bluuebunny/crossref_metadata_2025 huggingface dataset:
Schizophrenia -end of classical dopamine theory? what” s next?
Authors: Mititelu A.
Published: May 2011

Introduction

Schizophrenia (SZ) remains the most challenging psychiatric pathology at moment despite huge efforts made with the scope to achieve a clear better understanding of its etiology and pathophysiology. at least 1% of world populations suffers from this disease.

Objective

An avalanche of recent studies reveals the massive importance of glutamate abnormalities which appear in the debut phases and contribute essentially to the further development of severe symptoms. Old, classical and peculiar dopamine hypothesis starts day by day to become less feasible.

Aims

Based on a better understanding will be more efficient to develop more efficient therapeutic products. Based on more accuracy and real understanding of GABA and Glutamate roles in the pathophysiology of SZ is possible for staring more efficient therapies

Methods

In this sense we realised a thematical research study from vast bibliographical resources.between 2000–2009 all basic research and clinic-pathological studies, indexed on Pubmed, Medline and Wiley Science Library had been reviewed.

Results

Simple mechanical appreciation shows, unfortunately, that at moment dopamine theory still dominates the etio-pathology of this major psychiatric syndrome. In fact dopamine variations are secondary to glutamate dysfunctions. We don’t need to forget that most of actual treatments-second generation of antipsychotics- had been produced on basis of dopamine hyperfunction theory. The importance of glutamate and GABA deficiencies, which offer a more clear and logical explanation of pathology seen in SZ, cannot be considered as secondary to hypodopaminergic frontality or to hyperdopaminergic inputs from nucleus accumbens.
Quality of life and burden on caregivers of chronic psychotic patient: Analysys and correlation with psycopathology
Authors: Monteiro D.P.E. , Freitas T.H. , Clemente C.M. , Pinto J.P.
Published: May 2011

Objectives

To evaluate the subjective impact on quality of life and burden of caregivers of chronic psychotic patients and correlate with the impact that the type of patient’s symptoms according to PANSS (negative, positive, mixed or none).

Methods

We used the Caregiver's Burden scale to measure quality of life and subjective burden of caregivers of chronic psychotic patients followed up by the Psychotic Disorders Clinic of the Hospital Mental Health Messejana, in Fortaleza, Ceará, and the PANSS for the patients of the relatated caregiver. Then we correlated the data in order to observe whether the patient’s symptoms interfere with the quality of life and the burden of the caregivers.

Results

We observed that most caregivers were women, mothers of patients who had incomplete primary schooling, married, with incomes between one and two minimum wages. In most cases also with incomplete primary degree and mean disease duration was 16.51 (± 9.64) years. We found that higher scores on scales of positive and PANSS general psychopathology in the patient, the worse the quality of life and caregiver burden. In this sample, negative symptoms measured by the PANSS negative scale does not seem to interfere with quality of life and caregiver burden.OuvirLer foneticamente Dicionário - Ver dicionário detalhado

Conclusion

Demographic data did not affect the quality of life of caregivers; the main factors that contributed to a poorer quality of life and caregiver's burden were high scores in positive and general psychopathology of PANSS.
Short Message Service (SMS)-based strategy to improve antipsychotic adherence in schizophrenia
Authors: Montes J.M. , Gómez Beneyto M. , Tesoro A. , Díez T. , Maurino J.
Published: May 2011

Objective

Poor adherence to antipsychotic treatment is a well-recognized challenge among patients with schizophrenia and is associated with increased morbidity and consumption of health care resources.

We evaluated the effect of daily Short Message Service (SMS) reminders on patients’ adherence to antipsychotic medication in schizophrenia.

Methods

Clinically stabilized outpatients with schizophrenia and considered to be poor adherent (at least one affirmative answer of Morisky-Green questionnaire -MAQ) to antipsychotic monotherapy were included in a multicenter, randomized, open-label, controlled trial. Participants were randomized to receive a daily SMS reminder on their cell phone to take their medication during 3 months or current standard of care. The primary outcome measure was improvement in adherence rate (mean MAQ score) after 3 months.

Results

254 patients were analysed, 66.5% men. Mean age: 39.7 years (SD = 11.03). Baseline socio-demographic and clinical characteristics were similar between the two groups. No significant differences in baseline mean MAQ scores were observed between groups (2.23, SD = 0.94 and 2.23, SD = 0.85, respectively).

At month 3, mean MAQ score in the intervention group was 1.2 and 1.53 in the control group. Absolute difference in mean adherence rate between groups was −0.33 (95%CI −0.62, −0.03; p = 0.03). Largest change from baseline was observed in question 4 of the questionnaire “When you feel better, do you sometimes stop taking your medicine?” (percentage of affirmative answers in the SMS group vs control was 45% and 59%, respectively, p = 0.02).

Conclusions

SMS reminders, added to standard interventions for schizophrenia management, may help many patients to improve adherence to antipsychotic medication.
Is attention related with pathological personality in siblings of psychotic patients?
Authors: Moreno L. , Valero J. , Gaviria A.M. , Labad A.
Published: May 2011

Introduction

Impaired sustained and selective attention have been seen as vulnerability factors to psychotic disorders. Relatives of psychotic patients are a risk population for psychosis, and previous studies have shown that they displayed more attentional deficits compared with healthy controls. Additionally, relatives have more pathological personality and schizotypy, the least considered also to be the expression of the genetic vulnerability to schizophrenia. There are few studies that relate attention to personality factors in relatives of psychotic patients.

Aims

To compare attentional performance of siblings of psychotic patients with those of healthy controls, taking into account their pathological and schizotypal personality.

Methods

The Spanish version of the SPQ and the DAPP-BQ were administered to a sample of 51 subjects that were divided into four groups by a hierarchical cluster analysis: siblings with high pathological personality (SHPP), siblings with low pathological personality (SLPP), controls with high pathological personality (CHPP), and controls with low pathological personality (CLPP). In all the subjects we assessed a sustained attention index (SUA) and a selective attention index (SEA). We compared the performance of the four groups on these attentional indexes.

Results

We found that SHPP had worse performance on sustained attention compared with CLPP. Specifically this difference was in the reaction time item of the SUA.

Conclusions

The high schizotypy and pathological personality had an influence on sustained attentional performance in the siblings of patients with psychosis, but not in the healthy controls.
Conceptual disorganisation in paranoid schizophrenia inpatients and blood melatonin levels
Authors: Morera-Fumero A.L. , Diaz-Mesa E. , Abreu-Gonzalez P. , Jimenez-Sosa A. , Henry-Benitez M. , Gracia-Marco R.
Published: May 2011

Objectives

The aim of this research is to study whether serum melatonin level is related with positive psychopathology in a sample of paranoid schizophrenia patients.

Methods

32 acutely paranoid schizophrenia patients admitted to the psychiatric ward of the University Hospital of the Canary Islands took part in the study. All patients met DSM-IV criteria for paranoid schizophrenia. 22 were males and 9 females. The mean age was 36.7 ± 10.3 (standard deviation). Blood was sampled by venipuncture at 12:00 and 24:00 hours after having rested in bed one hour. This was done to avoid the body postural effect on melatonin levels. Blood extractions were carried out during the first 48 hours after admission. Psychopathology was assessed by the positive subscale of the Positive and Negative Syndrome Scale (PANSS). Melatonin serum levels were measured by ELISA techniques. Pearson correlations between melatonin serum levels and PANSS positive scores at 24:00 and 12:00 hours at admission and discharge were carried out.

Results

The only significant correlation, with a positive sign, was the item Conceptual Disorganisation (P2) with serum melatonin at 24:00 h (r = 0.355, p < 0.046).

Conclusions

Serum melatonin levels may be used as a biological marker of conceptual disorganisation in paranoid schizophrenia inpatients.

Acknowledgement

This study was partly supported by a grant (PI: 08/115) of the Fundacion Canaria de Investigacion y Salud (FUNCIS).
Improvement of positive and negative symptoms in patients with schizophrenia, under risperidone long acting injection (RLAI) treatment
Authors: Moruzzi E.
Published: May 2011

Introduction

Early treatment intervention and prevention may minimize the morbidity and persistent disability caused by schizophrenia that occurs over patients’ lifetimes.

Atypical antipsychotics with improved tolerability and less likely to cause movement disorders and secondary negative symptoms, are generally used as first line therapy.

Risperidone long acting injection (RLAI) is currently the only available long acting atypical antipsychotic, combining the better tolerability of an atypical with the benefits of injectable delivery.

Objective

To assess the maintained efficacy and safety of risperidone long acting injection after a direct treatment change from any antipsychotic medication in patients with schizophrenia.

Methods

Adults with schizophrenia received injections of long acting risperidone 25, 37.5, 50 mg in 14 days interval for 6 months.

Efficacy was measured by:

.

PANSS (Positive and negative symptoms scale)

.

CGI-S (Clinical Global Impression- Severity)

.

GAF (Global Assessment Functioning)

Tolerability was measured with TEAE (Treatments emergent adverse events)

Results

In this study, negative and positive symptoms were significantly improved. Clinical deterioration was substantially ameliorated between baseline and endpoint. Compared to baseline there were significant decreases in the occurrence of suicidal ideation and violent behaviour. Also, the treatment showed good safety and tolerability.

Conclusions

RLAI treatment was associated with a very good efficacy, tolerability, and an excellent improvement of functionality.
Association of deficits in smell identification, social and basic cognition in patients with schizophrenia-spectrum disorders, their first-degree relatives and matched healthy controls
Authors: Mossaheb N. , Schloegelhofer M. , Kaufmann R.M. , Aninilkumparambil T. , Gold A. , Himmelbauer C. , Inreiter S. , Schlehaider L. , Hoffmann H. , Aschauer H.N.
Published: May 2011

Introduction

Associations between smell identification deficits (SID) and impairments in basic cognitive domains have been shown in patients with neuropsychiatric disorders.

Objectives

We analyzed social and basic cognitive deficits and SID.

Aims

To assess differences in affective decision making tasks in patients with schizophrenia-spectrum disorders, their 1st degree relatives and healthy controls. Methods: We examined 51 patients with schizophrenia-spectrum disorders (49% female, age 33.1 years, SD 11), 21 first-degree relatives (61.9% female, age 49.5 years, SD 17.6, one affected, others non-affected) and 51 matched healthy controls (49% female, age 33 years, SD 12.1). Psychopathology was evaluated using the Positive and Negative Syndrome Scale (PANSS). Subjects were administered the University of Pennsylvania Smell Identification Test (UPSIT), the Facially Expressed Emotion Labelling (FEEL) test, the spatial span subtest of the Wechsler Memory Scale-Revised (WMS-R) and the Mehrfachwahl-Wortschatz Test (MWT-B).

Results

Patients, controls and 1st degree relatives differed in age (p = 0.000), WMS-R (p = 0.000) and FEEL scores (p = 0.007). In healthy controls, patients and 1st degree relatives FEEL correlated with age (p = 0.005, p = 0.003, p = 0.004, respectively). In patients FEEL also correlated with MWT-B (p = 0.000), UPSIT (p = 0.000) and PANSS negative scores (p = 0.016); furthermore, UPSIT correlated with MWT-B (p = 0.001). In 1st degree relatives age correlated with WMS-R (p = 0.04) and FEEL (p = 0.004), both of which inter-correlated (p = 0.006).

Conclusion

We found that SID, basic and social cognition, i.e. affective decision-making processes, inter-correlate in patients with schizophrenia-spectrum disorders and are partly under the influence of negative symptoms. Some of these relationships can also be seen in 1st degree relatives of patients.
Physical care of people suffering from schizopphrenia on risperidone long acting injectable depot
Authors: Najim H. , Rafiq R. , Islam N.
Published: May 2011

Background

People with severe mental illness neglect their physical health needs. They smoke a lot, they drink a lot and they don’t do exercise. They eat unhealthy food and put on weight. Unfortunately, the antipsychotic medication don’t help and some of the drugs are associated with side effects which make these problems worse.

Methods

Medical notes of patients who has been on risperidone long term injectable depot for a year, from the first of January till the 30th 2008 were reviewed and information were input on the form.

Results

65 notes were reviewed. 70% males. 70% between 18-50 years. The following was done baseline:

50% had physical examination.

25% had pulse, blood pressure and ECG.

Body weight 10%.

Triglycerides 20%.

Urea and electrolytes (U&E)15%.

40% had their liver function tests(LFT).

50% had comorbidity with other physical illness.

The following were done on six monthly maintenance measures:

Only 5% had maintenance ECG.

LFT 10%.

U&E 30%.

Triglycerides 5%.

Discussion

Only 50% of patients had physical examination. Only quarter of patients had their BP, pulse and ECG done as a baseline. There was no regular physical follow up and investigation and the investigation which were done sporadically. Physical co-morbidity was 50% of the sample while physical examination and investigations were done in less than half of the sample.

Conclusions

Proper physical assessment and regular follow up should be adopted.

Promotion of healthy living and eating, exercise and monitoring weight should be advised.
Severe generalize cortical atrophy inconsistent with her age, and neurocognitive impairment in an untreated schizophrenia patient: A case report
Authors: Oral E. , Güleç M. , Aydin N. , Ozan E. , Kırpınar I.
Published: May 2011

Background

In schizophrenia, frontal structural and functional deficits are replicated findings.

Case

AK was 40 years old. She had not been appealed to psychiatry department or took any medicine. She had had severe positive symptoms such as, grandiosity, delusions, auditory and visual hallucinations, hallucinatory behaviors, mystic contains of thoughts since her childhood. MRI had been showed that the severe cortical atrophy inconsistent with her age. In the assessment of neurocognitive tests we found that the signs of frontal - prefrontal and temporo-limbic impairment. On Rey Auditory learning test she could remember totally 34 words as a sum of the 1st to 5.th Readings. At 6.th reading she remembered 5 words and at 7th 6 words. At recognition part of the test she had 8 true positive and 3 false positive results. On Auditory trigram test, her score was 25 and on controlled word association test she could tell 20 total words. In digit span test her scores were 4 at forward section and 4 at backwards section. She could not perform trial making test part A or part B. On Stroop test she completed section 5 (main card reading time) at 26 seconds. These results suggested us that she had dysfunction in the cognitive domains such as; working memory, focused attention, short time verbal memory and frontal executive functions.

Conclusion

This sample has been attracted attention to neurodegenerative process notwithstanding without antipsychotic treatments effects.
The study of suicidal behavior at patients with anhedonia in schizophrenia
Authors: Orlova N. , Shkliar M. , Khaustova E.
Published: May 2011

Introduction

The suicidal behavior at patients with anhedonia in schizophrenia is one of the burn problems in modern psychiatry.

Objectives

Anhedonia belongs to negative symptoms in schizophrenia. The suicidal activity at patients with it consists from 7% tо 43%. At those patients fixed the suicidal ideas - 40%, suicidal attempts - 23% and complete suicide - 6,4%.

Aims

Study the methods of suicidal behavior at those patients.

Methods

The Columbia Suicide severity research scale (C-SSRS).

Results

157 patients with anhedonia. Selected 49 (31, 21%) patients with suicidal behavior on admission or in the past. 23 women and 26 men with a mean age of 34, 37(±1, 92) and mean illness duration of 7, 72(±1, 42). The anhedonia level was 21, 26(±1, 26). 73,48% were the patients with Schizophrenia among them 44,91% with “postpsychotic depression” (295.60), 28, 57% with paranoid schizophrenia (295.30) and 26,52% - patients with affective disorders (296.3×). All patients wished to die. 79,59% (n = 39) had a suicidal attempts and 20,41% (n = 10) had a suicidal ideas. Active suicidal ideas without the suicide plan had 79, 59% patients. The methods of suicidal attempts were poisoning (38, 52%), cutting (25, 64%), hanging (12, 8%), falls (20, 48%), drowning (2, 56%).

Conclusions

Anhedonia in schizophrenia is a risk factor of suicidal behavior. The suicidal behavior declared itself with suicidal attempts much more than suicidal ideas. Suicidal attempts were impulsive and dangerous with risk for life. It point to seriousness and danger results of suicidal behavior.
Oxidative stress markers in patients treated with typical and atypical antipsychotics
Authors: Padurariu M. , Ciobica A. , Dobrin I. , Joacabine C. , Stefanescu C.
Published: May 2011

Introduction

Studies performed in schizophrenia patients have generally suggested the presence of a compromised antioxidant system, but this is not always consistent with specific observed parameters, which on the whole, show evidences of dysregulation. There are also controversies regarding the oxidative stress status in patients treated with typical vs. atypical antipsychotics.

Aim

In this context, the aim of the present work was to evaluate the specific activity of some peripheral antioxidant defences like superoxide dismutase (SOD) and glutathione peroxidase (GPX) and the level of a lipid peroxidation maker (malondialdehyde-MDA), in schizophrenic patients treated with typical (haloperidol) or atypical (olanzapine, quetiapine and risperidone) antipsychotics, compared with age-matched healthy subjects.

Methods

The subjects of this study (n = 45), consisted of 35 patients who met DSM-IV criteria for schizophrenia and 10 healthy control age and gender-matched subjects. Patients were of paranoid subtype, with duration of illness for at least 5 years. Nine patients were under haloperidol (1–2 mg daily dose) treatment and 26 (8/10/8) patients were under atypical treatment: quetiapine (300 mg daily dose), olanzapine (20 mg daily dose) or risperidone (2–4 mg daily dose), respectively.

Results

We found a significant decrease in GPX specific activity and also a significant increase of MDA levels in schizophrenic patients, compared to age-matched control group, regardless of their type of treatment. Additionally, an increase in SOD specific activity was observed, mainly in the patients treated with haloperidol and quetiapine.

Conclusions

Further research is necessary in order to elucidate the effects of different antipsychotic agents on antioxidant enzymes.
The neuronal correlates of empathy in autism spectrum disorders
Authors: Michel T.M. , Herholz S. , Finkelmeier A. , Schneider F. , Brügmann E. , Haeck M. , Schneider K. , Vloet A. , Habel U.
Published: May 2011

Introduction

Autism spectrum disorders (ASD) are characterised by repetitive behaviour/interests, an impairment in reciprocal social interaction and communication. This implies the inadequate appreciation of socio-emotional cues and leads to a default in the responses to other people's emotions.

Objectives

Deficits in empathy have been described for individuals with autism spectrum disorders (ASD).

Aims

We aim to investigate the described deficits in empathy in a group of people with ASD on a behavioural and a neuronal level.

Methods

We assessed neuronal activity using functional magnetic resonance imaging (fMRI) during three different empathy tasks (“emotion-recognition”, “perspective-taking” and “affective-responsiveness”) of 12 adults with ASD and a matched group of healthy controls.

Results

Subjects with ASD did not have differences in affective responsiveness compared to healthy controls, but in emotion recognition and perspective taking. The reaction time was significantly longer in patients with ASD in all tasks. People with ASD showed a different pattern of brain activation in cortico-limbic areas during the empathy tasks compared to controls

Conclusion

Our findings of individuals with ASD having problems in emotions-recognition and in perspective taking are supported by previous results. These impairments are reflected by a different pattern of neuronal activation in several brain areas of individuals with ASD compared to controls. Although there are no differences in affective responsiveness in the ASD group a marked difference can be seen in the brain activation during this task. These findings might open up new avenues of intervention for individuals with ASD and their often described problems with empathy.
Subgroups with characteristically different electroencephalographic profiles identified by cluster analysis within schizophrenic patients
Authors: Papaliaga M.N. , Hatziefthimiou A.A. , Mouzas O. , Karatziou M. , Angelopoulos N.
Published: May 2011

Aim

To examine clinical, electrophysiological differences among subgroups of schizophrenic patients with different QEEG profiles identified by cluster analysis.

Method

Fifty-two schizophrenic patients were studied (age:34.64 ± 10.41, 18–58 years). Digital, resting electroencephalogram was recorded and submitted to quantitative-topographic spectrum analysis (QEEG), and patients’ clinical state was assessed by the Greek version of Positive and Negative Syndrome Scale (PANSS). QEEG data were submitted to cluster analysis, and QEEG, clinical differences were compared using Kruskal-Wallis non-parametric test.

Results

Three groups of patients with different electrophysiological profiles (p < 0.05) were detected by cluster analysis of QEEG data: Group A, characterized by increased levels of relative power in α frequency band, low levels in β, medium levels of relative power in δ, θ frequency bands; Group B, characterized by increased levels of relative power in δ, θ frequency bands and medium in α, β; Group C, characterized by increased levels of relative power in β frequency band, very low in α, medium in δ, θ bands. According to PANSS, group A patients had lower (p < 0.05) levels of agitation, hostility/aggression, difficulty in abstract thinking, stereotypic thought and attention deficit than patients of the other groups.

Conclusions

Cluster analysis can be used to identify characteristically different QEEG profiles of schizophrenic patients. The cluster with increased relative power in the α frequency band, low levels in β, and medium in δ, θ bands was “healthier” in specific PANSS parameters than the clusters with low α and increased relative power in δ, θ and β frequency bands.
Leading role of an animal in a schizophrenic delusion. A case-report
Authors: Paraschakis A. , Molochas G.
Published: May 2011

Aim

To impress the diversity of positive symptoms in patients with schizophrenia.

Method

Case report and review of the literature (PubMed).

Results

Male patient, 43 years old, single, elementary school graduate, living with his mother. First hospitalization.

Clinical features

Persecutory ideas and auditory hallucinations dating from 8 months: he was convinced that his neighbor wanted to harm him; for this reason he had recruited his dog. He noted that the dog was following him when he was going out in the neighborhood, and was very aggressive towards him (he“heard” the dog barking at him continuously). His fear made him stop working (scrap dealer) and he was afraid of coming out of his home. He had even thought of poisoning the animal. Laboratory as well as neuroimaging exams (EEG, brain CT) were normal. The patient was treated with haloperidol (30 mg daily) and olanzapine (15 mg daily). He was discharged after 18 days. Three months later, he spontaneously stopped medication (15 mg olanzapine daily); in three weeks time the same ideas had resurfaced and was “hearing” the neighbor's dog barking again loudly at him. Since then he takes his medication regularly without experiencing any symptoms. Only one relevant article was found in the literature (Dening, T.R., and West, A.“The Dolittle phenomenon: hallucinatory voices from animals”, Psychopathology. 1990; 23: 40–45).

Conclusions

Animals could, rarely, play a key role in the delusional ideas of patients with schizophrenia. This doesn’t make these ideas less debilitating or even potentially dangerous.
Anxiety sensitivity in patients with psychosis regarding a non-clinical sample
Authors: Pastor-Morales J. , Castillo-Gordillo E. , Fernández-Jiménez E. , Rivas-Marín F. , Sanz-Largo V.
Published: May 2011

Introduction

There is increasing empirical evidence that links the classical separated psychopathological spectrums neurosis and psychosis. In this sense, anxiety is a factor for delusional/hallucinative development and maintenance (Freeman and Garety, 2003).

Objectives

We intended to assess differences in Anxiety Sensitivity dimensions between patients with psychosis and a non-clinical sample.

Methods

Participants: 49 patients with DSM psychosis diagnosis (42 men and 7 women; mean age: 40), who attended a Mental Health Rehabilitation Service in 2008, were compared with a non-clinical sample (n = 582) from another study (Sandín, Valiente, Chorot and Santed, 2007).

Design, materials and procedure

A Cross-sectional design (one measurement) for a co-relational method of comparison between groups.

We used the Spanish validated Anxiety Sensitivity Index-3 -ASI 3- (Sandín et al., 2007), a 18-item Likert self-report that assesses fears of anxious symptoms. It presents a hierarchical structure (a general factor and three subscales -Physical, Cognitive and Social Concerns-). It's also used the first and third items (delusions and hallucinatory behaviour) of The Positive and Negative Syndrome Scale -PANSS- (Kay, Opler and Lindenmayer, 1988) to detect positive symptoms.

Results

Patients present a higher anxiety sensitivity in the General Factor (t = 2.06, p < 0.05) and Cognitive Subscale (t = 3.91, p < 0.001) than nonpatient sample.

Conclusions

Patients with psychosis show significant fears of symptoms of different anxious domains (ASI-total) regarding a non-clinical sample. Particularly, they are worried about the possibility that concentration difficulties and restlessness lead to mental incapacitation (ASI-cognitive).
Antpsychotics and CVD risk managment in rehabilitation inpatients - findings of an audit
Authors: Paul M.M. , Young M. , Wilkinson B.
Published: May 2011

Introduction

Patients with severe mental illness are at increased risk of cardiovascular disease because of lifestyle, co-morbidity and medication effects.

Aim/objectives

The aim of this audit is to ascertain the regularity of metabolic health checks, CVD risk assessment and adequate lipid modification therapy among patients on antipsychotic medication in 3 rehabilitation wards in county Durham and Darlington.

Method

According to audit standards (based on NICE guidelines-Schizophrenia, Lipid Modification, Maudsley guidelines), All patients should have Blood Pressure, Body Mass Index (BMI), CVD risk assessment using appropriate calculator, Fasting blood glucose and Fasting Lipid profile done at least once a year. Lipid modification therapy has to be offered to those with 10 year CVD risk of 20% or greater. All 31 patients in 3 rehabilitation wards were included. We searched for these readings between 1/09/2010 to 30/08/2010 in patient records.

Results

Of 31 patients, 26(84%) had blood pressure, 29(94%) had BMI and 11(35%) had either fasting blood sugar or HbA1c recorded. CVD risk assessment using calculator was not done in any patients. 19(61%) lipid profile done. Of the 19 patients 16 (84%) had abnormal lipid profile. 9 (26%) patients were on lipid modifying drugs, 6 (19%) patients were on appropriate dose of lipid modifying drugs.

Conclusion

Our audit identified a need for systemic assessment of physical health with emphasis on cardiovascular risk management (lifestyle education, lipid modification therapy) which are critical to minimising risks and preventing long term adverse health consequences.
The empirical status of CBT for psychosis: controlled efficacy, indication and therapeutic factors. A systematic review of meta-analytic findings
Authors: Pfammatter M.
Published: May 2011

A series of meta-analyses points to the benefits of cognitive behaviour therapy (CBT) in the treatment of psychosis. However, there are discrepancies in the controlled efficacy of CBT for psychosis depending on the targeted treatment goal or the control condition applied. This raises questions about its indication and therapeutic ingredients.

The findings of all existing meta-analyses were integrated. Relevant meta-analyses were identified by searching electronic data bases. In order to compare their findings the reported effect sizes were transformed into a standard effect size measure. Moderator analyses were performed regarding different treatment goals and controls. Furthermore, therapeutic components were related to outcome by calculating weighted mean correlation effect sizes in order to identify essential therapeutic factors. The statistical significance of the effect sizes was determined by computing 95% confidence intervals. Homogeneity tests were applied to examine the consistency of the effects and component-outcome relations.

The integration of meta-analytic findings demonstrates considerable differences in the controlled efficacy: CBT for psychosis has long-term effects on persisting positive and negative symptoms, but no effect on acute positive symptoms and limited benefits as an early intervention. Moreover, the advantages compared to non-specific supportive therapies are moderate. Component-outcome relations indicate that cognitive restructuring and coping skills training represent key therapeutic factors. However, component control designs also point to the importance of the therapeutic alliance and motivational processes for therapeutic change. Thus, there is a need to promote analyses of the determinants of a helpful therapeutic relationship and enhanced treatment motivation of people suffering from psychosis.
Psychosocial particularities for adherence concept at chronic schizophrenia patients
Authors: Pirlog M.C. , Marinescu D. , Marinescu I.
Published: May 2011

Background

Concept of therapeutic adherence in schizophrenia describes the level of agreement between patient's medication taking and the psychiatrist expectations. The literature data reveal the facts that therapeutic adherence is low in the case of chronic evolution of schizophrenia. The sociological concept follows the notion of adherence to treatment for the schizophrenic patient in the patient-family-psychiatrist relation.

Methods

To find the level of understanding the concept of therapeutic adherence at the level of schizophrenic patients, their families and psychiatrists, we used a scale with 5 items. This scale was applied to a lot of 30 schizophrenic patients, 30 members of family or caregivers and 30 psychiatrists. The items referred to efficacy of pharmacological therapy, adverse effects of antipsychotics, administration form of antipsychotic (daily or long action), accessibility to medication, the direct relationship between patient and therapeutically team in the moment of taking medication.

Results

For the patients: relationship between patient and psychiatrist, administration form and accessibility to medication.

For the family: accessibility to medication, adverse effects, efficacy of therapy.

For the psychiatrist: adverse effects, efficacy of therapy and accessibility to medication.

Discussion

For the patients the relation with therapeutically team is the most important element of adherence and is significant correlated with the long action antipsychotics therapy. The concept of adherence must be individualized depending to patient, family and psychiatrist. The results of this study can be a prerequisite for further research. Decrease of adherence to antipsychotics treatment suggests the switch to a long action antipsychotic.
Some aspects of quality of life among patients with chronic mental illness
Authors: Popovic I.
Published: May 2011

In this study we examined 62 patients, suffering from Schizophrenia (N-36), or Bipolar affective disorder or Major depression (N-26). They completed a Quality of life Checklist (QUOLC) on the basis of one hour semi structured interview. Satisfaction with each Sector of QUOLC was measured according to some social psychiatric characteristics of the patients, such as: age, gender, education, living place (village/town), duration of the illness, education, employment, as so as the type of the psychiatric disorder.

QUOLC include various aspects of living, such as: Housing, Knowledge& Education, Relationships, Dependency, Inner experience, Medical care, Leisure, Work and Religion. Results at the first place shows generally more satisfactory attitudes for Schizophrenia than Depression group of patients. Further, results show that schizophrenic patients significantly mark Unsatisfactory sectors: Relationships, Inner experience, Leisure and Work.

Significantly satisfactory aspects for them were: Environment, Medical care and vocational rehabilitation. For patients suffering from Bipolar disorder or Major depression significantly Unsatisfactory aspects of life were: Mental health, Inner experience, Physical health and Work, while they found Satisfactory Relationships, Knowledge, Housing and Communication. Also, better scores on the QOULC show patients with social characteristics: younger ones, living in village, shorter duration of the illness, employed.
Anxiety on heart function in psychiatric patients
Authors: Poulou K. , Damigos D. , Mavreas V. , Gouva M.
Published: May 2011

Introduction

Cardiac anxiety and its consequences is one of the issues in the research on pain. The special characteristics of people with psychiatric pathology affect the experience of this type of anxiety?

Aim

The aim of this study was to investigate the potential relationship between the cardiac anxieties with the experience of psychiatric pathology in persons hospitalized with a psychiatric problem.

Materials and methods

The study sample consisted of seventy patients hospitalized in a psychiatric clinic. The Cardiac Anxiety Questionnaire as well a demographic questionnaire was used in order to measure the necessary parameters.

Results

People coming from a small town have greater anxiety for their cardiac function in the total of the questionnaire (P = .026), as well in the subscale of the avoidance (P = .011).

The stressful event of childhood is a factor influencing the anxiety of focalization in cardiac function in adulthood (P = .013). Moreover, schizophrenic patients tend to have higher scores of cardiac anxiety, than patients with bipolar disorder (P = .040).

Conclusions

The genesis of cardiac anxiety depends on the experiences of childhood and the wider social situations. The psychiatric pathology contributes to the appearance of this type of anxiety. The establishment of educational programs for the health care staff would be useful in order to improve the diagnostic ability of the cardiac anxiety especially in the psychiatric population.
Evolution of subjective well-being in patients with schizophrenia or schizoaffective disorder. 4D study
Authors: Sanjuan J. , Prieto E. , Galan J. , Manuel B.
Published: May 2011

Introduction

The subjective well-being has been associated with dropouts of treatment and relapses.

Objectives

Determine baseline variables associated with a positive evolution in subjective well-being (increase of 20% and ≥10 points in subjective SWN-K). Assess the relationship between SWN-K and compliance of treatment.

Methods

Non-interventional, prospective (6 moths) study of a cohort of patients with schizophrenia of schizoaffective disorders who have had a clinical relapse that required a change in therapeutic strategy.

Results

305 patients were included, 288 (94.4%) was the population analyzed and 272 (89.1%) completed the follow-up. 226 (78.5%) of patients have a diagnosis of schizophrenia, the rest were diagnosed of schizoaffective disorder.

Mean total scores in SWN-K were statistically significant in every visit vs. baseline (69.5, 75.5, 77.8 and 80.0). All subscales (social, physical, emotional, mental and self-control) showed a parallel evolution. This progress was associated with compliance according to the evaluations by the psychiatrist, family and patient.

Baseline variables associated to positive response in SWN-K in logistic regression were: gender (female) and depressive symptoms (CDSS).

Conclusions

Progress in SWN-K score was related to compliance. Depressive symptoms and gender are the only variables at baseline associated with positive response in SWN-K.
Depressive symptoms in patients with schizofrenia or schizoaffective disorder, prevalence and importance in subjective evaluation. 4D study
Authors: Bousoño M. , Galan J. , Prieto E. , Sanjuan J.
Published: May 2011

Introduction

Depressive symptoms in patients with schizophrenia has been associated with overall worse outcomes.

Objective

Assess the prevalence and evolution of depressive symptoms, measured with the Calgary Depression Scale for Schizophrenia (CDSS), and its importance in subjective evaluation.

Methods

Non-interventional, prospective (6 moths of follow-up) study of a cohort of patients with schizophrenia of schizoaffective disorders who have had a clinical relapse that required a change in the therapeutic strategy.

Results

305 patients were included, 288 (94.4%) was the population analyzed and 272 (89.1%) completed the follow-up. 226 (78.5%) of patients have a diagnosis of schizophrenia, the rest were diagnosed of schizoaffective disorder.

CDSS (unlike SWN-K, PANSS, DAI-10, ICG-G nor PSP) at baseline was correlated (r = −0.18497, p = 0.0016) with Patient Global Impression (PGI) in month_6.

Depressive symptoms were the only ones at baseline with statistically significant association to positive response in SWN-K and PGI in the multivariate analysis.

Conclusions

Over 50% of patients had depression in relapse time, with a good progress of those symptoms in the follow-up period.

Depressive symptoms were the unique at baseline associated with a good subjective evaluation from the patient.
A B-Learning course to reduced self-stigma in schizophrenia: preparing individuals to active life
Authors: Queiros C. , Sousa S. , Marques A.J.
Published: May 2011

Introduction

Psychosocial Education is defined as give to the patient structured, systematic and didactic information about mental illness and his treatment. Actually is one the most frequent rehabilitation approaches, being used in several mental health departments. The good results obtained by this approach are congruent with the principles and guidelines defined for best practices in rehabilitation process (Rummel-Kluge et al, 2006).

Aims

Describe a psycho educative b-learning program develop to reduce self-stigma in schizophrenic individuals.

Methods

A psycho educative B-Learning program was developed using the results of other studies. This program was after applied during 4 months with 21 schizophrenic individuals followed in a psychiatric department, evaluated in a pre and pos-test model.

Results

The program includes 10 sessions intentionally prepared for those individuals, given information to reduced self-stigma using topics such us myths, stereotypes, self-esteem, self-confidence, relapse prevention, social interaction, feel include in the community, being able to ask for help and to recover. All those topics where discuss using Moodle platform from Porto University within a group in the presence of the therapist and individually at home. A sociodrama group was also developed.

Conclusions

This approach seems to empower the individuals, allowing them to achieve the program by their own rhythm and to participate within a group but also to be in contact using the Moodle platform, decreasing feeling of loneliness. Primary results seem to be good, with low relapse, low absenteeism in class and some success in finding a job.
Reduced risk of hospitalisation with risperidone long-acting injectable. Results of the french cohort for the general study of schizophrenia (CGS)
Authors: Grimaldi-Bensouda L. , Rouillon F. , Astruc B. , Rossignol M. , Benichou J. , Falissard B. , Thibaut F. , Limosin F. , Beaufils B. , Vaiva G. , Verdoux H. , Moride Y. , Abenhaim L. , Rasul F.
Published: May 2011

Introduction

Medication non-adherence is a significant risk factor for rehospitalisation in schizophrenia patients. Delayed release formulations like R-LAI may reduce rehospitalisation.

Objectives

To examine the association between R-LAI use and hospitalisation in schizophrenia patients.

Aims

To assess the effect of R-LAI, compared to non-use and use of other antipsychotic drugs, on the risk of hospitalization in real-life settings.

Method

The CGS study recruited schizophrenia patients from 177 public and private wards of psychiatric hospitals across France. Inclusion criteria were schizophrenia (DSM-IV), age 15–65 years, ambulatory/hospitalised for < 93 days at entry. Patients were followed up to 12 months for antipsychotic use and hospitalisation. The recruitment was stratified for long-acting second generation antipsychotic use. Multivariate Poisson regression adjusted for confounding with propensity scores and allowing for autocorrelation was used to estimate relative rates of hospitalisation.

Results

Of 2092 eligible patients, 1859 were included. Their mean age was 38.1 ± 11.1 years, 68.6% were male and 37.8% were hospitalised for < 93 days at entry. A total of 1659 patients (89.2%) were followed up for 12 months, accumulating 933 hospital stays (53.0 per 100 person-years). Compared to other schizophrenia patients, patients on R-LAI were younger, had more often a history of previous hospitalisation for equivalent severity, living conditions and other characteristics. The adjusted relative rate of hospitalisation for R-LAI use against non-use was 0.66 [95% CI 0.46–0.96], and 0.53 [95% CI 0.32–0.88] against long-acting first generation antipsychotics.

Conclusions

Use of R-LAI was associated with lower rates of hospitalization compared to non-use of R-LAI.
Protein-c-reactive as a marker of inflammation and cardiovascular disease in patients with schizophrenia: a cross-sectional analysis of a healthcare provider administrative claim database
Authors: Sicras-Mainar A. , Rejas J. , Navarro-Artieda R. , Blanca-Tamayo M.
Published: May 2011

Purpose

The goal of this research was to explore the use of PCR as a marker of inflammation and CVD in patients with Schizophrenia.

Methods

A cross-sectional analysis of the BSA administrative claim database was conducted including all men and women, >18 years, with a schizophrenia spectrum disorders (by DSM-IV criteria) diagnosis. PCR measurement together with socio-demographics, evolution, medical history, 10-years CVD risk (Framingham equation) and biochemistry data was extracted for analysis.

Results

705 patients [53.0% men, 48.2 ± 15.8 years (mean ± SD), 5.9 ± 3.2 years of evolution, 79.7% on atypical drugs] met criteria for analysis. Mean 10-year CVD risk was high; 11.9% ± 5.7% and mean PCR levels were 2.6 + 2.5 mg/L with 30.4% showing values above normal's (≥ 3 mg/L). Unadjusted PCR slightly correlated with CVD risk; r = 0.171, p < 0.001. After adjusting by age, sex, evolution, smoking and anti-inflammatory drugs treatment, PCR was linearly associated with 10-year CVD risk stratified by its level of risk (low, moderate, high/very high); respectively, 2.3 (95% CI: 2.1–2.5), 3.1 (2.6–3.5) and 3.7 (3.2–4.1) mg/L; F = 13.5, p < 0.001. Patients with known CVD showed also higher PCR levels; 3.7 (2.9–4.5) vs. 2.5 (2.4–2.7) mg/L, p = 0.008, and higher probability of values above normal's; Odds Ratio = 4.71 (2.01–11.04), p < 0.001.

Conclusions

High PCR levels (above normals) were associated with both known CVD and high/very high 10-year risk of CVD event in patients with schizophrenia. Then, PCR might be a marker of inflammation and CVD in this psychiatric disorder.
Dominant social frustrating factors and mechanisms of psychological adaptation among women with prolonged paranoid schizophrenia
Authors: Bomov P. , Reyblat S.
Published: May 2011

Given the dominance now in medical science biopsychosocial paradigm of mental disorder becomes relevant to study the social and frustrating factors and psychological defense mechanisms in patients with schizophrenia, particularly in patients with a prolonged course of disease. To study this question have been examined 11 patients with paranoid schizophrenia, a female, being hospitalized, aged 33–59 years with disease duration more than 5 years. Used clinical-psychopathological method objectification of clinical self-report scale (SCL - 90 - R), experimental psychology (questionnaireindex of life style). According to the questionnaire SCL - 90 - R obtained rather higher values on the scales: somatization (2.16), obsessive-compulsive (3.70), interpersonal anxiety (2.41), phobias (4,0), psychotism (2.3), which indicates a bright psychopathology in the current status. In these patients revealed the following psychological defense mechanisms: regression, denial, repression, displacement, which largely prevented adequate social and occupational adaptation of patients. The obtained results reflect the syndromic profile of the examined patients, as well as leading mechanisms of their psychological adaptation, which subsequently will provide an opportunity to more adequately use the methods of pharmacotherapy and psihorehabilitation activities in both inpatient and outpatient in this group of patients.