Relapsing versus non relapsing course of schizophrenia: a cohort study in a community based mental health service

2007 ◽  
Vol 16 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Vittorio Di Michele ◽  
Francesca Bolino ◽  
Monica Mazza ◽  
Rita Roncone ◽  
Massimo Casacchia
Keyword(s):  
Predictive Power ◽  
Cox Regression ◽  
Community Based ◽  
Course Of Illness ◽  
Clinical Phase ◽  
Syndrome Scale ◽  
Icd 10 ◽  
Dsm Iv ◽  
Negative Syndrome

SUMMARYAim - We examined the effect of several clinical variables on the tendency to relapse and to require hospitalization in a cohort of patients, living in the community and followed up naturalistically for seven years. Method - Forty-six patients affected by schizophrenia and schizoaffective disorder, according to both DSM-IV and ICD-10 criteria, were assessed by Positive and Negative Syndrome Scale and Life Skills Profile (LSP). All patients consecutively enrolled, were assessed in a stable clinical phase of illness and treated as usual by their reference psychiatrist. Social and clinical outcome was assessed yearly for seven years after the study entry and analyzed with survival analysis. Results - Patients who did not relapse, were characterized by higher functioning, lower positive symptoms, higher ability in self-care and non-turbulence and higher IQ at their baseline clinical evaluation. These variables were entered in a Cox regression model to corroborate the predictive power on the relapsing course of illness. Only IQ and non-turbulence scores of LSP were entered in the equation (Wald method: p=0.007 and p=0.002 respectively). Conclusions - Several factors interact with the course of illness and influence the tendency to require hospitalization. In the present study we report that non-turbulence is a significant predictor of a non-relapsing course of illness. Further studies are needed to clarify the role of other mediating variables.Declaration of Interest: none.

Role of traditional healers in the pathway to care of patients with schizophrenia in Egypt

2020 ◽  
Vol 66 (4) ◽  
pp. 382-388 ◽  
Author(s):  
Mona Ibrahim Awaad ◽  
Nesreen Mohsen Ibrahim ◽  
Rehab Mohamed Naguib ◽  
Sherien Ahmed Khalil ◽  
Mahmoud Elhabiby ◽  
...  
Keyword(s):  
Help Seeking ◽  
Traditional Healers ◽  
Clinical Correlates ◽  
Syndrome Scale ◽  
Seeking Behavior ◽  
Axis I ◽  
Dsm Iv ◽  
Negative Syndrome ◽  
Pathway To Care

Background: Traditional healers are considered one of the important stages in the pathway to care of schizophrenia patients because of the confidence in the system, affordability and accessibility of the service, exposing patients to hazardous management, delay in seeking psychiatric help and bad prognosis. Aim: To assess the pathway to care of schizophrenia patients and role of traditional healers into it, the sociodemographic and clinical correlates of those patients. Methods: We assessed 232 patients with schizophrenia after confirmation of diagnosis with Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I) research version using a questionnaire designed by authors to assess help seeking behavior in schizophrenia patients and its sociodemographic and clinical correlates. Positive and Negative Syndrome Scale to identify the presence and severity of symptoms. Results: A total of 41.8% sought traditional healers first, 58.1% sought a psychiatric consultation first, main symptoms related to traditional healers seeking were hallucinations in 51.5%, delusions 29.9%, 9.28% bizarre behavior and 9.28% formal though disorder. Main causes of traditional healers’ preference were society acceptance 30.39%, affordability 24.74% and accessibility 16.49%. Conclusion: This study shows that a significant percentage of the patients suffering from schizophrenia prefer to approach faith healers first due to their own beliefs, society acceptance, affordability and easy accessibility.

Sinistrality in subtypes of schizophrenia

2002 ◽  
Vol 17 (5) ◽  
pp. 272-277 ◽  
Author(s):  
Sonia Dollfus ◽  
Jacqueline A. Buijsrogge ◽  
Karim Benali ◽  
Pascal Delamillieure ◽  
Perrine Brazo
Keyword(s):  
Negative Correlation ◽  
Language Disorders ◽  
Normal Process ◽  
Deficit Syndrome ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Dsm Iv ◽  
Negative Syndrome ◽  
Hemisphere Specialization

SummarySinistrality, characterized by an excess of non-right-handedness, has been reported in schizophrenic patients, but the findings are controversial.Aim.As sinistrality could be linked to a failure of hemisphere specialization in schizophrenia that would translate into language disorders, sinistrality was found out in disorganized and positive schizophrenic patients characterized by language disorders.Methods.Seventy-three schizophrenic patients (DSM IV) and 81 controls were evaluated with the Edinburgh Handedness Inventory (EHI). Patients were evaluated and classified into five subtypes (deficit, positive, disorganized, mixed and residual) with the Positive and Negative Syndrome Scale and the Schedule for the Deficit Syndrome.Results.Disorganized patients had a significantly more severe sinistrality in comparison to the deficit, residual and mixed subtypes and controls. A negative correlation was found between the disorganization and the EHI scores (r = – 0.34; P < 0.01). A significantly more severe sinistrality was also observed in the positive subtype in comparison to controls, but there was no correlation between hallucinatory and EHI scores (r = 0.06).Conclusion.The findings provided further evidence that the defects in the normal process of lateralization observed in schizophrenia affects primarily disorganized patients.

scholarly journals Measuring memory impairment in community-based patients with schizophrenia

2006 ◽  
Vol 189 (2) ◽  
pp. 132-136 ◽  
Author(s):  
M. M. Al-Uzri ◽  
M. A. Reveley ◽  
L. Owen ◽  
J. Bruce ◽  
S. Frost ◽  
...  
Keyword(s):  
Memory Impairment ◽  
Memory Test ◽  
Reading Test ◽  
Community Based ◽  
Impaired Memory ◽  
Syndrome Scale ◽  
Adult Reading ◽  
National Adult Reading Test ◽  
Negative Syndrome

BackgroundThe majority of memory impairment studies in schizophrenia are cohort studies using laboratory-based tests, which make it difficult to estimate the true extent and relevance of memory impairment in patients with schizophrenia in the community.AimsTo examine the extent of memory impairment in community-based patients with schizophrenia using a clinically relevant test.MethodAll patients with schizophrenia (n = 190) in one catchment area were identified, of whom 133 were potentially eligible for the study; 73 patients volunteered to take part. They were assessed using the Rivermead Behavioural Memory Test (RBMT), the National Adult Reading Test, the Positive and Negative Syndrome Scale, the Health of the Nation Outcome Scales and the Office for National Statistics Classification of Occupation. Their performance on the memory test was compared with that of matched controls (n=71).ResultsPatients as a group performed significantly worse (P < 0.001) than controls on the RBMT. Using the RBMT normative scores, 81% of patients were found to have impaired memory compared with 28% of controls.ConclusionsUsing a clinically relevant test, the majority of community-based patients with schizophrenia may have memory impairment.

scholarly journals En innføring i depresjonsvurdering med PHQ-9

2020 ◽  
Author(s):  
Tomas Formo Langkaas ◽  
Even Rognan ◽  
Sverre Urnes Johnson
Keyword(s):  
Clinical Practice ◽  
Diagnostic Algorithm ◽  
Test Results ◽  
Measurement Instruments ◽  
National Guidelines ◽  
General Introduction ◽  
Icd 10 ◽  
Dsm Iv ◽  
Cutoff Scores

Assessment of depression is a routine task in clinical practice in Norway. National guidelines (Helsedirektoratet, 2009) recommend the use of measurement instruments in assessment of depression. PHQ-9 is widely used in research and practice. The official PHQ-9 manual provides practical guidance on interpreting test results with the use of clinical cutoff scores and a diagnostic algorithm for DSM-IV. With background from clinical practice and research, we summarize and provide guidance on the practical use of PHQ-9 beyond what the official PHQ-9 manual offers, applied to a Norwegian context. We provide a general introduction to diagnostic assessment of depression and the limited role of measurement instruments in such assessments. We describe how the original diagnostic algorithm can be adapted to ICD-10 criteria, we describe how to apply clinical significance to use PHQ-9 as a feedback instrument to monitor treatment progress, and we describe how to interpret results with missing answers. Finally, we discuss the shortcomings of relying on measurement instruments in assessment of depression and conclude that PHQ-9 is better suited in ordinary practice than other instruments recommended in the national guidelines.

scholarly journals The Role of OXT, OXTR, AVP, and AVPR1a Gene Expression in the Course of Schizophrenia

2022 ◽  
Vol 44 (1) ◽  
pp. 336-349
Author(s):  
Marta Broniarczyk-Czarniak ◽  
Janusz Szemraj ◽  
Janusz Śmigielski ◽  
Piotr Gałecki
Keyword(s):  
Gene Expression ◽  
Early Adulthood ◽  
Depression Scale ◽  
Emotional Behavior ◽  
Social And Emotional ◽  
Protein Levels ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
First Time

Schizophrenia is a serious and chronic mental illness, the symptoms of which usually appear for the first time in late adolescence or early adulthood. To date, much research has been conducted on the etiology of schizophrenia; however, it is still not fully understood. Oxytocin and vasopressin as neuromodulators that regulate social and emotional behavior are promising candidates for determining the vulnerability to schizophrenia. The aim of this study was to evaluate the expression of OXT, OXTR, AVP, and AVPR1a genes at the mRNA and protein levels in patients with schizophrenia. Due to the neurodegenerative nature of schizophrenia, the study group was divided into two subgroups, namely, G1 with a diagnosis that was made between 10 and 15 years after the onset of the illness, and G2 with a diagnosis made up to two years after the onset of the illness. Moreover, the relationship between the examined genes and the severity of schizophrenia symptoms, assessed using PANSS (Positive and Negative Syndrome Scale) and CDSS scales (Clinical Depression Scale for Schizophrenia) was evaluated. The analysis of the expression of the studied genes at the mRNA and protein levels showed statistically significant differences in the expression of all the investigated genes. OXT and AVPR1a gene expression at both the mRNA and protein levels were significantly lower in the schizophrenia group, and OXTR and AVP gene expression at both the mRNA and protein levels was higher in the schizophrenia subjects than in the controls. Furthermore, a significant correlation of OXT gene expression at the mRNA and protein levels with the severity of depressive symptoms in schizophrenia as assessed by CDSS was found.

scholarly journals Delirium: the role of psychiatry

2001 ◽  
Vol 7 (6) ◽  
pp. 433-442 ◽  
Author(s):  
David Meagher
Keyword(s):  
Medical Literature ◽  
Classification Systems ◽  
World Health ◽  
Clinical Settings ◽  
Mental Disturbance ◽  
Psychotropic Agents ◽  
Icd 10 ◽  
Dsm Iv ◽  
Health Organization

Acute mental disturbance associated with physical illness is well described in early medical literature, but it was not until 1 AD that Celsus coined the term ‘delirium’ (Lindesay, 1999). Although delirium has many synonyms that are applied in particular clinical settings (Box 1), all acute disturbances of global cognitive functioning are now recognised as ‘delirium’, a consensus supported by both ICD–10 (World Health Organization, 1992) and DSM–IV (American Psychiatric Association, 1994) classification systems. Delirium is a complex neuropsychiatric syndrome that typically involves a plethora of cognitive and non-cognitive symptoms, resulting in a broad differential diagnosis dominated by mental disorders. Psychiatrists' skills in assessing cognitive function and psychopathology, coupled with their knowledge of psychotropic agents, make them well suited to improving detection, coordinating management and facilitating research into this understudied disorder.

scholarly journals Prediction of Clinical Symptoms of Schizophrenia Based on Comt Methylation Marker

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Nour El Huda Abd Rahim ◽  
Mohd Nabil Fikri Rahim ◽  
Norsidah Ku Zaifah ◽  
Hanisah Mohd Noor ◽  
Kartini Abdullah ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Clinical Symptoms ◽  
Comt Gene ◽  
Psychotic Symptoms ◽  
Methylation Marker ◽  
Syndrome Scale ◽  
Dopamine Hypothesis ◽  
Negative Syndrome ◽  
The Relationship

Introduction: The dopamine hypothesis of schizophrenia is based on the fact that hyperdopaminergic state is involved in causing psychosis and antipsychotic drugs block the dopamine receptor. COMT regulates the homeostatic levels of neurotransmitter dopamine in the synapses and plays a role in the neurocognitive function. The dysregulation of dopamine in the prefrontal cortex influences the cognitive function and the severity of the psychotic symptoms in schizophrenia. During epigenetic event, methylated COMT gene may cause reduction in its expression and contribute to the clinical presentation of schizophrenia. Therefore, the aim of this study was to assess the feasibility of using COMT DNA methylation for the prediction of specific psychotic presentation of schizophrenia. Materials and method: In this study, 138 schizophrenia patients were recruited from the Psychiatry Clinic, Hospital Tengku Ampuan Afzan, Kuantan Pahang. Genomic DNA from peripheral blood was subjected to the Methylight Taqman® analysis for quantitative measurement of the COMT DNA methylation. The psychopathological symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Results: The regression analysis showed that the Positive and Excited subdomains of PANSS were significant predictors of COMT hypomethylation (β= -0.288, p= -0.031; β= - 0.288, p= -0.031). The Excited subdomain of PANSS was negatively correlated with COMT DNA methylation (r 2 = -0.380, p= 0.000) as well as the Depressed subdomain (r 2 = -0.288, p= 0.001). Conclusion: The relationship between DNA methylation of COMT with the positive, excited and depressed symptoms might indicate the epigenetic role of COMT gene in the manifestation of schizophrenia.

scholarly journals EEG Microstates and Its Relationship With Clinical Symptoms in Patients With Schizophrenia

2021 ◽  
Vol 12 ◽  
Author(s):  
Qiaoling Sun ◽  
Jiansong Zhou ◽  
Huijuan Guo ◽  
Ningzhi Gou ◽  
Ruoheng Lin ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Positive Symptoms ◽  
Healthy Controls ◽  
Syndrome Scale ◽  
Eeg Data ◽  
Class B ◽  
Icd 10 ◽  
Study Support ◽  
Negative Syndrome ◽  
Electroencephalogram Eeg

Schizophrenia is a complex and devastating disorder with unclear pathogenesis. Electroencephalogram (EEG) microstates have been suggested as a potential endophenotype for this disorder. However, no clear dynamic pattern of microstates has been found. This study aims to identify the dynamics of EEG microstates in schizophrenia and to test whether schizophrenia patients with altered clinical symptoms severity showed different microstates abnormalities compared with healthy controls. Resting-state EEG data in 46 individuals who met the ICD-10 diagnostic criteria for schizophrenia and 39 healthy controls was recorded. The patients with schizophrenia were divided into subgroups based on the level of their negative or positive symptoms assessed using the Positive and Negative Syndrome Scale. Microstate parameters (contribution, occurrence, and duration) of four prototypical microstate classes (A–D) were investigated. Compared with healthy controls, individuals with schizophrenia showed increased duration and contribution of microstate class C, decreased contribution and occurrence of microstate class B. Different microstate patterns were found between subgroups and healthy controls. Results in this study support the consistent observation of abnormal EEG microstates patterns in patients with schizophrenia and highlight the necessity to divide subjects into subgroups according to their clinical symptoms.

scholarly journals Sexual dysfunction: classification and assessment

2013 ◽  
Vol 19 (1) ◽  
pp. 48-55 ◽  
Author(s):  
Dinesh Bhugra ◽  
Gabriele Colombini
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Dysfunctions ◽  
Success Rates ◽  
Medical Interventions ◽  
Assessment And Treatment ◽  
Icd 10 ◽  
Diagnosis And Classification ◽  
Dsm Iv

SummarySexual dysfunction is one of the most common psychiatric disorders, but it is often ignored in assessment. It can be primary or secondary (a result of psychiatric disorder or medication). Success rates in managing sexual dysfunction are relatively high, with good response to psychological and medical interventions. In ICD-10 and DSM-IV-TR, sexual dysfunctions are broadly classified on the basis of the stages of sexual activity, from arousal to orgasm. There are major similarities between ICD and DSM in diagnosis and classification of sexual dysfunction, but both systems raise challenges. These include definitions of what is ‘normal’ and how abnormality is defined. In this article, we describe the role of the two systems and possible amendments that might help researchers and clinicians. We also present key principles for the assessment and treatment of people who experience sexual dysfunction. We consider problems that need to be managed in engaging and in the therapeutic alliance.

Prospective evaluation of neurological soft signs in first-episode schizophrenia in relation to psychopathology: state versus trait phenomena

2003 ◽  
Vol 33 (8) ◽  
pp. 1479-1484 ◽  
Author(s):  
P. WHITTY ◽  
M. CLARKE ◽  
S. BROWNE ◽  
O. McTIGUE ◽  
M. KAMALI ◽  
...  
Keyword(s):  
Clinical Course ◽  
Clinical State ◽  
First Episode ◽  
Neurological Soft Signs ◽  
Syndrome Scale ◽  
Dsm Iv ◽  
A Prospective Study ◽  
First Episode Schizophrenia ◽  
Negative Syndrome

Background. Although patients with schizophrenia have increased rates of neurological soft signs, few studies have examined prospectively their trait or state characteristics in relation to psychopathology.Method. In a prospective study of 97 patients with first-episode schizophrenia (DSM-IV criteria) we assessed neurological soft signs and psychopathology at presentation and at 6 month follow-up for 73 cases. To establish whether soft signs were associated with variations in clinical state, neurological soft signs were measured using two validated examinations (Neurological Evaluation Scale and Condensed Neurological Examination); psychopathology was assessed using the Positive and Negative Syndrome Scale.Results. There was significant improvement in overall neurological function, primarily in motor-related and cortical signs, which were associated with improvement in psychopathology. Conversely, ‘harder’ signs were unrelated to improvement in psychopathology.Conclusions. Neurological soft signs in schizophrenia are heterogenous. Motor and cortical signs evidence state-like characteristics and vary with clinical course, while ‘harder’ signs evidence more static, trait-like characteristics in accordance with a neurodevelopmental basis.

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