bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of DTNBP1 and comt risk variants and comorbid drug-abuse in patients with schizophrenia: A Gene-Environment Interaction?
Authors: Benkovits J. , Polgár P. , Fábián Á. , Czobor P. , Bitter I. , Réthelyi J. 
Published: May 2011

IntroductionEarlier studies have shown that candidate gene risk polymorphisms and psychoactive substance abuse influence the frequency and severity of psychosis.ObjectivesIn this study we examined whether the most studied schizophrenia risk polymorphisms and psychoactive substance abuse interact in their influence on symptom severity and neurocognition.MethodsWe analyzed the clinical data of 280 schizophrenia patients, including genotyping data of the candidate genes NRG1, DTNBP1, RGS4, G72/G30 and PIP5K2A. Patients were assessed clinically by the Positive and Negative Symptom Scale (PANSS) and information about substance abuse was based on self-report and reviewing patient charts. We tested for possible interactional effects using the General Linear Model (GLM) analysis.Results15,8% of patients reported episodic or regular substance abuse, the vast majority (92%) used cannabis or the combination of cannabis and another drug. Substance abuse was associated with higher scores of the PANSS hostility/excitement factor, independent of sex, age, or genetic results (F = 4,02;p = 0,04). We found significant interactional effects of the DTNBP1 gene risk polymorphisms and substance abuse on different PANSS factors: rs2619528 and positive substance abuse interaction were associated with higher scores on the PANSS negative factor (F = 4,6;p = 0,03), and the PANSS depression factor (F = 4,75;p = 0,03). Moreover the rs3213207 - substance abuse interaction was associated with higher scores on the PANSS cognitive factor (F = 7,55;p = 0,006). Carriers of the Val allele of the COMT Val158Met polymorphism demonstrated significantly higher scores on the PANSS depression factor (F = 5,53;p = 0,02).ConclusionsOur results underscore the importance of gene-environment interactions in the phenotypic heterogeneity of schizophrenia.
SMARCA2 common variant association and rare variant excess in Schizophrenia patients from an Algerian Trio Cohort
Authors: Benmessaoud D. , Lepagnol-Bestel A.-M. , Delepine M. , Hager J. , Moalic J.-M. , Gorwood P. , Kacha F. , Simonneau M. 
Published: May 2011

Genome wide association studies (GWAS) of Schizophrenia (SZ) patients have identified common variants in ten genes including SMARCA2 (Koga et al., HMG, 2009). We found that the SZ-GWAS genes are part of an interacting network centered on SMARCA2 (Loe-Mie et al., HMG, 2010). Furthermore, SMARCA2 was found disrupted in SZ (Walsh et al., Science, 2008). SMARCA2 encodes the ATPase (BRM) of the SWI/SNF chromatin remodeling complex that is at the interface of genome and environmental adaptation.Taking advantage of an Algerian trio cohort of one hundred SZ patients (Benmessaoud et al., BMC Psychiatry, 2008), we replicated the association of SNP rs2296212 localized in exon 33, already shown associated in Koga study and resulting in D1546E amino acid change in the SMARCA2 protein. We studied SMARCA2 codons and found that exon 33 displays a signature of positive evolution in the primate lineage.Our working hypothesis is that the coding regions displaying positive selection are target of novel rare variants. To address this question, we sequenced two exons displaying positive evolution and one exon without evidence of positive evolution.We found (i) that rare variants are significantly in excess in SZ-patients compared to their parents (p = 0.038, Fisher test) and (ii) a higher proportion of rare variants in the primate-accelerated exons compared with the non-evolutionary exon in SZ-patients (p = 0.032, Fisher test).SMARCA2 exon sequencing and whole exome sequencing from patients harboring SNP rs2296212 common variant are under progress. Altogether, these results are expected to give new insights into the genetic architecture of SZ.
Clinical improvement at Day 3 as factor influencing length of hospital stay and discharge of patients with schizophrenia
Authors: San-Molina L. , Rubio G. , Bernardo-Fernández I. , Miguélez-Fernández S. 
Published: May 2011

IntroductionThe type of treatment used for patients with schizophrenia and an improvement at Day 3 can affect the length of stay and symptom outcome.ObjectivesTo determine the influence of improvement at Day 3 in the lenght of hospital stay and hospital discharge in the case of patients with schizophrenia admitted to acute units.MethodsA multicenter, naturalistic, retrospective study evaluating medical intervention in 1346 patients with schizophrenia in acute units in Spain.ResultsThe mean of hospital stay days was 23.3 (range 1–260 days). 49.5% of patients with improvement at Day 3 had a shorter length of hospital stay. 78.7% received treatment with antipsychotics prior to admission. The most common drugs were risperidone, olanzapine and quetiapine. 99.8% and 99.7% were treated during hospital stay and on discharge, respectively. The drugs most commonly used were paliperidone ER, risperidone and olanzapine. 99.8% of patients with improvement measured by GCI at Day 3 and 100% with improvement at Day 5 had improved at discharge. The percentage of patients requiring use of benzodiazepines or physical/mechanical restriction decreased as the days passed.ConclusionsThe three most commonly used drugs during admission were effective, but the action of paliperidone ER is to be noted (its use increased from 4% prior to admission to 43% and 44% during hospital stay and on discharge, respectively). The results of this study appear to confirm that symptom improvement should be obtained as early as the first week of treatment to achieve a shorter hospital stay.
Reasons for relapses in patients with schizophrenia admitted to acute units
Authors: San-Molina L. , Rubio G. , Bernardo-Fernández I. , Miguélez-Fernández S. 
Published: May 2011

IntroductionRelapses are common and a higher number of relapses involve a greater cognitive impairment of the patient. Prevention of relapses is therefore the primary objective of treatment.ObjectivesTo establish why a sample of patients with schizophrenia experience relapses and are admitted to acute units as a result.MethodsA multicenter, naturalistic, retrospective study assessing medical intervention in 1346 patients with schizophrenia admitted to acute units in Spain, assessing the following causes of relapses: non-compliance, lack of efficacy, drug abuse, stress and high incidence of side effects.Results90.8% of patients were admitted for relapse. Reasons for admission were non-compliance in 67.1% (77.2% due to lack of insight and 30.59% due to drug abuse), lack of therapeutic efficacy in 27.2%, and drug abuse in 24.3%. In addition, stress and a high incidence of side effects in 5.8% of patients were other reasons for relapse.ConclusionsNon compliance is the main reason for relapses followed by lack of efficacy. The results appear to confirm that drug abuse might influence in a direct (drug abuse itself) or indirect (non compliance because of drug abuse) way in a higher number of relapses.
Correlation between clinical outcome in the first 5 Days of treatment and on hospital discharge in patients with schizophrenia
Authors: San-Molina L. , Rubio G. , Bernardo-Fernández I. , Miguélez-Fernández S. 
Published: May 2011

IntroductionIn patients with acute clinical symptoms, a short hospital stay and prevalent therapeutic objectives aimed at controlling symptoms overcome the clinician's concern for the functionality levels that will be even more significant after discharge.ObjectivesTo establish the clinical condition of patients admitted to acute/short-stay units in the first five days of hospital stay and on hospital discharge.MethodsA multicenter, naturalistic, retrospective, observational study to evaluate clinical assessment (CGI) obtained in patients with schizophrenia after treatment at the time of admission and on hospital discharge.ResultsThe mean score of the CGI questionnaire decreases from 5.3 recorded on admission to 4.3 on Day 5 and 3 on discharge. On Day 5 of hospital stay, symptoms had improved in 57.3% of cases. In 30.9% of cases there were no changes and in 1.7% symptoms had worsened. In 86.3% of patients symptoms had improved at discharge. 100% of patients with clinical improvement at Day 5 had a clinically significant improvement on hospital discharge.ConclusionsClinical improvement in the first five days after hospital admission appears to lead to a better clinical prognosis on hospital discharge. Hospital discharge should be scheduled from admission, so treatment choice should be geared to looking to control symptoms in the first few days and allow for better social and personal functioning after discharge.
Lost in translation: development and implementation of a metabolic monitoring protocol
Authors: Bizamcer A. , Jagarlamudi K. , MacIntyre K. 
Published: May 2011

IntroductionQuality assurance (QA) interventions are part of the core competencies that psychiatric trainees need to acquire prior to graduation of residency. The process of developing, implementing and monitoring standards of care for patients on antipsychotic medications is a practical illustration of the teaching of QA methods to psychiatric residents.ObjectiveWe will describe the process used by the residents and faculty of the Outpatient Psychiatry Department of Temple University School of Medicine to create and introduce metabolic follow up protocols for patients on antipsychotic medication.AimsWe will present the challenges encountered in this process.MethodsWe will describe the process used to create a monitoring protocol that satisfies expert practice guidelines. In addition, we will examine the social, economic and organizational variables that are a part of our urban outpatient training clinic. We will present the trends of the monthly QA reviews (July 2010 to February 2011). We will introduce the process of identifying and solving obstacles. Finally, we will describe the feedback loops that inform clinicians and faculty about the effectiveness of the QA protocols.ResultsSome of the challenges met include: expert disagreement on the exact particulars of follow-up frequency, patient noncompliance, disparities in health literacy, trainees’ learning curve, changes in medication, and coordination of care among providers.ConclusionTeaching QA is a difficult experiential process that articulates many of the skills acquired by residents in their training, from evidence-based medicine to delivery of care and program evaluation.
The efficacy and safety of the novel antipsychotic cariprazine in acute exacerbation of schizophrenia
Authors: Bose A. , Li D. , Migliore R. , Werner P. , Nemeth G. , Laszlovsky I. 
Published: May 2011

IntroductionCariprazine is a potent D3/D2 partial agonist with preferential binding to D3 receptors.Objectives/aimsTo evaluate the efficacy and safety of cariprazine versus placebo in acute exacerbation of schizophrenia.MethodsA multinational, multicenter, double-blind, randomized, placebo- and active-controlled, fixed-dose trial in patients aged 18–60 years with DSM-IV-TR-defined schizophrenia, current psychotic episode < 2 weeks, and PANSS total score between 80 and 120. After 1-week washout, patients received 6-weeks treatment (cariprazine 1.5, 3.0, or 4.5 mg/d, risperidone 4.0 mg/d, or placebo) and 2-week safety follow-up. Risperidone was used to assess assay sensitivity. Primary and secondary efficacy: baseline to Week 6 change (LOCF) in PANSS total and CGI-S scores, respectively. Safety: adverse events (AEs), vital signs, laboratory measures, extrapyramidal symptom (EPS) scales.ResultsOf 732 randomized patients, 64% completed the study. Mean baseline PANSS (98) and CGI-S scores (4.8) were similar across groups. PANSS total score improvement at Week 6 was statistically significant versus placebo for cariprazine 1.5 mg/d, 3.0 mg/d, and 4.5 mg/d (placebo-adjusted improvements: −7.5, −8.9, −10.4, respectively; P < .001; LOCF) and risperidone (−15.0, P < .001, LOCF); significant improvement on CGI-S was demonstrated for all active treatments (P < .05). The most common cariprazine AEs were insomnia, EPS, akathisia, sedation, nausea, dizziness, and constipation. AE discontinuation rates were 15% for placebo, 10%, 5% and 8% for cariprazine 1.5, 3.0, and 4.5 mg/d, respectively, and 9% for risperidone 4.0 mg/d.ConclusionsCariprazine significantly improved PANSS and CGI-S scores versus placebo in acute exacerbation of schizophrenia and was generally well tolerated.
Impact of a mental illness on diagnosis and management of comorbit medical conditions in hospitalized patients with schizophrenia and bipolar disorder
Authors: Briskman I. , Bar G. , Shargorodsky M. 
Published: May 2011

Co-morbit medical conditions such as hyperglycemia, diabetes, hypertension are frequent in psychiatric patients. Tragically, this population is less likely to receive necessary medical care during hospitalization and has higher rates of morbidity and mortality from medical illnesses when compared with nonpsychiatric population. The present study evaluated for diagnosis and management of comorbit medical conditions in hospitalized patients with and without mental illness.MethodsThe study group consisted of 200 hospitalized subjects, including 100 subjects with schizophrenia and bipolar disorder and 100 age-matched controls. All patients were evaluated for a comorbit conditions, concomitant medication, biochemical parameters (glucose, lipids, CRP) and blood pressure.ResultsTwo groups were similar in terms of age, gender, blood pressure, glucose and lipids. The overall frequency of previously diagnosed medical conditions such as hypertension, dyslipidemia and diabetes was significantly lower in psychiatric patients compared with nonpsychiatric population, regardless of the similar presence of these conditions according NCEP criteria in two groups. Significantly fewer subjects in psychiatric group received aspirin, statins, antihypertensive and antidiabetic medications. Although more obesity was diagnosed in psychiatric patients; significantly less diet intervention has been performed during hospitalization. While significantly more smokers and more pulmonary hospitalization were in psychiatric group, fewer subjects in this group received instruction for smoking cessation compared with nonpsychiatric population.ConclusionsHospitalization is the opportunity to bridge the gap between mental and physical health. However, comorbit medical conditions such as diabetes, hypertension, dyslipidemia and obesity are frequently underdiagnosed and undertreated in hospitalized psychiatric patients compared with nonpsychiatric population.
A case control study: Testing a new technique of rehabilitation in schizophrenia and other psychotic disorders using fiction films
Authors: Garcia del Castillo I. , Caballero Martinez L. , Magariños M. , Martin Calvo M.J. , Pelaez C. , Calero R. , Mateo I. , Diaz R. 
Published: May 2011

IntroductionFiction films offer unexplored support for rehabilitation in patients with schizophrenia and other psychoses. Schizophrenia produces deficits and distortions in perception and understanding of reality, also expressed in the perception and comprehension of films. After two years of experience “ad hoc” we have designed an experimental case-control study in order to study the effectiveness of the proposed technique compared with conventional “cinema-forum”Methodology20 patients treated at the Psychiatric Day Hospital in Puerta de Hierro Hospital (Majadahonda) will participate in the study. Initially, the researcher will collect information on socio-demographic and clinical data of all participants, as well as a written informed consent. There will be an initial assessment using the following instruments:-SCID-PANSS-SCIP (schizophrenia cognitive screening)-Scale GEOPTE (social cognition in schizophrenia)-Social Functioning Scale (SOFAS, PSP)-Scale of disease awareness-IPDE (TP)-Hamilton Scale (anxiety-depression)The material used will be the 12 chapters of the first season of TV series “The Sopranos” by David Chase (2004). Specific techniques of cognitive and affective work are compared against a “cinema-forum”. For the evaluation of the effectiveness of the proposed technique, it will be used a measurement tool designed specifically for the activity, which includes:1.60 item-Scale, specific on each chapter, evaluating:-Attention-Concentration-Memory-Comprehension of the main plot-Comprehension of subplots-Dialogues-Other-Self-identification of deficiencies or errors2. Heteroapplied analogical scales3. Semi-structured qualitative interview
A case of persecutory delusions presenting in a woman with normal pressure hydrocephalus due to idiopathic aqueductal stenosis
Authors: Chatziioannidis S. , Nikolaidis N. , Charatsidou I. , Ramantani E. , Genaris I. , Garyfallos G. , Giouzepas I. 
Published: May 2011

IntroductionNormal pressure hydrocephalus due to idiopathic aqueductal stenosis is an abnormal accumulation of CSF in the cerebral ventricles caused by an obstruction in the Sylvian aqueduct. Although NPH typically presents with the progressive ‘triad’ of cognitive impairment, gait disturbance and urinary incontinence it has been described that it rarely manifests with predominant psychotic symptoms.Objective and methodA clinical case was followed and reviewed to illustrate the psychiatric symptoms in NPH.ResultsA 32-year-old female was admitted to our acute psychiatric department because she exhibited verbal and physical aggressive behavior while being in an agitated state with persecutory delusions. Symptoms appeared and gradually exacerbated over a 5-year period reaching their climax two weeks before admission. The patient's increased body weight and bradykinetic appearance implied the presence of an underlying organic factor. However her endocrinological workup proved normal and her neurological examination revealed no actual focal deficits. An EEG also proved negative for seizure activity and encephalopathy.Neuropsychological batteries showed mild cognitive impairment and a CT scan revealed considerable dilatation of the ventricular system due to idiopathic aqueductal stenosis. While a conservative approach was chosen for the treatment of NPH our patient was initiated on atypical antipsychotics showing marked improvement of her psychiatric symptomatology.ConclusionsPatients without a prior psychiatric history who have soft nonlocalising neurological signs and mild cognitive deficits in association with prominent psychotic symptomatology should raise our index of suspicion and prompt the clinician to explore the existence of an organic factor contributing to a behavioral disorder.
Development and validation of polish version of matrics consensus cognitive battery
Authors: Ciołkiewicz A. , Jędrasik M. , Denisiuk M. , Linke M. , Gruszka A. , Zdunek I. , Jarema M. , Wichniak A. 
Published: May 2011

IntroductionNeurocognitive deficits account for most of the long-term poor functional outcomes of patients with schizophrenia. Effective treatment of cognitive impairment is the most important challenge in the treatment of this disorder.ObjectivesMeasurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Project produced a battery of 10 tests called the MATRICS Consensus Cognitive Battery (MCCB), designed to asses cognitive treatment effects in clinical trials of patients with schizophrenia.MethodsIn this validation study of Polish version of MCCB, 120 patients with schizophrenia will be investigated. 60 of them will be randomly chosen and examined again after 4 week. Altogether MCCB is going to be applied 180 times on 120 patients. The results will be compared with the results of American standardization study of MCCB (MATRICS-PASS).ResultsUntil now 19 patients (12 males, 7 females, mean age 25.63 ± 5.14) have been investigated. Following MCCB T-scores in seven cognitive domains were obtained: attention/vigilance (38.33 ± 9.03), working memory (40.95 ± 14.35), verbal learning (38.11 ± 8.37), visual learning (41.37 ± 10.48), reasoning/problem solving (36.95 ± 10.14), social cognition (35.79 ± 10.67), composite T-score (30.22 ± 12.93).ConclusionsThese preliminary results show that MCCB could be successfully adopted into Polish. After the end of validation process MCCB will be an important research tool in studies aiming at improvement of cognitive functioning in Polish patients with schizophrenia.
Non-adherence to oral antipsychotics in schizophrenia: Relapse and therapeutic strategies in a 12-month observational study
Authors: Ciudad A. , San L. , Bernardo M. , Olivares J.M. , Polavieja P. , Valladares A. , Gilaberte I. 
Published: May 2011

IntroductionNon-adherence influences schizophrenia prognosis.ObjectivesTo describe the clinical profiles, modifications of the therapeutic strategies and relapse rate of patients with schizophrenia who are at risk of non-adherence to oral antipsychotic (AP) medication.MethodsA cohort of 597 outpatients whose therapy was modified because of risk of non-adherence to oral AP was followed during 12 months. Authors used Cox regression to analyse the time to relapse.ResultsPatients’ mean (SD) age was 40.1 (11.1) and time since diagnosis was 15.2 (10.0) years; 64% were males. The clinical condition was at least moderate in most patients (CGI-S score ≥4 in 87%). Baseline AP medication was modified in 506 (85%) patients and non-pharmacological therapies in 190 (32%). In both cases, the main reason for modifications was insufficient efficacy. Concomitant medications were modified in 15%. The proportion of patients in AP monotherapy decreased in favour of polytherapy, and 15% started depot formulations.During 12 months, 90 patients (15%) relapsed. Among relapsing patients, the proportion on monotherapy decreased to 42%, and the depot prescriptions rose to 28%. The risk of relapse was greater among patients with substance use disorder or familial psychiatric antecedents and lower in patients with poor attitude to AP medication or undergoing modifications of their non-pharmacological therapy at baseline.ConclusionsNon-adherence management was focused on improving efficacy and consisted mainly of modifications of oral AP medication. The recognition and treatment, not necessarily pharmacological, of patients with a poor attitude to medication at baseline might explain their lower risk of relapse.
The potential of support vector machine as the diagnostic tool for schizophrenia: A systematic literature review of neuroimaging studies
Authors: Collins M.P. , Pape S.E. 
Published: May 2011

IntroductionSchizophrenia is a relatively common chronic psychotic mental illness, which usually continues throughout life. Current diagnosis is based on a set of psychiatrist-applied diagnostic criteria. There can be considerable differences between diagnostic classification based upon either the set of criteria used, or the individual who applies the criteria. For this reason, the development of an objective test to inform the diagnosis could be highly beneficial.ObjectivesTo assess the use of Support Vector Machine (SVM) as a potential diagnostic tool for schizophrenia, with a particular focus on the application of SVM to Magnetic Resonance Imaging (MRI) data.AimsTo show the use of SVM on MRI data to be a potentially viable diagnostic test.MethodA systematic literature search was carried out using the PubMed database, Web of Knowledge as well as Google Scholar. This search was conducted using the terms ‘Schizophrenia’, ‘SVM’/‘Support Vector Machine’ and ‘MRI/fMRI’. This was followed by the application of criteria relating to relevance to the desired search topic (as assesed by the author). Ten publications were identified as relevant.ResultsResults showed strong evidence that the application of SVM to MRI data can reliably differentiate between patients with schizophrenia and healthy controls.ConclusionsThe results indicate that using SVM to analyse MRI data can be reliably used to identify schizophrenia, although there is some variability between the results produced. The potential of SVM in application to fMRI (as opposed to structural MRI) data is yet to be fully explored.