Schizophrenia spectrum and other psychotic disorders

2015 ◽  
pp. 159-176
Author(s):  
Martin Brüne
Keyword(s):  
Social Life ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Social Withdrawal ◽  
Social Rank ◽  
Signs And Symptoms ◽  
Point Of View ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Motor Abnormalities

Schizophrenia spectrum disorders are characterized by the presence of delusions, hallucination, disorganized thinking, motor abnormalities, and/or negative symptoms. Behaviourally, schizophrenia patients have profound difficulties in regulating approach and avoidance, causing social withdrawal or aggressive behaviour. Evolutionary hypotheses of schizophrenia abound, but none covers all phenotypic aspects of the syndrome(s). Genetic risk for schizophrenia is partly conferred by genes that have undergone positive selection, whereby the reproductive advantage compensating for the reduced fecundity is as yet unknown. Environmental risk factors for schizophrenia comprise poverty, migration, and urbanicity, which has given rise to the hypothesis that individuals with schizophrenia are particularly sensitive to the exposure of strangers. In a more general vein, many signs and symptoms associated with schizophrenia can be interpreted from an evolutionary point of view. They pertain to diverse aspects of social life, including cooperation and trust (paranoia), mating (delusional jealousy, erotomania), and social rank (catatonic stupor, mutism).

Aripiprazole in adolescents with intellectual disabilities and schizophrenia: A case report

2011 ◽  
Vol 26 (S2) ◽  
pp. 271-271
Author(s):  
G. Giannakopoulos ◽  
S. Charitaki ◽  
T. Kotzia ◽  
G. Kolaitis
Keyword(s):  
Intellectual Disabilities ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Schizophrenia Spectrum Disorders ◽  
Symptom Scale ◽  
General Psychopathology ◽  
Schizophrenia Spectrum ◽  
Adolescent Inpatient ◽  
Motor Retardation ◽  
Spectrum Disorders

IntroductionAripiprazole has been shown to be effective in children and adolescents with Schizophrenia spectrum disorders and few adverse effects have been reported. However, little is known about the effectiveness of aripiprazole in the treatment of pediatric patients with Intellectual Disabilities (ID) and Schizophrenia.Aims and objectivesTo expand our knowledge on the use of aripiprazole in treating adolescents with ID for Schizophrenia.MethodsUsing a retrospective review, one female and one male adolescent inpatient (11.5 and 14 years old; Wechsler Scale of Intelligence full intelligence quotient equal to 61 and 38, respectively) with a diagnosis of Schizophrenia received aripiprazole 15 mg/day and were monitored for six weeks. The primary outcome was the Positive and Negative Symptom Scale (PANSS) from baseline to endpoint.ResultsThere was a significant reduction in the overall PANSS score in both adolescents with a marked decrease in negative symptoms (blunted affect, emotional withdrawal, poor rapport, passive/ apathetic social withdrawal, difficulty in abstract thinking, lack of spontaneity and flow of conversation, and stereotyped thinking). Among symptoms of general psychopathology, guilt feelings, motor retardation and poor attention were mostly improved. In both cases, positive and negative subscales showed significant reductions after week four. Female inpatient's weight increased from 49.5 Kg to 50 kg, while male inpatient's weight remained stable (75 kg) during monitoring. No other side effect (e.g. Q-T-corrected interval alterations, hyperprolactinemia, extrapyramidal symptoms) was developed.ConclusionsAripiprazole could be considered as a potential therapeutic agent for adolescents with ID and Schizophrenia, especially when negative symptoms are of major concern.

Suicidality in Schizophrenia Spectrum Disorders: The Relationship to Hallucinations and Persecutory Delusions

2015 ◽  
Vol 30 (7) ◽  
pp. 830-836 ◽  
Author(s):  
E. Kjelby ◽  
I. Sinkeviciute ◽  
R. Gjestad ◽  
R.A. Kroken ◽  
E.-M. Løberg ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Structural Equation ◽  
Suicide Risk ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Psychiatric Ward ◽  
Schizophrenia Spectrum Disorders ◽  
Persecutory Delusions ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

AbstractBackground:Assessment of suicide risk is crucial in schizophrenia and results concerning risk contributed by hallucinations and persecutory delusions are inconsistent. We aimed to determine factors associated with suicidal ideation and plans at the time of acute admission in patients suffering from schizophrenia spectrum disorders.Methods:One hundred and twenty-four patients older than 18 years admitted to an acute psychiatric ward due to psychosis were consecutively included. Predictors of suicidal ideation and suicide plans at the time of admission were examined with multinominal logistic regression and structural equation modelling (SEM). The study design was pragmatic, thus entailing a clinically relevant representation.Results:Depression Odds Ratio (OR) 12.9, Drug use OR 4.07, Hallucinations OR 2.55 and Negative symptoms OR 0.88 significantly predicted Suicidal ideation. Suspiciousness/ Persecution did not. Only Depression and Hallucinations significantly predicted Suicide plans. In the SEM-model Anxiety, Depression and Hopelessness connected Suspiciousness/Persecution, Hallucinations and Lack of insight with Suicidal ideation and Suicide plans.Conclusions:The study contributes to an increasing evidence base supporting an association between hallucinations and suicide risk. We want to emphasise the importance of treating depression and hallucinations in psychotic disorders, reducing hopelessness while working with insight and reducing drug abuse in order to lower suicide risk.Trial registration:ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/NCT00932529.

scholarly journals Acoustic speech markers for schizophrenia-spectrum disorders: a diagnostic and symptom-recognition tool

2021 ◽  
pp. 1-11
Author(s):  
J. N. de Boer ◽  
A. E. Voppel ◽  
S. G. Brederoo ◽  
H. G. Schnack ◽  
K. P. Truong ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Structured Interview ◽  
Diagnostic Value ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum Disorder ◽  
Speech Technology ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Abstract Background Clinicians routinely use impressions of speech as an element of mental status examination. In schizophrenia-spectrum disorders, descriptions of speech are used to assess the severity of psychotic symptoms. In the current study, we assessed the diagnostic value of acoustic speech parameters in schizophrenia-spectrum disorders, as well as its value in recognizing positive and negative symptoms. Methods Speech was obtained from 142 patients with a schizophrenia-spectrum disorder and 142 matched controls during a semi-structured interview on neutral topics. Patients were categorized as having predominantly positive or negative symptoms using the Positive and Negative Syndrome Scale (PANSS). Acoustic parameters were extracted with OpenSMILE, employing the extended Geneva Acoustic Minimalistic Parameter Set, which includes standardized analyses of pitch (F0), speech quality and pauses. Speech parameters were fed into a random forest algorithm with leave-ten-out cross-validation to assess their value for a schizophrenia-spectrum diagnosis, and PANSS subtype recognition. Results The machine-learning speech classifier attained an accuracy of 86.2% in classifying patients with a schizophrenia-spectrum disorder and controls on speech parameters alone. Patients with predominantly positive v. negative symptoms could be classified with an accuracy of 74.2%. Conclusions Our results show that automatically extracted speech parameters can be used to accurately classify patients with a schizophrenia-spectrum disorder and healthy controls, as well as differentiate between patients with predominantly positive v. negatives symptoms. Thus, the field of speech technology has provided a standardized, powerful tool that has high potential for clinical applications in diagnosis and differentiation, given its ease of comparison and replication across samples.

scholarly journals A Randomized Clinical Trial of Oxytocin or Galantamine in Schizophrenia: Assessing the Impact on Behavioral, Lexical, and Self-Report Indicators of Social Affiliation

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Kristen R Dwyer ◽  
Alexandra M Andrea ◽  
Christina L G Savage ◽  
Ryan D Orth ◽  
LeeAnn Shan ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Controlled Trial ◽  
Self Report ◽  
Schizophrenia Spectrum Disorders ◽  
Social Affiliation ◽  
Subjective Responses ◽  
Randomized Controlled ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
The Impact

Abstract Prior studies examining the impact of oxytocin on negative symptoms in schizophrenia have yielded mixed results. The current study explored whether oxytocin can improve more proximal indicators of social affiliation as indicated by changes in behavior, language and subjective indices of social affiliation among individuals with schizophrenia spectrum disorders during a role-play designed to elicit affiliative responses. We tested the hypothesis that daily intranasal oxytocin administered for 6 weeks would improve social affiliation as manifested by increased social skill ratings, use of positive, affiliative, and social words, and subjective responses from a previously published randomized controlled trial. Forty outpatients with schizophrenia or schizoaffective disorder were randomized to the oxytocin, galantamine, or placebo group and completed affiliative role-plays and self-report questionnaires of affect, reactions to the affiliative confederate, and willingness to interact at baseline and post-treatment. Results demonstrated that oxytocin was not effective at improving behavioral or subjective indicators of social affiliation. This study adds to a growing literature that the prosocial effects of oxytocin in schizophrenia are limited or null.

scholarly journals Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders

2013 ◽  
Vol 23 (3) ◽  
pp. 271-279 ◽  
Author(s):  
B. Schrank ◽  
M. Amering ◽  
A. Grant Hay ◽  
M. Weber ◽  
I. Sibitz
Keyword(s):  
Negative Symptoms ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Positive Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Stigma Of Mental Illness ◽  
Relevant Variables ◽  
Spectrum Disorders ◽  
Positive And Negative Symptoms

Aims.Insight, positive and negative symptoms, hope, depression and self-stigma are relevant variables in schizophrenia spectrum disorders. So far, research on their mutual influences has been patchy. This study simultaneously tests the associations between these variables.Methods.A total of 284 people with schizophrenia spectrum disorders were assessed using the Schedule for the Assessment of Insight, Positive and Negative Syndrome Scale, Integrative Hope Scale, Centre for Epidemiological Studies Depression Scale and Internalized Stigma of Mental Illness scale. Path analysis was applied to test the hypothesized relationships between the variables.Results.Model support was excellent. Strong and mutual causal influences were confirmed between hope, depression and self-stigma. The model supported the assumption that insight diminishes hope and increases depression and self-stigma. While negative symptoms directly affected these three variables, reducing hope and increasing depression and self-stigma, positive symptoms did not. However, positive symptoms diminished self-stigma on a pathway via insight.Conclusions.This study provides a comprehensive synopsis of the relationships between six variables relevant for schizophrenia spectrum disorders. Research implications include the need to investigate determinants of consequences of insight, and the sequence of influences exerted by positive and negative symptoms. Clinical implications include the importance of interventions against self-stigma and of taking a contextualized approach to insight.

Independence through Community Access and Navigation in adults with schizophrenia spectrum disorders Part 1: Theoretical and practical foundations

2011 ◽  
Vol 10 (1) ◽  
pp. 25-33
Author(s):  
Gretchen Snethen, PhD, LRT/CTRS ◽  
Bryan P. McCormick, PhD, CTRS ◽  
Marieke Van Puymbroeck, PhD, CTRS
Keyword(s):  
Community Participation ◽  
Negative Symptoms ◽  
World Health ◽  
International Classification Of Functioning ◽  
Population Increase ◽  
Positive Symptom ◽  
Schizophrenia Spectrum Disorders ◽  
Functional Impairments ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Negative symptoms and cognitive dysfunction are two symptomatic categories of schizophrenia spectrum disorders (SSDs) that significantly impair functioning. Treatment for adults with SSDs continues to focus primarily on medication adherence and positive symptom reduction, despite the fact that medication has little impact on negative and cognitive symptoms within this population and, thus, little impact on improving community functioning. This two-part series presents an intervention developed to increase community participation in adults with SSDs. This article presents a comprehensive description of the functional impairments experienced by this population, framed within the World Health Organization’s International Classification of Functioning, Disability, and Health. This article will also apply Self-Determination Theory to this population of adults with SSDs as a foundation to help this population increase community participation and successful integration.

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