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Lv X, Hou YS, Zhang ZH, Yue WH. OXTR polymorphisms associated with severity and treatment responses of schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:7. [PMID: 38184684 PMCID: PMC10851696 DOI: 10.1038/s41537-023-00413-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/13/2023] [Indexed: 01/08/2024]
Abstract
The mechanisms generating specific symptoms of schizophrenia remain unclear and genetic research makes it possible to explore these issues at a fundamental level. Taking into account the associations between the oxytocin system and social functions, which are apparently impaired in schizophrenia patients, we hypothesized that the oxytocin receptor gene (OXTR) might be associated with schizophrenia symptoms in both severity and responses to antipsychotics and did this exploratory positional study. A total of 2363 patients with schizophrenia (1181 males and 1182 females) included in our study were randomly allocated to seven antipsychotic treatment groups and received antipsychotic monotherapy for 6 weeks. Their blood DNA was genotyped for OXTR polymorphisms. Their symptom severity was assessed by Positive and Negative Syndrome Scale (PANSS), and the scores were transformed into seven factors (positive, disorganized, negative symptoms apathy/avolition, negative symptoms deficit of expression, hostility, anxiety and depression). Percentage changes in PANSS scores from baseline to week 6 were calculated to quantify antipsychotic responses. We found that OXTR polymorphisms were nominally associated with the severity of overall symptoms (rs237899, β = 1.669, p = 0.019), hostility symptoms (rs237899, β = 0.427, p = 0.044) and anxiety symptoms (rs13316193, β = -0.197, p = 0.038). As for treatment responses, OXTR polymorphisms were nominally associated with the improvement in negative symptoms apathy/avolition (rs2268490, β = 2.235, p = 0.0499). No association between severity or response to treatment and OXTR polymorphisms was found with statistical correction for multiplicity. Overall, our results highlighted the possibility of nominally significant associations of the OXTR gene with the severity and improvement in schizophrenia symptoms. Given the exploratory nature of this study, these associations are indicative of the role of the OXTR gene in the pathology of schizophrenia and may contribute to further elucidate the mechanism of specific symptoms of schizophrenia and to exploit antipsychotics more effective to specific symptoms.
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Affiliation(s)
- Xue Lv
- The First Affiliated Hospital of Xinxiang Medical College, 453100, Xinxiang, Henan, China
| | - Yue-Sen Hou
- The First Affiliated Hospital of Xinxiang Medical College, 453100, Xinxiang, Henan, China
- Henan Key Laboratory of Neurorestoratology, 453199, Xinxiang, Henan, China
- Henan Engineering Research Center of Physical Diagnostics and Treatment Technology for the Mental and Neurological Diseases, 453005, Xinxiang, Henan, China
| | - Zhao-Hui Zhang
- The First Affiliated Hospital of Xinxiang Medical College, 453100, Xinxiang, Henan, China.
| | - Wei-Hua Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, 100191, Beijing, China.
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Gong M, Yao L, Ge X, Liu Z, Zhang C, Yang Y, Amdanee N, Wang C, Zhang X. Empathy deficit in male patients with schizophrenia and its relationships with impulsivity and premeditated violence. Front Psychiatry 2023; 14:1160357. [PMID: 37398588 PMCID: PMC10308378 DOI: 10.3389/fpsyt.2023.1160357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
Objective To explore the pattern of empathy characteristics in male patients with schizophrenia (SCH) and to examine whether empathy deficit is associated with impulsivity and premeditated violence. Methods One hundred and fourteen male SCH patients were enrolled in this study. The demographic data of all patients were collected and the subjects were divided into two groups, namely, the violent group, including 60 cases, and the non-violent group, comprising 54 cases, according to the Modified Overt Aggression Scale (MOAS). The Chinese version of the Interpersonal Reactivity Index-C (IRI-C) was used to evaluate empathy and the Impulsive/Predicted Aggression Scales (IPAS) was employed to assess the characteristics of aggression. Results Among the 60 patients in the violent group, 44 patients had impulsive aggression (IA) and 16 patients had premeditated aggression (PM) according to the IPAS scale. In the violent group, the scores of the four subfactors of the IRI-C, i.e., perspective taking (PT), fantasy (FS), personal distress (PD), and empathy concern (EC), were significantly lower than in the non-violent group. Stepwise logistic regression showed that PM was independent influencing factor for violent behaviors in SCH patients. Correlation analysis revealed that EC of affective empathy was positively correlated with PM but not with IA. Conclusion SCH patients with violent behavior had more extensive empathy deficits compared with non-violent SCH patients. EC, IA and PM are independent risk factors of violence in SCH patients. Empathy concern is an important index to predict PM in male patients with SCH.
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Affiliation(s)
- Muxin Gong
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Psychiatry, Xuzhou Medical University, Xuzhou, China
| | - Lei Yao
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaodan Ge
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Zhenru Liu
- Department of Psychiatry, Xuzhou Medical University, Xuzhou, China
| | - Caiyi Zhang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yujing Yang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Nousayhah Amdanee
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chengdong Wang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiangrong Zhang
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
- Department of Psychiatry, Xuzhou Medical University, Xuzhou, China
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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D’Agostino A, Aguglia A, Barbui C, Bartoli F, Carrà G, Cavallotti S, Chirico M, Ostinelli EG, Zangani C, Martinotti G, Ostuzzi G. Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study. BMC Psychiatry 2022; 22:442. [PMID: 35773631 PMCID: PMC9245273 DOI: 10.1186/s12888-022-04071-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 06/03/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. METHOD In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. RESULTS SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. CONCLUSION Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns.
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Affiliation(s)
- Armando D’Agostino
- grid.4708.b0000 0004 1757 2822Department of Health Sciences, Università degli Studi di Milano, Milan, Italy ,grid.415093.a0000 0004 1793 3800Department of Mental Health, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Andrea Aguglia
- grid.5606.50000 0001 2151 3065Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy ,grid.410345.70000 0004 1756 7871IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Corrado Barbui
- grid.5611.30000 0004 1763 1124WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Francesco Bartoli
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Giuseppe Carrà
- grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Simone Cavallotti
- grid.415093.a0000 0004 1793 3800Department of Mental Health, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Margherita Chirico
- grid.4708.b0000 0004 1757 2822Department of Health Sciences, Università degli Studi di Milano, Milan, Italy ,grid.415093.a0000 0004 1793 3800Department of Mental Health, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Edoardo G. Ostinelli
- grid.4708.b0000 0004 1757 2822Department of Health Sciences, Università degli Studi di Milano, Milan, Italy ,grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.8241.f0000 0004 0397 2876Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK ,grid.416938.10000 0004 0641 5119Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Caroline Zangani
- grid.4708.b0000 0004 1757 2822Department of Health Sciences, Università degli Studi di Milano, Milan, Italy ,grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.8241.f0000 0004 0397 2876Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK ,grid.416938.10000 0004 0641 5119Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Giovanni Martinotti
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio”, Chieti, Italy
| | - Giovanni Ostuzzi
- grid.5611.30000 0004 1763 1124WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
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Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients. Healthcare (Basel) 2022; 10:healthcare10061078. [PMID: 35742130 PMCID: PMC9223291 DOI: 10.3390/healthcare10061078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 02/07/2023] Open
Abstract
Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand the associated variables predicting aggression for treatment and prevention purposes. The aim of the present study is to determine the relationship between alexithymia, sense of coherence and aggressive behavior in a sample of schizophrenic outpatients. Using a correlational research design, standardized self-report questionnaires assessed aggression (brief aggression questionnaire—BAQ), alexithymia (Toronto Alexithymia Scale—TAS) and sense of coherence (sense of coherence questionnaire—SOC) in a sample of 100 schizophrenic outpatients in clinical remission. Participants reported high levels of aggression and alexithymia along with reduced sense of coherence. Significant negative correlations were evidenced among scores on the SOC scale (p < 0.001) with both the TAS as well as with the BAQ scales. However, a positive correlation (p < 0.001) was observed between the TAS and BAQ scales. Regression indicated that 27% of the variation in the BAQ rating was explained by the TAS, while an additional 17.8% was explained by the sense of coherence. The difficulty identifying feelings of alexithymia and the comprehensibility and manageability components of sense of coherence significantly predicted anger, hostility and physical aggression. Sense of coherence mediated the relationship between alexithymia and aggression. From the path analysis, comprehensibility emerged as the key factor counterbalancing alexithymic traits and aggressive behaviors, and manageability effectuated higher anger control. The findings hold practical implications for the treatment and rehabilitation of schizophrenic patients.
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Kubota R, Okubo R, Ikezawa S, Matsui M, Adachi L, Wada A, Fujimaki C, Yamada Y, Saeki K, Sumiyoshi C, Kikuchi A, Omachi Y, Takeda K, Hashimoto R, Sumiyoshi T, Yoshimura N. Sex Differences in Social Cognition and Association of Social Cognition and Neurocognition in Early Course Schizophrenia. Front Psychol 2022; 13:867468. [PMID: 35496257 PMCID: PMC9051335 DOI: 10.3389/fpsyg.2022.867468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Both impairment and sex differences in social cognition and neurocognition have been documented in schizophrenia. However, whether sex differences exist in the association between social cognition and neurocognition are not known. We aimed to investigate the contribution of areas of neurocognition to theory of mind (ToM) and hostility bias, representing social cognition, according to sex in early course schizophrenia. Methods In this cross-sectional study, we assessed neurocognition using the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS) and assessed the ToM and hostility bias subdomains of social cognition using the Social Cognition Screening Questionnaire (SCSQ) in 131 participants (65 female, 66 male) diagnosed with schizophrenia within 5 years of onset. Sex differences were analyzed using t-tests. The associations of neurocognitive subdomains with ToM and hostility bias according to sex were analyzed using multiple regression analysis. Results were adjusted by age, estimated premorbid intelligence quotient, and symptomatology. Results No sex differences were found in ToM (p = 0.071) or hostility bias (p = 0.057). Higher verbal fluency was significantly associated with higher ToM in females (p < 0.01), whereas higher executive function was significantly associated with higher ToM in males (p < 0.05). Higher verbal fluency was significantly associated with lower hostility bias in females (p < 0.05), whereas neurocognition and hostility bias were not significantly associated in males. Conclusion The results suggest that neurocognition associated with social cognition differ according to sex. These differences should be considered for more effective treatment of social cognition.
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Affiliation(s)
- Ryotaro Kubota
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Ryo Okubo
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
- *Correspondence: Ryo Okubo,
| | - Satoru Ikezawa
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Endowed Institute for Empowering Gifted Minds, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Satoru Ikezawa,
| | - Makoto Matsui
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Leona Adachi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Ayumu Wada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Chinatsu Fujimaki
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Yuji Yamada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Koji Saeki
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Chika Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Akiko Kikuchi
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshie Omachi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Kazuyoshi Takeda
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naoki Yoshimura
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
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Girasek H, Nagy VA, Fekete S, Ungvari GS, Gazdag G. Prevalence and correlates of aggressive behavior in psychiatric inpatient populations. World J Psychiatry 2022; 12:1-23. [PMID: 35111577 PMCID: PMC8783168 DOI: 10.5498/wjp.v12.i1.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/18/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest. One reason for this is that psychiatric patients are generally considered more likely to be aggressive, which raises a related question of whether diagnoses of psychiatric disorders predict the prevalence of aggressive behavior. Predicting aggression in psychiatric wards is crucial, because aggressive behavior not only endangers the safety of both patients and staff, but it also extends the hospitalization times. Predictions of aggressive behavior also need careful attention to ensure effective treatment planning. This literature review explores the relationship between aggressive behavior and psychiatric disorders and syndromes (dementia, psychoactive substance use, acute psychotic disorder, schizophrenia, bipolar affective disorder, major depressive disorder, obsessive-compulsive disorder, personality disorders and intellectual disability). The prevalence of aggressive behavior and its underlying risk factors, such as sex, age, comorbid psychiatric disorders, socioeconomic status, and history of aggressive behavior are discussed as these are the components that mostly contribute to the increased risk of aggressive behavior. Measurement tools commonly used to predict and detect aggressive behavior and to differentiate between different forms of aggressive behavior in both research and clinical practice are also reviewed. Successful aggression prevention programs can be developed based on the current findings of the correlates of aggressive behavior in psychiatric patients.
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Affiliation(s)
- Hunor Girasek
- Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc South Pest Hospital, Budapest 1204, Hungary
| | - Vanda Adél Nagy
- Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc South Pest Hospital, Budapest 1204, Hungary
| | - Szabolcs Fekete
- Department of Psychiatry, National Institute of Forensic Psychiatry, Budapest 1108, Hungary
- School of PhD Studies, Semmelweis University, Budapest 1085, Hungary
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Crawley 6009, Australia
- Section of Psychiatry, University of Notre Dame, Fremantle 6160, Australia
| | - Gábor Gazdag
- Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc South Pest Hospital, Budapest 1204, Hungary
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest 1083, Hungary
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Ferracuti S, Del Casale A, Romano A, Gualtieri I, Lucignani M, Napolitano A, Modesti MN, Buscajoni A, Zoppi T, Kotzalidis GD, Manelfi L, de Pisa E, Girardi P, Mandarelli G, Parmigiani G, Rossi-Espagnet MC, Pompili M, Bozzao A. Correlations between cortical gyrification and schizophrenia symptoms with and without comorbid hostility symptoms. Front Psychiatry 2022; 13:1092784. [PMID: 36684000 PMCID: PMC9846757 DOI: 10.3389/fpsyt.2022.1092784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Interest in identifying the clinical implications of the neuropathophysiological background of schizophrenia is rising, including changes in cortical gyrification that may be due to neurodevelopmental abnormalities. Inpatients with schizophrenia can show abnormal gyrification of cortical regions correlated with the symptom severity. METHODS Our study included 36 patients that suffered an acute episode of schizophrenia and have undergone structural magnetic resonance imaging (MRI) to calculate the local gyrification index (LGI). RESULTS In the whole sample, the severity of symptoms significantly correlated with higher LGI in different cortical areas, including bilateral frontal, cingulate, parietal, temporal cortices, and right occipital cortex. Among these areas, patients with low hostility symptoms (LHS) compared to patients with high hostility symptoms (HHS) showed significantly lower LGI related to the severity of symptoms in bilateral frontal and temporal lobes. DISCUSSION The severity of psychopathology correlated with higher LGI in large portions of the cerebral cortex, possibly expressing abnormal neural development in schizophrenia. These findings could pave the way for further studies and future tailored diagnostic and therapeutic strategies.
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Affiliation(s)
- Stefano Ferracuti
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University, Rome, Italy.,Unit of Risk Management, Sant'Andrea University Hospital, Rome, Italy
| | - Antonio Del Casale
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Andrea Romano
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.,Unit of Neuroradiology, Sant'Andrea University Hospital, Rome, Italy
| | - Ida Gualtieri
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | | | | | - Martina Nicole Modesti
- Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy.,Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Andrea Buscajoni
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Teodolinda Zoppi
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Lorenza Manelfi
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Eleonora de Pisa
- Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy.,Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Paolo Girardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Gabriele Mandarelli
- Department of Interdisciplinary Medicine, Section of Criminology and Forensic Psychiatry, University of Bari, Bari, Italy
| | - Giovanna Parmigiani
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University, Rome, Italy
| | - Maria Camilla Rossi-Espagnet
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.,Department of Interdisciplinary Medicine, Section of Criminology and Forensic Psychiatry, University of Bari, Bari, Italy
| | - Maurizio Pompili
- Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy.,Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Alessandro Bozzao
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.,Unit of Neuroradiology, Sant'Andrea University Hospital, Rome, Italy
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Cheng X, Zhang H, Zhang J, Xu P, Jin P, Fang H, Chu K, Ke X. Comparison of clinical characteristics and treatment efficacy in childhood-onset schizophrenia and adolescent-onset schizophrenia in mainland China: A retrospective study. Early Interv Psychiatry 2021; 15:1721-1729. [PMID: 33465837 DOI: 10.1111/eip.13121] [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: 07/04/2020] [Revised: 12/18/2020] [Accepted: 01/04/2021] [Indexed: 12/23/2022]
Abstract
AIM The comparative study of childhood-onset schizophrenia (COS) and adolescent-onset schizophrenia (AOS) is scarce. This study aimed to examine the differences in clinical presentations and treatment efficacy between COS and AOS and further analyse the factors affecting the efficacy of early-onset schizophrenia (EOS). METHODS A total of 582 electronic medical records of inpatients with EOS (216 COS and 366 AOS inpatients) between 2012 and 2019 were retrospectively analysed. The positive and negative syndrome scale (PANSS) was used to assess psychotic symptoms. Logistic regression analysis was performed to analyse the predictors of efficacy. RESULTS The mean age of onset of EOS was 12.87 ± 2.19 years. The importance of better diagnosing COS appeared in a longer illness course, more frequently insidious onset, less frequent delusions, more severe negative symptoms and bizarre behaviours than AOS. Besides, COS had more frequent visual hallucinations and impulsive behaviours than AOS. After hospitalization, the improvement rate of psychotic symptoms in COS and AOS were 38.3% and 47.8%, respectively. The difference of efficacy between the two groups was statistically significant. Days of hospitalization, age of onset, presence of flat affect, PANSS total and negative score at admission were predictors of treatment efficacy in EOS individuals. CONCLUSIONS COS inpatients suffer more obvious negative symptoms, bizarre behaviours, visual hallucinations and impulsive behaviours and worse efficacy than AOS inpatients. The severity of negative symptoms and age of onset seem the most noteworthy predictors of efficacy. These findings highlight the importance of early detection and early intervention.
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Affiliation(s)
- Xin Cheng
- The Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Huihui Zhang
- The Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiuping Zhang
- The Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ping Xu
- Department of Psychiatry, Nanjing Lishui Psychiatric Hospital, Nanjing, China
| | - Peiying Jin
- The Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Fang
- The Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Kangkang Chu
- The Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyan Ke
- The Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Caruso R, Antenora F, Riba M, Belvederi Murri M, Biancosino B, Zerbinati L, Grassi L. Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience. Curr Psychiatry Rep 2021; 23:29. [PMID: 33825996 PMCID: PMC8026454 DOI: 10.1007/s11920-021-01233-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW We summarized peer-reviewed literature on aggressive episodes perpetrated by adult patients admitted to general hospital units, especially psychiatry or emergency services. We examined the main factors associated with aggressive behaviors in the hospital setting, with a special focus on the European experience. RECENT FINDINGS A number of variables, including individual, historical, and contextual variables, are significant risk factors for aggression among hospitalized people. Drug abuse can be considered a trans-dimensional variable which deserves particular attention. Although mental health disorders represent a significant component in the risk of aggression, there are many factors including drug abuse, past history of physically aggressive behavior, childhood abuse, social and cultural patterns, relational factors, and contextual variables that can increase the risk of overt aggressive behavior in the general hospital. This review highlights the need to undertake initiatives aimed to enhance understanding, prevention, and management of violence in general hospital settings across Europe.
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Affiliation(s)
- Rosangela Caruso
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy. .,University Hospital Psychiatry Unit and Consultation-Liaison Psychiatry and Program on Psycho-Oncology and Psychiatry in Palliative Care, S. Anna University Hospital and Health Trust, Via Fossato di Mortara 64a, 44121, Ferrara, Italy.
| | - Fabio Antenora
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Michelle Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, MI USA ,University of Michigan Comprehensive Depression Center, Ann Arbor, MI USA ,Psycho-oncology Program, University of Michigan Rogel Cancer Center, Ann Arbor, MI USA ,Department of Psycho-oncology, Cancer and Molecular Medicine, University of Leicester, Leicester, UK
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy ,University Hospital Psychiatry Unit and Consultation-Liaison Psychiatry and Program on Psycho-Oncology and Psychiatry in Palliative Care, S. Anna University Hospital and Health Trust, Via Fossato di Mortara 64a, 44121 Ferrara, Italy
| | | | - Luigi Zerbinati
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy ,University Hospital Psychiatry Unit and Consultation-Liaison Psychiatry and Program on Psycho-Oncology and Psychiatry in Palliative Care, S. Anna University Hospital and Health Trust, Via Fossato di Mortara 64a, 44121 Ferrara, Italy
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