Cognitively-oriented psychotherapy for early psychosis (COPE): Preliminary results

1998 ◽  
Vol 172 (S33) ◽  
pp. 93-100 ◽  
Author(s):  
H. Jackson ◽  
P. McGorry ◽  
J. Edwards ◽  
C. Hulbert ◽  
L. Henry ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Controlled Trial ◽  
Early Psychosis ◽  
First Episode ◽  
Psychotic Episode ◽  
Control Group ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Randomised Controlled

Background The present study describes the results of the pilottesting of a therapy we have developed for people with first-episode psychosis. Cognitively-oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode.Method Eighty people formed three groups: those who were offered and accepted COPE (COPE subjects); those who refused COPE (refusal subjects); and those who were offered neither COPE nor any other continuing treatment from our service (control subjects). The individuals were assessed prior to, and at the end of, COPE treatment (a 12-month period) on the Integration/Sealing Over, Explanatory Model, Scale for the Assessment of Negative Symptoms, Brief Psychiatric Rating Scale, Quality of Life, SCL–90–R, and Beck Depression Inventory measures.Results People who received COPE obtained significantly superior scores (P < 0.05) to the control group on four of the seven measures but only significantly out-performed the refusal group on one of the seven measures (P<0.05). The COPE group performed significantly worse on the BDI than the refusal group (P < 0.05). Effect sizes are also provided for each measure.Conclusions There seems to be a place for psychological therapy in this group of people butour results need to be replicated in a more definitive randomised controlled trial and such a study is now in progress.

Effect of an Open-Door Policy Combined with a Structured Activity Programme on the Residual Symptoms of Schizophrenic In-Patients

1994 ◽  
Vol 165 (S24) ◽  
pp. 52-57 ◽  
Author(s):  
Zhengshu Jin
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Control Group ◽  
Open Door Policy ◽  
Residual Symptoms ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
And Control ◽  
Experimental Group

Fifty female schizophrenic patients on the same locked ward were randomly assigned to experimental and control groups. Experimental group subjects were given as much autonomy and freedom as possible (they were permitted to leave the ward at will) and were encouraged to take part in collective activities. The control group were not permitted to leave the ward and did not take part in these activities. All patients were evaluated at enrolment and after six months – using Chinese versions of the Scale for Assessment of Negative Symptoms and the Brief Psychiatric Rating Scale – by psychiatrists who were blind to patients' treatment status. After the six-month intervention the severity of all types of both negative and positive symptoms and the mean dosage of medication in the experimental group were significantly less than in the control group.

scholarly journals Chinese herbal medicine for schizophrenia

2007 ◽  
Vol 190 (5) ◽  
pp. 379-384 ◽  
Author(s):  
John Rathbone ◽  
Lan Zhang ◽  
Mingming Zhang ◽  
Jun Xia ◽  
Xiehe Liu ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Medium Term ◽  
Chinese Herbal ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Randomised Controlled

BackgroundChinese herbal medicine has been used to treat millions of people with schizophrenia for thousands of years.AimsTo evaluate Chinese herbal medicine as a treatment for schizophrenia.MethodA systematic review of randomised controlled trials (RCTs).ResultsSeven trials were included. Most studies evaluated Chinese herbal medicine in combination with Western antipsychotic drugs; in these trials results tended to favour combination treatment compared with antipsychotic alone (Clinical Global Impression ‘not improved/worse’ n= 123, RR=0.19, 95% CI 0.1-0.6, NNT=6,95% CI 5–11; n=109, Brief Psychiatric Rating Scale ‘not improved/worse’ RR=0.78,95% CI 0.5-1.2; n=109, Scale for the Assessment of Negative Symptoms ‘not improved/worse’ RR=0.87,95% CI 0.7-1.2; n= 109, Scale for the Assessment of Positive Symptoms ‘not improved/worse’ RR=0.69,95% CI 0.5-1.0, NNT=6 95% CI 4-162). Medium-term study attrition was significantly less for people allocated the herbal/antipsychotic mix (n=897, four RCTs, RR=0.34,95% CI 0.2–0.7, NNT=23,95% CI 18-43).ConclusionsResults suggest that combining Chinese herbal medicine with antipsychotics is beneficial.

The Effect of Risperidone on Cognitive and Psychopathological Manifestations of Schizophrenia

CNS Spectrums ◽  
1998 ◽  
Vol 3 (10) ◽  
pp. 55-69 ◽  
Author(s):  
Isabelle Lussier ◽  
Emmanuel Stip
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Extrapyramidal Symptoms ◽  
Control Group ◽  
Long Term Memory ◽  
Cognitive Evaluation ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

AbstractThe purpose of this study was to evaluate the effect of risperidone on the cognitive functioning of patients with schizophrenia and how it relates to the alleviation of psychopathological symptoms usually observed in patients receiving treatment. Twelve schizophrenic patients were evaluated while being treated with a traditional neuroleptic, and again approximately 8 and 24 weeks after initiation of risperidone. Patients were compared with a group of normal controls (n=24) who underwent the same cognitive evaluation across time. The normal control group was included to evaluate the level of impairments in patients, but also to test for practice effects. The cognitive evaluation included measures of short-term and long-term memory; attention (alertness, sustained and selective); and executive functioning (verbal and category fluency). Clinical symptoms were rated on the Positive and Negative Symptoms Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS). Extrapyramidal symptoms were rated with the Extrapyramidal Symptoms Rating Scale.During treatment with risperidone, schizophrenic patients improved their BPRS and PANSS scores, their performance level on tests of alertness, and both sustained and selective attention.

Suicide Prevention in First Episode Psychosis: The Development of a Randomised Controlled Trial of Cognitive Therapy for Acutely Suicidal Patients With Early Psychosis

2003 ◽  
Vol 37 (4) ◽  
pp. 414-420 ◽  
Author(s):  
P.J.R. Power ◽  
R.J. Bell ◽  
R. Mills ◽  
T. Herrman-Doig ◽  
M. Davern ◽  
...  
Keyword(s):  
Early Intervention ◽  
Treatment Group ◽  
Young People ◽  
Controlled Trial ◽  
First Episode Psychosis ◽  
Early Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Randomised Controlled ◽  
Suicidal Patients

Background: Young people with early psychosis are at particularly high risk of suicide. However, there is evidence that early intervention can reduce this risk. Despite these advances, first episode psychosis patients attending these new services still remain at risk. To address this concern, a program called LifeSPAN was established within the Early Psychosis Prevention and Intervention Centre (EPPIC). The program developed and evaluated a number of suicide prevention strategies within EPPIC and included a cognitively oriented therapy (LifeSPAN therapy) for acutely suicidal patients with psychosis. We describe the development of these interventions in this paper. Method: Clinical audit and surveys provided an indication of the prevalence of suicidality among first episode psychosis patients attending EPPIC. Second, staff focus groups and surveys identified gaps in service provision for suicidal young people attending the service. Third, a suicide risk monitoring system was introduced to identify those at highest risk. Finally, patients so identified were referred to and offered LifeSPAN therapy whose effectiveness was evaluated in a randomised controlled trial. Results: Fifty-six suicidal patients with first episode psychosis were randomly assigned to standard clinical care or standard care plus LifeSPAN therapy. Forty-two patients completed the intervention. Clinical ratings and measures of suicidality and risk were assessed before, immediately after the intervention, and 6 months later. Benefits were noted in the treatment group on indirect measures of suicidality, e.g., hopelessness. The treatment group showed a greater average improvement (though not significant) on a measure of suicide ideation. Conclusions: Early intervention in psychosis for young people reduces the risk of suicide. Augmenting early intervention with a suicide preventative therapy may further reduce this risk.

Effects of Neuroleptic Reduction in Schizophrenic Outpatients Receiving High Doses

1994 ◽  
Vol 39 (4) ◽  
pp. 223-229 ◽  
Author(s):  
Gérard Leblanc ◽  
Hugues Cormier ◽  
Marie-Andrée Gagné ◽  
Sylvie Vaillancourt
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
High Dose ◽  
Clinical Effects ◽  
Relative Paucity ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
High Doses ◽  
Schizophrenic Outpatients

This paper presents an open study which evaluated the clinical effects of a partial and progressive reduction in neuroleptic medication in 32 outpatients suffering from schizophrenia who were receiving high doses (equivalent of ≥ 18 mg of oral haloperidol per day; EHL). After an observation period of twelve weeks, each subject's dose of neuroleptics was reduced by 50% at the rate of 10% every four weeks. Patients were receiving a mean of 62 mg per day EHL at the beginning of the study and 30 mg per day EHL at the completion of the study. After the reduction, the following was observed: 1. a significant but modest change in psychopathology: a decrease in negative symptoms and in the total score on Brief Psychiatric Rating Scale; and 2. a significant increase in tardive dyskinesia symptoms. Six subjects relapsed but five of them recovered without increasing their reduced medication. Results of this study are discussed in the context of trying to find a minimal maintenance dose in the treatment of schizophrenia. The relative paucity of change despite a large reduction in medication argues for réévaluation of dosage in patients on high or very high doses of neuroleptics. The results suggest that many patients taking high doses could be maintained on significantly lower doses of neuroleptics. With gradual reduction of medication it would seem that many patients who are receiving a high dose of neuroleptic can achieve a lower dose than their current maintenance level.

Treatment of drug-resistant chronic schizophrenics with an association of neuroleptics and the calcium antagonist nimodipine

1992 ◽  
Vol 7 (4) ◽  
pp. 177-182 ◽  
Author(s):  
F Brambilla ◽  
GL Gessa ◽  
A Sciascia ◽  
A Latina ◽  
M Maggioni ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Psychiatric Symptomatology ◽  
Brief Psychiatric Rating Scale ◽  
Chronic Schizophrenics ◽  
Daily Dose ◽  
Effect Of Therapy ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Plasma Mhpg

SummaryNimodipine was administered at the daily dose of 90 mg po, for 30 days, to ten chronic undifferentiated schizophrenics, eight men and two women, aged 31-35 years, maintained on previously longlasting neuroleptic treatments. In five patients, a placebo period of 15 days preceded the administration of the drug. Monitoring of psychiatric symptomatology by the Brief Psychiatric Rating Scale (BPRS) revealed significant nimodipine-induced improvement. However, the Andreasen Rating Scale for Positive Symptoms (SAPS) showed favourable effects only in the five patients who had not received placebo, while in the others both SAPS and the Andreasen Rating Scale for Negative Symptoms (SANS) showed no significant effect of therapy. The Tardive Dyskinesia Scale revealed no improvements of neurological symptoms after either placebo or drug treatment. Measurement of plasma MHPG concentrations revealed no significant changes induced by either placebo or nimodipine, while HVA plasma levels showed a trend toward decrease, and prolactin a trend toward increase, after nimodipine.

Combined clozapine-lithium treatment for schizophrenia and schizoaffective disorder

1998 ◽  
Vol 13 (2) ◽  
pp. 104-106 ◽  
Author(s):  
M Moldavsky ◽  
D Stein ◽  
R Benatov ◽  
P Sirota ◽  
A Elizur ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Schizoaffective Disorder ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Lithium Treatment ◽  
Brief Psychiatric Rating Scale ◽  
Psychiatric Rating ◽  
Clinically Significant ◽  
Psychiatric Rating Scale ◽  
Positive And Negative Symptoms

SummaryThree adolescent and two adult patients suffering from chronic excited psychoses (either schizophrenia or schizoaffective disorder) resistant to traditional neuroleptics and clozapine were treated with combined clozapine-lithium. Improvement was assessed with the Positive and Negative Symptoms Scale, the Brief Psychiatric Rating Scale and the Clinical Global Impressions, administered before and during combined clozapine-lithium treatment. All patients demonstrated a significant improvement with this combination. There was no occurrence of agranulocytosis, neuroleptic malignant syndrome or other clinically significant adverse effects.

Pre-emptive ice cube cryotherapy for reducing pain from local anaesthetic injections for simple lacerations: a randomised controlled trial

2017 ◽  
Vol 35 (2) ◽  
pp. 103-107 ◽  
Author(s):  
JaeWoo Song ◽  
HyukHoon Kim ◽  
EunJung Park ◽  
Jung Hwan Ahn ◽  
Eunhui Yoon ◽  
...  
Keyword(s):  
Injection Site ◽  
Local Anaesthetic ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Control Group ◽  
Ice Cube ◽  
Perceived Pain ◽  
Randomised Controlled ◽  
Numeric Rating

ObjectiveSubcutaneous local anaesthetic injection can be painful to patients in the ED. We evaluated the effect of cryotherapy by application of an ice cube to the injection site prior to injection in patients with simple lacerations.MethodsWe conducted a prospective, randomised, controlled trial in consented patients with simple lacerations needing primary repair at a single emergency centre from April to July 2016. We randomly assigned patients undergoing repair for simple lacerations to either the cryotherapy group or the control group (standard care; no cryotherapy or other pretreatment of the injection site). In cryotherapy group subjects, we applied an ice cube (size: 1.5×1.5×1.5 cm) placed inside a sterile glove on the wound at the anticipated subcutaneous lidocaine injection site for 2 min prior to injection. The primary outcome was a subjective numeric rating (0–10 scale) of the perceived pain from the subcutaneous local anaesthetic injections. Secondary outcomes were (a) perceived pain on a numeric scale for cryotherapy itself, that is, pain from contact of the ice cube/glove with the skin and (b) the rate of complications after primary laceration repair.ResultsFifty patients were enrolled, consented and randomised, with 25 in the cryotherapy group and 25 in the control group. The numeric rating scale for subcutaneous anaesthetic injections was median, IQR, 95% CI 2.0 (1 to 3.5), 1.81 to 3.47, respectively, in the cryotherapy group and 5.0 (3 to 7), 3.91 to 6.05 in the control group (Mann-Whitney U=147.50, p=0.001). No wound complications occurred in either group. The numeric rating scale for cryotherapy itself was median, IQR, 95% CI: 2.0 (1 to 3.5), 1.90 to 3.70.ConclusionPre-emptive topical injection site cryotherapy lasting 2 min before subcutaneous local anaesthetic injections can significantly reduce perceived pain from subcutaneous local anaesthetic injections in patients presenting for simple laceration repair.Trial registration numberKCT0001990.

Symptomatic Response to Antipsychotics Differs between Recent Onset and Recurrent Chronic Schizophrenic Patients

1992 ◽  
Vol 26 (3) ◽  
pp. 417-422 ◽  
Author(s):  
Christine Hill ◽  
Nicholas A. Keks ◽  
Henry Jackson ◽  
Jayashri Kulkarni ◽  
Deborah Hannah ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Active Phase ◽  
Retardation Factor ◽  
Antipsychotic Treatment ◽  
Recent Onset ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
First Admission

The symptomatic response to standard antipsychotic treatment was assessed over the first 4 weeks of hospitalisation in 39 patients with DSM-III schizophrenia, active phase, using the Brief Psychiatric Rating Scale (BPRS). While highly significant improvement was noted overall, 36% of patients either did not improve or worsened. Furthermore there was no diminution in the withdrawal-retardation factor of the BPRS. Patients experiencing their first admission to hospital, all with recent-onset illness, were then compared with patients who presented with a recurrence and had illness of at least 3 years duration. Despite similarities in overall response, withdrawal-retardation scores did not diminish in recent-onset patients, in contrast to multiple admissions who demonstrated significant improvement. These findings suggest greater responsiveness of negative symptoms to treatment in patients with longstanding illness, and possibly a poorer prognosis in first admission patients with deficit manifestations.

scholarly journals Efficacy and safety of Jie-du-qing-nao granules for first-episode schizophrenics: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Ziyan Li ◽  
Yanzhe Ning ◽  
Pei Chen ◽  
Yi Zhang ◽  
Dongqing Yin ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Complete Blood Count ◽  
Controlled Trial ◽  
First Episode ◽  
Control Group ◽  
Study Group ◽  
Efficacy And Safety ◽  
Clinical Trial Registry ◽  
Symptom Scale ◽  
Double Blind

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 .

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