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Abstract
Recent debates concerning the abolition of the schizophrenia label in psychiatry have focused upon problems with the scientific status of the concept. In this article, I argue that rather than attacking schizophrenia for its lack of scientific validity, we should focus on the conceptual history of this label. I reconstruct a specific tradition when exploring the conceptual history of schizophrenia. This is the concern with the question of the sense of life itself, conducted through the confrontation with schizophrenia as a form of life that does not live, or as Robert Jay Lifton termed it "lifeless life" (1979: 222-39). I conclude by arguing that the contemporary attempt to deconstruct or abolish the schizophrenia concept involves a fundamental shift in concern. The attempt both to normalize psychotic experiences, and to conceive them purely in terms of cognitive processes that can be mapped onto brain function, results in a fundamental move away from the attempt to understand the experience of madness.
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102
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Abstract
OBJECTIVE To assess health care disparities among black and Latino adults with schizophrenia receiving services during the period July 1994-June 2006, and to evaluate trends in observed disparities. DATA SOURCES Administrative claims data from the Florida Medicaid program. Data sources included membership files (demographic information), medical claims (diagnostic, service, and expenditure information), and pharmacy claims (prescriptions used and expenditures). STUDY DESIGN We identified adults with at least two schizophrenia claims during a fiscal year. We used generalized estimating equation models to estimate disparities in spending on psychotropic drugs, psychiatric inpatient services, all mental health services, and all health services. PRINCIPAL FINDINGS Spending on psychotropic drugs, mental health, and all health was 0.9-70 percent lower for blacks and Latinos than for whites. With the exception of blacks with substance use disorder comorbidity, minorities were less likely than whites to use psychiatric inpatient services. Psychiatric inpatient spending among users did not differ by race/ethnicity. With the exception of psychiatric inpatient utilization/spending, trend analyses showed no change or modest reductions in disparities. CONCLUSIONS Black and Latino Medicaid recipients diagnosed with schizophrenia experience health care disparities. Some but not all disparities narrowed modestly over the study period.
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Affiliation(s)
| | - Thomas G McGuire
- Department of Health Care Policy, Harvard Medical SchoolBoston, MA
| | - Margarita Alegria
- Center for Multicultural Mental Health Research, Cambridge Health Alliance/Harvard Medical SchoolSomerville, MA
| | - Richard G Frank
- Department of Health Care Policy, Harvard Medical SchoolBoston, MA
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Kirkbride JB, Croudace T, Brewin J, Donoghue K, Mason P, Glazebrook C, Medley I, Harrison G, Cooper JE, Doody GA, Jones PB. Is the incidence of psychotic disorder in decline? Epidemiological evidence from two decades of research. Int J Epidemiol 2009; 38:1255-64. [PMID: 18725359 PMCID: PMC3307031 DOI: 10.1093/ije/dyn168] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2008] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND It is unclear whether the incidence of first episode psychoses is in decline. We had the opportunity to determine whether incidence had changed over a 20-year period in a single setting, and test whether this could be explained by demographic or clinical changes. METHODS The entire population at-risk aged 16-54 in Nottingham over three time periods (1978-80, 1993-95 and 1997-99) were followed up. All participants presenting with an ICD-9/10 first episode psychosis were included. The remainder of the population at-risk formed the denominator. Standardized incidence rates were calculated at each time period with possible change over time assessed via Poisson regression. We studied six outcomes: substance-induced psychoses, schizophrenia, other non-affective psychoses, manic psychoses, depressive psychoses and all psychotic disorders combined. RESULTS Three hundred and forty-seven participants with a first episode psychosis during 1.2 million person-years of follow-up over three time periods were identified. The incidence of non-affective or affective psychoses had not changed over time following standardization for age, sex and ethnicity. We observed a linear increase in the incidence of substance-induced psychosis, per annum, over time (incidence rate ratios: 1.15; 95% CI 1.05-1.25). This could not be explained by longitudinal changes in the age, sex and ethnic structure of the population at-risk. CONCLUSIONS Our findings suggest psychotic disorders are not in decline, though there has been a change in the syndromal presentation of non-affective disorders, away from schizophrenia towards other non-affective psychoses. The incidence of substance-induced psychosis has increased, consistent with increases in substance toxicity over time, rather than changes in the prevalence or vulnerability to substance misuse. Increased clinical and popular awareness of substance misuse could also not be excluded.
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Affiliation(s)
- J B Kirkbride
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.
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104
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Chen X, Sun C, Chen Q, O'Neill FA, Walsh D, Fanous AH, Chowdari KV, Nimgaonkar VL, Scott A, Schwab SG, Wildenauer DB, Che R, Tang W, Shi Y, He L, Luo XJ, Su B, Edwards TL, Zhao Z, Kendler KS. Apoptotic engulfment pathway and schizophrenia. PLoS One 2009; 4:e6875. [PMID: 19721717 PMCID: PMC2731162 DOI: 10.1371/journal.pone.0006875] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Accepted: 07/14/2009] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Apoptosis has been speculated to be involved in schizophrenia. In a previously study, we reported the association of the MEGF10 gene with the disease. In this study, we followed the apoptotic engulfment pathway involving the MEGF10, GULP1, ABCA1 and ABCA7 genes and tested their association with the disease. METHODOLOGY/PRINCIPAL FINDINGS Ten, eleven and five SNPs were genotyped in the GULP1, ABCA1 and ABCA7 genes respectively for the ISHDSF and ICCSS samples. In all 3 genes, we observed nominally significant associations. Rs2004888 at GULP1 was significant in both ISHDSF and ICCSS samples (p = 0.0083 and 0.0437 respectively). We sought replication in independent samples for this marker and found highly significant association (p = 0.0003) in 3 Caucasian replication samples. But it was not significant in the 2 Chinese replication samples. In addition, we found a significant 2-marker (rs2242436 * rs3858075) interaction between the ABCA1 and ABCA7 genes in the ISHDSF sample (p = 0.0022) and a 3-marker interaction (rs246896 * rs4522565 * rs3858075) amongst the MEGF10, GULP1 and ABCA1 genes in the ICCSS sample (p = 0.0120). Rs3858075 in the ABCA1 gene was involved in both 2- and 3-marker interactions in the two samples. CONCLUSIONS/SIGNIFICANCE From these data, we concluded that the GULP1 gene and the apoptotic engulfment pathway are involved in schizophrenia in subjects of European ancestry and multiple genes in the pathway may interactively increase the risks to the disease.
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Affiliation(s)
- Xiangning Chen
- Department of Psychiatry and Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, Virginia, USA.
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105
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Abstract
BACKGROUND This study was the first national survey ever conducted in Greece aiming to monitor the level of stigma Greeks hold against people with schizophrenia (PWS). AIM To investigate sources, degree of knowledge and attitudes towards PWS in Greece. METHOD A cross-sectional nationwide survey was conducted by face-to-face household interviews ( n = 1,199, aged 15 years and over). RESULTS Television was the main source of information (65.9%). Negative portrayals of PWS were recalled by 60.5%. Only 27.7% attributed schizophrenia to a combination of psychosocial, genetic and environmental factors. Respondents believed that PWS are dangerous (74.6%), have split personalities (81.3%) and cannot work (83.2%). Regarding attitudes, a negative relationship between closeness and social distance was observed. Most respondents (92.1%) would not marry someone with schizophrenia, half (50.5%) would be disturbed by working with PWS and one third (32.9%) would feel afraid to start a conversation. Urban residence and higher education were generally associated with better knowledge and more positive attitudes towards PWS. CONCLUSIONS Knowledge about schizophrenia in Greece is poor. The Greek public has stigmatizing attitudes towards PWS. Educational interventions should especially target rural and semi-urban residents of a lower educational level. The role of television can be crucial.
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Affiliation(s)
- Marina Economou
- University Mental Health Research Institute, Athens University Medical School, Athens, Greece
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106
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López SR, Ramírez García JI, Ullman JB, Kopelowicz A, Jenkins J, Breitborde NJK, Placencia P. Cultural variability in the manifestation of expressed emotion. Fam Process 2009; 48:179-94. [PMID: 19579904 PMCID: PMC2845540 DOI: 10.1111/j.1545-5300.2009.01276.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We examined the distribution of expressed emotion (EE) and its indices in a sample of 224 family caregivers of individuals with schizophrenia pooled from 5 studies, 3 reflecting a contemporary sample of Mexican Americans (MA 2000, N = 126), 1 of an earlier study of Mexican Americans (MA 1980, N = 44), and the other of an earlier study of Anglo Americans (AA, N = 54). Chi-square and path analyses revealed no significant differences between the 2 MA samples in rates of high EE, critical comments, hostility, and emotional over-involvement (EOI). Only caregiver warmth differed for the 2 MA samples; MA 1980 had higher warmth than MA 2000. Significant differences were consistently found between the combined MA samples and the AA sample; AAs had higher rates of high EE, more critical comments, less warmth, less EOI, and a high EE profile comprised more of criticism/hostility. We also examined the relationship of proxy measures of acculturation among the MA 2000 sample. The findings support and extend Jenkins' earlier observations regarding the cultural variability of EE for Mexican Americans. Implications are discussed regarding the cross-cultural measurement of EE and the focus of family interventions.
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Affiliation(s)
- Steven R López
- Department of Psychology, University of Southern California, 3620 S. McClintock, Los Angeles, CA 90089-1061, USA.
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107
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Abstract
The radical psychiatrist R.D. Laing's first book, "The Divided Self" (1960), is informed by the work of Christian thinkers on scriptural interpretation -- an intellectual genealogy apparent in Laing's comparison of Karl Jaspers's symptomatology with the theological tradition of "form criticism." Rudolf Bultmann's theology, which was being enthusiastically promoted in 1950s Scotland, is particularly influential upon Laing. It furnishes him with the notion that schizophrenic speech expresses existential truths as if they were statements about the physical and organic world. It also provides him with a model of the schizoid position as a form of modern-day Stoicism. Such theological recontextualization of "The Divided Self" illuminates continuities in Laing's own work, and also indicates his relationship to a wider British context, such as the work of the "clinical theologian" Frank Lake.
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108
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Ma J, Fan JB, Wu SN, Zhang CS, Ji BH, Wang L, Li XW, Gu NF, Feng GY, St Clair D, He L. [Association study of an (AC)n dinucleotide repeat and schizophrenia in Asian and European populations]. Yi Chuan 2009; 29:1207-13. [PMID: 17905710 DOI: 10.1360/yc-007-1207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Linkage studies have suggested that chromosome 15q13-q14 may harbor a susceptibility locus for schizophrenia. In the current study, the association between a (AC)n dinucleotide repeat polymorphism at D15S118 and schizophrenia was investigated using three independent samples from the Han Chinese population and the Scotland population. In the population-based study, a significant difference was found between the allele frequency distributions in schizophrenia patients and control subjects in the Scottish samples (P = 0.04), but was not replicated in the Chinese samples. In a family-based study, no significant transmission disequilibrium from heterozygous parents to affected offspring was observed. Overall, our results did not support the hypothesis that the (AC)n dinucleotide repeat polymorphism plays a major role in schizophrenia susceptibility, at least in the Chinese population. Further studies are needed to elucidate its role in schizophrenia susceptibility in European population.
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Affiliation(s)
- Jie Ma
- Bio-X Center, Shanghai Jiao Tong University, Shanghai, China.
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109
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Lin C, Tang W, Hu J, Gao L, Huang K, Xu Y, He G, Liang P, Feng G, He L, Shi Y. Haplotype analysis confirms association of the serotonin transporter (5-HTT) gene with schizophrenia in the Han Chinese population. Neurosci Lett 2009; 453:210-3. [PMID: 19429037 DOI: 10.1016/j.neulet.2009.02.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 02/10/2009] [Accepted: 02/11/2009] [Indexed: 11/17/2022]
Abstract
Serotonin transmission has long been suspected as being involved in the pathogenesis of schizophrenia. 5-HTT is a promising candidate gene for schizophrenia due to its critical role in regulating serotonin transmission and role in the mechanism of the atypical antipsychotic drugs. A common polymorphism STin2 VNTR in the 5-HTT gene has been extensively investigated in the genetic association studies, but the results are conflicting. Meanwhile, the SNPs of the 5-HTT gene have been much less explored. We therefore conducted a case-control study of the association between STin2 VNTR and three tagging SNPs in 5-HTT and schizophrenia in the Han Chinese population based on a cohort of 329 schizophrenic patients and 288 control subjects. No association was found in the single locus, but haplotype-based analyses revealed significant association between two haplotypes with schizophrenia even after Bonferroni correction (P=0.00000538 and 0.011).
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Affiliation(s)
- Chuwen Lin
- Bio-X Center, Shanghai Jiao Tong University, Shanghai, China
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110
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Gilmer TP, Ojeda VD, Barrio C, Fuentes D, Garcia P, Lanouette NM, Lee KC. Adherence to antipsychotics among Latinos and Asians with schizophrenia and limited English proficiency. Psychiatr Serv 2009; 60:175-82. [PMID: 19176410 PMCID: PMC3235435 DOI: 10.1176/appi.ps.60.2.175] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The authors examined data for 7,784 Latino, Asian, and non-Latino white Medi-Cal beneficiaries with schizophrenia to determine the relationship between patients' preferred language for mental health services--English, Spanish, or an Asian language--and their adherence to treatment with antipsychotic medications. METHODS Data reflected 31,560 person-years from 1999 to 2004. Pharmacy records were analyzed to assess medication adherence by use of the medication possession ratio (MPR). Clients were defined as nonadherent (MPR<.5), partially adherent (MPR=.5-<.8), or adherent (MPR=.8-1.1) or as an excess filler of prescriptions (MPR<1.1). Regression models were used to examine adherence, hospitalization, and costs by race-ethnicity and language status. RESULTS Latinos with limited English proficiency were more likely than English-proficient Latinos to be medication adherent (41% versus 36%; p<.001) and less likely to be excess fillers (15% versus 20%; p<.001). Asians with limited English proficiency were less likely than English-proficient Asians to be adherent (40% versus 45%; p=.034), more likely to be nonadherent (29% versus 22%; p<.001), and less likely to be excess fillers (13% versus 17%; p=.004). When analyses controlled for adherence and comorbidities, clients with limited English proficiency had lower rates of hospitalization and lower health care costs than English-proficient and white clients. CONCLUSIONS Adherence to antipsychotic medications varied by English proficiency among and within ethnic groups. Policies supporting the training of bilingual and multicultural providers from ethnic minority groups and interventions that capitalize on patients' existing social support networks may improve adherence to treatment in linguistically diverse populations.
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Affiliation(s)
- Todd P. Gilmer
- Dr. Gilmer and Dr. Ojeda are affiliated with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD), 9500 Gilman Dr., La Jolla, CA 92093-0622 (e-mail: ). Dr. Barrio and Ms. Fuentes are with the School of Social Work, University of Southern California, Los Angeles. Dr. Garcia is with San Diego County Adult and Older Adult Mental Health Services. Dr. Lanouette is with the Department of Psychiatry and Dr. Lee is with the Skaggs School of Pharmacy and Pharmaceutical Sciences, both at UCSD
| | - Victoria D. Ojeda
- Dr. Gilmer and Dr. Ojeda are affiliated with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD), 9500 Gilman Dr., La Jolla, CA 92093-0622 (e-mail: ). Dr. Barrio and Ms. Fuentes are with the School of Social Work, University of Southern California, Los Angeles. Dr. Garcia is with San Diego County Adult and Older Adult Mental Health Services. Dr. Lanouette is with the Department of Psychiatry and Dr. Lee is with the Skaggs School of Pharmacy and Pharmaceutical Sciences, both at UCSD
| | - Concepcion Barrio
- Dr. Gilmer and Dr. Ojeda are affiliated with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD), 9500 Gilman Dr., La Jolla, CA 92093-0622 (e-mail: ). Dr. Barrio and Ms. Fuentes are with the School of Social Work, University of Southern California, Los Angeles. Dr. Garcia is with San Diego County Adult and Older Adult Mental Health Services. Dr. Lanouette is with the Department of Psychiatry and Dr. Lee is with the Skaggs School of Pharmacy and Pharmaceutical Sciences, both at UCSD
| | - Dahlia Fuentes
- Dr. Gilmer and Dr. Ojeda are affiliated with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD), 9500 Gilman Dr., La Jolla, CA 92093-0622 (e-mail: ). Dr. Barrio and Ms. Fuentes are with the School of Social Work, University of Southern California, Los Angeles. Dr. Garcia is with San Diego County Adult and Older Adult Mental Health Services. Dr. Lanouette is with the Department of Psychiatry and Dr. Lee is with the Skaggs School of Pharmacy and Pharmaceutical Sciences, both at UCSD
| | - Piedad Garcia
- Dr. Gilmer and Dr. Ojeda are affiliated with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD), 9500 Gilman Dr., La Jolla, CA 92093-0622 (e-mail: ). Dr. Barrio and Ms. Fuentes are with the School of Social Work, University of Southern California, Los Angeles. Dr. Garcia is with San Diego County Adult and Older Adult Mental Health Services. Dr. Lanouette is with the Department of Psychiatry and Dr. Lee is with the Skaggs School of Pharmacy and Pharmaceutical Sciences, both at UCSD
| | - Nicole M. Lanouette
- Dr. Gilmer and Dr. Ojeda are affiliated with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD), 9500 Gilman Dr., La Jolla, CA 92093-0622 (e-mail: ). Dr. Barrio and Ms. Fuentes are with the School of Social Work, University of Southern California, Los Angeles. Dr. Garcia is with San Diego County Adult and Older Adult Mental Health Services. Dr. Lanouette is with the Department of Psychiatry and Dr. Lee is with the Skaggs School of Pharmacy and Pharmaceutical Sciences, both at UCSD
| | - Kelly C. Lee
- Dr. Gilmer and Dr. Ojeda are affiliated with the Department of Family and Preventive Medicine, University of California, San Diego (UCSD), 9500 Gilman Dr., La Jolla, CA 92093-0622 (e-mail: ). Dr. Barrio and Ms. Fuentes are with the School of Social Work, University of Southern California, Los Angeles. Dr. Garcia is with San Diego County Adult and Older Adult Mental Health Services. Dr. Lanouette is with the Department of Psychiatry and Dr. Lee is with the Skaggs School of Pharmacy and Pharmaceutical Sciences, both at UCSD
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Ahmad Y, Bhatia MS, Mediratta PK, Sharma KK, Negi H, Chosdol K, Sinha S. Association between the ionotropic glutamate receptor kainate3 (GRIK3) Ser310Ala polymorphism and schizophrenia in the Indian population. World J Biol Psychiatry 2009; 10:330-3. [PMID: 19921975 DOI: 10.3109/15622970802688044] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Various studies have been done to check the status of glutamate receptor gene in the pathogenesis of schizophrenia. The T928G (Ser310Ala) polymorphism of ionotropic glutamate receptor kainate 3 gene (GRIK3) and its positive association with schizophrenia was reported in Caucasians, whereas no association of this polymorphism with schizophrenia was shown in two other populations, Chinese and Japanese. However, no literature is available regarding the prevalence of this polymorphism and its association with schizophrenia in the Indian population. As genetic susceptibility profiles in India are often different from those of white Caucasians or Orientals, we investigated the status of Ser310Ala polymorphism of GRIK3 in 100 schizophrenic patients and 100 healthy controls in the Indian population by the PCR-RFLP (restriction fragment length polymorphism) method. A statistically significant difference in the genotype and allelic distributions (P<0.000001 and P=0.01, respectively) of Ser310Ala polymorphism was found in schizophrenics than in control, considering Ala-allele as being associated with the disease (OR=1.7, 95% CI=1.137-2.540). Our study suggests a potential role for GRIK3 for susceptibility to schizophrenia in Indian population.
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Affiliation(s)
- Yusra Ahmad
- Department of Pharmacology, University College of Medical Sciences, GTB-Hospital, India
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112
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Xiang YT, Weng YZ, Leung CM, Tang WK, Lai KYC, Ungvari GS. Prevalence and correlates of insomnia and its impact on quality of life in Chinese schizophrenia patients. Sleep 2009; 32:105-109. [PMID: 19189785 PMCID: PMC2625313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
STUDY OBJECTIVES This study aimed to determine the prevalence and the sociodemographic and clinical correlates of insomnia in Chinese schizophrenia outpatients and its impact on patients' quality of life (QOL). DESIGN Two hundred fifty-five clinically stable schizophrenia outpatients were randomly selected in Hong Kong and their counterparts matched according to sex, age, age at onset, and length of illness were recruited in Beijing, China. All subjects at both sites were interviewed by the same investigator using standardized assessment instruments. SETTING Hong Kong and Beijing, China. PATIENTS OR PARTICIPANTS Clinically stable schizophrenia outpatients. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS In the combined Beijing-Hong Kong sample the frequency of at least one type of insomnia over the previous 12 months was 36.0%; the rates of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 21.2%, 23.6%, and 11.9%, respectively. Poor sleep was significantly associated with advanced age, older age at onset, fewer psychiatric admissions, severity of positive symptoms, anxiety, extrapyramidal symptoms (EPS) and depressive symptoms, less frequent use of atypical antipsychotic medications (AP), and more frequent use of benzodiazepines (BZD) and hypnotics. Poor sleepers had significantly poorer QOL in all domains than patients without insomnia. After controlling for the potential confounding effects of sociodemographic and clinical factors, a significant difference remained between the 2 groups with regard to the physical QOL domain. A multiple logistic regression analysis found that advanced age, fewer psychiatric admissions, severity of depressive symptoms and use of hypnotics were significant contributors to poor sleep. CONCLUSION Insomnia is independently associated with poor QOL. More attention should be paid in clinical practice to the high rate of insomnia in Chinese schizophrenia patients.
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Affiliation(s)
- Yu-Tao Xiang
- Department of Psychiatry, Chinese University ofHong Kong, Hong Kong SAR, China, BeijingAnding Hospital, Capital Medical University, Beijing, China.
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113
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Selten JP, Hoek HW. Does misdiagnosis explain the schizophrenia epidemic among immigrants from developing countries to Western Europe? Soc Psychiatry Psychiatr Epidemiol 2008; 43:937-9. [PMID: 18587677 DOI: 10.1007/s00127-008-0390-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Veling W, Hoek HW, Mackenbach JP. Perceived discrimination and the risk of schizophrenia in ethnic minorities: a case-control study. Soc Psychiatry Psychiatr Epidemiol 2008; 43:953-9. [PMID: 18575790 DOI: 10.1007/s00127-008-0381-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Accepted: 05/22/2008] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies have reported a very high incidence of schizophrenia for immigrant ethnic groups in Western Europe. The explanation of these findings is unknown, but is likely to involve social stress inherent to the migrant condition. A previous study reported that the incidence of schizophrenia in ethnic groups was higher when these groups perceived more discrimination. We conducted a case-control study of first-episode schizophrenia, and investigated whether perceived discrimination at the individual level is a risk factor for schizophrenia. METHODS Cases included all non-western immigrants who made first contact with a physician for a psychotic disorder in The Hague, the Netherlands, between October 2000 and July 2005, and received a diagnosis of a schizophrenia spectrum disorder (DSM IV: schizophrenia, schizophreniform disorder, schizoaffective disorder) (N = 100). Two matched control groups were recruited, one among immigrants who made contact with non-psychiatric secondary health care services (N = 100), and one among siblings of the cases (N = 63). Perceived discrimination in the year before illness onset was measured with structured interviews, assessing experiences of prejudice, racist insults or attacks, and perception of discrimination against one's ethnic group. Conditional logistic regression analyses were used to predict schizophrenia as a function of perceived discrimination. RESULTS Cases reported somewhat higher rates of perceived discrimination in the year prior to illness onset than their siblings and the general-hospital controls, but these differences were not statistically significant; 52% of the cases and 42% of both control groups had perceived any discrimination. Perceived discrimination at the individual level was not a risk factor for schizophrenia in these data. Perceived discrimination was positively correlated with cultural distance and cannabis use, and negatively with ethnic identity, self-esteem, and mastery. CONCLUSIONS The relationship between racial discrimination and psychosis may vary with the aspect of discrimination that is studied, and may also depend upon the social context in which discrimination takes place.
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Affiliation(s)
- Wim Veling
- Parnassia Bavo Group, Centre for Early Psychosis, The Hague, The Netherlands.
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Dazzan P, Lloyd T, Morgan KD, Zanelli J, Morgan C, Orr K, Hutchinson G, Fearon P, Allin M, Rifkin L, McGuire PK, Doody GA, Holloway J, Leff J, Harrison G, Jones PB, Murray RM. Neurological abnormalities and cognitive ability in first-episode psychosis. Br J Psychiatry 2008; 193:197-202. [PMID: 18757976 DOI: 10.1192/bjp.bp.107.045450] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND It remains unclear if the excess of neurological soft signs, or of certain types of neurological soft signs, is common to all psychoses, and whether this excess is simply an epiphenomenon of the lower general cognitive ability present in psychosis. AIMS To investigate whether an excess of neurological soft signs is independent of diagnosis (schizophrenia v. affective psychosis) and cognitive ability (IQ). METHOD Evaluation of types of neurological soft signs in a prospective cohort of all individuals presenting with psychoses over 2 years (n=310), and in a control group from the general population (n=239). RESULTS Primary (P<0.001), motor coordination (P<0.001), and motor sequencing (P<0.001) sign scores were significantly higher in people with any psychosis than in the control group. However, only primary and motor coordination scores remained higher when individuals with psychosis and controls were matched for premorbid and current IQ. CONCLUSIONS Higher rates of primary and motor coordination signs are not associated with lower cognitive ability, and are specific to the presence of psychosis.
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Affiliation(s)
- Paola Dazzan
- Department of Psychiatry, Box 63, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
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Luo XJ, Diao HB, Wang JK, Zhang H, Zhao ZM, Su B. Association of haplotypes spanning PDZ-GEF2, LOC728637 and ACSL6 with schizophrenia in Han Chinese. J Med Genet 2008; 45:818-26. [PMID: 18718982 DOI: 10.1136/jmg.2008.060657] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Schizophrenia is a complex genetic disorder caused by multiple genetic and environmental factors. Several lines of linkage and association studies have repeatedly suggested that the chromosome 5q22-33 region is implicated in the aetiology of schizophrenia. However, most of the previous studies on the linkage of 5q22-33 with schizophrenia were from European populations, and it was not well characterised in other populations. METHODS We analysed eight single nucleotide polymorphisms (SNPs) located in the 5q23.3 region in a cohort of 506 schizophrenia patients and 672 control subjects from south western China. Single marker association, haplotypic association, sex-specific association and molecular evolutionary analysis were performed. RESULTS Single marker analysis indicated that SNP5 (rs1355095) in LOC728637 is associated with schizophrenia. When males and females were analysed separately, SNP4 (rs31251) in PDZ-GEF2 is associated with schizophrenia in females. Further analysis using haplotypes demonstrated that a haplotype block spanning PDZ-GEF2, LOC728637 and ACSL6 is highly associated with schizophrenia and several haplotypes in this haploblock have about twofold to 10-fold increase in the affected subjects. In addition, molecular evolutionary analysis suggests that PDZ-GEF2 has undergone adaptive evolution due to Darwinian positive selection in the human lineage. CONCLUSION Our data provide evidence of the association of 5q22-33 with schizophrenia in Han Chinese. This chromosomal region is likely responsible for genetic susceptibility to schizophrenia, supporting previous data from European patients. In addition, our evolutionary analysis is consistent with the hypothesis that genes contributing to schizophrenia are likely under positive selection during human evolution.
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Laurens KR, West SA, Murray RM, Hodgins S. Psychotic-like experiences and other antecedents of schizophrenia in children aged 9-12 years: a comparison of ethnic and migrant groups in the United Kingdom. Psychol Med 2008; 38:1103-1111. [PMID: 17935641 DOI: 10.1017/s0033291707001845] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The incidence of schizophrenia and the prevalence of psychotic symptoms in the general adult population are elevated in migrant and ethnic minority groups relative to host populations. These increases are particularly prominent among African-Caribbean migrants to the UK. This study examined the associations of ethnicity and migrant status with a triad of putative antecedents of schizophrenia in a UK community sample of children aged 9-12 years. The antecedent triad comprised: (i) psychotic-like experiences; (ii) a speech and/or motor developmental delay or abnormality; and (iii) a social, emotional or behavioural problem. MethodChildren (n=595) and their primary caregivers, recruited via schools and general practitioners in southeast London, completed questionnaires. Four indices of risk were examined for associations with ethnicity and migrant status: (i) certain experience of at least one psychotic-like experience; (ii) severity of psychotic-like experiences (total psychotic-like experience score); (iii) experience of the antecedent triad; and (iv) severity of antecedent triad experiences (triad score). RESULTS African-Caribbean children, as compared to white British children, experienced greater risk on all four indices. There were trends for South Asian and Oriental children to present lowered risk on several indices, relative to white British children. Migration status was unrelated to any risk index. ConclusionPrevalence of the putative antecedents of schizophrenia is greater among children of African-Caribbean origin living in the UK than among white British children. This parallels the increased incidence of schizophrenia and elevated prevalence of psychotic symptoms among adults of African-Caribbean origin.
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Affiliation(s)
- K R Laurens
- Department of Forensic Mental Health Science, Institute of Psychiatry, King's College London, London, UK.
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Abstract
BACKGROUND Being a small and culturally different minority, or having a different appearance, has been invoked to account for the increased prevalence of psychotic disorders among immigrants. The majority of the Jewish Israeli population are first- or second-generation immigrants from Europe, North Africa or Asia, and during the late 1980s and 1990s, 885 000 persons immigrated to Israel from the former Soviet Union and 43 000 immigrated from Ethiopia. These Ethiopian immigrants came from a very different culture compared to the rest of the population, and have a distinct appearance. To further understand the association between immigration and schizophrenia, we compared risk for later schizophrenia between adolescents who immigrated from Ethiopia with risk among the other immigrant groups, and with native-born Israelis. MethodOf 661 792 adolescents consecutively screened by the Israeli Draft Board, 557 154 were native-born Israelis and 104 638 were immigrants. Hospitalization for schizophrenia was ascertained using a National Psychiatric Hospitalization Case Registry. All analyses controlled for socio-economic status (SES). RESULTS Risk for schizophrenia was increased among both first- [hazard ratio (HR) 1.62, 95% confidence interval (CI) 1.18-2.22] and second-generation immigrants [HR 1.41, 95% CI 1.01-1.95 (one immigrant parent) and HR 1.49, 95% CI 1.11-2.0 (two immigrant parents)]. When risk for schizophrenia was calculated for each immigrant group separately, immigrants from Ethiopia were at highest risk of later schizophrenia (HR 2.95, 95% CI 1.88-4.65). ConclusionThis comparison between diverse groups of immigrants supports the notion that immigrants who differ in culture and appearance from the host population are at increased risk for schizophrenia.
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Affiliation(s)
- M Weiser
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel.
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119
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Abstract
Individuals from minority groups in the United States have been found less likely than non-Hispanic whites to participate in research studies. The recruitment and retention of individuals from minority groups has also proved challenging. We describe the challenges that we encountered in recruiting and retaining a sample of severely mentally ill Mexican and Puerto Rican ethnicity for a study of the context of HIV risk. We recruited women in San Diego County, California and northeastern Ohio who were between the ages of 18 and 50 and who had diagnoses of schizophrenia, bipolar disorder, or major depression. We identified challenges to recruitment and retention at the macro, mediator, and micro levels. We were able to retain 81.1% of the Puerto Rican cohort and 26.7% of the Mexican cohort over a 5-year period. The vast majority of barriers to recruitment and retention within the Puerto Rican cohort occurred at the micro (individual) level. Macro level barriers occurred more frequently and impacted retention to a greater extent within the cohort of Mexican women. Our experience underscores the importance of outreach to the community and the interaction between staff and individual participants. Diverse strategies are required to address the impact of migration on follow-up, which may vary across groups.
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Affiliation(s)
- Sana Loue
- Department of Epidemiology and Biostatistics, Center for Minority Public Health, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4945, USA.
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Abstract
Brain-derived neurotrophic factor (BDNF) has been advanced as a candidate gene for schizophrenia by virtue of its effects on neurotransmitter systems that are dysregulated in psychiatric disorder and its involvement in the response to antipsychotic drugs. The extensively examined BDNF gene Val66Met (or rs6265) variant has been associated with schizophrenia, and studies have linked this polymorphism to brain morphology, cognitive function, and psychiatric symptoms in schizophrenia. Moreover the BDNF Val66Met variant has been reported to be associated with age of onset in schizophrenia. Genotyping of African-American subjects with schizophrenia for five BDNF coding region single nucleotide polymorphisms revealed variance only at the Val66Met allele. The results of statistical analyses indicate a relationship between the BDNF Val66Met genotype and the ages of first psychiatric hospitalization and first schizophrenia symptoms.
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Affiliation(s)
- Helen M. Chao
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
- New York University Medical Center, New York, New York Helen M. Chao ()
- * Correspondence to Helen M. Chao, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, Orangeburg, NY 10962
| | - Hung-Teh Kao
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
- New York University Medical Center, New York, New York Helen M. Chao ()
| | - Barbara Porton
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
- New York University Medical Center, New York, New York Helen M. Chao ()
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Pinto R, Ashworth M, Jones R. Schizophrenia in black Caribbeans living in the UK: an exploration of underlying causes of the high incidence rate. Br J Gen Pract 2008; 58:429-34. [PMID: 18505621 PMCID: PMC2418996 DOI: 10.3399/bjgp08x299254] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 02/22/2008] [Accepted: 02/27/2008] [Indexed: 10/31/2022] Open
Abstract
The incidence of schizophrenia in black Caribbeans living in the UK is substantially higher than in the white British population. When first reported, these findings were assumed to be a first-generation migrant effect or merely the result of methodological artefacts associated with inconsistencies in the diagnosis of schizophrenia in black Caribbeans and doubts about population denominators. More recently, it has become clear that the incidence of schizophrenia, based on standardised diagnosis and sophisticated census methods, is higher still in second-generation black Caribbeans. The largest study to date has demonstrated a ninefold higher risk of schizophrenia in UK-resident black Caribbeans: findings that are of concern to black Caribbean communities, to their GPs, and to health service managers responsible for resource allocation. A literature search was carried in order to explore possible reasons for the reported excess incidence of schizophrenia in UK-resident black Caribbeans. Competing hypotheses are reviewed and the paper concludes with a summary of specific social and psychological risk factors of significance within the black Caribbean community. Awareness of the factors associated with the onset and presentation of schizophrenia in black Caribbeans may help early diagnosis and rapid access to appropriate treatment which, in turn, appear to be related to improved long-term outcomes.
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Affiliation(s)
- Rebecca Pinto
- Department of General Practice and Primary Care, Division of Health and Social Care Research, King's College London, 5 Lambeth Walk, London
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122
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Xiang YT, Weng YZ, Leung CM, Tang WK, Ungvari GS. Socio-demographic and clinical correlates of lifetime suicide attempts and their impact on quality of life in Chinese schizophrenia patients. J Psychiatr Res 2008; 42:495-502. [PMID: 17663994 DOI: 10.1016/j.jpsychires.2007.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Revised: 06/11/2007] [Accepted: 06/15/2007] [Indexed: 01/28/2023]
Abstract
This study determines the socio-demographic and clinical correlates of suicide attempts in Chinese schizophrenia outpatients and their impact on patients' quality of life (QOL). Two hundred and fifty-five clinically stable schizophrenia outpatients were randomly selected in Hong Kong (HK) and their counterparts matched according to sex, age, age at onset and length of illness were recruited in Beijing (BJ). All subjects at both sites were interviewed by the same investigator using standardized assessment instruments. Basic socio-demographic and clinical data and history of suicide attempts were collected. The lifetime prevalence of suicide attempts was 26.7% in the whole sample and 20% and 33.6% in the HK and BJ samples, respectively. Patients with a history of suicide attempts were less likely to receive depot antipsychotic (AP) medication, more likely to receive clozapine, benzodiazepines (BZD) and higher doses of APs; were younger at onset, had more hospitalizations; had more severe positive, depressive, anxiety and extrapyramidal (EPS) symptoms; were poorer QOL in the physical, psychological, social and environmental domains; and were more likely to be BJ residents. In multiple logistic regression analysis, early age at onset, poor physical QOL, use of clozapine and BZDs, and study site (HK vs BJ) were significant contributors to lifetime suicide attempts. Significant difference was found between matched samples in HK and BJ with respect to suicide attempts. HK is a cosmopolitan city with a Western social structure and mental health system, whereas in BJ more traditional Chinese cultural values predominate, with a mental health policy radically different from that of HK. These differences suggest that socio-cultural factors play a significant role in determining suicide attempts in schizophrenia.
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Affiliation(s)
- Yu-Tao Xiang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
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123
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Wang YH, Li WQ, Huang Z, Shi YZ, Wang XY, Huang JS, Zhou XH, Chen HX, Hao W. 5-HT2A receptor gene polymorphism and negative symptoms in first episode (drug-naive) Chinese Han nationality individuals with schizophrenia. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2008; 33:293-298. [PMID: 18460771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To investigate whether the 5-hydroxytryptamine 2A receptor (5-HT2A) gene T102C polymorphism is associated with the severity symptoms and negative symptoms in the first episode Chinese Han nationality patients with schizophrenia. METHODS Altogether 201 first episode Chinese Han nationality patients with schizophrenia were enrolled in this study. Genotyping of 5-HT2A gene T102C polymorphism was performed by PCR-RFLP technique. The positive and negative Symptom Scale (PANSS) was used for the evaluation of the severity of psychotic symptoms before any drug treatment. RESULTS 5-HT2A receptor 102-T/T genotype was significantly associated with both the PANSS total and negative symptom subscale baseline scores before the treatment, but not with the positive and general psychopathology subscales. CONCLUSION 5-HT2A T102C functional polymorphism may play a role in negative symptoms and prognosis of Chinese Han nationality people with schizophrenia.
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Affiliation(s)
- Yu-hong Wang
- Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China
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124
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Kymalainen JA, Weisman de Mamani AG. Expressed emotion, communication deviance, and culture in families of patients with schizophrenia: a review of the literature. Cultur Divers Ethnic Minor Psychol 2008; 14:85-91. [PMID: 18426280 DOI: 10.1037/1099-9809.14.2.85] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aim of this article is to critically review the literature on expressed emotion (EE), communication deviance (CD), and culture in families of patients with schizophrenia. There is growing evidence that EE and CD are highly linked. Yet the two constructs together predict the development of schizophrenia and the associated symptoms better than either construct alone. In this article, the authors review data indicating that both the expression and the levels of high EE and CD vary by ethnicity. It may be especially difficult for family members to communicate coherently and in a less critical manner when focusing on patients' inability to sustain particular cultural norms and values that are endorsed by their family and ethnic background. The authors propose that more attention to the role of culture in EE and CD and greater focus on the proper assessment of these variables would further enhance our understanding of these constructs.
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125
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Ji X, Takahashi N, Branko A, Ishihara R, Nagai T, Mouri A, Saito S, Maeno N, Inada T, Ozaki N. An association between serotonin receptor 3B gene (HTR3B) and treatment-resistant schizophrenia (TRS) in a Japanese population. Nagoya J Med Sci 2008; 70:11-17. [PMID: 18807291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Genetic factors are thought to be involved in the development of treatment-resistant schizophrenia (TRS). Since several antipsychotic drugs inhibit the release of neurotransmitters via the serotonin receptors 3 (5-HT3), a dysfunction of this kind of receptor might be associated with the development of TRS. Thus, single-marker and haplotype analyses of the tag-single nucleotide polymorphisms (SNPs) of the 5-HT3B subunit gene (HTR3B) were performed in TRS (n = 101) and non-TRS (n = 244) patients. The deletion allele at the 3 bp-insertion/deletion polymorphism site (-100_-102delAAG) located in the putative HTR3B promoter region is significantly more frequent in the TRS group than the insertion allele by a single-marker comparison (p = 0.031). In addition, luciferase promoter assays showed that the deletion allele exhibited significantly higher transcriptional activity than the insertion allele in COS7 cells (p < 0.05). These results suggest that HTR3B is involved in the development of TRS in the Japanese population.
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Affiliation(s)
- Xiaofei Ji
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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126
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Akanji AO, Ohaeri JU, Al-Shammri SA, Fatania HR. Associations of blood levels of insulin-like growth factor (IGF)-I, IGF-II and IGF binding protein (IGFBP)-3 in schizophrenic Arab subjects. Clin Chem Lab Med 2008; 45:1229-31. [PMID: 17635080 DOI: 10.1515/cclm.2007.265] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Insulin-like growth factors (IGFs) are believed to be important in brain development and repair following neuronal damage. It is also speculated that IGFs are involved in the association of foetal and pre-adult growth with schizophrenia (SZ). METHODS The aim of this study was to assess levels of IGF-I, IGF-II and IGF binding protein (IGFBP)-3 and their associations in male Arab patients with SZ (n=53) and healthy control subjects (HC; n=52). Anthropometric and demographic data were collected for each subject for whom blood specimens were analysed for serum lipoproteins, apolipoprotein B (apoB), IGF-I, IGF-II and IGFBP-3. RESULTS The SZ group had lower serum total cholesterol, apoB and uric acid levels than the HC group (p<0.05). IGF-II levels were significantly higher in the SZ group (p=0.02) and correlated positively with levels of atherogenic lipoproteins--total cholesterol, low-density lipoprotein, apoB--and IGFBP-3. The pattern of correlations between the IGFs and the various parameters differed somewhat between the HC and SZ groups. CONCLUSIONS These results demonstrate that IGF-II levels are increased in patients with SZ and show significant associations with atherogenic lipoproteins. We suggest a possible link between IGF-II metabolism and atherogenesis in SZ.
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Affiliation(s)
- Abayomi O Akanji
- Department of Pathology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
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So HC, Chen RYL, Chen EYH, Cheung EFC, Li T, Sham PC. An association study of RGS4 polymorphisms with clinical phenotypes of schizophrenia in a Chinese population. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:77-85. [PMID: 17722013 DOI: 10.1002/ajmg.b.30577] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The regulator of G-protein signaling 4 (RGS4) has been suggested as a candidate gene for schizophrenia. However, following an initial positive report, subsequent association studies between RGS4 and schizophrenia have yielded inconclusive results. Also, few studies have investigated the association of RGS4 polymorphisms with the phenotypic subgroups of schizophrenia. To further clarify the role of RGS4 in this disease, we performed a case-control study (504 cases and 531 controls of Han Chinese descent) to examine the association of RGS4 with schizophrenia and with clinical and neurocognitive profiles. The four markers (SNPs 1, 4, 7, and 18) implicated in the original association study were genotyped. We detected significant association of four-marker haplotypes with schizophrenia (UNPHASED: global P = 0.037; PHASE: global P = 0.048). The haplotype G-G-G-G, which was implicated in at least three previous studies, was the major risk haplotype (UNPHASED: P = 0.019; PHASE: P = 0.010). Regarding the clinical phenotypes, the Wechsler Adult Intelligence Test (WAIS) information subtest score was associated with SNP4 genotypes (P = 0.001). PANSS total and global psychopathology scores were also associated with SNP4, but may not reliably reflect the general severity of disease as the scores may be affected by confounders like medication response. Our study provides further support for a role of RGS4 in the pathogenesis of schizophrenia. We identified G-G-G-G as the risk haplotype in our Chinese sample. The association with information subtest score suggests an effect of RGS4 on premorbid functioning, which may be related to neurodevelopmental processes. Further independent studies are required to verify our findings.
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Affiliation(s)
- Hon-Cheong So
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
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128
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Abstract
Overdiagnosis or misdiagnosis of schizophrenia among African American clients is a longstanding and critical disparity in mental health services. Overdiagnosis of schizophrenia is detrimental because it increases the potential for treatment with the wrong medications. Inadequate assessment of mood disorders, co-occurring substance abuse, and client characteristics are three factors believed to be associated with the overdiagnosis of schizophrenia. This article examines the relationships among demographic characteristics, co-occurring substance abuse, and admission diagnoses of schizophrenia and mood disorder for clients admitted to state psychiatric hospitals in Indiana. Data were obtained from the state management information system for a sample of 2,404 clients. The sample comprised white clients (80.5 percent) and African American clients (19.5 percent). All but a few of the clients were involuntarily hospitalized, and more than half of them had a diagnosis of schizophrenia. African American clients were less frequently diagnosed with bipolar and major depressive disorders and more frequently diagnosed with schizophrenia than were white clients. After controlling for the influence of other demographic variables, client race was the strongest predictor of admission diagnoses of schizophrenia. Implications for social work practice in the field of mental health and mental health services research are discussed.
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Affiliation(s)
- Arnold Barnes
- Department of Sociology and Social Work, North Carolina Agricultural and Technical State University, Greensboro, NC 27411, USA.
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129
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Tang YL, Gillespie CF, Epstein MP, Mao PX, Jiang F, Chen Q, Cai ZJ, Mitchell PB. Gender differences in 542 Chinese inpatients with schizophrenia. Schizophr Res 2007; 97:88-96. [PMID: 17628430 DOI: 10.1016/j.schres.2007.05.025] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Revised: 04/30/2007] [Accepted: 05/15/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate gender differences in the onset and other clinical features of Han Chinese inpatients with schizophrenia. METHODS Five-hundred-and-forty-two Han Chinese inpatients with DSM-IV schizophrenia were assessed with the Positive and Negative Symptoms Scale (PANSS), the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Function scale (GAF) and locally-developed standardized data collection forms. Comparisons were made between male and female patients. RESULTS This is the largest study of gender differences in schizophrenia to be conducted in a Chinese population. In our sample, we found that schizophrenia onset occurred at a significantly earlier age in male patients compared to female patients and that late-onset schizophrenia (as defined by onset> or =45 years) was significantly more common in female patients. The paranoid subtype of schizophrenia was less common in male patients, males received higher daily doses of antipsychotics and demonstrated a different pattern of antipsychotic usage, being less likely to be treated with SGAs. Further, cigarette smoking was more common in male patients and male patients were more likely to be single or never married. By contrast, female patients showed a different pattern of ongoing symptoms and severity, being more likely to have persistent positive symptoms, more severe positive and affective symptoms, and a greater number of suicide attempts whereas male patients were more likely to show severe deterioration over time. CONCLUSIONS There are notable gender differences in the age at onset, treatment and a range of other clinical features in Han Chinese patients with schizophrenia. Such differences were largely consistent with those reported in Western studies. These gender differences need to be considered in the assessment and management of Chinese patients with schizophrenia.
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Affiliation(s)
- Yi-Lang Tang
- Beijing Anding Hospital, Capital Medical University, Beijing, PR China.
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130
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Goldenstein N. [Dementia praecox: a modern folie?]. Braz J Psychiatry 2007; 29:382-383. [PMID: 18200403 DOI: 10.1590/s1516-44462007000400019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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131
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Yang LH. Application of mental illness stigma theory to Chinese societies: synthesis and new directions. Singapore Med J 2007; 48:977-985. [PMID: 17975685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The rapidly-evolving literature concerning stigma towards psychiatric illnesses among Chinese groups has demonstrated pervasive negative attitudes and discriminatory treatment towards people with mental illness. However, a systematic integration of current stigma theories and empirical findings to examine how stigma processes may occur among Chinese ethnic groups has yet to be undertaken. This paper first introduces several major stigma models, and specifies how these models provide a theoretical basis as to how stigma broadly acts on individuals with schizophrenia through three main mechanisms: direct individual discrimination, internalisation of negative stereotypes, and structural discrimination. In Chinese societies, the particular manifestations of stigma associated with schizophrenia are shaped by cultural meanings embedded within Confucianism, the centrality of "face", and pejorative aetiological beliefs of mental illnesses. These cultural meanings are reflected in severe and culturally-specific expressions of stigma in Chinese societies. Implications and directions to advance stigma research within Chinese cultural settings are provided.
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Affiliation(s)
- L H Yang
- Department of Epidemiology, Columbia University, 722 West 168th Street, Room 1610, New York, NY 10032, USA.
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Williams JM, Gandhi KK, Steinberg ML, Foulds J, Ziedonis DM, Benowitz NL. Higher nicotine and carbon monoxide levels in menthol cigarette smokers with and without schizophrenia. Nicotine Tob Res 2007; 9:873-81. [PMID: 17654300 DOI: 10.1080/14622200701484995] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined whether smoking menthol cigarettes was associated with increased biochemical measures of smoke intake. Expired carbon monoxide (CO) and serum nicotine and cotinine were measured in 89 smokers with schizophrenia and 53 control smokers immediately after smoking an afternoon cigarette. Serum nicotine levels (27 vs. 22 ng/ml, p = .010), serum cotinine levels (294 vs. 240 ng/ml, p = .041), and expired CO (25 vs. 21 ppm, p = .029) were higher in smokers of menthol compared with nonmenthol cigarettes, with no differences in 3-hydroxycotinine/cotinine ratios between groups when controlling for race. Backward stepwise linear regression models showed that, in addition to having a diagnosis of schizophrenia, smoking menthol cigarettes was a significant predictor of nicotine and cotinine levels. Individuals with schizophrenia or schizoaffective disorder smoked more generic or discount value brands (Basic, Doral, Monarch, USA, Wave, others) compared with control smokers (28% vs. 6%, p = .002) but did not smoke more brands with high nicotine delivery as estimated by the U.S. Federal Trade Commission method. Although rates of mentholated cigarette smoking were not higher in smokers with schizophrenia overall, they were significantly higher in non-Hispanic White people with schizophrenia compared with controls of the same ethnic/racial subgroup (51% vs. 28%, p<.0001). The higher exhaled CO in menthol smokers suggests that the higher nicotine levels are at least partly related to increased intake of smoke from menthol cigarettes, although menthol-mediated inhibition of nicotine metabolism also may be a factor. Menthol is an important cigarette additive that may help explain why some groups have lower quit rates and more smoking-caused disease.
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Affiliation(s)
- Jill M Williams
- UMDNJ-Robert Wood Johnson Medical School and UMDNJ-School of Public Health Tobacco Dependence Program, New Brunswick, NJ 08901, USA.
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Rosa A, Gardner M, Cuesta MJ, Peralta V, Fatjó-Vilas M, Miret S, Navarro ME, Comas D, Fañanás L. Family-based association study of neuregulin-1 gene and psychosis in a Spanish sample. Am J Med Genet B Neuropsychiatr Genet 2007; 144B:954-7. [PMID: 17503451 DOI: 10.1002/ajmg.b.30511] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Neuregulin 1 (NRG1) is one of the most exciting candidate genes for schizophrenia since its first association with the disorder in an Icelandic population. Since then, many studies have analyzed allele and haplotype frequencies in European and Asian populations in cases and controls yielding varying results. We investigated the association of NRG1 with psychosis in a total sample set of 575 individuals from 151 Spanish nuclear families. We tested eight SNPs across 1.2 Mb along NRG1 including regions previously associated to schizophrenia in association studies. After correction for multiple testing, the TDT analysis for each marker did not show a significant over-transmission of alleles from the parents to the affected offspring for any of the markers (P > 0.05). The haplotypic analysis with TRANSMIT and PDT did not show preferential transmission for any of the haplotypes analyzed in our sample. These results do not seem to suggest that the investigated NRG1 markers play a role in schizophrenia in the Spanish population, although the finding of a trend for association with one SNP in the 3'of the gene warrants further investigation.
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Affiliation(s)
- Araceli Rosa
- Unitat de Biologia Evolutiva, Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain.
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134
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Ma G, Shi Y, Tang W, He Z, Huang K, Li Z, He G, Feng G, Li H, He L. An association study between the genetic polymorphisms within TBX1 and schizophrenia in the Chinese population. Neurosci Lett 2007; 425:146-50. [PMID: 17850965 DOI: 10.1016/j.neulet.2007.07.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2007] [Revised: 07/04/2007] [Accepted: 07/26/2007] [Indexed: 01/30/2023]
Abstract
The strong association between common psychiatric disorders and the 22q11.2 microdeletion suggests that haploinsufficiency of one or more genes in the region confers susceptibility to these disorders. Recent mouse studies have shown that the T-box 1 (TBX1) gene in the 22q11.2 region can cause prepulse inhibition (PPI) impairment in the heterozygous state. A study has also shown that phenotypic features of 22q11 deletion syndrome (22q11DS) were segregated with an inactivating mutation of TBX1 in one family, suggesting that the TBX1 gene plays a role in the pathogenesis of some psychiatric disorders. We performed an association study between three single nucleotide polymorphisms (SNPs) in the TBX1 gene and schizophrenia. However, we found no significant difference in the genotype or allele distributions between the 328 schizophrenics and 288 controls for any of the polymorphisms, nor was there any haplotype association. Our data suggest that the genetic polymorphisms within TBX1 do not confer an increased susceptibility to schizophrenia in the Chinese population.
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Affiliation(s)
- Gang Ma
- Bio-X Center, PO Box 501, Hao Ran Building, Shanghai Jiao Tong University, 1954 Hua Shan Road, Shanghai 200030, China
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135
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Abstract
BACKGROUND The effectiveness of a psychosocial skills training (PSST) approach applied to chronic out-patients with schizophrenia was examined. We hypothesized that the PSST programme, which included treatment as usual (TAU), PSST and family therapy (FT), would reduce positive and negative symptoms, prevent relapse and rehospitalization, and improve psychosocial functioning (PSF), global functioning and treatment adherence. METHOD Eighty-two patients were randomly assigned to receive either TAU [antipsychotic medication (AP); n=39] or the PSST approach (TAU+PSST+FT; n=43). The two groups were assessed at intake and after completion of 1 year of treatment. RESULTS There were statistically significant differences between the two groups. Patients in the PSST group improved their symptomatology, psychosocial and global functioning (symptoms and psychological, social and occupational functioning), showed lower relapse, rehospitalization and drop-out rates, a higher level of compliance with AP medication, and a high level of therapeutic adherence in comparison with TAU patients, whose symptoms also improved although they showed no improvement in any of the clinical or psychosocial variables. A comparison of the standardized effect sizes showed a medium and a large effect size of PSF and global functioning for the PSST group and a non-effect size for the TAU group. CONCLUSIONS A higher level of effectiveness was demonstrated when combining TAU, PSST and FT in comparison with AP medication alone. The PSST approach should be recommended for clinical practice.
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Affiliation(s)
- Marcelo Valencia
- Division of Epidemiology and Psychosocial Research, National Institute of Psychiatry, Mexico City, Mexico.
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136
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Salyers MP, Godfrey JL, Mueser KT, Labriola S. Measuring illness management outcomes: a psychometric study of clinician and consumer rating scales for illness self management and recovery. Community Ment Health J 2007; 43:459-80. [PMID: 17514504 DOI: 10.1007/s10597-007-9087-6] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Accepted: 03/27/2007] [Indexed: 11/30/2022]
Abstract
Psychometric properties of the Illness Management and Recovery (IMR) Scales (consumer and clinician versions), new 15-item instruments measuring illness self-management and pursuit of recovery goals, were evaluated in consumers with severe mental illness. Both versions had moderate internal consistency and high 2-week test-retest reliability. In addition, the consumer version was correlated with self-ratings of recovery and symptoms, and the clinician version was correlated with clinician ratings of community functioning, indicating convergent validity. The results suggest the IMR Scales have adequate psychometric properties and may be useful in treatment planning and assessing recovery in individuals with severe mental illness.
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Affiliation(s)
- Michelle P Salyers
- ACT Center of Indiana, Roudebush VA Medical Center, 1481 W. 10th St. (11H), Indianapolis, IN 46202, USA.
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137
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Abstract
Insight, psychopathology and functioning are related in schizophrenia, but it is unclear whether insight relates independently to functioning after controlling for psychopathology. Equally, any such relationship may vary culturally. We investigated the relationship between insight, psychopathology and functioning in 60 patients with schizophrenia in Mzuzu, a town in Malawi. After controlling for psychopathology, functioning was associated with the ;symptom relabelling' dimension of insight (P=0.01). This preliminary finding suggests that symptom-focused psychoeducation might be appropriate for African patients with schizophrenia.
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Affiliation(s)
- Niall Crumlish
- St John of God Community Mental Health Services, PO Box 744, Mzuzu, Malawi.
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138
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Mensah AK, De Luca V, Stachowiak B, Noor A, Windpassinger C, Lam STS, Kennedy JL, Scherer SW, Lo IFM, Vincent JB. Molecular analysis of a chromosome 4 inversion segregating in a large schizophrenia kindred from Hong Kong. Schizophr Res 2007; 95:228-35. [PMID: 17644315 DOI: 10.1016/j.schres.2007.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Revised: 06/12/2007] [Accepted: 06/13/2007] [Indexed: 11/26/2022]
Abstract
The present study looks at a paracentric inversion on chromosome 4 [inv(4)(q13;q25)] in members of a large schizophrenia kindred from Hong Kong, and the possibility of a susceptibility gene for schizophrenia at one of the inversion breakpoints. Fluorescence in situ hybridization with BAC and fosmid clones was used to determine the location of the 4q13 and 4q25 breakpoints, however bioinformatic analysis indicated that no known genes are directly disrupted by the breakpoints. We identified several putative genes and expressed sequence tags (ESTs) from around the breakpoint regions, and have characterized them further in order to determine whether they may represent full-length mRNAs that are disrupted by the inversion. Overall, it appears that, while no known genes are disrupted, an as yet undiscovered gene, or indeed, a known gene, may be present near one of the breakpoints and may be disrupted by position effect. We hypothesized that either the 4q13 or 4q25 breakpoint region may contain a common susceptibility gene for schizophrenia. We genotyped 117 schizophrenia families for several short tandem repeat polymorphisms close to the breakpoints. Family based association testing showed no association at the 4q13 breakpoint region, but showed significant allelic association for marker D4S2989 at the 4q25 breakpoint region (p=0.016). This study suggests that the 4q breakpoint regions may harbour a gene that contributes to the illness in the large Hong Kong pedigree, and this 4q25 region should be examined further in other schizophrenia samples.
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Affiliation(s)
- Albert K Mensah
- Molecular Neuropsychiatry and Development Laboratory, Toronto, Canada
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139
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Liu CM, Liu YL, Fann CSJ, Chen WJ, Yang WC, Ouyang WC, Chen CY, Jou YS, Hsieh MH, Liu SK, Hwang TJ, Faraone SV, Tsuang MT, Hwu HG. Association evidence of schizophrenia with distal genomic region of NOTCH4 in Taiwanese families. Genes Brain Behav 2007; 6:497-502. [PMID: 17054719 DOI: 10.1111/j.1601-183x.2006.00276.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Evidence for association with schizophrenia has been reported for NOTCH4, although results have been inconsistent. Previous studies have focused on polymorphisms in the 5' promoter region and first exon of NOTCH4. Our aim was to test the association of the entire genomic region of NOTCH4 in 218 families with at least two siblings affected by schizophrenia in Taiwan. We genotyped seven single nucleotide polymorphisms (SNPs) of this gene, with average intermarker distances of 5.3 kb. Intermarker linkage disequilibrium (LD) was calculated using gold software, and single-locus and haplotype association analyses were performed using transmit software. We found that the T allele of SNP rs2071285 (P= 0.035) and the G allele of SNP rs204993 (P= 0.0097) were significantly preferentially transmitted to the affected individuals in the single-locus association analysis. The two SNPs were in high LD (D' > 0.8). Trend for overtransmission was shown for the T-G haplotype of the two SNPs to affected individuals (P= 0.053), with the A-A haplotype significantly undertransmitted (P= 0.034). The associated region distributed across the distal portion of the NOTCH4 gene and overlapped with the genomic region of the G-protein signaling modulator 3 and pre-B-cell leukemia transcription factor 2. In summary, we found modest association evidence between schizophrenia and the distal genomic region of NOTCH4 in this Taiwanese family sample. Further replication for association with the distal genomic region of NOTCH4 is warranted.
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Affiliation(s)
- C-M Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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140
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He Z, Li Z, Shi Y, Tang W, Huang K, Ma G, Zhou J, Meng J, Li H, Feng G, He L. The PIP5K2A gene and schizophrenia in the Chinese population--a case-control study. Schizophr Res 2007; 94:359-65. [PMID: 17555944 DOI: 10.1016/j.schres.2007.04.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Revised: 03/27/2007] [Accepted: 04/22/2007] [Indexed: 02/07/2023]
Abstract
Results from a number of molecular and pharmacological studies suggest that the phosphatidylinositol-4-phosphate 5-kinase IIalpha (PIP5K2A) gene may be involved in the development of schizophrenia. A recent family-based transmission disequilibrium test in the German and Israeli populations found that four single nucleotide polymorphisms, rs1417374, rs10828317, rs746203 and rs8341 in this gene or nearby intergenic regions are significantly associated with schizophrenia. The objective of our study was to investigate whether these four SNPs are also associated with schizophrenia in the Chinese population. Our study found that SNP rs8341 (p=0.0045, Odds Ratio=1.415, 95%CI=1.113-1.799 for the minor allele) and a haplotype (p=0.0039, Odds Ratio=1.440, 95%CI=1.123-1.845) are significantly associated with schizophrenia. Our results confirm that the PIP5K2A gene merits further study as a susceptible gene for schizophrenia.
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Affiliation(s)
- ZangDong He
- Bio-X Life Science Research Center, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, PR China
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141
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Amar S, Shamir A, Ovadia O, Blanaru M, Reshef A, Kremer I, Rietschel M, Schulze TG, Maier W, Belmaker RH, Ebstein RP, Agam G, Mishmar D. Mitochondrial DNA HV lineage increases the susceptibility to schizophrenia among Israeli Arabs. Schizophr Res 2007; 94:354-8. [PMID: 17566709 DOI: 10.1016/j.schres.2007.04.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Revised: 04/23/2007] [Accepted: 04/24/2007] [Indexed: 11/16/2022]
Abstract
Haplotypes and haplogroups are linked sets of common DNA variants, acting as susceptibility or protective factors to complex disorders. Growing evidence suggests that dysfunction of mitochondrial bioenergetics contributes to the schizophrenia phenotype. We studied mitochondrial DNA haplogroups in schizophrenia patients. Since mitochondria are inherited from the mothers, we used healthy fathers as an ideal case-control group. Analysis of the distribution of mitochondrial haplogroups in schizophrenia patients compared to their healthy fathers (202 pairs) resulted in an over-representation of the mtDNA lineage cluster, HV, in the patients (p=0.01), with increased relative risk (odds ratio) of 1.8. Since mitochondrial DNA is small relative to nuclear DNA, a total mitochondrial genome analysis was possible in a hypothesis-free manner. However, mitochondrial DNA haplogroups are highly variable in human population and it will be necessary to replicate our results in other human ethnic groups.
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Affiliation(s)
- Shirly Amar
- Stanley Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheva, Israel
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142
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Zhao X, Qin S, Shi Y, Zhang A, Zhang J, Bian L, Wan C, Feng G, Gu N, Zhang G, He G, He L. Systematic study of association of four GABAergic genes: glutamic acid decarboxylase 1 gene, glutamic acid decarboxylase 2 gene, GABA(B) receptor 1 gene and GABA(A) receptor subunit beta2 gene, with schizophrenia using a universal DNA microarray. Schizophr Res 2007; 93:374-84. [PMID: 17412563 DOI: 10.1016/j.schres.2007.02.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2006] [Revised: 02/28/2007] [Accepted: 02/28/2007] [Indexed: 11/16/2022]
Abstract
Several studies have suggested the dysfunction of the GABAergic system as a risk factor in the pathogenesis of schizophrenia. In the present study, case-control association analysis was conducted in four GABAergic genes: two glutamic acid decarboxylase genes (GAD1 and GAD2), a GABA(A) receptor subunit beta2 gene (GABRB2) and a GABA(B) receptor 1 gene (GABBR1). Using a universal DNA microarray procedure we genotyped a total of 20 SNPs on the above four genes in a study involving 292 patients and 286 controls of Chinese descent. Statistically significant differences were observed in the allelic frequencies of the rs187269C/T polymorphism in the GABRB2 gene (P=0.0450, chi(2)=12.40, OR=1.65) and the -292A/C polymorphism in the GAD1 gene (P=0.0450, chi(2)=14.64 OR=1.77). In addition, using an electrophoretic mobility shift assay (EMSA), we discovered differences in the U251 nuclear protein binding to oligonucleotides representing the -292 SNP on the GAD1 gene, which suggests that the -292C allele has reduced transcription factor binding efficiency compared with the 292A allele. Using the multifactor-dimensionality reduction method (MDR), we found that the interactions among the rs187269C/T polymorphism in the GABRB2 gene, the -243A/G polymorphism in the GAD2 gene and the 27379C/T and 661C/T polymorphisms in the GAD1 gene revealed a significant association with schizophrenia (P<0.001). These findings suggest that the GABRB2 and GAD1 genes alone and the combined effects of the polymorphisms in the four GABAergic system genes may confer susceptibility to the development of schizophrenia in the Chinese population.
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Affiliation(s)
- Xu Zhao
- Bio-X Life Science Research Center, Shanghai Jiao Tong University, Hao Ran Building, Shanghai 200030, China
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143
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Compton MT, Brudno J, Kryda AD, Bollini AM, Walker EF. Facial measurement differences between patients with schizophrenia and non-psychiatric controls. Schizophr Res 2007; 93:245-52. [PMID: 17459661 DOI: 10.1016/j.schres.2007.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2006] [Revised: 03/14/2007] [Accepted: 03/19/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Several previous reports suggest that facial measurements in patients with schizophrenia differ from those of non-psychiatric controls. Because the face and brain develop in concert from the same ectodermal tissue, the study of quantitative craniofacial abnormalities may give clues to genetic and/or environmental factors predisposing to schizophrenia. Using a predominantly African American sample, the present research question was two-fold: (1) Do patients differ from controls in terms of a number of specific facial measurements?, and (2) Does cluster analysis based on these facial measurements reveal distinct facial morphologies that significantly discriminate patients from controls? METHOD Facial dimensions were measured in 73 patients with schizophrenia and related psychotic disorders (42 males and 31 females) and 69 non-psychiatric controls (35 males and 34 females) using a 25-cm head and neck caliper. Due to differences in facial dimensions by gender, separate independent samples Student's t-tests and logistic regression analyses were employed to discern differences in facial measures between the patient and control groups in women and men. Findings were further explored using cluster analysis. Given an association between age and some facial dimensions, the effect of age was controlled. RESULTS In unadjusted bivariate tests, female patients differed from female controls on several facial dimensions, though male patients did not differ significantly from male controls for any facial measure. Controlling for age using logistic regression, female patients had a greater mid-facial depth (tragus-subnasale) compared to female controls; male patients had lesser upper facial (trichion-glabella) and lower facial (subnasale-gnathion) heights compared to male controls. Among females, cluster analysis revealed two facial morphologies that significantly discriminated patients from controls, though this finding was not evident when employing further cluster analyses using secondary distance measures. When the sample was restricted to African Americans, results were similar and consistent. CONCLUSIONS These findings indicate that, in a predominantly African American sample, some facial measurements differ between patients with schizophrenia and non-psychiatric controls, and these differences appear to be gender-specific. Further research on gender-specific quantitative craniofacial measurement differences between cases and controls could suggest gender-specific differences in embryologic/fetal neurodevelopmental processes underpinning schizophrenia.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 101 Woodruff Circle, Suite 4000, Atlanta, Georgia, 30322, United States.
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144
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Liu CM, Liu YL, Fann CSJ, Yang WC, Wu JY, Hung SI, Chen WJ, Chueh CM, Liu WM, Liu CC, Hsieh MH, Hwang TJ, Faraone SV, Tsuang MT, Hwu HG. No association evidence between schizophrenia and dystrobrevin-binding protein 1 (DTNBP1) in Taiwanese families. Schizophr Res 2007; 93:391-8. [PMID: 17407805 DOI: 10.1016/j.schres.2007.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Revised: 02/06/2007] [Accepted: 02/09/2007] [Indexed: 10/23/2022]
Abstract
Several linkage studies have shown significant linkage of schizophrenia to chromosome 6p region, which includes the positional candidate genes, Dystrobrevin-binding protein 1 (DTNBP1). The aim was to examine the association evidence of the candidate gene in 693 Taiwanese families with at least two affected siblings of schizophrenia. We genotyped nine SNPs of this gene with average intermarker distance of 17 kb. Intermarker linkage disequilibrium was calculated with GOLD. Single locus and haplotype association analyses were performed with TRANSMIT program. We found no significant association between schizophrenia and DTNBP1 either through single locus or haplotype analyses. We failed to replicate the association evidence between DTNBP1 and schizophrenia and this gene may not play a major role in the etiology of schizophrenia in this Taiwanese family sample.
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Affiliation(s)
- Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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145
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Abstract
OBJECTIVES This study tested the effectiveness of a family psychoeducation group program over a 12-month period for families of Chinese patients in Hong Kong with schizophrenia. The psychoeducation program is a needs-based group intervention that addresses the perceptions, knowledge, and skills of families in caring for relatives with schizophrenia. METHODS A controlled trial was conducted with 84 family members. Patient and family variables were measured at recruitment and at one week and 12 months after completion of the intervention. RESULTS Multivariate analyses of variance showed that participants in the psychoeducation group reported greater improvements in families' and patients' functioning, families' burden of care, and the number and length of patients' rehospitalizations over the 12-month follow-up period, compared with the standard care group. CONCLUSIONS These findings support the effectiveness of the family psychoeducation group program in improving the psychosocial health and functioning of Chinese patients with schizophrenia and their families.
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Affiliation(s)
- Wai Tong Chien
- Nethersole School of Nursing, The Chinese University of Hong Kong, 7/F, Esther Lee Building, Shatin, New Territories, Hong Kong.
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146
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Guo SZ, Huang K, Shi YY, Tang W, Zhou J, Feng GY, Zhu SM, Liu HJ, Chen Y, Sun XD, He L. A case-control association study between the GRID1 gene and schizophrenia in the Chinese Northern Han population. Schizophr Res 2007; 93:385-90. [PMID: 17490860 DOI: 10.1016/j.schres.2007.03.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2006] [Revised: 03/07/2007] [Accepted: 03/08/2007] [Indexed: 11/18/2022]
Abstract
The glutamatergic dysfunction hypothesis of schizophrenia implicates the genes involved in glutamatergic transmission as strong candidates for schizophrenia-susceptibility. Recent linkage and association studies have identified the glutamate receptor, ionotropic, delta 1 gene GRID1 on 10q22 as a strong candidate for schizophrenia. In this current association study, we genotyped five genetic variants within the GRID1 gene in 567 Chinese Han subjects recruited from Northeast of China (260 schizophrenics and 307 normal controls). Four SNPs, rs1902666 (P=0.024), rs2814351 (P=0.027), rs11591408 (P=0.0000107) and rs999383 (P=0.000093) were found to be significantly associated with schizophrenia. Haplotype analysis also revealed significance with global P values of 0.0081 and 0.00076 for SNPs 1-2 and SNPs 3-4-5 haplotypes, respectively. Our results strongly support previously reported association studies, implicating GRID1 in the etiology of schizophrenia.
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Affiliation(s)
- Sheng-Zhen Guo
- Bio-X Center, Shanghai Jiao Tong University, Shanghai 200030, PR China
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147
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Xiang YT, Weng YZ, Leung CM, Tang WK, Ungvari GS. Clinical and social determinants of antipsychotic polypharmacy for Chinese patients with schizophrenia. Pharmacopsychiatry 2007; 40:47-52. [PMID: 17447172 DOI: 10.1055/s-2007-970062] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Most prescription pattern surveys have found a high rate of antipsychotic polypharmacy. To date few studies have investigated antipsychotic polypharmacy in Chinese patients with schizophrenia in general and outpatients in particular. This study examined the frequency and sociodemographic and clinical correlates of antipsychotic polypharmacy in Hong Kong (HK) and Beijing (BJ), China. Three hundred and ninety-eight clinically stable outpatients with schizophrenia were randomly selected and interviewed in HK and BJ using standardized assessment instruments. Antipsychotic polypharmacy was found in 17.6% ( N=70) of the whole sample and in 28% and 7.1% of the HK and BJ samples, respectively. Polypharmacy was associated with monthly income, severity of negative symptoms and extrapyramidal side effects (EPS), use of depot antipsychotic and anticholinergic drugs, doses of antipsychotics, and the number of hospitalizations. In multiple logistic regression analysis, younger age, number of hospitalizations, site (HK vs. BJ), and the use of depot antipsychotics were all significantly associated with antipsychotic polypharmacy. Although the ethnic and clinical characteristics of the two cohorts were nearly identical, there was a wide variation in the prescription frequency of antipsychotic polypharmacy between HK and BJ, suggesting that sociocultural and economical factors and traditions of psychiatric practice all played a role in determining antipsychotic polypharmacy. Clinicians should bear in mind that, at least for clinically stable patients, no scientifically sound therapeutic principles for antipsychotic polypharmacy exist.
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Affiliation(s)
- Y-T Xiang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
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148
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Abstract
UNLABELLED Despite notable advances in the field, schizophrenia is still considered a major public health problem on international level. The combination of frequency, chronicity and severity make it, for some authors, the "cancer of mental disorders". However, according to the many cross-cultural studies, in particular, the two mammoth research projects of the WHO (IPSS and DOSMED, it is now irrefutable that the course and outcome of schizophrenia are better in patients from developing countries. The reasons for better outcome and more favorable course of schizophrenia in developing countries are still far from clear and remain speculative. AIM OF THE STUDY We have carried out a study among a population of schizophrenic patients admitted to our hospital during the past year, to question the issues of outcome, course and prognosis in Tunisia, which is an emerging country, ranking half-way between the most and the least developed countries. RESULTS It appears that the outcome of schizophrenia is similar to that of developed countries. A community survey reported an annual prevalence of 5.7 and an incidence of 3. 266 patients with schizophrenia were admitted between August 2003 and 2004, representing 40% of the whole hospitalized population; 80% were former patients who had been hospitalized an average of 8 times. One patient out of five will be readmitted at least once within the same year. Only 16.5% were married, and 10% had a regular job, in spite of a high level of education. A chronic course without remission is not unusual and long stay patients now account for a fourth of the hospital population. COMMENTS It seems clearly and paradoxically that the course and outcome of schizophrenia is deteriorating and getting closer to what is observed in the industrialized societies. The same trend was observed in the western countries during the last centuries, leading some authors to claim that schizophrenia is a modern disease, which appeared in the XIX(e) century and spread in the XX(e). Besides, other than the controversy regarding the recent evolution of its incidence, it seems that we are not witnessing the anticipated decrease in incidence that comes with the therapeutic progress and the decline in fertility among individuals with schizophrenia. DISCUSSION We shall discuss three hypotheses to try to explain the aggravation of schizophrenia along with the economic development: the heterogeneity of the disease with two clinical presentations: a benign form (good prognosis), more frequent in developing countries, and a severe form, observed mainly in developed societies. The progress in medicine and gynecology-obstetrics, which contributes to the survival of patients with serious schizophrenia and the vulnerable newborn exposed to multiple assaults and risk factors related to birth. The progress in psychiatry that is selecting the more serious subtypes of schizophrenia, which are overrepresented today. Research issues pertaining to course and outcome of schizophrenia are still unresolved. It is likely that prognosis of schizophrenia varies according to the economic development rather than to the culture. This observation could open new research and prevention perspectives.
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Affiliation(s)
- S Douki
- Service de Psychiatrie A, Hôpital Razi, La Manouba
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149
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Affiliation(s)
- David R Williams
- Harvard School of Public Health, 677 Huntington Avenue, Room 615, Boston, MA 02115-6096, USA.
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Kirkbride JB, Fearon P, Morgan C, Dazzan P, Morgan K, Murray RM, Jones PB. Neighbourhood variation in the incidence of psychotic disorders in Southeast London. Soc Psychiatry Psychiatr Epidemiol 2007; 42:438-45. [PMID: 17473901 DOI: 10.1007/s00127-007-0193-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND Urbanicity is a risk factor for schizophrenia, but it is unclear whether this risk is homogenous across urban areas. AIMS To determine whether the incidence of psychotic disorders varied within an urban area, beyond variation attributable to individual-level characteristics. METHODS All incident cases of ICD-10 psychoses from a large, 2-year, epidemiological study of first-episode psychoses in Southeast London were identified. Incidence rates for 33 wards were standardised for age, sex and ethnicity. Bayesian models produced accurate relative risk estimates that were then mapped. RESULTS 295 cases were identified during 565,000 person-years of follow-up. We observed significant heterogeneity in relative risks for broad and non-affective psychoses (schizophrenia), but not for affective psychoses. Highest risks were observed in contiguous wards. CONCLUSIONS Neighbourhood variation in the incidence of non-affective psychoses could not be explained by individual-level risk, implicating neighbourhood-level socioenvironmental factors in their aetiology. The findings are consistent with classical sociological models of mental disorders.
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Affiliation(s)
- James B Kirkbride
- Dept. of Psychiatry, University of Cambridge, Box 189, Cambridge CB2 2QQ, UK.
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