bluuebunny/crossref_metadata_2025 huggingface dataset:
Variables Associated with Attitude Towards Medication and Compliance of Treatment in Outpatients with Stable Schizophrenia
Authors: Valmisa E. , Galan J.
Published: May 2011

Introduction

Attitude towards medication has been associated with compliance, but different variables have been associated with them.

Purpose

Assess relationship between attitude towards medication and compliance, and to evaluate variables related to treatment associated with them.

Methods

Non-interventional, multicentre, cross-sectional study. Outpatients with stable schizophrenia (according to clinical criteria) who had the last acute episode at least 2 months before were included.

Results

941 patients recruited were included in the study, 931 patients were included in the statistical analysis.

Mean score on DAI was 4.2 and in its subscales: 1.6 on general attitude 2.8 on subjective effect 2.8. Mean score on compliance (a component of David's scale of insight), with range from 0 to 4, was: 3.0.

There were statistically significant (p < 0.0001) correlations between this subscale of David's insight scale and total DAI score (r = 0.495), with general attitude (r = 0.480) and with subjective effect (r = 0.419).

Variables related to medication with association statistically (p < 0.005) with DAI (total score and both subscales) were: length of treatment with current antipsychotic, number of total adverse events (AEs), moderate AEs, severe AEs, and total severity of adverse events (sum of severity of each one). All of them, except number of severe AEs, had statistically significant relationship (p < 0.05) with compliance.

Conclusion

Variables related to attitude towards medication (DAI total and both subscale) were very similar to those related to compliance (construct of David's insight scale). Adverse events and length of antipsychotic treatment had a clear clinical relevance. Study sponsored by AstraZeneca Spain, S.A.
The Role of Threat Appraisals and Safety-Seeking Behaviours in Determining Need for Care in Psychosis
Authors: Gaynor K. , Ward T. , Garety P. , Peters E.
Published: May 2011

Introduction

Van Os et al. (2009) have proposed a Proneness-Persistence-lmpairment model to explain the psychosis continuum, and cognitive models of psychosis have suggested that appraisals of anomalous experiences may be key in determining ‘need for care’.

Objectives

The present study investigated the interaction between appraisals and safety behaviours in the maintenance of impairing psychotic symptoms.

Aims

It was predicted that individuals with psychotic symptoms without a need for care would display fewer threat appraisals and safety behaviours than their clinical counterparts, and that these variables would predict distress.

Methods

The study recruited people with persistent psychotic experiences but who had no-need-for-care (Persistence group; n = 39) and individuals diagnosed with a psychotic disorder who were receiving current treatment (Impairment group; n = 28). The participants were assessed on semi-structured interviews of appraisals and safety behaviours in relation to their psychotic experiences and on anxiety and depression questionnaires.

Results

Both groups had similar levels of psychotic symptoms in the last month, including first rank symptoms. However there was a large significant difference between Impairment and Persistence groups in threat appraisals and safety behaviours, with the Persistence group reporting higher levels of both. A mediation analysis found that threat appraisals mediated the relationship between safety behaviours and anomaly-related distress, suggesting that threat appraisals may maintain anomaly-related distress, a defining feature of Impairment status.

Conclusions

These data provide support for the cognitive model of psychosis, with threat appraisals potentially playing a major role in the transition from non-clinical anomalous experiences to clinical psychotic status.
Improving insight in patients diagnosed with schizophrenia and understanding insight from a patient perspective - a mixed methods study
Authors: Joergensen R. , Hansson L. , Zoffmann V. , Munk-Joergensen P.
Published: May 2011

The method Guided Self-Determination (GSD), originally developed and proven effective in difficult diabetes care, has been adjusted to patients with schizophrenia. Currently a randomised controlled study investigates if the method GSD has effect on the outcomes insight, self-esteem, recovery, psychopathology and social functioning when applied in psychiatric care in 3 Assertive Outreach Teams and 3 Psychosis Teams.

As an extension from the RCT we just started a qualitative study using Classic Grounded Theory. The overall approach is a Mixed Methods Approach with a Sequential Explanatory Strategy.

The RCT hypothesize that the method GSD improves both clinical and cognitive insight in patients, measured by Birchwood Insight Scale and Beck Cognitive Insight Scale that both are self-rating scales. Lack of insight into illness is often associated with patients diagnosed with schizophrenia. Also poorer treatment compliance, clinical outcome, social functioning and response to vocational rehabilitation are linked to lack of insight.

In the literature lack of insight is a complex and multi dimensional phenomenon with disagreement on etiology but always described and investigated from health professionals’ perspective. Both insight self-rating scales are also developed by and represent health professionals’ perspective on insight. Apparently it appears that the patients’ perspective and understanding of insight is missing in the literature.

The qualitative study will both aim on identifying patients’ perspective on insight, emerging in a grounded theory and the grounded theory elaborating on the results on clinical and cognitive insight from the RCT.

The poster will illustrate the two designs in a Mixed Methods Approach.
Use of sarcosine to augment treatment of schizophrenia- review of evidence
Authors: Latif Z. , Nerval D.
Published: May 2011

Introduction

A growing number‘of patients with schizophrenia are using complementary and alternative medicine (CAM) interventions. In this paper, we review the published scientific evidence on the benefits and risks of a natural supplement Sarcosine in patients with schizophrenia. Sarcosine, also known as N-methylglycine, is thought to modulate N-methyl-D-aspartate (NMDA) function through the glycine modulator. It has been investigated as a putative adjunct therapy for a wide variety of disorders ranging from schizophrenia to prostate cancer.

Methods and Materials

We performed a comprehensive review of schizophrenia literature, focusing on complementary and alternative approached for augmentation treatment. We identified studies published from 01/1985 through 12/ 2010, by searching the PsycINFO, MEDLINE and CURRENT CONTENTS using the medical subject headings sarcosine, schizophrenia, complementary and alternative therapies and N-methylglycine. We found 6 randomized trials for use NMDA-glycine site agonists or glycine transporter-1 inhibitors. Inclusion criteria included randomized assignment, comparison with placebo and use of standardized outcome measures (PANS). The results are summarized in Table 1.

Conclusions

Overall the limited current evidence suggests that intake of 2 g/day sarcosine as adjunctive therapy to certain antipsychotic medication in schizophrenia may have additional benefits on both positive and negative symptoms of schizophrenia. Sarcosine had been tolerated well with no notable side effects in excess of the placebo therapy.

Unfortunately most of these studies are small and the routine use of Sarcosine in schizophrenia cannot be recommended without further evidence. In the meantime, patients need to be informed about the possible risks associated with the use of these interventions.
Developing a methodology for measuring readiness in mental illness recovery
Authors: Marques A.J. , Nogueira T. , Queiros C.
Published: May 2011

Introduction

Psychosocial Rehabilitation is actually understood as essential to promote the effective improvement of quality of life of mental ill people. Recovery is view as a process where individual plays an active role, choosing their own way. In this process, readiness is the interest, desire and motivation of the individual in his rehabilitation, being ready to change.

Aims

Develop a methodology to assess readiness of people with mental illness, and known the opinion of health professionals about this methodology.

Methods

Using the results of different studies, a methodology to assess readiness was developed and described. This description was after submitted to a focus group with six professionals and to a Delphi panel of 25 professionals, all evaluating the methodology to be used with people with schizophrenia.

Results

The methodology developed includes several steps to apply with mentally ill people. The focus group discusses the methodology and the results agree with the conclusions of other studies and with theoretical constructs about this topic. The Delphi panel yields an agreement rate exceeding 90% and suggests the application of the methodology to people with schizophrenia.

Conclusions

The methodology developed to assess readiness of mentally ill people to change and define their own recovery process seems to be useful and provide a more deep understanding of individual differences linked to the process of recovery. Also seems to provide a translation into quantitative indicators and to identify the overall level of readiness, being a practical tool to support the definition of rehabilitation projects.
The information viruses model in genesis of schizophrenia
Authors: Mykhaylov B.
Published: May 2011

Based analysis the theoretical revive and clinical observation the new conceptual ethiopathogenic model of schizophrenia was developed. The analysis more then 1000 references on a schizophrenia problem was conducted. Also 350 schizophrenic patients and 250 patients with a psychoorganic pathology stipulated diffuse and local cerebral defeats are subjected complex clinico-pathological, instrumental and biochemical investigation. The analysis of literary dates has shown, that the intrinsic performance pathological signs for want of schizophrenia consists in pathological violations of a mental orb. For want of it without dependence from theoretical premises and methodological base all contributors unequivocally describe a pathology of a mental orb in frameworks of enough specific violation of thinking, orbs of perceptions and is emotional - affective orbs. Actually violation of processes of an information inside an information system, which is represented by a mental orb of each person and interaction mechanisms with visible information space. In a structure of the psychopathological signs connection with structurally functional cerebral defeats, as system, and also levels is traced. In a structure schizophrenia signs such connection is not present, and attempt to find it have a frankly speculative character. The structural analysis signs of schizophrenia and its changes testifies to progressing structural - dynamic violation of process of information processing. It has enabled to justify the concept ethiopathogenic of schizophrenia owing to existence of information viruses (in difference with biological viruses). In this occasion new psychotherapeutic psychological, psychopharmacological correctional complex were established.
Clinical indices of institutional stress in relocating to a new hospital
Authors: Nurenberg J.R. , Schleifer S.
Published: May 2011

Relocating an entire state hospital population to a new facility poses stress for patients and staff. Preparation for 414 patients (57% hospitalized >2 years) proceeded over 18 months. Several scales for each patient: BPRS, a 4-point transition scale (“none” to “a lot”), and the 5-point Greystone Intrusiveness Measure (GIM) completed. Data are available for 195 patients both before and after the move. Total BPRS decreased from 41.4 + 13.0 < mean+/−sd> to 34.7 + 14.6 (paired t = 6.5, df 194, p < 0.001), and mean GIM from 2.13 + 1.28 to 1.78 + 1.12 (t = 3.8, df 193, p < 0.001). GIM pre-move correlated with concurrent (r = 0.43, p < 0.001) and post-move (r = .24, p < 0.001) BPRS. Anticipated difficulty (35% some/11% a lot) was associated with pre-move BPRS (r = .33;p < 0.001) and GIM (r = .28, p < 0.001), but to only a lesser degree with post-move BPRS (r = .18;p < 0.02) and GIM (r = .16;p < 0.03). Reported post-move difficulties (23% some/6% a lot) were less than expected (t = 3.3, df 194, p < 0.001) and not associated with anticipated difficulties (r = 0.06, p ns). Only 37% of those predicted were reported to have post-move difficulty. Post-move difficulty was associated with pre-move BPRS (r = 0.21, p < 0.01) and GIM (r = 0.17, p < 0.02), more so with the concurrent post-move BPRS (r = 0.46, p < 0.001) and GIM (r = 0.58, p < 0.001). Hospital-wide antipsychotic polypharmacy spiked preceding the move, returning toward baseline in the post-move months. The findings suggest that anticipation of the event was associated with greater clinical stress than the move. The extensive hospital planning may account for both high anticipatory stress and reduced adverse consequences post-move. Clinicians have only a modest ability to predict who will have difficulty with clinical transitions.
Improvement in patient symptoms and functioning during long-term treatment with olanzapine long-acting injection (OLAI)
Authors: Peuskens J. , Porsdal V. , Pecenak J. , Handest P. , D’yachkova Y. , Brousil R. , Casillas M. , Deberdt W.
Published: May 2011

Introduction, objectives and aims

To evaluate the outcome of patients with schizophrenia during maintenance treatment with OLAI.

Methods

Data from three studies with OLAI were pooled and patients classified according to a cluster analysis [Lipkovich, Psychiatry Res, 2009] into five categories according severity of psychiatric symptoms (sx) and functional impairment (imp):

A

(minimal sx/mild imp),

B

(minimal sx/moderate imp),

C

(moderate sx/mild to moderate imp),

D

(moderate sx/severe imp),

E

(moderate to severe sx/severe imp).

Improvement was defined as a change from B or C to A, or from D or E to A, B or C. Changes between the categories in the 6 months were analyzed. Stepwise logistic regression modeling was done to determine factors associated with improvement.

Results

1182 patients were classified. Patients who remained in the studies at 6 months had lower baseline CGI-S (3.04 vs 3.28, p < 0.001), lower PANSS (61.38 vs 64.05, p = 0.012) and higher QLS (1.76 vs 1.39, p = 0.001). (Table 1) As patients in category A couldn’t improve and in category D&E couldn’t worsen, 261(39%) patients from categories B, C, D and E improved and only 55(10%) from categories A, B and C got worse during 6 months. Baseline factors associated with improvement were: baseline category (p < 0.001), CGI-S score (p = 0.022), and PANSS positive (p = 0.003)

Conclusions

Majority of patients with schizophrenia who stay on 6 months treatment with OLAI improve or maintain their symptoms and functioning level. The strongest factor associated with a higher chance of improvement was poor baseline category.
Quality: A non-interventional study evaluating quality of life in schizophrenic patients treated with atypical antipsychotics in the ambulatory setting
Authors: Peuskens J. , Fontaine E. , Vanlerberghe T.
Published: May 2011

Objectives

The QUALITY study evaluated Quality-of-Life in schizophrenic patients treated with atypical antipsychotics (AAPs) in the ambulatory setting.

Methods

This study was a 9-month, observational, multicentre prospective study. Patients (18–65 years-old) diagnosed with schizophrenia and treatment started with one AAP before visit-1 (minimum: 4-weeks, maximum: 8-weeks) were enrolled into this Belgian study. At visit-1 patients’ demographics and medical history were recorded with follow-up visits after 3-, 6- and 9-months. At each visit, patients completed the Subjective Well-being under Neuroleptic treatment short form (SWN-K), while investigators assessed the Positive and Negative Symptom Scale (PANSS-8) and Global Assessment of Functioning.

Results

121 patients were enrolled: 91 male, mean age 36.7 ± 10.8years. The main AAPs were risperidone (38/121), apripirazole (28/121) and quetiapine (25/121). On average, most mean changes from baseline in SWN-K-subscale scores were positive (between −0.5 and +0.5, range −1.8–1.6) suggesting patients felt better, although there were no treatment-group differences. The associations between baseline SWN-K-subscales and age were small (RC [regression co-efficient] range: −0.03–0.01). PANSS-8-score changes were slightly negative (means between −0.77 and −0.43) suggesting decreased symptom severity. Patients with more severe negative symptoms considered their mental- and physical-functioning to be better throughout the study, indicated by significant correlations between these SWN-K-subscale scores and negative PANSS-scores (RC = 0.19, p = 0.0282; RC = 0.15, p = 0.0258). The associations between SWN-K-scores and positive PANSS-scores were small (RC: 0.01–0.14). The number of hospitalizations decreased during the study (9.6% between visit-1 and 2 vs. 7.5% visit-3 and −4).

Conclusions

Quality-of-life for all patients seemed to improve slightly, without any differences between treatment-groups.
Social skills vs. Neurocognitive training in psychotic patients
Authors: Piegari G. , Galderisi S. , Bucci P. , Mucci A. , De Riso F. , Campana T. , Maj M.
Published: May 2011

Introduction

It has been hypothesized that cognitive remediation with adjunctive psychiatric rehabilitation would be associated with greater improvements in functional outcome than standalone treatment approaches (1).

Moving from these observations our group designed an individualized rehabilitation program including a computerized cognitive training (CCT) and social skills training (SST), which showed promising results (2).

A critical evaluation of recent studies examining standalone and combined treatment approaches included the understanding of the differential impact of the two approaches among crucial areas for future research (3).

Objectives

The present study compared the effects of CCT and SST on several indices of outcome in psychotic patients. Fifty-eight patients with schizophrenia or schizoaffective disorder were randomly assigned to one of two treatment groups: CCT or SST. Changes in cognitive, psychopathological and psychosocial indices after 6 and 12 months were compared between the two groups.

Results

After both 6 and 12 months, an improvement of psychosocial indices was observed in both groups, while cognitive functions improved only after CCT; the improvement of psychopathological indices, observed in both groups, was greater in the CCT group.

Conclusions

Our findings suggest that CCT is associated with a greater impact than SST on different indices of outcome in psychotic patients. Future research should focus on possible synergistic effects of cognitive remediation and social skills training on functional outcome.
Decision-making strategies are inconsistent in schizophrenia: Results from the Ultimatum game
Authors: Polgár P. , Csukly G. , Tombor L. , Réthelyi J. , Kéri S.
Published: May 2011

Introduction

Impaired social cognition is a characteristic feature of schizophrenia, which is associated with the level of community functioning. Socioeconomic games are well-established in behavioral economy and widely used to examine decision-making strategies. They can also provide a useful method in the investigation of social decision-making in psychiatric diseases such as schizophrenia. The strength of these games compared to classic paradigms is that they allow observing subjects directly engaged in interpersonal situations, thus real-time interactions with implicit processes become available to investigation.

Aims

Investigating decision-making strategies in schizophrenia patients and healthy controls.

Methods

29 healthy controls and 58 patients with schizophrenia were compared by a series of Ultimatum Game interactions in a computerized setting. In this game two players have to split a sum of money. The proposer offers a portion to the responder, who decides to either accept or reject the offer. Rejection results in no income to either of the parties. Cognitive testing included emotion recognition, memory and executive function. Symptoms were assessed by MINI 5.0 and Positive and Negative Symptom Scale.

Results

Association between offer and probability of acceptance was different in schizophrenia patients and controls (Chi2 = 18.8, n = 87, df = 4, p = 0.0009): schizophrenia was associated with an increased likelihood of acceptance at lower offers and a decreased likelihood of acceptance at higher offers. Ratio of inconsistent decisions was significantly higher in the schizophrenia group (Chi2 = 4.7, df = 1, p = 0.03).

Conclusion

Our results suggest that schizophrenia patients are impaired in socioeconomic interactions requiring decision-making, which may result in unstable behavioral strategies.
Perceptions about mental illness in a sample of portuguese polytechnic students
Authors: Queiros C. , Faria S. , Marques A.J.
Published: May 2011

Introduction

People with mental illness are frequently perceived as dangerous, suffering social stigma and exclusion. Deinstitutionalization movement implies a closer contact between citizen and individuals with mental illness. However, social perceptions can be a barrier to social inclusion, provoking unfavorable attitudes. Some studies found that social rejection is different according the pathology. Vogel and Boysen (2008) found that different mental illnesses provoke different attitudes of social distance. Norman and colleagues (2008) found that social distance was associated with the diagnosis, provoking schizophrenia greater social distance than depression.

Aims

Compare the perceptions about mental illness (in general), depression, bipolar disorder and schizophrenia.

Methods

Data were collected using a translation of Mental Illness Stigma Scale (Day, 2007), fulfill on-line and in an anonym way by 315 Portuguese polytechnic students, studying in brief technological courses. The sample was composed by 69% male and 31% female; mean age 26.5 years.

Results

Students have little contact with people with mental illness (mean = 1.5 in a Likert scale 1–5 points) but they fell comfortable when they contact a friend or a neighbor with mental illness (respectively, mean = 3.2 and mean = 2.7). They present some anxiety when they interact with people with mental illness and they avoid this contact, revealing attitudes of social exclusion. Schizophrenia and bipolar disorder was perceived more negatively than depression.

Conclusions

Deinstitutionalization movement provokes more contact between citizens and individuals with mental illness, but social stigma still exist. Students can learn how to interact with those persons without anxiety and help to do better social inclusion.
Effect of selegiline augmentation with antipsychotic drugs on treatment of the negative symptoms in patients with schizophrenic disorder
Authors: Ranjbar F. , Sabagh Razavi M. , Ghorayshizadeh M.A. , Shokri J. , Asadlo M.
Published: May 2011

Introduction

Considering the shortcomings of antipsychotics in treatment of negative symptoms of schizophrenic patients, the use of augmentation treatment for decreasing the negative symptoms is highly important.

Aims

The aim of this research was to study the effect of selegiline augmentation with antipsychotic drugs in decreasing the negative symptoms of schizophrenic patients.

Methods

In this double blind randomized control trial study 70 schizophrenic in- patients who were under treatment with antipsychotics were randomly divided into two intervention and control groups. The patients of both groups were given placebo for two weeks along with antipsychotics. For 12 weeks the intervention group was given selegiline 10 mg/day and control group was given placebo. The patients were evaluated with PANSS scale and Hamilton depression test at the end of first and second weeks and then at the end of every other week for twelve weeks. Then the results were analyzed statistically.

Results

There was no significant difference between intervention and control groups considering PANSS score on first and second weeks, but the difference on 4-14 weeks was statistically significant. There was also no statistically significant difference in Hamilton depression Test between the two groups in first to 10 Th weeks. But the difference was statistically significant in 12–14 weeks.

Conclusions

Augmentation treatment with selegiline can improve the negative symptoms of schizophrenic patients.
Profile of psychotic patients with social isolation
Authors: Rodriguez M. , Castillo S. , Malagon A. , Corcoles D. , Martin L.M. , Bulbena A.
Published: May 2011

Introduction

Social isolation is a factor associated to mortality and morbidity in general population.

This symptom has been considered as prodrome in ‘high-risk mental states’ for a possible development of psychosis. Social isolation is a frequent problem in psychotic patients visited by mobile crisis unit (EMSE).

Objective

To describe the differences between psychotic patients with social isolation with patients without it.

Methods

A descriptive observational and cross-linked study in patients with diagnostic of psychotic disorder visited by EMSE from 2004 to 2010. The sample was divided in two groups; present and absence of social isolation as the main problem. We evaluated demographic and clinical variables including the aggressive behaviour and violence scale (AVAT) and positive and negative syndrome scale (PANSS).

Results

N: 662 subjects (61.3% men; mean age 44+-16 years) with psychotic disorder. 15.1% present social isolation like the main problem against 84.9% who present others main problems: delusion/hallucination (44.7%), behaviour disturbance (18.1%) and agitation/aggressivity (14%).

Patients with social isolation are mostly men (72%, p < 0.05), live with family (79.4%, p < 0.05), are less aggressive (AVAT 2.77 p < 0.05) than psychotic patients that are not isolated. The punctuation in subscale negative syndrome of PANSS is higher (26.19 versus 20.25, p0.001).

Conclusions

This study concludes that patients with psychotic disorder and social isolation are mainly men and they have less aggressivity and predominantly negative syndrome. These results are important to improve the multidisciplinary therapeutic approach.
Tolerability and treatment response in patients with recently diagnosed vs. chronic schizophrenia treated with paliperidone ER
Authors: Schreiner A. , Hoeben D. , Tessier C. , Lahaye M. , Turczynski J. , Vauth R. , Millet B. , Franco M. , Sacchetti E.
Published: May 2011

Objective

To explore tolerability and treatment response in adult patients with recently diagnosed (<5 years) and chronic (>5 years) schizophrenia treated with flexible doses of paliperidone ER.

Methods

International prospective open-label 6-month study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), patient functioning and treatment-emergent adverse events (TEAEs).

Results

Of 713 recently diagnosed patients, most were male (60.9%), mean age was 33.6 ± 11.2 years and mean time since diagnosis was 2.3 ± 1.7 years. Chronic patients (n = 1003) were predominantly male (59.2%) with a mean age of 43.8 ± 11.4 and mean time since diagnosis of 15.6 ± 9.2 years. 70.4% and 71.7% of patients completed the study, respectively. Mean mode doses of paliperidone ER were similar between recently diagnosed and chronic patients (7.0 ± 2.9 mg/day and 7.2 ± 2.9 mg/day). 63.1% of recently diagnosed and 60.8% of chronic patients switching due to lack of efficacy with their previous antipsychotic had a >20% improvement in PANSS total score at endpoint, and improvement with other switching reasons was consistently numerically higher in recently diagnosed patients. The rate of patients with mild or no functional impairment increased from 17.7% to 39.8% in recently diagnosed and from 14.4% to 32.9% in chronic patients. TEAEs reported in >5% were insomnia (10.7% and 8.1%), anxiety (8.6% and 6.0%) and somnolence (5.8% and 3.4%), respectively.

Conclusion

These data suggest that both recently diagnosed and chronic patients previously unsuccessfully treated with other oral antipsychotics may benefit from paliperidone ER, with a tendency for recently diagnosed patients showing some higher treatment response in psychotic symptoms and patient functioning.
Validation of a liability syndrome for schizophrenia (‘schizotaxia’) and effects of low dose risperidone on neurocognitive, clinical and social functioning: results from the Changsha study
Authors: Stone W.S. , Hsi X. , Giuliano A.J. , Seidman L.J. , Tsuang M.T.
Published: May 2011

Introduction

The Changsha study identifies adult, non-psychotic relatives of patients with schizophrenia who show deficits in neurocognitive, social, clinical and other dimensions, and who meet proposed diagnostic criteria for a liability syndrome for schizophrenia (’schizotaxia’).

Objectives

To define and validate schizotaxia.

Aims

To develop and validate diagnostic criteria for schizoaxia, and to reduce its symptoms using risperidone.

Methods

We investigated whether a low dose (2.0 mg) of risperidone, a second generation antipsychotic medication, could attenuate negative symptoms, neurocognitive deficits, and other measures of clinical and social function in subjects who met our research criteria for schizotaxia. One hundred eighty nine relatives were assessed at the Mental Health Institute, Second Xiangya Hospital, in Changsha, China. Eighty six of these individuals met criteria for schizotaxia, and 36 agreed to enter a 6-week, double-blind, placebo-controlled protocol.

Results

ANCOVAs using age and gender as covariates showed significant improvement in the risperidone group (n = 20) on neurocognitive function (Wisconsin Card Sorting Test Total Errors and Perseverative Errors) and on a self-report measure of social function (Social Adjustment Scale), compared to the placebo-control group (n = 16). Effect sizes were small to medium. Notably, risperidone effect sizes were larger (medium to large) in a subset of subjects (risperidone = 15; placebo = 10) whose membership in the schizotaxic group was confirmed by cluster analysis.

Conclusions

The results are generally consistent with previous open-label investigations of risperidone administration in subjects with schizotaxia, and provide evidence that significant neurocognitive and clinical problems are amenable to remediation in non-psychotic relatives of people with schizophrenia.
Meta-analysis of the efficacy of asenapine for acute schizophrenia: comparisons with placebo and other atypical antipsychotics
Authors: Szegedi A. , Verweij P. , van Duijnhoven W. , Mackle M. , Cazorla P. , Karson C. , Fennema H.
Published: May 2011

Introduction

Asenapine is an FDA-approved atypical antipsychotic (AAP) indicated in adults for treatment of schizophrenia.

Objective

Present meta-analyses of asenapine vs placebo and other antipsychotics in acute schizophrenia.

Aim

Further demonstrate the efficacy of asenapine in acute schizophrenia.

Methods

PANSS total score changes from baseline to week 6 were assessed using last observation carried forward (LOCF) and mixed model for repeated measures (MMRM). Comparisons of asenapine and antipsychotics vs placebo were obtained from 4 placebo-controlled asenapine studies. Head-to-head comparisons among AAPs assessed in the same trials (including those for which no direct comparisons are available) were conducted with network meta-analyses using a published database (Leucht et al, Am J Psychiatry 2009;166:152–166) of 74 studies updated with data from 5 AAP-controlled asenapine trials.

Results

PANSS change from baseline with asenapine exceeded that of placebo (LOCF: 3.7 [95% CI, 1.5–5.9], P = 0.001; MMRM: 4.1 [95% CI, 1.6–6.5], P = 0.001), a treatment effect comparable to other antipsychotics (LOCF: 4.1 [95% CI, 1.7–6.5], P = 0.001; MMRM: 4.6 [95% CI, 1.9–7.3], P = 0.001). Head-to-head network meta-analysis reported comparable efficacy with asenapine and other AAPs; PANSS differences ranged from 3.9 points better than ziprasidone (95% CI, 0.3–7.4) to 2.9 points worse than olanzapine (95% CI, -5.-0.1).

Discussion

These meta-analyses demonstrate superiority of asenapine over placebo in acute schizophrenia, with treatment effects of asenapine at least comparable to antipsychotics used in the same studies. Further, the network meta-analysis suggests the efficacy of asenapine for acute schizophrenia is comparable to that of established AAPs.
Internal encoding style and schizotypy in a sub-clinical sample
Authors: Valérie R.V. , Belayachi S. , Van der Linden M.
Published: May 2011

Introduction

This study examined the relation between schizotypy and the encoding style in a sub-clinical sample. We evaluated, first, the level of schizotypy with the Schizotypal Personality Questionnaire (SPQB) (Raine and al, 1995). Three factors are evaluated

a)

cognitive-perceptual factor,

b)

b) interpersonal factor and disorganisation.

For the encoding style, we use the Encoding Style Questionnaire (ESQ) (Lewicki, 2005). Two type of encoding process exist, the “hasty” (or internal, based on internal encoding schemata) versus conservative (or external, base on data from external stimuli) (Lewicki, 2005). Internal encoding style may contribute to the development of different psychopathological symptoms, like Paranoia, Anxiety disorders and Depression (Hill, Lewiski and Neubauer, 1991), because of the self-perpetuation of dysfunctional schemata.

Participants and procedure

A total of 184 students (113 women and 71 men) participated at this study. The mean age of the sample was 22,58 years (SD = 1,96). They were test using a French version of the ESQ, the brief SPQB, State-Trait Anxiety Inventory (STAI), The Center for Epidemiologic Studies Depression (CES-D) Scale.

Results

The results demonstrated that we have a positive correlation between internal encoding style, schizotypy, depression and anxiety. Secondly, a high level of internal encoding style means a high level of congnitivo-perceptual and for interpersonal factors with an impact of depression and anxiety.

Conclusion

An internal encoding style is link with a high score in schizotypy.
Impact of variables related to treatment on quality of life and functioning of patients with stable schizophrenia
Authors: Valmisa E. , Galan J.
Published: May 2011

Introduction

Quality of life in patients with schizophrenia has been associated with severity of psychotic symptoms, adverse events and insight.

Objectives

Determine variables related to quality of life. This communication is focused on variables directly related to pharmacological treatment.

Methods

Non-interventional, multicentre, cross-sectional study. Outpatients with stable schizophrenia (according to clinical criteria) who had the last acute episode at least 2 months before were included. EuroQol-5D was used to assess quality of life, and GAF to assess functioning.

Results

941 patients were included in the study and 931 patients were analyzed. Mean index EuroQol-5D score (range: from -0.594 to1) was 0.7 (CI95%: 0.7,0.8), on EuroQol-5D Visual Analog Scale (VAS) was 65.4 (CI95%: 64.2,66.6) and GAF mean score was 59.7 (CI95%: 58.7,60.8).

Variables with correlations statistically significant (p < 0.05) on quality of life and functioning were: no. of antipsychotics, length on antipsychotic treatment, no. of non-antipsychotic drugs, no. total of drugs, no. of adverse events (AEs), no. of moderate AEs, no. of severe AEs and severity of AEs (sum of severity of every AEs from 1 to 5).

Conclusion

In this sample a difference in quality of life and functioning in patients based on the number of treatments (antipsychotic and non-antipsychotic), length with antipsychotic treatment and adverse events (any severity) was shown. In order not to impair quality of life and functioning, the least number of drugs should be used and attitude towards medication should be worked.

Study sponsored by AstraZeneca Spain.
Activity, duration of rest, daytime sleepiness and sleep quality in schizophrenia patients treated with sertindole and olanzapine
Authors: Wichniak A. , Wierzbicka A. , Czasak K. , Musińska I. , Jakubczyk T. , Jernajczyk W. , Jarema M.
Published: May 2011

Objectives

Low activity and long rest times are frequent in patients with schizophrenia and are related to increased risk for metabolic disorder. We investigated whether patients who were switched from sedative antipsychotics to sertindole, an antipsychotic drug without sedative effect, were more active than patients with good tolerance to sedative effect of olanzapine.

Methods

18 patients with schizophrenia treated with sertindole (9 females, mean age 27.9 ± 4,1, mean dose 15.6 ± 3.0 mg/d) and 18 sex and age matched patients treated with olanzapine (mean dose 15.3 ± 6.5 mg/d) underwent actigraphy for seven days. Daytime sleepiness and sleep quality were evaluated with Epworth Sleepiness Scale (ESS), Athens insomnia scale (AIS) and sleep diaries. PANSS, UKU, BARS scales were used to rate mental state and medication side effects.

Results

At the time of the assessment PANNS score was similar in sertindole (43.6 ± 7.1) and olanzapine (42.3 ± 12.2) groups. The difference in time in bed as measured by actigraphy was not significant between patients treated with sertindole (572.7 ± 54.8 min.) and olanzapine (600.6 ± 53.6 min.). Also mean 24-h-activity was comparable in both groups (86.6 ± 29.6 and 81.6 ± 27.9 units, respectively). There were not any significant differences in AIS and ESS scales.

Conclusions

Although sertindole does not induce sedation, patients who were switched from sedative antipsychotics to sertindole were not more active than patients treated with olanzapine. Adjustment of pharmacological treatment has to be supplemented with non-pharmacological interventions to promote activity in patients with schizophrenia.
Impact of breast cancer on sexuality: what’s about the tunisian women?
Authors: Mnif L. , Masmoudi J. , Charfi N. , Baati I. , Guermazi M. , Jaoua A.
Published: May 2011

Introduction

The sexual functioning problems in women after breast cancer are common. Certain factors related to treatment and its clinical implications may contribute to these problems.

Objectives were to

- Evaluate the changes in sexual life after treatment of breast cancer relative to the general population.

- Identify the influence of demographic and clinical factors on sexuality.

Methods

We recruited 50 patients who were in remission for at least 3 months after initial treatment of breast cancer, and 50 healthy women.

Sexuality and body image was evaluated using the Arabic version of the specific scale of breast cancer QLQ-BR23, which is an additional module to the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire.

Results

Compared with control subjects, patients reported more dyspareunia (61.5% vs 38.5%) and vaginal dryness (61.3% vs 38.7%). A diminished sense of sexual attractiveness was significantly more frequent within patients (p = 0.001).

The patients had poor sexual functioning and sexual satisfaction and the mean scores were respectively 45.3% and 43.9%. Additional analyses indicated that menopausal status and sexual difficulties in the partner was significantly related to poorer sexual satisfaction (p respectively 0.018 and 0.014).

The mean score of body image was 47.7% and its alteration had no significant impact on the themes of sexuality.

Conclusion

These findings confirm and extend previous reports of impaired sexual functioning among breast cancer survivors. Results suggest that relief of sexual difficulties in partner should be an essential component of efforts to improve sexuality of patients.
Pedophilia: Etiologic models
Authors: Moutinho A. , Jorge G. , Pereira A.V.
Published: May 2011

Pedophilia is defined as a recurrent sexual attraction towards pre-pubescent children. It is a serious and ubiquitous problem with clinical, social, moral and legal implications.

The aim of this poster is to describe the factors that are most often associated with this paraphilia and to analyse some of the proposed etiological theories. In the past, etiological theories gave more importance to environmental factors, but recent studies have emphasized more and more the importance of neurobiological factors.

Even though several factors have been identified, there are very few certainties when it comes to their role in the etiology of this disease and most of the proposed theories have a speculative nature.
Sexual dysfunction among male patients on antidepressant theraphy
Authors: Sibinovic V. , Tosic-Golubovic S. , Selimovic G.
Published: May 2011

Introduction

Sexual dysfunction is common among individuals with major depressive disorder but not optimally treated often.

Objectives

The aim of this study was to determine differece in sexual dysfunction among male patients on antidepressant theraphy.

Methods

Stadu group consisted of 69 male outpatients who met DSM IV criteria for Major depressive disorder; aged 21–65 (mean 46.3 years). Studu excluded patients: with a previous history of sexual dysfunction, somatic diseases, other psychiatric co morbid condition. They did not used medication able to cause sexual dysfunction unless antidepressants or medications to improve erectile dysfunction. The ASEX and HDRS scales were applied at a single interview.

Results

The prevalence of sexual dysfunction observed was 66% patients, 57, 7% in group under 50 and 74, 3% in group being 50 years old or older.

Sexual dysfunction, revealed by a high score on the ASEX scale (mean overall score of 26.9) was in group of patient over 50 years old. (p < 0, 01). There are no statistical, significant differences in the points obtained on the HDRS scores in both groups. (p < 0.01). Sexual dysfunction were reported more frequently in patients taking TCA (p < 0.005) or SSRIs (p < 0.001) compared to patients treated with mirtazapine.

The use of TCA is associated with loss of libido and erectile dysfunction, SSRIs with delayed ejaculation as well as impairment of libido and arousal.

Conclusions

Frequency of sexual dysfunction is higher in patients over 50 years. The less impact on sexual function have mirtazapine.
“Sexsomnia” - sleep sexual behaviour
Authors: Moutinho A. , Pereira A.V. , Jorge G.
Published: May 2011

Sexsomnia is a disorder that is characterized by abnormal sexual behaviours during sleep and can vary from explicit sexual vocalizations to violent masturbation and complex sexual acts including oral, vaginal or anal penetration. This disorder has clinical, psychosocial and medico-legal consequences, both to the patient and the people that surround him. Despite the scarce literature and infrequent reports, there are some descriptions of violent behaviours, sexual assault and sexual involvement of minors. Whenever we suspect that a patient suffers from sexsomnia, we must write a rigorous and complete clinical history, make a neurologic and phychiatric evaluation and nocturnal videopolysomnography. As soon as the diagnosis is established, we must plan treatment approaches. More attention should be payed to the psychosocial and medico-legal issues, and new research is needed to provide for better understanding of etiology and to improve the clinical evaluation and management.
Quantitative electrophysiology during night- and daytime including electroencephalography and event-related potential EEG/ERP topography and tomography (LORETA) in hyperthyroidism
Authors: Rosales-Rodriguez S. , Saletu B. , Anderer P. , Ludvik B. , Saletu-Zyhlarz G.M.
Published: May 2011

Introduction

In contrast to the abundance of visual qualitative EEG reports in patho-endocrinology, there is a paucity of quantitative EEG findings.

Objectives

Electrophysiology may be utilized for differential diagnosis of hypersomnolence.

Aims

To investigate long-term daytime sleepiness in a young female neurologist with the tentative diagnosis of narcolepsy in addition to moderate depression/anxiety and congenital thyroid hypoplasia treated with thyroxin.

Methods

Three-night polysomnography, multiple sleep latency test (MSLT), visual EEG/ERP-mapping, LORETA, psychometrics and blood analyses were performed.

Results

Polysomnography revealed normal sleep efficiency and sleep architecture, but a high arousal index of up to 63/h TST. The MSLT showed a shortened mean sleep latency of 3.7 min. without REM-sleep onsets, objectifying the high Epworth Sleepiness score of 18. Visual EEG evaluation exhibited a fast alpha rhythm with intermittent theta and delta intrusions and paroxysmal activities. EEG-mapping showed an accelerated dominant frequency and ubiquitous increase in absolute (especially delta and beta) power, ERP revealed shortened N1 latency and very high amplitudes in all components (P300 > 5 SD). LORETA demonstrated significant regional increases in delta, alpha-2 and beta-1 power in the anterior cingulate, orbital, ventromedial, dorsolateral prefrontal cortex and temporal cortex, predominantly right hemispherically. Psychometry showed increased anxiety (SAS) and depression (SDS) and reduced quality of life. Finally, hormonal analysis pointed to thyrotoxicosis factitia (ICD-10 E05.4).

Conclusion

Diagnostic investigations clearly elucidated the pathogenesis of the presenting diagnosis of organic hypersomnia triggered by increased sleep-microarousals due to thyrotoxicosis factitia. Discontinuation of hormone substitution led to a normalization process that will be discussed.
Associations occupational stress with pain and musculoskeletal disorders
Authors: Bugajska J.
Published: May 2011

Introduction

Musculoskeletal pain and disorders (MSDs) belong to the main health problems for occupationally active persons. Risk factors for these disorders include many working environment factors, such as: biomechanical (body posture, repetitive movements, load handling), physical (vibration, ambient temperature), organizational (working time, work-home balance) or psychosocial (work requirements, job insecurity, scope of control, feeling of support) factors.

Aims

The study aims to determine associations between psychosocial factors in the working environment and pain and MSDs.

Methods

To assess the psychosocial aspect of work (work demands, job control and social support), the Karasek questionnaire was used. Prevalence and intensity of musculoskeletal pains was assessed using NMQ and VAS. Diagnosis of MSDs was based on physical examination schedule and criteria developed by Sluiter JK. (2001). Associations of psychosocial factors in the working environment, organizations of work and demographic data with pains and MSDs were explored by logistic regression using the SPSS program.

Results

A one-year prospective study was conducted among 725 occupationally active persons aged 20–67. Logistic analysis, taking into account interactions between demographic data (gender, age), work organization factors (daily working hours, shifts organization, type of work) and psychosocial factors (work demands, job control, social support, job insecurity) indicated that low job control, low social support and high job insecurity are the main risk factors for both pain and MSDs.

Conclusions

The results of the study show the necessity to implement activities that improve psychosocial working conditions into prevention programmes in order to reduce the prevalence of pain and MSDs.