Predictive factors of functional capacity and real-world functioning in patients with schizophrenia

2015 ◽  
Vol 30 (5) ◽  
pp. 622-627 ◽  
Author(s):  
I. Menendez-Miranda ◽  
M.P. Garcia-Portilla ◽  
L. Garcia-Alvarez ◽  
M. Arrojo ◽  
P. Sanchez ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Functional Capacity ◽  
Real World ◽  
Negative Symptoms ◽  
Social Performance ◽  
Performance Skills ◽  
Predictive Variables ◽  
Syndrome Scale ◽  
Report Data ◽  
Negative Syndrome

AbstractPurposeThis study was performed to identify the predictive factors of functional capacity assessed by the Spanish University of California Performance Skills Assessment (Sp-UPSA) and real-world functioning assessed by the Spanish Personal and Social Performance scale (PSP) in outpatients with schizophrenia.MethodsNaturalistic, 6-month follow-up, multicentre, validation study. Here, we report data on 139 patients with schizophrenia at their baseline visit. Assessment: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S), Sp-UPSA and PSP. Statistics: Pearson's correlation coefficient (r) was used to determine the relationships between variables, and multivariable stepwise linear regression analyses to identify predictive variables of Sp-UPSA and PSP total scores.ResultsFunctional capacity: scores on the PSP and PANSS-GP entered first and second at P < 0.0001 and accounted for 21% of variance (R2 = 0.208, model df = 2, F = 15.724, P < 0.0001). Real-world functioning: scores on the CGI-S (B = −5.406), PANSS-N (B = −0.657) and Sp-UPSA (B = 0.230) entered first, second and third, and accounted for 51% of variance (model df = 3, F = 37.741, P < 0.0001).ConclusionIn patients with schizophrenia, functional capacity and real-world functioning are two related but different constructs. Each one predicts the other along with other factors; general psychopathology for functional capacity, and severity of the illness and negative symptoms for real-world functioning. These findings have important clinical implications: (1) both types of functioning should be assessed in patients with schizophrenia and (2) strategies for improving them should be different.

Amendment of traditional assessment measures for the negative symptoms of schizophrenia

2018 ◽  
Vol 49 ◽  
pp. 50-55 ◽  
Author(s):  
Aida Farreny ◽  
Judith Usall ◽  
Jorge Cuevas-Esteban ◽  
Susana Ochoa ◽  
Gildas Brébion
Keyword(s):  
Verbal Memory ◽  
Regression Models ◽  
Negative Symptoms ◽  
Linear Regression Models ◽  
Illness Duration ◽  
Traditional Assessment ◽  
Syndrome Scale ◽  
Assessment Measures ◽  
Negative Syndrome ◽  
The Relationship

AbstractSchizophrenia research based on traditional assessment measures for negative symptoms appears to be, to some extent, unreliable. The limitations of the Positive and Negative Syndrome Scale (PANSS) and the Scale for the Assessment of Negative Symptoms (SANS) have been extensively acknowledged and should be taken into account. The aim of this study is to show how the PANSS and the SANS conflate negative symptoms and cognition and to offer alternatives for the limitations found.MethodsA sample of 117 participants with schizophrenia from two independent studies was retrospectively investigated. Linear regression models were computed to explore the effect of negative symptoms and illness duration as predictors of cognitive performance.ResultsFor the PANSS, the item “abstract thinking” accounted for the association between negative symptoms and cognition. For the SANS, the “attention” subscale predicted the performance in verbal memory, but illness duration emerged as a stronger predictor than negative symptoms for outcomes of processing speed, verbal and working memory.ConclusionUtilizing alternative models to the traditional PANSS and SANS formats, and accounting for illness duration, provide more precise evidence on the relationship between negative symptoms and cognition. Since these measures are still extensively utilized, we recommend adopting more rigorous approaches to avoid misleading results.

scholarly journals Efficacy and safety of brexpiprazole in patients with schizophrenia presenting with severe symptoms: Post-hoc analysis of short- and long-term studies

2020 ◽  
Vol 34 (8) ◽  
pp. 829-838
Author(s):  
Nicole Meade ◽  
Lily Shi ◽  
Stine R Meehan ◽  
Catherine Weiss ◽  
Zahinoor Ismail
Keyword(s):  
Least Squares ◽  
Social Performance ◽  
Mean Difference ◽  
Syndrome Scale ◽  
Scale Total Score ◽  
Short And Long Term ◽  
Negative Syndrome ◽  
Performance Scale ◽  
Long Term Studies

Background: The treatment of patients with severe schizophrenia symptoms can be complicated and expensive. Aims: The purpose of this study was to evaluate the short- and long-term effects of brexpiprazole in patients with schizophrenia presenting with severe symptoms. Methods: Data were pooled from three six-week, randomized, double-blind, placebo-controlled studies and two 52-week, open-label extension studies. In the short-term studies, 1405 patients received placebo or brexpiprazole 2–4 mg/day; 412 brexpiprazole-treated patients rolled over into the long-term studies and received brexpiprazole 1–4 mg/day. More severe symptoms were defined as a Positive and Negative Syndrome Scale Total score >95 (median score at baseline). Outcomes included change in Positive and Negative Syndrome Scale Total and Personal and Social Performance scale scores. Results: Brexpiprazole improved Positive and Negative Syndrome Scale Total score over 6 weeks among more severely ill patients, with a least squares mean difference versus placebo of −6.76 (95% confidence limits: −9.80, −3.72; p<0.0001; Cohen’s d: 0.43). Brexpiprazole also improved Personal and Social Performance scale score over 6 weeks in more severely ill patients (least squares mean difference: 4.38; limits: 2.14, 6.62; p=0.0001; Cohen’s d: 0.38). Improvement of functioning was greatest in the ‘Self-care’ domain, followed by ‘Personal and social relationships’. Among less severely ill patients, brexpiprazole was superior to placebo on Positive and Negative Syndrome Scale Total and Personal and Social Performance scale at Week 6. Improvements were maintained over 58 weeks. No new safety or tolerability concerns were observed. Conclusions: Brexpiprazole is an efficacious and well-tolerated treatment for schizophrenia in patients with more severe, and less severe, symptoms.

scholarly journals A Two-Factor Model Better Explains Heterogeneity in Negative Symptoms: Evidence from the Positive and Negative Syndrome Scale

2016 ◽  
Vol 7 ◽  
Author(s):  
Seon-Kyeong Jang ◽  
Hye-Im Choi ◽  
Soohyun Park ◽  
Eunju Jaekal ◽  
Ga-Young Lee ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Factor Model ◽  
Syndrome Scale ◽  
Negative Syndrome

scholarly journals Brain-Derived Neurotropic Factor Serum Level and Severity Symptom of Bataknese Male Patients with Schizophrenia in North Sumatera, Indonesia

2019 ◽  
Vol 7 (12) ◽  
pp. 1957-1961
Author(s):  
Deasy Hendriati ◽  
Elemeida Effendy ◽  
Mustafa Mahfud Amin ◽  
Vita Camellia ◽  
Muhammad Surya Husada
Keyword(s):  
Serum Level ◽  
Negative Correlation ◽  
Symptom Severity ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Serum Levels ◽  
Cross Sectional ◽  
Syndrome Scale ◽  
Male Patients ◽  
Negative Syndrome

BACKGROUND: Schizophrenia is a severe mental disorder that is multi-causative and multi-factor, generally affecting about 1% of the population. The elevation level of brain-derived neurotrophic factor (BDNF) offers several protections from other neurodegenerative processes that occur in schizophrenia since this deficit of neurotrophic factors can contribute to changes in brain structure and function that underlie the schizophrenia psychopathology.AIM: To analyse the correlation between BDNF serum levels and symptom severity by using the Positive and Negative Syndrome Scale (PANSS) instrument in Bataknese male patients with schizophreniaMETHODS: This study was a correlative analytical study with a cross-sectional approach using the Positive and Negative Syndrome Scale (PANSS) instrument to assess symptom severity with 60 subjects of Bataknese male patients with chronic schizophrenia. Moreover, this research was conducted at the Psychiatric Hospital of Prof. Dr M. Ildrem Medan, Indonesia. BDNF serum was analysed with the Quantitative sandwich enzyme immunoassay technique by via Quantikine ELISA Human CXCL8/IL-8 HS. Also, the data analysis was performed through Spearman's correlative bivariate analytics using SPSS software.RESULTS: A negative correlation between the BDNF serum level and the negative scale PANSS score in men with schizophrenia (r = -0.820, p < 0.001) was found. Moreover, there is a negative correlation between BDNF serum levels and PANSS total scores in men with schizophrenia (r = -0.648, p < 0.001)CONCLUSION: BDNF serum level in Bataknese male patients with schizophrenia has a relationship that affects the severity of symptoms in schizophrenic patients, especially for negative symptoms.

scholarly journals Tratamento em regime compulsivo ambulatório: estudo de follow-up após um ano em Portugal

2017 ◽  
pp. 21-9
Author(s):  
Sofia Brissos ◽  
Sofia Brissos ◽  
Gonçalo Sobreira ◽  
João Miguel Oliveira ◽  
Zita Gameiro ◽  
...  
Keyword(s):  
Mental Disorder ◽  
Word Association ◽  
Social Performance ◽  
Digit Span ◽  
Association Test ◽  
Word Association Test ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
Performance Scale

Enquadramento: Não existem evidências suficientes relativamente ao impacto do tratamento em regime compulsivo ambulatório (TCA). Objetivos: Avaliámos o impacto do TCA ao longo de um ano em sintomas, funcionamento pessoal e social, insight e cognição. Métodos: Análise naturalística, longitudinal, no início e no follow-up após um ano, de 15 pacientes seguidos numa consulta especializada de TCA. Os pacientes foram submetidos a avaliação estandardizada com o Positive and Negative Syndrome Scale (PANSS) (Escala Positiva e Negativa do Síndroma), Personal and Social Performance Scale (PSP) (Escala de Desempenho Pessoal e Social), Berrios-Markova Scale to Assess Unawareness in Mental Disorder (SUMD) (Escala de Avaliação da Falta de Consciência no Distúrbio Mental), Trails A e B, Digit Span, e o Controlled Oral Word Association Test (COWA) (Teste de Associação Verbal Controlada). Resultados: No follow-up houve melhorias significativas no funcionamento pessoal e social (PSP inicial total: média=46,9; follow-up: média=59,3), e nomeadamente nas atividades socialmente úteis incluindo trabalho e estudos (p=0,012) e relações pessoais e sociais (p=0,033). Três pacientes (20%) pontuaram =>69 no PSP, um bom nível de funcionamento. Porém, não verificámos melhorias significativas nos sintomas (PANSS=56,8), insight subjetivo ou objetivo (Berrios-Markova=10,0 e SUMD=11,0), ou desempenho cognitivo. Conclusões: No follow-up após um ano, os pacientes em TCA revelaram melhorias significativas no funcionamento pessoal e social, especificamente nas atividades socialmente úteis incluindo trabalho e estudos e nas relações pessoais e sociais, mas não registaram melhorias nos sintomas, insight e funcionamento cognitivo.

scholarly journals Socio Demographic Profile and Risperidone Response in New Versus Old Schizophrenia Patients

2020 ◽  
Vol 18 (1) ◽  
pp. 82-85
Author(s):  
Mohan Belbase ◽  
Jyoti Adhikari
Keyword(s):  
Negative Symptoms ◽  
Total Duration ◽  
P Value ◽  
Base Line ◽  
Age Group ◽  
Old Patients ◽  
Syndrome Scale ◽  
Significant Difference ◽  
The Mean ◽  
Negative Syndrome

Introduction: Schizophrenia is a mental disorder characterized with disorganized thinking, perception, expression of reality with significant social and occupational dysfunction. Two groups of drugs are in recent use namely first generation (typicals) and second generation (atypical) antipsychotics. Risperidone is a broad spectrum antipsychotic and has a role as a first-line agent for first break, mild to moderately ill patients and for severely ill treatment–refractory patients. Aims: This article tries to compare the risperidone response in newly diagnosed schizophrenia patients versus old patients already on some antipsychotics other than risperidone. Methods: This is an experimental intervention study of patients attending to psychiatry OPD and indoor in Nepalgunj Medical College, Kohalpur. Total 40 patients (27 new and 13 old) were selected and sample was collected in one year from January 2018 till December 2018. Positive and negative syndrome scale questionnaire was used to record the positive and negative symptoms of schizophrenia on baseline (week 0). Patients were followed up on week 4 and week 8 and the same positive and negative syndrome scale questionnaire was applied to record the improvement. Risperidone was given in therapeutic dose (4-8mg) on the basis of symptoms and improvement. Results: The study subjects were divided into new N=27 (17 male and 10 female) and old N=13 (7 male and 6 female). Maximum number of schizophrenia cases were in age group 15-25 and 35-44 years comprising 30 % in each group. Mean total duration of illness in new group was 23.89 ± 29.51 months (median being 12.0 months) while in old group it was 123.69 ± 83.34 months (median being 96.0 months) with significant difference between two groups (p= <0.001).The mean risperidone dose in milligram on base line (week 0) was 4.15 ±  0.55 for old group while it was 4.04 ± 0.52 for new group. On week 4, the mean dose for old group was 5.08 ± 0.95 while for the new group it was 4.81 ± 1.08. On week 8, the dose for old group was 6.08 ± 1.32 while it was 5.15 ± 1.35 for new group. There was a significant difference in the drug dose on week 8 between old group and new group with p value of 0.047 (statistically significant).  Conclusion: Our study suggests that schizophrenia is found in most productive age group. Risperidone is  effective in both new and old schizophrenia patients however old patients need higher dose of risperidone than new patients.

scholarly journals Symptom Outcome 1 Year after Admission to an Early Psychosis Program

2003 ◽  
Vol 48 (3) ◽  
pp. 204-207 ◽  
Author(s):  
Jean Addington ◽  
Erin Leriger ◽  
Donald Addington
Keyword(s):  
Negative Symptoms ◽  
Depression Scale ◽  
Early Psychosis ◽  
First Episode ◽  
First Year ◽  
Positive Symptoms ◽  
Syndrome Scale ◽  
Assessment Measures ◽  
Symptom Outcome ◽  
Negative Syndrome

Objective: To determine the change in positive, negative, and depressive symptoms after 1 year in an early psychosis program. Method: One hundred and eighty subjects were included from the first 257 admissions for a first episode of psychosis to a comprehensive early psychosis program. Most had a diagnosis of schizophrenia or schizophreniform disorder. Subjects were assessed on admission to the program and at 3, 6, and 12 months after admission. All 180 subjects completed the 1-year assessment. Assessment measures included the Positive and Negative Syndrome Scale and the Calgary Depression Scale for Schizophrenia. Results: There was a clinically and statistically significant improvement in positive symptoms by 3 months, depression increased at 3 months but significantly improved by 12 months, and negative symptoms changed little over the first year. Conclusions: The differential changes in symptoms in the first year after admission have implications for treatment.

scholarly journals Individual differences in schizophrenia

BJPsych Open ◽  
2017 ◽  
Vol 3 (6) ◽  
pp. 265-273 ◽  
Author(s):  
Edmund T. Rolls ◽  
Wenlian Lu ◽  
Lin Wan ◽  
Hao Yan ◽  
Chuanyue Wang ◽  
...  
Keyword(s):  
Individual Differences ◽  
Antipsychotic Medication ◽  
Negative Symptoms ◽  
Unimodal Distribution ◽  
Multiple Episode ◽  
Syndrome Scale ◽  
Before And After ◽  
Motor Retardation ◽  
Negative Syndrome

BackgroundWhether there are distinct subtypes of schizophrenia is an important issue to advance understanding and treatment of schizophrenia.AimsTo understand and treat individuals with schizophrenia, the aim was to advance understanding of differences between individuals, whether there are discrete subtypes, and how fist-episode patients (FEP) may differ from multiple episode patients (MEP).MethodThese issues were analysed in 687 FEP and 1880 MEP with schizophrenia using the Positive and Negative Syndrome Scale for (PANSS) schizophrenia before and after antipsychotic medication for 6 weeks.ResultsThe seven Negative Symptoms were correlated with each other and with P2 (conceptual disorganisation), G13 (disturbance of volition), and G7 (motor retardation). The main difference between individuals was in the cluster of seven negative symptoms, which had a continuous unimodal distribution. Medication decreased the PANSS scores for all the symptoms, which were similar in the FEP and MEP groups.ConclusionsThe negative symptoms are a major source of individual differences, and there are potential implications for treatment.

Carbonyl stress in schizophrenia

2014 ◽  
Vol 42 (2) ◽  
pp. 468-472 ◽  
Author(s):  
Masanari Itokawa ◽  
Mitsuhiro Miyashita ◽  
Makoto Arai ◽  
Toshio Miyata
Keyword(s):  
Vitamin B6 ◽  
Negative Symptoms ◽  
Therapeutic Agent ◽  
Active Form ◽  
Carbonyl Stress ◽  
Research Approach ◽  
Treatment Resistant ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Negative Syndrome

We have identified idiopathic carbonyl stress in a subpopulation of schizophrenic patients. We first identified a patient with a mutation in GLO1 (glyoxalase I) who showed increased AGE (advanced glycation end-product) levels and decreased vitamin B6 levels. By applying the observations from this rare case to the general schizophrenic population, we were able to identify a subset of patients (20%) for whom carbonyl stress may represent a causative pathophysiological process. Genetic defects in GLO1 increase the risk of carbonyl stress 5-fold, and the resulting increased AGE levels correlate significantly with PANSS (Positive and Negative Syndrome Scale) scored negative symptoms. Pyridoxamine, an active form of vitamin B6 and scavenger for carbonyl stress, could represent a novel and efficacious therapeutic agent for these treatment-resistant symptoms. In the present article, we describe a unique research approach to identify the causative process in the pathophysiology of a subset of schizophrenia. Our findings could form the basis of a schizophrenia subtype classification within this very heterogeneous disease and ultimately lead to better targeted therapy.

scholarly journals Prevalence and correlates of antipsychotic polypharmacy among outpatients with schizophrenia attending a tertiary psychiatric facility in Nigeria

2016 ◽  
Vol 7 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Nosa Godwin Igbinomwanhia ◽  
Sunday Osasu Olotu ◽  
Bawo Onesirosan James
Keyword(s):  
Psychosocial Functioning ◽  
Side Effect ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Cross Sectional Study ◽  
Global Assessment Of Functioning ◽  
Psychiatric Facility ◽  
Cross Sectional ◽  
Syndrome Scale ◽  
Negative Syndrome

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.

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