Tobacco use in schizophrenia: a study of cotinine concentrations in the saliva of patients and controls

2005 ◽  
Vol 20 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Jan-Erik Strand ◽  
Henrik Nybäck
Keyword(s):  
Tobacco Use ◽  
Negative Symptoms ◽  
Smoking Status ◽  
Psychiatric Patients ◽  
Psychotic Symptoms ◽  
Social Avoidance ◽  
Self Medication ◽  
Symptom Profiles ◽  
Schizophrenic Patients ◽  
Drug Doses

AbstractNicotine has been proposed to provide anxiety relief, oral gratification and self-medication of psychotic symptoms in psychiatric patients. In order to investigate the relations between psychopathology and tobacco use we measured the concentration of cotinine, the major metabolite of nicotine, in the saliva of psychiatric patients and healthy volunteers. In a sample of 42 schizophrenic patients we correlated smoking status, cotinine levels, symptom profiles (PANSS), and neuroleptic side effects (Simpson–Angus). Despite reporting the same amount of cigarettes consumed per day the saliva concentration of cotinine was significantly higher in patients with schizophrenia than in the controls. There were no significant differences in clinical characteristics between smoking and non-smoking schizophrenic patients, but smokers tended to be on higher drug doses. High cotinine concentrations correlated significantly with the negative symptoms Passive withdrawal and Social avoidance. The results indicate that the schizophrenic patients smoke cigarettes more intensely than other patients and healthy subjects. The correlation between high cotinine levels and negative symptomatology may reflect an attempt by schizophrenic patients to overcome the emotional withdrawal and thus the results may lend support to a self-medication hypothesis.

New dopaminergic and non-dopaminergic theories in schizophrenia and their therapeutic impact

1997 ◽  
Vol 9 (2) ◽  
pp. 64-67
Author(s):  
R.S. Kahn
Keyword(s):  
Cognitive Deficits ◽  
Negative Symptoms ◽  
Dopamine Neurons ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
The Core ◽  
Schizophrenic Patients ◽  
Core Symptoms ◽  
Influential Theory

The dopamine (DA) hypothesis of schizophrenia, postulating that schizophrenia is characterized by increased dopamine function, has been the most influential theory on the pathogenesis of schizophrenia. It has recently been revised based on the appreciation that the core symptoms of schizophrenia may not be the positive (psychotic) symptoms, but rather the negative symptoms and the cognitive deficits found in schizophrenic patients. This revision has prompted the hypothesis that schizophrenia is characterized by both decreased prefrontal dopamine activity (causing deficit symptoms) and increased dopamine activity in mesolimbic dopamine neurons (causing positive symptoms).Notwithstanding this revision of a role for dopamine in schizophrenia, it has become increasingly evident that dysfunction of other monoaminergic systems may be as important in contributing to the pathophysiology of schizophrenia. Specifically, the putative role of serotonin (5-hydroxytryptamine, 5-HT) in schizophrenia is gaining considerable attention. Several observations, such as the ability of the 5-HT antagonist, ritanserin, to alleviate schizophrenic symptoms and, when added to haloperidol (Haldol®), to decrease its extrapyramidal side-effects (EPS), have stimulated studies into a role of 5-HT in schizophrenia. The finding that clozapine (Leponex®), clinically superior to conventional neuroleptics, is a weak DA2 antagonist but a potent 5-HT1c and 5-HT2 antagonist has further stimulated 5-HT-related research in schizophrenia.

Symptoms of Psychoses

1995 ◽  
Vol 166 (2) ◽  
pp. 236-240 ◽  
Author(s):  
Toshinori Kitamura ◽  
Yuji Okazaki ◽  
Akira Fujinawa ◽  
Masahiro Yoshino ◽  
Yomishi Kasahara
Keyword(s):  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Current Knowledge ◽  
Psychiatric Patients ◽  
Psychotic Symptoms ◽  
Formal Thought Disorder ◽  
Affective Symptoms ◽  
Five Factors ◽  
Thought Disorders ◽  
Positive And Negative Symptoms

BackgroundThe literature on the statistical analysis of symptoms of psychoses was limited to positive and negative symptoms in schizophrenia. The present study explored the relationship between positive and negative symptoms as well as affective symptoms in a wider category of psychotic disorders.MethodThe symptoms of 584 psychiatric patients, consecutively admitted to any of the 95 mental hospitals in Japan, were studied. They manifested at least one of the following: (a) delusions, (b) hallucinations, (c) formal thought disorder, (d) catatonic symptoms, or (e) negative (defect) symptoms.ResultsFactor analysis yielded five factors interpretable as (a) manic symptoms, (b) depressive symptoms, (c) negative (defect) symptoms and formal thought disorders, (d) positive (psychotic) symptoms, and (e) catatonic symptoms.ConclusionThese results suggest that although major symptoms seen among psychotic patients can be categorised into positive, negative, manic, and depressive groups, corresponding to current knowledge of phenomenology, catatonic symptoms constitute a discrete syndrome, while formal thought disorders merge into the negative syndrome.

scholarly journals Decision analytic economic paliperidone ER in relapsing schizophrenic patients in Italy

2008 ◽  
Vol 9 (2) ◽  
pp. 95-108 ◽  
Author(s):  
Patrizia Berto ◽  
Cristina Negrini ◽  
Luigi Ferrannini
Keyword(s):  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Development Program ◽  
Sensitivity Analyses ◽  
Psychotic Symptoms ◽  
Base Case ◽  
Management Options ◽  
Pharmacological Management ◽  
Clinical Development Program ◽  
Schizophrenic Patients

Schizophrenia, with its typical chronic and relapsing course, is very burdensome, both clinically and economically. Its pharmacological management relies on two main drug classes: the older, or typical, antipsychotics, which are quite effective on positive symptoms, but limited by low tolerability and poor efficacy on negative symptoms, and atypical antipsychotics, which are better tolerated and effective on a wider range of psychotic symptoms. In this article, the authors briefly discuss current management options for patients with schizophrenia and highlight some unmet clinical needs in the field. After outlining the main clinical features shown by paliperidone ER, a novel antipsychotic, in its clinical development program, a decision analytic economic appraisal of its use in relapsing schizophrenic patients in Italy, as compared to the other available atypical antipsychotics, is presented. Under base-case assumption and after applying national costs and tariffs, the model predicts paliperidone ER to be associated with better clinical outcomes, expressed in terms of stable days, and lower costs; this means that paliperidone is dominant over the alternatives, according to the principles of economic evaluation of healthcare technologies. One-way sensitivity analyses conducted on structural and cost parameters indicated robustness of base-case estimates, which remain to be confirmed by “real world” national data.

scholarly journals Symptom Profile of Psychiatric Patients With Psychosis or Psychotic Mood Disorder in Prison

2018 ◽  
Vol 62 (13) ◽  
pp. 4158-4173 ◽  
Author(s):  
J. van Beek ◽  
P. J. Vuijk ◽  
J. M. Harte ◽  
E. J. A. Scherder
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Violent Behavior ◽  
Psychotic Symptoms ◽  
Psychiatric Ward ◽  
Symptom Profile ◽  
Patient Groups ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

There is evidence that psychiatric patients with psychotic or manic disorders who are incarcerated suffer from the same symptoms as psychiatric patients who are treated in the community. There are also indications that their symptoms might be more severe. The aim of this study was to examine the severity of psychotic and manic symptoms, as well as to collect information about the emotional functioning of patients admitted to a prison psychiatric ward. Incarcerated patients with a diagnosis of psychotic or a manic disorder were examined with the Brief Psychiatric Rating Scale–Expanded (BPRS-E). With the scores of 140 assessments, a symptom profile was created using the domains of the BPRS-E. This profile was compared with the clinical profile of three nonincarcerated patient groups described in literature with a diagnosis in the same spectrum. We found high scores on positive and manic psychotic symptoms and hostility, and low scores on guilt, depression, and negative symptoms. High scores on manic and psychotic symptoms are often accompanied by violent behavior. Low scores on guilt, depression, and negative symptoms could be indicative of externalizing coping skills. These characteristics could complicate treatment in the community and warrant further research along with clinical consideration.

scholarly journals Cannabis-associated symptom profiles in patients with first episode psychosis and population controls

2019 ◽  
Author(s):  
Diego Quattrone ◽  
Laura Ferraro ◽  
Giada Tripoli ◽  
Erika La Cascia ◽  
Harriet Quigley ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Experiences ◽  
Study Item ◽  
Heterogeneous Distribution ◽  
Symptom Profiles ◽  
Episode Psychosis

AbstractObjectiveThe evidence is mixed on whether cannabis use is associated with a particular symptomatology in first episode psychosis (FEP) patients.The authors set out to investigate a) patterns of association between cannabis use and transdiagnostic symptom dimensions; b) whether the extent of use of cannabis contributes to the variation in clinical and subclinical symptom profiles.MethodThe authors analysed data from 901 patients and 1235 controls recruited across six countries, as part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. Item response modelling was used to estimate two bifactor models, which included general and specific dimensions of psychotic symptoms in patients and psychotic experiences in controls. The associations between these dimensions and cannabis use was evaluated using linear mixed effects models analyses.ResultsIn patients, there was a linear relationship between the positive symptom dimension and the extent of lifetime exposure to cannabis, with daily users of high potency cannabis having the highest score (B=0.35; 95%CI 0.14 to 0.56). Moreover, negative symptoms were more common among patients who never used cannabis compared with those with any pattern of use (B=-0.27; 95%CI −0.42 to −0.12).In controls, psychotic experiences were associated with current use of cannabis but not with the extent of lifetime use.Neither patients nor controls presented differences in the depressive dimension related to cannabis use.ConclusionsThe extent of use of cannabis explains part of the heterogeneous distribution of positive and negative symptoms of FEP patients.

Relationships Between Smoking, Psychopathology and Medication Outside Effects in Schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S273-S273
Author(s):  
L. Ghanmi ◽  
K. Zitoun ◽  
L. Zouari ◽  
M. Maalej
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Age Of Onset ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Variables ◽  
Extrapyramidal Signs ◽  
Schizophrenic Patients ◽  
Competing Interest

AimTo determine the relationship between smoking status and clinical characteristics of schizophrenic patients.MethodsIt was a cross-sectional study. One hundred and seventy-five schizophrenic outpatients were assessed by the Positive And Negative Syndrome Scale (PANSS), the Global Assessment of Functioning Scale (GAF), the scale of measurement of abnormal involuntary movements (AIMS) and by the rating scale akathisia caused by a drug Thomas Barnes. Current smokers (n = 85) were compared to non-smokers (n = 90) on clinical variables.ResultsThe mean number of cigarettes was 15 cig/day. In our sample, current smokers account for half of the patients and were exclusively men. Smokers were significantly more single patients (76.5 vs. 58.9, P = 0.01). There were no significant differences between smokers and non-smokers regarding clinical variables, including age of onset of the disease, the duration of the disease, the severity of positive and negative symptoms, and GAF scores. Smoking was significantly associated with more frequent prescription of conventional neuroleptics (98.8 vs. 92%, P = 0.03) and poorer adherence to treatment (77 vs. 62.2%, P = 0.02). There were no significant differences between the 2 groups regarding the average doses of neuroleptics, the presence of extrapyramidal signs, scores on the AIMS score and akathisia.ConclusionSmoking is common in patients suffering from schizophrenia. Smoking status should be considered in the assessment of neuroleptic treatment in schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The impact of a history of psychotic symptoms on cognitive function in euthymic bipolar patients: a comparison with schizophrenic patients and healthy controls

2011 ◽  
Vol 33 (4) ◽  
pp. 353-361 ◽  
Author(s):  
Sofia Brissos ◽  
Vasco Videira Dias ◽  
Márcio Gerhardt Soeiro-de-Souza ◽  
Vicent Balanzá-Martínez ◽  
Flavio Kapczinski
Keyword(s):  
Negative Symptoms ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Neurocognitive Performance ◽  
Cross Sectional ◽  
Neurocognitive Dysfunction ◽  
Schizophrenic Patients ◽  
History Of ◽  
Bipolar Patients ◽  
The Impact

BACKGROUND: About two-thirds of patients with bipolar disorder (BD) have a lifetime history of at least one psychotic symptom. Objective: To compare the neurocognitive performance of four groups: BD patients with and without a history of psychotic symptoms (BD HPS+ and BD HPS-, respectively); patients with schizophrenia (SZ); and healthy control (HC) subjects. METHOD: In this cross-sectional study, 35 stabilized patients with SZ, 79 euthymic (44 HPS+ and 35 HPS-) patients with BD, and 50 HC were administered a comprehensive battery of neuropsychological tests. RESULTS: There was worse neurocognitive functioning in both BD and SZ patients compared to HC. Overall, data from both groups of BD patients did not differ on sociodemographic, clinical, or neurocognitive variables. However, BD HPS+ patients had significantly more negative symptoms, as measured by the Positive and Negative Syndrome Scale (PANSS), and showed a trend toward worse performance on executive functions compared to BD HPS- patients. Moreover, both BD groups had better performance on all neurocognitive tests compared to SZ group. CONCLUSIONS: Neurocognitive dysfunction may be more marked in SZ than in BD, yet qualitatively similar. A history of past psychotic symptoms in BD was not associated with more severe cognitive impairment during euthymia. Therefore, BD with psychotic symptoms does not appear to be a distinct neurocognitive phenotype.

A Trial of Two Cognitive-Behavioural Methods of Treating Drug-Resistant Residual Psychotic Symptoms in Schizophrenic Patients: I. Outcome

1993 ◽  
Vol 162 (4) ◽  
pp. 524-532 ◽  
Author(s):  
Nicholas Tarrier ◽  
Richard Beckett ◽  
Sue Harwood ◽  
Amanda Baker ◽  
Lawrence Yusupoff ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Controlled Trial ◽  
Psychotic Symptoms ◽  
Behavioural Treatment ◽  
Treatment Benefit ◽  
Residual Symptoms ◽  
Cognitive Behavioural ◽  
Schizophrenic Patients ◽  
Demand Condition

Despite neuroleptic medication, many schizophrenic patients continue to experience residual positive psychotic symptoms. These residual symptoms cause distress and disability. We report a controlled trial of two cognitive-behavioural treatments to alleviate residual hallucinations and delusions. Forty-nine patients were recruited into the trial, of whom 27 entered the trial and completed post-treatment assessment, and 23 were reassessed at six-month follow-up. Patients were randomly allocated to either coping strategy enhancement (CSE) or problem solving (PS). Half the patients were allocated to a high-expectancy positive demand condition and half to a counterdemand condition to evaluate expectation of improvement. Patients receiving either cognitive-behavioural treatment showed significant reductions in pyschotic symptoms compared with those in the waiting period, who showed no improvement. There was some evidence, although equivocal, that patients receiving CSE improved more than those receiving PS. There was no evidence that improvements generalised to negative symptoms or social functioning, nor was there evidence that expectancy of treatment benefit contributed to the treatment effect.

scholarly journals Impact of Duration of Untreated Psychosis on Cognitive Function in Schizophrenia

2021 ◽  
Vol 10 (1) ◽  
pp. 20
Author(s):  
Rina Krismiati Gani ◽  
Erikavitri Yulianti ◽  
Ifa Tunisya
Keyword(s):  
Cognitive Function ◽  
Negative Symptoms ◽  
Clinical Syndrome ◽  
Psychotic Symptoms ◽  
Duration Of Untreated Psychosis ◽  
Disease Symptoms ◽  
Differences Of Opinion ◽  
Schizophrenic Patients ◽  
Neurodevelopmental Hypothesis ◽  
The Impact

Background: Schizophrenia is a chronic and serious clinical syndrome with very aggravating psychopathology involving perception, cognition, emotion, and behaviour. Currently, cognitive dysfunction is seen as a core disorder of schizophrenia. Duration of Untreated Psychosis (DUP) refers to the period from the onset of psychotic symptoms to the first adequate administration of antipsychotics.Aims: This review aims to analyse the impact of DUP on cognitive function in schizophrenia.Methods: PubMed and Google Scholar were searched using the following keyword: (cognitive function) and (neurodevelopmental OR neurotoxicity hypothesis) and (duration of untreated psychosis or DUP) and (schizophrenia or psychosis or psychotic) using the journal publication filter for the 2014-2020 issue. We also used textbooks published in the last 10 years and were related to writing themes.Review: There are two different opinions about the impact of DUP on the cognitive function of schizophrenic patients: (1) the neurodevelopmental hypothesis says there is no impact of the length of DUP on the cognitive function of schizophrenic patients; (2) the neurotoxicity hypothesis says the length of the DUP will impact the patient's cognitive function. Despite differences of opinion about the impact of DUP on cognitive function in schizophrenia, early intervention in schizophrenic patients is important because DUP is associated with worse general disease symptoms, lower likelihood of remission, more severe positive and negative symptoms, and worse social functioning and overall outcomes.Summary: There are differences of opinion about the impact of DUP on cognitive function in schizophrenic patients.

Cocaine Use and Liability to Psychotic Symptoms

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
E.J. Franzek
Keyword(s):  
Negative Symptoms ◽  
Cocaine Addiction ◽  
Stress Factors ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Cocaine Use ◽  
Cycloid Psychoses ◽  
Schizophrenia Spectrum ◽  
Schizophrenic Patients ◽  
Core Symptoms

In a pilot study with 55 inpatients, primarily admitted for cocaine addiction, the following hypotheses were found: Patients with cocaine addiction and comorbide core schizophrenia (according to Kreapelin, n=17) respond completely different on cocaine use than all other groups of patients including a schizophrenia spectrum group (without core schizophrenia according to Kraepelin). When using cocaine the schizophrenic patients do not experience new psychotic symptoms and existing symptoms do not get worse. Most of them are less bothered of negative symptoms and some of them are, even more, less bothered of positive symptoms. In all other patients with various comorbidity (n=28) and without comorbide psychiatric disorders (n=10) positive psychotic symptoms occur dependent on the dosage of cocaine. In some of them the positive symptoms are also triggered by stress alone. The symptoms occurred in a dosage dependent hierarchical structure: mistrust - delusions of reference with fear - delusions of persecution and illusions with anxiety or panic - threatening voices and noises - disorganized and catatonic behavior.The psychopathology induced by cocaine prooved to be similar to one of the core symptoms of cycloid psychoses.The hypothesis is raised that there is an individual genetically and/or environmentally caused liability to the developing of positive psychotic symptoms under various stress factors including drugs. These reactive psychoses have to be distinguished from schizophrenia. Their relationship to the spectrum of cycloid psychoses is discussed.

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