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Yi C, Li F, Wang J, Li Y, Zhang J, Chen W, Jiang L, Yao D, Xu P, He B, Dong W. Abnormal trial-to-trial variability in P300 time-varying directed eeg network of schizophrenia. Med Biol Eng Comput 2024:10.1007/s11517-024-03133-9. [PMID: 38834855 DOI: 10.1007/s11517-024-03133-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 05/18/2024] [Indexed: 06/06/2024]
Abstract
Cognitive disturbance in identifying, processing, and responding to salient or novel stimuli are typical attributes of schizophrenia (SCH), and P300 has been proven to serve as a reliable psychosis endophenotype. The instability of neural processing across trials, i.e., trial-to-trial variability (TTV), is getting increasing attention in uncovering how the SCH "noisy" brain organizes during cognition processes. Nevertheless, the TTV in the brain network remains unrevealed, notably how it varies in different task stages. In this study, resorting to the time-varying directed electroencephalogram (EEG) network, we investigated the time-resolved TTV of the functional organizations subserving the evoking of P300. Results revealed anomalous TTV in time-varying networks across the delta, theta, alpha, beta1, and beta2 bands of SCH. The TTV of cross-band time-varying network properties can efficiently recognize SCH (accuracy: 83.39%, sensitivity: 89.22%, and specificity: 74.55%) and evaluate the psychiatric symptoms (i.e., Hamilton's depression scale-24, r = 0.430, p = 0.022, RMSE = 4.891; Hamilton's anxiety scale-14, r = 0.377, p = 0.048, RMSE = 4.575). Our study brings new insights into probing the time-resolved functional organization of the brain, and TTV in time-varying networks may provide a powerful tool for mining the substrates accounting for SCH and diagnostic evaluation of SCH.
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Affiliation(s)
- Chanlin Yi
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Fali Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, Chengdu, 2019RU035, China
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Macau, China
| | - Jiuju Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yuqin Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Jiamin Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Wanjun Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Lin Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, Chengdu, 2019RU035, China
- School of Electrical Engineering, Zhengzhou University, Zhengzhou, 450001, China
| | - Peng Xu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, 611731, China.
- School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
- Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, 610041, China.
- Rehabilitation Center, Qilu Hospital of Shandong University, Jinan, 250012, China.
| | - Baoming He
- Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
| | - Wentian Dong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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Çinar B, Gica Ş, Çelikkiran P, Kara A, Yeşilkaya UH, Karamustafalioğlu N. Eveningness chronotype influences social functioning by deteriorating depressive symptoms in remitted patients with schizophrenia. Chronobiol Int 2024; 41:847-858. [PMID: 38752353 DOI: 10.1080/07420528.2024.2353859] [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: 09/10/2023] [Accepted: 05/01/2024] [Indexed: 06/12/2024]
Abstract
Sleep and circadian rhythm disruption (SCRD) is common in schizophrenia patients, who also typically experience impaired social functioning. While various factors influence social functioning in schizophrenia, the specific impact of sleep and circadian rhythm disruption remains unclear. This study aimed to investigate the connection between chronotype and social functioning in remitted schizophrenia patients, examining the mediating roles of depression and sleep quality. The study included 185 patients diagnosed with schizophrenia based on DSM-5 criteria. After categorizing the patients into morningness, eveningness, or intermediate chronotypes using the Morningness-Eveningness Questionnaire(MEQ), they were assessed with the Positive and Negative Syndrome Scale(PANSS), Calgary Depression Scale for Schizophrenia(CDSS), Personal and Social Performance Scale(PSPS) and Pittsburgh Sleep Quality Index(PSQI). The eveningness chronotype group showed higher CDSS and PSQI scores and lower PWBS and PSPS-Total scores than the other groups (p < 0.05). A hierarchical linear regression model assessed MEQ, PSQI, and CDSS scores' effects on PSPS total scores. MEQ scores' significance diminished when CDSS scores were included. Eveningness chronotype, particularly with increased depressive symptoms, negatively impacts social functioning in remitted schizophrenia patients.These findings contribute to the understudied area of chronotype in schizophrenia and its impact on social functioning, including its interaction with sleep..
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Affiliation(s)
- Bilge Çinar
- Department of Psychiatry, Ardahan State Hospital, Ardahan, Turkiye
| | - Şakir Gica
- Department of Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkiye
| | - Pinar Çelikkiran
- Department of Psychiatry, Bakirkoy Dr. Mazhar Osman Clinic of Psychiatry and Neurology, Istanbul, Turkiye
| | - Aysu Kara
- Department of Psychiatry, Van State Training and Research Hospital, Van, Turkiye
| | - Umit Haluk Yeşilkaya
- Department of Psychiatry, Bakirkoy Dr. Mazhar Osman Clinic of Psychiatry and Neurology, Istanbul, Turkiye
- Regenerative and Restorative Medicine Research Center (REMER), Institute for Health Sciences and Technologies (SABITA), İstanbul Medipol University, İstanbul, Turkiye
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
| | - Nesrin Karamustafalioğlu
- Department of Psychiatry, Bakirkoy Dr. Mazhar Osman Clinic of Psychiatry and Neurology, Istanbul, Turkiye
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Lho SK, Kim T, Moon SY, Kim M, Kwon JS. Alteration in left frontoparietal connectivity correlates with impaired cognitive reappraisal in early psychosis. Schizophr Res 2024; 267:130-137. [PMID: 38531160 DOI: 10.1016/j.schres.2024.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/08/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Impaired cognitive reappraisal is a notable symptom of early psychosis, but its neurobiological basis remains underexplored. We aimed to identify the underlying neurobiological mechanism of this impairment by using resting-state functional connectivity (FC) analyses focused on brain regions related to cognitive reappraisal. METHODS Resting-state functional magnetic resonance images were collected from 36 first-episode psychosis (FEP) patients, 32 clinical high-risk (CHR) individuals, and 48 healthy controls (HCs). Whole-brain FC maps using seed regions associated with cognitive reappraisal were generated and compared across the FEP, CHR and HC groups. We assessed the correlation between resting-state FC, reappraisal success ratio, positive symptom severity and social functioning controlling for covariates. RESULTS FEP patients showed higher FC between the left superior parietal lobe and left inferior frontal gyrus than HCs. Higher FC between the left superior parietal lobe and left inferior frontal gyrus negatively correlated with the reappraisal success ratio in the FEP group after controlling for covariates. Lower FC correlated with lower positive symptom severity and improved global functioning in the FEP group. CONCLUSIONS Alteration in left frontoparietal connectivity reflects impaired cognitive reappraisal in early psychosis, and such alteration correlates with increased positive symptoms and decreased global functioning. These findings offer a potential path for interventions targeting newly emerging symptoms in the early stages of psychosis.
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Affiliation(s)
- Silvia Kyungjin Lho
- Department of Psychiatry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Taekwan Kim
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Sun-Young Moon
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Public Health Service, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jun Soo Kwon
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
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Jerome L, Matanov A, Bird V, Priebe S, McNamee P. Comparison of subjective quality of life domains in schizophrenia, mood, and anxiety disorders; an individual patient data meta-analysis. Psychiatry Res 2024; 332:115707. [PMID: 38184891 DOI: 10.1016/j.psychres.2023.115707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 12/19/2023] [Accepted: 12/28/2023] [Indexed: 01/09/2024]
Abstract
This study sought to compare satisfaction with different subjective quality of life domains across individuals with three different mental health disorders. Samples from four separate studies were combined to conduct a one-step individual patient data meta-analysis. 5329 individuals with either a schizophrenia (n = 1839), mood (n = 1650), or anxiety disorder (n = 1840) were included. Mean satisfaction ratings for each life domain were compared across disorders. Associations between satisfaction ratings and personal characteristics were investigated using multivariable mixed effect models. Results showed that individuals with an anxiety disorder had the widest range of scores and reported lower satisfaction in most domains compared to those with a schizophrenia or mood disorder. Individuals with a schizophrenia disorder rated domains to do with 'others', such as relationships with family and sex life, as lower than individuals with a mood or anxiety disorder. Satisfaction ratings were often more impacted by personal characteristics, such as employment status, than by diagnostic category. These results demonstrate that specific life areas are impacted differently in the three mental health disorders studied. However, further research needs to consider the impact of personal characteristics across disorders, and the subjective quality of life in individuals with anxiety disorders in particular warrants further investigation.
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Affiliation(s)
- Lauren Jerome
- Wolfson Institute of Population Health, Queen Mary, University of London, London, UK.
| | - Aleksandra Matanov
- Wolfson Institute of Population Health, Queen Mary, University of London, London, UK
| | - Victoria Bird
- Wolfson Institute of Population Health, Queen Mary, University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, East London NHS Foundation Trust, London, UK
| | - Philip McNamee
- Unit for Social and Community Psychiatry, East London NHS Foundation Trust, London, UK
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Kølbæk P, Mors O, Correll CU, Østergaard SD. Treatment of schizophrenia evaluated via the pharmacopsychometric triangle-An integrative approach with emphasis on well-being and functioning. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:88. [PMID: 38104195 PMCID: PMC10725501 DOI: 10.1038/s41537-023-00420-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 11/23/2023] [Indexed: 12/19/2023]
Abstract
Quantification of treatment response is crucial to optimize outcomes for patients with schizophrenia. In this study, we evaluated the relationship between quantitative measures of clinician-rated symptom severity and self-rated side effects, well-being, and functioning among inpatients with schizophrenia using the six-item version of the Positive and Negative Syndrome Scale (PANSS-6), the Glasgow Antipsychotic Side-effect Scale (GASS), the WHO-Five Well-being Index (WHO-5), and the Sheehan Disability Scale (SDS). All measurements were conducted as close to admission and discharge as possible. Well-being and functioning were found to be most strongly associated with the additive effect of symptoms and side effects, while changes in side effects, well-being, and functioning appeared to be relatively independent from changes in symptom severity. The use of both symptom and side effect measures should inform clinical decision-making in the treatment of schizophrenia, as it has the potential to optimize functioning and well-being.
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Affiliation(s)
- Pernille Kølbæk
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Palle Juul-Jensens Boulevard 175, 8200, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark.
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Palle Juul-Jensens Boulevard 175, 8200, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
| | - Christoph U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY, 11004, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA
- Department of Child and Adolescent Psychiatry and Psychotherapy, Charite Universitätsmedizin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Søren D Østergaard
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Palle Juul-Jensens Boulevard 175, 8200, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Palle Juul-Jensens Boulevard 175, 8200, Aarhus, Denmark
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Handest R, Molstrom IM, Gram Henriksen M, Hjorthøj C, Nordgaard J. A Systematic Review and Meta-Analysis of the Association Between Psychopathology and Social Functioning in Schizophrenia. Schizophr Bull 2023; 49:1470-1485. [PMID: 37260350 PMCID: PMC10686359 DOI: 10.1093/schbul/sbad075] [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] [Indexed: 06/02/2023]
Abstract
BACKGROUND Impaired social functioning is a major, but under-elucidated area of schizophrenia. It's typically understood as consequential to, eg, negative symptoms, but meta-analyses on the subject have not examined psychopathology in a broader perspective and there's severe heterogeneity in outcome measures. To enhance functional recovery from schizophrenia, a more comprehensive understanding of the nature of social functioning in schizophrenia is needed. STUDY DESIGN In this systematic review and meta-analysis, we searched PubMed, PsycInfo, and Ovid Embase for studies providing an association between psychopathology and social functioning. Meta-analyses of the regression and correlation coefficients were performed to explore associations between social functioning and psychopathology, as well as associations between their subdomains. STUDY RESULTS Thirty-six studies with a total of 4742 patients were included. Overall social functioning was associated with overall psychopathology (95% CI [-0.63; -0.37]), positive symptoms (95% CI [-0.39; -0.25]), negative symptoms (95% CI [-0.61; -0.42]), disorganized symptoms (95% CI [-0.54; -0.14]), depressive symptoms (95% CI [-0.33; -0.11]), and general psychopathology (95% CI [-0.60; -0.43]). There was significant heterogeneity in the results, with I2 ranging from 52% to 92%. CONCLUSIONS This is the first systematic review and meta-analysis to comprehensively examine associations between psychopathology and social functioning. The finding that all psychopathological subdomains seem to correlate with social functioning challenges the view that impaired social functioning in schizophrenia is mainly a result of negative symptoms. In line with classical psychopathological literature on schizophrenia, it may be more appropriate to consider impaired social functioning as a manifestation of the disorder itself.
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Affiliation(s)
- Rasmus Handest
- Mental Health Center Amager, Copenhagen University Hospital, København V, Denmark
| | - Ida-Marie Molstrom
- Mental Health Center Amager, Copenhagen University Hospital, København V, Denmark
| | - Mads Gram Henriksen
- Mental Health Center Amager, Copenhagen University Hospital, København V, Denmark
- Center for Subjectivity Research, Department of Communication, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health—CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Hellerup, Denmark
| | - Julie Nordgaard
- Mental Health Center Amager, Copenhagen University Hospital, København V, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Nauman S, Malik SZ, Saleem F, Ashraf Elahi S. How emotional labor harms employee’s performance: unleashing the missing links through anxiety, quality of work-life and Islamic work ethic. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2023. [DOI: 10.1080/09585192.2023.2167522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Shazia Nauman
- Riphah School of Business and Management, Riphah International University, Lahore, Pakistan
| | | | - Farida Saleem
- College of Business Administration, Prince Sultan University; Riyadh, Saudi Arabia
| | - Sabreen Ashraf Elahi
- Riphah School of Business and Management, Riphah International University, Lahore, Pakistan
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Wright AC, Browne J, Cather C, Meyer-Kalos P, Mueser KT. Relationship between patterns of cannabis use and functional and symptomatic trajectories in first-episode psychosis. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01441-5. [PMID: 35900474 DOI: 10.1007/s00406-022-01441-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 05/29/2022] [Indexed: 02/04/2023]
Abstract
Cannabis use is common in first-episode psychosis (FEP) but evidence is mixed about the extent to which cannabis use predicts symptoms and functional outcomes among those who seek treatment. This study sought to characterize cannabis use patterns and examine the relationship with clinical outcomes, including interactions with early intervention services (EIS). Data were drawn from the Recovery After an Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study including FEP individuals receiving treatment at sites randomized to provide either EIS (NAVIGATE) or community care (CC). Cannabis use was assessed monthly and symptom and functioning data were collected at baseline, 6, 12, 18, and 24 months. Among the 404 participants enrolled, 334 were classified into four cannabis use groups (consistent, sporadic, stopped, and never users) based on their use during the first year. Consistent and sporadic cannabis users were younger, whereas those who had stopped using were older. Sporadic users had the highest depression and the lowest functioning at baseline and improved less during treatment in negative emotions and intrapsychic foundations (e.g., motivation and sense of purpose) than non-users. However, sporadic users who received NAVIGATE improved more in overall symptoms and functioning than those who received CC. Consistent users did not tend to differ in their trajectories from non-users. Individuals with FEP who use cannabis sporadically showed less clinical improvement than non-users. However, EIS treatment reduced the negative effects of sporadic cannabis use on clinical outcomes. Those who use cannabis sporadically may have unique needs that require attention in EIS.
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Affiliation(s)
- Abigail C Wright
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Julia Browne
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA
| | - Corinne Cather
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Piper Meyer-Kalos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA.
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Anxiety and Depression in a Non-Clinical Sample of Young Polish Adults: Presence of Meaning in Life as a Mediator. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106065. [PMID: 35627602 PMCID: PMC9140330 DOI: 10.3390/ijerph19106065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 12/10/2022]
Abstract
Early adulthood, between 18 and 25, is viewed as a decisive period of life for the prevention and treatment of anxiety and depression. Although the topic of their mutual relationship is well-known, little has been uncovered about the mechanism underlying this connection. To understand the indirect pathways between anxiety and depression, we chose the sense of meaning of life as a mediator because people's beliefs that their lives are or can be purposeful may protect against depression. The sample was composed of 277 Polish young adults. A small majority of the participants were women (58.8%). The mean age was M = 22.11 (SD = 1.72). We used in the research the Direct Behavior Rating-Scale Items Scale, the Meaning in Life Questionnaire, and the Brief Screen for Depression. Correlational analysis showed that, consistent with past findings, anxiety correlated positively with depression and searching for meaning. It was also negatively associated with presence of meaning. Moreover, depression was negatively linked to presence of meaning and positively with searching for meaning. Regression-based mediation analyses (PROCESS macro 3.4) proved that the relationship between anxiety and depression was mediated by presence of meaning in life, suggesting that having a sense of meaning may be a pathway by which feelings of tension relative to adverse events protect against depression.
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Tan EJ, Toh WL, Rossell SL. Examining relationships between state and trait psychotic symptoms and quality of life in schizophrenia spectrum disorders. Psychiatry Res 2022; 310:114450. [PMID: 35183988 DOI: 10.1016/j.psychres.2022.114450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 11/30/2022]
Abstract
Positive and negative symptoms are core aspects of schizophrenia and have been shown to influence patient quality of life (QOL). Previous studies have largely focused on current or state symptoms, with limited work on the contributions of trait symptoms to QOL. This study sought to examine the relationship between both state and trait symptoms and objective and subjective QOL. Fifty-three schizophrenia spectrum disorder patients and 47 healthy controls were recruited. State symptomatology was assessed using the Positive and Negative Syndrome Scale in the patients only. In all participants, trait symptoms were assessed using the Oxford-Liverpool Inventory of Feelings and Experiences, and QOL using Lehman's QOL Interview. Hierarchical linear regression analyses, controlling for depression and neurocognition, revealed that negative state symptoms were related to objective QOL within the patients, while negative trait symptoms were associated with both objective and subjective QOL in patients and healthy controls. No relationships were observed with positive state or trait symptoms and either QOL measure. The findings suggest a degree of complexity in the associations between symptoms and QOL, with primacy for negative symptoms at both state and trait levels. A greater appreciation of trait symptoms may help explain non-complementary QOL changes following symptom remission.
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Affiliation(s)
- Eric Josiah Tan
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.
| | - Wei Lin Toh
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Susan Lee Rossell
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
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Rotstein A, Shadmi E, Roe D, Gelkopf M, Levine SZ. Gender differences in quality of life and the course of schizophrenia: national study. BJPsych Open 2022; 8:e35. [PMID: 35101158 PMCID: PMC8867859 DOI: 10.1192/bjo.2022.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Evidence from various sources suggests that females with schizophrenia tend to report lower quality of life than males with schizophrenia despite having a less severe course of the disorder. However, studies have not examined this directly. AIMS To examine gender differences in the association between quality of life and the risk of subsequent psychiatric hospital admissions in a national sample with schizophrenia. METHOD The sample consisted of 989 (60.90%) males and 635 (39.10%) females with an ICD-10 diagnosis of schizophrenia. Quality of life was assessed and scored using the Manchester Short Assessment of Quality of Life. The course of schizophrenia was assessed from the number of psychiatric hospital admissions. Participants completed the quality of life assessment and were then followed up for 18-months for subsequent psychiatric admissions. Hazard ratios (HR) from Cox proportional hazards regression models were estimated unadjusted and adjusted for covariates (age at schizophrenia onset and birth year). Analyses were computed for males and females separately, as well as for the entire cohort. RESULTS A subsample of 93 males and 55 females was admitted to a psychiatric hospital during follow-up. Higher quality of life scores were significantly (P < 0.05) associated with a reduced risk of subsequent admissions among males (unadjusted: HR = 0.96, 95% CI 0.93-0.99; adjusted HR = 0.96, 95% CI 0.93-0.99) but not among females (unadjusted: HR = 0.97, 95% CI 0.93-1.02; adjusted HR = 0.97, 95% CI 0.93-1.02). CONCLUSIONS Quality of life in schizophrenia is a gender-specific construct and should be considered as such in clinical practice and future research.
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Affiliation(s)
- Anat Rotstein
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| | - Efrat Shadmi
- Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| | - David Roe
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| | - Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| | - Stephen Z Levine
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
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Öztürk Z, Şahi N Altun Ö. The effect of nursing interventions to instill hope on the internalized stigma, hope, and quality of life levels in patients With schizophrenia. Perspect Psychiatr Care 2022; 58:364-373. [PMID: 33861468 DOI: 10.1111/ppc.12800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This study was conducted to determine the effect of nursing interventions to instill hope on the internalized stigma, hope, and quality of life. METHODS The study was conducted as a quasi-experimental study with the experimental and control groups and repeated measurements. The data were collected using the Personal Information Form, Internalized Stigma Scale in Mental Illnesses (ISMI), Herth Hope Index (HHS), and Quality of Life Scale (QLS) for schizophrenia patients. RESULTS The difference between ISMI, HHS, and QLS posttest and follow-up test average scores was found to be statistically significant between the experimental and control groups. CONCLUSION It was determined that nursing interventions aimed at improving hope effectively decreased the internalized stigmatization level of patients with schizophrenia and increased hope and life quality levels.
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Affiliation(s)
- Zeynep Öztürk
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Özlem Şahi N Altun
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
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13
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Varghese A, Watson T, Whitehorn D, Tibbo P. Self-compassion, mindfulness and their relationship to depression and anxiety in individuals diagnosed with a psychotic disorder. Schizophr Res 2021; 237:76-78. [PMID: 34507057 DOI: 10.1016/j.schres.2021.08.035] [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: 11/29/2020] [Revised: 08/29/2021] [Accepted: 08/29/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Ashwin Varghese
- Department of Psychiatry, Dalhousie University, 6299 South St, Halifax, NS B3H 4R2, Canada; Department of Psychiatry, Monash Health, 62-70 Kangan Drive, Berwick, Victoria 3806, Australia.
| | - Tayler Watson
- Mental Health, Drugs and Alcohol Service, Barwon Health, Bellerine Street, Geelong, Victoria 3220, Australia
| | - David Whitehorn
- Department of Psychiatry, Dalhousie University, 6299 South St, Halifax, NS B3H 4R2, Canada
| | - Phil Tibbo
- Nova Scotia Early Psychosis Program, Nova Scotia Health Authority, 78 Lovett Lake Ct, Halifax, NS B3S 1B8, Canada; Dr. Paul Janssen Chair in Psychotic Disorders, Department of Psychiatry, Dalhousie University, 6299 South St, Halifax, NS B3H 4R2, Canada
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ÖZCAN TOZOĞLU E, ALKAN E, ÖZPOLAT G. Covid-19 pandemisinde toplum ruh sağlığı merkezlerinin hizmet şekli değişikliği ile şizofreni hastalarındaki anksiyete düzeyleri arasındaki ilişki. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.903054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Measuring the effectiveness of psychoeducation on adherence, depression, anxiety and stress among patients with diagnosis of schizophrenia. a control trial. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-00255-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AbstractDespite evidence of the impact of depression and stress on attitudes towards medication in general medical pathology regimens, little is known of the effects of depression and stress on attitudes towards medication in schizophrenia. This study explores the effects of a hope-based psychoeducation on attitudes towards medication, depression, anxiety and stress, and predictors of attitudes towards medication. The participants in the study (n = 29) were randomly allocated to either the psychoeducation group or the control group. Results from the psychoeducation group revealed that attitudes towards medication were significantly improved and anxiety was significantly reduced. Given the small sample, which was recruited from among patients of a day mental health centre, findings should be interpreted tentatively. Being longer in pharmacotherapy, having experienced fewer occurrences of hospitalisation, and being less depressed predicted positivity towards medication. Patients in the control group did not exhibit significant change in any of the studied variables. Findings were interpreted in the light of research on stigma and insight into illness, and add modestly to literature arguing for the importance of patients’ retention of hope, empowerment and sense of control over illness. This study proposed that psychoeducation is an appropriate intervention to address a wide range of factors that compound adherence to medication and patients’ symptoms, such as patients’ interpretations of causal models, their sense of hope and control over the illness, and their insight into illness and self-stigma.
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Karpov B, Kieseppä T, Lindgren M, Wegelius A, Suvisaari J. Anxiety symptoms in first-episode psychosis. Early Interv Psychiatry 2021; 15:569-576. [PMID: 32510786 DOI: 10.1111/eip.12986] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/03/2020] [Accepted: 04/28/2020] [Indexed: 02/06/2023]
Abstract
AIM Anxiety disorders and symptoms are common in people with psychotic disorders, having a negative impact on clinical status, function level and overall prognosis. However, research on the significance of anxiety in predicting remission and long-term functioning in first-episode psychosis (FEP) is still scarce. This study investigated the effects of anxiety and obsessive-compulsive symptoms (OCS) on clinical and functional improvement in individuals with FEP. METHODS FEP patients (N = 97) aged 18-40 years were recruited from the University Hospital District of Helsinki and the City of Helsinki. Psychotic and anxiety symptoms were measured using the Brief Psychiatric Rating Scale. Obsessive-compulsive symptoms were assessed using the Obsessive-Compulsive Inventory (OCI-R), and functioning was evaluated using the Social and Occupational Functioning Assessment Scale (SOFAS). Follow-up measurements were performed at 2 and 12 months. We specifically studied whether anxiety and obsessive-compulsive symptoms at the 2-month follow-up assessment, at a time when the initial treatment response had been achieved, would predict outcomes at 12 months. RESULTS Symptoms of anxiety and OCS correlated moderately with each other and psychotic symptoms, but at the 12-month follow-up, OCS no longer correlated significantly with psychotic and anxiety symptoms. When the level of psychotic symptoms was adjusted for, more severe OCS at the 2-month follow-up was associated with a lower rate of remission at 12 months, whereas a higher level of anxiety symptoms at 2 months was associated with better functioning at 12 months. CONCLUSIONS OCS may be predictive of poorer clinical outcomes, whereas anxiety symptoms may predict better functional outcomes.
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Affiliation(s)
- Boris Karpov
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maija Lindgren
- Department of Public Health Solutions, Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Asko Wegelius
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Suvisaari
- Department of Public Health Solutions, Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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Lange SMM, Schirmbeck F, Stek ML, Murk Jansen YR, van Rooijen G, de Haan L, Penninx BWJH, Rhebergen D. A comparison of depressive symptom profiles between current major depressive disorder and schizophrenia spectrum disorder. J Psychiatr Res 2021; 135:143-151. [PMID: 33486162 DOI: 10.1016/j.jpsychires.2021.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/03/2020] [Accepted: 01/04/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Depressive symptoms are highly prevalent and clinically relevant in schizophrenia spectrum disorder (SSD) patients. So far, little is known about to what extent the depressive symptom profile in SSD is comparable to that seen in major depressive disorder (MDD). METHODS Data were derived from the Genetic Risk and Outcome of Psychosis study (GROUP) and the Netherlands Study of Depression and Anxiety (NESDA). We examined differences in severity of depressive symptom profiles and distribution of mood/cognition and somatic/vegetative depressive symptoms using the Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR) within SSD patients (n = 449), MDD patients (n = 816) and healthy controls (n = 417), aged 18 to 50. Within SSD, associations between depression severity and clinical and demographic data were examined. RESULTS 60.4% of SSD patients showed substantial depressive symptomatology (QIDS-SR≥6). The difference in mood/cognition symptoms between SSD and MDD was larger (higher symptoms in MDD, effect size = 1.13), than the differences in somatic/vegetative symptoms (effect size 0.74). In patients with SSD, multivariable regression analyses showed that lower social functioning, male gender, use of benzodiazepine and more severe positive symptoms were associated with higher overall depressive symptomatology. The use of antipsychotics or antidepressants was associated with more somatic/vegetative symptoms. CONCLUSION More than half of SSD patients have considerable depressive symptomatology, with a relative preponderance of somatic/vegetative symptoms compared to the profile seen in MDD. Future research could explore whether depressive symptom profile in SSD may also be associated with biological dysregulations like in MDD.
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Affiliation(s)
- Sjors M M Lange
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands.
| | - Frederike Schirmbeck
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Max L Stek
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands
| | - Yentl R Murk Jansen
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands
| | - Geeske van Rooijen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Lieuwe de Haan
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands
| | - Didi Rhebergen
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands
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Kozhuharova P, Diaconescu AO, Allen P. Reduced cortical GABA and glutamate in high schizotypy. Psychopharmacology (Berl) 2021; 238:2459-2470. [PMID: 34146134 PMCID: PMC8373725 DOI: 10.1007/s00213-021-05867-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/02/2021] [Indexed: 12/04/2022]
Abstract
RATIONALE Abnormal functioning of the inhibitory gamma-aminobutyric acid (GABA) and excitatory (glutamate) systems is proposed to play a role in the development of schizophrenia spectrum disorder. Although results are mixed, previous 1H-magnetic resonance spectroscopy (MRS) studies in schizophrenia and clinical high-risk samples report these metabolites are altered in comparison to healthy controls. Currently, however, there are few studies of these metabolites in schizotypy samples, a personality dimension associated with the experience of schizophrenia and psychosis-like symptoms. OBJECTIVES We investigated if GABA and glutamate metabolite concentrations are altered in people with high schizotypy. We also explored the relationship between resilience to stress, GABA metabolite concentrations and schizotypy. METHODS We used MRS to examine GABA and glutamate levels in the medial prefrontal cortex in people with low and high schizotypy traits as assessed with the Schizotypal Personality Questionnaire. Resilience to stress was assessed using the Connor-Davidson Resilience Scale. RESULTS Compared to individuals with low schizotypy traits, high schizotypy individuals showed lower cortical prefrontal GABA (F (1,38) = 5.18, p = 0.03, η2 = 0.09) and glutamate metabolite levels (F (1, 49) = 6.25, p = 0.02, η2 = 0.02). Furthermore, participants with high GABA and high resilience levels were significantly more likely to be in the low schizotypy group than participants with low GABA and high resilience or high GABA and low resilience (95% CI 1.07-1.34, p < .001). CONCLUSIONS These findings demonstrate that subclinical schizotypal traits are associated with abnormal functioning of both inhibitory and excitatory systems and suggest that these transmitters are implicated in a personality trait believed to be on a continuum with psychosis.
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Affiliation(s)
- Petya Kozhuharova
- Centre for Cognition, Neuroscience and Neuroimaging, Department of Psychology, University of Roehampton, Holybourne Ave, Roehampton, London, SW15 4JD, UK.
| | - Andreea O Diaconescu
- Department of Psychiatry, Brain and Therapeutics, Krembil Centre for Neuroinformatics, CAMH, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Paul Allen
- Centre for Cognition, Neuroscience and Neuroimaging, Department of Psychology, University of Roehampton, Holybourne Ave, Roehampton, London, SW15 4JD, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Golubović B, Gajić Z, Ivetić O, Milatović J, Vuleković P, Đilvesi Đ, Golubović S, Vrban F, Subašić A, Rasulić L. FACTORS ASSOCIATED WITH DEPRESSION IN PATIENTS WITH SCHIZOPHRENIA. Acta Clin Croat 2020; 59:605-614. [PMID: 34285431 PMCID: PMC8253071 DOI: 10.20471/acc.2020.59.04.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/05/2019] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to analyze risk factors present in schizophrenic patients with depressive symptomatology. The sample comprised of 76 respondents diagnosed with schizophrenia. In the study, we used the Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia. The prevalence of depression was estimated to be 30%. The mean scores on the negative subscale of the PANSS were significantly higher in patients with schizophrenia and depression compared to control group (U=3.64, p=0.00), and so were those on the General Psychopathology Scale (U=4.91, p=0.00). Socio-demographic factors were identified as important factors (p<0.05). Personal and environmental factors such as loneliness, immediate social environment, social support and isolation were statistically significantly different between the groups (p<0.05). There was a correlation of poor compliance with psycho-pharmacotherapy, increased number of hospitalizations and shorter remission period with the severity of clinical presentation (p<0.05). Since the presence of these factors is associated with depression in schizophrenia, their early detection in clinical practice is vital to ensure timely prevention of the development of depressive symptomatology.
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Affiliation(s)
| | - Zoran Gajić
- 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; 2Department of Psychiatry, Clinical Centre of Vojvodina, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6University of Health Applied Sciencies, Zagreb, Croatia; 7University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 8Division of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Olga Ivetić
- 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; 2Department of Psychiatry, Clinical Centre of Vojvodina, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6University of Health Applied Sciencies, Zagreb, Croatia; 7University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 8Division of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Jovan Milatović
- 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; 2Department of Psychiatry, Clinical Centre of Vojvodina, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6University of Health Applied Sciencies, Zagreb, Croatia; 7University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 8Division of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Petar Vuleković
- 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; 2Department of Psychiatry, Clinical Centre of Vojvodina, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6University of Health Applied Sciencies, Zagreb, Croatia; 7University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 8Division of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Đula Đilvesi
- 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; 2Department of Psychiatry, Clinical Centre of Vojvodina, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6University of Health Applied Sciencies, Zagreb, Croatia; 7University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 8Division of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Sonja Golubović
- 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; 2Department of Psychiatry, Clinical Centre of Vojvodina, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6University of Health Applied Sciencies, Zagreb, Croatia; 7University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 8Division of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Filip Vrban
- 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; 2Department of Psychiatry, Clinical Centre of Vojvodina, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6University of Health Applied Sciencies, Zagreb, Croatia; 7University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 8Division of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Ante Subašić
- 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; 2Department of Psychiatry, Clinical Centre of Vojvodina, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6University of Health Applied Sciencies, Zagreb, Croatia; 7University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 8Division of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Lukas Rasulić
- 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; 2Department of Psychiatry, Clinical Centre of Vojvodina, Novi Sad, Serbia; 3Department of Neurosurgery, Clinical Centre of Vojvodina, Novi Sad, Serbia; 4Clinical Centre of Vojvodina, Novi Sad, Serbia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6University of Health Applied Sciencies, Zagreb, Croatia; 7University of Belgrade, Faculty of Medicine, Belgrade, Serbia; 8Division of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Department of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
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Opoka SM, Sundag J, Riehle M, Lincoln TM. Emotion-Regulation in Psychosis: Patients with Psychotic Disorders Apply Reappraisal Successfully. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10163-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Background
Emotion-regulation is assumed to be impaired in psychosis: patients with psychotic disorders (PD) self-report to use reappraisal less frequently than healthy controls (HC), but it is uncertain whether they are also less successful in applying reappraisal. Moreover, it has not been investigated whether the habitual use of reappraisal is associated with the ability to use reappraisal successfully.
Methods
To address these questions, PD (n = 60), a clinical control group of patients with anxiety disorders (AD; n = 40) and HC (n = 40) completed questionnaires on habitual emotion-regulation and alexithymia, performed tests on neurocognitive functioning and jumping-to-conclusion bias, and were subjected to an emotion-regulation paradigm, in which they were asked to down-regulate induced anxiety and sadness.
Results
No differences were found between PD and HC regarding the habitual use of reappraisal, but PD reported to use reappraisal more frequently than AD. All groups were able to down-regulate anxiety and sadness via reappraisal following instructions. The habitual use of reappraisal and the reduction of anxiety and sadness after instruction were uncorrelated.
Conclusion
These findings question the common assumption that PD use reappraisal less often or less successfully. At least under laboratory condition, PD do not appear to be impaired in reducing negative affect via reappraisal successfully.
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Garel N, Bloom D, Joober R. Treating anxious syndromes with pregabalin in patients with psychosis. J Psychiatry Neurosci 2020; 45:370. [PMID: 32820880 PMCID: PMC7850152 DOI: 10.1503/jpn.200033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Nicolas Garel
- From the psychiatry residency program (Garel) and the Douglas Mental Health University Institute (Bloom, Joober), McGill University, Montreal, Que., Canada
| | - David Bloom
- From the psychiatry residency program (Garel) and the Douglas Mental Health University Institute (Bloom, Joober), McGill University, Montreal, Que., Canada
| | - Ridha Joober
- From the psychiatry residency program (Garel) and the Douglas Mental Health University Institute (Bloom, Joober), McGill University, Montreal, Que., Canada
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Berghöfer A, Martin L, Hense S, Weinmann S, Roll S. Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model. Qual Life Res 2020; 29:2073-2087. [PMID: 32170584 PMCID: PMC7363717 DOI: 10.1007/s11136-020-02470-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE This study (a) assessed quality of life (QoL) in a patient sample with severe mental illness in an integrated psychiatric care (IC) programme in selected regions in Germany, (b) compared QoL among diagnostic groups and (c) identified socio-demographic, psychiatric anamnestic and clinical characteristics associated with QoL. METHODS This cross-sectional study included severely mentally ill outpatients with substantial impairments in social functioning. Separate dimensions of QoL were assessed with the World Health Organisation's generic 26-item quality of life (WHOQOL-BREF) instrument. Descriptive analyses and analyses of variance (ANOVAs) were conducted for the overall sample as well as for diagnostic group. RESULTS A total of 953 patients fully completed the WHOQOL-BREF questionnaire. QoL in this sample was lower than in the general population (mean 34.1; 95% confidence interval (CI) 32.8 to 35.5), with the lowest QoL in unipolar depression patients (mean 30.5; 95% CI 28.9 to 32.2) and the highest in dementia patients (mean 53.0; 95% CI 47.5 to 58.5). Main psychiatric diagnosis, living situation (alone, partner/relatives, assisted), number of disease episodes, source of income, age and clinical global impression (CGI) scores were identified as potential predictors of QoL, but explained only a small part of the variation. CONCLUSION Aspects of health care that increase QoL despite the presence of a mental disorder are essential for severely mentally ill patients, as complete freedom from the disorder cannot be expected. QoL as a patient-centred outcome should be used as only one component among the recovery measures evaluating treatment outcomes in mental health care.
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Affiliation(s)
- Anne Berghöfer
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany.
| | - Luise Martin
- Klinik f. Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Otto-Heubner-Centrum für Kinder- und Jugendmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sabrina Hense
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Stefan Weinmann
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Stephanie Roll
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany
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Level of functioning, perceived work ability, and work status among psychiatric patients with major mental disorders. Eur Psychiatry 2020; 44:83-89. [DOI: 10.1016/j.eurpsy.2017.03.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/24/2017] [Accepted: 03/26/2017] [Indexed: 12/12/2022] Open
Abstract
AbstractBackground:Major mental disorders are highly disabling conditions that result in substantial socioeconomic burden. Subjective and objective measures of functioning or ability to work, their concordance, or risk factors for them may differ between disorders.Methods:Self-reported level of functioning, perceived work ability, and current work status were evaluated among psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n = 113), bipolar disorder (BD, n = 99), or depressive disorder (DD, n = 188) within the Helsinki University Psychiatric Consortium Study. Correlates of functional impairment, subjective work disability, and occupational status were investigated using regression analysis.Results:DD patients reported the highest and SSA patients the lowest perceived functional impairment. Depressive symptoms in all diagnostic groups and anxiety in SSA and BD groups were significantly associated with disability. Only 5.3% of SSA patients versus 29.3% or 33.0% of BD or DD patients, respectively, were currently working. About half of all patients reported subjective work disability. Objective work status and perceived disability correlated strongly among BD and DD patients, but not among SSA patients. Work status was associated with number of hospitalizations, and perceived work disability with current depressive symptoms.Conclusions:Psychiatric care patients commonly end up outside the labour force. However, while among patients with mood disorders objective and subjective indicators of ability to work are largely concordant, among those with schizophrenia or schizoaffective disorder they are commonly contradictory. Among all groups, perceived functional impairment and work disability are coloured by current depressive symptoms, but objective work status reflects illness course, particularly preceding psychiatric hospitalizations.
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Hanssen E, Balvert S, Oorschot M, Borkelmans K, van Os J, Delespaul P, Fett AK. An ecological momentary intervention incorporating personalised feedback to improve symptoms and social functioning in schizophrenia spectrum disorders. Psychiatry Res 2020; 284:112695. [PMID: 31831201 DOI: 10.1016/j.psychres.2019.112695] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/10/2019] [Accepted: 11/16/2019] [Indexed: 12/22/2022]
Abstract
This study examined the feasibility and effectiveness of an interactive smartphone application that aimed to improve daily-life social functioning and symptoms in schizophrenia spectrum disorders (SZ) with Experience Sampling Method (ESM) derived personalised feedback.Two groups of outpatients with a diagnosis of SZ were included (one receiving ESM-derived personalised feedback (n = 27) and one without feedback (n = 23)) and used the interactive smartphone application for three weeks. Main outcomes were momentary symptoms and social functioning, as assessed by ESM questionnaires. Additionally, feasibility and user-friendliness of the application were assessed. The response rate was 64% for the ESM questionnaires. In the feedback group, participants indicated that on 49% of the ESM days they acted on at least one personalised feedback prompt per day. Momentary psychotic symptoms significantly decreased over time only in the feedback group. Momentary loneliness and questionnaire-assessed psychotic symptoms decreased over time, irrespective of feedback. Participants evaluated the app as user-friendly and understandable. Momentary personalised feedback may impact momentary psychosis in daily life. Feelings of loneliness and questionnaire-based measured psychotic symptoms may be more responsive to non-specific effects of daily-life self-monitoring, not requiring specific feedback. Ecological momentary interventions offer opportunities for accessible and effective interventions in SZ.
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Affiliation(s)
- Esther Hanssen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, and Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, the Netherlands.
| | - Sanne Balvert
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, and Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, the Netherlands
| | | | - Karel Borkelmans
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands; Mondriaan Mental Health Trust, Heerlen, The Netherlands
| | - Anne-Kathrin Fett
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, and Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, the Netherlands; Department of Psychology, City University of London, London, United Kingdom; CSI Lab, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, United Kingdom
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Wang WL, Zhou YQ, Chai NN, Li GH, Liu DW. Mediation and moderation analyses: exploring the complex pathways between hope and quality of life among patients with schizophrenia. BMC Psychiatry 2020; 20:22. [PMID: 31941476 PMCID: PMC6964047 DOI: 10.1186/s12888-020-2436-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The underlying mechanism between hope and quality of life is as yet unknown. We aim to examine the potential mediating effect of depression and resilience and the moderated effect of sex in this well-established association. METHODS Two hundred seven patients diagnosed with schizophrenia were administered a questionnaire battery that measured hope, depression, resilience and QOL. A multiple mediation model was used to examine the mediating effect of resilience and depression on the association between hope and QOL. A subgroup analysis was performed and a moderated mediation model was examined to find and test the moderated effect of sex on the mediation model. We used Mplus to perform moderation and mediation analyses so that the mediators and moderator could function together in the same model. RESULT Sex was the moderator on the direct path between hope and QOL. The relationship between hope and QOL was mediated by resilience and depression in both sexes. When compared with female patients, the effect of hope on QOL was completely mediated by resilience and depression in males. In female patients, the model was partially mediated, and the direct effect of hope on QOL was significantly negatively correlated with the level of hope. CONCLUSION We present a conceptual model containing the mediated effects of resilience and depression and the moderated effect of sex between hope and QOL, which we believe facilitates the understanding of these associations. This model should be useful in the formulation of strategies to improve QOL.
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Affiliation(s)
- Wei-Liang Wang
- grid.410736.70000 0001 2204 9268School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang China
| | - Yu-Qiu Zhou
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang, China.
| | - Nan-Nan Chai
- grid.443353.60000 0004 1798 8916School of Nursing, Chifeng University, Chifeng, the Autonomous Region China
| | - Guo-Hua Li
- Chifeng Anding Hospital, Chifeng, the Autonomous Region China
| | - Dong-Wei Liu
- grid.410736.70000 0001 2204 9268School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang China
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Taylor SF, Grove TB, Ellingrod VL, Tso IF. The Fragile Brain: Stress Vulnerability, Negative Affect and GABAergic Neurocircuits in Psychosis. Schizophr Bull 2019; 45:1170-1183. [PMID: 31150555 PMCID: PMC6811817 DOI: 10.1093/schbul/sbz046] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Persons with schizophrenia exhibit sensitivity to stress and negative affect (NA), both strongly correlated with poor functional outcome. This theoretical review suggests that NA reflects a "fragile brain," ie, vulnerable to stress, including events not experienced as stressful by healthy individuals. Based on postmortem evidence of altered gamma-aminobutyric acid (GABA) function in parvalbumin positive interneurons (PVI), animal models of PVI abnormalities and neuroimaging data with GABAergic challenge, it is suggested that GABAergic disruptions weaken cortical regions, which leads to stress vulnerability and excessive NA. Neurocircuits that respond to stressful and salient environmental stimuli, such as the hypothalamic-pituitary-adrenal axis and the amygdala, are highly dysregulated in schizophrenia, exhibiting hypo- and hyper-activity. PVI abnormalities in lateral prefrontal cortex and hippocampus have been hypothesized to affect cognitive function and positive symptoms, respectively; in the medial frontal cortex (dorsal anterior cingulate cortex and dorsal medial prefrontal cortex), these abnormalities may lead to vulnerability to stress, NA and dysregulation of stress responsive systems. Given that postmortem PVI disruptions have been identified in other conditions, such as bipolar disorder and autism, stress vulnerability may reflect a transdiagnostic dimension of psychopathology.
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Affiliation(s)
- Stephan F Taylor
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, Ann Arbor, MI,To whom correspondence should be addressed; tel: 734-936-4955, fax: 734-936-7868, e-mail:
| | - Tyler B Grove
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, Ann Arbor, MI
| | | | - Ivy F Tso
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, Ann Arbor, MI
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27
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The association of clinical insight and depression with quality of life in schizophrenia. Psychiatry Res 2019; 279:350-352. [PMID: 30902352 DOI: 10.1016/j.psychres.2019.02.069] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/27/2019] [Accepted: 02/27/2019] [Indexed: 11/21/2022]
Abstract
This study assesses how insight influences depression and Quality of Life (QOL) in schizophrenia-spectrum outpatients and whether depression modifies the relationship between insight and QOL. 141 patients with schizophrenia or schizoaffective disorders with stable disease completed the EUROQOL-5D-5L and SQLS-R4, SAI-E and Calgary scales. Univariate and multivariate linear regression models were fitted to assess whether insight was related to QOL and/or depression. Higher levels of insight were (inversely) only related to EuroQOL-health but showed no relationship with depression. Depression showed an inversely strong relationship with EuroQOL-health. The relationship between clinical insight and QOL does not seem to be associated with depression.
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Abstract
The present study aims at evaluating the impact of anxiety on functional outcome in patients with schizophrenia, also taking into account the other main predictors of functioning identified by literature, to disentangle specific subcomponents which contribute to functional outcome. One hundred five patients with DSM-IV-TR schizophrenia were recruited and underwent a broad functional, psychopathological, and clinical-neuropsychological battery. A forward stepwise regression model was used to assess the predictive effect of anxiety and other factors on daily functioning, showing significant results only for global neurocognitive status and anxiety. These results confirm the role of neurocognition and are also in line with the hypothesis that trait anxiety has a direct impact on functional outcome. Overall, the findings support the role of anxiety as a core feature of schizophrenia pathology, with important implications for both research and clinical settings.
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Nuttall AK, Thakkar KN, Luo X, Mueser KT, Glynn SM, Achtyes ED, Kane JM. Longitudinal associations of family burden and patient quality of life in the context of first-episode schizophrenia in the RAISE-ETP study. Psychiatry Res 2019; 276:60-68. [PMID: 31026764 PMCID: PMC6538431 DOI: 10.1016/j.psychres.2019.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 10/27/2022]
Abstract
The present study examined longitudinal associations between family member perceived burden and clinical correlates to understand potential covariation in change over time in the context of first-episode schizophrenia in the RAISE-ETP study (N = 282). Across 24 months, family burden, patient quality of life, and positive symptoms improved. Findings from the present study suggest covariation in change over time in quality of life and family burden. As patient quality of life improved, family burden decreased. However, initial levels of quality of life were not significantly associated with changes in family burden and vice versa. Initial levels of positive symptoms were significantly associated with initial levels of family burden. These findings have treatment implications by suggesting the potential for interventions aimed at improving quality of life to have a spillover effect on family burden, or alternatively, that reducing perceived family burden may improve patient quality of life.
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Affiliation(s)
- Amy K. Nuttall
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI,Center for Research in Autism, Intellectual and Other Neurodevelopmental Disabilities, Michigan State University, East Lansing, MI, USA,Corresponding Author: Amy K. Nuttall, phone +1 517 884-9443;
| | - Katharine N. Thakkar
- Center for Research in Autism, Intellectual and Other Neurodevelopmental Disabilities, Michigan State University, East Lansing, MI, USA,Department of Psychology, Michigan State University, East Lansing, MI, USA,Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Xiaochen Luo
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kim T. Mueser
- Center for Psychiatric Rehabilitation and Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston, MA, USA,Departments of Psychological and Brain Sciences and Psychiatry, Boston University, Boston, MA, USA
| | | | - Eric D. Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA,Cherry Health, Grand Rapids, MI, USA
| | - John M. Kane
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, NY, USA,Feinstein Institute for Medical Research, NY, USA,The Zucker Hillside Hospital, Glen Oaks, NY, USA
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30
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Melo-Dias C, Lopes RC, Cardoso DFB, Bobrowicz-Campos E, Apóstolo JLA. Schizophrenia and Progressive Muscle Relaxation - A systematic review of effectiveness. Heliyon 2019; 5:e01484. [PMID: 31049425 PMCID: PMC6479115 DOI: 10.1016/j.heliyon.2019.e01484] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/28/2019] [Accepted: 04/03/2019] [Indexed: 12/16/2022] Open
Abstract
Objective We perform a systematically search, appraise and synthesize of the best available evidence on the effectiveness of Progressive Muscle Relaxation (PMR) in the adults with schizophrenia, in any setting, regarding anxiety, personal and social functioning, cognition, and well-being. Method Major databases were searched to find both published and unpublished studies from inception until April 2017, using Schizophren* AND Relax* as keywords, and studies published in Portuguese, English, Spanish, Italian, French were considered for inclusion in this review. Methodological quality was assessed by two independent reviewers using the Critical Appraisal Checklist for Randomized Controlled Trials from the Joanna Briggs Institute. Results From a total of 1172 studies, five studies, involving 216 adults with schizophrenia, met the inclusion criteria for this systematic review after assessment of their methodological quality. These studies reported benefits in experimental group participants after PMR intervention on anxiety (assessed with State anxiety inventory, Beck Anxiety Inventory and Spielberger Trait Anxiety Inventory), well-being (assessed with Subjective Exercise Experiences Scale) and personal and social functioning (assessed with Sheehan Disability Scale and Therapist Rating Scale). Conclusions Evidence suggests that PMR was effective in adults diagnosed with schizophrenia, except in one study where was only effective when combined with education. Thus, PMR may be useful to decrease state anxiety, improve well-being and social functioning in adults diagnosed with schizophrenia. However, due to the diversity of clinical intervention designs of PMR (different number and length of sessions) and outcome assessment scales, no strong evidence was found in this systematic review.
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Affiliation(s)
- Carlos Melo-Dias
- Nursing School of Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
- The Portugal Centre for Evidence-Based Practice: A Joanna Briggs Institute Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
- Corresponding author.
| | - Rosa Cristina Lopes
- Nursing School of Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Daniela Filipa Batista Cardoso
- Nursing School of Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
- The Portugal Centre for Evidence-Based Practice: A Joanna Briggs Institute Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Elzbieta Bobrowicz-Campos
- Nursing School of Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - João Luís Alves Apóstolo
- Nursing School of Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
- The Portugal Centre for Evidence-Based Practice: A Joanna Briggs Institute Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
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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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Ertekin Pinar S, Tel H. The Effect of Music on Auditory Hallucination and Quality of Life in Schizophrenic Patients: A Randomised Controlled Trial. Issues Ment Health Nurs 2019; 40:50-57. [PMID: 30111213 DOI: 10.1080/01612840.2018.1463324] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The study was conducted to determine the effects of music on auditory hallucination and quality of life in schizophrenic patients. The sample of this randomised controlled study consisted of 28 patients (14 experimental and 14 control groups) hospitalised with a diagnosis of schizophrenia (DSM-IV) and auditory hallucination. The study data were collected with the Information Form, The Scale for the Assessment of Positive Symptoms (SAPS), Characteristics of Auditory Hallucinations Questionnaire, and The World Health Organization Quality of Life Scale (WHOQOL-BREF). The hallucination, positive formal thought, and total SAPS scores of the patients in the experimental group obtained during their hospitalisation were determined to be higher than those obtained at discharge and at follow-ups after discharge. The characteristics of auditory hallucination questionnaire scores of the patients in the experimental and control groups decreased. The physical, mental, environmental, and national environmental domain scores of the quality of life in the experimental group increased at sixth month after discharge. Listening to music had positive effects on positive symptoms and the quality of life of patients with auditory hallucination. In line with these results, listening to music may be recommended to cope with auditory hallucinations and to provide positive quality of life.
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Affiliation(s)
| | - Havva Tel
- a Faculty of Health Sciences, Cumhuriyet University , Sivas , Turkey
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33
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Buonocore M, Bosia M, Baraldi MA, Bechi M, Spangaro M, Cocchi F, Bianchi L, Guglielmino C, Mastromatteo AR, Cavallaro R. Exploring anxiety in schizophrenia: New light on a hidden figure. Psychiatry Res 2018; 268:312-316. [PMID: 30092453 DOI: 10.1016/j.psychres.2018.07.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 05/17/2018] [Accepted: 07/28/2018] [Indexed: 11/30/2022]
Abstract
Anxiety is among the least studied features of schizophrenia, despite evidence of its significant impact on disease outcome. This work aims to investigate the anxiety construct in a sample of outpatients with schizophrenia, exploring the interplay of clinical, neurocognitive and social cognitive domains, as well as adverse childhood experiences and their relative contribute in determining anxiety. A forward stepwise regression model was performed on a sample of 68 outpatients with schizophrenia, to examine the predictive effect of different variables on anxiety. Predictors have been selected based on previous literature and include psychopathological, neurocognitive and social cognitive measures, as well as premorbid environmental factors. The analysis showed a significant contribution of childhood adverse experiences, followed by personal distress, while no significant effect was found for symptom's severity, nor global cognitive efficiency. The results show that anxiety is mainly determined by early environmental factors, as well as by socio-cognitive dimensions, such as personal distress. Data also suggest that anxiety can be considered as an independent construct, rather than as a mere epiphenomenon of the illness. The study has clinical implications as it highlights the importance of implementing both standardized assessments and group interventions specifically targeting anxiety in schizophrenia.
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Affiliation(s)
- Mariachiara Buonocore
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marta Bosia
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita -Salute San Raffaele University, Milan, Italy.
| | | | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Spangaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita -Salute San Raffaele University, Milan, Italy
| | - Federica Cocchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Bianchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carmelo Guglielmino
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Rita Mastromatteo
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita -Salute San Raffaele University, Milan, Italy
| | - Roberto Cavallaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita -Salute San Raffaele University, Milan, Italy
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Sagayadevan V, Lee SP, Ong C, Abdin E, Chong SA, Subramaniam M. Quality of Life across Mental Disorders in Psychiatric Outpatients. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2018. [DOI: 10.47102/annals-acadmedsg.v47n7p243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: Literature has shown that individuals with various psychiatric disorders experience a lower quality of life (QoL). However, few have examined QoL across disorders. The current study explored differences in QoL and symptom severity across 4 psychiatric diagnostic groups: anxiety disorders (including obsessive compulsive disorder [OCD]), depressive disorders, schizophrenia, and pathological gambling. Materials and Methods: Data analysed was from a previous study that examined the prevalence of hoarding symptoms among outpatients (n = 500) in a tertiary psychiatric hospital in Singapore. Measures utilised included the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II) and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). Sociodemographic information and details on type and number of comorbidities were also collected. Results: The depressive disorder group had the highest level of depressive and anxiety symptoms and the lowest QoL whereas; the schizophrenia group had the lowest level of depressive symptoms and the highest QoL. Age and employment status were the only sociodemographic correlates which were significantly associated with QoL. After controlling for sociodemographic factors, only the type of mental disorder was found to have a significant effect in explaining BAI, BDI-II and Q-LES-Q-SF. Conclusion: Findings offer insight in terms of the burden associated with the various disorders.
Key words: Anxiety, Comorbid, Depression, Symptom severity
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Affiliation(s)
| | - Siau Pheng Lee
- Research Division, Institute of Mental Health, Singapore
| | - Clarissa Ong
- Research Division, Institute of Mental Health, Singapore
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Rotstein A, Roe D, Gelkopf M, Levine SZ. Age of onset and quality of life among males and females with schizophrenia: A national study. Eur Psychiatry 2018; 53:100-106. [DOI: 10.1016/j.eurpsy.2018.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 01/26/2023] Open
Abstract
AbstractBackground:Age of onset is considered central to understanding the course of schizophrenia, yet little is known regarding its association with quality of life in general, and specifically among males and females.Aims:To examine the association between the age of schizophrenia onset and quality of life, in general, and among males and females, using data from a national sample and competing statistical models.Methods:Participants with a diagnosis of schizophrenia (N = 1624) completed the Manchester Short Assessment of Quality of Life (MSA-QoL) and were rated on a parallel measure by their professional caregivers (N = 578). Multiple regression analysis models were computed for self-appraised quality of life, and mixed models with random intercepts were used for caregivers. Six competing models were tested for parsimony for each rating source. Three models without adjustment and three models adjusted for confounding variables. Sensitivity analyses were conducted for males and females separately.Results:Age of onset was statistically significantly (P <.05) negatively associated with self-appraised and caregiver-appraised quality of life on aggregate and among females. Among males, a significant (P <.01) quadratic effect of onset age on self-appraised quality of life demonstrated a negative association up to onset age of 36.67 years, after which the association was positive.ConclusionsAn earlier age of onset is associated with a better quality of life in schizophrenia which is tentatively explained by social decline. Specific trends in psychiatric symptom severity may account for this association among females while social advantages may account for the particular results found among males.
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36
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Relationship between behavioral measures of anxiety and latent inhibition in mature rats. Learn Behav 2018; 47:59-65. [PMID: 29926398 PMCID: PMC6422955 DOI: 10.3758/s13420-018-0331-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study adopted a novel approach to relating nonhuman and human studies of anxiety and latent inhibition, by exploring the degree to which rats’ “temperaments” in relation to anxiety predicted the development of latent inhibition. It investigated whether anxiety levels in one situation (i.e., an elevated-plus maze) involving 38 intact, mature rats, could predict performance on a latent inhibition task (i.e., an animal model of attention), and, thus, reproduce findings from human studies. Rats were subjected to two tasks: a novel within-subject, appetitive stimulus pre-exposure procedure, and an elevated-plus maze task. In the stimulus pre-exposure task, non-reinforced exposure to a light led to facilitation of conditioning (perceptual learning) during the first 3 days, and to retardation of conditioning (latent inhibition) during the last 5 days. In the elevated-plus maze task, moderate levels of anxiety were observed. Regression analyses revealed that anxiety levels (plus maze) were a significant predictor of latent inhibition (stimulus pre-exposure). Measures of locomotor activity did not predict performance on the latent inhibition task. Rats with moderate levels of anxiety had better performance in the late inhibition task than animals with low levels of anxiety. These data and the methodology have implications for understanding nonhuman models of schizophrenia, and for the design of studies investigating these issues with nonhumans.
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DeRosse P, Nitzburg GC, Blair M, Malhotra AK. Dimensional symptom severity and global cognitive function predict subjective quality of life in patients with schizophrenia and healthy adults. Schizophr Res 2018; 195:385-390. [PMID: 29056491 PMCID: PMC5908765 DOI: 10.1016/j.schres.2017.10.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/23/2017] [Accepted: 10/09/2017] [Indexed: 11/28/2022]
Abstract
Over the last several decades Quality of Life (QoL) has become increasingly important as an indicator of treatment outcomes; particularly in schizophrenia spectrum disorders because of its close association with functional disability. Numerous studies seeking to elucidate the factors that contribute to QoL in this population have implicated both symptom severity and cognition in determining QoL but the findings have been mixed. The critical factors that appear to impede the lack of consensus in the extant literature examining determinants of QoL include the heterogeneity of the samples and measures examined as well as medication effects across different studies. Thus, the present study sought to address some of these issues by examining the relationship between subjective QoL and both symptom severity and cognitive function in a relatively homogeneous patient sample of patients and a community control sample assessed for dimensional symptom severity. Our results suggest that both global cognitive function and psychiatric symptoms have a significant impact on the subjective QoL of both people with schizophrenia spectrum disorders and psychiatrically healthy adults. Specifically, we found that a global index of cognition as well as self-reported avolitional and depressive symptoms were significantly predictive of QoL in both samples. These findings highlight the importance of addressing cognitive, depressive and avolitional symptoms in the treatment of patients with schizophrenia spectrum disorders and suggest that improvements in these domains may have a meaningful impact on their overall QoL.
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Affiliation(s)
- Pamela DeRosse
- Hofstra-Northwell School of Medicine, Department of Psychiatry, Hempstead, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA.
| | - George C. Nitzburg
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA,Teachers College, Columbia University, New York, NY, USA
| | - Melanie Blair
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA,Graduate Center, City University of New York, New York, NY, USA
| | - Anil K. Malhotra
- Hofstra-Northwell School of Medicine, Department of Psychiatry, Hempstead, NY, USA,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, NY, USA
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Schjerning O, Damkier P, Lykkegaard SE, Jakobsen KD, Nielsen J. Pregabalin for anxiety in patients with schizophrenia - A randomized, double-blind placebo-controlled study. Schizophr Res 2018; 195:260-266. [PMID: 28919128 DOI: 10.1016/j.schres.2017.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 09/10/2017] [Accepted: 09/13/2017] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Anxiety is frequent in patients with schizophrenia and poses a major impact on patients perceived quality of life, daily functioning and risk of suicide. Pregabalin has shown effective in the treatment of generalized anxiety disorder and has been suggested for the treatment of anxiety in patients with schizophrenia. As evidence is sparse regarding treatment of anxiety in this patient group, we aimed to investigate the use of pregabalin for anxiety in patients with schizophrenia. METHODS A randomized, double-blind placebo controlled study was used. Patients were randomized to either placebo or pregabalin (≤600mg/d) as add-on treatment. Primary analyses were intention-to-treat based with change in Hamilton Anxiety Scale after 4 and 8weeks of treatment as primary outcome. Secondary outcomes were change in psychopathology, quality-of-life, cognitive functioning and sleep. The study used centralized raters to increase accuracy and minimize baseline inflation. RESULTS A total of 54 patients were included with 46 completing the study. Pregabalin reduced the HAM-A6 score significantly compared to placebo and with a medium effect size 0.72 (p=0.01). No significant between-group difference was found for the overall HAM-A14. Most common side-effects were weight gain, dizziness, sedation and increased duration of sleep. CONCLUSIONS Although no effect was found on overall HAM-A14, pregabalin might be effective in the treatment of psychic anxiety symptoms in patients with schizophrenia with a medium effect size.
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Affiliation(s)
- Ole Schjerning
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Per Damkier
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Klaus Damgaard Jakobsen
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jimmi Nielsen
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
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McGranahan R, Hansson L, Priebe S. Psychopathological Symptoms and Satisfaction with Mental Health in Patients with Schizophrenia. Psychopathology 2018; 51:192-197. [PMID: 29566391 DOI: 10.1159/000487399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/30/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND The patient's view of their mental health is a central aspect in research and practice. Yet, little is known about which psychopathological symptoms are linked with patients' satisfaction with their mental health. We aimed to identify these symptoms in patients with schizophrenia. METHODS An individual patient data meta-analysis was conducted with data from 2,488 patients from 8 independent studies. Satisfaction with mental health was rated on a 7-point scale, and symptoms were observer-rated using identical items from the Brief Psychiatric Rating Scale and the Positive and Negative Symptom Scale. Mixed multilevel univariate followed by multivariate regression models were used to identify symptoms associated with satisfaction with mental health. RESULTS In univariate regressions, all subscales - not age and gender - were associated with mental health satisfaction. In the multivariate regression, only affective and negative symptoms were significantly associated with a lower satisfaction with mental health, explaining 22.5% of the variance. CONCLUSIONS Observer-rated psychopathological symptoms are linked to patients' mental health satisfaction. In addition to affective symptoms - which are commonly negatively linked with satisfaction ratings - a higher level of negative symptoms makes patients less satisfied with their mental health, whilst positive and other symptoms do not influence mental health satisfaction.
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Affiliation(s)
- Rose McGranahan
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
| | - Lars Hansson
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
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Fleury MJ, Grenier G, Bamvita JM. Associated and mediating variables related to quality of life among service users with mental disorders. Qual Life Res 2017; 27:491-502. [DOI: 10.1007/s11136-017-1717-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 11/24/2022]
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The associations between quality of life and clinical symptoms in individuals with an at-risk mental state and first-episode psychosis. Psychiatry Res 2017; 254:54-59. [PMID: 28448805 DOI: 10.1016/j.psychres.2017.04.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 01/27/2017] [Accepted: 04/18/2017] [Indexed: 11/22/2022]
Abstract
Quality of life (QOL) is strongly associated with severity of clinical symptoms and is often compromised in patients with chronic or first-episode psychosis (FEP). However, it remains unclear whether baseline QOL in individuals with an at-risk mental state (ARMS) for psychosis is higher or lower than that in patients with FEP, or what specific clinical symptoms relate to a decreased QOL in individuals with ARMS and FEP. The World Health Organization's WHOQOL-BREF, an instrument assessing QOL, was administered to 104 individuals with ARMS and 53 with FEP. Clinical symptoms were assessed by the Positive and Negative Syndrome Scale and the Beck Depression Inventory-II. We compared the four domain scores of the WHOQOL-BREF between the two groups, and calculated Pearson correlations between each WHOQOL-BREF domain score and the clinical symptoms and compared these correlations between the groups. We observed significant correlations between poor QOL and severity of depressive symptoms in both the FEP and ARMS group. No between-group differences were found in any correlation coefficients between WHOQOL-BREF domains and clinical symptoms. Thus, depressive symptoms should be investigated as a key factor relating to poor QOL in both individuals with ARMS and those with FEP.
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Anxiety does not contribute to social withdrawal in the subchronic phencyclidine rat model of schizophrenia. Behav Pharmacol 2017; 28:512-520. [PMID: 28704273 DOI: 10.1097/fbp.0000000000000325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Social withdrawal should not be considered a direct measure of the negative symptoms of schizophrenia as it may result not only from asociality (primary negative symptom) but also from other altered processes such as anxiety. To understand the contribution of these two factors to social deficit, we investigated whether the social withdrawal observed in the subchronic phencyclidine (PCP) rat model of schizophrenia could be attributed to increased anxiety. Compared to saline controls, PCP-treated rats (5 mg/kg, twice daily for 7 days, followed by a washout period) spent significantly less time in social interaction, but did not show anxiety-like behaviors in different relevant behavioral paradigms. In addition, their social deficit was not affected by a behavioral procedure known to reduce anxiety-like behavior (repeated exposure to the same partner) nor by systemic administration of the classical anxiolytic diazepam. In contrast, PCP-induced social withdrawal was reversed by the cannabinoid agonist CP55,940, a drug with known anxiogenic properties. Furthermore, when using the social approach task, PCP-treated animals performed similarly to control animals treated with diazepam, but not to those treated with the anxiogenic compound pentylenetetrazole. Taken together, our results indicate that PCP-induced social withdrawal cannot be attributed to increased anxiety. These data are discussed in the context of primary versus secondary negative symptoms and the deficit syndrome of schizophrenia.
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Examining the Psychometric Properties of the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire in Two Samples of Youth with OCD. Child Psychiatry Hum Dev 2017; 48:180-188. [PMID: 27329368 DOI: 10.1007/s10578-016-0662-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Researchers have demonstrated that quality of life (QOL) is an important construct to measure in individuals with mental health disorders, yet only a small amount of research has been dedicated to examining QOL and its response to treatment in children and adolescents with obsessive-compulsive disorder (OCD). The current study explored the psychometric properties of a measure of QOL, the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q), by examining the reliability, validity, and treatment sensitivity of this measure delivered in two separate RCTs for OCD (total N = 251 across both studies). Our results provide evidence for the reliability and validity of the PQ-LES-Q in adolescents with OCD (all Cronbach's alphas >.89, convergent validity correlations significant at the p < .05 level), but that an adaptation of the measure many be necessary for valid use in younger children with OCD.
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Kokaçya MH, Virit O, Çöpoğlu ÜS, Savaş H, Ari M, Bahçeci B. Symptomatic Remission Determines Functional Improvement and Quality of Life in Schizophrenia. Noro Psikiyatr Ars 2016; 53:328-333. [PMID: 28360807 DOI: 10.5152/npa.2016.11327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 08/15/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Schizophrenia is a chronic illness that negatively affects the quality of life and psychosocial functions. Defined criteria to assess remission in schizophrenia are considered to be useful in the long-term follow-up of patients and in discriminating diagnostic factors. This study investigated the quality of life and functionality in schizophrenia patients in symptomatic remission (R-Sch) and not in remission (Non-R-Sch). METHODS Sociodemographic data were collected for 40 R-Sch and 40 Non-R-Sch patients, and the following scales were administered: the Clinical Global Impression-Severity (CGI-S) Scale; Positive and Negative Syndrome Scale (PANSS), World Health Organization Quality of Life Questionnaire-Short Form, Turkish Version (WHOQOL-BREF-TR), Quality of Life Scale for Schizophrenia Patients (QLS), and Global Assessment of Functioning Scale (GAF). RESULTS The total and all subscale scores of PANSS and the CGI-S score were significantly lower in the R-Sch group than in the Non-R-Sch group, whereas the GAF scores and all subscales of QLS and WHOQOL-BREF-TR were significantly higher. CONCLUSION This study demonstrates that improvement in symptoms in schizophrenia patients improves quality and functionality in all areas of life, suggesting that an improvement in symptoms is the most important determinant of functional recovery in the treatment of schizophrenia.
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Affiliation(s)
- Mehmet Hanifi Kokaçya
- Department of Psychiatry, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Osman Virit
- Department of Psychiatry, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Ümit Sertan Çöpoğlu
- Department of Psychiatry, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Haluk Savaş
- Department of Psychiatry, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Mustafa Ari
- Department of Psychiatry, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Bülent Bahçeci
- Department of Psychiatry, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
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Hou CL, Ma XR, Cai MY, Li Y, Zang Y, Jia FJ, Lin YQ, Chiu HFK, Ungvari GS, Hall BJ, Zhong BL, Cao XL, Xiang YT. Comorbid Moderate-Severe Depressive Symptoms and their Association with Quality of Life in Chinese Patients with Schizophrenia Treated in Primary Care. Community Ment Health J 2016; 52:921-926. [PMID: 27306990 DOI: 10.1007/s10597-016-0023-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 05/27/2016] [Indexed: 11/26/2022]
Abstract
This study described the prevalence and correlates of comorbid moderate-severe depressive symptoms (comorbid depression thereafter) and their association with quality of life (QOL) in schizophrenia patients treated in primary care. 623 schizophrenia patients were enrolled. Patients' socio-demographic and clinical characteristics including comorbid depression [defined as a total score of 18 or above on the Montgomery-Asberg Depression Rating Scale (MADRS)] were recorded. Depressive symptoms (defined as a total score of 9 or above on the MADRS) were present in 54.1 % of patients, while 17.7 % had comorbid depression. Analysis of covariance revealed that comorbid depression was significantly associated with lower mental QOL. Multiple logistic regression analysis revealed that more severe positive and negative symptoms, anxiety symptoms, use of first-generation antipsychotics and antidepressants, were independently associated with comorbid depression. Given the negative association between comorbid depression and QOL, attempts to address comorbid depression in schizophrenia patients treated in primary care should be made.
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Affiliation(s)
- Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Xin-Rong Ma
- Ningxia Mental Health Center, Ningxia Ning-An Hospital, Yinchuan, Ningxia, China
| | - Mei-Ying Cai
- Guangzhou Yuexiu Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Yan Li
- Mood Disorders Centre, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yu Zang
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
- Marian Centre, The University of Notre Dame Australia, Perth, Australia
| | - Brian J Hall
- Department of Psychology, University of Macau, Macao SAR, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiao-Lan Cao
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Avenida da Universidade, 3/F, Building E12, Macau SAR, Taipa, China.
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Alptekin K, Akdede BB, Akvardar Y, Celikgün S, Dilşen NS, Durak G, Türk A, Fidaner H. Quality of Life Assessment in Turkish Patients with Schizophrenia and Their Relatives. Psychol Rep 2016; 95:197-206. [PMID: 15460376 DOI: 10.2466/pr0.95.1.197-206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Quality of life of first-degree relatives living in the same household with patients having schizophrenia has not been sufficiently explored. 30 patients with schizophrenia (16 women, 14 men), diagnosed using DSM–IV criteria, 31 of their relatives (15 women, 16 men), and 34 control subjects (21 women, 13 men) were included in the study. The mean age of the patients, their relatives, and the control subjects were 39.8 ± 10.9, 58.1 ± 12.5 and 37.3 ± 17.0, respectively. The World Health Organization Quality of Life–Brief Form was administered to all subjects. Quality of life was worse for the patient group than for their relatives and control subjects, but relatives of the patients and control subjects were not significantly different on Quality of life. Quality of life was negatively correlated with the severity of psychopathology and extrapyramidal side effects induced by antipsychotic drugs in the patients.
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Affiliation(s)
- Köksal Alptekin
- Department of Psychiatry, Adnan Menderes University Medical School, Aydin, Turkey.
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Tomotake M, Kaneda Y, Iga JI, Kinouchi S, Tayoshi S, Motoki I, Sumitani S, Yamauchi K, Taniguchi T, Ishimoto Y, Ueno SI, Ohmori T. Subjective and Objective Measures of Quality of Life Have Different Predictors for People with Schizophrenia. Psychol Rep 2016; 99:477-87. [PMID: 17153817 DOI: 10.2466/pr0.99.2.477-487] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the relationship between subjective and objective quality of life and assessed predictors in people with schizophrenia. The study population consisted of 99 stabilized outpatients with schizophrenia (DSM-IV) who had been regularly receiving outpatient treatment at the Department of Psychiatry, The Tokushima University Hospital. Subjective and objective quality of life were estimated using the Schizophrenia Quality of Life Scale and the Quality of Life Scale, respectively. Psychiatric symptoms were also measured with the Brief Psychiatric Rating Scale and the Calgary Depression Scale for Schizophrenia. Scores on the Schizophrenia Quality of Life Scale Motivation and Energy scales significantly correlated with the Quality of Life Scale total scores –.40 ( p <.001), and with the scores on Interpersonal Relations subscale –.42 ( p <.001), Instrumental Role subscale –.28 ( p = .005), Intrapsychic Foundations subscale –.39 ( p <.001), and Common Objects and Activities subscale –.25 ( p = .014). The Schizophrenia Quality of Life Scale Psychosocial scale significantly correlated with only the Quality of Life Scale total score –.20 ( p = .05), and there was no significant correlation between the scores on the Schizophrenia Quality of Life Scale Symptoms and Side-effects scales and the Quality of Life Scale. Stepwise regression analyses showed that the Calgary Depression Scale for Schizophrenia score was the most important predictor of each scale of the Schizophrenia Quality of Life Scale, and the Brief Psychiatric Rating Scale Negative Symptoms score was the most important predictor of the Quality of Life Scale total score and each subscale. These results suggest that subjective and objective quality of life have different predictors and should be considered as separate and complementary outcome variables.
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Affiliation(s)
- Masahito Tomotake
- Department of Psychiatry, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15, Kuramoto-cho, Tokushimashi, Tokushima 770-8503, Japan.
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Abstract
Anxiety symptoms can occur in up to 65 % of patients with schizophrenia, and may reach the threshold for diagnosis of various comorbid anxiety disorders, including obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). We review the clinical presentation, diagnosis, neurobiology, and management of anxiety in patients with schizophrenia, with a particular focus on pharmacotherapy. The prevalence of any anxiety disorder (at syndrome level) in schizophrenia is estimated to be up to 38 %, with social anxiety disorder (SAD) being the most prevalent. Severity of positive symptoms may correlate with severity of anxiety symptoms, but anxiety can occur independently of psychotic symptoms. While anxiety may be associated with greater levels of insight, it is also associated with increased depression, suicidality, medical service utilization, and cognitive impairment. Patients with anxiety symptoms are more likely to have other internalizing symptoms as opposed to externalizing symptoms. Diagnosis of anxiety in schizophrenia may be challenging, with positive symptoms obscuring anxiety, lower levels of emotional expressivity and communication impeding diagnosis, and conflation with akathisia. Higher diagnostic yield may be achieved by assessment following the resolution of the acute phase of psychosis as well as by the use of screening questions and disorder-specific self-report instruments. In schizophrenia patients with anxiety, there is evidence of underactive fear circuitry during anxiety-provoking stimuli but increased autonomic responsivity and increased responsiveness to neutral stimuli. Recent findings implicate the serotonin transporter (SERT) genes, brain-derived neurotropic factor (BDNF) genes, and the serotonin 1a (5HT1a) receptor, but are preliminary and in need of replication. There are few randomized controlled trials (RCTs) of psychotherapy for anxiety symptoms or disorders in schizophrenia. For pharmacotherapy, data from a few randomized and open trials have shown that aripiprazole and risperidone may be efficacious for obsessive-compulsive and social anxiety symptoms, and quetiapine and olanzapine for generalized anxiety. Older agents such as trifluoperazine may also reduce comorbid anxiety symptoms. Alternative options include selective serotonin re-uptake inhibitor (SSRI) augmentation of antipsychotics, although evidence is based on a few randomized trials, small open trials, and case series, and caution is needed with regards to cytochrome P450 interactions and QTc interval prolongation. Buspirone and pregabalin augmentation may also be considered. Diagnosis and treatment of anxiety symptoms and disorders in schizophrenia is an important and often neglected aspect of the management of schizophrenia.
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Affiliation(s)
- Henk Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Education Centre, Valkenberg Hospital, Private Bag X1, Observatory, Cape Town, 7935, South Africa.
| | - Dan J Stein
- Department of Psychiatry and Mental Health, MRC Unit on Anxiety and Stress Disorders, University of Cape Town, Groote Schuur Hospital (J-2), Anzio Rd, Observatory, Cape Town, 7925, South Africa
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Abstract
The identification of genetic variants responsible for behavioral variation is an enduring goal in biology, with wide-scale ramifications, ranging from medical research to evolutionary theory on personality syndromes. Here, we use for the first time a large-scale genetical genomics analysis in the brains of chickens to identify genes affecting anxiety as measured by an open field test. We combine quantitative trait locus (QTL) analysis in 572 individuals and expression QTL (eQTL) analysis in 129 individuals from an advanced intercross between domestic chickens and Red Junglefowl. We identify 10 putative quantitative trait genes affecting anxiety behavior. These genes were tested for an association in the mouse Heterogeneous Stock anxiety (open field) data set and human GWAS data sets for bipolar disorder, major depressive disorder, and schizophrenia. Although comparisons between species are complex, associations were observed for four of the candidate genes in mice and three of the candidate genes in humans. Using a multimodel approach we have therefore identified a number of putative quantitative trait genes affecting anxiety behavior, principally in chickens but also with some potentially translational effects as well. This study demonstrates that chickens are an excellent model organism for the genetic dissection of behavior.
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Rasmussen SA, Rosebush PI, Anglin RE, Mazurek MF. The predictive value of early treatment response in antipsychotic-naive patients with first-episode psychosis: Haloperidol versus olanzapine. Psychiatry Res 2016; 241:72-7. [PMID: 27156027 DOI: 10.1016/j.psychres.2016.04.097] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 02/26/2016] [Accepted: 04/26/2016] [Indexed: 11/30/2022]
Abstract
Early antipsychotic response predicts outcomes for psychotic patients, but recent evidence suggests that this may not be true for patients treated with olanzapine. In this study, we assessed the predictive value of early response to olanzapine or haloperidol in 75 antipsychotic-naive, first-episode psychosis inpatients. Patients were assessed weekly using the Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and Young Mania Rating Scale (YMRS). Regression analyses were used to determine whether improvement at week 2 or week 3 predicted improvement at hospital discharge. The majority of patients in both groups experienced a decrease in symptom severity of ≥50% at week 2. In the haloperidol group, week 2 improvement predicted improvement at discharge for all measures except the HAM-A. In the olanzapine group, week 2 improvement only predicted improvement at discharge for HAM-D scores. However, week 3 improvement in the olanzapine group predicted improvement at discharge for all measures except the HAM-A. Olanzapine non-responders at week 3 (but not week 2) benefited from having olanzapine switched to another antipsychotic. These results suggest that a 2 week trial of haloperidol is sufficient to predict treatment outcomes, while a 3 week trial is required for olanzapine.
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Affiliation(s)
- Sean A Rasmussen
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Patricia I Rosebush
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca E Anglin
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Department of Medicine (Gastroenterology), McMaster University, Hamilton, Ontario, Canada
| | - Michael F Mazurek
- Department of Medicine (Neurology), McMaster University, Hamilton, Ontario, Canada
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