bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between the P 300 wave and symptom improvement in adolescent psychosis -case report
Authors: Kostic J.S. , Stankovic M. , Milosavljevic L.
Published: May 2011

Objectives

Event-related potentials are a powerful tool for real-time investigation of the brain’s electrical activity during cognitive processes. There is little data in literature on P 300 evaluation among adolescents suffering from schizophrenia psychosis.

Methods

Our goal was to see the relation between the clinical symptoms, improvement of symptoms and medical state on P 300. P 300, were recorded in two adolescent patients - one, with a first episode of psychosis, and another, with long-term diagnosis of schizophrenia. The P 300 wave was evaluated at the begining of the medical treatment and after 8 weeks of medication. We also monitored patient’s clinical state and looked for any improvements on the PANSS.

Results

At the start of the tretman we found a reduced amplitude and a prolonged latency of the P 300 wave. In a follow-up test, a well-formed responses of latency and amplitude, within normal range, were detected in the first case, which coincided with improvements of clinical state and on the PANSS. In the second case, despite an observed clinical improvement and an improvement on the PANSS, the P 300 wave of the patient remained unchanged when compared with the first test.

Conclusion

Our humble results in the context of adolescent schizophrenic psychosis fit in with the fact that the P 300 wave is modulated by changes in positive, but not by changes in negative symptoms or different neuroleptics, which may go to further the claim that the P 300 wave can depend on the clinical state of the patient.
Metabolic syndrome in schizophrenia patients observed in German clinical practice - how do untreated patients differ from patients with previous antipsychotic medication?
Authors: Kraemer S. , Minarzyk A. , Pamulapati S. , Forst T. , Kopf D.
Published: May 2011

Introduction

For antipsychotic therapy and for schizophrenia associations with increased prevalence of metabolic syndrome (MetS) have been reported. This post-hoc analysis of a German, prospective, observational study assessed MetS-prevalence at baseline and month-3 in adults with schizophrenia.

Methods

Patients previously untreated (UT, N = 108; 60.2% females) or on different antipsychotic therapy (PT, N = 367; 47.7% females) were initiated or switched to new antipsychotic medication at baseline (choice unrestricted). Analyzed were patients with complete metabolic data (fasting blood samples, physical parameters, baseline/month-3) without medication change. Prevalence of MetS (AHA/NHLB-definition) and MetS-factors were determined; 95% confidence intervals (CI) were derived from exploratory ANCOVA analyses, adjusting for treatment group and sex.

Results

PT had significantly higher MetS prevalence at both visits than UT (baseline: 49.9% [CI 44.6;55.1] vs. 25.9% [18.0;35.3]; month-3: 54.5% [49.3;59.7] vs. 32.4% [23.7;42.1]); MetS prevalence increased by 4.6% in PT and 6.5% in UT. At baseline, UT had significantly better values than PT for triglycerides (p = 0.0048), HDL-cholesterol (p = 0.0044), blood pressure (SBP/ DBP; p = 0.0090/0.0067), fasting glucose (P = 0.0304), waist circumference (p=< .0001). At month-3 differences were no longer significant, except for DBP (p = 0.0227). ANCOVA for both groups pooled revealed a significant effect on change from baseline for DBP (p = 0.0227), and a sex effect for fasting triglycerides (p = 0.0006) and HDL-cholesterol (p = 0.0015 in favor of women.

Conclusion

Physical and metabolic parameters initially were better in UT, compared to PT. At month-3, UT and PT values had converged, indicating that antipsychotic treatment may be associated with increased metabolic burden in an at-risk population.
Dysfunctional impulsivity in schizophrenia: a functional MRI investigation
Authors: Kumari V. , Raghuvanshi S. , Sumich A. , Barkataki I. , Taylor P. , Williams S. , Das M.
Published: May 2011

Introduction

Dysfunctional impulsivity reflects ‘recklessness without deliberation and evaluation of consequences’ and has negative consequences whereas functional impulsivity reflects ‘rapid responding to situational demands in order to maximise one's circumstances’ and often has positive consequences (1).

Objective

To examine the functional brain basis of dysfunctional impulsivity in healthy people and in people with schizophrenia.

Methods

Thirteen healthy controls and 21 schizophrenia patients (10/21 with serious repetitive violence) underwent fMRI during a Go/ NoGo task. Dysfunctional impulsivity was indexed using the Impulsiveness subscale and functional impulsivity using the Venturesomeness subscale of the Impulsiveness-Venturesomeness-Empathy questionnaire (2).

Results

Violent patients had elevated Impulsiveness scores relative to non-violent patients and controls. Impulsiveness did not correlate significantly with task performance in healthy controls or patients. Impulsiveness, but not Venturesomeness, scores correlated during the NoGO condition with lower activity in the anterior cingulate (AC) in controls, and lower inferior temporal and hippocampal activity in patients.

Conclusions

These findings accord with previously reported associations between reduced hippocampal volume and dysfunctional impulsivity in schizophrenia (3) and, combined with our earlier observations of reduced AC activation during a working memory task in violent antisocial individuals (4), suggest that the influence of dysfunctional impulsivity in antisocial and criminal behaviour is mediated via deficient (inhibitory) functions of the AC and hippocampus.
Sense of familiarity and face emotion recognition in schizophrenia
Authors: Lahera G. , de los Ángeles V. , Fernández C. , Bardón M. , Herrera S. , Fernández-Liria A.
Published: May 2011

Introduction

Patients with schizophrenia show a deficit in emotion recognition through facial expression. Familiarity means the implicit memory of past affective experiences and it involves fast cognitive processes and it is triggered by certain signals.

Objectives

To assess the emotion recognition in familiar and unfamiliar faces in a sample of schizophrenic patients and healthy controls.

Methods

18 outpatients diagnosed with schizophrenia (DSM-IVTR) and 18 healthy volunteers were assessed with the Ekman Test of emotion recognition in unfamiliar faces. In addition each subject was accompanied by 4 familiar people (parents, siblings or friends), which was photographed by expressing the 6 Ekman’s basic emotions.

Results

Schizophrenic patients recognize worse emotions in their relatives than in neutral faces, a greater extent than controls (Mann-Whitney U = 81, p = .01). The patient group showed a mean score on the Ekman test (neutral faces) lower than control group (16 (SD 2.38) versus 17.82 (2.13; U p = 0.03). Regarding familiar faces, the group patients showed a worse performance than the control group (13.22 (3.8) versus 17.18 (2.82); U p = 0.00). In both tests, the highest number of errors was with emotions of anger and fear. The patients group showed a lower level of familiarity and emotional valence to their families (U = 33, p < 0.01).

Conclusions

The sense of familiarity may be a factor involved in face emotion recognition and it may be disturbed in schizophrenia.
Four European countries survey of patients with schizophrenia treated in everyday clinical practice: characteristics of patients in short-term hospitalization
Authors: Larmo I.
Published: May 2011

Aim

The survey performed in four European countries (Germany, Greece, Italy, Spain) aimed at characterizing patients with schizophrenia treated in everyday clinical practice in terms of demographic characteristics, presenting symptomatology, and current antipsychotic treatement. We present here characteristics of patients in short term hospitalization.

Methods

A survey involving 744 psychiatrists gathered anonimous retrospective data from 3,996 patients with schizophrenia. To ensure representativeness of participating physicians, the dataset was adjusted post hoc. Principal component analysis was used to structure the patient attributes relevant for antipsychotic choice, identifying two discriminating variables (disease severity and socioeconomic level) accounting for 91% of the variance in the data. Methodology is described in full detail by Gorwood (2010).

Results

Out of 3,996 surveyed patients, 21.7% were in short term hospitalization, with a mean of 7.5 previous episodes and 5.5 previous hospitalizations. Two thirds of subjects lived with theirfamily, with primary caregiver in 47% of subjects) being a relative. Most frequently observed symptoms were delusions (in 54% of subjects) and ideals of persecution (in 41% of subjects). 71% of subjects were smokers, 21% had drug and 18% alcohol addiction. 43% of subjects had a verified cardiometabolic comorbidity and 21% were obese. 29% of subjects had verified medication non-adherence. Most frequently used drug was risperidone (in 22% of subjects). Ziprasidone was used in 11% of subjects. 10% of subjects were on depot medication and 19% on orally disintegrating tablets.

Conclusion

Subjects with schizophrenia in current short-term hospitalization have high rates of cardiometabolic risk factors or cardiometabolic comorbidity.
The effects of a documentary film on reducing stigmatisation about schizophrenia in a sample of undergraduate psychology students
Authors: Laroi F. , Van der Linden M.
Published: May 2011

Negative public reactions concerning mental illness, and in particular schizophrenia, may result in a number of negative consequences, including aggravating their clinical condition and making it even more difficult for patients to assimilate into society. The present study examined young people's attitudes about schizophrenia and furthermore evaluated the effect of a documentary film (that depicts the lives of schizophrenia patients) on reducing stigmatization about schizophrenia. One hundred and fifteen undergraduate psychology students first provided information concerning their attitudes and knowledge about schizophrenia, in addition to filling out a questionnaire assessing their degree of acceptance of stereotypes and degree of social distance towards schizophrenia patients. One week later, participants viewed the documentary film and completed the same questionnaire. The film significantly and positively influenced participants’ attitudes concerning schizophrenia. In particular, after having watched the film, participants revealed less stereotypical attitudes about schizophrenia and desired less social distance with schizophrenia patients. This change was not related to social desirability or to age, sex or years of education.
Comparison of pragmatic and cognitive functioning in adolescents with childhood onset schizophrenia and Asperger syndrome: common and differential patterns
Authors: Le Gall E. , Iakimova G. , Serret S. , Askenazy F.
Published: May 2011

Introduction

Adolescents with childhood onset schizophrenia (COS) and adolescents with Asperger syndrome (AS) are characterized by impairments in pragmatics and in cognition.

Objectives

The study of the specificity of pragmatic and cognitive deficits in COS and in AS is important to highlight some fundamental areas to each disorder and to refine behavioural phenotypes which may provide a link to gene-brain-behaviour.

Aims

The present study directly compares the pragmatic and cognitive functions in adolescents with COS and AS.

Methods

Twelve adolescents with COS and 14 adolescents with AS, matched on general IQ, verbal IQ and performance IQ, were compared. Pragmatics was explored by the Children's Communication Checklist, a parental report of language and communication in naturalistic context. Cognition was explored by Wechsler Intelligence Scale and by several specific tasks: Theory of Mind (ToM), Figurative Language Comprehension, executive functions (WCST), mental flexibility and working memory (TMT) and inhibition (Stroop).

Results

Compared to adolescents with COS, adolescents with AS exhibited more severe pragmatic impairments in naturalistic context and had more reduced figurative comprehension. In contrast, compared to AS, adolescents with COS exhibited impaired inhibition and deficit in verbal reasoning (subtest “Similarities” of the Wechsler). Both groups had similar results on ToM, WCST and TMT tasks, and on the all other Wechsler’s subtests.

Conclusions

Despite some similarities, adolescents with AS and with COS differed when pragmatics was evaluated in naturalistic context. Cognitive impairments observed in inhibition and in verbal reasoning may be specifically related to thought disorder, a core feature of schizophrenia.
Characteristics of patients with schizophrenia and good medication adherence treated in everyday clinical practice across four European countries
Authors: Levy P.
Published: May 2011

Aim

Little is known about patients with schizophrenia treated in everyday clinical practice who have good medication adherence. The survey performed in four European countries (Germany, Greece, Italy and Spain) aimed to characterize these patients in terms of demographic characteristics, presenting symptomatology, and current antipsychotic treatement.

Methods

A survey involving 744 psychiatrists gathered anonimous retrospective data from 3,996 patients with schizophrenia. Principal component analysis was used to structure the patient attributes relevant for antipsychotic choice, identifying two discriminating variables (disease severity and socioeconomic level) accounting for 91% of the variance in the data. Methodology is described in full detail by Gorwood (2010).

Results

35% of 3,996 patients were assessed as having good medication adherence. They had a mean 5.0 previous episodes and 3.2 previous hospitalizations, 67% were assessed as having mild to moderately severe illness, and 42% as having mild cognitive dysfunction, and 76% had high or satisfactory insight on the disease. 62% of them were outpatients, 18% were living alone and 72% with the family, with a relative being principal caregiver in 58% of subjects. 48% were smokers, 6% had drug and 6% alcohol addiction. Risperidone and quetiapine were used most frequently (each in 20% of subjects). Ziprasidone was used in 10% of patients.

Conclusion

Approximately 2/3 of the patients with good medication adherence were living with a family. 40% of subjects had mild cognitive dysfunction. Rates of smoking and drug/alcohol addiction were substantially lower than in other patient subpopulations investigated in this survey.
Dynamics of psychopathological symptomatology and cytokine levels in the process of schizophrenic patients treatment
Authors: Lobacheva O.A. , Vetlugina T.P. , Menyavtseva T.A.
Published: May 2011

Objective

Investigation of spontaneous, mitogen-induced production and serum concentration of IFN-γ, IL-4 and TNF-α of schizophrenic patients with different dynamic of psychopathological symptomatology during therapy.

Methods

Clinical Global Impression Scale (CGI, subscale CGI-С) was used to estimate dynamic of psychopathological symptomatology during treatment: 32 schizophrenics were divided into two groups: group 1 (10 patients) - with considerable improvement of psychopathological symptomatology; 2 (22 persons) - with non-considerable improvement or without changes.

Serum concentration, spontaneous, mitogen-induced production of IFN-γ, IL-4, TNF-α by leukocytes of schizophrenics was identified with sets for immune-enzyme analysis in dynamic of treatment (point 1 - during admission in hospital, point 2 - by week 6 of treatment).

Results

In point 1, mitogen-induced production of IL-4, serum IFN-γ, spontaneous production and serum TNF-α significantly exceeded values in control. Simultaneously, in these examined we noticed decrease of induced production of IFN-γ and TNF-α. Group 1 showed higher values of induced production of IFN-γ and lower values induced production of TNF-α as compared with group 2.

In point 2, in patients of group 1, we established significant increase of mitogen-induced and spontaneous production of TNF-α, spontaneous production of IFN-γ as compared with conformable values prior to treatment. Increase of induced production of IL-4 has a trend toward lowering serum concentration of TNF-α, what was shown in both groups.

Conclusion

Thus, schizophrenia is accompanied by disturbances of cytokine levels. We identified that favorable clinical dynamic was followed by the positive dynamic of mitogen-induced production of IFN-γ and serum level of TNF-α.
P03-265 The importance of the multidisciplinary attention in the mental serious disorder. About a case
Authors: López Marco D. , Consuegra Sánchez R. , Mártinez Pérez I. , Gómez Poveda A.
Published: May 2011

Introduction

El following work tries to show the difficulty of adherence to the treatment of our patients and the factors that influence the same one.

Aims

To establish an alliance terapeútica in a patient with diagnosis of paranoid Esuizofrenia submitted to dialysis with void conscience of disease.

Material and methods

Secondary chronicle treats itself about a 49-year-old male diagnosed of paranoid Schizophrenia with a renal disease to a chronic familiar GN in phase V in dialysis nowadays. He does not arouse of mental illness.

Personal precedents

Renal chronic insufficiency in daily dialysis. Badly TA’s control and irregular follow-up of the diet. From Nefrología’s consultation they request interconsultation and psychiatric treatment.It is sent for nefróloga for valuation of pharmacological treatment by the aim to improve the adherence to his dialysis. From the first moment it considers to work together with nefrología to adapt treatment, being the mediating one the sister-in-law. We initiate treatment with paliperidona 3mgr/día. We remind that it of the nefróloga every day on having come to dialysis. Later we initiate treatment with injectable Risperidona of long duration 25mgr/14 days in increasing dose up to 75mgr/14días with good response.

Results

Though it keeps small conscience of presenting a mental illness, he accepts the treatment, improving both the psychotic symptomatology and the acceptance of his physical ailments.

Conclusions

The multidisciplinary attention in the psychiatric patient and especially in the mental serious patient it is fundamental to obtain a good alliance and adherence to the treatment, and therefore to improve the forecast.
Innovation and modification of criteria for prevention of venous thromboembolism in psychiatric patients
Authors: Malý R. , Masopust J. , Kalnická D. , Konupĉíková K. , Bažant J. , Hosák L.
Published: May 2011

Venous thromboembolism (VTE) may represent a serious complication in the treatment of hospitalized psychiatric patients with a reduced movement. Immobilization due to a physical restraint, pharmacotherapy with antipsychotics and/or benzodiazepines, a total reduction of mobility, obesity, and dehydration may participate in etiopathogenesis of VTE. We prospectively followed individuals with a reduced mobility hospitalized at an acute psychiatric admission ward. Forty-four patients (women N = 9) with a reduced locomotion for eight hours at least presented the study sample. VTE prevention in the naturalistic setting was compared to the our previously published guidelines for VTE control in every case. The observed VTE prevention was found to be in accordance with the published guidelines in 55% of cases (N = 24). Low molecular weight heparin (LMWH) was applied to 25% of immobilized patients (N = 11), according to their grade of VTE risk. After the analysis we adjusted the VTE prevention algorithm based on our clinical experience, knowledge on the observed cases, and new literary evidence. The new version of recommended procedures (physical exercises of lower extremities, sufficient hydratation, graduated compression stockings and administration of LMWH in high risk patients) is more simple, and makes the decision on VTE prevention in hospitalized psychiatric patients easier.
Assessment of microalbuminuria and ankle-brachial index in outpatients with schizophrenia treated with antipsychotics - a possible predictors of cardiovascular disease
Authors: Malý R. , Kalnická D. , Masopust J. , Minářová K. , Vašatová M. , Pavlíková L. , Bažant J.
Published: May 2011

Schizophrenia and related psychoses are associated with excess morbidity and mortality from cardiovascular (CV) disease. Microalbuminuria (MA) is associated with an increased risk of CV disease and mortality. This association is independent of other known CV risk factors such as hypertension, dyslipidemia, obesity, smoking, and impaired renal function. The ankle brachial index (ABI), which is the ratio of systolic pressure at the ankle to that in the arm, is quick and easy to measure and has been used to confirm the diagnosis and assess the severity of peripheral artery disease. Low ABI has been related to an increased incidence of total and CV mortality and CV events. The objective of prospective pilot study was to determine MA and ABI as well as the prevalence of CV risk factors (glucose tolerance status, lipids levels, obesity, hypertension, smoking) and assessment of Framingham risk score in patients with schizophrenia treated with antipsychotic drugs. The study included thirty-three outpatient subjects (female, n = 16), aged 21–66 years. The exclusion criteria included urinary infection and presence of diabetes mellitus. Three patients (7,7%) has abnormal (>26 mg/d) levels of MA, non of ABI.In conclusion, stratification by MA can help identify a high-risk subset of nondiabetic patients with schizophrenia in risk of CV events.
Olanzapine and zuclopenthixol combined therapy for the treatment of refractory schizophrenia: 2 case reports
Authors: Manea M. , Rusanu V. , Patrichi B.E. , Puiu M.G. , Stoean R.M. , Stefanache A.A.
Published: May 2011

Introduction

Patients who remain unresponsive to two different antipsychotics should be given clozapine. However, some of the schizophrenic patients had presented an unsatisfactory benefit under clozapine monotherapy or clozapine cannot be used because of toxicity or patient refusal. Finding an efficient therapy represents a tough challenge in this situation, other drugs or drug combinations can be tried.

The aim

To choose a therapeutic scheme that improves acute psychotic symptoms and has a good tolerability. Olanzapine has antagonist activity at dopamine, serotonin, muscarinic, α1-adrenergic and histamine receptors. Zuclopenthixol has high affinity for both dopamine D1 and D2 receptors, high affinity for α1-adrenergic and 5-HT2 receptors, a weaker histamine H1 receptor blocking activity, and even lower affinity for muscarinic cholinergic and α2-adrenergic receptors.

Methods

2 schizophrenic females patients, hospitalized for an active phase episode. Both patient had perssistent hallucinations during the course of their illness despite the antipsychotic treatment and the good compliance. In the past they followed multiple therapeutic schemes. Antipsychotic medication was adjusted following the clinical outcome. Instruments: PANSS, CGI, weight, glycemia, lipide profile, blood pressure, heart rate, full blood count, hepatic enzymes, EKG, adverse events and relapse (follow-up 6 months).

Results

Olanzapine and zuclopenthixol combined therapy led to psychotic symptoms remission.

Conclusions

In this case olanzapine and zuclopenthixol may represent an option for treatment of refractory schizophrenia. No new side effects have been observed or any unfavorable drug interactions. These results have maintained untill the end of the follow-up period.
Sexuality perceptions of people with schizophrenia: preliminary results in a portuguese sample
Authors: Marques A.J. , Santos T. , Queiros C.
Published: May 2011

Introduction

Sexuality is an important dimension of life. To promote the well-being and quality of life of people with Schizophrenia, they must experience their sexuality in healthy ways. However, the lack of studies about this topic makes difficult to develop interventions in this area.

Aims

Understand the knowledge, beliefs and attitudes related with sexuality of schizophrenic individuals.

Methods

Data were collected using a questionnaire intentionally prepared for this study, with questions related to biologic, emotional and social dimensions of sexuality, evaluating: knowledge, beliefs and attitudes about sexuality; sexual activity; emotional intimacy, friendship and social life. The sample was composed by 35 individuals with Schizophrenia: 83% male and 17% female; mean age 41 years.

Results

The data revealed that 86% of the sample is single and only 6% have an affective relationship. They have difficulties to have friends, to have a satisfactory social life, and only 20% have a job. Despite the correct knowledge about sexuality, they reveal difficulties in fulfilling emotional or intimate relationships, they feel lonely and unsatisfied about their sexual life. They also feel negative effects of anti-psychotic drugs, often neglected by health professionals, views as non-preoccupied with the quality of the sexual life of the patients.

Conclusions

The sample valorized being asked about their sexuality, revealing that this topic is forgot by the professionals. It seems necessary to develop interventions regarding the sexuality of those individuals. Our future research is to ameliorate the questionnaire, preparing it to be useful when professionals discuss sexuality with schizophrenic individuals.
Stigma in mental health: perceptions of students who will be future health professionals
Authors: Marques A.J. , Barbosa T. , Queiros C.
Published: May 2011

Introduction

Actually, in society, stigma against mental illness stills strong, making difficult to develop recovery and social integration of people suffering from mental illness, witch affects their well-being and quality of life. Studies indicates that stigma can be elicited by different social groups, which include, in addition to the general population, the relatives, the individuals with mental illness and event health professionals (Schulze, 2007).

Aims

Compare attitudes and stigma against mental illness from students who will work in mental health teams.

Methods

Data were collected using a translation of Attribution Questionnaire - AQ 27 (Corrigan, 2003), fulfil in an anonym way from 486 Portuguese students of Medicine, Psychology, Occupational Therapy and Nursing. The sample was composed by 22% male and 78% female; mean age 20.4 years, 65% at begging of the course and 35% finishing.

Results

The data reveal that the sample has little contact with mentally ill individuals (only 19% have relatives with mental illness). Students from Medicine and Psychology present higher values in stigma dimensions, while Occupational Therapy and Nursing show lower values. Students begging the course shows higher stigma than those finishing. Having regular contact with mentally ill individuals seems to decrease stigma attitudes.

Conclusions

Some attitudes related to stigma were found, contradicting the actual knowledge about mental illness and politics of social inclusion. It seems necessary to modify theoretical topics about mental illness learned by students, and also pedagogical methods. Therefore, stigma and social exclusion will be discuss and avoid since the beginning of the courses.
Perceptions and stereotypes about mental illness in a sample of Portuguese employers
Authors: Marques A.J. , Lopes L. , Queiros C.
Published: May 2011

Introduction

Despite society argues that all citizens have equal rights and equal opportunities, mentally ill individuals face discrimination, especially in the employment context. Research reported benefits of working and have a job, witch help play social roles and feel useful, key components in social inclusion and recovery of mentally ill individuals.

Employers have an important role in the access of mentally ill individuals into work. They take decisions that affect life opportunities, but, due to their powerful position, their attitudes can influence all enterprise and maintain stereotypes and stigma.

Aims

Know perceptions and stereotypes about mental illness in Portuguese employers.

Methods

Data were collected using a translation of Attitude Scale for Mental Illness (Hahn, 2002), evaluating dimensions such as separatism, stereotyping, restrictiveness, benevolence, pessimistic prediction and stigmatization. The scale was fulfil using online anonym way, by 50 employers from small (under 250 employees) metallurgic or textile enterprises (60% male, 40% female; mean age 45.9 years).

Results

None of the enterprises have employees with mental illness, neither integration policies. Employers prefer to give a job to people with physical disabilities than to people with mental illness, choosing people with schizophrenia as the last possibility. They have little contact with mentally ill individuals, 96% don’t know governmental policies for job inclusion and only 54% accepts to participate in meetings to understand those policies. Stereotyping, benevolence and pessimistic prediction present highest values.

Conclusions

Employers must be informed about governmental policies using work as a form of social inclusion from mentally ill people.
The portuguese version of the personal and social performance scale (PSP): reliability, validity, and relationship with cognitive measures in hospitalized and community schizophrenia patients
Authors: Brissos S. , Marques J.G. , Palhavã F. , Mexia S. , Carmo A.L. , Carvalho M. , Dias C. , Franco J.D. , Mendes R. , Zuzarte P. , Carita A.I. , Molodynski A. , Figueira M.L.
Published: May 2011

Introduction

Deficits in social functioning are a core feature of schizophrenia and are influenced by both symptomatic and neurocognitive variables.

Objectives

In the present study we aimed to determine the reliability and validity of the Portuguese version of the Personal and Social Performance (PSP) scale, and possible correlations with measures of cognitive functioning.

Methods

One-hundred and four community and inpatients with schizophrenia were assessed using measures of social functioning and symptom severity alongside measures of executive function, processing speed and verbal memory.

Results

The reliability of the PSP was found to be satisfactory, with a Cronbach's alpha coefficient of 0.789. Inter-rater reliability in the four domains of the PSP varied from 0.430 to 0.954. Low-functioning patients (PSP < 70) were older, had longer duration of illness, were more symptomatic and had worse cognitive performances, as compared to high-functioning patients (PSP ≥ 70). In a regression model, deficits in social functioning were strongly predicted both by symptomatic and neurocognitive variables; these together accounted for up to 62% of the variance.

Conclusions

The present study supports the reliability and validity of the Portuguese language version of the PSP and further supports the original measure. The co-administration of brief cognitive assessments with measures of functioning may lead to more focused interventions, possibly improving outcomes in this group.
Impact of family psychoeducation in treatment adherence in psychosis
Authors: Martin M.F. , Rigau N. , Garcia M.T.
Published: May 2011

Introduction

Failure of antipsychotic treatment in schizophrenia is 80% according to a study by Corrigan and Weiden et al. They reported rates of pharmacologic treatment failure as 50% one year after psychiatric admission and 75% after two years. Between many factors influencing, one is the relationship between the professional and the family. There are different models of family intervention that have been effective in improving relapse rate, symptoms, social and occupational functioning, adherence and knowledge of illness and family burden (Zhang, Yan, Yao, & Ye et al., 1993).

Objectives

To assess the association and strength between the performance of family psycho education groups and adherence to treatment in a schizophrenic population.

Material and methods

Observational non blinded descriptive study in people with schizophrenia treated in an outpatient service which has 75000 inhabitants of reference population. We divided the patients into two groups whether family psycho education was done or not in the past 5 years. In each group we randomly sampled and reached an n > 30 and then we practiced a 2-year prospective follow-up recording the following variables: diagnosis, disease evolution, comorbidity with affective disorder, GAF and CGI, type of drug treatment both at the beginning and end of follow up, number of therapeutic changes, compliance visits, number of hospital admissions, number of emergency visits and side effects tolerance. After the follow-up we will do a descriptive statistics (Student t, X2, ANOVA) through SPSS version 11.5.

Results and conclusions

Will be sent at the end of the study.
The EMEA ADHES survey in schizophrenia: psychiatrists’ perceptions of reasons for partial or non-adherence
Authors: Gorwood P. , Alptekin K. , Azorin J.M. , Cañas F. , Dubois V. , Emsley R. , Haddad P. , Naber D. , Olivares J.M. , Papageorgiou G. , Roca M. , Thomas P. , Martinez L. , Schreiner A.
Published: May 2011

Introduction

Partial or non-adherence to medication is high amongst patients with schizophrenia. Many and often overlapping factors are considered to impact on treatment adherence, including: patient-related (lack of insight, psychotic, negative or cognitive symptoms), treatment-related (adverse effects, insufficient efficacy), environmental (living situation, negative attitudes of relatives/friends), and physician-related (patient-healthcare professionals relationship) factors.

Objectives

The objective of the ADHES EMEA (Europe, Middle East and Africa) survey was to collect psychiatrist's perceptions of the assessment, reasons and management of partial and non-adherence to medication.

Aims

To present psychiatrist's opinion through EMEA of potential reasons for partial or non-adherence

Methods

The ADHES survey comprised 20 questions and was conducted in 36 countries across EMEA (over 4500 psychiatrists treating patients with schizophrenia).

Results

Across EMEA 37% of psychiatrists viewed lack of insight as the most important reason for their patients stopping medication. 23% of psychiatrists viewed patient's feeling better and thinking it unnecessary to take medication as the most important reason for their patients stopping medication. 7% or less of psychiatrists viewed undesirable side effects, insufficient efficacy, cognitive impairment or drug/alcohol abuse as the most important reasons for their patients stopping medication.

Discussion

In this survey, psychiatrists estimated that patient’s lack of insight and subjective improvement could constitute the main factors explaining poor adherence. Other factors (i.e., side effects, substance abuse) were regarded as less important. Strategies aimed at raising awareness of maintaining treatment, are warranted within EMEA, with the aim of improving clinical outcomes.
The EMEA ADHES survey in schizophrenia, an initiative to raise awareness of non-adherence to medication. demographics and methodology
Authors: Olivares J.M. , Alptekin K. , Azorin J.M. , Cañas F. , Dubois V. , Emsley R. , Gorwood P. , Haddad P. , Naber D. , Papageorgiou G. , Roca M. , Thomas P. , Martinez L. , Schreiner A.
Published: May 2011

Introduction

Rates of non-adherence of up to 72% have being reported, in schizophrenia, depending on the method used and the patient population. Rates of approximately 59% over 1 year have been reported for individuals with a first episode. Patients who stop medication are almost five times more likely to experience relapse than adherent patients. Failure to adhere to medication can have a major impact on the course of illness and treatment outcomes.

Objectives

The EMEA (Europe, Middle East and Africa) ADHES schizophrenia survey was a survey of psychiatrists across the region, treating patients with schizophrenia, designed to canvas their perceptions of assessment, potential reasons and management for partial or non-adherence to medication amongst their patients.

Aims

To present methodology and demographics of the EMEA ADHES survey in schizophrenia.

Methods

The EMEA ADHES survey comprised 20 questions and was conducted in 36 countries across EMEA. In addition to recording the gender, age and practice setting of the respondents, questions related directly to the issue of partial-/non-adherence in patients with schizophrenia.

Results

The survey was conducted amongst psychiatrists (including neurologists with psychiatric background in Germany) from January - March 2010. Results were obtained from 4722 respondents. Psychiatrists perceived that during the previous month more than half of their patients (53%) were partially or non-adherent across all EMEA regions

Discussion

The EMEA ADHES schizophrenia survey is a large and geographically broad survey providing insight on psychiatrists’ perceptions of the assessment, causes and management of partial and non-adherence to medication.
The EMEA ADHES survey in schizophrenia: psychiatrists’ perceptions of the extent of assessment and management of partial and non-adherence to medication
Authors: Naber D. , Alptekin K. , Azorin J.M. , Cañas F. , Dubois V. , Emsley R. , Haddad P. , Gorwood P. , Olivares J.M. , Papageorgiou G. , Roca M. , Thomas P. , Martinez L. , Schreiner A.
Published: May 2011

Introduction

Partial or non-adherence to medication is high amongst patients with schizophrenia. Rates of non-adherence of up to 72% have being reported depending on the method used and the patient population. Adherence is essential for optimal long-term patient outcomes in schizophrenia and failure to adhere to medication can have a major impact on the course of illness and treatment outcomes.

Objectives

The objective of the EMEA (Europe, Middle east and Africa) ADHES survey was to collect psychiatrist's perceptions of the assessment, reasons and management of partial and non-adherence to medication.

Aims

The aim of this poster is to present psychiatrist's perceptions collected in the EMEA ADHES survey.

Methods

The survey was devised to ascertain psychiatrists’ preferred methods of assessing adherence, their perceptions of the level of adherence, reasons for non-adherence and on strategies to improve adherence.

Results

Psychiatrists estimated that during the previous month more than half of their patients (53%) were partially or non-adherent. They estimated that as few as a third of patients who deteriorated after stopping medication was able to attribute this to their non-adherence. 76% of psychiatrists assessed adherence most frequently by asking their patient explicitly. Use of long-acting treatment was the preferred choice to address adherence problems for 62% of respondents.

Discussion

This EMEA-wide survey illustrates that while respondents recognised the relevance and importance of partial and non-adherence to medication, there remains a need for more proactive management of treatment adherence of patients with schizophrenia to reduce the frequency and consequences of relapse.
Treatment with glutamatergic drugs in the resistant schizophrenia
Authors: Martínez de Velasco Soriano R. , Pando Velasco F. , Serrano Díaz de Otálora M. , Artieda Urrutia P. , Riaza Bermudo-Soriano C.
Published: May 2011

Introduction

The neurodevelopmental hypothesis defends the existance of factors that would cause an early impairment on the normal brain development. The neurodegenerative hypothesis proposes the existance of later and progressive pathological phenomena, responsible of the appearance of clinical manifestations and changes on neuroimaging. Both hypotheses would be complementary. Neurodevelopment is completed during adolescence. Within this period, these deficts on executive functions would become apparent, reflecting a neurodevelopmental impairment. Glutamate is the main excitatory neurotransmitter, present throughout the normal postnatal brain development and maduration. In schizophrenic patients and unaffected relatives, a glutamatergic hypofunction has been found and so, an alteration of the dopaminergic mesocortical limbic and nigrostriatal pathways.

Objectives

Usage of molecules that are capable of reversing the glutamatergic hypofunction would be potentially benefitial for either positive or negative symptomathology in schizophrenia.

Method

We have performed a review of several clinical trials (on humans and animals) using glutamatergic drugs alone and combined with neuroleptics to diminish behavioural disturbances related to NMDA blockage.

Results

Usage of glycine binding site agonists (glycine, D- cicloserine, D-serine) has been proposed. D-serine is effective both as monotherapy and combined with neuroleptics. D-cicloserine is not effective on negative symptoms. Usage of high doses of oral glycine (30–60 mg a day) on its own has not shown any clinical change but there is an improvement on negative and positive symptoms if combined with neuroleptics.

Conclusion

Nowadays, there is no glutamatergic agonist used in schizophrenia treatment. Out of the three previously mentioned drugs, only D-serine has shown some efficacy.
Treatment resistant psicosis
Authors: Martínez Manjarrés J.D. , Gallardo Ponce R. , Botillo Martin C. , González Pablos E.
Published: May 2011

The aim is to charactherize the clinical data: psychopathologic state, pharmacological treatment and sociodemographical data; in a population of long-term institutionalized schizophrenic patients. Treatment resistant patients will be compared to non treatment resistant schizophrenics.

The target population is a convenience sample of our institutionalized patients. We chose a total of 60 schizophrenic patients, 100% women, diagnosed following the ICD-10 criteria. Specific survey was applied by the group of investigators: PANSS, Global Assessment Scale (GAS), and Clinical Global Impression (CGI).

Statistical analysis was performed with SPSS v 15.0, including descriptive statistics and correlation analysis.

Neuroleptic Polipharmacy is the most frequent tretment prescribed, just a 3,7% of the treatment resistant patients is on monotherapy. Despite polipharmacy, patients show a long term acute state.
Differences in quality of life between groups of patients with schizophrenia
Authors: Mas-Expósito L. , Gómez-Benito J. , Amador-Campos J.A. , Lalucat-Jo L. ,   Working Group on Severe Mental Disorder
Published: May 2011

Introduction

Studies about Quality of Life (QOL) in schizophrenia usually involve the validation of questionnaires, the effects of treatments or its association with relevant variables but, so far, the literature about differences in QOL between groups of patients with schizophrenia is scarce.

Objectives and aims

This work aims to show differences in QOL between groups of patients with schizophrenia defined according to socio-demographic, clinical, psychosocial and use of services variables.

Method

The sample comprised 241 patients that meet the following inclusion criteria: 1) International Classification of Diseases-10 diagnosis of schizophrenia, 2) Global Assessment Functioning scores or GAF ≤ 50 and 3) Illness duration greater than 2 years. Patients were evaluated regarding socio-demographic, clinical, psychosocial and use of service variables. T-tests and analysis of variance tests were used.

Results

There were no differences in QOL between groups of patients with schizophrenia established according to socio-demographic variables. There were significant differences in QOL between groups of patients with schizophrenia defined according to clinical, psychosocial and use of service variables. Patients with schizophrenia who were anxious, disabled, lacked social support and used more social services showed poorer levels of QOL.

Conclusions

Our results are consistent with previous studies that support that, in patients with schizophrenia, the association between socio-demographic characteristics and QOL cannot be considered significant and that QOL is associated with disability, social support, psychiatric symptoms and care needs. This work highlight differences between groups of patients with schizophrenia, which may be a useful information to tailor interventions to this sample population.
Side effects of treatment and quality of life among patients with schizophrenia
Authors: Ben Thabet J. , Feki I. , Sallemi R. , Masmoudi J. , Zouari L. , Zouari N. , Maâlej M.
Published: May 2011

The aim of our study was to assess the treatment side effects and their implications on quality of life in a population of schizophrenic patients.

We included 50 patients with schizophrenia treated at Hthe psychiatry department of the university hospital in Sfax (Tunisia). We used the PANSS, the UKU side effect rating scale and the SF-36 to assess, respectively, the severity of disease, the treatment side effects and the quality of life. The statistical analysis was carried out by software SPSS.

The assessment of quality of life revealed a global average score of 59.11 and an alteration in 54% of patients. Impaired quality of life was significantly correlated with irregular follow-up (p = 0.02), bad treatment compliance (p = 0.016) and polytherapy (p = 0.024). The presence of side effects which affect either moderately or severely daily activity was significantly correlated with impaired quality of life (p = 0.007). The presence of side effects was correlated in a significant way with altered quality of life (p = 0,007).

Our study showed a relatively high frequency of side effects of treatment in patients with schizophrenia. They were correlated with impaired quality of life. They are also factors of bad compliance. Reduction and prevention of side effects requires the use of atypical antipsychotics which are better tolerated and more active on negative symptoms. However, they pose the problem of high costs. But it must be noted here that the overall cost of disease is higher with conventional antipsychotics than with atypical ones.
Patients’ attitudes to antipsychotic depot medication
Authors: Mnif L. , Masmoudi J. , Baâti I. , Masmoudi R. , Damak R. , Jaoua A.
Published: May 2011

Introduction

The advantages of conventional depots (CDs) in treating schizophrenia have been demonstrated in several studies. Indeed, the use of CDs continues to have a great importance in our psychiatric sectors due to the unavailability of atypical depot formulations.

Objective

The aim of this work was to assess the perspectives of patients with schizophrenia towards CDs.

Methods

We conducted a cross-sectional survey using fifty schizophrenic/schizoaffective outpatients treated by CDs for at least 3 months. The questionnaire included sociodemographic data, data concerning the disease and perspectives of CDs.

Results

80% of the patients were males. The mean age was 30.7 years. 40% were married and 70% unemployed.

76% were diagnosed as schizophrenic patients (58% undifferentiated, 18% disorganized) and 24% as schizoaffective patients. The average duration of the disease was 15.5 years. The time of the last hospitalization went back to 10.1 years on average.

For all the patients, the initiative of CDs’ prescription was taken by the psychiatrist by reason of the poor adherence (72%) and the inefficiency of the previous treatment (38%). 80% of the patients preferred CDs to oral neuroleptics because the former:

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allowed avoidance of oblivion (70%),

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were more effective (60%),

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made relapses less frequent (50%),

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ensured distant intakes of treatment (50%),

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were better tolerated (40%),

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improved patient's autonomy (32.5%).

Conclusion

The patients in our study have high regard for CDs, which explains their adherence success.

Their autonomy and their tolerance of neuroleptics might be improved by using atypical depot formulations.