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 ◽  
...  

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.

2020 ◽  
Vol 12 (5) ◽  
pp. 24-31
Author(s):  
D. V. Ivashchenko ◽  
S. Z. Khoang ◽  
M. Kh. Tazagulova ◽  
B. V. Makhmudova ◽  
N. I. Buromskaya ◽  
...  

Children and adolescents are more likely than adults to experience adverse side effects when taking antipsychotics. Pharmacogenetic testing allows one to more accurately choose the initial dose of a drug. The genes of pharmacokinetic factors have been shown to be of high prognostic value for the safety of antipsychotics in adults.Patients and methods. The study enrolled 36 adolescents (58.3% male) (mean age, 14.83±1.84 years). All the patients took an antipsychotic. The follow-up lasted 28 days. On 14 and 28 days of treatment, its efficiency and safety were evaluated using the Children's Global Assessment Scale (CGAS), the Positive and Negative Syndrome Scale (PANSS), the Udvalg for Kliniske Undersњgelser Side Effects Rating Scale (UKU-SERS), the Simpson-Angus Scale (SAS), and the Barnes Akathisia Rating Scale (BARS). The patients were genotyped for CYP3A4*22, CYP3A5*3, CYP2D6*4, *9, *10, ABCB1 1236C>T, 2677G>T/A, 3435C>T, DRD2 rs1800497, DRD4 rs1800955, and HTR2A rs6313.Results and discussion. The decrease in the mean score of the PANSS subscale “Productive symptoms” was more pronounced in carriers of the DRD2 rs1800497 polymorphic variant (-6.5 [-10.25; -3.75] vs -3 [-6.5; -2 ] on 14 day (p=0.028) and (-11 [-13; -9.5] vs -5 [-9; -3.5] on 28 day (p=0.001) compared to baseline. The carriage of ABCB1 3435CT+TT was associated with worse tolerance to pharmacotherapy on 14 day (the total score of the UKU-SERS M, 8 [3; 11.75] vs M, 2 [1; 6]; p=0.034). The carriers of DRD2 rs1800497 reported a greater severity of antipsychotic-induced neurological disorders (UKU-SERS subscale score M, 1 [0; 2.25] vs M 0 [0; 1]; p=0.029).Conclusion. The polymorphic variants DRD2 rs1800497 and ABCB1 3435C>T were established to be significantly associated with the efficacy and safety of antipsychotics in adolescents with an acute psychotic episode.


2020 ◽  
Vol 23 (12) ◽  
pp. 775-782
Author(s):  
Areoo Samaei ◽  
Kamyar Moradi ◽  
Sayna Bagheri ◽  
Amir Ashraf-Ganjouei ◽  
Rosa Alikhani ◽  
...  

Abstract Background Patients with schizophrenia can generally manifest a broad variety of primary negative symptoms. The current study aimed to assess the efficacy and tolerability of resveratrol add-on therapy in the treatment of negative symptoms in patients with stable schizophrenia. Methods In a randomized, double-blind, and placebo-controlled setting, schizophrenia patients were assigned to receive either 200 mg/d resveratrol or matched placebo in addition to a stable dose of risperidone for 8 weeks. Patients were assessed using the positive and negative syndrome scale, the extrapyramidal symptom rating scale, and Hamilton Depression Rating Scale over the trial period. The primary outcome was considered as the change in positive and negative subscale score from baseline to week 8 between the treatment arms. Results A total 52 patients completed the trial (26 in each arm). Baseline characteristics of both groups were statistically similar (P  &gt; .05). Despite the statistically similar behavior of positive symptoms between the groups across time (Greenhouse-Geisser corrected: F = 1.76, df = 1.88, P = .180), the resveratrol group demonstrated greater improvement in negative, general psychopathology, and total scores (Greenhouse-Geisser corrected: F = 12.25, df = 2.04, P &lt; .001; F = 5.42, df = 1.56, P = .011; F = 7.64, df = 1.48, P = .003). HDRS scores and its changes, ESRS score, and frequency of other complications were not significantly different between resveratrol and placebo groups. Conclusion Adding resveratrol to risperidone can exhibit remarkable efficacy and safety in terms of management of schizophrenia-related negative symptoms.


2019 ◽  
Vol 7 (2) ◽  
pp. 61-64
Author(s):  
Carla R. Marchira ◽  
Irwan Supriyanto

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.


2007 ◽  
Vol 37 (10) ◽  
pp. 1427-1436 ◽  
Author(s):  
NIELS BERGEMANN ◽  
PETER PARZER ◽  
BENNO RUNNEBAUM ◽  
FRANZ RESCH ◽  
CHRISTOPH MUNDT

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.


2015 ◽  
Vol 27 (4) ◽  
pp. 221-227 ◽  
Author(s):  
Li Su ◽  
Jianxiong Long ◽  
Runde Pan ◽  
Xinfeng Xie ◽  
Xixiang Mao ◽  
...  

BackgroundNRGNis one of the most promising candidate genes for schizophrenia based on function and position. Therefore, this study aimed to examine the genetic association of this polymorphism with schizophrenia in the Zhuang and Han populations of south China.Subjects and methodsA total of 282 patients (188 Han and 94 Zhuang) and 282 healthy subjects (188 Han and 94 Zhuang) were recruited. Of these, 246 schizophrenia patients underwent an assessment of psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS). A TaqMan genotyping assay method was used to determine the genotypes.ResultsWe did not find a significant association of rs12807809 polymorphism with schizophrenia in the total pooled samples, or in the separate ethnic groups. However, in Han schizophrenia patients, quantitative data analyses showed that the CC genotype of the rs12807809 polymorphism was associated with PANSS aggression subscale score and activation subscale score. Furthermore, carriers of the C allele of rs12807809 polymorphism among Han schizophrenia patients had higher scores of general, activation, depression, aggression, and global symptoms than the T allele carriers.ConclusionIn conclusion rs12807809 polymorphism may not contribute to the risk of schizophrenia but influence the clinical symptoms of schizophrenia in the Han population.


2012 ◽  
Author(s):  
Παναγιώτης Παναγιωτίδης

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.


2020 ◽  
Vol 21 (1) ◽  
pp. 56
Author(s):  
Simi Paul ◽  
James Wilson Joseph ◽  
Alok Pratap

Background:Â Around one percent population is affected with Schizophrenia which is a severe mental illness. Typically onset is in late adolescence and remains for a lifetime. Objectives: The current study examined the impact of Empowerment intervention in Schizophrenia. Methods and Materials: This was a quasi-experimental, hospital-based intervention study, used purposive sampling to select 15 patients diagnosed with schizophrenia and admitted in Central Institute of Psychiatry, Ranchi.. Recovery Assessment Scale (RAS), Positive and Negative Syndrome Scale (PANSS) were administered. The study group received 6 sessions of empowerment intervention over a period of one month. Pre-post measurements were taken. Data were analysed using SPSS. Results: Findings suggested significant improvement in personal confidence, willingness, goal, reliance, and positive and negative syndrome than treatment as usual over a period of one month therapy. Conclusion: Empowerment intervention found to be effective in the management of schizophrenia. Findings indicate viable resource and pathways for future development are suggested.


2016 ◽  
Vol 7 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Nosa Godwin Igbinomwanhia ◽  
Sunday Osasu Olotu ◽  
Bawo Onesirosan James

Background: The study aimed to determine the prevalence, pattern and correlates of antipsychotic polypharmacy (APP) among outpatients with schizophrenia attending a tertiary psychiatric facility in Nigeria. Method: A cross-sectional study of 250 patients with schizophrenia attending the outpatient clinic of a regional tertiary psychiatric facility in Nigeria was undertaken. They were administered a sociodemographic questionnaire, the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Liverpool University Side Effects Rating Scale (LUNSERS). Results: Of the 250 subjects interviewed, 176 (70.4%) were on APP. APP was significantly associated with higher prescribed chlorpromazine equivalent doses of antipsychotics ( p < 0.001), increased frequency of dosing ( p < 0.001), negative symptoms ( p < 0.01), poorer functioning ( p = 0.04) and greater side-effect burden ( p = 0.04). Conclusion: The APP rate reported from this study is high. Clinicians should be mindful of its impact on dosage and side-effect profiles as APP use is associated with negative symptoms and poor psychosocial functioning.


2016 ◽  
Vol 33 (S1) ◽  
pp. s228-s228
Author(s):  
S. Ovejero ◽  
M. Iza ◽  
S. Vallejo ◽  
C. Vera ◽  
A. Sedano ◽  
...  

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.


2015 ◽  
Vol 30 (S2) ◽  
pp. S151-S151
Author(s):  
A. Schreiner ◽  
P. Bergmans ◽  
P. Cherubin ◽  
L. Hargarter

ObjectifÉvaluer l’effet du palmitate de palipéridone (PP) à doses flexibles sur les symptômes négatifs, la dépression/anxiété, le fonctionnement et les symptômes extrapyramidaux chez des patients adultes souffrant de schizophrénie non-aiguë, en échec à un traitement par aripiprazole oral.MéthodesÉtude internationale, prospective, en ouvert de 6 mois.ÉvaluationsVariations entre début d’étude (baseline) et dernière observation rapportée sur la PANSS (Positive and Negative Syndrome Scale), la sous-échelle négative de la PANSS, les facteurs de Marder de la PANSS « symptômes négatifs » et « anxiété/dépression », les échelles de fonctionnement PSP (Personal and Social Performance) et Mini-ICF (Mini International Classification of Functioning) et l’échelle ESRS (Extrapyramidal Symptom Rating Scale).RésultatsQuarante-six patients analysés (73,9 % hommes, âge moyen 34,4 ± 9,4 ans, 78,3 % schizophrénie paranoïde). Parmi les patients, 67,4 % ont terminé l’étude. Avant l’inclusion, la dose moyenne d’aripiprazole oral était de 22,7 ± 10,7 mg/jour. Le score de la sous-échelle négative de PANSS s’est significativement amélioré de 20,3 ± 5,0 (baseline) à 17,3 ± 6,1 (fin d’étude) (variation moyenne = −3,0 ± 5,0 ; IC 95 % = −4,4 ; −1,5 ; p < 0,0001), ainsi que les scores des facteurs de Marder « symptômes négatifs » (de 19,5 ± 5,8 à 16,6 ± 5,9 ; IC95 % = −4,5 ; −1,3, p < 0,0001) et « anxiété/dépression » (de 10,3 ± 3,6 à,5 ± 2,9 ; IC95 % = −3,0 ; −0,6, p = 0,0031). Le score ESRS s’est aussi amélioré de manière significative (de −0,6 ± 3,4 ; IC 95 % = −1,6 ; 0,4, p = 0,0456). Le fonctionnement du patient s’est amélioré de manière significative sur les échelles PSP (de 58,9 ± 13,4 à 62,9 ± 15,2, p = 0,041) et Mini-ICF (de 19,0 ± 7,78 à 16,1 ± 9,84 ; IC 95 % −5,1, −0,7 ; p = 0,0079). Le seul événement indésirable sous traitement rapporté chez ≥ 5 patients a été l’anxiété (n = 6).ConclusionsLa transition d’un échec au traitement par aripiprazole oral à un traitement par PP à doses flexibles chez des patients souffrant de schizophrénie non-aiguë a été bien tolérée et s’est traduit par une amélioration significative des symptômes négatifs, dépressifs, anxieux et des symptômes extrapyramidaux, ainsi que du fonctionnement du patient.Traduction de l’abstract résumé présenté au congrès EPA 2015 (European Congress of Psychiatry, Vienna, Austria, 28–31 March 2015)


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