONS PP3M dominated PP1M in all analyses and was, therefore, cost-effective for treating chronic relapsing schizophrenia in Spain. For patients who require long-acting therapy, PP3M appears to be a good alternative anti-psychotic treatment.
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Affiliation(s)
- Thomas R Einarson
- a Leslie Dan Faculty of Pharmacy , University of Toronto , Toronto , ON , Canada
| | - Basil G Bereza
- a Leslie Dan Faculty of Pharmacy , University of Toronto , Toronto , ON , Canada
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Evensen S, Ueland T, Lystad JU, Bull H, Klungsøyr O, Martinsen EW, Falkum E. Employment outcome and predictors of competitive employment at 2-year follow-up of a vocational rehabilitation programme for individuals with schizophrenia in a high-income welfare society. Nord J Psychiatry 2017; 71:180-187. [PMID: 27774843 DOI: 10.1080/08039488.2016.1247195] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Employment is an important part of recovery for individuals with schizophrenia. The employment rate for this group is as low as 10% in Norway, and major system related barriers to employment are evident. AIMS This study reports the competitive employment outcome at 2-year follow-up of a vocational rehabilitation study augmented with cognitive remediation (CR) or elements from cognitive behaviour therapy (CBT) for individuals with schizophrenia spectrum disorders. It also investigates if global functioning, self-esteem, and depression at baseline predicts employment outcome, and if change in these variables during the intervention period is associated with employment outcome. METHOD One hundred and forty-eight participants with schizophrenia spectrum disorders in six Norwegian counties received 10 months vocational rehabilitation augmented with either CBT (n = 84) or CR (n = 64). Both competitive and sheltered workplaces were used. Participants were assessed at baseline, at the end of the intervention period, and at 2-year follow-up. RESULTS At 2-year follow-up, 21.2% had obtained competitive employment. A further 25.3% had work placements in competitive workplaces. Significant improvements were found in global functioning, self-esteem, and depression during the intervention period, but no significant differences between the two intervention groups. High baseline global functioning and self-esteem, as well as positive change in these variables during the intervention period, were significantly associated with higher competitive employment outcome at 2-year follow-up. CONCLUSION The results add to existing evidence that competitive employment is attainable for individuals with schizophrenia. High global functioning and self-esteem were strongly associated with competitive employment outcome.
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Affiliation(s)
- Stig Evensen
- a Department of Research, Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway
| | - Torill Ueland
- a Department of Research, Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway.,b Department of Psychology , University of Oslo , Oslo , Norway
| | - June Ullevoldsæter Lystad
- a Department of Research, Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway
| | - Helen Bull
- a Department of Research, Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway
| | - Ole Klungsøyr
- a Department of Research, Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway.,c Oslo Center for Biostatistics and Epidemiology , Oslo University Hospital , Oslo , Norway
| | - Egil W Martinsen
- a Department of Research, Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway.,d Department of Clinical Medicine , University of Oslo , Oslo , Norway
| | - Erik Falkum
- a Department of Research, Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway.,d Department of Clinical Medicine , University of Oslo , Oslo , Norway
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Nordstroem AL, Talbot D, Bernasconi C, Berardo CG, Lalonde J. Burden of illness of people with persistent symptoms of schizophrenia: A multinational cross-sectional study. Int J Soc Psychiatry 2017; 63:139-150. [PMID: 28134026 DOI: 10.1177/0020764016688040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies have examined the impact of persistent symptoms of schizophrenia, especially with respect to patient-reported outcomes (PROs), carer burden and health economic impact. AIMS Analyse data relating to burden and severity of illness, functional impairment and quality of life for patients with persistent symptoms of schizophrenia. METHODS A cohort of stable outpatients with persistent symptoms of schizophrenia across seven countries were assessed in a multicentre, non-interventional, cross-sectional survey and retrospective medical record review using PRO questionnaires, clinical rating scales and carer questionnaires. RESULTS Overall, 1,421 patients and 687 carers were enrolled. Approximately two-thirds of patients had moderate/mild schizophrenia with more severe negative symptoms predominating. Patients showed impaired personal/social functioning and unsuitability for work correlated with various patient factors, most notably symptom-related assessments. Quality-of-life assessments showed 25% to ⩾30% of patients had problems with mobility, washing or dressing. Carer burden was also considerable, with carers having to devote an average of 20.5 hours per week and notable negative impact on quality-of-life measures. Healthcare resource utilisation for in-hospital, outpatient and other care provider visits was significant. CONCLUSION These results demonstrate the significant burden of schizophrenia for patients, carers and society and highlight the need for improved treatment approaches.
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Vizzotto ADB, Celestino DL, Buchain PC, Oliveira AM, Oliveira GMR, Di Sarno ES, Napolitano IC, Elkis H. A pilot randomized controlled trial of the Occupational Goal Intervention method for the improvement of executive functioning in patients with treatment-resistant schizophrenia. Psychiatry Res 2016; 245:148-156. [PMID: 27543828 DOI: 10.1016/j.psychres.2016.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 05/01/2016] [Accepted: 05/02/2016] [Indexed: 11/29/2022]
Abstract
Schizophrenia is a chronic disabling mental disorder that involves impairments in several cognitive domains, especially in executive functions (EF), as well as impairments in functional performance. This is particularly true in patients with Treatment-Resistant Schizophrenia (TRS). The aim of this study was to test the efficacy of the Occupational Goal Intervention (OGI) method for the improvement of EF in patients with TRS. In this randomized, controlled, single-blind pilot study, 25 TRS patients were randomly assigned to attend 30 sessions of either OGI or craft activities (control) over a 15-week period and evaluated by the Behavioural Assessment of the Dysexecutive Syndrome (BADS) as the primary outcome and the Direct Assessment of Functional Status (DAFS-BR) as well as the Independent Living Skills Survey (ILSS-BR) as secondary outcomes, all adapted for the Brazilian population. The Positive and Negative Syndrome Scale (PANSS) was used for monitoring symptom severity. Results showed significant statistical differences, favoring the OGI group in terms of improvement on the BADS, both in subtests (Action Program and Key Search) and the total score. Improvements in EFs were observed by families in various dimensions as measured by different subtests of the ILSS-BR inventory. The OGI group showed no significant results in secondary outcomes (DAFS-BR) except in terms of improvement of communication skills. Although preliminary, our results indicate that the OGI method is efficacious and effective for patients with TRS.
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Affiliation(s)
- Adriana D B Vizzotto
- Service of Occupational Therapy, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil; Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.
| | - Diego L Celestino
- Service of Occupational Therapy, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Patricia C Buchain
- Service of Occupational Therapy, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Alexandra M Oliveira
- Service of Occupational Therapy, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Graça M R Oliveira
- Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil; Service of Psychology and Neuropsychology, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Elaine S Di Sarno
- Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Isabel C Napolitano
- Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Helio Elkis
- Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil; Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
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Bjornestad J, Joa I, Larsen TK, Langeveld J, Davidson L, Ten Velden Hegelstad W, Anda LG, Veseth M, Melle I, Johannessen JO, Bronnick K. "Everyone Needs a Friend Sometimes" - Social Predictors of Long-Term Remission In First Episode Psychosis. Front Psychol 2016; 7:1491. [PMID: 27757090 PMCID: PMC5047905 DOI: 10.3389/fpsyg.2016.01491] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/16/2016] [Indexed: 11/23/2022] Open
Abstract
Background: Predictors of long-term symptomatic remission are crucial to the successful tailoring of treatment in first episode psychosis. There is lack of studies distinguishing the predictive effects of different social factors. This prevents a valid evaluating of their independent effects. Objectives: To test specific social baseline predictors of long-term remission. We hypothesized that first, satisfaction with social relations predicts remission; second, that frequency of social interaction predicts remission; and third, that the effect of friend relationship satisfaction and frequency will be greater than that of family relations satisfaction and frequency. Material and Methods: A sample of first episode psychosis (n = 186) completed baseline measures of social functioning, as well as clinical assessments. We compared groups of remitted and non-remitted individuals using generalized estimating equations analyses. Results: Frequency of social interaction with friends was a significant positive predictor of remission over a two-year period. Neither global perceived social satisfaction nor frequency of family interaction showed significant effects. Conclusions: The study findings are of particular clinical importance since frequency of friendship interaction is a possibly malleable factor. Frequency of interaction could be affected through behavioral modification and therapy already from an early stage in the course, and thus increase remission rates.
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Affiliation(s)
- Jone Bjornestad
- Tidlig Oppdagelse og Behandling av Psykoser - Centre for Clinical Research in Psychosis, Stavanger University HospitalStavanger, Norway; Network for Medical Sciences, University of StavangerStavanger, Norway
| | - Inge Joa
- Tidlig Oppdagelse og Behandling av Psykoser - Centre for Clinical Research in Psychosis, Stavanger University HospitalStavanger, Norway; Network for Medical Sciences, University of StavangerStavanger, Norway
| | - Tor K Larsen
- Tidlig Oppdagelse og Behandling av Psykoser - Centre for Clinical Research in Psychosis, Stavanger University HospitalStavanger, Norway; Section of Psychiatry, Department of Clinical Medicine, University of BergenBergen, Norway
| | - Johannes Langeveld
- Tidlig Oppdagelse og Behandling av Psykoser - Centre for Clinical Research in Psychosis, Stavanger University Hospital Stavanger, Norway
| | - Larry Davidson
- School of Medicine and Institution for Social and Policy Studies, Yale University, New Haven CT, USA
| | - Wenche Ten Velden Hegelstad
- Tidlig Oppdagelse og Behandling av Psykoser - Centre for Clinical Research in Psychosis, Stavanger University Hospital Stavanger, Norway
| | - Liss G Anda
- Tidlig Oppdagelse og Behandling av Psykoser - Centre for Clinical Research in Psychosis, Stavanger University Hospital Stavanger, Norway
| | - Marius Veseth
- Faculty of Health and Social Sciences, Bergen University College Bergen, Norway
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research, University of Oslo Oslo, Norway
| | - Jan O Johannessen
- Tidlig Oppdagelse og Behandling av Psykoser - Centre for Clinical Research in Psychosis, Stavanger University HospitalStavanger, Norway; Section of Psychiatry, Department of Clinical Medicine, University of BergenBergen, Norway
| | - Kolbjorn Bronnick
- Tidlig Oppdagelse og Behandling av Psykoser - Centre for Clinical Research in Psychosis, Stavanger University HospitalStavanger, Norway; Section of Psychiatry, Department of Clinical Medicine, University of BergenBergen, Norway
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Rofail D, Regnault A, le Scouiller S, Lambert J, Zarit SH. Assessing the impact on caregivers of patients with schizophrenia: psychometric validation of the Schizophrenia Caregiver Questionnaire (SCQ). BMC Psychiatry 2016; 16:245. [PMID: 27431493 PMCID: PMC4950699 DOI: 10.1186/s12888-016-0951-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 06/15/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The Schizophrenia Caregiver Questionnaire (SCQ) was developed to assess the impact on caregivers of caring for patients with schizophrenia. The objective of this study was to develop a scoring algorithm for the SCQ, and evaluate its measurement properties. METHODS The SCQ was administered to 358 caregivers of patients with schizophrenia included in the observational PATTERN study of stabilized patients with persistent symptoms of schizophrenia receiving outpatient care. SCQ item selection and creation of scores were based on exploration of item response distribution, factor analyses, and Rasch model. Construct validity, reliability, and ability to detect change of the SCQ scores were investigated. RESULTS The final questionnaire comprised a 'Humanistic impact' supra-domain composed of a global score and four subdomain scores ('Physical'; 'Emotional'; 'Social'; 'Daily life'), and eight other domain scores related to the caregiving role ('Exhaustion with caregiving'; 'Feeling alone'; 'Patient Dependence'; 'Worries for the patient'; 'Perception of caregiving'; 'Financial dependence of the patient'; 'Financial impact of caregiving'; 'Overall difficulty of caregiving'). Two items from the SCQ were deleted. SCQ scores showed very good construct validity: Item convergent/discriminant validity were satisfactory; SCQ scores of caregivers of patients with more severe symptoms were higher indicating more impact (p < 0.05 for all scores); SCQ scores were meaningfully associated with measures of schizophrenia severity (PANSS and PSP) and caregivers' Health-Related Quality of Life (Medical Outcome Survey Short Form 36 items). The SCQ Humanistic impact supra-domain scores demonstrated very good internal consistency reliability (Cronbach's alphas between 0.80 and 0.96) and test-retest reliability (Intraclass Coefficient correlations ranging from 0.75 and 0.87); Other SCQ domain scores showed lower but still acceptable reliability coefficients. SCQ scores clearly increased for caregivers of patients whose schizophrenia worsened. CONCLUSIONS Overall, the 30-item SCQ demonstrated very good measurement properties supporting its relevance to comprehensively measure the experience of caregivers of patients with schizophrenia.
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Affiliation(s)
- Diana Rofail
- Roche Products LTD, Shire Park, Welwyn Garden City, Hertfordshire UK
| | - Antoine Regnault
- Patient-centered Outcomes, Mapi, 27 rue de la Villette, 69003 Lyon, France
| | | | - Jérémy Lambert
- Patient-centered Outcomes, Mapi, 27 rue de la Villette, 69003, Lyon, France.
| | - Steven H. Zarit
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA USA
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Zink M, Englisch S. Schizophrenia treatment: an obstacle course. Lancet Psychiatry 2016; 3:310-2. [PMID: 26922476 DOI: 10.1016/s2215-0366(16)00023-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 01/15/2016] [Accepted: 01/15/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Mathias Zink
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, University of Heidelberg, D-68072 Mannheim, Germany.
| | - Susanne Englisch
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, University of Heidelberg, D-68072 Mannheim, Germany
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