scholarly journals Impact of Duration of Untreated Psychosis on Cognitive Function in Schizophrenia

2021 ◽  
Vol 10 (1) ◽  
pp. 20
Author(s):  
Rina Krismiati Gani ◽  
Erikavitri Yulianti ◽  
Ifa Tunisya
Keyword(s):  
Cognitive Function ◽  
Negative Symptoms ◽  
Clinical Syndrome ◽  
Psychotic Symptoms ◽  
Duration Of Untreated Psychosis ◽  
Disease Symptoms ◽  
Differences Of Opinion ◽  
Schizophrenic Patients ◽  
Neurodevelopmental Hypothesis ◽  
The Impact

Background: Schizophrenia is a chronic and serious clinical syndrome with very aggravating psychopathology involving perception, cognition, emotion, and behaviour. Currently, cognitive dysfunction is seen as a core disorder of schizophrenia. Duration of Untreated Psychosis (DUP) refers to the period from the onset of psychotic symptoms to the first adequate administration of antipsychotics.Aims: This review aims to analyse the impact of DUP on cognitive function in schizophrenia.Methods: PubMed and Google Scholar were searched using the following keyword: (cognitive function) and (neurodevelopmental OR neurotoxicity hypothesis) and (duration of untreated psychosis or DUP) and (schizophrenia or psychosis or psychotic) using the journal publication filter for the 2014-2020 issue. We also used textbooks published in the last 10 years and were related to writing themes.Review: There are two different opinions about the impact of DUP on the cognitive function of schizophrenic patients: (1) the neurodevelopmental hypothesis says there is no impact of the length of DUP on the cognitive function of schizophrenic patients; (2) the neurotoxicity hypothesis says the length of the DUP will impact the patient's cognitive function. Despite differences of opinion about the impact of DUP on cognitive function in schizophrenia, early intervention in schizophrenic patients is important because DUP is associated with worse general disease symptoms, lower likelihood of remission, more severe positive and negative symptoms, and worse social functioning and overall outcomes.Summary: There are differences of opinion about the impact of DUP on cognitive function in schizophrenic patients.

scholarly journals The impact of a history of psychotic symptoms on cognitive function in euthymic bipolar patients: a comparison with schizophrenic patients and healthy controls

2011 ◽  
Vol 33 (4) ◽  
pp. 353-361 ◽  
Author(s):  
Sofia Brissos ◽  
Vasco Videira Dias ◽  
Márcio Gerhardt Soeiro-de-Souza ◽  
Vicent Balanzá-Martínez ◽  
Flavio Kapczinski
Keyword(s):  
Negative Symptoms ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Neurocognitive Performance ◽  
Cross Sectional ◽  
Neurocognitive Dysfunction ◽  
Schizophrenic Patients ◽  
History Of ◽  
Bipolar Patients ◽  
The Impact

BACKGROUND: About two-thirds of patients with bipolar disorder (BD) have a lifetime history of at least one psychotic symptom. Objective: To compare the neurocognitive performance of four groups: BD patients with and without a history of psychotic symptoms (BD HPS+ and BD HPS-, respectively); patients with schizophrenia (SZ); and healthy control (HC) subjects. METHOD: In this cross-sectional study, 35 stabilized patients with SZ, 79 euthymic (44 HPS+ and 35 HPS-) patients with BD, and 50 HC were administered a comprehensive battery of neuropsychological tests. RESULTS: There was worse neurocognitive functioning in both BD and SZ patients compared to HC. Overall, data from both groups of BD patients did not differ on sociodemographic, clinical, or neurocognitive variables. However, BD HPS+ patients had significantly more negative symptoms, as measured by the Positive and Negative Syndrome Scale (PANSS), and showed a trend toward worse performance on executive functions compared to BD HPS- patients. Moreover, both BD groups had better performance on all neurocognitive tests compared to SZ group. CONCLUSIONS: Neurocognitive dysfunction may be more marked in SZ than in BD, yet qualitatively similar. A history of past psychotic symptoms in BD was not associated with more severe cognitive impairment during euthymia. Therefore, BD with psychotic symptoms does not appear to be a distinct neurocognitive phenotype.

scholarly journals Childhood adversity and psychosis: generalised or specific effects?

2015 ◽  
Vol 25 (4) ◽  
pp. 349-359 ◽  
Author(s):  
E. Longden ◽  
M. Sampson ◽  
J. Read
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Negative Symptoms ◽  
Childhood Adversity ◽  
Clinical Intervention ◽  
Current Data ◽  
Psychotic Symptoms ◽  
Multiple Exposures ◽  
Specific Effects ◽  
The Impact

Background.This study examines relationships between childhood adversity and the presence of characteristic symptoms of schizophrenia. It was hypothesised that total adversity exposures would be significantly higher in individuals exhibiting these symptoms relative to patients without. Recent proposals that differential associations exist between specific psychotic symptoms and specific adversities was also tested, namely: sexual abuse and hallucinations, physical abuse and delusions, and fostering/adoption and delusions.Method.Data were collected through auditing 251 randomly selected medical records, drawn from adult patients in New Zealand community mental health centres. Information was extracted on presence and subtype of psychotic symptoms and exposure to ten types of childhood adversity, including five types of abuse and neglect.Results.Adversity exposure was significantly higher in patients experiencing hallucinations in general, voice hearing, command hallucinations, visions, delusions in general, paranoid delusions and negative symptoms than in patients without these symptoms. There was no difference in adversity exposure in patients with and without tactile/olfactory hallucinations, grandiose delusions or thought disorder. Indication of a dose–response relationship was detected, in that total number of adversities significantly predicted total number of psychotic symptoms. Although fostering/adoption was associated with paranoid delusions, the hypothesised specificity between sexual abuse and hallucinations, and physical abuse and delusions, was not found. The two adversities showing the largest number of associations with psychotic symptoms were poverty and being fostered/adopted.Conclusions.The current data are consistent with a model of global and cumulative adversity, in which multiple exposures may intensify psychosis risk beyond the impact of single events. Implications for clinical intervention are discussed.

scholarly journals SOCIAL SKILL TRAINING PADA PENYANDANG SKIZOFRENIA

2013 ◽  
Vol 2 (3) ◽  
Author(s):  
Anita E. Dundu
Keyword(s):  
Social Skill ◽  
Skill Training ◽  
Key Words Schizophrenia ◽  
Social Skill Training ◽  
Psychotic Symptoms ◽  
Social Rehabilitation ◽  
The Social ◽  
Schizophrenic Patients ◽  
The Impact

Abstract: Besides psychotic symptoms, schizophrenic patients also show alterations in cognitive function, verbal information, and emotional response, due to disturbances of interpersonal interaction. The impact of all of these is the disturbance in social function. Treatment of schizophrenic patients with psychopharmacotherapy can only suppress the symptoms, but it can not overcome the functional deficit. For this reason, combination of psychopharmacotherapy, psychotherapy, and social rehabilitationin is introduced to obtain a better result in schizophrenic management. Social skill training is a part of the social rehabilitation that is very useful in improving the patients’ quality of life in preparing them to be functional in their society. Key words: schizophrenia, social rehabilitation, social skill training.  Abstrak: Pada penyandang skizofrenia selain gejala-gejala psikotik juga terdapat perubahan dalam fungsi kognisi, informasi verbal dan respon emosi akibat terganggunya interaksi interpersonal, yang berdampak gangguan dalam fungsi sosial. Pengobatan skizofrenia dengan menggunakan psikofarmaka hanya dapat menekan gejala-gejala penyakit ini tetapi tidak dapat mengatasi defisit fungsional. Untuk hal ini, pada pengobatan skizofrenia terkini digunakan kombinasi psikofarmaka, psikoterapi dan rehabilitasi sosial. Social skill training merupakan salah satu bagian dari rehabilitasi sosial yang bermanfaat meningkatkan kwalitas hidup dalam mempersiapkan penyandang skizofrenia  untuk dapat berfungsi kembali dalam masyarakat. Kata kunci: skizofrenia, rehabilitasi sosial, social skill training.

New dopaminergic and non-dopaminergic theories in schizophrenia and their therapeutic impact

1997 ◽  
Vol 9 (2) ◽  
pp. 64-67
Author(s):  
R.S. Kahn
Keyword(s):  
Cognitive Deficits ◽  
Negative Symptoms ◽  
Dopamine Neurons ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
The Core ◽  
Schizophrenic Patients ◽  
Core Symptoms ◽  
Influential Theory

The dopamine (DA) hypothesis of schizophrenia, postulating that schizophrenia is characterized by increased dopamine function, has been the most influential theory on the pathogenesis of schizophrenia. It has recently been revised based on the appreciation that the core symptoms of schizophrenia may not be the positive (psychotic) symptoms, but rather the negative symptoms and the cognitive deficits found in schizophrenic patients. This revision has prompted the hypothesis that schizophrenia is characterized by both decreased prefrontal dopamine activity (causing deficit symptoms) and increased dopamine activity in mesolimbic dopamine neurons (causing positive symptoms).Notwithstanding this revision of a role for dopamine in schizophrenia, it has become increasingly evident that dysfunction of other monoaminergic systems may be as important in contributing to the pathophysiology of schizophrenia. Specifically, the putative role of serotonin (5-hydroxytryptamine, 5-HT) in schizophrenia is gaining considerable attention. Several observations, such as the ability of the 5-HT antagonist, ritanserin, to alleviate schizophrenic symptoms and, when added to haloperidol (Haldol®), to decrease its extrapyramidal side-effects (EPS), have stimulated studies into a role of 5-HT in schizophrenia. The finding that clozapine (Leponex®), clinically superior to conventional neuroleptics, is a weak DA2 antagonist but a potent 5-HT1c and 5-HT2 antagonist has further stimulated 5-HT-related research in schizophrenia.

166 – NRG1, cognitive function and psychotic symptoms in schizophrenic patients. Is there an association?

2008 ◽  
Vol 98 ◽  
pp. 101-102
Author(s):  
B.B. Magnusdottir ◽  
H.M. Haraldsson ◽  
R.G. Morris ◽  
R. Murray ◽  
E. Sigurdsson ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Psychotic Symptoms ◽  
Schizophrenic Patients

scholarly journals Personal Beliefs about Experiences in those at Clinical High Risk for Psychosis

2014 ◽  
Vol 43 (6) ◽  
pp. 669-675 ◽  
Author(s):  
Jacqueline Stowkowy ◽  
Diana O. Perkins ◽  
Scott W. Woods ◽  
Karissa Nyman ◽  
Jean Addington
Keyword(s):  
High Risk ◽  
Negative Symptoms ◽  
Intervention Strategies ◽  
Psychotic Symptoms ◽  
Clinical High Risk ◽  
Personal Beliefs ◽  
Negative Beliefs ◽  
The Impact ◽  
Important Objective

Background: Negative beliefs about illness in early psychosis have been shown to have an unfavourable impact on one's quality of life. A shift of focus in psychosis research has been on the detection of individuals considered to be at clinical high risk (CHR) of developing psychosis. Little is known about the impact that beliefs about psychotic like experiences or attenuated psychotic symptoms may have on CHR individuals. Aim: To explore these beliefs in a large sample of young people at CHR of developing psychosis using the Personal Beliefs about Experiences Questionnaire (PBEQ). Method: Beliefs about unusual experiences were assessed in 153 CHR individuals with the PBEQ. Prodromal symptoms (measured by the SIPS) and depression (measured by the CDSS) were also assessed. Results: In CHR individuals, holding more negative beliefs was associated with increased severity in depression and negative symptoms. Higher scores on suspiciousness were associated with increased negative beliefs, and higher levels of grandiosity were associated with decreased negative beliefs. Those who later transitioned to psychosis agreed significantly more with statements concerning control over experiences (i.e. “my experiences frighten me”, “I find it difficult to cope). Conclusions: The results suggest that targeting negative beliefs and other illness related appraisals is an important objective for intervention strategies.

scholarly journals Decision analytic economic paliperidone ER in relapsing schizophrenic patients in Italy

2008 ◽  
Vol 9 (2) ◽  
pp. 95-108 ◽  
Author(s):  
Patrizia Berto ◽  
Cristina Negrini ◽  
Luigi Ferrannini
Keyword(s):  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Development Program ◽  
Sensitivity Analyses ◽  
Psychotic Symptoms ◽  
Base Case ◽  
Management Options ◽  
Pharmacological Management ◽  
Clinical Development Program ◽  
Schizophrenic Patients

Schizophrenia, with its typical chronic and relapsing course, is very burdensome, both clinically and economically. Its pharmacological management relies on two main drug classes: the older, or typical, antipsychotics, which are quite effective on positive symptoms, but limited by low tolerability and poor efficacy on negative symptoms, and atypical antipsychotics, which are better tolerated and effective on a wider range of psychotic symptoms. In this article, the authors briefly discuss current management options for patients with schizophrenia and highlight some unmet clinical needs in the field. After outlining the main clinical features shown by paliperidone ER, a novel antipsychotic, in its clinical development program, a decision analytic economic appraisal of its use in relapsing schizophrenic patients in Italy, as compared to the other available atypical antipsychotics, is presented. Under base-case assumption and after applying national costs and tariffs, the model predicts paliperidone ER to be associated with better clinical outcomes, expressed in terms of stable days, and lower costs; this means that paliperidone is dominant over the alternatives, according to the principles of economic evaluation of healthcare technologies. One-way sensitivity analyses conducted on structural and cost parameters indicated robustness of base-case estimates, which remain to be confirmed by “real world” national data.

Conventional versus atypical neuroleptics: subjective quality of life in schizophrenic patients

1997 ◽  
Vol 170 (5) ◽  
pp. 422-425 ◽  
Author(s):  
M. Franz ◽  
Stefanie Lis ◽  
K. Plüddemann ◽  
B. Gallhofer
Keyword(s):  
Quality Of Life ◽  
Social Life ◽  
Well Being ◽  
Subjective Quality ◽  
Psychotic Symptoms ◽  
Atypical Neuroleptics ◽  
Subjective Quality Of Life ◽  
Schizophrenic Patients ◽  
The Impact

BackgroundThe effectiveness of anti-psychotic drugs against positive psychotic symptoms has been demonstrated in many studies, but their effects on quality of life have yet to be clarified. The impact of different neuroleptic therapies on the subjective quality of life of schizophrenic patients is evaluated in a cross-sectional open study.MethodDuring a four-month period a standardised quality of life interview for schizophrenic patients was applied on day 10 after admission; 33 patients on atypical neuroleptics (AAP) were compared with 31 matched patients on conventional neuroleptics (CAP).ResultsThe AAP group had significantly higher scores in general quality of life as well as in different life domains: physical well-being, social life and everyday life. In separate comparisons of the AAP group, patients on clozapine and risperidone were found to have a higher quality of life score than patients on CAP or zotepine.ConclusionsThe pharmacological profile of clozapine and risperidone may provide a basis for explaining the higher subjective quality of life found in this study. The lower quality of life of the CAP group may possibly be related to intrinsic effects of the conventional antipsychotics.

Treatment with glutamatergic drugs in the resistant schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1447-1447
Author(s):  
R. Martínez de Velasco Soriano ◽  
F. Pando Velasco ◽  
M. Serrano Díaz de Otálora ◽  
P. Artieda Urrutia ◽  
C. Riaza Bermudo-Soriano
Keyword(s):  
Brain Development ◽  
Negative Symptoms ◽  
Clinical Manifestations ◽  
Normal Brain ◽  
Excitatory Neurotransmitter ◽  
Schizophrenic Patients ◽  
Neurodevelopmental Impairment ◽  
High Doses ◽  
Neurodevelopmental Hypothesis ◽  
Normal Brain Development

IntroductionThe neurodevelopmental hypothesis defends the existance of factors that would cause an early impairment on the normal brain development. The neurodegenerative hypothesis proposes the existance of later and progressive pathological phenomena, responsible of the appearance of clinical manifestations and changes on neuroimaging. Both hypotheses would be complementary. Neurodevelopment is completed during adolescence. Within this period, these deficts on executive functions would become apparent, reflecting a neurodevelopmental impairment. Glutamate is the main excitatory neurotransmitter, present throughout the normal postnatal brain development and maduration. In schizophrenic patients and unaffected relatives, a glutamatergic hypofunction has been found and so, an alteration of the dopaminergic mesocortical limbic and nigrostriatal pathways.ObjectivesUsage of molecules that are capable of reversing the glutamatergic hypofunction would be potentially benefitial for either positive or negative symptomathology in schizophrenia.MethodWe have performed a review of several clinical trials (on humans and animals) using glutamatergic drugs alone and combined with neuroleptics to diminish behavioural disturbances related to NMDA blockage.ResultsUsage of glycine binding site agonists (glycine, D- cicloserine, D-serine) has been proposed. D-serine is effective both as monotherapy and combined with neuroleptics. D-cicloserine is not effective on negative symptoms. Usage of high doses of oral glycine (30–60 mg a day) on its own has not shown any clinical change but there is an improvement on negative and positive symptoms if combined with neuroleptics.ConclusionNowadays, there is no glutamatergic agonist used in schizophrenia treatment. Out of the three previously mentioned drugs, only D-serine has shown some efficacy.

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.

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