scholarly journals Abnormally low prolactin levels in schizophrenia patients after switching to aripiprazole in a randomized trial: a biomarker for rebound in psychotic symptoms?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ya-Wen Jen ◽  
Tzung-Jeng Hwang ◽  
Hung-Yu Chan ◽  
Ming H. Hsieh ◽  
Chen-Chung Liu ◽  
...  
Keyword(s):  
Prolactin Level ◽  
Age At Onset ◽  
Psychotic Symptoms ◽  
Warning Sign ◽  
Multivariable Logistic Regression Analysis ◽  
Early Age ◽  
Positive Symptoms ◽  
Cumulative Proportion ◽  
Syndrome Scale ◽  
Negative Syndrome

Abstract Background Switching to aripiprazole from other antipsychotics can avoid antipsychotic-induced hyperprolactinemia but may result in an abnormally low prolactin level. This study aimed to assess whether the aripiprazole-induced abnormally low prolactin level was a biomarker for subsequent rebound of positive symptoms in schizophrenia patients. Methods Participants were 63 patients in an 8-week trial of switching to aripiprazole, in which preswitching antipsychotics were maintained for the first 2 weeks and aripiprazole was fixed at 15 mg orally throughout the trial. A prolactin level of < 3.7 ng/ml was defined as abnormally low, and an increase of two or more points in the positive subscore of the Positive and Negative Syndrome Scale at two adjacent ratings was defined as a psychotic rebound. Results Among 63 patients, 25 (39.7%) had an abnormally low prolactin level and 21 (33.3%) had a psychotic rebound after switching to aripiprazole. In patients with abnormally low prolactin levels, 48.0% of them had a rebound in psychotic symptoms, whereas in those without abnormally low prolactin levels 23.7% did so. Multivariable logistic regression analysis with adjustment for sex, early age at onset, and preswitching medications revealed that abnormally low prolactin levels were associated with psychotic rebound (adjusted odds ratio = 3.55, 95% confidence interval = 1.02, 12.5). Furthermore, there was concurrency between the trend of the cumulative proportion of patients having an abnormally low prolactin level and that of the cumulative proportion of patients having a rebound in psychotic symptoms. Conclusions An abnormally low prolactin level after switching to aripiprazole in schizophrenia patients was a potential warning sign of a psychotic rebound. Hence, monitoring of prolactin levels after switching to aripiprazole may help avoid such rebound in schizophrenia. Trial registration NCT00545467; Date of registration: 17/10/2007.

scholarly journals Shifts in positive and negative psychotic symptoms and anger: effects on violence

2018 ◽  
Vol 48 (14) ◽  
pp. 2428-2438 ◽  
Author(s):  
Jeremy W. Coid ◽  
Constantinos Kallis ◽  
Mike Doyle ◽  
Jenny Shaw ◽  
Simone Ullrich
Keyword(s):  
Community Violence ◽  
Negative Symptoms ◽  
Positive Symptom ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Protective Effects ◽  
Post Discharge ◽  
Affective Symptoms ◽  
Syndrome Scale ◽  
Negative Syndrome

BackgroundChanges in positive and negative symptom profiles during acute psychotic episodes may be key drivers in the pathway to violence. Acute episodes are often preceded by fluctuations in affect before psychotic symptoms appear and affective symptoms may play a more important role in the pathway than previously recognised.MethodsWe carried out a prospective cohort study of 409 male and female patients discharged from medium secure services in England and Wales to the community. Measures were taken at baseline (pre-discharge), 6 and 12 months post-discharge using the Positive and Negative Syndrome Scale. Information on violence was obtained using the McArthur Community Violence Instrument and Police National Computer.ResultsThe larger the shift in positive symptoms the more likely violence occurred in each 6-month period. However, shifts in angry affect were the main driving factor for positive symptom shifts associated with violence. Shifts in negative symptoms co-occurred with positive and conveyed protective effects, but these were overcome by co-occurring shifts in anger. Severe but stable delusions were independently associated with violence.ConclusionsIntensification of angry affect during acute episodes of psychosis indicates the need for interventions to prevent violence and is a key driver of associated positive symptoms in the pathway to violence. Protective effects against violence exerted by negative symptoms are not clinically observable during symptom shifts because they are overcome by co-occurring anger.

scholarly journals T91. THE POSITIVE AND NEGATIVE SYNDROME SCALE SUPERIOR TO A SELF-REPORT QUESTIONNAIRE IN THE PHARMACOTHERAPY MONITORING AND OUTCOME SURVEY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S266-S266
Author(s):  
Annegien Bartels-Velthuis ◽  
Koen Ties ◽  
Ellen Visser ◽  
Johan Arends ◽  
Marieke Pijnenborg ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Data Set ◽  
Syndrome Scale ◽  
Outcome Monitoring ◽  
Negative Syndrome

Abstract Background Aiming to improve the quality of care for patients with a psychotic disorder, the ongoing Pharmacotherapy Monitoring Outcome Survey (PHAMOUS) started in 2006 in four large mental health care organizations in the Northern Netherlands, by adding it to the at that time mandatory Routine Outcome Monitoring program. However, since the cuts in the financial budgets for mental health care, research nurses are increasingly experiencing time-pressure in the assessments. The Positive and Negative Syndrome Scale (PANSS), part of the assessment, is a time-consuming interview, taking approximately 30 minutes. Therefore, we developed and validated a short self-report questionnaire assessing positive psychotic symptoms, the Brief Positive Symptoms Questionnaire (BPSQ). Methods The BPSQ was added to PHAMOUS and filled in once by patients in four mental health care institutions in 2017 and 2018. The BPSQ consists of nine items and takes about 2–3 minutes to complete. It was validated against the PANSS positive scale and two items of the Health of the Nations Outcome Scale (HoNOS), with item 6 assessing the problems that patients experience due to hallucinations and delusions and item 8 assessing further mental and behavioural problems. Results BPSQ data were obtained from n=287 patients (mean age 47.1 years, 67.6% male). The PANSS was assessed in n=244 and HoNOS data were available for n=156 patients. Scores of one patient were considered unreliable and thus removed from the data set. The BPSQ had a Cronbach’s alpha of .81. Spearman’s correlation coefficient of the BPSQ and the PANSS positive scale was significant (ρ(243) = .63, p &lt; .05). Correlations between the BPSQ and HoNOS items 6 and 8 were significant (ρ(155) = .488, p &lt; .05 and ρ(155) = .251, p &lt; .05 respectively). Post hoc analysis showed that the more severely psychotic the patients were, the less the BPSQ and the PANSS positive scale were corresponding. Discussion Given the medium correlation of the BPSQ with the PANSS positive scale and the low concurrent validity with the two relevant HoNOS items, we argue that the widely used and validated PANSS is indispensable in the PHAMOUS assessment of positive symptoms in a chronic population with psychotic disorders. Replication of this study in first-episode psychotic patients is recommended.

scholarly journals M216. ASSOCIATIONS OF EXTRAPYRAMIDAL SYMPTOMS WITH PSYCHOTIC SYMPTOMS IN A COHORT OF HOMELESS OR PRECARIOUSLY HOUSED PERSONS WITH OR WITHOUT SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S218-S218
Author(s):  
David Kim ◽  
Ric Procyshyn ◽  
Lik Hang Lee ◽  
William Panenka ◽  
Olga Leonova ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Extrapyramidal Symptoms ◽  
Analysis Of Covariance ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Syndrome Scale ◽  
Clinically Significant

Abstract Background There is considerable evidence supporting the association between extrapyramidal symptoms (EPS) and psychotic symptoms in patients with schizophrenia (SCZ). However, it is not well understood whether such an association exists in individuals without SCZ and how the association differs from those with SCZ. Our aim was to examine the associations of EPS with psychotic symptoms and compare them between SCZ and non-SCZ individuals. Methods We used data from a 10-year community-based study of homeless or precariously housed persons from Vancouver, Canada. Diagnosis of SCZ was made according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Severity of psychotic symptoms was rated using the Positive and Negative Syndrome Scale (PANSS). Severity of parkinsonism, dyskinesia, and dystonia was rated using the Extrapyramidal Symptom Rating Scale (ESRS), and akathisia using the Barnes Akathisia Rating Scale (BARS). Presence of EPS was defined as having at least moderate severity on the ESRS (i.e., ≥4 out of 8) or BARS (i.e., ≥3 out of 5) Clinical Global Impression-Severity (CGI-S) scale. Absence of EPS was defined as scoring ≤2 on the ESRS or ≤1 on the BARS CGI-S scale. Two-way analysis of covariance was performed using SCZ and EPS as independent variables and PANSS five factors (i.e., positive symptoms, negative symptoms, disorganization, excitement, and depression) as dependent variables, controlling for age, antipsychotic users, and cocaine- or methamphetamine-dependent individuals. Multiple linear regression analysis was performed for both SCZ and non-SCZ groups, controlling for the same confounding variables, to examine 1) associations of the severity of EPS subtypes with PANSS factors and 2) whether the presence of multiple EPS subtypes would be associated with increased SCZ symptoms relative to the presence of a single subtype. Results A total of 223 participants were included in this study (mean age: 44.1 ± 12.0 years; 76.1% male). Eighty-four participants met the diagnosis of SCZ, of whom 39 met our criteria for having EPS and 32 for not having EPS. The remaining 139 participants were not diagnosed with SCZ, of whom 50 had EPS and 72 did not. None of the participants had clinically significant dystonia. Overall, significant main effects of EPS were found for total symptoms (F1,182 = 24.4, p &lt; 0.001), negative symptoms (F1,182 = 16.3, p &lt; 0.001), disorganization (F1,181 = 16.6, p &lt; 0.001), and excitement (F1,182 = 15.8, p &lt; 0.001), but not positive symptoms or depression. The presence of EPS was associated with greater total symptoms and disorganization in both SCZ and non-SCZ groups. Significant interaction effects between SCZ and EPS were found for negative symptoms (F1,182 = 6.0, p = 0.015) and excitement (F1,182 = 3.9, p = 0.050), where the presence of EPS was associated with greater negative symptoms and excitement in SCZ participants, but not in non-SCZ participants. Consistent in both SCZ and non-SCZ groups, there were significant positive associations of the severity of 1) parkinsonism with negative symptoms, 2) dyskinesia with disorganization and total symptoms, and 3) akathisia with excitement. The presence of multiple EPS subtypes, relative to a single subtype, was not associated with significant increases in any SCZ symptoms, except a significant increase in excitement in non-SCZ participants. Discussion The presence of EPS is clearly associated with greater symptoms of SCZ, even in individuals without SCZ. People with SCZ may experience greater negative symptoms and excitement as a result of EPS than those without SCZ. Subtypes of EPS are distinctively associated with factors of SCZ symptoms. Future studies should elucidate the mechanisms underlying these associations.

Estrogen, menstrual cycle phases, and psychopathology in women suffering from schizophrenia

2007 ◽  
Vol 37 (10) ◽  
pp. 1427-1436 ◽  
Author(s):  
NIELS BERGEMANN ◽  
PETER PARZER ◽  
BENNO RUNNEBAUM ◽  
FRANZ RESCH ◽  
CHRISTOPH MUNDT
Keyword(s):  
Menstrual Cycle ◽  
Rating Scale ◽  
Premenopausal Women ◽  
Psychotic Symptoms ◽  
Cycle Phase ◽  
Syndrome Scale ◽  
Regular Menses ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Negative Syndrome

ABSTRACTBackgroundEstrogen has been hypothesized to have a protective and antipsychotic-like effect in women at risk for schizophrenia. The aim of the present study was to evaluate the association between menstrual cycle and/or estrogen levels and psychotic symptoms in a sample of women with schizophrenia.MethodOne hundred and twenty-five premenopausal women with schizophrenia and regular menses were examined. The levels of 17β-estradiol and other hormones of the gonadal axis were assessed in the follicular, peri-ovulatory, and luteal phases of the menstrual cycle. The effects of the menstrual cycle phase and/or the estradiol level on the Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS) scores were calculated by means of regression analyses.ResultsSignificant improvement in psychotic, but not depressive, symptoms was observed during the luteal phase, compared with other days of the menstrual cycle.ConclusionsThe present findings indicate that estradiol may have specific antipsychotic-like effects on the symptoms of schizophrenia. Thus further investigation into the therapeutic effect of estrogen may be worthwhile.

Influence ofNRGNrs12807809 polymorphism on symptom severity in individuals with schizophrenia in the Han population but not the Zhuang population of south China

2015 ◽  
Vol 27 (4) ◽  
pp. 221-227 ◽  
Author(s):  
Li Su ◽  
Jianxiong Long ◽  
Runde Pan ◽  
Xinfeng Xie ◽  
Xixiang Mao ◽  
...  
Keyword(s):  
South China ◽  
Clinical Symptoms ◽  
Subscale Score ◽  
Assay Method ◽  
Psychotic Symptoms ◽  
Han Population ◽  
Syndrome Scale ◽  
General Activation ◽  
Negative Syndrome ◽  
Pooled Samples

BackgroundNRGNis one of the most promising candidate genes for schizophrenia based on function and position. Therefore, this study aimed to examine the genetic association of this polymorphism with schizophrenia in the Zhuang and Han populations of south China.Subjects and methodsA total of 282 patients (188 Han and 94 Zhuang) and 282 healthy subjects (188 Han and 94 Zhuang) were recruited. Of these, 246 schizophrenia patients underwent an assessment of psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS). A TaqMan genotyping assay method was used to determine the genotypes.ResultsWe did not find a significant association of rs12807809 polymorphism with schizophrenia in the total pooled samples, or in the separate ethnic groups. However, in Han schizophrenia patients, quantitative data analyses showed that the CC genotype of the rs12807809 polymorphism was associated with PANSS aggression subscale score and activation subscale score. Furthermore, carriers of the C allele of rs12807809 polymorphism among Han schizophrenia patients had higher scores of general, activation, depression, aggression, and global symptoms than the T allele carriers.ConclusionIn conclusion rs12807809 polymorphism may not contribute to the risk of schizophrenia but influence the clinical symptoms of schizophrenia in the Han population.

Tolerability and treatment response in patients with recently diagnosed vs. chronic schizophrenia treated with paliperidone ER

2011 ◽  
Vol 26 (S2) ◽  
pp. 1502-1502
Author(s):  
A. Schreiner ◽  
D. Hoeben ◽  
C. Tessier ◽  
M. Lahaye ◽  
J. Turczynski ◽  
...  
Keyword(s):  
Treatment Response ◽  
Chronic Schizophrenia ◽  
Psychotic Symptoms ◽  
Chronic Patients ◽  
Open Label ◽  
Patient Functioning ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
Mean Time ◽  
Time Since Diagnosis

ObjectiveTo explore tolerability and treatment response in adult patients with recently diagnosed (<5 years) and chronic (>5 years) schizophrenia treated with flexible doses of paliperidone ER.MethodsInternational prospective open-label 6-month study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), patient functioning and treatment-emergent adverse events (TEAEs).ResultsOf 713 recently diagnosed patients, most were male (60.9%), mean age was 33.6 ± 11.2 years and mean time since diagnosis was 2.3 ± 1.7 years. Chronic patients (n = 1003) were predominantly male (59.2%) with a mean age of 43.8 ± 11.4 and mean time since diagnosis of 15.6 ± 9.2 years. 70.4% and 71.7% of patients completed the study, respectively. Mean mode doses of paliperidone ER were similar between recently diagnosed and chronic patients (7.0 ± 2.9 mg/day and 7.2 ± 2.9 mg/day). 63.1% of recently diagnosed and 60.8% of chronic patients switching due to lack of efficacy with their previous antipsychotic had a >20% improvement in PANSS total score at endpoint, and improvement with other switching reasons was consistently numerically higher in recently diagnosed patients. The rate of patients with mild or no functional impairment increased from 17.7% to 39.8% in recently diagnosed and from 14.4% to 32.9% in chronic patients. TEAEs reported in >5% were insomnia (10.7% and 8.1%), anxiety (8.6% and 6.0%) and somnolence (5.8% and 3.4%), respectively.ConclusionThese data suggest that both recently diagnosed and chronic patients previously unsuccessfully treated with other oral antipsychotics may benefit from paliperidone ER, with a tendency for recently diagnosed patients showing some higher treatment response in psychotic symptoms and patient functioning.

scholarly journals Sex-dependent effect on the association of COMT Val158Met polymorphism with schizophrenia clinical symptoms and cognitive impairment

2021 ◽  
Author(s):  
Hang Xu ◽  
Yongjie Zhou ◽  
Jiesi Wang ◽  
Meihong Xiu ◽  
Dachun Chen ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Clinical Symptoms ◽  
Chronic Schizophrenia ◽  
Positive Symptoms ◽  
Sexually Dimorphic ◽  
Genotype Distribution ◽  
Immediate Memory ◽  
Neuropsychological Status ◽  
Syndrome Scale ◽  
Negative Syndrome

Abstract Catechol-O-methyltransferase (COMT) Val158Met (rs4680) polymorphism is thought to be involved in the pathogenesis of schizophrenia, which is related to the regulation of dopamine transmission in the prefrontal cortex. Recent studies have shown that the influence of COMT Val158Met variation is sexually dimorphic. This study aims to explore the possible effect of the interaction between COMT Val158Met polymorphism and sex on patients’ clinical characteristics and cognitive function. 367 inpatients with chronic schizophrenia (246 males and 121 females) and 419 healthy controls (172 males and 247 females) are recruited. The cognitive performances are assessed by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the COMT Val158Met polymorphism is genotyped. The psychopathological symptoms of the patients are assessed by the Positive and Negative Syndrome Scale (PANSS). We find that: 1) sex difference in the allele frequency and genotype distribution of COMT Val158Met are found only in schizophrenia patients; 2) there is sex × COMT genotype interaction in positive symptoms, immediate memory, attention, and RBANS total score indexes in patients with schizophrenia; 3) mainly in the male patients’ sample, Val/Val carriers exhibit more positive symptoms and more severe cognitive impairment than Met carriers. These findings suggest that COMT Val158Met polymorphism is associated with the risk and severity of schizophrenia in a sexually dimorphic way, which is helpful to understand the factors that may lead to different manifestations of male and female patients with schizophrenia.

scholarly journals Deficient auditory gamma-BOLD coupling in schizophrenia is related to sensory gating deficits

2021 ◽  
Author(s):  
Michael Jacob ◽  
Kaia Sargent ◽  
Brian Roach ◽  
Elhum Shamshiri ◽  
Daniel Mathalon ◽  
...  
Keyword(s):  
Resting State ◽  
Sensory Gating ◽  
Psychotic Symptoms ◽  
Gamma Range ◽  
Syndrome Scale ◽  
Regional Hemodynamics ◽  
Gamma Power ◽  
Eyes Open ◽  
Pulse Sound ◽  
Negative Syndrome

Background: Schizophrenia is associated with aberrant gamma band power, hypothesized to reflect imbalance in the excitation-inhibition (E/I) ratio and undermine neural signal efficiency. Relationships between resting-state gamma, E/I balance, and regional hemodynamics from the fMRI BOLD signal are unknown. Methods: We recorded simultaneous EEG-fMRI at rest, with eyes open, in people with schizophrenia (n= 57) and people without a psychiatric diagnosis (n= 46) and identified gamma and aperiodic EEG parameters associated with E/I balance. Measures from all EEG channels were entered into a whole-brain, parametric modulation analysis followed by statistical correction for multiple comparisons. Sensory gating was assessed using the Sensory Gating Inventory, and psychotic symptoms were assessed using the Positive and Negative Syndrome Scale. Results: Across groups, gamma power modestly predicts a steeper aperiodic slope (greater inhibition), without group differences in either gamma power or aperiodic slope. In schizophrenia, gamma-BOLD coupling was reduced in bilateral auditory regions of the superior temporal gyri and inversely correlated with sensory gating deficits and symptom severity. Analysis of the spectral features of scanner sounds revealed distinct peaks in the gamma range, reflecting a rapidly repeating scanner pulse sound present throughout the resting state recording. Conclusion: Regional hemodynamic support for putative inhibitory and excitatory contributions to resting EEG are aberrant in SZ. Deficient gamma coupling to auditory BOLD may reflect impaired gating of fMRI-scanner sound.

scholarly journals The Relationship Between Serum Cytokine Levels and the Degree of Psychosis and Cognitive Impairment in Patients With Methamphetamine-Associated Psychosis in Chinese Patients

2020 ◽  
Vol 11 ◽  
Author(s):  
Xue Yang ◽  
Hui Zhao ◽  
Xuebing Liu ◽  
Qin Xie ◽  
Xiaoliang Zhou ◽  
...  
Keyword(s):  
Negative Relationship ◽  
Serum Levels ◽  
Chinese Patients ◽  
Psychotic Symptoms ◽  
Delayed Recall ◽  
Syndrome Scale ◽  
Cytokine Levels ◽  
Function Impairment ◽  
Negative Syndrome ◽  
The Relationship

Background: Cytokine levels can be changed in methamphetamine (METH) use disorders (MUDs) and primary psychosis. The present study assessed serum levels of some kinds of interleukins (ILs) in METH-associated psychosis (MAP) and their relationships with psychotic symptoms and cognitive dysfunction.Methods: Serum IL-2R, IL-6, IL-8, and IL-10 levels were examined by chemiluminescence assays in MAP patients (n = 119) and healthy controls (n = 108). The Positive and Negative Syndrome Scale (PANSS) and Montreal Cognitive Assessment (MOCA) were administered.Results: Serum levels of IL-6 and IL-8 were significantly increased in MAP patients (all p &lt; 0.05). There was a negative relationship between IL-2R levels and PANSS positive (P) subscale scores (r = −0.193, p = 0.035). IL-6, IL-8 and IL-10 levels were all negatively correlated with the naming, delayed recall and orientation subscores on the MOCA (r = −0.209, p = 0.022; r = −0.245, p = 0.007; r = −0.505, p &lt; 0.001, respectively).Conclusions: Our results indicate that immune disturbances are related to MAP and that IL-2R, IL-6, IL-8, and IL-10 are associated with the severity of psychotic symptoms and cognitive function impairment.

Cognitive Group Therapy for Paranoid Schizophrenics: Applying Cognitive Dissonance

1998 ◽  
Vol 12 (1) ◽  
pp. 3-12 ◽  
Author(s):  
Joseph Levine ◽  
Yoram Barak ◽  
Ilana Granek
Keyword(s):  
Group Therapy ◽  
Cognitive Dissonance ◽  
Control Group ◽  
Positive Symptoms ◽  
Wide Acceptance ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Supportive Group ◽  
Negative Syndrome

Psychotherapy with paranoid schizophrenics is a hard and often unrewarding task. Individual and group therapies are usually supportive only and are not aimed at changing the paranoid mode of thinking. Although cognitive therapy has been applied in schizophrenic patients, it has not gained wide acceptance. Cognitive dissonance postulates that individuals experience discomfort and tension when holding two dissonant beliefs simultaneously. We here present the group therapy of six schizophrenic paranoids treated by modified cognitive group therapy implementing cognitive dissonance as the vector of change. A control group of six age- and sex-matched paranoid schizophrenics was treated by supportive group therapy. Analysis of the results, using the Positive and Negative Syndrome Scale (PANSS), during therapy and at follow-up of 4 weeks demonstrates statistically significant improvement in total PANSS score as well as in the positive symptoms subscale.

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