scholarly journals Evaluation of paliperidone on social function in patients with chronic schizophrenia

2018 ◽  
Vol 31 (2) ◽  
pp. e000011
Author(s):  
Yan Gu ◽  
Hong Peng ◽  
Jingjing Dai ◽  
Hui Gao ◽  
Xianghong Yang ◽  
...  

BackgroundThe impairment of social function is widespread in the patients with chronic schizophrenia, which seriously affects family, life and work conditions.AimsThe main purpose of this study was to investigate the efficacy of paliperidone in the treatment of social function in chronic schizophrenia.MethodsA total of 81 patients who met the standard criteria for schizophrenia and long-term hospitalised inpatients were randomly divided into the treatment group and normal control group following a 1- year prospective follow-up study. The reatment group (41 cases) used paliperidone extended-release tablets for reducing dosage, as appropriate, based on the original treatment strategy; and the control group (40 cases) used the former drugs. All patients were assessed using the Positive and Negative Symptom Scales (PANSS), and the Treatment Emergent Symptom Scale (TESS) was used to assess adverse drug reactions. The Hospitalised Psychiatric Patients’ Social Functions Rating Scale (SSPI) was used to assess social function of participants before and after 8  weeks, 6  months and 1 year of treatment.ResultsAt baseline there were no significant differences between the two groups in age, duration of illness, educational background and dosage of antipsychotic drugs (converted into chlorpromazine equivalency). There was statistically significant difference in PANSS positive symptoms by interaction effect (Fgroup×time=18.24, df=3237, p<0.001) and time effect (Ftime=21.66, df=3, p<0.01) and the difference in PANSS positive symptoms by grouping effect (Fgroup=0.68, df=1, p=0.41) was not statistically significant. The difference of grouping effect of PANSS negative symptoms (Fgroup=9.93, df=1, p=0.002), time effect (Ftime=279.15, df=3, p<0.001) and interaction effect (Fgroup×time=279.15, df=3237, p<0.001) were statistically significant. There were statistically significant differences in the grouping effect (Fgroup=6.59, df=1, p=0.012), time effect (Ftime=152.97, df=3, p<0.001) and interaction effect (Fgroup×time=148.82, df=3237, p<0.001) of PANSS general pathological symptoms, the same as the total score of the PANSS, which showed large differences in grouping effect (Fgroup=7.04, df=1, p=0.001), time effect (Ftime=210.78, df=3, p<0.001) and interaction effect (Fgroup×time=205.20, df=3237, p<0.01). We found in the total SSPI score, grouping effect (Fgroup=31.70, df=1, p<0.001), time effect (Ftime=161.84, df=3, p<0.001) and interaction effect (Fgroup×time=132.74, df=3237, p<0.001) were demonstrated to be significantly different. Even though adverse reactions occurred 7 times in the treatment group and 44 times in the control group based on the Treatment Emergent Symptom Scale (TESS), incidence rate was significantly lower than that of the control group (χ²=18.854, p<0.001).ConclusionPaliperidone can safely and effectively improve negative symptoms and social function in patients with chronic schizophrenia.

1992 ◽  
Vol 160 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Elizabeth J. B. Davis ◽  
Milind Borde ◽  
L. N. Sharma

Cognitive impairment, negative and positive symptoms, primitive release reflexes, and age/temporal disorientation were assessed in 20 male patients meeting the DSM–III–R criteria for chronic schizophrenia and Schooler & Kane's criteria for TD. The control group comprised 20 age-matched male chronic schizophrenic patients without TD. Significant associations were found between TD, cognitive impairment, some negative symptoms, and formal thought disorder. These associations were independent of other illness and treatment variables. The severity of TD correlated significantly with that of cognitive impairment.


2001 ◽  
Vol 29 (1) ◽  
pp. 45-55 ◽  
Author(s):  
Nicholas Tarrier ◽  
Caroline Kinney ◽  
Ellis McCarthy ◽  
Anja Wittkowski ◽  
Lawrence Yusupoff ◽  
...  

Results are presented from a randomized controlled trial indicating which psychotic symptoms respond to cognitive behaviour therapy. The aim of the study was to investigate whether different types of psychotic symptoms are more or less responsive to cognitive-behaviour therapy compared to treatment received by control groups. Seventy-two patients suffering from chronic schizophrenia who experienced persistent positive psychotic symptoms were assessed at baseline and randomized to either cognitive-behaviour therapy and routine care, supportive counselling and routine care, or routine care alone and were re-assessed after 3 months of treatment (post-treatment). Independent and blind assessment of outcome indicated delusions significantly improved with both cognitive behaviour therapy and supportive counselling compared to routine care. Hallucinations significantly decreased with cognitive-behaviour therapy compared to supportive counselling. There was no difference in the percentage change of hallucinations compared to delusions in patients treated by cognitive behaviour therapy. There was little change in measures of affective symptoms but there was no evidence that a reduction in positive symptoms was associated with an increase in depres sion. In fact, a reduction in positive symptoms was positively correlated with a reduction in depression. There were significant differences in the reductions in thought disorder and negative symptoms with an advantage of cognitive-behaviour therapy compared to routine care.


2020 ◽  
pp. 1-8 ◽  
Author(s):  
Lisa A. Bartolomeo ◽  
Hannah C. Chapman ◽  
Ian M. Raugh ◽  
Gregory P. Strauss

Abstract Background Schizophrenia (SZ) is typically preceded by a prodromal (i.e. pre-illness) period characterized by attenuated positive symptoms and declining functional outcome. Negative symptoms are prominent among individuals at clinical high-risk (CHR) for psychosis (i.e. those with prodromal syndromes) and highly predictive of conversion to illness. Mechanisms underlying negative symptoms in the CHR population are unclear. Two studies were conducted to evaluate whether abnormalities in a reward processing mechanism thought to be core to negative symptoms in SZ, value representation, also exist in CHR individuals and whether they are associated with negative symptoms transphasically. Methods Study 1 included 33 individuals in the chronic phase of illness who have been diagnosed with schizophrenia or schizoaffective disorder (SZ) and 40 healthy controls (CN). Study 2 included 37 CHR participants and 45 CN. In both studies, participants completed the delay discounting (DD) task as a measure of value representation and the Brief Negative Symptom Scale was rated to measure negative symptoms. Results Results indicated that patients with SZ had steeper discounting rates than CN, indicating impairments in value representation. However, CHR participants were unimpaired on the DD task. In both studies, steeper discounting was associated with greater severity of negative symptoms. Conclusions These findings suggest that deficits in value representation are associated with negative symptoms transphasically.


2015 ◽  
Vol 45 (10) ◽  
pp. 2031-2043 ◽  
Author(s):  
J. Ventura ◽  
A. Ered ◽  
D. Gretchen-Doorly ◽  
K. L. Subotnik ◽  
W. P. Horan ◽  
...  

BackgroundNumerous studies have reported links between theory of mind (ToM) deficits, neurocognition and negative symptoms with functional outcome in chronic schizophrenia patients. Although the ToM deficit has been observed in first-episode patients, fewer studies have addressed ToM as a possible trait marker, neurocognitive and symptom correlations longitudinally, and associations with later functioning.MethodRecent-onset schizophrenia patients (n = 77) were assessed at baseline after reaching medication stabilization, and again at 6 months (n = 48). Healthy controls (n = 21) were screened, and demographically comparable with the patients. ToM was assessed with a Social Animations Task (SAT), in which the participants’ descriptions of scenes depicting abstract visual stimuli ‘interacting’ in three conditions (ToM, goal directed and random) were rated for degree of intentionality attributed to the figures and for appropriateness. Neurocognition, symptoms and role functioning were also assessed.ResultsOn the SAT, patients had lower scores than controls for both intentionality (p < 0.01) and appropriateness (p < 0.01) during the ToM condition, at baseline and 6 months. The ToM deficit was stable and present even in remitted patients. Analyses at baseline and 6 months indicated that for patients, ToM intentionality and appropriateness were significantly correlated with neurocognition, negative symptoms and role functioning. The relationship between ToM and role functioning was mediated by negative symptoms.ConclusionsThe ToM deficit was found in recent-onset schizophrenia patients and appears to be moderately trait-like. ToM is also moderately correlated with neurocognition, negative and positive symptoms, and role functioning. ToM appears to influence negative symptoms which in turn makes an impact on role functioning.


1994 ◽  
Vol 24 (4) ◽  
pp. 869-884 ◽  
Author(s):  
B. Schmand ◽  
T. Kuipers ◽  
M. Van Der Gaag ◽  
J. Bosveld ◽  
F. Bulthuis ◽  
...  

SynopsisThe problem of a possible lack of motivation to perform cognitive tasks, which is often encountered in psychotic patients, has been approached from the perspective of the ‘energetics’ of cognition (Hockey et al. 1986) and from the broader clinical context of psychosis as an ‘amotivational syndrome’ and its related negative symptoms.The presence of motivational deficits was investigated in a group of psychotic in-patients (N = 73, and 40 had schizophrenia) compared with a control group of non-psychotic psychiatric in-patients (N = 23). The motivational deficit was operationalized in terms of Sanders's (1983) cognitive–energetic model as a large effect of ‘time-on-task’ during a simple, monotonous reaction test. Significantly more psychotic patients than control patients showed evidence of this type of motivational deficit. The deficit appeared to be related with negative but not with positive symptoms of psychosis. Furthermore, the deficit was shown to be related to the cognitive disorders of psychosis, which have been amply documented in the literature, i.e. disorders of vigilance, verbal memory and distractibility. These results suggest that the cognitive disorders of psychosis are not of a ‘computational’ but of an ‘energetical’, i.e. motivational nature.


2020 ◽  
Author(s):  
Ziyan Li ◽  
Yanzhe Ning ◽  
Pei Chen ◽  
Yi Zhang ◽  
Dongqing Yin ◽  
...  

Abstract BackgroundAt present, the focus and difficulty of schizophrenia (SCZ) treatment is to improve cognitive function and negative symptoms. Jie-du-qing-nao granules(JQG) , a traditional Chinese medicine(TCM) prescription , has a good clinical effectiveness in enhancing the cognition and negative symptoms of patients with SCZ. However, its clear effectiveness and safety have not been adequately supported by clinical studies. The main objective of this study is to explore the efficacy and safety of JQG for first-episode schizophrenics.Methods/designThis trial is a prospective, randomized, single-centered, parallel-controlled clinical study with double-blind design. A total of 96 eligible participants will be randomly assigned to either the study group or the control group in a ratio of 1:1. Participants allocated to the study group will receive JQG and aripiprazole, control group will receive placebo and aripiprazole. The treatment course will last 12 weeks, with follow-up every 4 weeks. Outcome measurements include Positive and Negative Syndrome Scale (PANSS), self face test , MATRICS Consensus Cognitive Battery (MCCB), TNFα, IL-6, IL-1β, BDNF, vital signs, complete blood count, liver and kidney function tests, urinalysis, and electrocardiograph. Adverse reactions will be evaluated using the Treatment Emergent Symptom Scale (TESS).DiscussionThis study will provide evidence for the efficacy and safety of JQG as a complementary approach, which can be initiated following with antipsychotics therapy. Trial registration Chinese Clinical Trial Registry, ID: ChiCTR1900028250 . Registered on December 16, 2019, http://www.chictr.org.cn/edit.aspx?pid=41880&htm=4 .


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S316-S316
Author(s):  
Luca Carlone ◽  
Marianna Frascarelli ◽  
Antonino Buzzanca ◽  
Tommaso Accinni ◽  
Francesco Ghezzi ◽  
...  

Abstract Background 22q11DS is the most common microdeletion with an incidence of 1:4000 live births. It is considered a genetic biological model for psychosis vulnerability: 25–28% of 22q11DS adults is affected by a psychotic disorder. Few data are available regarding functioning in 22q11DS. Our aim was to test the hypothesis that functioning is similar in 22q11DS psychotic and non-psychotic patients, and idiopathic schizophrenic subjects. We expected also a correlation between negative symptoms and functioning. Methods Data come from Italian Network for Research on Psychoses for the Schizophrenic (SCZ, N=252) and Control groups (HC, N=110). 22q11DS psychotic (22q11DS_SCZ, N=21) and non-psychotic patients (22q11DS, N=23) were enrolled at Policlinico Umberto I, in Rome. The SLOF scale (Specific Levels of Functioning) and the Brief Negative Symptom Scale interview (BNSS) were employed. Results The Global Functioning was significantly different between all groups but not between 22q11DS groups and SCZ. The multivariate analysis of variance showed the higher effect size for the Interpersonal Functioning, in which differences resulted significant between all groups, except for the comparison between 22q11DS-SCZ and SCZ. Differences between groups in BNSS were significant except for the post-hoc 22q11DS-SCZ vs SCZ. Global and Interpersonal Functioning showed a significant negative correlation with BNSS scores in the three clinical groups. Discussion 22q11DS-SCZ showed a severe deficit in Interpersonal Functioning, similar to that of idiopathic schizophrenia. 22q11DS showed a deficit in Interpersonal Functioning respect to control group, but less severe than psychotic groups. Our data suggest a common impairment shared among the clinical groups, that may be the functional correlate of an underlying neurobiological mechanism.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Lucy D. Vanes ◽  
Elias Mouchlianitis ◽  
Krisna Patel ◽  
Erica Barry ◽  
Katie Wong ◽  
...  

Abstract Psychotic illness is associated with cognitive control deficits and abnormal recruitment of neural circuits subserving cognitive control. It is unclear to what extent this dysfunction underlies the development and/or maintenance of positive and negative symptoms typically observed in schizophrenia. In this study we compared fMRI activation on a standard Stroop task and its relationship with positive and negative symptoms in early psychosis (EP, N = 88) and chronic schizophrenia (CHR-SZ, N = 38) patients. CHR-SZ patients showed reduced frontal, striatal, and parietal activation across incongruent and congruent trials compared to EP patients. Higher positive symptom severity was associated with reduced activation across both trial types in supplementary motor area (SMA), middle temporal gyrus and cerebellum in EP, but not CHR-SZ patients. Higher negative symptom severity was associated with reduced cerebellar activation in EP, but not in CHR-SZ patients. A negative correlation between negative symptoms and activation in SMA and precentral gyrus was observed in EP patients and in CHR-SZ patients. The results suggest that the neural substrate of positive symptoms changes with illness chronicity, and that cognitive control related neural circuits may be most relevant in the initial development phase of positive symptoms. These findings also highlight a changing role for the cerebellum in the development and later maintenance of both positive and negative symptoms.


1977 ◽  
Vol 7 (1) ◽  
pp. 171-173 ◽  
Author(s):  
C. D. Frith

SynopsisThe performance of 21 chronic schizophrenic patients was investigated on two tests of feature selection. It was found that patients with negative symptoms (muteness, withdrawal, etc.) were characterized by an extreme lack of persistence, but selected usual features; whereas patients with positive symptoms (hallucinations, delusions, etc.) had a normal degree of persistence, but selected unusual features.


Author(s):  
Nuryil Yilmaz ◽  
Zekeriya Yelboga ◽  
Yavuz Yilmaz ◽  
Ozlem Demirpence

Background: Schizophrenia is a chronic mental disorder, characterized by acute exacerbation and remission phases. Immune system has a role in the pathophysiology of schizophrenia. High mobility group box-1 (HMGB-1)  is a macrophage secreted protein activating immune cells to produce cytokines. The aim of this study was to evaluate HMGB-1 levels among patients with schizophrenia both in acute exacerbation and remission phases. Methods: Consecutive schizophrenia patients in acute exacerbation and remission phases were enrolled and compared with each other and with age-sex matched healthy subjects. Patients were assessed with the Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression Scale (CGI). Results: Mean HMGB-1 levels were not significantly different in acute exacerbation phase versus remission phase schizophrenia patients (2139±564 pg/ml vs. 2326±471 pg/ml, p=0.335) and both were individually higher than the control group (1791±444 pg/ml, p=0.05 for acute exacerbation vs control, p=0.002 for remission vs control). In remission phase schizophrenic patients, HMGB-1 levels were positively correlated with Scale For The Assessment of Positive Symptoms (r=0.447, p=0.015) and BPRS (r=0.397, p=0.033) scores and HMGB-1 levels were independently associated with BPRS. Conclusion: Serum HMGB-1 levels were shown to be increased in patients with schizophrenia patients irrespective of phase and HMGB-1 levels were related to symptom severity according to psychiatric scales among patients in remission phase of schizophrenia.  


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