bluuebunny/crossref_metadata_2025 huggingface dataset:
The usage of new antipsychotics in treatment of schizophrenia with obsessive-compulsive symptoms
Authors: Reznik I. , Yadin S. , Weizman A.
Published: May 2011

Background

Obsessive-compulsive (OC) symptoms have been observed in a substantial proportion of schizophrenic patients. Different etiopathological origins of OC symptoms make this type of schizophrenia to be a heterogeneous entity in phenomenological as well as in therapeutic aspects. The complex nature of the treatment response in this group of schizophrenic patients is as yet unclear.

Methods

We present a large case series study describes our experience with clozapine, risperidone, olanzapine, quetiapine, ziprazidone, amisulpiride, sertindole and paliperidone as a sole agents and in combination with serotonin reuptake inhibitors (SRIs) in patients with OCD-schizophrenia (n = 55) and schizo-obsessive disorder (n = 64).

Results

In patients with OCD-schizophrenia treatment with atypicals (other than clozapine), the better results (significant reduction of OC as well as schizophrenia symptoms) were achieved in combination with SRIs, while olanzapine showed the fastest overall improvement. In schizo-obsessive patients, treatment with atypicals (including clozapine) as monotherapy was the better therapeutic modality, and the risperidone showed the best results. Quetiapine, amisulpiride, sertindole, paliperidone and ziprazidone (as sole agents and with SRIs) were shown as approximately equal in their antipsychotic and antiobsessive activity and overall safety.

Conclusions

The effects of different atypicals (with/without SRIs) on psychotic and OC symptoms are vary, probably due to different origin of OC symptoms. We suggest that:

1) schizo-obsessive patients might be successfully treated with atypicals alone;

2) in OCD-schizophrenia atypicals monotherapy may be less efficient, and in some cases may worsen OC symptoms, so it should be treated concomitantly with SRIs. Further investigations are needed to substantiate our observations.
Impact of religion on acute schizophrenia in IRAQ
Authors: Rhemah S.J.
Published: May 2011

Background

Religion plays an important role in symptoms phenomenology, attribution and management in the Arab culture. Mentally ill patients in the Arab countries tend to pass through different health care providing filters. Traditional healers form part of the informal and sometimes unofficial health care sector.

Aims

Explore the timing of local traditions contacts in regard to diagnosis and treatment, and identify types of local traditions contacts of Iraqi schizophrenic patients.

Methods

Hundred Iraqi acute schizophrenic patients, admitted to Ibn-Rushd psychiatric teaching hospital, Baghdad, Iraq, with informative informant were examined. Information list of 3 parts was prepared: 1st part asking about the contact timing with faith healers in regard to diagnosis and treatment; 2nd asking about the types of traditional faith healer contacts; 3rd was asking about the causes of illness.

Results

22% have no any contact, 47% contact faith healer before and after, 7% before, 24% after the diagnosis and treatment. Types of traditional faith healer contacts were: Sayed 37%; visiting Emams 54%; jinn dealers 32%; Daraweesh 17%; witchcraft 3%; and reading Holly Quran 9%. Causes of illness were: life stresses 42%; patient himself 25%; poor faith and belief 14%; weak personality 11%; genetic causes 4%; witchcraft 5%; Jinn possession 11%; and wish of God 13%.

Conclusions

This study explores the importance of religious background in the course of diagnosis and treatment of acute schizophrenia. Psycho-education was needed to increase the awareness of publics about faith, beliefs, traditional healers, and mental illness.
Blood polyamine levels in drug-free schizophrenics
Authors: Riaza Bermudo-Soriano C. , Vaquero-Lorenzo C. , Dîaz-Hernândez M. , Garda Dorado M. , Sânchez-Pâez P. , Durân Cristobal I. , Manzanero Estopinân R. , Gômez-Arnau J. , Baca-Garcîa E. , Pérez Piqueras J. , Sâiz Ruiz J. , Chinchilla Moreno A.
Published: May 2011

Background

Natural polyamines (putrescine, spermidine and spermine) are low molecular weight highly protonated aliphatic molecules that physiologically modulate NMDA, AMPA/kainate glutamatergic receptors and limbic dopaminergic neurotransmission. Previous studies had demonstrated that polyamine metabolism might be disrupted in schizophrenia, what could potentially be linked to glutamatergic dysfunction. In particular, polyamine levels in blood and fibroblast cultures from patients with schizophrenia had previously been found to be higher than in healthy controls. Indeed, a significant positive correlation between blood polyamine levels and severity of illness may exist.

Methods

In order to test potential differences in blood polyamine levels between drug-free schizophrenia in-patients (n = 12), and healthy controls (n = 26, blood donors), spermidine (spd), spermine (spm), and spermidine/spermine index (spd/spm) were determined using HPLC after dansylation.

Results

No significant differences were found between groups (t = 0,974; df = 36; P = 0,337 for spd, t = l0, 52; df = 36; P = 0,959 for Spm, and, t = 0, 662; df = 36; P = 0,512 for spd/spm).

Conclusions

Though we couldn’t replicate previous findings suggesting disturbances in blood polyamine levels in schizophrenia, this issue may be a promising target. Future research should take into account possible factors such as sex, nutritional state, and stress.
The schizophrenia caregiver quality of life questionnaire (S-CGQoL): development and validation of an instrument to measure quality of life of caregivers of individuals with schizophrenia
Authors: Richieri R. , Boyer L. , Loundou A. , Simeoni M.-C. , Reine G. , Auquier P. , Lançon C.
Published: May 2011

Objective

This study aims to validate a self-administered, multidimensional QoL instrument based on the point of view of caregivers of individuals with schizophrenia.

Methods

Data were collected through the departments of six psychiatric hospitals in France (n = 246). The item reduction and validation processes were based on both item response theory and classical test theory.

Results

The S-CGQoL contains 25 items describing seven dimensions (Psychological and Physical Well-Being; Psychological Burden and Daily Life; Relationships with Spouse; Relationships with Psychiatric Team; Relationships with Family; Relationships with Friends; and Material Burden). The seven-factor structure accounted for 74.4% of the total variance. Internal consistency was satisfactory; Cronbach's alpha coefficients ranged from 0.79 to 0.92 in the whole sample. The scalability was satisfactory, with INFIT statistics falling within an acceptable range. In addition, the results confirmed the absence of DIF and supported the invariance of the item calibrations.

Conclusion

The S-CGQoL is a self-administered QoL instrument that presents satisfactory psychometric properties and can be completed in 5 min, thereby fulfilling the goal of brevity sought in research and clinical practice.
Visual evoked responses to a gamma-frequency flicker are enhanced in acute schizophrenia
Authors: Riecansky I. , Kasparek T. , Rehulova J. , Katina S. , Prikyl R.
Published: May 2011

Disturbances of visual perception, such as illusions and hallucinations, are a hallmark of psychotic disorders. In perceptual processes, synchronous neuronal activity in gamma frequencies (> 30 Hz) is considered to play a major role. Steady-state visual evoked potentials (ssVEP) allow for testing the ability of the visual cortex to support synchronous neural responses to periodically flickering light. We employed photic stimulation at 40 Hz in order to specifically drive cortical gamma synchrony. In acute schizophrenia patients, compared to healthy control subjects, we found significantly increased evoked synchrony at 40 Hz, but decreased synchrony in the alpha band (8–13 Hz). Linear decomposition of ssVEP waveforms separated the activity of independent neural sources and revealed their different dynamics in the patients and the controls. The results indicate an aberrant processing of transient visual events in acute schizophrenia.
Aripiprazole treatment effects on metabolic syndrome parameters in schizophrenia patients: Preliminary results
Authors: Said M. , Sulaiman A.H. , Habil M.H.
Published: May 2011

Introduction

Metabolic abnormalities have historically been associated with illness such as schizophrenia. However, many studies found aripiprazole has a safer metabolic profile and metabolic neutral for schizophrenic patient.

Objective

This is a prospective 24 weeks follow-up study. The primary objective of this study was to investigate the improvements in metabolic syndrome parameters observed in patients who were switched from other antipsychotics.

Methods

Patients with schizophrenia treated with antipsychotic who were having abnormal metabolic parameters were switched to aripiprazole. They were analyzed to quantify clinically significant changes in metabolic parameters. At baseline, weight, waist circumference, blood pressure and fasting blood sugar were assessed. Fasting lipid profile was taken for total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides at baseline. The same assessments were repeated at 4-weeks, 12-week and 24-week. Paired t-test and last observation carried forward (LOCF) were used for the statistical analysis.

Preliminary results for those who completed 12 weeks follow up were presented.

Results

46 schizophrenic patients with 26 (56.5%) male and 20 (43.5%) female have completed the 12 weeks follow up. There was statistically significant reduction in mean weight (73.3 ± 19.2 kg) to (71.2 ± 20.5 kg), mean BMI (27.1 ± 5.4) to (26.2 ± 6.0), mean waist circumference for male (96.2 ± 14.1 cm) to (92.9 ± 17.9), mean triglycerices (1.86 ± 0.83 mmol) to (1.59 ± 0.54 mmol).

Conclusion

In short-term, switching to aripiprazole treatment resulted in clinically significant improvements in weight, BMI, waist circumference in male, and triglycerices in at-risk patients.
Searching for the genetic markers connected with paranoid schizophrenia and conditioning the treatment efficiency
Authors: Tybura P. , Samochowiec J.
Published: May 2011

Aim

The aim of the study was to find genetic markers which can influence on susceptibility of paranoid schizophrenia and the treatment efficiency measured by the PANSS. We analyzed genes polymorphisms: DRD2 (Taq 1A, in egzon 8, - 141 C ins/del), DAT, GRIK3, SERT, 5HT2A, MAO-A, COMT.

Method

One hundred and ninety one patients with the diagnosis of paranoid schizophrenia were recruited as study group. To obtain the diagnosis meeting the criteria to ICD-10 we used the polish version of CIDI - Composite International Diagnostic Interview. Exclusion criteria included serious neurological disorders, major somatic disorders impairing cognitive functions and diagnosed mental impairment. The intensity of psychopathological symptoms was examined using the PANSS. Genomic DNA was extracted from leucocytes using the Miller's salting method. Polymorphisms were studied by the PCR method.

Statistical analyses were performed by the Statistica computer program, specifically Pearson's chi-square test. Associations between the treatment progress and the genotype were studied by analysis of variance (ANOVA).

Results

We didn’t find associations between investigated genes polymorphisms and susceptibility of paranoid schizophrenia. Probably, there is no influence of studied polymorphisms on the treatment efficiency.

Conclusions

No differences were found in the genotypes distribution in investigated genes polymorphisms between the whole schizophrenics and the control group. No association was found between any particular genotype and the effect of antipsychotic treatment.
Comparative research of polypharmacy efficiency in long-time outpatient therapy of schizophrenia
Authors: Samokhvalova O. , Samokhvalov V.
Published: May 2011

Introduction

A question at issue of clinical psychiatry and psychopharmacology is efficiency of multi-class polypharmacy, adjunctive polypharmacy, augmentation and total polypharmacy in longtime treatment of schizophrenia. It is very important question of pharmacoeconomisc, compliance evaluation, prevention of exacerbation with succeeding hospitalization and social impairment.

Objects

4 casual samples of patients with the diagnosis of schizophrenia by ICD 10 (F20), undergoing treatment in out-patient conditions for 3 years. Each sample included 50 patients (25 men and 25 women).

1

sample - therapy by combinations of typical and atypical antipsychotics 2 generation,

2

sample - therapy by combinations of antipsychotics and antidepressants,

3

sample - therapy by combinations of antipsychotics and tranquillizers,

4

sample - monotherapy of typical or atypical antipsychotics.

Aims

To establish dependence of effect of therapy on aggravation (exacerbation) a schizophrenia from number and combinations of psychotropic preparations.

Methods

The clinical-psychopathological method, a comparative statistical method - processing of results was spent by means of SPSS program.

Results

As a result of research it is revealed that efficiency of therapy reliably does not differ in all 4 groups.

Conclusion

Research calls into question expediency of polypharmacy in prevention of exacerbation at a schizophrenia which, probably, is necessary to replace with dynamic monotherapy depending on a leading syndrome at exacerbation.
Cannabis use disorders and age at onset of psychosis in 606 patients with first episode psychosis
Authors: Schimmelmann B. , Kupferschmid S. , Conus P. , Cotton S. , McGorry P. , Lambert M.
Published: May 2011

Background

Age at onset of psychosis (AAO) may be younger in patients with cannabis use disorders (CUD) compared to those without CUD (NCUD). Most previous studies did not control for potential confounders, did not report effect sizes and included mostly adult patients from non-representative samples.

Methods

Controlling for relevant confounders, differences in AAO between patients with and without lifetime CUD were analysed in a large epidemiologically based cohort of 606 first-episode psychosis (FEP) patients (age 14 to 29 years) admitted within three years to the Melbourne Early Psychosis Prevention and Intervention Centre. Data were collected from medical files using a standardized scale.

Results

Overall, AAO was not significantly different in CUD (n = 449; 74.1%) compared to NCUD, neither univariate nor when controlling for gender and premorbid functioning. However, AAO was younger in those with early CUD (starting before age 14) compared to NCUD (F(1) = 11.3; p = 0.001; partial η2 = 0.042). When considering the subgroups of early versus late onset psychosis, AAO was even later in early onset psychosis patients with CUD compared to those with NCUD (F(1) = 8.4; p = 0.004; partial η2 = 0.072). These findings were consistent for patients with non-affective psychoses, in those with CUD without other substance use disorders and in those with CUD explicitly starting in the pre-psychotic phase. Notably, 89.1% started cannabis before the onset of psychotic symptoms.

Conclusions

CUD starting before age 14 was associated with an earlier AAO at a small effect size, but only in adult onset FEP patients.
Niacin sensitivity in patients with schizophrenia-spectrum disorders, their 1st Degree Relatives and Healthy Controls
Authors: Schloegelhofer M. , Mossaheb N. , Kaufmann R. , Aninilkumparambil T. , Gold A. , Himmelbauer C. , Inreiter S. , Schlehaider L. , Aschauer H.
Published: May 2011

Introduction

Schizophrenia has often been associated with a reduced skin flush response to niacin. Blunted response suggests potential disturbance in phospholipid metabolism.

Objectives

We performed niacin skin tests in patients with schizophrenia, their first-degree relatives and healthy controls.

Aims

To examine possible differences in skin flush response to niacin.

Methods

We examined 51 patients (female 49%, age 33.1 years, SD 11), with schizophrenia-spectrum disorders, 51 matched healthy controls (female 49%, age 33 years, SD 12.1), and 21 first-degree relatives (female 61,9%, age 49,5 years, SD 17,6, one affected, others non-affected). The Positive and Negative Syndrome Scale and the Mini International Neuropsychiatrie Interview were used to assess psychopathology and diagnosis, respectively. The non-invasive niacin skin flush test was used to assess vasodilatative reaction to four different concentrations of niacin on the forearms of subjects.

Results

We found no differences in total scores on the niacin skin flush test between the three groups (p = 0.774). Mean scores were 60.27 (SD 14.2) in healthy controls, 58.84 (SD 10.2) in patients and 58.48 (SD 9.4) in first-degree relatives.

Conclusion

Contrary to our expectations we did not find a significantly blunted niacin skin flush reaction in patients with schizophrenia-spectrum disorders compared to healthy controls or 1st degree relatives.
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.
Impact of care and support rendered by families on schizophrenic patients following discharge
Authors: Sefasi A.P.
Published: May 2011

Introduction

We recruited patients with schizophrenia four weeks post-discharge from Zomba mental hospital and followed them for six months to find out if care and support had an impact on their staying well and avoid relapse in their local communities.

Objective

To establish skills and knowledge family members hold to take care of their schizophrenic relative.

Aims

We hypothesized that good support and care would be positively associated with good recovery and reduced relapse rate among schizophrenic patients.

Method

This Study was carried out in Zomba city and areas surrounding Zomba mental hospital. We used both quantitative and qualitative approach to research; simple random sampling was used to get a sample of 70 participants in this study. In-depth interviews were used to collect data from discharged schizophrenic patients while focus group discussion was used to get views of family members and nurses who take part in provision of care and support.

Results

Our findings indicate that where patients following discharge receive good support and care from family members the rate of relapse becomes low and patients also live a more productive life in society. However, 31% of family members felt they had no knowledge as how to handle their sick relative at home hence they were unsure on what to do to help.

Conclusion

We recommend to intensify carer educatioin order to equip guardians with necessary knowledge which will in the long run reduce re-admissions and hence congestion in mental hospitals.
Planum parietale volume in antipsychotic-naïve schizophrenia
Authors: Shivakumar V. , Kalmady S.V. , Venkatasubramanian G. , Gautham S. , Aditi S. , Rao N.P. , Gangadhar B.N.
Published: May 2011

Introduction

First Rank Symptoms (FRS) - a group of intriguing experiences characterized by striking breach of ‘self versus non-self’ boundaries - have had a critical influence on the diagnosis of schizophrenia. Inferior Parietal Lobule is implicated in the pathogenesis of FRS in Schizophrenia. However, the role of Planum Parietale (PP) in the genesis of FRS is yet to be examined.

Aims & objectives

This first time study (to the best of our knowledge), aims to examine antipsychotic-naïve schizophrenia patients for the effect of FRS status on volume of PP.

Method

In this study we examined the volume of PP in antipsychotic-naïve schizophrenia patients (n = 32; M:F = 16:16) in comparison with age, sex, and handedness matched (as a group) healthy comparison subjects (n = 34; M:F = 16:18) using valid method with good inter-rater reliability.

Results

Female Schizophrenia patients showed significant volume reduction in right PP in comparison with female healthy controls (F = 7.2; p = 0.01). However, male patients did not. There was a significant effect of schneiderian FRS in female patients in that those who had FRS had significantly smaller volume of right PP than healthy controls (F = 3.8; p = 0.03); where those female patients who were FRS negative did not differ. Left PP volume did not differ between patients and controls.

Conclusions

Current study supports previous studies which have implicated the role of parietal lobe in pathogenesis of FRS. Specific role of PP in FRS generation and possible implication of sex differences needs further systematic studies.
Acetylcholinesterase inhibitors for schizophrenia
Authors: Singh J. , Kour K. , Jayaram M.
Published: May 2011

Introduction

As evidenced by ongoing research and partial effectiveness of the antipsychotics on cognitive and negative symptoms, the search is on for drugs that may improve these domains of functioning for someone suffering from schizophrenia.

Objectives

To do a sytematic review to find out if acetylcholinesterase inhibitors could be used for schizophrenia condisering there use in dementia for cognitive symptoms.

Aim

The aim of review was to determine the clinical effects, safety and cost effectiveness of acetylcholinesterase inhibitors for treating patients with schizophrenia.

Methods

We searched the Cochrane Schizophrenia Group’s Register and references of all identified studies were inspected. We included all clinical randomised trials comparing acetylcholinesterase inhibitors with antipsychotics or placebo either alone or in combination for schizophrenia and schizophrenia-like psychoses. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random-effects model. For continuous data, we calculated weighted mean differences (WMD) again using random-effects model.

Results

The acetylcholiesterase inhibitor plus antipsychotic showed benefit over antipsychotic and placebo in the mental state, cognitive domain and tolerability. No difference was noted between the two arms in other outcomes. The overall rate of participants leaving studies early was low and showed no clear difference between the two groups.

Conclusions

The results seem to favour the use of acetylcholiesterase inhibitors in combination with antipsychotics in different oucomes, but because of the various limitations, this review highlights the need for large, independent, well designed, conducted and reported pragmatic randomised studies.
Levomepromazine for schizophrenia
Authors: Sivaraman P. , Rattehalli R. , Jayaram M.B. ,   Cochrane Schizophrenia Group
Published: May 2011

Levomepromazine is an ‘older’ typical antipsychotic licensed for use in schizophrenia but sparingly prescribed in the UK. Our objective is to determine the clinical effects and safety of levomepromazine compared with placebo or antipsychotics for schizophrenia and schizophreniform psychoses. All randomised trials comparing levomepromazine with placebo or other antipsychotics for schizophrenia and schizophreniform psychoses were included in our systematic review which currently includes 4 RCTs with 192 participants. For our primary outcome of leaving the study early, levomepromazine was not significantly different compared with other antipsychotics. The levomepromazine arm was significantly better on CGI severity compared with chlorpromazine (n = 38, 1 RCT, WMD -0.80 CI -1.51 to -0.09). Recipients given levomepromazine had a better BPRS endpoint score (n = 38, 1 RCT, WMD -9.00, CI -17.46 to -0.54) and PANSS total score (n = 38, 1 RCT, WMD -15.90, CI -30.30 to -1.50) than chlorpromazine. Levomepromazine caused less tremor (n = 41, 1 RCT RR 0.12 CI 0.02 to 0.87 NNTB 3 CI 2 to 8), less antiparkinsonian medication administration (n = 79, 2 RCTs, RR 0.39 CI 0.17 to 0.90, NNTB 5, CI 2 to 21) compared with haloperidol.

Levomepromazine caused less akathisia compared with chlorpromazine, but more hypotension compared with risperidone (n = 42, 1 RCT, RR 2.50 CI 1.21 to 5.18, NNTH 3, CI 2 to 7). Dizziness was common with levomepromazine compared with other antipsychotic medications. Available data does not enable us to confidently comment on the effectiveness of levomepromazine for schizophrenia. Larger, more robust, studies comparing levomepromazine with other antipsychotics including clozapine are much needed.
Four European countries survey of patients with schizophrenia treated in everyday clinical practice: characteristics of patients in long-term hospitalization
Authors: Sturlason R.
Published: May 2011

Aim

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

Methods

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

Results

Of 3,996 surveyed patients, 15.8% were in long term hospitalization. They had a mean of 7.1 previous episodes and 5.5 previous hospitalizations. They typically presented with positive symptoms, with delusions, hallucinatory behavior and ideas of persecusion being most frequently observed. 78% of subjects were smokers, 19% had drug and 9% alcohol addiction. 36% of subjects had a verified cardiometabolic comorbidity and 22% were obese. 54% of subjects had verified medication non-adherence. Most frequently used antipsychotic was risperidone (in 24% of subjects). Ziprasidone was used in 9% of subjects. 13% of subjects were on depot medication and 17% was receiving orally disintegrating tablets.

Conclusion

Subjects with schizophrenia in long term hospitalization have high rates of positive symptoms despite receiving antipsychotic treatment regularly. Smoking rates were alarmingly high.
A pooled analysis of the effects of asenapine on the persistent negative symptoms of schizophrenia
Authors: Potkin S.G. , Phiri P. , Zhao J. , Alphs L. , Buchanan R.W. , Szegedi A. , Panagides J. , Cazorla P.
Published: May 2011

Introduction

Asenapine and olanzapine reduced persistent negative symptoms (PNS) of schizophrenia in 2 double-blind, randomized 26-week studies and subsequent 26-week extensions; superiority of asenapine over olanzapine was observed in neither core study and only 1 extension.

Objective

Further explore the efficacy of asenapine on PNS using pooled data.

Aim

Demonstrate superiority of asenapine over olanzapine on PNS.

Methods

Core study participants were randomized to twice-daily asenapine 5 or 10 mg or once-daily olanzapine 5–20 mg; extension participants continued existing treatment. Changes from core study 16-item Negative Symptom Assessment (NSA-16) Scale baseline at Weeks 26 and 52 were estimated using MMRM.

Results

Of 949 treated participants (asenapine, 485; olanzapine, 464), 613 (277; 336) completed the core studies and 412 (170; 242) completed the extensions. Discontinuation due to lack of therapeutic effect was significantly greater with asenapine vs olanzapine for the first 26 weeks (13.6% vs 7.3%, p = 0.0016) and during the extension (5.5% vs 2.1%, p = 0.0458) for core and extension study participants, respectively. Between-group differences in least squares mean ± SE NSA-16 score change from core study baseline were significantly greater with asenapine at Week 52 for core (-14.6 ± 0.8 vs -12.6 ± 0.7; p = 0.0497) and extension (-16.5 ± 0.9 vs -13.6 ± 0.7; p = 0.0083) participants, but were not significant at Week 26.

Conclusions

In pooled analyses, asenapine and olanzapine reduced PNS, with statistical superiority of asenapine observed at Week 52 but not Week 26. These results should be interpreted in view of the fact that participants who entered the extensions did so without rerandomization.
Maladaptive connectivity of broca’s area in schizophrenia during audiovisual speech perception: an FMRI study
Authors: Szycik G.R. , Ye Z. , Mohammadi B. , Dillo W. , te Wildt B.T. , Samii A. , Frieling H. , Bleich S. , Münte T.F.
Published: May 2011

Introduction

Natural speech perception relies on both, auditory and visual information. Both sensory channels provide redundant and complementary information, such that speech perception is enhanced in healthy subjects, when both information channels are present.

Objectives

Patients with schizophrenia have been reported to have problems regarding this audiovisual integration process, but little is known about which neural processes are altered.

Aims

In this study we investigated functional connectivity of Broca’s area in patients with schizophrenia.

Methods

Functional magnetic resonance imaging (fMRI) was performed in 15 schizophrenia patients and 15 healthy controls to study functional connectivity of Broca’s area during perception of videos of bisyllabic German nouns, in which audio and video either matched (congruent condition) or die not match (incongruent; e.g. video = hotel, audio = island).

Results

There were differences in connectivity between experimental groups and between conditions. Broca’s area of the patient group showed connections to more brain areas than the control group. This difference was more prominent in the incongruent condition, for which only one connection between Broca's area and the supplementary motor area was found in control participants, whereas patients showed connections to 8 widely distributed brain areas.

Conclusions

The findings imply that audiovisual integration problems in schizophrenia result from maladaptive connectivity of Broca's area in particular when confronted with incongruent stimuli and are discussed in light of recent audio visual speech models.
Analisis of quality of life long-term hospitalized schizophrenic patients
Authors: Tasic G. , Anakiev S. , Milosevic D. , Cvetanovic M.
Published: May 2011

Introduction

Long term hospitalization are often caused by social reasons wich significantly affects the quality of the patients.

Aim

Comparing the quality of long-term hospitalized schizophrenic patients in relation to sex.

Method

We have used following rating scale: a brief psychiatric assessment scale BPRS, QLS Quality of life scale, “Lancashir” profile quality of life scale LQOLP, a short questionnaire for the “needs assessment Cambersels” scale CANSAS. Analysis included 80 inpatients, 40 male and 40 female, with Schizophrenia according to ICD 10 criteria. All patients were hospitalized according to ICD 10 criteria. All patients were hospitalized in a Special Hospital For Psychiatric Illness G. Toponica more than two years.

Results

Significant differences in quality of life between male and female patients about what is discussed in further study.

Conclusions

Research has shown that long-term hospitalizing has adverse effects on quality of life of schizophrenic patients of both sexes. His essential that the length of hospital stay should be reduced to the period reduced to the period for reduction of symptoms and provide the patient a stable life in the community after hospital treatment.
Tardive dyskinesia and deficit schizophrenia
Authors: Telfer S. , Shivashankar S. , McCreadie R. , Kirkpatrick B.
Published: May 2011

Introduction

Despite comparable antipsychotic exposure, some patients experience involuntary movements yet others do not. Negative symptoms have been associated with tardive dyskinesia, but it is not certain that this is an association with primary negative symptoms.

Aims

To determine whether patients with deficit schizophrenia (who have primary negative symptoms) are more likely to experience tardive dyskinesia than those with non-deficit schizophrenia.

Methods

In 2006 all the people with a clinical diagnosis of schizophrenia in Nithsdale, South West Scotland, were identified using the ‘key informant’ method. These patients were assessed using the Schedule for the Deficit Syndrome (SDS) and for the presence of dyskinesia using the Abnormal Involuntary Movements Scale (AIMS). Patients were also assessed for akathisia using the Barnes-Akathisia Scale and for extrapyramidal side effects using the Simpson and Angus rating scale.

Results

There is a significant association between deficit and TD when controlling for age. Those with tardive dyskinesia are more likely to have deficit schizophrenia. The odds ratio is 3.08 (95% CI 1.28, 7.37), p = 0.012.

Conclusions

Our findings support the proposal that the pathological process underlying deficit schizophrenia can predispose to the development of tardive dyskinesia.
Thyroid dysfunction in chronic schizophrenia in albania
Authors: Themeli Y. , Aliko I. , Hashorva A.
Published: May 2011

Background

Thyroid dysfunction is relatively common in patients with schizophrenia.This study seeks to determine the prevalence and pattern of thyroid dysfunction and thyroid antibodies presence in a group of adult psychiatric inpatients with chronic schizophrenia.

Methods

Thyroid function tests and thyroid antibodies measurement were performed on 88 patients hospitalized in Psichiatric Clinic of UHC “Mother Teresa” from december 2006 to december 2007.

55 of them (62,5%) were females and 33 of them (37,5%) males. A median age of 43 years (range16 to 70 years) and a median duration of hospitalization of 10 years (range 1 to 30 years) was assessed.

Results

TAb were found in 22 patients (25%), of which 18 females and 4 males. 16% of them resulted with positive anticorps for Hashimoto Thyroiditis; 9% for Graves‘disease.

According to thyroid function tests

70% had normal test, 8% had elevated TSH: 3% of them with low thyroid hormones and 5% with normal thyroid hormones. 20% of cases had low TSH: 5% of them with high level of thyroid hormones, 15% with normal thyroid hormones. Hypothyroidism was more frequent in elderly patients ( > 60 years old), and in those treated with Risperidone. Most of cases (73%) with thyroid disorders resulted from endemic geographic areas. 37% of them mentioned familial history for thyroid pathology, and 23% for diabetes mellitus type 1.

Conclusion

Thyroid abnormalities are common in patients with chronic schizophrenia.This fact call for caution in the use and interpretation of thyroid function tests in these patients.
A group psychoeducational intervention for parents of individuals with schizophrenia
Authors: Tsiouri I. , Gena A. , Mouzas O.
Published: May 2011

Introduction

Families of individuals with schizophrenia experience disempowerment and helplessness because of unique stressors in their everyday life, mainly derived from the positive and negative symptoms of the illness (Bauml, et al., 2006). Another line of research provides evidence that working with families of people with schizophrenia is effective in reducing family burden and distress levels, through structured psychoeducational interventions (Falloon, 2003; Bauml, et al., 2006).

Objectives, aims

Despite evidence of their efficacy, psychoeducational interventions have not been widely implemented in standard clinical practice. The goal of this ongoing research project is to investigate the efficacy of a group psychoeducational intervention for parents of individuals with schizophrenia in reducing family burden and in improving their communication and problem solving skills, as well as their general family functioning.

Methods

The theoretical foundations of family psychoeducation is mainly derived from behavioral family therapy. Four couples (all parents of one or two individuals with schizophrenia) participated in this psychoeducational intervention program. Twenty three group sessions were conducted, organized around three primary goals: a) provision of information about the nature and the treatment of schizophrenia b) management of social and self-stigmatization and c) teaching family members problem-solving and communication skills (Solomon, 2000).

Results and conclusions

Pre and post treatment measures, as well as direct measures during treatment, were used to quantitatively assess family burden, family rituals, knowledge about the nature of the disorder, coping with stigma, communication and problem solving skills and general family functioning. Findings will be discussed.
Personal and social performance scale (PSP) in community-based patients with serious mental illness
Authors: Tsouvalas T. , Konstantinidou L. , Georgiou G. , Birmpili E.-M. , Nikolara R.
Published: May 2011

Introduction

PSP scale is a reliable and valid instrument for assessing the functioning of patients with with serious and persistent mental illness (SPMI).

Objectives

To assess PSP performance in patients with SPMI.

Aims

Relapse prevention and maintenance of social functioning in the long-term management of SPMI.

Methods

Assessments were made at the local CMHC on June, September and December 2009. Clinical and demographic characteristics were recorded.

44 patients’ function per each domain was rated at six levels.

The impact on total PSP scores of the following variables was examined (random intercept model): type of medication, gender, age, marital status, professional status, residence location, everyday living, follow-up visits and time under treatment.

Results

The sample included 35. 80% male, 75% unmarried, 89% pensioners, 82% living with their families, 71% living in villages, 29% living in cities. Paranoid schizophrenia was the most frequent diagnosis.

Statistically significant improvement from baseline to month 3 was showed for self care, personal and social relations subscales of PSP scale. Socially useful actions stabilized between month 3 and month 6, as well.

The mean PSP scores increased from baseline to month 3 by 4.0 units (p = 0.012) and then stabilized. The mean score changed from month 3 to month 6 by approximately 0.1 units (P = 1.00).

Conclusion

The functioning of patients with SPMI improved over time due to the monitoring by trained physicians and caregivers.

The advices offered from the treating physicians towards functioning maintenance seemed to improve patients’ functioning.
Biochemical and biophysical aspects of the pathophysiology of first episode of schizophrenia
Authors: Uzbekov M. , Smolina N. , Syrejshchikova T. , Misionzhnik E. , Gryzunov Y. , Dobretsov G. , Tokarev V.
Published: May 2011

Introduction

The knowledge of pathophysiology of first psychotic episode is still fragmentary.

Aim

To investigate some biochemical and biophysical parameters in first-episode, drug-naive schizophrenic (FES) patients.

Methods

26 FES patients (ICD-10; F 20.0 and F 20.3) and 15 age-and gender-match volunteers were investigated. Clinical severity of FES patients were assessed by PANSS scale. Platelet monoamine oxidase (MAO) and serum semicarbazide-sensitive amine oxidase (SSAO) activities, middle-mass endotoxic molecules (MMEM) and malondialdehyde (MDA) levels were measured using respective methods. Steady-state and subnanosecond fluorescent spectroscopy were used for the investigation of albumin conformational changes.

Results

Severity of disorder prior the treatment was 75.5 ± 2.2 (PANSS score). FES patients were characterized by significant increase in MAO activity (99%) and MMEM concentration (124%) and significant decrease in SSAO activity (26%) as compared with controls. Changes of albumin conformational and functional parameters (“effective” albumin concentration and “reserve” of albumin binding) estimated by steady-state fluorescent spectroscopy were insignificant. Factor analysis revealed that MAO and SSAO are more tightly connected with pathogenetic mechanisms of FES then MMEM, MDA and albumin functional parameters. Significant conformational changes of albumin of FES patients were detected using pulse fluorescent spectroscopy with subnanosecond resolution. Results are compared with the data received in chronic schizophrenic patients.

Conclusion

From pathophysiological point of view FES is the initial step in development of pathologically disturbed biochemical status characteristic to chronic schizophrenia. The study was supported by grant # 3156 from International Science and Technology Center (ISTC).
Impact of the “puente project” on the public disease expenditure of a patient with schizophrenia in belgium
Authors: Van Loon H. , Vandenbroele H. , De Bruyne S. , Glorieux M. , Wybo A. , Gillain B. , Dubois V. , Peuskens J.
Published: May 2011

Introduction

The “Puente project”, rises up the adherence rate with 38% (1). The aim of the study was to analyse the economic impact of this disease management prgramme of patients with a schizophrenic disorder.

Subjects and methods

“Puente” stands for a programme of LAAP with active outreaching of patients with schizophrenia. The details of the data collection and the subjects have been described elsewhere (1).The hospitalisation rate and the length of stay of the 117 case control pairs have been compared. The cost of hospitalisation in Belgium, recently adjusted by De Ridder et al. (2), have been used in order to map the differences.

Results

The number of hospital days totalised by 23 cases, was 2,152 days, in comparison to 6,371 realised by 42 controls,wich gives 18,6 hospital days per year for the cases and 38.9 days for the controls. Given an hospital cost per day in Belgium of 163.8 € per day, a crude saving of 3,328.5 € per case per year can be realised, correespondng with a net diminution of 2,428.5 € per patient year. Enrolling 1,675 cases per year, creates a saving of 4,066,533 € per year, an equivalent of 24,826 hospital days, or the cost of a psychiatric hospital of 85 beds occupied at 80%.

Conclusion

The Puente programme realised a substantial drop in public patient expenditure of 3,328.5 € per patient year. This is a very strong argument to implement, to finance and to support “Puente” like disease programmes in Belgium.
Low rates of treatment of cardiovascular risk factors in patients treated with antipsychotics
Authors: van der Heijden F. , Steylen P. , Kok H. , Slaar A. , Verhoeven W.
Published: May 2011

Introduction

Cardiovascular disease is the most common cause of death in patients with severe mental illness (SMI). Patients are more likely to be overweight and to have hypertension, dyslipidemia, hyperglycemia and diabetes mellitus. Antipsychotic medication can induce or worsen these cardiovascular risk factors.

Objectives

Accessibility to healthcare and adequate somatic treatment is limited in patients with SMI.

Aims

Prevalence of inadequate treatment for metabolic cardiovascular risk factors in patients treated with antipsychotic medication.

Methods

A health monitor was introduced as a screening instrument in a schizophrenia treatment and recovery program (so called F-ACT) at the outpatient departments. Assesment included physical and laboratory examination, demographics, DSM-IV diagnoses, remission-criteria, social functioning, use of medication and drugs.

Results

Over a period of 18 months (2009–2010), 520 of the 600 patients included in the F-ACT were evaluated. Preliminary analysis shows that 452 patients met DSM-IV criteria of schizophrenia and other psychotic disorders. All patients were treated with at least one antipsychotic agent. Metabolic syndrome according to ATP-III was present in 50% of patients (60% abdominal obesity, 58% hypertension, 24% hyperglycemia, 52% high triglycerides, 49% low HDL-cholesterol). Rates of non-treatment ranged from 78% for hypertension, 85% for dyslipidemia and 48% for diabetes mellitus. Rates of inadequate treatment ranged from 69% for hypertension and 83% for dyslipidemia.

Conclusions

1.

Metabolic cardiovascular risk factors are highly prevalent in patients treated with antipsychotics

2.

Inadequate treatment of metabolic cardiovascular risk factors is common

3.

There is a need to improve the cooperation between psychiatrists and general practitioners
Neurotrophic proteins and symptom profile in psychotic disorders
Authors: van de Kerkhof N. , Fekkes D. , van der Heijden F. , Verhoeven W.M.A.
Published: May 2011

Background

Psychotic disorders are highly prevalent and are treated with antipsychotics. There are no biological markers to predict or measure treatment effects. Research to neurotrophic proteins Brain Derived Neurotrophic Factor (BDNF) and S100B demonstrated association with psychotic symptoms and suggested association with treatment outcome and symptomatology.

Objectives

Investigate the relevance of neurotrophic proteins BDNF and S100B in patients with psychotic disorders treated with antipsychotics.

Aims

Primary objective is to investigate the relationship between serum levels of BDNF and S100B and symptomatology at baseline and after six weeks of treatment. Furthermore, a detailed evaluation of symptom profile and treatment effect is performed.

Methods

80 patients with acute and chronic psychotic disorder were evaluated during six weeks while receiving antipsychotic treatment of any kind. Symptomatology was assessed using CASH, PANSS and CGI-S/I. Biochemical parameters were determined at baseline and after six weeks. Symptomatology and treatment effect were related to biochemical results.

Results

Preliminary analyses show an overall treatment response of 19% (reduction of PANSS). A significant difference was found at baseline between patients with first-episode psychosis and patients with relapse or chronic psychosis (BDNF 12,4 vs. 21,7μg/l P ≤ 0,01, S100B 0,1055 vs. 0,05937 μg/l, P < 0,05). During treatment, serum levels of neurotrophic proteins returned to normal values in both groups.

Conclusions

Six weeks of antipsychotic treatment results in a modest symptomatic improvement. In subgroups with first episode psychosis, S100B levels are higher and BDNF levels are lower. The normalization of both serum levels suggests an effect of antipsychotic treatment on brain neurochemical processes.