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Zhang YJ, Hu HX, Wang LL, Wang X, Wang Y, Huang J, Wang Y, Lui SSY, Hui L, Chan RCK. Altered neural mechanism of social reward anticipation in individuals with schizophrenia and social anhedonia. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01505-6. [PMID: 36305919 DOI: 10.1007/s00406-022-01505-6] [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: 05/07/2022] [Accepted: 10/14/2022] [Indexed: 01/10/2023]
Abstract
Altered social reward anticipation could be found in schizophrenia (SCZ) patients and individuals with high levels of social anhedonia (SA). However, few research investigated the putative neural processing for altered social reward anticipation in these populations on the SCZ spectrum. This study aimed to examine the underlying neural mechanisms of social reward anticipation in these populations. Twenty-three SCZ patients and 17 healthy controls (HC), 37 SA individuals and 50 respective HCs completed the Social Incentive Delay (SID) imaging task while they were undertaking MRI brain scans. We used the group contrast to examine the alterations of BOLD activation and functional connectivity (FC, psychophysiological interactions analysis). We then characterized the beta-series social brain network (SBN) based on the meta-analysis results from NeuroSynth and examined their prediction effects on real-life social network (SN) characteristics using the partial least squared regression analysis. The results showed that SCZ patients exhibited hypo-activation of the left medial frontal gyrus and the negative FCs with the left parietal regions, while individuals with SA showed the hyper-activation of the left middle frontal gyrus when anticipating social reward. For the beta-series SBNs, SCZ patients had strengthened cerebellum-temporal FCs, while SA individuals had strengthened left frontal regions FCs. However, such FCs of the SBN failed to predict the real-life SN characteristics. These preliminary findings suggested that SCZ patients and SA individuals appear to exhibit altered neural processing for social reward anticipation, and such neural activities showed a weakened association with real-life SN characteristics.
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Affiliation(s)
- Yi-Jing Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, 16 Lincui Road, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hui-Xin Hu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, 16 Lincui Road, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ling-Ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, 16 Lincui Road, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xuan Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, 16 Lincui Road, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, 16 Lincui Road, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, 16 Lincui Road, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, 16 Lincui Road, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Li Hui
- The Affiliated Guangji Hospital of Soochow University, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, CAS Key Laboratory of Mental Health, Chinese Academy of Sciences, 16 Lincui Road, Beijing, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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2
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Fulford D, Mote J, Gonzalez R, Abplanalp S, Zhang Y, Luckenbaugh J, Onnela JP, Busso C, Gard DE. Smartphone sensing of social interactions in people with and without schizophrenia. J Psychiatr Res 2021; 137:613-620. [PMID: 33190842 PMCID: PMC8084875 DOI: 10.1016/j.jpsychires.2020.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/17/2020] [Accepted: 11/02/2020] [Indexed: 12/23/2022]
Abstract
Social impairment is a cardinal feature of schizophrenia spectrum disorders (SZ). Smaller social network size, diminished social skills, and loneliness are highly prevalent. Existing, gold-standard assessments of social impairment in SZ often rely on self-reported information that depends on retrospective recall and detailed accounts of complex social behaviors. This is particularly problematic in people with SZ given characteristic cognitive impairments and reduced insight. Ecological Momentary Assessment (EMA; repeated self-reports completed in the context of daily life) allows for the measurement of social behavior as it occurs in vivo, yet still relies on participant input. Momentary characterization of behavior using smartphone sensors (e.g., GPS, microphone) may also provide ecologically valid indicators of social functioning. In the current study we tested associations between both active (e.g., EMA-reported number of interactions) and passive (GPS-based mobility, conversations captured by microphone) smartphone-based measures of social activity and measures of social functioning and loneliness to examine the promise of such measures for understanding social impairment in SZ. Our results indicate that passive markers of mobility were more consistently associated with EMA measures of social behavior in controls than in people with SZ. Furthermore, dispositional loneliness showed associations with mobility metrics in both groups, while general social functioning was less related to these metrics. Finally, interactions detected in the ambient audio were more tied to social functioning in SZ than in controls. Findings speak to the promise of smartphone-based digital phenotyping as an approach to understanding objective markers of social activity in people with and without schizophrenia.
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Affiliation(s)
- Daniel Fulford
- Sargent College of Health & Rehabilitation Sciences, Boston University, USA; Department of Psychological & Brain Sciences, Boston University, USA.
| | - Jasmine Mote
- Sargent College of Health & Rehabilitation Sciences, Boston University, USA
| | - Rachel Gonzalez
- Department of Psychology, San Francisco State University, USA
| | - Samuel Abplanalp
- Sargent College of Health & Rehabilitation Sciences, Boston University, USA
| | - Yuting Zhang
- Department of Computer Science, Metropolitan College, Boston University, USA
| | - Jarrod Luckenbaugh
- Department of Electrical and Computer Engineering, The University of Texas at Dallas, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, USA
| | - Carlos Busso
- Department of Electrical and Computer Engineering, The University of Texas at Dallas, USA
| | - David E Gard
- Department of Psychology, San Francisco State University, USA
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3
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White R, Haddock G, Campodonico C, Haarmans M, Varese F. The influence of romantic relationships on mental wellbeing for people who experience psychosis: A systematic review. Clin Psychol Rev 2021; 86:102022. [PMID: 33819779 DOI: 10.1016/j.cpr.2021.102022] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/29/2021] [Accepted: 03/17/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE Whilst it is generally accepted that supportive relationships facilitate recovery from psychosis, much less is known about the role of romantic relationships in people with psychosis. This review aimed to synthesise quantitative literature regarding the impact of romantic relationships on the mental health and general wellbeing of people who experience psychosis. METHOD A systematic review of electronic databases (PsychINFO, PubMed, Web of Science) was carried out using search terms relating to psychosis and romantic relationships. Papers were selected for inclusion by independent reviewers. Quality assessment was completed and a narrative synthesis produced. RESULTS Fifty-eight studies reporting the association between romantic relationships and psychotic symptoms, depression, posttraumatic stress disorder, suicidality, quality of life, satisfaction with life and self-esteem were included. Results were mixed but indicated having a romantic partner may be associated with reduced positive and negative symptoms of psychosis, but increased depressive symptoms. Tentative explanations for these findings, such as functioning prior to onset of psychosis, social support and relationship quality are explored. CONCLUSION Findings highlight the importance of this often-overlooked area in clinical practice. Studies with robust design, which specifically aim to understand the relationship between romantic relationships and wellbeing for people who experience psychosis are needed.
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Affiliation(s)
- Rebecca White
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, Manchester, UK
| | - Carolina Campodonico
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
| | - Maria Haarmans
- Cathie Marsh Institute, Centre on Dynamics of Ethnicity (CoDE), Department of Sociology, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
| | - Filippo Varese
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, Manchester, UK
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Mow JL, Gandhi A, Fulford D. Imaging the "social brain" in schizophrenia: A systematic review of neuroimaging studies of social reward and punishment. Neurosci Biobehav Rev 2020; 118:704-722. [PMID: 32841653 DOI: 10.1016/j.neubiorev.2020.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/20/2020] [Accepted: 08/07/2020] [Indexed: 10/23/2022]
Abstract
Decreased social functioning and high levels of loneliness and social isolation are common in schizophrenia spectrum disorders (SSD), contributing to reduced quality of life. One key contributor to social impairment is low social motivation, which may stem from aberrant neural processing of socially rewarding or punishing stimuli. To summarize research on the neurobiology of social motivation in SSD, we performed a systematic literature review of neuroimaging studies involving the presentation of social stimuli intended to elicit feelings of reward and/or punishment. Across 11 studies meeting criteria, people with SSD demonstrated weaker modulation of brain activity in regions within a proposed social interaction network, including prefrontal, cingulate, and striatal regions, as well as the amygdala and insula. Firm conclusions regarding neural differences in SSD in these regions, as well as connections within networks, are limited due to conceptual and methodological inconsistencies across the available studies. We conclude by making recommendations for the study of social reward and punishment processing in SSD in future research.
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Affiliation(s)
- Jessica L Mow
- Department of Psychological & Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, United States.
| | - Arti Gandhi
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, United States
| | - Daniel Fulford
- Department of Psychological & Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, United States; Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, United States
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5
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Ådnanes M, Cresswell-Smith J, Melby L, Westerlund H, Šprah L, Sfetcu R, Straßmayr C, Donisi V. Discharge planning, self-management, and community support: Strategies to avoid psychiatric rehospitalisation from a service user perspective. PATIENT EDUCATION AND COUNSELING 2020; 103:1033-1040. [PMID: 31836249 DOI: 10.1016/j.pec.2019.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Psychiatric rehospitalisation is often seen as a negative outcome in terms of healthcare quality and cost, as well as potentially hindering the process of recovery. The purpose of our study was to explore psychiatric rehospitalisation from a service-user perspective, paying attention to how rehospitalisation can be avoided. METHOD Eight focus groups, including a total of 55 mental health service users, were conducted in six European countries (Austria, Finland, Italy, Norway, Romania, and Slovenia). The results were analysed using systematic text condensation. RESULTS All participants had been in touch with mental health services for at least one year, and had experienced more than one psychiatric hospitalisation. Participants emphasised the importance of discharge planning and psychoeducation both during and after the hospital stay, as well as the benefits of structured plans, coping strategies, self-monitoring techniques, and close contact with local community services.Social contacts and meaningful activities were also considered to be critical, as was support from peers and family members. CONCLUSION Efforts to avoid psychiatric rehospitalisation should include actions that support a functional day-to-day life, improve coping strategies, and build on cross-sectoral collaboration. PRACTICE IMPLICATIONS The study emphasises the need for psychoeducational and psychosocial interventions, starting already during the inpatient stay.
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Affiliation(s)
- M Ådnanes
- SINTEF Digital, Dept of Health Research, PO Box 4760 Torgarden, 7465 Trondheim, Norway.
| | - J Cresswell-Smith
- National Institute for Health and Welfare (THL), Mental Health Unit, Helsinki, Finland.
| | - L Melby
- SINTEF Digital, Dept of Health Research, Trondheim, Norway.
| | - H Westerlund
- Competence Centre for Experiential Knowledge and Service Development, Trondheim, Norway.
| | - L Šprah
- Research Centre of the Slovenian Academy of Sciences and Arts, Sociomedical Institute, Ljubljana, Slovenia.
| | - R Sfetcu
- National School of Public Health, Management and Professional Development, Bucharest; 2. Faculty of Psychology and Educational Sciences, Bucharest, Romania.
| | - C Straßmayr
- IMEHPS. Research - Forschungsinstitut für Sozialpsychiatrie, Vienna, Austria.
| | - V Donisi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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6
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Social motivation in schizophrenia: How research on basic reward processes informs and limits our understanding. Clin Psychol Rev 2018; 63:12-24. [PMID: 29870953 DOI: 10.1016/j.cpr.2018.05.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 05/18/2018] [Accepted: 05/26/2018] [Indexed: 12/17/2022]
Abstract
Limited quantity and quality of interpersonal exchanges and relationships predict worse symptomatic and hospitalization outcomes and limit functional recovery in people with schizophrenia. While deficits in social skills and social cognition contribute to much of the impairment in social functioning in schizophrenia, our focus on the current review is social motivation-the drive to connect with others and form meaningful, lasting relationships. We pay particular attention to how recent research on reward informs, and limits, our understanding of the construct. Recent findings that parse out key components of human motivation, especially the temporal nature of reward and effort, are informative for understanding some aspects of social motivation. This approach, however, fails to fully integrate the critical influence of uncertainty and punishment (e.g., avoidance, threat) in social motivation. In the current review, we argue for the importance of experimental paradigms and real-time measurement to capture the interaction between social approach and avoidance in characterizing social affiliation in schizophrenia. We end with suggestions for how researchers might move the field forward by emphasizing the ecological validity of social motivation paradigms, including dynamic, momentary assessment of social reward and punishment using mobile technology and other innovative tools.
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McPherson P, Krotofil J, Killaspy H. Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes. BMC Psychiatry 2018; 18:128. [PMID: 29764420 PMCID: PMC5952646 DOI: 10.1186/s12888-018-1725-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 05/04/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Post-deinstitutionalisation, mental health supported accommodation services have been implemented widely. The available research evidence is heterogeneous in nature and resistant to synthesis attempts, leaving researchers and policy makers with no clear summary what works and for whom. In this context, we undertook a comprehensive systematic review of quantitative studies in order to synthesise the current evidence on mental health and psychosocial outcomes for individuals residing in mental health supported accommodation services. METHODS Using a combination of electronic database searches, hand searches, forward-backward snowballing and article recommendations from an expert panel, 115 papers were identified for review. Data extraction and quality assessments were conducted, and 33 articles were excluded due to low quality, leaving 82 papers in the final review. Variation in terminology and service characteristics made the comparison of service models unfeasible. As such, findings were presented according to the following sub-groups: 'Homeless', 'Deinstitutionalisation' and 'General Severe Mental Illness (SMI)'. RESULTS Results were mixed, reflecting the heterogeneity of the supported accommodation literature, in terms of research quality, experimental design, population, service types and outcomes assessed. There is some evidence that supported accommodation is effective across a range of psychosocial outcomes. The most robust evidence supports the effectiveness of the permanent supported accommodation model for homeless SMI in generating improvements in housing retention and stability, and appropriate use of clinical services over time, and for other forms of supported accommodation for deinstitutionalised populations in reducing hospitalisation rates and improving appropriate service use. The evidence base for general SMI populations is less developed, and requires further research. CONCLUSIONS A lack of high-quality experimental studies, definitional inconsistency and poor reporting continue to stymie our ability to identify effective supported accommodation models and practices. The authors recommend improved reporting standards and the prioritisation of experimental studies that compare outcomes across different service models.
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Affiliation(s)
- Peter McPherson
- Division of Psychiatry, Faculty of Brain Sciences, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Joanna Krotofil
- 0000000121901201grid.83440.3bDivision of Psychiatry, Faculty of Brain Sciences, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Helen Killaspy
- 0000000121901201grid.83440.3bDivision of Psychiatry, Faculty of Brain Sciences, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
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8
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Lewis LF. Meta-Ethnography of Qualitative Research on the Experience of Being a Partner to an Individual with Schizophrenia Spectrum Disorder. Issues Ment Health Nurs 2017; 38:219-232. [PMID: 27996343 DOI: 10.1080/01612840.2016.1259699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Several qualitative studies explore the experience of being a partner to an individual with schizophrenia spectrum disorder, but these studies remain isolated "islands of knowledge." This meta-ethnography aimed to synthesize current qualitative studies using Noblit and Hare's method. Thirteen studies were identified for inclusion. Three overarching themes were revealed: unmet expectations of relationship, renegotiating relationship roles, and separation versus togetherness. Themes interacted as a cycle with separation versus togetherness as temporal endpoints. Partners also renegotiated relationships with mental health professionals to accommodate unmet expectations. Leverage points for intervention were identified.
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Affiliation(s)
- Laura Foran Lewis
- a University of Vermont , College of Nursing and Health Sciences , Burlington , Vermont , USA
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Arsova S, Barsova GK. Patients with Schizophrenia and Social Contacts. Open Access Maced J Med Sci 2016; 4:388-391. [PMID: 27703560 PMCID: PMC5042620 DOI: 10.3889/oamjms.2016.084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 07/09/2016] [Accepted: 07/10/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Patients with schizophrenia have severe problems with personal and social relations which affect their quality of life. AIM The aim of the paper was to monitor personal and social relations in patients with schizophrenia and to find out the differences regarding socio-demographic characteristics and ambulatory and day hospital treatment. MATERIAL AND METHODS The investigation included 120 subjects each with diagnosis F20 according to ICD 10 criteria; divided into two groups of 60 patients regarding their actual treatment (the first group received ambulatory care whereas those from the second group had a day hospital treatment). Patients were of different age and gender, receiving regular antipsychotic therapy. They were included in individual and group psychosocial therapeutic procedures during the day hospital treatment. The investigation utilised the following diagnostic instruments: standardised clinical interview and Personal and social performance scale (PSP scale), a non-standardized questionnaire of socio-demographic data, family support and existence of mental disorder in other family members. RESULTS The results have shown better personal and social functioning in patients who had family support, in those who are employed, in those with no mental disorder in other family members and in patients on day hospital treatment against patients receiving ambulatory care. CONCLUSION Day hospital treatment, family support and social support improve the ability for personal and social contacts of patients with schizophrenia.
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Affiliation(s)
- Slavica Arsova
- University Psychiatry Clinic, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Gabriela Kopacheva Barsova
- University Clinic for Ear, Nose and Throat, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Vodnjanska 17, Skopje 1109, Republic of Macedonia
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10
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Kalache SM, Mulsant BH, Davies SJC, Liu AY, Voineskos AN, Butters MA, Miranda D, Menon M, Kern RS, Rajji TK. The impact of aging, cognition, and symptoms on functional competence in individuals with schizophrenia across the lifespan. Schizophr Bull 2015; 41:374-81. [PMID: 25103208 PMCID: PMC4332950 DOI: 10.1093/schbul/sbu114] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Life expectancy in individuals with schizophrenia continues to increase. It is not clear whether cognitive deficits associated with schizophrenia remain as strong predictors of function in older and younger individuals. Thus, we assessed the relationship between cognition and functional competence in individuals with schizophrenia across 7 decades of life. METHODS We analyzed data obtained in 232 community-dwelling participants with schizophrenia (age range: 19-79 years). Cognition was assessed using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. Functional competence was assessed using the UCSD Performance-based Skills Assessment, which includes measures of Comprehension and Planning of Recreational Activities Skills, Financial Skills, Communication Skills, Transportation Skills, and Household Management Skills. To assess the effects of Global Cognition on functional competence, we performed hierarchical multivariate linear or logistic regression analyses controlling for age, education, gender, and negative symptoms. RESULTS Participants' mean age was 49.1 (SD = 13.2, range = 19-79 years), 161 (69%) were male, and 55 (24%) were aged ≥60. Global Cognition was a predictor of Comprehension and Planning Skills (Exp(β) = 1.048), Financial Skills (Exp(β) = 1.104), Communication Skills (ΔR (2) = .31) and Transportation Skills (Exp(β) = 1.066), but not Household Management Skills after adjusting for age, education, gender, and negative symptoms of schizophrenia. CONCLUSION Cognition remains a strong predictor of functional competence across the lifespan. These findings suggest that treating cognitive impairment associated with schizophrenia could improve individuals' function independent of their age.
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Affiliation(s)
- Sawsan M. Kalache
- Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada;,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Benoit H. Mulsant
- Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada;,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Simon J. C. Davies
- Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada;,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Angela Y. Liu
- Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada;,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Aristotle N. Voineskos
- Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada;,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Meryl A. Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Dielle Miranda
- Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada
| | - Mahesh Menon
- Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada;,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Robert S. Kern
- Department of Psychiatry and Department of Veterans Affairs VISN 22 MIRECC, University of California, Los Angeles, CA
| | - Tarek K. Rajji
- Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada;,Department of Psychiatry, University of Toronto, Toronto, Canada;,*To whom correspondence should be addressed; Centre for Addiction and Mental Health, 80 Workman Way, 6th Floor, Room 6312, Toronto, ON M6J1H4, Canada; tel: 416-535-8501 ext. 33661, fax: 416-583-1307,
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11
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Simić-Medojević I, Burgić-Radmanović M. Quality of life of schizophrenic patients with or without depot neuroleptics. SCRIPTA MEDICA 2015. [DOI: 10.5937/scrimed1501060s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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12
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Arsova S, Bajraktarov S, Barbov I, Hadzihamza K. Patients with Schizophrenia and Self-Care. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION: Patients with schizophrenia have severe problems with self-care which affects their quality of life.OBJECTIVE: The aim of the paper was to monitor self-care in patients with schizophrenia and to find out the differences regarding socio-demographic characteristics and ambulatory and day hospital treatment.METHOD: The investigation included 120 subjects each with diagnosis F20 according to ICD 10 criteria; divided in two groups of 60 patients regarding their actual treatment (the first group received ambulatory care whereas those from the second group had a day hospital treatment). Patients were of different age and gender, receiving regular antipsychotic therapy. They were included in individual and group psychosocial therapeutic procedures during the day hospital treatment. The investigation utilized the following diagnostic instruments: standardized clinical interview and Personal and social performance scale (PSP scale), non-standardized questionnaire of socio-demographic data, family support and existence of mental disorder in other family members.RESULTS: The results have shown better personal and social functioning in patients who had family support, in those who are employed, in those with no mental disorder in other family members and in patients on day hospital treatment against patients receiving ambulatory care.CONCLUSION: Day hospital treatment, family support and social support improve self-care of patients with schizophrenia.
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13
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Nakagawa S, Hayashi N. Clinical correlates of objective and subjective quality of life among middle-aged and elderly female inpatients with chronic schizophrenia. Asian J Psychiatr 2013; 6:389-93. [PMID: 24011685 DOI: 10.1016/j.ajp.2013.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 03/16/2013] [Accepted: 03/30/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to illustrate the relationship between objective and subjective measures of quality of life (QOL) and to identify the factors influencing QOL in a sample of middle-aged and elderly female patients with schizophrenia in Japan. METHODS Middle-aged and elderly female inpatients with schizophrenia (n=66; mean age [SD]: 68.0 [8.0]) were assessed using the Quality of Life Scale (QLS), Lancashire Quality of Life Profile (LQLP), Positive and Negative Symptoms Scale (PANSS), and Rehabilitation Evaluation Hall and Baker (REHAB). Correlation analyses among the measures and regression analyses of objective and subjective QOL measures (QLS and LQLP) were conducted. Explanations of results for the two types of QOL measures in terms of psychotic symptomatology and adjustment variables (PANSS and REHAB) are discussed. RESULTS There was no salient correlation between objective and subjective QOL measures. The regression analyses identified PANSS anergia and REHAB community skills as factors influencing objective QOL, whereas PANSS depression and paranoid/belligerence were factors influencing subjective QOL. CONCLUSIONS Results indicated that objective and subjective QOL domains should be treated separately in clinical practice for this patient population. Some QOL factors identified in the regression analyses can be used as targets to improve QOL. The findings have important clinical implications for the assessment and treatment of this patient population.
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Affiliation(s)
- Seishu Nakagawa
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, 2-1-1 Kamikitazawa, Setagaya-ku, Tokyo 156-0057, Japan; Department of Functional Brain Imaging, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan.
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Determinants of treatment satisfaction of schizophrenia patients: results from the ESPASS study. Schizophr Res 2012; 139:211-7. [PMID: 22704996 DOI: 10.1016/j.schres.2012.05.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 05/02/2012] [Accepted: 05/28/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Knowing the determinants of treatment satisfaction can provide better understanding of patient expectations in schizophrenia. The aim of this study was to determine which treatment-related factors were associated with treatment satisfaction, independently of patient-related or illness-related factors, in schizophrenia patients. METHODS A cross-sectional study of data collected nationwide in France between 2005 and 2006 was conducted. 5500 adult patients with non-acute schizophrenia and requiring a switch of antipsychotic drug were included by 995 psychiatrists. Treatment satisfaction was assessed using the "PAtient SAtisfaction with Psychotropics" (PASAP) self-report questionnaire. Linear mixed model was used to explore the association between treatment satisfaction and treatment-related factors-including the current antipsychotic drug (none, first or second-generation antipsychotic) and psychosocial therapy-independently of patient-related and illness-related factors. FINDINGS 3630 (66%) patients filled in the PASAP questionnaire. Main treatment-related determinants of higher levels of satisfaction were: (1) being on second-generation antipsychotics compared to first-generation antipsychotics (olanzapine: ß=1.2; CI95%=[0.5; 2.0], risperidone: ß=0.9; CI95%=[0.1; 1.6], clozapine: ß=2.5; CI95%=[0.6; 4.3] and amisulpride: ß=1.2; CI95%=[0.3; 2.1]) and (2) participating in psychosocial therapy (ß=0.9; CI95%=[0.3; 1.5]). CONCLUSION Treatment satisfaction in non-acute schizophrenia was related to the more recent antipsychotic agents and psychosocial therapy, which may reflect expectations of more pro-active care.
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Ritsner MS, Lisker A, Arbitman M. Ten-year quality of life outcomes among patients with schizophrenia and schizoaffective disorders: I. Predictive value of disorder-related factors. Qual Life Res 2011; 21:837-47. [PMID: 21912845 DOI: 10.1007/s11136-011-9988-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE To provide data on long-term health-related quality of life (HRQL) outcomes among patients with schizophrenia (SZ) and schizoaffective (SA) disorders and determine the predictive value of disorder-related factors. METHODS A total of 108 patients with SZ/SA were assessed during stabilization phase and over 10 years with the Quality of Life Enjoyment and Life Satisfaction Questionnaire (Q-LES-Q), Clinical Global Impression Scale, Positive and Negative Syndromes Scale (PANSS), Distress Scale for Adverse Symptoms (DSAS), Talbieh Brief Distress Inventory (TBDI), Brief Symptom Inventory-Somatization Scale (BSI-S), and Global Assessment of Functioning Scale (GAF). Variability and relationships between Q-LES-Q and disorder-related dimensions over time were analyzed. RESULTS There were no differences in Q-LES-Q dimensions between patients with SZ and SA disorders. Poor outcomes were found among 76% of the patients with SZ/SA disorders who remained dissatisfied (64%) or worsened (12%) with their HRQL over time. However, 24% of patients reported improved quality of life (16%), or remained satisfied (8%). Changes in TBDI, DSAS, BSI-S, PANSS, and GAF measures accounted for 20-50% of the total variance in satisfaction changes in Q-LES-Q domains across time. CONCLUSIONS Long-term quality of life outcomes are characterized by four different types that fit changes over time in emotional distress, side effects, somatization, symptom dimensions, and general functioning scores. Revealed predictors are factors that can be ameliorated and thereby enhance satisfaction with quality of life over time.
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Affiliation(s)
- Michael S Ritsner
- Department of Psychiatry, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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Salokangas RKR, Honkonen T, Stengård E. Social role behaviour of patients with long-term schizophrenia in the community during sharp decline in number of psychiatric beds. J Ment Health 2009. [DOI: 10.1080/09638230701494860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Thomas P. Psychosocial and economic issues related to physical health in psychiatric illness. Eur Neuropsychopharmacol 2008; 18 Suppl 2:S115-20. [PMID: 18346599 DOI: 10.1016/j.euroneuro.2008.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
As well as the obvious medical consequences associated with physical health problems in individuals with schizophrenia, physical health problems lead to a number of psychosocial consequences--further contributing to the existing burden of schizophrenia itself. Weight gain can seriously impair quality of life through decreased functioning, social stigmatization, discrimination and potential financial consequences. However, patients with schizophrenia may be less capable of managing their weight via exercise and dietary interventions compared with the general population, and may, therefore, be more prone to non-compliance with a medication that induces weight gain. This may lead to exacerbation of the mental illness. Patients' perceptions and experience of antipsychotic treatments are also important as these can further impact on overall patient wellbeing. It is hoped that by increasing awareness of the psychosocial consequences of physical health impairment, we can move towards reducing the burden that patients face.
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Affiliation(s)
- Pierre Thomas
- Service de Psychiatrie, Hopital M. Fontan CHRU de Lille, 6, rue Veraeghe, 59037 Lille, France.
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Evaluation of schizophrenic patients quality of life. VOJNOSANIT PREGL 2008; 65:383-91. [DOI: 10.2298/vsp0805383o] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
<zakljucak> I pored metodoloskih i epistemioloskih nedostataka istrazivanja kvaliteta zivota shizofrenih bolesnika (manjkavost jedinstvenog metodoloskog pristupa, sto povlaci za sobom neodredjenosti u definisanju problema istrazivanja i teskoce u operacionalizaciji) ova ispitivanja su se pokazala kao pouzdan indikator ishoda (outcome indicator) razlicitih oblika tretmana shizofrenih bolesnika, primene lekova, posebno. I ako rezultati ovih, u sustini multidimenzionih, istrazivanja zavise od depresivnog raspolozenja, crta licnosti i mehanizama prilagodjavanja koje shizofreni ispitanik koristi, istrazivanja kvaliteta zivota shizofrenih bolesnika ce ostati pouzdan, naucno verifikovan pokazatelj humanog statusa najbrojnijih medju teskim psihijatrijskim bolesnicima. Sto se instrumenata istrazivanja kvaliteta zivota tice, izdvojili bismo tri. Prvi od njih, Upitnik o kvalitetu zivota (QLS), najstariji je i dugo se, zbog dobrih metrickih svojstava, koristio u istrazivanjima ove vrste u svetu, ukljucujuci i domace autore 84. Sledeci, Mancesterski upitik o kvalitetu zivota (MANSA) relativno je kratak i primenjivan je u novijim istrazivanjima kvaliteta zivota psihijatrijskih bolesnika u svetu i kod nas. Najzad, izdvojili bismo onaj koji se najvise koristi. To je WHO-QOL-Brief, kraca verzija Upitnika o kvalitetu zivota shizofrenih bolesnika SZO. On se vrlo cesto pojavljuje u najnovijim istrazivanjima ove vrste (poslednjih pet godina) u svetu, a posebno u studijama sa transkulturnim obelezjima. Izbor ovog poslednjeg instrumenta omogucio bi nasim istrazivacima, ne samo brzo prikupljanje podataka, nego i validnije poredjenje sopstvenih rezultata istrazivanja sa slicnima u svetu. Istrazivanja kvaliteta zivota psihijatrijskih bolesnika, a shizofrenih bolesnika posebno, smatramo nezaobilaznim, ne samo u naucnim studijama vezanim za probleme najrasirenijeg psihoticnog poremecaja, nego i vaznim za planiranje i evaluaciju programa pomoci hronicnim psihoticnim bolesnicima uopste, posebno ako se imaju u vidu ambiciozne reforme institucijske psihijatrijske zastite zapocete kod nas.
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Abstract
Social skills training consists of learning activities utilizing behavioral techniques that enable persons with schizophrenia and other disabling mental disorders to acquire interpersonal disease management and independent living skills for improved functioning in their communities. A large and growing body of research supports the efficacy and effectiveness of social skills training for schizophrenia. When the type and frequency of training is linked to the phase of the disorder, patients can learn and retain a wide variety of social and independent living skills. Generalization of the skills for use in everyday life occurs when patients are provided with opportunities, encouragement, and reinforcement for practicing the skills in relevant situations. Recent advances in skills training include special adaptations and applications for improved generalization of training into the community, short-term stays in psychiatric inpatient units, dually diagnosed substance abusing mentally ill, minority groups, amplifying supported employment, treatment refractory schizophrenia, older adults, overcoming cognitive deficits, and negative symptoms as well as the inclusion of social skills training as part of multidimensional treatment and rehabilitation programs.
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Affiliation(s)
- Alex Kopelowicz
- San Fernando Mental Health Center, 10605 Balboa Boulevard, Suite 100, Granada Hills, CA 91344, USA.
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