scholarly journals Clinical Utility of Wearable Sensors and Patient-Reported Surveys in Patients With Schizophrenia: Noninterventional, Observational Study

10.2196/26234 ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. e26234
Author(s):  
Adrienne C Lahti ◽  
Dai Wang ◽  
Huiling Pei ◽  
Susan Baker ◽  
Vaibhav A Narayan
Keyword(s):  
Physical Activity ◽  
Rating Scale ◽  
Depression Scale ◽  
Warning Signs ◽  
Syndrome Scale ◽  
Patient Reported ◽  
Scale Total Score ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Activity Survey

Background Relapse in schizophrenia may be preceded by early warning signs of biological, sensory, and clinical status. Early detection of warning signs may facilitate intervention and prevent relapses. Objective This study aims to investigate the feasibility of using wearable devices and self-reported technologies to identify symptom exacerbation correlates and relapse in patients with schizophrenia. Methods In this observational study, patients with schizophrenia were provided with remote sensing devices to continuously monitor activity (Garmin vivofit) and sleep (Philips Actiwatch), and smartphones were used to record patient-reported outcomes. Clinical assessments of symptoms (Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale) were performed biweekly, and other clinical scales on symptoms (Clinical Global Impression-Schizophrenia, Calgary Depression Scale), psychosocial functioning, physical activity (Yale Physical Activity Survey), and sleep (Pittsburgh Sleep Quality Index) were assessed every 4 weeks. Patients were observed for 4 months, and correlations between clinical assessments and aggregated device metrics data were assessed using a mixed-effect model. An elastic net model was used to predict the clinical symptoms based on the device features. Results Of the 40 patients enrolled, 1 patient relapsed after being stable with evaluable postbaseline data. Weekly patient-reported outcomes were moderately correlated with psychiatric symptoms (Brief Psychiatric Rating Scale total score, r=0.29; Calgary Depression Scale total score, r=0.37; and Positive and Negative Syndrome Scale total score, r=0.3). In the elastic net model, sleep and activity features derived from Philips Actigraph and Garmin vivofit were predictive of the sitting index of the Yale Physical Activity Survey and sleep duration component of the Pittsburgh Sleep Quality Index. On the basis of the combined patient data, a high percentage of data coverage and compliance (>80%) was observed for each device. Conclusions This study demonstrated that wearable devices and smartphones could be effectively deployed and potentially used to monitor patients with schizophrenia. Furthermore, metrics-based prediction models can assist in detecting earlier signs of symptom changes. The operational learnings from this study may provide insights to conduct future studies. Trial Registration ClinicalTrials.gov NCT02224430; https://www.clinicaltrials.gov/ct2/show/NCT02224430

scholarly journals Clinical Utility of Wearable Sensors and Patient-Reported Surveys in Patients With Schizophrenia: Noninterventional, Observational Study (Preprint)

2020 ◽  
Author(s):  
Adrienne C Lahti ◽  
Dai Wang ◽  
Huiling Pei ◽  
Susan Baker ◽  
Vaibhav A Narayan
Keyword(s):  
Physical Activity ◽  
Rating Scale ◽  
Depression Scale ◽  
Warning Signs ◽  
Syndrome Scale ◽  
Patient Reported ◽  
Scale Total Score ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Activity Survey

BACKGROUND Relapse in schizophrenia may be preceded by early warning signs of biological, sensory, and clinical status. Early detection of warning signs may facilitate intervention and prevent relapses. OBJECTIVE This study aims to investigate the feasibility of using wearable devices and self-reported technologies to identify symptom exacerbation correlates and relapse in patients with schizophrenia. METHODS In this observational study, patients with schizophrenia were provided with remote sensing devices to continuously monitor activity (Garmin vivofit) and sleep (Philips Actiwatch), and smartphones were used to record patient-reported outcomes. Clinical assessments of symptoms (Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale) were performed biweekly, and other clinical scales on symptoms (Clinical Global Impression-Schizophrenia, Calgary Depression Scale), psychosocial functioning, physical activity (Yale Physical Activity Survey), and sleep (Pittsburgh Sleep Quality Index) were assessed every 4 weeks. Patients were observed for 4 months, and correlations between clinical assessments and aggregated device metrics data were assessed using a mixed-effect model. An elastic net model was used to predict the clinical symptoms based on the device features. RESULTS Of the 40 patients enrolled, 1 patient relapsed after being stable with evaluable postbaseline data. Weekly patient-reported outcomes were moderately correlated with psychiatric symptoms (Brief Psychiatric Rating Scale total score, <i>r</i>=0.29; Calgary Depression Scale total score, <i>r</i>=0.37; and Positive and Negative Syndrome Scale total score, <i>r</i>=0.3). In the elastic net model, sleep and activity features derived from Philips Actigraph and Garmin vivofit were predictive of the sitting index of the Yale Physical Activity Survey and sleep duration component of the Pittsburgh Sleep Quality Index. On the basis of the combined patient data, a high percentage of data coverage and compliance (&gt;80%) was observed for each device. CONCLUSIONS This study demonstrated that wearable devices and smartphones could be effectively deployed and potentially used to monitor patients with schizophrenia. Furthermore, metrics-based prediction models can assist in detecting earlier signs of symptom changes. The operational learnings from this study may provide insights to conduct future studies. CLINICALTRIAL ClinicalTrials.gov NCT02224430; https://www.clinicaltrials.gov/ct2/show/NCT02224430

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.

A Comparative Trial of Depot Pipothiazine

1986 ◽  
Vol 14 (2) ◽  
pp. 72-77 ◽  
Author(s):  
J Steinert ◽  
A Neder ◽  
E Erba ◽  
C R Pugh ◽  
C Robinson ◽  
...  
Keyword(s):  
Side Effects ◽  
Rating Scales ◽  
Rating Scale ◽  
Statistical Significance ◽  
Depression Scale ◽  
Psychotic Symptoms ◽  
Biochemical Tests ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Flupenthixol Decanoate

Thirty-nine chronic schizophrenic patients were selected for a 12-month double-blind evaluation of the effectiveness of pipothiazine palmitate (PPT) and flupenthixol decanoate (FPX) in the maintenance management of their illness. Allocation was at random and, in order to allow constant injection intervals, the patients typically received every 2 weeks either 40 mg of flupenthixol decanoate or alternating injections of 100 mg of pipothiazine palmitate and placebo. At monthly intervals the patients were assessed using both a battery of rating scales (which included the Brief Psychiatric Rating Scale (BPRS), the Extrapyramidal Symptoms Rating Scale (EPS)) and a general side-effects evaluation. At 3-monthly intervals they were also rated on the Comprehensive Psychiatric Rating Scale (CPRS) and the Zung Depression Scale. Haematological and biochemical tests were performed every 3 months. Both drugs provided good control of psychotic symptoms and side-effects were not troublesome. No substantial difference was detected on the CPRS and the Zung scales. There was a trend in favour of PPT on the BPRS survey, detectable at 6 months and reaching statistical significance by 12 months. We conclude that the PPT regime is at least as effective as the FPX treatment and probably more so. It is possible that even longer periods of control could be obtained with PPT.

An open trial of clozapine in neuroleptic-resistant childhood-onset schizophrenia

1997 ◽  
Vol 170 (6) ◽  
pp. 507-510 ◽  
Author(s):  
M. Turetz ◽  
T. Mozes ◽  
P. Toren ◽  
T. Chernauzan ◽  
R. Yoran-Hegesh ◽  
...  
Keyword(s):  
Rating Scale ◽  
Favourable Outcome ◽  
Childhood Onset ◽  
Conventional Antipsychotics ◽  
Syndrome Scale ◽  
Increased Risk ◽  
Childhood Onset Schizophrenia ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

BackgroundStudies performed with schizophrenic adults who were resistant to classical neuroleptics showed improvement in 30% of the patients when treated with clozapine. Very early onset schizophrenic patients benefit only partially from conventional antipsychotics and are at increased risk of developing extrapyramidal symptoms; clozapine may offer an alternative treatment for these patients.MethodEleven neuroleptic-resistant children (< 13 years) with schizophrenia were treated with clozapine. Improvement was monitored during the first 16 weeks using the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale and Clinical Global Impression. The mean clozapine dosage was 227.3 (s.d. 34.4) mg/day at the end of the 16 weeks.ResultsThere was an overall statistically significant reduction in all parameters, especially positive symptoms, implying a favourable outcome. Most of the improvement occurred during the first 6 to 8 weeks. The major side-effects were somnolence and drooling (no agranulocytosis).ConclusionClozapine may be a promising drug for the treatment of resistant childhood-onset schizophrenia.

Subjective and Objective Measures of Quality of Life Have Different Predictors for People with Schizophrenia

2006 ◽  
Vol 99 (2) ◽  
pp. 477-487 ◽  
Author(s):  
Masahito Tomotake ◽  
Yasuhiro Kaneda ◽  
Jun-Ichi Iga ◽  
Sawako Kinouchi ◽  
Sumiko Tayoshi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rating Scale ◽  
Depression Scale ◽  
Quality Of Life Scale ◽  
Objective Quality ◽  
Life Scale ◽  
Scale Total Score ◽  
Psychiatric Rating Scale ◽  
Objective Quality Of Life

This study investigated the relationship between subjective and objective quality of life and assessed predictors in people with schizophrenia. The study population consisted of 99 stabilized outpatients with schizophrenia (DSM-IV) who had been regularly receiving outpatient treatment at the Department of Psychiatry, The Tokushima University Hospital. Subjective and objective quality of life were estimated using the Schizophrenia Quality of Life Scale and the Quality of Life Scale, respectively. Psychiatric symptoms were also measured with the Brief Psychiatric Rating Scale and the Calgary Depression Scale for Schizophrenia. Scores on the Schizophrenia Quality of Life Scale Motivation and Energy scales significantly correlated with the Quality of Life Scale total scores –.40 ( p <.001), and with the scores on Interpersonal Relations subscale –.42 ( p <.001), Instrumental Role subscale –.28 ( p = .005), Intrapsychic Foundations subscale –.39 ( p <.001), and Common Objects and Activities subscale –.25 ( p = .014). The Schizophrenia Quality of Life Scale Psychosocial scale significantly correlated with only the Quality of Life Scale total score –.20 ( p = .05), and there was no significant correlation between the scores on the Schizophrenia Quality of Life Scale Symptoms and Side-effects scales and the Quality of Life Scale. Stepwise regression analyses showed that the Calgary Depression Scale for Schizophrenia score was the most important predictor of each scale of the Schizophrenia Quality of Life Scale, and the Brief Psychiatric Rating Scale Negative Symptoms score was the most important predictor of the Quality of Life Scale total score and each subscale. These results suggest that subjective and objective quality of life have different predictors and should be considered as separate and complementary outcome variables.

The Positive and Negative Syndrome Scale and the Brief Psychiatric Rating Scale

1992 ◽  
Vol 180 (11) ◽  
pp. 723-728 ◽  
Author(s):  
MORRIS BELL ◽  
ROBERT MILSTEIN ◽  
JOSEPH BEAM-GOULET ◽  
PAUL LYSAKER ◽  
DOMENIC CICCHETTI
Keyword(s):  
Rating Scale ◽  
Brief Psychiatric Rating Scale ◽  
Syndrome Scale ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Negative Syndrome

Oral olanzapine versus oral haloperidol in the maintenance treatment of schizophrenia and related psychoses

1998 ◽  
Vol 172 (6) ◽  
pp. 499-505 ◽  
Author(s):  
Pierre V. Tran ◽  
Mary Anne Dellva ◽  
Gary D. Tollefson ◽  
Anita L. Wentley ◽  
Charles M. Beasley
Keyword(s):  
Maintenance Therapy ◽  
Rating Scale ◽  
Acute Therapy ◽  
Double Blind ◽  
Kaplan Meier ◽  
Oral Olanzapine ◽  
Scale Total Score ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
One Year

BackgroundThree studies compared olanzapine and haloperidol given orally in maintenance therapy for schizophrenia and related psychoses.MethodData were from double-blind extensions of acute studies. The subjects met criteria for schizophrenia, schizophreniform disorder or schizoaffective disorder. Subjects had responded to acute therapy (Brief Psychiatric Rating Scale total score decreased $ 40% from baseline (Studies 1, 2, and 3) or was $ 18 (Studies I and 2)) and were out-patients at their last acute phase visit. Relapse was defined as hospitalisation for psychopathology. Subjects treated with olanzapine in the three studies were pooled to form the olanzapine group and subjects treated with haloperidol were pooled to form the haloperidol group.ResultsOlanzapine-treated subjects experienced less relapse (P=0.034). The Kaplan-Meier estimated one-year risk of relapse was 19.7% with olanzapine and 28% with haloperidol.ConclusionOlanzapine was superior to haloperidol in the maintenance therapy of schizophrenia and related psychoses.

scholarly journals Clinical relevance of findings in trials of antipsychotics: systematic review

2011 ◽  
Vol 198 (5) ◽  
pp. 341-345 ◽  
Author(s):  
Peter Lepping ◽  
Rajvinder S. Sambhi ◽  
Richard Whittington ◽  
Steven Lane ◽  
Rob Poole
Keyword(s):  
Systematic Review ◽  
Clinical Relevance ◽  
Rating Scale ◽  
Data Sets ◽  
Syndrome Scale ◽  
Minimal Improvement ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
First And Second Generation ◽  
Negative Syndrome

BackgroundThere is concern over the methods used to evaluate antipsychotic drugs.AimsTo assess the clinical relevance of findings in the literature.MethodA systematic review identified studies of antipsychotics that used the Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS). A published method of translating these into Clinical Global Impression – Change scale (CGI–C) scores was used to measure clinical relevance.ResultsIn total 98 data-sets were included in the BPRS analysis and 202 data-sets in the PANSS analysis. When aggregated scores were translated into notional CGI–C scores, most drugs reached ‘minimal improvement’ on the BPRS, but few reached that level for PANSS. This was true of both first- and second-generation drugs, including clozapine. Amisulpride and olanzapine had better than average CGI–C scores.ConclusionsOur findings show improvements of limited clinical relevance. The CGI–C scores were better for the BPRS than for the PANSS.

scholarly journals Do Leptin Play a Role in Metabolism–Related Psychopathological Symptoms?

2021 ◽  
Vol 12 ◽  
Author(s):  
Yelei Zhang ◽  
Xiaoyue Li ◽  
Xianhu Yao ◽  
Yating Yang ◽  
Xiaoshuai Ning ◽  
...  
Keyword(s):  
Rating Scale ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Serum Leptin ◽  
Psychopathological Symptoms ◽  
Syndrome Scale ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Psychopathology Symptoms ◽  
Negative Syndrome

Objectives: Leptin is a crucial regulator of energy balance and is associated with obesity. In recent years, it has also been recognized as involved in the psychopathological mechanism. Our study aimed to elucidate the relationships between serum leptin levels, body mass index (BMI), and psychopathology symptoms in patients with schizophrenia.Methods: A cross-sectional assessment of 324 inpatients with schizophrenia was conducted. Schizophrenia symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS). Serum leptin levels were assessed by the Enzyme-Linked Immunosorbent Assay (ELISA).Results: Significant differences in sex, BMI, and negative symptom subscale (PANSS-N) scores were found between the groups with high and low leptin levels in the study. Leptin levels were positively correlated with BMI (B = 2.322, t = 9.557, P &lt; 0.001) and negatively correlated with PANSS-N scores (B = −0.303, t = −2.784, P = 0.006).Conclusions: Our results suggest that the increase in leptin levels is responsible for antipsychotic-induced weight gain and improved psychopathological symptoms.

A clinimetric analysis of a BPRS-6 scale for schizophrenia severity

2018 ◽  
Vol 30 (4) ◽  
pp. 187-191 ◽  
Author(s):  
Per Bech ◽  
Stephen F Austin ◽  
Nina Timmerby ◽  
Thomas A Ban ◽  
Stine Bjerrum Møller
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Theory Model ◽  
Primary Objective ◽  
Clinical State ◽  
Clinical Validity ◽  
Syndrome Scale ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Negative Syndrome

ObjectiveA restricted Brief Psychiatric Rating Scale (BPRS-6) with the six schizophrenia specific items from the Positive and Negative Syndrome Scale (PANSS) has been investigated. These six items from the PANSS have recently been found to have both clinical validity and ‘unidimensionality’ in measuring the severity of schizophrenic states. The primary objective of this study was to evaluate the clinical validity of the BPRS-6. The secondary objective was to evaluate the ‘unidimensionality’ of the BPRS-6 by an ‘item response theory’ model.MethodsThe BPRS-6 was scored independently by two psychiatrists and two psychologists while viewing six open-ended videotaped interviews in patients with a DSM-III diagnosis of schizophrenia. The interviews were conducted by Heinz E. Lehmann, an experienced psychiatrist. They were focused on the psychopathology that contributed most to the ‘severity’ of the patient’s clinical state.ResultsThe BPRS-6 with three positive symptoms (delusions, conceptual disorganisation, hallucinations) and three negative symptoms (blunted affect, emotional withdrawal, poverty of speech) was found to be clinically valid and captured the variables that contribute most to the severity of schizophrenia. The BPRS-6 was also found to have acceptable ‘unidimensionality’ (coefficient of homogeneity 0.45) and inter-rater reliability (inter-class-coefficient 0.81).ConclusionThe BPRS-6 was found to capture the information that translates into the severity of schizophrenia. It has also acceptable psychometric validity.

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