Συχνότητα των ήπιων νευρολογικών σημείων σε ασθενείς με σχιζοφρενικού τύπου ψύχωση

2012 ◽  
Author(s):  
Παναγιώτης Παναγιωτίδης
Keyword(s):  
Trait Anxiety ◽  
Rating Scale ◽  
Depression Scale ◽  
Hand Preference ◽  
T Test ◽  
State Trait Anxiety Inventory ◽  
Greek Version ◽  
Young Mania ◽  
Syndrome Scale ◽  
Negative Syndrome

Η παρά τη κλίνη εξέταση των νευρολογικών διαταραχών, μέσω μίας τυπικής νευρολογικής κλινικής εξέτασης θεωρείται ως μία άμεση και ανέξοδη μέθοδος για την αξιολόγηση της εγκεφαλικής δυσλειτουργίας στη σχιζοφρένεια. Κατά τη διάρκεια των τελευταίων σαράντα ετών οι ερευνητικές εργασίες αναφέρουν συστηματικά την αυξημένη παρουσία των ήπιων νευρολογικών σημείων (ΗΝΣ) στους ασθενείς με σχιζοφρένεια, σε σύγκριση με τον υγιή πληθυσμό ή τους μη-ψυχωτικούς ψυχιατρικούς ασθενείς. Ωστόσο, η λειτουργική τους συσχέτιση παραμένει ασαφής και η ειδικότητά τους έχει συχνά αμφισβητηθεί, αν και υπάρχουν ενδείξεις μίας σχετικής ειδικότητας ως προς τη διάγνωση ή τη συμπτωματολογία. Παράγοντες όπως οι ανεπιθύμητες ενέργειες των νευροληπτικών φαρμάκων, το φύλο, η ηλικία ή το οικογενειακό ψυχιατρικό ιστορικό, θεωρείται ότι επηρεάζουν τα αποτελέσματα της νευρολογικής εκτίμησης, ενώ μόνο ένας σχετικά μικρός αριθμός ερευνών αναφέρει δεδομένα μίας μακροχρόνιας παρακολούθησης των ΗΝΣ σε έναν επαρκή αριθμό ατόμων προκειμένου να αξιολογηθεί μία πιθανή έκπτωση των νευρολογικών λειτουργιών. Η παρούσα μελέτη προσπάθησε να διερευνήσει τη συχνότητα και τη φύση των ΗΝΣ σε ασθενείς με σχιζοφρένεια, καθώς και σε μία ομάδα υγιών μαρτύρων. Στοχεύσαμε στη διερεύνηση των διαφορών μεταξύ των μελετώμενων πληθυσμών και των συσχετίσεων μεταξύ συγκεκριμένων ομάδων νευρολογικών σημείων και κλινικών, κοινωνικοδημογραφικών και θεραπευτικών χαρακτηριστικών του πληθυσμού των ασθενών, κατά την αρχική εκτίμηση, καθώς και μετά την πάροδο δώδεκα μηνών. Συνολικά εντάχθηκαν στη μελέτη 133 νοσηλευόμενοι και εξωτερικοί ασθενείς. Οι διαγνώσεις τέθηκαν βάση της ελληνικής έκδοσης 5.0.0. της σύντομης διεθνούς νευροψυχιατρικής συνέντευξης (Mini International Neuropsychiatric Interview, MINI Greek version 5.0.0.). Επιπλέον, 122 υγιείς μάρτυρες συμπεριλήφθηκαν στη μελέτη και αντιστοιχήθηκαν ως προς το φύλο και την ηλικία με τον πληθυσμό των ασθενών. Όλοι οι ενταχθέντες στη μελέτη υποβλήθηκαν αρχικά σε νευρολογική εξέταση εστιασμένη στη διερεύνηση των ΗΝΣ, βάση της Neurological Evaluation Scale (NES) κλίμακας. Τα εξωπυραμιδικά συμπτώματα εκτιμήθηκαν με τις κλίμακες Simpson-Angus Rating Scale (SARS) και Extrapyramidal Symptoms Rating Scale (ESRS). Τα ανευρεθέντα κλινικά συμπτώματα του πληθυσμού της μελέτης αξιολογήθηκαν με τις κλίμακες Positive And Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), State-Trait Anxiety Inventory form Y (STAI-T and STAI-S) και Young Mania Rating Scale (YMRS). Τέλος, η εκτίμηση της γενικής λειτουργικότητας έγινε βάση των οδηγιών της Αμερικάνικης Ψυχιατρικής Εταιρείας (κλίμακα GAF), ενώ η προτίμηση χρήσης των χεριών εκτιμήθηκε με την κλίμακα Annett Hand Preference Questionnaire (AHPQ). Για λόγους στατιστικής ανάλυσης υιοθετήθηκε τιμή p τέτοια ώστε να είναι επαρκής για πολλαπλές συγκρίσεις και ορίστηκε σε επίπεδο p<0.001. Για την ανάλυση των δεδομένων χρησιμοποιήθηκε το t-test για ένα δείγμα, η δοκιμασία x2, η δοκιμασία t-test για ανεξάρτητα δείγματα και ο συντελεστής συσχέτισης Pearson, όπου αυτό απαιτείτο. Συμπεράσματα: Τα ήπια νευρολογικά σημεία είναι εξαιρετικά συχνά σε ασθενείς με σχιζοφρένεια (90%), ενώ μάλλον σπάνια σε υγιείς μάρτυρες (12%), εύρημα κοινό σε όλες τις υποομάδες στις οποίες κατηγοριοποιούνται. Η παρουσία τους έχει μορφή δομικών χαρακτηριστικών (trait-like), με σταθερότητα στο χρόνο, και είναι ανεξάρτητα από κοινωνικοδημογραφικούς παράγοντες, κλινικά χαρακτηριστικά της νόσου και την υπάρχουσα φαρμακοθεραπεία, αν και η ύπαρξή τους ενδεχομένως υποδεικνύει νόσο με φτωχότερη έκβαση. Δε φαίνεται να επιδεινώνονται με το πέρασμα της ηλικίας, τουλάχιστον μέχρι την ηλικία των 65 ετών.

Use of inhaled loxapine in acute psychiatric agitation

2016 ◽  
Vol 33 (S1) ◽  
pp. s228-s228
Author(s):  
S. Ovejero ◽  
M. Iza ◽  
S. Vallejo ◽  
C. Vera ◽  
A. Sedano ◽  
...  
Keyword(s):  
Rating Scale ◽  
Psychiatric Inpatient ◽  
Physical Restraint ◽  
Inpatient Unit ◽  
Young Mania ◽  
Non Invasive ◽  
Psychiatric Inpatient Unit ◽  
Syndrome Scale ◽  
Competing Interest ◽  
Negative Syndrome

ObjectivesThe aim of this work is to study the efficacy of loxapine inhalation powder on agitated patients in a psychiatric inpatient unit.MethodsNineteen patients sample, with an average age of 39.4 years old, diagnosed with schizophrenia, bipolar disorder or schizoaffective disorder. Patients inhaled loxapine 10 mg, using the staccato system, when they suffered a psychomotor agitation. The clinical efficacy was measured as a change from baseline in the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) and in the Young Mania Rating Scale (YMRS) one hour after the administration of loxapine.ResultsA mean of 9.8 points reduction (22.6 at baseline and 12.7 one hour after the administration) was found on the PANSS-EC (t-test, P < .001) and 68.4% of the patients were considered responders as they obtained a reduction of at least 40% of the basal score. On 10 of the total of the agitated patients showed an improvement of the psychomotor excitement, and this allowed the clinicians to remove the physical restraint; on 6 of the agitated patients the physical restraint could be avoided during the whole treatment; and 3 of the patients experienced a reduction of the excitement. The reduction on PANNS-EC on the latest group was not statistically significant (t-test, P = .121).ConclusionsInhaled loxapine was a non-invasive, rapid and effective alternative treatment for acute agitation in a psychiatric inpatient unit. It resulted more effective on mild and moderate cases; not been significantly effective on the severe cases of agitation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Delusions in a Sample of Patients with Schizophrenia and Bipolar Disorder: The same or different?

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M E Azzam ◽  
M A Hamed ◽  
Y A Elhawary ◽  
A H A Mohammed
Keyword(s):  
Bipolar Disorder ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Psychotic Symptoms ◽  
University Hospitals ◽  
Young Mania ◽  
Syndrome Scale ◽  
Psychotic Features ◽  
Negative Syndrome ◽  
Depressive Episodes

Abstract Background Growing evidences indicate that there is overlapping between schizophrenia (SCZ) and bipolar disorder (BP) in neurobiology, phenomenology or even in changing of diagnosis from schizophrenia to bipolar disorder or vice versa. Psychotic symptoms can be observed during manic or depressive episodes in bipolar disorder. While manic or depressive episodes can be observed between or during psychotic episodes in schizophrenia. Aim of the work To describe delusional types present in both groups of study sample: a group of patients with schizophrenia and a group of patients with bipolar disorder accompanied by psychotic features. Also to compare between types of delusions in patients with schizophrenia and patients with bipolar disorder accompanied by psychotic features. Patients and Methods total 80 patients (40 in group of Schizophrenia and 40 in group of bipolar disorder accompanied by psychotic features) were selected as convenient sampling from patients during the first two weeks of their admission in the Institute of Psychiatry, Ain Shams University Hospitals. Nature and types of the delusions were assessed by using Scale for the Assessment of Negative Symptoms (SANS), Positive and Negative Syndrome Scale (PANSS) and Young Mania Rating Scale (YMRS) in study period from 1st of October 2017 till 1st of April 2018. Results Delusion of persecution is the commonest delusion in group of SCZ (37.5%), while delusion of grandiosity is the commonest delusion in group of BP accompanied by psychotic features (32.5%). Monothematic delusions are doubling frequent in group of BP accompanied by psychotic features (75%) if it compared to group of SCZ (35%). Non systematized delusions are the dominant in group of SCZ (45%) while most delusions in other group are some systematized (45%). Delusions of most patients in group of SCZ are incongruent with mood (77.5%). While delusions of most patients in group of BP accompanied by psychotic features are congruent with mood (65%). The presence of delusion is positively correlated to higher score of: SANS (in both groups), PANSS (in both groups) and YMRS (in BP accompanied by psychotic features). Conclusion delusions of schizophrenia are different in nature and types when it compared to delusions of bipolar disorder.

scholarly journals Duration of untreated psychosis of first-episode psychotic disorders in Yogyakarta, Indonesia

2019 ◽  
Vol 7 (2) ◽  
pp. 61-64
Author(s):  
Carla R. Marchira ◽  
Irwan Supriyanto
Keyword(s):  
Psychotic Disorders ◽  
Rating Scale ◽  
First Episode ◽  
Medical Facility ◽  
Duration Of Untreated Psychosis ◽  
Global Assessment Of Functioning ◽  
Global Functioning ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
Gaf Scores

Introduction: Duration of untreated psychosis (DUP) is an important predictor for prognosis in first episode of psychotic disorders. Caregivers often seek help from alternative healers first and health professional later. These would delay proper treatments for the patients, resulting in more severe symptoms and lower functioning on their visit to medical facility. The present study aims to find the association between DUP, symptoms severity, and global functioning in patients with first-episode psychotic disorders. Methods: We identified 100 patients with first episode of psychotic disorders and their caregivers. The instruments used were Brief Psychotic Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Premorbid Schizoid-Schizotypal Traits (PSST), and Global Assessment of Functioning (GAF). Results: There were no significant association between BPRS, PANSS, PSST, and GAF scores and DUP in our subjects. Nevertheless, we found that men had significantly longer DUP compared to women. Conclusion: We found significant association between sex and DUP in this study. Longer DUP leads to delayed treatments and poorer prognosis. Further study is required to confirm our finding.

Efficacy of Booster Sessions after Training in Assertiveness

1986 ◽  
Vol 62 (3) ◽  
pp. 791-798 ◽  
Author(s):  
Helmut P. R. Riedel ◽  
Catherine R. Fenwick ◽  
C. R. Jillings
Keyword(s):  
Training Program ◽  
Trait Anxiety ◽  
Significant Interaction ◽  
Depression Scale ◽  
State Trait Anxiety Inventory ◽  
Self Rating ◽  
Booster Sessions ◽  
Assertion Training ◽  
Significant Superiority

28 subjects participated in a 6-wk. assertion training program. Of these, 22 remained in the study for a 6-mo. follow-up period, during which half received monthly booster sessions and half did not. Assignment to the booster and no-booster groups was random, with the qualification that subjects were equated on trait anxiety before training in assertiveness. Subjects filled out the Gambrill-Richey Assertion Inventory, the Spielberger State-Trait Anxiety Inventory, and the Zung Self-rating Depression Scale before the 6-wk. assertion training, after this program, at a 3-mo. follow-up, and at a 6-mo. follow-up. It was hypothesized that the booster group would exhibit significant superiority on these measures at the 3-mo. and 6-mo. follow-ups. On all measures both groups significantly improved from before to after the training program with good maintenance throughout the follow-ups. There were no differences between the booster and no-booster groups on the measures of assertiveness and anxiety. However, there was a significant interaction for the depression scores when the booster and no-booster groups were compared from posttreatment to 6-mo. follow-up. The depression scores of subjects in the booster group were lower than the depression scores of subjects in the no-booster group at the 6-mo. follow-up. These results were discussed with suggestions for further research.

Estrogen, menstrual cycle phases, and psychopathology in women suffering from schizophrenia

2007 ◽  
Vol 37 (10) ◽  
pp. 1427-1436 ◽  
Author(s):  
NIELS BERGEMANN ◽  
PETER PARZER ◽  
BENNO RUNNEBAUM ◽  
FRANZ RESCH ◽  
CHRISTOPH MUNDT
Keyword(s):  
Menstrual Cycle ◽  
Rating Scale ◽  
Premenopausal Women ◽  
Psychotic Symptoms ◽  
Cycle Phase ◽  
Syndrome Scale ◽  
Regular Menses ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Negative Syndrome

ABSTRACTBackgroundEstrogen has been hypothesized to have a protective and antipsychotic-like effect in women at risk for schizophrenia. The aim of the present study was to evaluate the association between menstrual cycle and/or estrogen levels and psychotic symptoms in a sample of women with schizophrenia.MethodOne hundred and twenty-five premenopausal women with schizophrenia and regular menses were examined. The levels of 17β-estradiol and other hormones of the gonadal axis were assessed in the follicular, peri-ovulatory, and luteal phases of the menstrual cycle. The effects of the menstrual cycle phase and/or the estradiol level on the Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS) scores were calculated by means of regression analyses.ResultsSignificant improvement in psychotic, but not depressive, symptoms was observed during the luteal phase, compared with other days of the menstrual cycle.ConclusionsThe present findings indicate that estradiol may have specific antipsychotic-like effects on the symptoms of schizophrenia. Thus further investigation into the therapeutic effect of estrogen may be worthwhile.

The psychometric properties of the Greek version of the State-Trait Anxiety Inventory in cancer patients receiving palliative care

2009 ◽  
Vol 24 (10) ◽  
pp. 1215-1228 ◽  
Author(s):  
Kyriaki Mystakidou ◽  
Eleni Tsilika ◽  
Efi Parpa ◽  
Pavlos Sakkas ◽  
Lambros Vlahos
Keyword(s):  
Palliative Care ◽  
Psychometric Properties ◽  
Cancer Patients ◽  
Trait Anxiety ◽  
The State ◽  
State Trait Anxiety Inventory ◽  
Greek Version

Subjective awareness of tardive dyskinesia and insight in schizophrenia

2011 ◽  
Vol 26 (5) ◽  
pp. 293-296 ◽  
Author(s):  
R. Emsley ◽  
D.J.H. Niehaus ◽  
P.P. Oosthuizen ◽  
L. Koen ◽  
B. Chiliza ◽  
...  
Keyword(s):  
Mental Illness ◽  
Tardive Dyskinesia ◽  
Rating Scale ◽  
Subscale Score ◽  
Domain Specific ◽  
Subjective Awareness ◽  
Syndrome Scale ◽  
Mild Impairment ◽  
Negative Syndrome ◽  
Insight Into

AbstractBackgroundLack of awareness of tardive dyskinesia (TD) and poor insight into mental illness are common in schizophrenia, raising the possibility that these phenomena are manifestations of a common underlying dysfunction.MethodsWe investigated relationships between low awareness of TD and poor insight into mental illness in 130 patients with schizophrenia and TD. We also examined selected demographic and clinical correlates of these two phenomena.ResultsSixty-six (51%) patients had no or low awareness of TD and 94 (72%) had at least mild impairment of insight into their mental illness. Low awareness of TD was not significantly correlated with greater impairment of insight into mental illness. Regression analyses indicated that the Positive and Negative Syndrome Scale (PANSS) disorganised factor (β = 0.72, t = 11.88, p < 0.01) accounted for 52% of the variance in insight into mental illness (adjusted R2 = 0.55) (F[2, 127] = 81.00, p < 0.01) and the Extrapyramidal Symptom Rating Scale (ESRS) dyskinesia subscale score (β = 0.47, t = 6.80, p < 0.01), PANSS disorganised factor (β = −0.26, t = −3.73, p < 0.01), and ESRS parkinsonism subscale score (β = 0.31, t = 4.55, p < 0.01) together accounted for 37% of the variance in awareness of TD (adjusted R2 = 0.37) (F[3, 126] = 26.87, p < 0.01).ConclusionThe two phenomena appear to be dissociated, and may be domain-specific.

scholarly journals Evaluation of Anxiety, Depression, and Biological Markers in Health Professionals with Burnout 

Folia Medica ◽  
2021 ◽  
Vol 63 (1) ◽  
pp. 122-128
Author(s):  
Tanya I. Deneva ◽  
Youri P. Ianakiev
Keyword(s):  
Trait Anxiety ◽  
Emotional Exhaustion ◽  
Health Professionals ◽  
Glycated Hemoglobin ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Medical Professionals ◽  
Control Group ◽  
State Trait Anxiety Inventory ◽  
Depressive States

Introduction: Medical profession is a stress factor for the development of burnout, symptoms of anxiety and depression as a result of 24-hour work, delayed work-life balance gratification and challenges associated with patient care.&nbsp; Aim: This study aimed to verify the rates of burnout, anxiety, and depression presented by health professionals working 24-hour shifts under emergency conditions. Saliva cortisol and glycated hemoglobin were also studied as stress-related biomarkers.&nbsp; Materials and methods: Ninety-five medical professionals &ndash; physicians, biologists, chemists, and laboratory technicians were compared to a control group working outside medicine. Burnout was measured by the Maslach Burnout Inventory. Anxiety and depression were measured by the State-Trait Anxiety Inventory and the Zung Depression Scale. Salivary cortisol and glycated hemoglobin were analyzed by the immunoassay methods.&nbsp; Results: The level of burnout in the subscale of emotional exhaustion was high in 95.6% of medical professionals. In the subscale of personal accomplishment, 100% had high scores. Regarding the State-Trait Anxiety Inventory, 22.2% and 68.9% of the medical specialists showed a positive score (&ge;40) for S-anxiety and T-anxiety scale, respectively. 11.1% indicated greater anxiety (score &ge; 55) for T-anxiety. In relation to the depression scale, 31.1% had mildly depressive states and 8.9% had moderately depressive states. Participants with a high level of emotional exhaustion presented higher results for saliva cortisol and glycated hemoglobin compared to the control group. A significant positive correlation existed between the two dimensions - emotional exhaustion and depression (r=0.683, p<0.01). Conclusions: Our study may be relevant for further research in order to decrease the negative aspects of professional stress.

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