scholarly journals Exploring the Relationship Between Movement Disorders and Physical Activity in Patients With Schizophrenia: An Actigraphy Study

2021 ◽  
Author(s):  
Lydia E Pieters ◽  
Jeroen Deenik ◽  
Diederik E Tenback ◽  
Jasper van Oort ◽  
Peter N van Harten
Keyword(s):  
Physical Activity ◽  
Movement Disorders ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Defined Daily Dose ◽  
Clinical Value ◽  
Somatic Comorbidity ◽  
Extrapyramidal Syndromes ◽  
The Relationship

Abstract Low physical activity (PA) and sedentary behavior (SB) are major contributors to mental health burden and increased somatic comorbidity and mortality in people with schizophrenia and related psychoses. Movement disorders are highly prevalent in schizophrenia populations and are related to impaired functioning and poor clinical outcome. However, the relationship between movement disorders and PA and SB has remained largely unexplored. Therefore, we aimed to examine the relationship between movement disorders (akathisia, dyskinesia, dystonia, and parkinsonism) and PA and SB in 216 patients with schizophrenia and related psychoses. Actigraphy, the St. Hans Rating Scale for extrapyramidal syndromes, and psychopathological ratings (PANSS-r) were applied. Data were analyzed using multiple linear regression, adjusting for sex, age, negative symptoms, and defined daily dose of prescribed antipsychotics. Parkinsonism was significantly associated with decreased PA (β = −0.21, P < .01) and increased SB (β = 0.26, P < .001). For dystonia, only the relationship with SB was significant (β = 0.15, P < .05). Akathisia was associated with more PA (β = 0.14, P < .05) and less SB (β = −0.15, P < .05). For dyskinesia, the relationships were non-significant. In a prediction model, akathisia, dystonia, parkinsonism and age significantly predicted PA (F(5,209) = 16.6, P < .001, R2Adjusted = 0.27) and SB (F(4,210) = 13.4, P < .001, R2Adjusted = 0.19). These findings suggest that movement disorders, in particular parkinsonism, are associated with reduced PA and increased SB in patients with psychotic disorders. Future studies should take movement disorders into account when examining PA and SB, to establish the clinical value of movement disorders in activating people with psychotic disorders to improve their mental and somatic health.

Sustained improvement of clinical outcome with risperidone long-acting injectable in psychotic patients previously treated with olanzapine

2005 ◽  
Vol 19 (5_suppl) ◽  
pp. 32-38 ◽  
Author(s):  
M. Gastpar ◽  
M. Masiak ◽  
M. A. Latif ◽  
S. Frazzingaro ◽  
R. Medori ◽  
...  
Keyword(s):  
Movement Disorders ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Patient Adherence ◽  
Symptomatic Improvement ◽  
Good Tolerability ◽  
Previous Medication ◽  
Insufficient Response ◽  
Long Acting

The efficacy and tolerability of risperidone long-acting injectable were investigated in patients with schizophrenia or other psychotic disorders who had previously been symptomatically stable on olanzapine treatment. Patients received risperidone long-acting injectable, 25mg, by intramuscular injection every 2 weeks; the dose could be increased to 37.5 or 50 mg if necessary. Patients were transferred directly from their previous medication to risperidone long-acting injectable without a runin period of oral risperidone treatment. Of 192 patients recruited, 134 patients (70%) completed the study. The principal reasons for discontinuation were withdrawal of consent (8%), adverse events (6%), insufficient response (5%) and non-compliance (4%). Risperidone long-acting injectable produced a significant improvement (p = 0.0001) in Positive and Negative Syndrome Scale (PANSS) total scores, from 74.2±21.3 at baseline to 65.8±21.4 at endpoint. There were also significant reductions in PANSS subscales (positive symptoms, negative symptoms, general psycho-pharmacology) and Marder factor scores. The Clinical Global Impression increased significantly from baseline to endpoint (p = 0.0001), as reflected by the increase in the proportion of patients rated as ‘not ill’ or ‘borderline ill’ from 10% at baseline to 21% at endpoint. Risperidone long-acting injectable was also associated with significant improvements in Global Assessment of Function, patient satisfaction with treatment, and quality of life, measured on the SF-36 scale. Movement disorders, measured on the Extrapyramidal Symptom Rating Scale, were significantly reduced following the change to risperidone long-acting injectable. Treatment with risperidone long-acting injectable was well tolerated, and no significant weight gain occurred during the study. This open study suggests that risperidone long-acting injectable produces symptomatic improvement in schizophrenia patients previously considered symptomatically stable with olanzapine, along with improvement in movement disorders. The combination of improved efficacy and good tolerability may have important implications for patient adherence to therapy and subsequent long-term outcomes.

The Relationship among Television Watching, Physical Activity, and Body Composition of 5- or 6-Year-Old Children

1996 ◽  
Vol 8 (1) ◽  
pp. 15-26 ◽  
Author(s):  
Robert H. DuRant ◽  
William O. Thompson ◽  
Maribeth Johnson ◽  
Tom Baranowski
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Composition ◽  
Rating Scale ◽  
The Body ◽  
Activity Level ◽  
Television Watching ◽  
Activity Rating ◽  
The Relationship

This follow-up investigation examined the relationship among observed time of television watching, physical activity, and body composition in 5- to 6-year-old children previously studied 2 years ago. Activity level on school and nonschool days was measured with the Children’s Activity Rating Scale. Television watching time was assessed by direct observation, and body composition was measured with the body mass index, skinfold thicknesses, and waist/hip ratio. Television watching behavior, which increased from the earlier study, was not associated with body composition. Physical activity was lower during television watching than nontelevision watching time.

scholarly journals Cognitive impairment as a risk factor for psychosis

2005 ◽  
Vol 7 (1) ◽  
pp. 31-38 ◽  
Keyword(s):  
Risk Factor ◽  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Brain Function ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Epidemiological Studies ◽  
Psychotic Symptoms ◽  
Future Research ◽  
The Relationship

Since the time of Kraepelin and Bleuler, it has been recognized that schizophrenia is associated with a profound and persistent cognitive impairment. This paper reviews the major clinical and epidemiological studies of cognitive functioning in schizophrenia and other psychotic disorders, and presents several possible models to explain the association between cognitive impairment and psychosis. Cognitive impairment is present in the majority of patients with schizophrenia, and, in some, it is already evident in the premorbid stages of the disorder. This cognitive impairment is not secondary to psychotic symptoms, negative symptoms, or socioeconomic status. Cognitive impairment can also be observed in nonpsychotic family members of psychotic patients. On the basis of this evidence, it has been proposed that abnormal cognitive functioning can be considered as a possible causal risk factor for psychosis. Recent studies assessing the relationship between genetic background, cognition, brain function, and schizophrenia are presented here as an outline for future research.

scholarly journals Symptom rating scales for schizophrenia and other primary psychotic disorders in ICD-11

2017 ◽  
Vol 27 (3) ◽  
pp. 219-224 ◽  
Author(s):  
J. W. Keeley ◽  
W. Gaebel
Keyword(s):  
Negative Symptoms ◽  
Rating Scales ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Field Testing ◽  
International Classification Of Diseases ◽  
Severity Rating ◽  
Classification Of Diseases ◽  
The Cost ◽  
Symptom Rating

The subtype system for categorising presentations of schizophrenia will be removed from International Classification of Diseases 11th Revision. In its place will be a system for rating six domains of psychotic disorder pathology: positive symptoms, negative symptoms, depressive symptoms, manic symptoms, psychomotor symptoms and cognitive symptoms. This paper outlines the rationale and description of the proposed symptom rating scale, including current controversies. In particular, the scale could adopt either a 4-point severity rating or a 2-point presence/absence rating. The 4-point scale has the advantage of gathering more information, but potentially at the cost of reliability. The paper concludes by describing the field testing process for evaluating the proposed scale.

The Relationship Between Physical Activity Levels and Pain in Children with Juvenile Idiopathic Arthritis

2013 ◽  
Vol 41 (2) ◽  
pp. 345-351 ◽  
Author(s):  
Elizaveta Limenis ◽  
Haddas A. Grosbein ◽  
Brian M. Feldman
Keyword(s):  
Physical Activity ◽  
Juvenile Idiopathic Arthritis ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Activity Level ◽  
Pain Interference ◽  
Activity Levels ◽  
Healthy Children ◽  
Physical Activity Levels ◽  
The Relationship

Objective.Pain and reduced physical activity levels are common in children with juvenile idiopathic arthritis (JIA). Currently, there is no consensus about the role of physical activity in managing pain in JIA. The purpose of our study was to assess the relationship between physical activity level and pain in children ages 11 to 18 years with JIA.Methods.A random sample of 50 patients with JIA were approached by mailed questionnaires. Physical activity was determined using the Physical Activity Questionnaire (PAQ). Pain measures included the Numerical Rating Scale (pain severity), SUPER-KIDZ body diagram (number of painful areas), and the Child Activities Limitations Inventory-21 (pain interference). Generalized linear models were used to assess the relationship between physical activity and pain, as well as the roles of sex and age.Results.The response rate was 84%. Thirty-four respondents completed the questionnaire package. The median age was 15 years. The mean PAQ score was 2.16/5. Physical activity declines with increasing age in youth with JIA (r = 0.53, p = 0.0014). Lower physical activity is associated with greater pain interference (r = 0.39, p = 0.0217) and more severe pain (r = 0.35, p = 0.0422).Conclusion.Children with JIA report significantly less activity than healthy children based on PAQ scores, with physical activity declining throughout adolescence. Physical activity is inversely related to pain interference and severity in children with JIA. Our findings suggest that physical activity interventions may play an important role in the management of pain in JIA.

Duration of untreated psychosis: a critical examination of the concept and its importance

2001 ◽  
Vol 31 (3) ◽  
pp. 381-400 ◽  
Author(s):  
ROSS M. G. NORMAN ◽  
ASHOK K. MALLA
Keyword(s):  
Treatment Outcome ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Critical Examination ◽  
Duration Of Untreated Psychosis ◽  
Relationship Of ◽  
The Relationship

Background. The concept of duration of untreated psychosis (DUP) has recently attracted much interest because of its possible relationship to treatment outcome and implications for preventive efforts with reference to psychotic disorders, especially schizophrenia. In this paper we review critically the literature concerning the concept and its importance.Methods. Articles concerned with measuring DUP and those that have been suggested to provide indirect or direct evidence of the effect of DUP on treatment outcome are reviewed.Results. Evidence thus far suggests that DUP may be related to ease of reducing psychotic symptoms once treatment begins for first episode patients, but there is no evidence of a relationship to likelihood of relapse. There has been little investigation of the relationship of DUP to other long-term outcomes such as negative symptoms and cognitive functioning neither have the possible confounds of DUP been widely investigated or controlled.Conclusions. It is important that there should be more thorough investigations of DUP, its correlates, and the extent to which it does mediate any advantages of earlier intervention.

scholarly journals M119. DECONSTRUCTING PSYCHOSIS AND CROSS-VALIDATING THE R-PAS VARIABLES TARGETING ITS CONSTRUCTS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S180-S180
Author(s):  
Kirsten Buckingham ◽  
Gregory J Meyer ◽  
Emily T O’Gorman ◽  
Joni L Mihura
Keyword(s):  
Interrater Reliability ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Clinical Sample ◽  
Symptom Assessment ◽  
Assessment System ◽  
Hierarchical Regression ◽  
Traditional Measure ◽  
Reality Testing ◽  
The Relationship

Abstract Background Consistent with the contemporary literature that psychosis constructs are best represented as continuous syndromes, this study aims to determine if dimensional psychosis measures outperform traditional categorical measures, thereby improving detection of symptom severity. The Rorschach Performance Assessment System (R-PAS) contains meta-analytically supported internationally normed scales for assessing disordered thinking and reality testing that have been replicated in many countries. Given the literature trend of utilizing a dimensional approach when assessing psychosis, a dimensional R-PAS scale for assessing disordered thinking was recently developed. Therefore, it is important to determine if this new measure outperforms the traditional measure. We also attempt to replicate recent research by deconstructing the key components of psychosis (e.g., disorganized thinking, hallucinations, and negative symptoms) and evaluating the validity of the R-PAS measures designed to assess these constructs. Methods Our study uses an archival clinical sample of 70 male inpatients with schizophrenia, schizoaffective, and major depressive disorder (Mean age = 41.9, Range 20 to 63) that were collected as part of an IRB-approved research project. Two trained diagnosticians independently interviewed the patients using the Structured Clinical Interview for DSM (SCID) and blindly assigned diagnoses as well as Brief Psychiatric Rating Scale (BPRS) ratings. Interrater reliability of their ratings using ICCs will be computed. The Rorschach was administered and relevant R-PAS variables were scored by trained research assistants. The new R-PAS dimensional measure of disorganized thinking (SPCT) will be coded by the first author, and a subset of protocols will be blindly coded by the third author. Interrater reliability will be computed for all variables. Results First, we will conduct correlational analyses to test the relationship between clinician ratings of disorganized thinking (on the BPRS Conceptual Disorganization and relevant SCID criteria) and the traditional measure of disorganized thinking on R-PAS (WSumCog). We will then use hierarchical regression analyses to determine whether the new dimensionalized measure of disorganized thinking (SPCT) provides incremental prediction of the clinician ratings of disorganized thinking on the BPRS and SCID-P over the traditional R-PAS measure (WSumCog). To replicate previous research, we will test the relationship between negative symptom ratings (on the BPRS and SCID) and R-PAS measures of behavioral, perceptual, and emotional task engagement (Complexity & FQ-%). Further, we anticipate that clinician ratings of delusions (on the BPRS and the SCID) will correlate with R-PAS measures of inaccurate understanding of human intention and action (M-) and illogical thinking (SPCT Illogical Thinking subscale). Lastly, we use correlational analyses to test the relationship between clinician ratings of hallucinations (on the BPRS and SCID) and an R-PAS measure of visual misperceptions (FQ-%). Discussion Implications of this research provide additional validation for assessing key components of psychosis with a standardized internationally normed measure. Psychosis components (e.g., poor reality testing) limit the accuracy of patients’ self-reported symptoms and inflate rates of misdiagnosis; these R-PAS measures provide a framework for clinicians to behaviorally assess symptoms on a continuum ranging from nonclinical to severe psychosis-level disturbance. This research will aid in more accurate symptom assessment, thereby improving prognosis and treatment planning.

Dynamic interplay between life events and course of psychotic disorders: 10-year longitudinal study following first admission

2020 ◽  
pp. 1-8
Author(s):  
Kayla R. Donaldson ◽  
Katherine G. Jonas ◽  
Yuan Tian ◽  
Emmett M. Larsen ◽  
Daniel N. Klein ◽  
...  
Keyword(s):  
Life Events ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Negative Events ◽  
First Onset ◽  
Specific Symptoms ◽  
The Impact ◽  
The Relationship ◽  
Reality Distortion ◽  
First Admission

Abstract Background Life events (LEs) are a risk factor for first onset and relapse of psychotic disorders. However, the impact of LEs on specific symptoms – namely reality distortion, disorganization, negative symptoms, depression, and mania – remains unclear. Moreover, the differential effects of negative v. positive LEs are poorly understood. Methods The present study utilizes an epidemiologic cohort of patients (N = 428) ascertained at first-admission for psychosis and followed for a decade thereafter. Symptoms were assessed at 6-, 24-, 48-, and 120-month follow-ups. Results We examined symptom change within-person and found that negative events in the previous 6 months predicted an increase in reality distortion (β = 0.07), disorganized (β = 0.07), manic (β = 0.08), and depressive symptoms (β = 0.06), and a decrease in negative symptoms (β = −0.08). Conversely, positive LEs predicted fewer reality distortion (β = −0.04), disorganized (β = −0.04), and negative (β = −0.13) symptoms, and were unrelated to mood symptoms. A between-person approach to the same hypotheses confirmed that negative LEs predicted change in all symptoms, while positive LEs predicted change only in negative symptoms. In contrast, symptoms rarely predicted future LEs. Conclusions These findings confirm that LEs have an effect on symptoms, and thus contribute to the burden of psychotic disorders. That LEs increase positive symptoms and decrease negative symptoms suggest at least two different mechanisms underlying the relationship between LEs and symptoms. Our findings underscore the need for increased symptom monitoring following negative LEs, as symptoms may worsen during that time.

scholarly journals S172. GLUTAMATE RELATED CONNECTIVITY DISTURBANCES OF THE SALIENCE AND DEFAULT MODE NETWORKS IN PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S102-S103
Author(s):  
Rob McCutcheon ◽  
Toby Pillinger ◽  
Sameer Jauhar ◽  
Fiona Pepper ◽  
Maria Rogdaki ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Network Connectivity ◽  
Anterior Cingulate ◽  
Dopamine Antagonist ◽  
Healthy Controls ◽  
1H Mrs ◽  
Default Mode ◽  
The Relationship

Abstract Background Cortical dysconnectivity and dysfunctional glutamatergic signalling are both implicated in the pathophysiology of psychotic illness. The relationship between these two systems, and the relevance to psychotic disorders remains unknown. Methods 50 individuals with a psychotic disorder and 54 healthy controls received baseline imaging using 1H-MRS to measure anterior cingulate glutamate concentrations, and resting state MRI to characterise functional brain networks. These measures were subsequently repeated following 3 days treatment with either the glutamatergic regulator riluzole (N=36), or a dopamine antagonist (N=14). The network-based statistic was used to examine relationships between glutamate concentrations and connectivity of the salience and default mode networks in patients and controls, and to investigate how this changed following pharmacological manipulation. Results In healthy controls higher baseline anterior cingulate glutamate concentrations were associated with reduced salience network connectivity, particularly for interhemispheric connections. This pattern was not seen in patients, and the greater the divergence from the relationship observed in controls, the greater the severity of negative symptoms. Default mode-salience internetwork connectivity was greater in patients compared to controls, and inversely correlated with baseline glutamate concentrations. Furthermore, riluzole associated changes in glutamate concentrations were associated with an inverse change in internetwork connectivity suggesting a causal relationship. Discussion Individuals with a psychotic disorder showed marked alterations in the relationship between anterior cingulate cortex glutamate concentration and connectivity of the salience and default mode networks. A pharmacological challenge with a glutamate regulating agent modulated this association, highlighting that the relationship is potentially malleable.

scholarly journals Physical Activity as a Predictor of Clinical Trial Outcomes in Bipolar Depression: A Subanalysis of a Mitochondrial-Enhancing Nutraceutical Randomized Controlled Trial

2019 ◽  
Vol 65 (5) ◽  
pp. 306-318 ◽  
Author(s):  
Melanie M. Ashton ◽  
Mohammadreza Mohebbi ◽  
Alyna Turner ◽  
Wolfgang Marx ◽  
Michael Berk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Clinical Trial ◽  
Randomized Controlled Trial ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
The Relationship

Objectives Individuals with bipolar disorder (BD) generally engage in low levels of physical activity (PA), and yet few studies have investigated the relationship between PA and change in BD symptom severity. The aim of this subanalysis of an adjunctive nutraceutical randomized controlled trial for the treatment of bipolar depression was to explore the relationship between PA, the active adjunctive treatments (a nutraceutical “mitochondrial cocktail”), and clinical outcomes. Methods Participants with bipolar depression were randomized to receive N-acetylcysteine alone, N-acetylcysteine with a combination of nutraceuticals (chosen for the potential to increase mitochondrial activity), or placebo for 16 weeks. Participants ( n = 145) who completed the International Physical Activity Questionnaire–Short Form (IPAQ-SF; measured at Week 4) were included in this exploratory subanalysis. Assessments of BD symptoms, functioning, and quality of life were completed at monthly visits up until Week 20. Generalised Estimating Equations were used to explore whether IPAQ-SF scores were a moderator of treatment received on outcomes of the study. Results Week-4 PA was not related to changes in Montgomery Åsberg Depression Rating Scale scores across the study until Week 20. However, participants who engaged in more PA and who received the combination treatment were more likely to have a reduction in scores on the Bipolar Depression Rating Scale ( P = 0.03). However, this was not consistent in all domains explored using the IPAQ-SF. Participants who engaged in higher levels of PA also experienced greater improvement in social and occupational functioning and less impairment in functioning due to their psychopathology and improvement in quality of life at Week 20, irrespective of treatment. Conclusions This study provides novel evidence of the association between PA and reduction in BD symptoms in a nutraceutical clinical trial. However, further research assessing the potential synergistic effects of PA in BD is required.

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