bluuebunny/crossref_metadata_2025 huggingface dataset:
The efficacy of cognitive- behavior group therapy and social skill trainings on reduction of negative symptoms of schizophrenic patients
Authors: Shafiei Amiri M. , Ahmadi Gatab T. , Babakhani N.
Published: May 2011

Introduction

Schizophrenia is a destructive disease that can break the personality structure down in severe conditions and causes disturbance of thoughts, feelings and actions, and thus affects the personal, family and social performance and relationships, and disturbs them.

Aims

The aim of this study is the investigation of the efficacy of cognitive -behavior therapy and social skill trainings on reduction of negative symptoms of schizophrenic patients.

Methods

The present study is experimental design based on pre-test, post-test with control group and to select randomly, the available sampling method was used. (15persons)were selected for each group and they were randomly assigned to two groups: experimental group (combination of cognitive-behavior group therapy and social skill training) and control group (cognitive- behavior group therapy).

Results

After three months the administration of combination program of cognitive-behavior group therapy and social skill training than cognitive- behavior group therapy, the negative symptoms of experimental group decreased significantly. Also, social skills of experimental group were significantly higher than the control group that causes the significant reduction of negative symptoms of schizophrenic patients.

Conclusions

The obtained results show that: on improvement of symptoms of schizophrenic patients, the efficacy of combination of cognitive -behavior group therapy and social skills is more than cognitive- behavior group therapy.
The weight of the weight! including the parents in the adolescent weight centered group follow up
Authors: Shehu-Brovina S. , Chamay Weber C. , Narring F.
Published: May 2011

The weight gain prevalence in child and adolescents is rapidly increasing and presents a major health problem with also the psychiatric impact. In Switzerland, one child of five is in weight excess. The parents of the obese adolescents are also in sufferance.

In 2007, the Federal Commission aprouved the project of the Swiss Society of the Pediatrics, applied in the Geneva University Hospitals as Contrepoids - pediatric weight management programe. It includes the psycho-educative groups (14 to 18 groups), one or two sport activities a weak and the “parents” groups (8–14 groups).

The effect of these programs is measured mainly by the weight evolution.

As far as we know, there are no other criteria of the evaluation of these programs. Or, it is known that just à small number of these children regain their normal weight.

Purpose

To explore the parents’ representations of te wheight problem after one year To evaluate if this changement of the representations has un effect in the well being of the adolescents, their parents and their family relations.

Methods

Two focus groups were conducted at the end of a one year Family-Based Behavioural Treatment (FBBT) for obese teenagers (12–18 years), involving 16 parents. Four Open-ended questions were used.

Results

Parents reported that the participation in a group program allowed them to reduce their sense of isolation. It helped them to decrease their sense of guilt and also in the transition from childhood to adolescence. Less attention was payed to the diet.
Catastrophic scenario in the treatment of hypochondriasis, OCD and anxiety disorders
Authors: Sigmundova Z. , Grambal A. , Kamaradova D. , Vrbova K. , Jelenova D. , Kovacsova A. , Bulikova B. , Prasko J.
Published: May 2011

Patients with strong anxiety, especially health-anxiety, obsessions and GAD are very often not able to describe concrete consequences of their putative somatic diseases. They block their thoughts due to strong anxiety attended this thoughts. In some instances the health-anxious patients try not to think about illness at all, by attempting to control their thoughts or by distraction. Our method is based on therapeutic dialogue, using Socratic questioning, and inductive which force patient to think beyond the actual blocks. In second step, patients are asked to think out all other possibilities of newly discovered future. They are forced to imagine the worse consequences of all dread situations. Dialog is led through one's serious illness status, with its somatic, psychological and social consequences, dying experience to moment of death, which has to be described with all belonging emotions and details. Further, we ask patients to fantasize and constellate possible “after death experiences”. In next session patient brings written conception of the redoubtable situation previously discussed. Than we work with the text as used in imaginative exposure therapy. Gradual habituation after several reading sessions, due to our observations, leads to remarkable release of anxiety symptoms, safety and avoidant behaviour. Supported by the research grant IGA MZ CR NS 10301-3/2009
Self-concept clarity and symptoms of neurosis fluctuations during the psychotherapeutic process and the effectiveness of psychotherapy
Authors: Styla R.
Published: May 2011

Introduction

The process-outcome studies present ambiguous results concerning the fluctuations of psychopathological symptoms during psychotherapy. We also know that self-concept clarity is connected with the level of psychological functioning (Campbell et al, 1996), but no research is available exploring the dynamics of this variable in psychotherapy.

Aims

The study was designed to find if the intensity of fluctuation of the self-concept clarity and symptoms of neurosis during psychotherapy was connected with positive outcome.

Methods

All participants were in a program of 8–12 week intensive eclectic group psychotherapy. 85 patients with a diagnosis of neurosis and/or personality disorders filled in questionnaires measuring the self-concept clarity and symptoms of neurosis every 2 weeks. Additionally the features of neurotic personality were measured. The root mean square error (RMSE) of log-linear regression for each participant is the indicator of fluctuations.

Results

There is a positive correlation between the fluctuation of the self-concept clarity during psychotherapy and the symptom reduction at the end of the therapy for all patients (r = 0,24). Among the subgroup of patients with high initial self-concept clarity and high intensity of neurotic personality features this correlation was notably high (r = 0,53). No statistically significant correlations were found concerning the fluctuation of neurosis symptoms.

Conclusions

Fluctuations of the self-concept clarity during psychotherapy are thought to be beneficial for patients with neurosis and personality disorders - particularly for those integrated around their disturbed personality. This observation is discussed in the perspective of the integrated dynamic systems model of change in psychotherapy (Hayes, Strauss, 1998).
Mindfulness meditation, psychological wellbeing and resilience to stress: development and pilot study of the newly designed meditation based awareness training
Authors: Sundin E.C. , Shonin E. , Van Gordon W. , Horgan L.
Published: May 2011

Mindfulness meditation has been practiced in the Eastern world for more than 25 centuries but only recently it has become popular in the West. Today, therapeutic interventions such as ‘Mindfulness Based Stress Reduction’ are used within health services throughout Europe as a means of improving patient wellbeing. Whilst these interventions have proved successful in reducing stress and depression a limitation is that they tend to apply the practices of mindfulness in an ‘out of context’ manner. Meditation Based Awareness Training (MBAT), on the other hand, includes a composite array of ‘spiritual-based’ trainings, which are traditionally assumed to enhance the cultivation of a more sustainable quality of wellbeing within the meditator.

The purpose of this program is to design, implement, and evaluate MBAT as an approach to meditation and mindfulness that can be adapted to meet the needs of various populations. In the current phase, MBAT was developed in a general format for individuals from the general population who want to increase their levels of wellbeing. A controlled comparison trial has been run to evaluate this version of MBAT: Participants of the study undertook an 8-week MBAT program and comparisons were made with a control group on perceived psychological wellbeing (depression, anxiety, and anger management) and stress. In a second phase (not included in this presentation) MBAT will be adapted to populations with special needs, e.g., elderly people, trauma victims, and forensic inmates.

Findings from the trial will be reported and implications for further development of MBAT will be discussed.
Relationship between perceived family functioning and recovery from surgery
Authors: Vaz-Leal F.J. , Cardoso-Moreno M.J. , Ramos-Fuentes M.I. , Rodriguez-Santos L. , Fernandez-Sanchez N.
Published: May 2011

Objective

The aim of the study was to assess the impact of several psychological and/or biological variables in the recovery from surgery.

Methods

The selected sample was composed of 42 patients (age range: 25–70) admited for surgical treatment to a University Hospital. The patients who presented impaired cognitive functioning were excluded from the study. Prior to surgical intervention (48 to 72 hours), patients were administered the Family Adaptability and Cohesion Evaluation Scale (FACES-II). Salivary cortisol was measured 24 hours before surgery. Following surgical intervention, recovery was coded as “good” or “poor” accordingly to Moix et al.’s criteria (1995). Dietary intake, resting and sleeping time, fever, perceived pain and surgery-related complications were assessed on a daily basis.

Results

Significant relationships between better recovery, family cohesion and salivary cortisol level were found. The patients with lower scores in the cohesion dimension of the FACES-II and higher cortisol levels had more complications during the recovery phase (F = 10.96, p = 0.006).

Conclusions

Our results suggest that social support (family cohesion) and the activity of the hypothalamus-pituitary-adrenal axis (cortisol levels) can have a significant influence on postoperatory recovery. Taking these data into account, it would be suitable to assess psychopathology and social support in patients waiting for surgically interventions.
A psychotherapy program for soldiers dependents: The effect on recall rates. “They are not going for three weeks and the fighting has already begun!”
Authors: Wise M. , Wise I.
Published: May 2011

Introduction

Deployment to conflict areas poses problems for service families. These stressors pose a high cost from increased rates of marital/family break-up and the impact on operational effectiveness, through early recall from combat zones. Soldiers look forward to a mission whilst partners are more ambivalent. The time before deployment is hard on those who stay behind, who experience high levels of anxiety. Those about to be deployed feel guilty, and have to manage their own anxieties about what the mission will bring - hard work, excitement and danger. Most do not talk about this to their partners, who in turn have to manage their own inner turmoil and worst case ‘fantasies’.

Aims

The project grew from concerns about the welfare of families of deployed army personnel.

Objectives

The project aimed to help them develop a greater capacity to manage, contain and function with these worries. The program provided psychodynamic psychoanalytic practices to a previously neglected group that was not wholly army, but is essential to its well-being.

Methods

The program gave the families a greater understanding of the emotional difficulties faced by their partners before, during and after deployment and lessened the stress in their relationships; strengthening their own and their partners’ sense of self, resilience, and the marital bond.

Results

Usually 3–5% of a unit would be recalled from combat operations, over the duration of a tour, this was reduced to 1%.

Conclusion

A psychotherapy programme for the families of soldiers reduces attrition rates.
The therapist's low self-esteem as a factor that sustains the learned helpnessness of the patient with depression. The supervision case report
Authors: Wojtyna E.
Published: May 2011

Introduction

Negative self-esteem is frequently associated with a pessimistic style of explaining events. People experiencing events may see themselves as the cause, moreover they see the situation as unchangeable, and affecting all aspects of life. After experiencing some inability to avoid an adverse situation individual learns to act or behave helplessly.

Working with a depressive patient can lead to the therapist's negative emotions such as frustration caused by the slow improvement, lack of the patient's engagement or escalation of suicidal tendencies. In such situation supervision seems to be essential.

Aims

The aims of this case report is analysis of relation between therapist's low self-esteem and patient's learned helplessness.

Methods

The studies includes analysis of supervision case report. The supervisee has completed the CBT education and he was a psychiatrist with five years of clinical experience.

Results

This supervision showed the therapist's poor self-esteem as a factor escalating the patient's learned helplessness. The therapist needed to prove himself and his excessive activity unmotivated the patient and decreased his sense of competence. The work on these dysfunctional cognitions was very important and reduced the therapist's anxiety. The increase of the therapist's self-consciousness improved the progress of therapy.

Conclusions

This analysis showed the impact of the therapist's cognitions on the course of therapy. The work on therapist's negative cognitions about himself is very important and can reduce the problems in therapy, e.g. learned helplessness of patient with depression.
Postural instability in schizophrenics: A study using computerized static and dynamic posturography
Authors: Agarwal N.K. , Agarwal S.K.
Published: May 2011

Introduction

Schizophrenic patients have a high incidence of falls and fractures. We evaluated postural stability in schizophrenic patients using computerized static and dynamic posturography (CDP).

Objectives

To measure normal and perturbed stability in schizophrenics.

Aims

To objectively demonstrate postural abnormalities in schizophrenics.

Methods

We retrospectively evaluated CDP studies on 54 consecutive schizophrenic patients. CDP was done using FallTrak (R). Patients performed normal stability - eyes open (NS/EO), normal stability- eyes closed (NS/EC), perturbed stability - eyes open (PS/EO), and perturbed stability - eyes closed (PS/EC) for 30 seconds each. Findings were classified as normal or abnormal based on age-matched normative data.

Results

The ages ranged from 31 to 77 years. There were 34 (63.0%) males and 20 (37.0%) females. Of the total 54 patients, 48 (88.9%) exhibited abnormalities on CDP testing. NS-EO was abnormal in 29 (53.7%), NS-EC was abnormal in 37 (68.5%); both NS-EO and NS-EC were abnormal in 25 (46.3%); PS-EO was abnormal in 27 (50.0%) and PS-EC was abnormal in 20 (37.0%). Both PS-EO and PS-EC were abnormal in 14 (25.9%). Both PS and NS were abnormal in 26 (48.1%). NS was normal in 13 (24.1%) and PS was normal in 21 (38.9%). Both NS and PS were normal in 6 (11.1%) patients.

Conclusions

Most schizophrenic patients show abnormalities in both normal and perturbed stability when tested using static and dynamic posturography. Balance was normal in only 11.1 % of the patients. Further studies are needed to evaluate the clinical significance of these findings.
Smoking in institutionalized schizophrenic patients
Authors: Agarwal N.K. , Agarwal S.K.
Published: May 2011

Introduction

Schizophrenia and smoking are closely linked. Non-instutionalized schizophrenics have a much higher rate of smoking and smoke more cigarettes than the general population. We studied the smoking patterns in institutionalized schizophrenic patients.

Objectives

Boarding Homes (BH) provide boarding with daily activity and health care supervision. All residents are over 18 years old, ambulatory and do not require skilled nursing care. The objective of the study was to evaluate the smoking patterns in schizophrenics living in these institutions.

Aims

The aim was to evaluate the effect of supervision on the smoking habits of institutionalized schizophrenic patients.

Methods

Smoking history was obtained from 100 consecutive BH schizophrenics sent to our office for annual physicals. All were under care of psychiatrists.

Results

Of the 100 patients [54 (54%) males; 46 (46%) females], 96 [52 (54%) males; 44 (46%) females] were current smokers. 32 [20 (63%) males; 12 (37%) females] reported smoking up to 10 cigarettes per day, 42 [22 (52%) males; 20 (48%) females] up to 20 cigarettes per day, while 22 [10 (45%) males, 12 (54%) females] 30 or more cigarettes per day.

Conclusions

Schizophrenics living in institutions have extremely high rates of smoking, in spite of being supervised. These rates are higher than that reported with schizophrenics living independently and extremely higher than the general population. They also smoke more cigarettes per day. Strategies to reduce smoking and protect this population from the harmful effects of this addiction need to be established.
Use of amisulpride in clozapine-resistant schizophrenic patients: Three case reports
Authors: Ahlund S.E. , Gosai I.
Published: May 2011

Introduction

It is generally accepted that Clozapine is the gold standard treatment in patients with treatment resistant schizophrenia. Large numbers of patients treated with Clozapine discontinue treatment for various reasons including severe side-effects and insufficient response. There is limited literature supporting the next-step treatment option following the discontinuation of Clozapine.

Objectives

The atypical antipsychotic Amisulpride as a next-step treatment option beyond Clozapine, is hypothesised to be useful in some patients due to its first pass metabolism which differs from other second generation antipsychotics. The authors present the clinical response from using Amisulpride in three Clozapine-resistant schizophrenic patients.

Aims

The authors aim to demonstrate the role of Amisulpride monotherapy in patients with schizophrenia who are resistant to, Clozapine.

Method

Three cases of individuals with residual psychotic symptoms despite Clozapine use and/ or with significant side effects precipitating discontinuation, are presented. They were changed to Amisulpiride and their response was evaluated by clinical assessment.

Results

Positive clinical results were obtained in all three patients, with improvement of psychotic symptoms and of some of the more common side effects of Clozapine.

Conclusion

The findings from these cases suggest that Amisulpride can be of benefit in treating Clozapine-resistant schizophrenic patients. Further, more structured trials are needed to understand these findings.
Pplication of the valproate in Schizophrenia, with Treatment Resistant Verbal Hallucinosis
Authors: Aliyev N. , Aliyev Z.
Published: May 2011

Background

The goal of this study vas to examine the efficacy of valpoate (depakine-chrono) with combination by haloperidol decanoat in schizophrenia patients with treatment resistant verbal hallucinosis.

Methods

46 outpatients (men) diagnosed according to ICD-10. Patients treated haloperidol decoanat (in ampoules) 100 mg intramuscularly over 7 days plus 1500 mg depakine-chrono (in caps.) in day, per os. Treatment duration was 7 to 28 days. The expressiveness of psychopathology was estimated 7 balls system by the positive scale score of PANSS. The significance of differences between baseline and at the termination was assessed by the Wilcoxon Rank Sum Test.

Results

All surveyed patients apparently efficiency of treatment of schizophrenia with verbal hallucinosis after treatment was higher statistically significance.

Conclusion

Haloperidol decanoat with the combination by depakin chrono represents a usefully method for the treatment of patients with treatment resistant verbal hallucinosis.
Cerebellum and schizophrenia: From concepts to clinical practice
Authors: Almeida J. , Afonso J.G.
Published: May 2011

Introduction

The role of cerebellum in schizophrenia has been highlighted by Andreasen's hypothesis of “cognitive dysmetria”. Evidence is accumulating that cerebellar dysfunction could underlay some of the clinical psychiatric and neurological symptoms as well as cognitive dysfunctions observed in schizophrenia.

Objectives

To provide an up-to-date review of the putative role of the cerebellum in schizophrenia.

Aims

To inform clinicians of the neurobiological findings involving the cerebellum and schizophrenia and its possible translational applications in clinics.

Methods

We conducted a MEDLINE search of all English articles published between 1966 and 2009 using the key words “psychosis” “schizophrenia,” “cerebellum” and “cerebellar”. Priority was given to controlled data; uncontrolled studies were considered if sample size was reasonable (more than 10). Case reports were included if deemed to provide therapeutical insights.

Results

Results from several neuropsychiatric and imagiological studies have documented abnormalities in cerebellar function and structure in schizophrenic patients. Moreover, pharmacologic and psychosocial therapeutic interventions for these patients have been linked with changes in cerebellar function. Some psychopharmacological approaches seem to be preferable in patients with schizophrenia-like symptoms and confirmed cerebellar pathology. Novel experimental therapeutical approaches with cerebellar transcranial magnetic stimulation in treatment-resistant schizophrenia seem promising.

Conclusion

Although different lines of research converge to suggest that a cerebellar dysfunction could exist at least in some patients with schizophrenia, the relationship with cerebellar pathology remains obscure and should be the focus of future research.
Effects of detections and cure in prodromal stadium in schizophrenia relapses on hospital treatment duration
Authors: Anakiev S. , Stanojevic A. , Milosevic D. , Tasic G. , Cvetanovic M.
Published: May 2011

Introduction

Schizophrenia is a chronic disease with devastating consequences for individuals, families and society. Illness is characterized by alternately periods of relapses and remission. It is therefore of particular importance recognition of prodromal symptoms, which announced a new worsening of the disease and act with treatment timely. This is to prevent early deterioration of personality, shorter stays in hospital, better socialization and significant economic effects.

Objectives

126 female patients who were admitted on Female Admission Department of Special Hospital for Psychiatrics disease during 2009. with already verified schizophrenia. Patients with somatic disease, social and administrative reasons for prolonged hospitalization were excluded from study.

Aim

Aim of the study was to investigate effects on admission in prodromal stadium in schizophrenia relapses on hospital treatment length.

Method

Patients were divided in to two groups. First group were patients with prodromal symptoms (anxiety, hostility, irritability, insomnia, inapetitio, aggressive behavior, social withdrawal), and second one were patients with manifest psychotic symptoms (delusions and hallucinations). All data about symptoms were given by heteroanmnesis. In research are used descriptive statistical measures (frequencies, percents and arithmetical mean) and CHI- square test for confirmation statistically significant differences.

Results

Results of study revealed very highly significant differences between two groups (p = .000, p < 0,005).

Conclusions

Recognizing the importance of prodrome and early intervention affect the length of hospital stay showed that the comparative study was made.
Effect of safranal, a constituent of crocus sativus, on MK-801-induced behavioral and memory deficits in rat
Authors: Asadpour E. , Sadeghnia H.R.
Published: May 2011

The psychotomimetic MK-801, non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist, induce behavioral and cognitive impairments similar to those seen in schizophrenia. Safranal, a constituent of Crocus sativus (saffron), was found to have anti-seizure and anti-ischemic effects. In the present study, we investigated the effect of safranal on behavioral changes and spatial memory deficits induced by MK-801 in adult male Wistar rats, using radial maze. Safranal (72.75, 145.5 and 291 mg/kg, i.p.) was administrated 30 min before MK-801 (5 mg/kg, i.p.). Single systemic injection of MK-801 significantly increased locomotion, stereotypic behavior (rearing, grooming, sniffing) and ataxia (p < 0.01) which became evident on day 1. Moreover, average reference and working memory errors were significantly increased within 10 days after MK-801 administration (p < 0.05).

Pretreatment with safranal (291 mg/kg) significantly reduced locomotor hyperactivity and behavioral changes elicited by MK-801 (p < 0.001). Average reference errors were also significantly decreased in comparison with MK-801 treated animals (p < 0.01). These data indicated that treatment with safranal attenuated behavioral and spatial memory deficits in a rat model of an acute psychotic episode.
Risk factors of auditory hallucinations in childhood: adversity and the formation of psychotic-like ideation
Authors: Bartels-Velthuis A.A. , Van de Willige G. , Jenner J.A. , Van Os J. , Wiersma D.
Published: May 2011

Auditory vocal hallucinations (AVH) in general had limited functional impact in 7–8 year old children. However, transitory developmental expression of psychotic symptoms may become more persistent (and clinically relevant), depending on the degree of exposure to environmental risk factors. Therefore, in a five-year follow-up study of a case-control sample associations of (severity of) AVH with social adversity (traumatic experiences and stressful events) and the formation of delusional ideation were examined. In total 337 children (mean age 13.1 years; SD = 0.5) were reassessed. Forty children had continued to hear voices (24%, persistent group), 15 had heard voices for the first time (9%, incident group), 130 children no longer reported AVH (remitted group) and 152 never heard voices (referent group). Early social adversity was strongly associated with both incident and persistent AVH, and predicted greater AVH severity at follow-up. Children with both AVH and delusions were more likely to have experienced traumatic or stressful events than children with either symptom alone. AVH severity was shown to be a mediator in the association between TE (but not SE) and delusion formation. These results suggest that, although hearing voices in 7–8 year olds is in most cases benign, experience of social adversity can predict persistence and onset of new AVH closer to puberty. Given evidence for the association with delusion formation, they do pose a significant clinical risk.
Remission and functioning after two years undergoing Long-Acting Injectable Risperidone (LAIR) in recent-onset schizophrenia
Authors: Batalla A. , Pons A. , Ortiz A. , Grande I. , Undurraga J. , Parellada E.
Published: May 2011

Introduction

Improving adherence in the early stages of illness by means of long-acting antipsychotics can lead to reduced number of readmissions and enhanced remission rates, which could lead to improved performance in the medium-long term.

Objectives

Assessing clinical remission, number of admissions and personal and social performance in recent-onset schizophrenic patients undergoing LAIR.

Methods

Longitudinal retrospective study of a cohort of thirty-one recent-onset schizophrenic patients ( ≤ 2 years) who started LAIR treatment between 2004–2008. Twenty-six (83.9%) were treated for two years. PANSS scale was assessed at baseline; PANSS, Personal and Social Performance scale (PSP) and remission criteria after two years.

Results

Twenty-six patients (83.9%), 61.5% male aged between 16–44 years old, completed two years of treatment. All patients met criteria for schizophrenia (DSM-IV) with an average duration of 0.8 year since diagnosis. The main reason to using LAIR was poor adherence (76.9%). The PANSS total and all its subscale scores improved significantly (p < 0.005) with 80.8% of patients showing a ≥ 50% improvement on the PANSS total. Seventeen patients (65.4%) achieved remission criteria. Five patients (19.2%) were admitted during the follow-up. The average on global functioning (PSP) was 72.4 (IC 95%, 66.4-78.4). LAIR doses at baseline were 25 mg (46.2%), 37.5 mg (30.8%) or 50 mg (23.1%); after two years, 25 mg (34.6%), 37.5 mg (34.6%), 50 mg (23.1%) or 75 mg (7.7%).

Conclusions

Despite the limitation of retrospective observational studies, our data, including the good adherence rate (83.9%), suggest that LAIR could be effective in the treatment of recent-onset schizophrenia.
The effect of DTNBP1 and comt risk variants and comorbid drug-abuse in patients with schizophrenia: A Gene-Environment Interaction?
Authors: Benkovits J. , Polgár P. , Fábián Á. , Czobor P. , Bitter I. , Réthelyi J.
Published: May 2011

Introduction

Earlier studies have shown that candidate gene risk polymorphisms and psychoactive substance abuse influence the frequency and severity of psychosis.

Objectives

In this study we examined whether the most studied schizophrenia risk polymorphisms and psychoactive substance abuse interact in their influence on symptom severity and neurocognition.

Methods

We analyzed the clinical data of 280 schizophrenia patients, including genotyping data of the candidate genes NRG1, DTNBP1, RGS4, G72/G30 and PIP5K2A. Patients were assessed clinically by the Positive and Negative Symptom Scale (PANSS) and information about substance abuse was based on self-report and reviewing patient charts. We tested for possible interactional effects using the General Linear Model (GLM) analysis.

Results

15,8% of patients reported episodic or regular substance abuse, the vast majority (92%) used cannabis or the combination of cannabis and another drug. Substance abuse was associated with higher scores of the PANSS hostility/excitement factor, independent of sex, age, or genetic results (F = 4,02;p = 0,04). We found significant interactional effects of the DTNBP1 gene risk polymorphisms and substance abuse on different PANSS factors: rs2619528 and positive substance abuse interaction were associated with higher scores on the PANSS negative factor (F = 4,6;p = 0,03), and the PANSS depression factor (F = 4,75;p = 0,03). Moreover the rs3213207 - substance abuse interaction was associated with higher scores on the PANSS cognitive factor (F = 7,55;p = 0,006). Carriers of the Val allele of the COMT Val158Met polymorphism demonstrated significantly higher scores on the PANSS depression factor (F = 5,53;p = 0,02).

Conclusions

Our results underscore the importance of gene-environment interactions in the phenotypic heterogeneity of schizophrenia.
SMARCA2 common variant association and rare variant excess in Schizophrenia patients from an Algerian Trio Cohort
Authors: Benmessaoud D. , Lepagnol-Bestel A.-M. , Delepine M. , Hager J. , Moalic J.-M. , Gorwood P. , Kacha F. , Simonneau M.
Published: May 2011

Genome wide association studies (GWAS) of Schizophrenia (SZ) patients have identified common variants in ten genes including SMARCA2 (Koga et al., HMG, 2009). We found that the SZ-GWAS genes are part of an interacting network centered on SMARCA2 (Loe-Mie et al., HMG, 2010). Furthermore, SMARCA2 was found disrupted in SZ (Walsh et al., Science, 2008). SMARCA2 encodes the ATPase (BRM) of the SWI/SNF chromatin remodeling complex that is at the interface of genome and environmental adaptation.

Taking advantage of an Algerian trio cohort of one hundred SZ patients (Benmessaoud et al., BMC Psychiatry, 2008), we replicated the association of SNP rs2296212 localized in exon 33, already shown associated in Koga study and resulting in D1546E amino acid change in the SMARCA2 protein. We studied SMARCA2 codons and found that exon 33 displays a signature of positive evolution in the primate lineage.

Our working hypothesis is that the coding regions displaying positive selection are target of novel rare variants. To address this question, we sequenced two exons displaying positive evolution and one exon without evidence of positive evolution.

We found (i) that rare variants are significantly in excess in SZ-patients compared to their parents (p = 0.038, Fisher test) and (ii) a higher proportion of rare variants in the primate-accelerated exons compared with the non-evolutionary exon in SZ-patients (p = 0.032, Fisher test).

SMARCA2 exon sequencing and whole exome sequencing from patients harboring SNP rs2296212 common variant are under progress. Altogether, these results are expected to give new insights into the genetic architecture of SZ.
Stage dependant effect of omega-3 fatty acids in emerging psychosis
Authors: Berger G. , Amminger P. , McGorry P. ,   ORYGEN Youth Health and Medical University Vienna
Published: May 2011

Omega-3 fatty acid supplementation studies are inconclusive. We performed two intervention studies. The first study (Berger et al 2007) was a double blind, placebo-controlled randomized trial comparing 2 g Ethyl-eicosapentaenoic acid (EPA) versus placebo in addition to antipsychotic medication in 79 first episode psychosis patients. Mixed model analysis suggests that EPA augmented first episode psychosis patients respond quicker compared to placebo for time to response (p = 0.06). Post hoc analysis for cumulative response rates confirm a higher response rate at week 6 (42.9% versus 17.6% for all subjects, p = .036; 54,2% versus 17.2% for non-affective psychosis, p = .008) that was not significant anymore at week 12 (potential ceiling effect). In the second study (Amminger et al, 2010) using 840 mg EPA and 700 mg docosahexaenoic acid per day as sole treatment in 81 prodromal adolescents only 1 of 38 UHR adolescents (2.6%) in the EPA/DHA group compared to 8 of 38 (21.1%) prodromal adolescents in the placebo group met exit criteria for psychotic disorder (Chi-square Fisher's exact test =6.2, df = 1, p = 0.028; OR = 9.9). The change from baseline on the PANSS total symptom score (p = 0.006), and the GAF score (p = 0.025) were also significant between the treatment groups showing a clinically relevant advantage of EPA/DHA over placebo. Stage of illness may be more relevant for the use of the benign treatments such as omega-3 fatty acids in emerging psychosis and explain previous inconclusive findings. Research designs for future omega-3 fatty acid intervention trials and potential pitfalls will be discussed.
Clinical improvement at Day 3 as factor influencing length of hospital stay and discharge of patients with schizophrenia
Authors: San-Molina L. , Rubio G. , Bernardo-Fernández I. , Miguélez-Fernández S.
Published: May 2011

Introduction

The type of treatment used for patients with schizophrenia and an improvement at Day 3 can affect the length of stay and symptom outcome.

Objectives

To determine the influence of improvement at Day 3 in the lenght of hospital stay and hospital discharge in the case of patients with schizophrenia admitted to acute units.

Methods

A multicenter, naturalistic, retrospective study evaluating medical intervention in 1346 patients with schizophrenia in acute units in Spain.

Results

The mean of hospital stay days was 23.3 (range 1–260 days). 49.5% of patients with improvement at Day 3 had a shorter length of hospital stay. 78.7% received treatment with antipsychotics prior to admission. The most common drugs were risperidone, olanzapine and quetiapine. 99.8% and 99.7% were treated during hospital stay and on discharge, respectively. The drugs most commonly used were paliperidone ER, risperidone and olanzapine. 99.8% of patients with improvement measured by GCI at Day 3 and 100% with improvement at Day 5 had improved at discharge. The percentage of patients requiring use of benzodiazepines or physical/mechanical restriction decreased as the days passed.

Conclusions

The three most commonly used drugs during admission were effective, but the action of paliperidone ER is to be noted (its use increased from 4% prior to admission to 43% and 44% during hospital stay and on discharge, respectively). The results of this study appear to confirm that symptom improvement should be obtained as early as the first week of treatment to achieve a shorter hospital stay.
Reasons for relapses in patients with schizophrenia admitted to acute units
Authors: San-Molina L. , Rubio G. , Bernardo-Fernández I. , Miguélez-Fernández S.
Published: May 2011

Introduction

Relapses are common and a higher number of relapses involve a greater cognitive impairment of the patient. Prevention of relapses is therefore the primary objective of treatment.

Objectives

To establish why a sample of patients with schizophrenia experience relapses and are admitted to acute units as a result.

Methods

A multicenter, naturalistic, retrospective study assessing medical intervention in 1346 patients with schizophrenia admitted to acute units in Spain, assessing the following causes of relapses: non-compliance, lack of efficacy, drug abuse, stress and high incidence of side effects.

Results

90.8% of patients were admitted for relapse. Reasons for admission were non-compliance in 67.1% (77.2% due to lack of insight and 30.59% due to drug abuse), lack of therapeutic efficacy in 27.2%, and drug abuse in 24.3%. In addition, stress and a high incidence of side effects in 5.8% of patients were other reasons for relapse.

Conclusions

Non compliance is the main reason for relapses followed by lack of efficacy. The results appear to confirm that drug abuse might influence in a direct (drug abuse itself) or indirect (non compliance because of drug abuse) way in a higher number of relapses.
Correlation between clinical outcome in the first 5 Days of treatment and on hospital discharge in patients with schizophrenia
Authors: San-Molina L. , Rubio G. , Bernardo-Fernández I. , Miguélez-Fernández S.
Published: May 2011

Introduction

In patients with acute clinical symptoms, a short hospital stay and prevalent therapeutic objectives aimed at controlling symptoms overcome the clinician's concern for the functionality levels that will be even more significant after discharge.

Objectives

To establish the clinical condition of patients admitted to acute/short-stay units in the first five days of hospital stay and on hospital discharge.

Methods

A multicenter, naturalistic, retrospective, observational study to evaluate clinical assessment (CGI) obtained in patients with schizophrenia after treatment at the time of admission and on hospital discharge.

Results

The mean score of the CGI questionnaire decreases from 5.3 recorded on admission to 4.3 on Day 5 and 3 on discharge. On Day 5 of hospital stay, symptoms had improved in 57.3% of cases. In 30.9% of cases there were no changes and in 1.7% symptoms had worsened. In 86.3% of patients symptoms had improved at discharge. 100% of patients with clinical improvement at Day 5 had a clinically significant improvement on hospital discharge.

Conclusions

Clinical improvement in the first five days after hospital admission appears to lead to a better clinical prognosis on hospital discharge. Hospital discharge should be scheduled from admission, so treatment choice should be geared to looking to control symptoms in the first few days and allow for better social and personal functioning after discharge.
Lost in translation: development and implementation of a metabolic monitoring protocol
Authors: Bizamcer A. , Jagarlamudi K. , MacIntyre K.
Published: May 2011

Introduction

Quality assurance (QA) interventions are part of the core competencies that psychiatric trainees need to acquire prior to graduation of residency. The process of developing, implementing and monitoring standards of care for patients on antipsychotic medications is a practical illustration of the teaching of QA methods to psychiatric residents.

Objective

We will describe the process used by the residents and faculty of the Outpatient Psychiatry Department of Temple University School of Medicine to create and introduce metabolic follow up protocols for patients on antipsychotic medication.

Aims

We will present the challenges encountered in this process.

Methods

We will describe the process used to create a monitoring protocol that satisfies expert practice guidelines. In addition, we will examine the social, economic and organizational variables that are a part of our urban outpatient training clinic. We will present the trends of the monthly QA reviews (July 2010 to February 2011). We will introduce the process of identifying and solving obstacles. Finally, we will describe the feedback loops that inform clinicians and faculty about the effectiveness of the QA protocols.

Results

Some of the challenges met include: expert disagreement on the exact particulars of follow-up frequency, patient noncompliance, disparities in health literacy, trainees’ learning curve, changes in medication, and coordination of care among providers.

Conclusion

Teaching QA is a difficult experiential process that articulates many of the skills acquired by residents in their training, from evidence-based medicine to delivery of care and program evaluation.
The efficacy and safety of the novel antipsychotic cariprazine in acute exacerbation of schizophrenia
Authors: Bose A. , Li D. , Migliore R. , Werner P. , Nemeth G. , Laszlovsky I.
Published: May 2011

Introduction

Cariprazine is a potent D3/D2 partial agonist with preferential binding to D3 receptors.

Objectives/aims

To evaluate the efficacy and safety of cariprazine versus placebo in acute exacerbation of schizophrenia.

Methods

A multinational, multicenter, double-blind, randomized, placebo- and active-controlled, fixed-dose trial in patients aged 18–60 years with DSM-IV-TR-defined schizophrenia, current psychotic episode < 2 weeks, and PANSS total score between 80 and 120. After 1-week washout, patients received 6-weeks treatment (cariprazine 1.5, 3.0, or 4.5 mg/d, risperidone 4.0 mg/d, or placebo) and 2-week safety follow-up. Risperidone was used to assess assay sensitivity. Primary and secondary efficacy: baseline to Week 6 change (LOCF) in PANSS total and CGI-S scores, respectively. Safety: adverse events (AEs), vital signs, laboratory measures, extrapyramidal symptom (EPS) scales.

Results

Of 732 randomized patients, 64% completed the study. Mean baseline PANSS (98) and CGI-S scores (4.8) were similar across groups. PANSS total score improvement at Week 6 was statistically significant versus placebo for cariprazine 1.5 mg/d, 3.0 mg/d, and 4.5 mg/d (placebo-adjusted improvements: −7.5, −8.9, −10.4, respectively; P < .001; LOCF) and risperidone (−15.0, P < .001, LOCF); significant improvement on CGI-S was demonstrated for all active treatments (P < .05). The most common cariprazine AEs were insomnia, EPS, akathisia, sedation, nausea, dizziness, and constipation. AE discontinuation rates were 15% for placebo, 10%, 5% and 8% for cariprazine 1.5, 3.0, and 4.5 mg/d, respectively, and 9% for risperidone 4.0 mg/d.

Conclusions

Cariprazine significantly improved PANSS and CGI-S scores versus placebo in acute exacerbation of schizophrenia and was generally well tolerated.
Impact of a mental illness on diagnosis and management of comorbit medical conditions in hospitalized patients with schizophrenia and bipolar disorder
Authors: Briskman I. , Bar G. , Shargorodsky M.
Published: May 2011

Co-morbit medical conditions such as hyperglycemia, diabetes, hypertension are frequent in psychiatric patients. Tragically, this population is less likely to receive necessary medical care during hospitalization and has higher rates of morbidity and mortality from medical illnesses when compared with nonpsychiatric population. The present study evaluated for diagnosis and management of comorbit medical conditions in hospitalized patients with and without mental illness.

Methods

The study group consisted of 200 hospitalized subjects, including 100 subjects with schizophrenia and bipolar disorder and 100 age-matched controls. All patients were evaluated for a comorbit conditions, concomitant medication, biochemical parameters (glucose, lipids, CRP) and blood pressure.

Results

Two groups were similar in terms of age, gender, blood pressure, glucose and lipids. The overall frequency of previously diagnosed medical conditions such as hypertension, dyslipidemia and diabetes was significantly lower in psychiatric patients compared with nonpsychiatric population, regardless of the similar presence of these conditions according NCEP criteria in two groups. Significantly fewer subjects in psychiatric group received aspirin, statins, antihypertensive and antidiabetic medications. Although more obesity was diagnosed in psychiatric patients; significantly less diet intervention has been performed during hospitalization. While significantly more smokers and more pulmonary hospitalization were in psychiatric group, fewer subjects in this group received instruction for smoking cessation compared with nonpsychiatric population.

Conclusions

Hospitalization is the opportunity to bridge the gap between mental and physical health. However, comorbit medical conditions such as diabetes, hypertension, dyslipidemia and obesity are frequently underdiagnosed and undertreated in hospitalized psychiatric patients compared with nonpsychiatric population.
A case control study: Testing a new technique of rehabilitation in schizophrenia and other psychotic disorders using fiction films
Authors: Garcia del Castillo I. , Caballero Martinez L. , Magariños M. , Martin Calvo M.J. , Pelaez C. , Calero R. , Mateo I. , Diaz R.
Published: May 2011

Introduction

Fiction films offer unexplored support for rehabilitation in patients with schizophrenia and other psychoses. Schizophrenia produces deficits and distortions in perception and understanding of reality, also expressed in the perception and comprehension of films. After two years of experience “ad hoc” we have designed an experimental case-control study in order to study the effectiveness of the proposed technique compared with conventional “cinema-forum”

Methodology

20 patients treated at the Psychiatric Day Hospital in Puerta de Hierro Hospital (Majadahonda) will participate in the study. Initially, the researcher will collect information on socio-demographic and clinical data of all participants, as well as a written informed consent. There will be an initial assessment using the following instruments:

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SCID

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PANSS

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SCIP (schizophrenia cognitive screening)

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Scale GEOPTE (social cognition in schizophrenia)

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Social Functioning Scale (SOFAS, PSP)

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Scale of disease awareness

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IPDE (TP)

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Hamilton Scale (anxiety-depression)

The material used will be the 12 chapters of the first season of TV series “The Sopranos” by David Chase (2004). Specific techniques of cognitive and affective work are compared against a “cinema-forum”. For the evaluation of the effectiveness of the proposed technique, it will be used a measurement tool designed specifically for the activity, which includes:

1.

60 item-Scale, specific on each chapter, evaluating:

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Attention

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Concentration

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Memory

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Comprehension of the main plot

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Comprehension of subplots

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Dialogues

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Other

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Self-identification of deficiencies or errors

2. Heteroapplied analogical scales

3. Semi-structured qualitative interview