FAMILY SUPPORT-BASED PSYCHOEDUCATION IN CARING SCHIZOPHRENIC PATIENTS: A LITERATURE REVIEW

Background: The burden of family in caring a schizophrenia impacts on psychological shock and emotional burden; lack of disease knowledge and care skills; poor patient medication adherence; the difficulty of getting along with patients; conflict in the family or at work; financial burden; and need adequate social support. Aim: This study discussed how family support takes care of people with schizophrenia with a psychoeducational approach in mental health service settings. Method: A non-systematic literature review was carried out using the PICO (Population, Intervention, Comparison, Outcome) framework utilizing Scopus, CINAHL, and ProQuest databases in the last 5 years, searching with keywords: Family Support AND Schizophrenia OR Family Psychoeducation. Results: Families with schizophrenia experience the most potent stressors on the burden of care borne, in addition to stigma and the frequency of relapse of sufferers. Community care providers can involve the family in various ways, such as providing psychoeducation, supporting the family's physical, emotional and social needs, and behavioral family assessment or family therapy. Conclusion: Mental health services must develop and imply family psychoeducation training.

Schizophrenia and Hospital Admissions for Cardiovascular Events in a Large Population: The APNA Study

(1) Background: Patients with schizophrenia have higher mortality, with cardiovascular diseases being the first cause of mortality. This study aims to estimate the excess risk of hospital admission for cardiovascular events in schizophrenic patients, adjusting for comorbidity and risk factors. (2) Methods: The APNA study is a dynamic prospective cohort of all residents in Navarra, Spain. A total of 505,889 people over 18 years old were followed for five years. The endpoint was hospital admissions for a cardiovascular event. Direct Acyclic Graphs (DAG) and Cox regression were used. (3) Results: Schizophrenic patients had a Hazard Ratio (HR) of 1.414 (95% CI 1.031–1.938) of hospital admission for a cardiovascular event after adjusting for age, sex, hypertension, type 2 diabetes, dyslipidemia, smoking, low income, obesity, antecedents of cardiovascular disease, and smoking. In non-adherent to antipsychotic treatment schizophrenia patients, the HR was 2.232 (95% CI 1.267–3.933). (4) Conclusions: Patients with schizophrenia have a higher risk of hospital admission for cardiovascular events than persons with the same risk factors without schizophrenia. Primary care nursing interventions should monitor these patients and reduce cardiovascular risk factors.

Molecular genetic study of clinical and cognitive features of schizophrenia: No associations with genes SOD2, GSTO1, NQO1

The main features of schizophrenia are characterized by three domains of symptoms, including positive symptoms, negative symptoms, and cognitive defi cits, the overlap of which forms a polymorphism of clinical manifestations. Previous molecular genetic studies have found signifi cant genetic overlaps between the cognitive abilities and the risk of schizophrenia developing. Recent evidence suggests that oxidative stress may play an important role in the pathophysiology of schizophrenia.Aim. The aim of the study was to investigate the associations of polymorphisms of genes encoding the antioxidant enzymes SOD2, GSTO1, and NQO1 with clinical polymorphism of schizophrenia and the severity of cognitive deficit.Material and Methods. A comprehensive examination of 457 patients with a diagnosis of schizophrenia was carried out. Out of the total group of examined patients, cognitive functions were assessed using the BACS scale in 150 schizophrenic patients. The control group comprised 135 healthy individuals with age and gender corresponding to patient group. Their cognitive function was assessed. Genotyping of SOD2 (rs4880), GSTO1 (rs4925), and NQO1 (rs1800566) was done by realtime PCR.Results. When analyzing the distribution of genotypes and alleles of polymorphic variants of genes encoding the antioxidant enzymes SOD2, GSTO1, and NQO1, no associations between the studied loci and schizophrenia in the Russian population of the Siberian region were revealed. Also, no associations were found with clinical polymorphism of disease (disease course type, leading symptoms (positive or negative), and age of disease onset). The cognitive abilities of schizophrenic patients and healthy individuals were diff erent as expected, but no associations with genetic characteristics were found.Conclusion. In this work, we obtained negative results in regard to associations of polymorphic variants of genes encoding the antioxidant enzymes SOD2 (rs4880), GSTO1 (rs4925), and NQO1 (rs1800566) with the development of schizophrenia in the Russian population in the Siberian region, as well as with the severity of cognitive defi cit. The genetic profi le for the studied loci did not aff ect the clinical manifestations of disease in the examined sample.

Schizophrenia and Hospital Admissions for Cardiovascular Events in a Large Population. The APNA Study

(1) Background: Patients with schizophrenia have higher mortality, with cardiovascular diseases being the first cause of mortality. This study aims to estimate the excess risk of hospital admission for cardiovascular events in schizophrenic patients, adjusting for comorbidity and risk factors. (2) Methods: The APNA study is a dynamic prospective cohort of all residents in Navarra, Spain. 505889 people over 18 years were followed for five years. The endpoint was hospital admissions for a cardiovascular event. Direct Acyclic Graphs (DAG) and Cox regression were used. (3) Results: Schizophrenic patients had a Hazard Ratio (HR) of 1.414 (95% CI 1.031-1.938) of hospital admission for a cardiovascular event after adjusting for age, sex, hypertension, type 2 diabetes, dyslipidemia, smoking, low income, obesity, antecedents of cardiovascular disease, and smoking. In non-adherent to antipsychotic treatment schizophrenia patients, the HR was 2.232 (95% CI 1.267-3.933). (4) Conclusions: Patients with schizophrenia have a higher risk of hospital admission for cardiovascular events than persons with the same risk factors without schizophrenia. Primary care nursing interventions should monitor these patients and reduce cardiovascular risk factors.

Psychosocial, Internal and External Factors of Treatment Compliance of Schizophrenic Patients: A Literature Review

Compliance to treatment is one of the important and essential components of healing and schizophrenia patient’s quality of life. Treatment compliance can be improved by identifying internal and external factors from the patient. This review aims to identify Psychosocial, Internal and External Factors of Treatment Compliance of Schizophrenic Patients. The systematic research for articles begins by identifying research articles in four databases, from Scopus, Science Direct, Sage and Proquest in 2019 – 2021 using predetermined keywords. Articles were selected using PRISMA methode, and based on the inclusion and exclusion criteria that set out. Twenty-five articles analyzed in this lyteratur review were all quantitative studies. The results of the research review show that psychosocial, internal factors and external factors are components of supporting compliance to treatment for schizophrenic patients

Candidate genes of the development of antipsychotic-induced parkinsonism in patients with schizophrenia

Antipsychotic-induced parkinsonism is an undesirable reaction from the extrapyramidal system that occurs against the background of taking antipsychotics (AP), more often in patients with schizophrenia. Antipsychotic-induced parkinsonism belongs to the group of secondary parkinsonism. Its prevalence in the world is about 36%. It is assumed that this undesirable AP reaction is genetically determined. In recent years, numerous associative genetic studies of predisposition to the development of antipsychotic-induced parkinsonism have been conducted. However, the research results are contradictory.Purpose. Review of the results of studies of genetic predictors of antipsychotic-induced parkinsonism in patients with schizophrenia.Materials and methods. We searched for full-text publications in Russian and English in the RSCI, PubMed, Web of Science, Springer databases using keywords and combined searches for words over the past decade.Results. The review considers candidate genes encoding proteins/enzymes involved in the pharmacodynamics and pharmacokinetics of AP. We analyzed 23 genome-wide studies examining 108 genetic variations, including SNV/polymorphisms of 26 candidate genes involved in the development of AIP in schizophrenic patients. Among such a set of obtained results, only 22 positive associations were revealed: rs1799732 (141CIns/Del), rs1800497 (C/T), rs6275 (C/T) DRD2; rs167771 (G/A) DRD3; VNTR*9R DAT1; rs4680 (G/A) СOMT; rs6311 (C/T) 5HTR2A; rs6318 (C/G), rs3813929 (С/Т), haplotype-997G, -759C, -697C и 68G HTR2C; rs2179652 (C/T), rs2746073 (T/A), rs4606 (C/G), rs1152746 (A/G), rs1819741 (С/Т), rs1933695 (G/A), haplotype rs1933695-G, rs2179652-C, rs4606-C, rs1819741-T и rs1152746-G, haplotype rs1933695-G, rs2179652-T, rs4606-G, rs1819741-C и rs1152746-A RGS2; haplotype TCCTC ADORA2A; rs4795390 (C/G) PPP1R1B; rs6265 (G/A) BDNF; rs12678719 (C/G) ZFPM2; rs938112 (C/A) LSMAP; rs2987902 (A/T) ABL1; HLA-B44; rs16947 (A/G), rs1135824 (A/G), rs3892097 (A/G), rs28371733 (A/G), rs5030867 (A/C), rs5030865 (A/C), rs1065852 (C/T), rs5030863 (C/G), rs5030862 (A/G), rs28371706 (C/T), rs28371725 (A/G), rs1080983 (A/G) CYP2D6. However, at the present time it should be recognized that there is no final or unique decision about the leading role of any particular SNV/polymorphism in the development of AIP.Conclusion. Disclosure of genetic predictors of AP-induced parkinsonism development may provide a key to the development of a strategy for personalized prevention and treatment of the neurological complication of AP-therapy of schizophrenia in real clinical practice.

Medication compliance in schizophrenic out patients with psychoactive substance use co-morbidity: a cross-sectional study

Background: Medication adherence is an important issue in the treatment and management of persons with psychiatric disorders including schizophrenia. Apart from side effects and inefficient outcomes of psychiatric medications, substance abuse also complicates the adherence pattern to the prescribed medications. Present study was designed to estimate the magnitude of medication non-adherence and its correlates in patients with schizophrenia having co-morbid psychoactive substance use.Method: The 60 schizophrenic patients with active substance use were taken from OPD of institute of mental health and hospital, Agra. Positive and negative syndrome scale (PANSS), alcohol, smoking and substance involvement screening test (ASSIST), medication adherence rating scale (MARS) and Morisky 8-item medication adherence questionnaire (MMAQ-8) were used to gather relevant clinical data along with a proforma for recording socio-demographic characteristics.Results: The results revealed an alarming level of medication adherence. The 91.7% sample (55 patients) met the criteria for medication non-adherence. Majority of the patients were using alcohol (58.3%) and cannabis (51.7%). Conclusions: Given the high rate of medication non-compliance it is suggested that specific intervention aimed at compliance to prescribed medication is needed in this population.

Environmental Barriers and Functional Outcomes in Patients with Schizophrenia in Taiwan: The Capacity-Performance Discrepancy

Environmental factors are crucial determinants of disability in schizophrenic patients. Using data from the 2014–2018 Certification of Disability and Care Needs dataset, we identified 3882 adult patients (46.78% females; age, 51.01 ± 13.9 years) with schizophrenia. We found that patients with severe schizophrenia had lower capacity and performance than those with moderate schizophrenia. The chances of having an access barrier to environmental chapter 1 (e1) products and technology in moderate schizophrenic patients and in severe schizophrenic patients were 29.5% and 37.8%, respectively. Logistic regression analyses demonstrated that the performance score was related to accessibility barriers in the categories described in e1, with adequate fitness of models in category e110 for personal consumption, e115 for personal usage in daily living activities, and e120 for personal outdoor and indoor mobility and transportation. Furthermore, the capacity-performance discrepancy was higher in moderate schizophrenic patients with accessibility barriers in the e110, e115, and e120 categories than that in moderate schizophrenic patients without accessibility barriers. However, severe schizophrenic patients with category e120 accessibility barriers were prone to a lower discrepancy, with institutional care a potentially decreasing factor. In conclusion, providing an e1 barrier-free environment is necessary for patients with schizophrenia to decrease their disability.

Therapeutic Communication Strategies in Nursing Process of Angry, Anxious, and Fearful Schizophrenic Patients

Schizophrenia is a group of psychotic disorders with primary personality disorders, characteristic distortions of thought processes. Schizophrenic disorders are characterized by fundamental and characteristic distortions of thought and perception and incompatible or blunted effects. Anger, anxiety, and fear are the most common hallucinations in Schizophrenic patients. These feelings drive the continued negative behaviour of the Schizophrenic patient. The therapeutic communication technique in the nursing process is one of the techniques in the healing process of patients, especially those with mental disorders nursing problems. This study was conducted based on anxiety about the results of observations, preliminary research, and reports obtained about the number of therapy failures for Schizophrenic patients caused by communication errors during treatment. In this study, researchers aimed to determine the Therapeutic Communication of Nurses to Patients. This qualitative research uses a Quasy-experimental design using a One-Group Pre-Post Test Design research design. The conclusion emerged in the study that 22 people (88%) of respondents were in the Bad category in controlling negative thoughts. Meanwhile, three respondents (12%) have an excellent ability to control negative thoughts. There are also research results that show 3 variables that support effective and efficient therapeutic communication. These are Build Trust, Troubleshooting with Constructive Coping, and Giving Appreciation.