scholarly journals Real-World Functioning in Patients With Schizophrenia: Beyond Negative and Cognitive Symptoms

2021 ◽  
Vol 12 ◽  
Author(s):  
María Paz García-Portilla ◽  
Leticia García-Álvarez ◽  
Leticia González-Blanco ◽  
Francesco Dal Santo ◽  
Teresa Bobes-Bascarán ◽  
...  

Introduction: Interest in the idea of recovery for certain patients with schizophrenia has been growing over the last decade. Improving symptomatology and functioning is crucial for achieving this. Our study aims to identify those factors that substantially contribute to real-world functioning in these patients.Methods: We carried out a cross-sectional study in stable outpatients with schizophrenia on maintenance antipsychotic monotherapy. Patients: We studied 144 outpatients with schizophrenia (DSM-IV-TR criteria) meeting the following criteria: (1) 18–65 years of age; (2) being clinically stable for at least the previous three months; (3) on maintenance antipsychotic monotherapy (prescriptions ≤ 10 mg olanzapine, ≤200 mg quetiapine, or ≤100 mg levomepromazine as hypnotics were also allowed); and (4) written informed consent. Assessment: We collected information on demographic and clinical variables by using an ad hoc questionnaire. For psychopathology, we employed the Spanish versions of the following psychometric instruments: the Positive and Negative Syndrome Scale (PANSS), the Brief Negative Symptom Scale (BNSS-Sp), and the Calgary Depression Scale (CDS). In addition, cognitive domains were assessed using the Verbal Fluency Test (VFT), the Digit Symbol Substitution Test (DSST), and the Trail Making Test, parts A and B (TMT-A and TMT-B). Finally, we employed the Spanish versions of the University of California San Diego Performance-based Skills Assessment (Sp-UPSA) and the Personal and Social Performance (PSP) for assessing functional capacity and real-world functioning, respectively. Statistical analysis: A forward stepwise regression was conducted by entering those variables significantly associated with PSP total score into the univariate analyses (Student's t-test, ANOVA with Duncan's post-hoc test, or bivariate Pearson correlation).Results: A total of 144 patients; mean age 40 years, 64% males, mean length of illness 12.4 years, PSP total score 54.3. The final model was a significant predictor of real-world functioning [F(7, 131) = 36.371, p < 0.001] and explained 66.0% of the variance. Variables retained in the model: BNSS-Sp abulia, asociality, and blunted affect, PANSS general psychopathology, Sp-UPSA transportation, TMT-B, and heart rate.Conclusion: Our model will contribute to a more efficient and personalized daily clinical practice by assigning specific interventions to each patient based on specific impaired factors in order to improve functioning.

2016 ◽  
Vol 33 (S1) ◽  
pp. s245-s245
Author(s):  
M. Corbo ◽  
T. Acciavatti ◽  
S. Marini ◽  
E. Cinosi ◽  
L. Di Tizio ◽  
...  

IntroductionA certain degree of depressive symptoms is common in schizophrenic patients. The assessment and treatment of depressive symptoms in schizophrenia is clinically challenging.ObjectivesWe conducted a cross-sectional study to investigate the depressive dimension of schizophrenic patients.AimsThe aim was to evaluate the effect of pharmacotherapy on depressive symptomatology.MethodsThirty-four outpatients (18-65 years old) with stable schizophrenia in monotherapy with FGAs or SGAs. We evaluated: depressive symptoms with Calgary Depression Scale for Schizophrenia; positive and negative symptoms (with Positive and Negative Symptom Scale); neurocognition (with Matrics Cognitive Consensus Battery); social cognition (with Facial Emotional Identification Test); social functioning (with Personal and Social Performance Scale and with UCSD Performance-based Skills Assessment). Collected data underwent statistical analyses.ResultsA SGAs therapy was associated with: lower depressive symptoms (mean SGAs group = 4.0; mean FGAs group = 7.86, P < 0.05); lower mean positive symptoms (mean SGAs group = 12.65; mean FGAs group = 17.43, P < 0.05); lower negative symptoms (mean SGAs group = 21.35; mean FGAs group = 29.07, P < 0.05); lower scores on the PANSS-total (mean SGAs group = 71.05; mean FGAs group = 91.86, P < 0.01). After correction for multiple variables, the SGAs group still had significantly lower values towards the FGAs group (P < 0.05).ConclusionsOur study support the notion that switch from a FGA to a SGA could be a relatively simple first-step for the treatment of this condition. Atypical antipsychotics might exercise antidepressant effects with different potential mechanism including: remission of a FGA-induced depression and action on of 5-hydroxytryptamine, dopamine [other than postsynaptic D2], and α1-noradrenergic receptor sites.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Vol 78 (3) ◽  
pp. 133-138 ◽  
Author(s):  
Nina LATYSHEVA ◽  
Elena FILATOVA ◽  
Diana OSIPOVA ◽  
Alexey B. DANILOV

Abstract Cognitive impairment has been described in all phases of a migraine attack and interictally. However, the prevalence and phenotype of such impairment in chronic migraine (CM) have not yet been studied. Objectives: The aim of this study was to evaluate both the prevalence of the objective cognitive deficit in patients with CM and the factors underlying its etiology. Methods: 144 patients with CM and 44 age-matched patients with low-frequency episodic migraine (EM) (a maximum of 4 headache days per month) participated in this study. Neuropsychiatric characteristics were measured with the HADS Hospital Anxiety and Depression Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20). Results: Compared to EM, CM subjects demonstrated higher subjective and objective cognitive impairment across all tests. CM patients had 4 times higher odds of achieving a RAVLT score in the lower quartile range compared to EM (Odds Ratio [OR] 3.8; 95% confidence interval [95%CI] 1.5‒9.6; р=0.005). In the MoCA, CM patients demonstrated the most striking impairment in memory/delayed recall (65.3%), attention (46.5%), abstraction (30.6%), and language (27.1%). Chronic headache and level of education, but not gender, depression or anxiety, were independent predictors of cognitive impairment. Conclusions: Cognitive impairment is prevalent in the CM population during their mildest possible pain and may be caused by a central sensitization. Timely preventive treatment of EM is warranted.


2020 ◽  
Author(s):  
Michelle Marie Ramey ◽  
Grant S Shields ◽  
Andrew P. Yonelinas

Background: Although it is widely known that consumption of plant-based foods is important for physical health, little is known about the relationship between plant-based foods and cognitive health. Emerging evidence suggests that some macronutrients may exert effects on cognition, but it is unclear which domains of cognition are involved; more importantly, it is unknown how a plant-based dietary pattern relates to cognition.Objective: To examine associations between a plant-based dietary pattern and multiple cognitive functions (i.e., memory and two aspects of executive function).Methods: Participants were 3,039 older adults who participated in the 2011-2014 waves of the National Health and Nutrition Examination Survey (NHANES). The present cross-sectional study used data on macronutrient intake from two 24-hour dietary interviews, as well as performance on tests of long-term memory and executive function (i.e., delayed word recall, digit symbol substitution test, and animal fluency). Principal component analysis was used to extract a dietary pattern consistent with a plant-based diet.Results: Greater adherence to a dietary pattern consistent with a plant-based diet was related to better performance on all cognitive tasks. Secondary analyses indicated that the associations between a plant-based dietary pattern and executive function accounted for the association between a plant-based dietary pattern and memory. Furthermore, this same plant-based dietary pattern was associated with reduced baseline inflammation in a separate dataset.Conclusions: Experimental manipulations are needed to determine the direction and timescale of the observed associations, but these results suggest that a plant-based diet is related to better cognition, especially through improved executive control. Future work should also attempt to extend these results by examining potential mechanisms underlying these associations, such as reduced inflammation.


Author(s):  
E.W. Katzman ◽  
S.J. Nielsen

Background: Many studies have focused on the association between diet and cognitive function. While a subset of these studies focused on a diet that includes tree nuts (TN), there is limited data on the association between peanut and peanut butter consumption (P/PB) and cognitive health. Objective: This study investigated the association of P/PB consumption and cognitive function. Design: This was a cross-sectional study using 2011-2014 NHANES data. Participants/setting: Individuals 60-80 years old in 2011-2014 NHANES who had two 24-hour dietary recalls, cognitive function tests, and education level and with no history of stroke. Measurements: P/PB and TN consumption was measured as well as participant performance on the CERAD Word Learning subtest (CERAD W-L), Animal Fluency test (AFT), and the Digit Symbol Substitution test (DSST). Scores from the three cognitive tests were dichotomized. Individuals were classified as either P/PB consumers or non-consumers and TN consumers or non-consumers. Logistic regression models examined associations between P/PB consumption, tree nut consumption, and cognitive function with adjusted models including age, sex, and education as covariates. Results: A total of 2,454 adults, aged 60-80 years old (mean age=69.4) participated. Approximately half were male (48%), 18% were P/PB consumers, and 14% consumed TN. Participants who did not consume P/PB were more likely to do poorly on the CERAD W-L (adjusted OR=1.56, 95% CI 1.24-1.97; p<0.05), AFT (adjusted OR=1.29, 95% CI 1.03-1.61; p<0.05), and DSST (adjusted OR=1.43, 95% CI 1.12-1.82; p<0.05) when compared to those who did consume P/PB. Conclusions: These findings suggest an association between P/PB consumption and cognitive function; however, this is a cross sectional study and a causal relationship cannot be established. More studies are needed to determine causality.


2020 ◽  
Vol 16 ◽  
Author(s):  
Salman Khazaei ◽  
Erfan Ayubi ◽  
Saeid Bashirian ◽  
Ronak Hamzehei ◽  
Ensiyeh Jenabi

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.


2021 ◽  
pp. 002076402110001
Author(s):  
Esra’ O Taybeh

Background: The magnitude of postpartum depression in Jordan is under documented, and little is known about its potential sociodemographic and clinical correlates. Purpose: The aim of this study was to explore the prevalence and risk factors associated with postpartum depression among Jordanian mothers in the first 18 months after delivery. Method: This descriptive cross-sectional study was carried out from April to June 2020 in Jordan. A web-based survey was used for recruiting eligible participants. An Arabic version of the validated self-administered Edinburgh Postnatal Depression Scale questionnaire was used to measure postpartum depression with a cut-off score of ⩾12 which indicates probable depression. Results: A total of 1,071 Jordanian women participated in the study. Of those, 567 women had postpartum depression (52.9%). Multivariate logistic regression analysis revealed that postpartum depression was significantly associated with marital conflict (OR: 4.91; 95% CI: 2.36–10.20), negative attitude from the pregnancy (OR: 0.67; 95% CI: 0.45–0.99), unplanned pregnancies (OR: 1.73; 95% CI: 1.16–2.60), lack of social support (OR: 1.93; 95% CI: 1.12–3.32), time from last delivery (OR: 0.99; 95% CI: 0.98–1.00), insomnia (OR: 0.53; 95% CI: 0.35–0.82), and depression during the pregnancy (OR: 0.51; 95% CI: 0.33–0.78). Most of the participants (65.7%) sought social support to avoid, reduce, or treat postpartum depression. Conclusions: Postpartum depression among Jordanian women was the highest in comparison to that of women in other countries in the region. Therefore, screening for the presence of depressive symptoms should be implemented during regular pregnancy care visits. Social support should be encouraged in order to avoid, reduce, or treat postpartum depression.


2021 ◽  
Vol 281 ◽  
pp. 312-320
Author(s):  
Minghuan Wang ◽  
Qian Zhao ◽  
Caihong Hu ◽  
Yang Wang ◽  
Jie Cao ◽  
...  

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 199
Author(s):  
Myeong Sook Yoon ◽  
Israel Fisseha Feyissa ◽  
So-Won Suk

In the COVID-19 pandemic, marginalized groups like migrants are disproportionately affected. As panic, fear of neglect, and mistrusting institutions in these groups are presumed to be apparent, their detachment to health services still needs to be investigated. This study comparatively analyzed the level of panic and trust between South Koreans and immigrants who are living within highly affected areas of South Korea. Mann–Whitney-U-Test and Pearson correlation showed panic is more pronounced in the Korean group while having a similar panic display pattern with the immigrants. The immigrant group appears to highly trust the Korean health system, health institutions, local media, and the local native community. Beyond conventional expectations, participant’s average panic score showed a statistically significant positive correlation with items of the trust scale, indicating a level of individual reliance amid the pandemic panic. Thus, ascertaining institutional trust and matured citizenry are identified as factors for effective public health outcomes. During such a pandemic, this study also reminded the public health needs of immigrants as secondary citizens, and presumptions of immigrants’ mistrust in such settings might not always be true.


Author(s):  
Sebastián Videla ◽  
Aurema Otero ◽  
Sara Martí ◽  
M. Ángeles Domínguez ◽  
Nuria Fabrellas ◽  
...  

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic started in December 2019 and still is a major global health challenge. Lockdown measures and social distancing sparked a global shift towards online learning, which deeply impacted universities’ daily life, and the University of Barcelona (UB) was not an exception. Accordingly, we aimed to determine the impact of the SARS-CoV-2 pandemic at the UB. To that end, we performed a cross-sectional study on a sample of 2784 UB members (n = 52,529). Participants answered a brief, ad hoc, online epidemiological questionnaire and provided a nasal swab for reverse transcription polymerase chain reaction (RT-PCR) SARS-CoV-2 analysis and a venous blood sample for SARS-CoV-2 IgG antibody assay. Total prevalence of SARS-CoV-2 infection (positive RT-PCR or positive IgG) was 14.9% (95%CI 13.3 to 17.0%). Forty-four participants (1.6%, 95%CI: 1.2–2.1%) were positive for SARS-CoV-2 RT-PCR. IgG against SARS-CoV-2 was observed in 12.8% (95%CI: 11.6–14.1%) of participants. Overall, while waiting for population vaccination and/or increased herd immunity, we should concentrate on identifying and isolating new cases and their contacts.


Sign in / Sign up

Export Citation Format

Share Document