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Książek K, Masarczyk W, Głomb P, Romaszewski M, Stokłosa I, Ścisło P, Dębski P, Pudlo R, Buza K, Gorczyca P, Piegza M. Assessment of symptom severity in psychotic disorder patients based on heart rate variability and accelerometer mobility data. Comput Biol Med 2024; 176:108544. [PMID: 38723395 DOI: 10.1016/j.compbiomed.2024.108544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Advancement in mental health care requires easily accessible, efficient diagnostic and treatment assessment tools. Viable biomarkers could enable objectification and automation of the diagnostic and treatment process, currently dependent on a psychiatric interview. Available wearable technology and computational methods make it possible to incorporate heart rate variability (HRV), an indicator of autonomic nervous system (ANS) activity, into potential diagnostic and treatment assessment frameworks as a biomarker of disease severity in mental disorders, including schizophrenia and bipolar disorder (BD). METHOD We used a commercially available electrocardiography (ECG) chest strap with a built-in accelerometer, i.e. Polar H10, to record R-R intervals and physical activity of 30 hospitalized schizophrenia or BD patients and 30 control participants through ca. 1.5-2 h time periods. We validated a novel approach to data acquisition based on a flexible, patient-friendly and cost-effective setting. We analyzed the relationship between HRV and the Positive and Negative Syndrome Scale (PANSS) test scores, as well as the HRV and mobility coefficient. We also proposed a method of rest period selection based on R-R intervals and mobility data. The source code for reproducing all experiments is available on GitHub, while the dataset is published on Zenodo. RESULTS Mean HRV values were lower in the patient compared to the control group and negatively correlated with the results of the PANSS general subcategory. For the control group, we also discovered the inversely proportional dependency between the mobility coefficient, based on accelerometer data, and HRV. This relationship was less pronounced for the treatment group. CONCLUSIONS HRV value itself, as well as the relationship between HRV and mobility, may be promising biomarkers in disease diagnostics. These findings can be used to develop a flexible monitoring system for symptom severity assessment.
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Affiliation(s)
- Kamil Książek
- Institute of Theoretical and Applied Informatics, Polish Academy of Sciences, Bałtycka 5, Gliwice, 44-100, Poland.
| | - Wilhelm Masarczyk
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pyskowicka 49, Tarnowskie Góry, 42-612, Poland
| | - Przemysław Głomb
- Institute of Theoretical and Applied Informatics, Polish Academy of Sciences, Bałtycka 5, Gliwice, 44-100, Poland
| | - Michał Romaszewski
- Institute of Theoretical and Applied Informatics, Polish Academy of Sciences, Bałtycka 5, Gliwice, 44-100, Poland
| | - Iga Stokłosa
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pyskowicka 49, Tarnowskie Góry, 42-612, Poland
| | - Piotr Ścisło
- Psychiatric Department of the Multidisciplinary Hospital, Tarnowskie Góry, 42-612, Poland
| | - Paweł Dębski
- Institute of Psychology, Humanitas University in Sosnowiec, Kilińskiego 43, Sosnowiec, 41-200, Poland
| | - Robert Pudlo
- Department of Psychoprophylaxis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pyskowicka 49, Tarnowskie Góry, 42-612, Poland
| | - Krisztián Buza
- Budapest Business University, Buzogány utca 10-12, Budapest, 1149, Hungary; BioIntelligence Group, Department of Mathematics-Informatics, Sapientia Hungarian University of Transylvania, Târgu Mureş, Romania
| | - Piotr Gorczyca
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pyskowicka 49, Tarnowskie Góry, 42-612, Poland
| | - Magdalena Piegza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Pyskowicka 49, Tarnowskie Góry, 42-612, Poland
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Cognitive Dysfunctions Measured with the MCCB in Deficit and Non-Deficit Schizophrenia. J Clin Med 2023; 12:jcm12062257. [PMID: 36983258 PMCID: PMC10053076 DOI: 10.3390/jcm12062257] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
This study compared cognitive domains between deficit schizophrenia (DS) and non-deficit schizophrenia (NDS) patients and healthy controls (HC), analyzing relationships between psychopathological dimensions and cognitive domains. A total of 29 DS patients, 45 NDS patients, and 39 HC subjects participated. Cognitive domains were measured using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Battery. Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale. Clinical groups performed poorer than HC groups in regards to speed of processing, attention/vigilance, working memory, verbal and visual learning and memory, reasoning and problem solving, and social cognition. DS patients scored poorer than NDS patients in terms of all cognitive domains and the overall score, except for reasoning and problem solving. Positive, negative, disorganization, and resistance symptoms were related to cognitive functions only in NDS patients. Our findings suggest that the MCCB battery is sensitive to detecting cognitive dysfunctions in both deficit and non-deficit schizophrenia.
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Executive Functions and Psychopathology Dimensions in Deficit and Non-Deficit Schizophrenia. J Clin Med 2023; 12:jcm12051998. [PMID: 36902784 PMCID: PMC10003976 DOI: 10.3390/jcm12051998] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
This study: (a) compared executive functions between deficit (DS) and non-deficit schizophrenia (NDS) patients and healthy controls (HC), controlling premorbid IQ and level of education; (b) compared executive functions in DS and NDS patients, controlling premorbid IQ and psychopathological symptoms; and (c) estimated relationships between clinical factors, psychopathological symptoms, and executive functions using structural equation modelling. Participants were 29 DS patients, 44 NDS patients, and 39 HC. Executive functions were measured with the Mazes Subtest, Spatial Span Subtest, Letter Number Span Test, Color Trail Test, and Berg Card Sorting Test. Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale, Brief Negative Symptom Scale, and Self-evaluation of Negative Symptoms. Compared to HC, both clinical groups performed poorer on cognitive flexibility, DS patients on verbal working memory, and NDS patients on planning. DS and NDS patients did not differ in executive functions, except planning, after controlling premorbid IQ and negative psychopathological symptoms. In DS patients, exacerbation had an effect on verbal working memory and cognitive planning; in NDS patients, positive symptoms had an effect on cognitive flexibility. Both DS and NDS patients presented deficits, affecting the former to a greater extent. Nonetheless, clinical variables appeared to significantly affect these deficits.
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Waszczuk K, Kucharska-Mazur J, Tyburski E, Rek-Owodziń K, Plichta P, Rudkowski K, Podwalski P, Grąźlewski T, Mak M, Misiak B, Michalczyk A, Tarnowski M, Sielatycka K, Szczęśniak A, Łuczkowska K, Dołęgowska B, Budkowska M, Ratajczak MZ, Samochowiec J. Psychopathology and Stem Cell Mobilization in Ultra-High Risk of Psychosis and First-Episode Psychosis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106001. [PMID: 35627537 PMCID: PMC9141672 DOI: 10.3390/ijerph19106001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 02/04/2023]
Abstract
Although regenerative and inflammatory processes are involved in the etiopathogenesis of many psychiatric disorders, their roles are poorly understood. We investigate the potential role of stem cells (SC) and factors influencing the trafficking thereof, such as complement cascade (CC) components, phospholipid substrates, and chemokines, in the etiology of schizophrenia. We measured sphingosine-1-phosphate (S1P), stromal-derived factor 1 (SDF-1), and CC cleavage fragments (C3a, C5a, and C5b-C9; also known as the membrane attack complex) in the peripheral blood of 49 unrelated patients: 9 patients with ultra-high risk of psychosis (UHR), 22 patients with first-episode psychosis (FEP), and 18 healthy controls (HC). When compared with the HC group, the UHR and FEP groups had higher levels of C3a. We found no significant differences in hematopoietic SC, very small embryonic-like stem cell (VSEL), C5a, S1P, or SDF-1 levels in the UHR and FEP groups. However, among FEP patients, there was a significant positive correlation between VSELs (CD133+) and negative symptoms. These preliminary findings support the role of the immune system and regenerative processes in the etiology of schizophrenia. To establish the relevance of SC and other factors affecting the trafficking thereof as potential biomarkers of schizophrenia, more studies on larger groups of individuals from across the disease spectrum are needed.
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Affiliation(s)
- Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
- Correspondence: ; Tel./Fax: +48-91-35-11-322
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Ernest Tyburski
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (E.T.); (K.R.-O.); (P.P.); (M.M.)
| | - Katarzyna Rek-Owodziń
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (E.T.); (K.R.-O.); (P.P.); (M.M.)
| | - Piotr Plichta
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (E.T.); (K.R.-O.); (P.P.); (M.M.)
| | - Krzysztof Rudkowski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Piotr Podwalski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Tomasz Grąźlewski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (E.T.); (K.R.-O.); (P.P.); (M.M.)
| | - Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Anna Michalczyk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Maciej Tarnowski
- Department of Physiology, Pomeranian University of Medicine, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Katarzyna Sielatycka
- Institute of Biology, Faculty of Exact and Natural Sciences, University of Szczecin, Felczaka 3c, 71-415 Szczecin, Poland;
| | - Angelika Szczęśniak
- Department of Laboratory Medicine, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.S.); (B.D.)
| | - Karolina Łuczkowska
- Department of General Pathology, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Barbara Dołęgowska
- Department of Laboratory Medicine, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.S.); (B.D.)
| | - Marta Budkowska
- Department of Medical Analytics, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Mariusz Z. Ratajczak
- Stem Cell Institute at James Graham Brown Cancer Center, University of Louisville, Louisville, KY 40292, USA;
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
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Jiang Z, Luskus M, Seyedi S, Griner EL, Rad AB, Clifford GD, Boazak M, Cotes RO. Utilizing computer vision for facial behavior analysis in schizophrenia studies: A systematic review. PLoS One 2022; 17:e0266828. [PMID: 35395049 PMCID: PMC8992987 DOI: 10.1371/journal.pone.0266828] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/28/2022] [Indexed: 12/22/2022] Open
Abstract
Background Schizophrenia is a severe psychiatric disorder that causes significant social and functional impairment. Currently, the diagnosis of schizophrenia is based on information gleaned from the patient’s self-report, what the clinician observes directly, and what the clinician gathers from collateral informants, but these elements are prone to subjectivity. Utilizing computer vision to measure facial expressions is a promising approach to adding more objectivity in the evaluation and diagnosis of schizophrenia. Method We conducted a systematic review using PubMed and Google Scholar. Relevant publications published before (including) December 2021 were identified and evaluated for inclusion. The objective was to conduct a systematic review of computer vision for facial behavior analysis in schizophrenia studies, the clinical findings, and the corresponding data processing and machine learning methods. Results Seventeen studies published between 2007 to 2021 were included, with an increasing trend in the number of publications over time. Only 14 articles used interviews to collect data, of which different combinations of passive to evoked, unstructured to structured interviews were used. Various types of hardware were adopted and different types of visual data were collected. Commercial, open-access, and in-house developed models were used to recognize facial behaviors, where frame-level and subject-level features were extracted. Statistical tests and evaluation metrics varied across studies. The number of subjects ranged from 2-120, with an average of 38. Overall, facial behaviors appear to have a role in estimating diagnosis of schizophrenia and psychotic symptoms. When studies were evaluated with a quality assessment checklist, most had a low reporting quality. Conclusion Despite the rapid development of computer vision techniques, there are relatively few studies that have applied this technology to schizophrenia research. There was considerable variation in the clinical paradigm and analytic techniques used. Further research is needed to identify and develop standardized practices, which will help to promote further advances in the field.
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Affiliation(s)
- Zifan Jiang
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States of America
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States of America
- * E-mail:
| | - Mark Luskus
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States of America
| | - Salman Seyedi
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Emily L. Griner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Ali Bahrami Rad
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States of America
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States of America
| | - Mina Boazak
- Animo Sano Psychiatry, PLLC, Durham, NC, United States of America
| | - Robert O. Cotes
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
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Hintze B, Rowicka M, Barczak A. Are Executive Functions Deficits in Early-Onset Chronic Schizophrenia More Severe than in Adult-Onset Chronic Schizophrenia? CLINICAL NEUROPSYCHIATRY 2022; 19:54-63. [PMID: 35360466 PMCID: PMC8951167 DOI: 10.36131/cnfioritieditore20220108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective The research on the age of schizophrenia onset and cognitive impairments leads to contradictory conclusions. It is still unknown whether neurocognitive deficits in early-onset schizophrenia (EOS) are more intense than adulthood-onset schizophrenia (AOS). The study aimed to examine specific aspects of the executive functions of chronic outpatients with different ages of schizophrenia onset. Method Two clinical groups (EOS and AOS) consisted of 60 chronic outpatients with schizophrenia recruited from the community-based support system. The executive functions were measured with the Wisconsin Card Sorting Test (WCST), Trail Making Test A&B (TMT A&B), verbal fluency task (VFT), and the N-back test. Obtained results were compared to control groups consisting of 40 healthy subjects, matched with age, sex, and years of education, respectively. Results There were no differences in various aspects of executive dysfunctions between EOS and AOS outpatients. The outpatients in general, had lower scores than healthy controls regardless of their age of symptom onset. The most important finding suggests that some cognitive domains (visual working memory and processing speed) in presented schizophrenia patients were similar to those in healthy controls. Despite the demographic differences, both clinical groups present the same level of executive functioning. In addition, similar to the healthy participants, the outpatients had no problems in working memory and processing speed. Conclusions These observations suggest that EOS might not be associated with more severe cognitive deterioration. Moreover, the stabilization or improvement of their functioning might be linked with long-term psycho-social rehabilitation and modern pharmacotherapy.
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Affiliation(s)
- Beata Hintze
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland,Corresponding author Institute of Psychology, The Maria Grzegorzewska University, Szczesliwicka Street 40, 02-353 Warsaw, Poland E-mail:
| | - Magdalena Rowicka
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
| | - Anna Barczak
- Rare Diseases Research Platform, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
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Pawełczyk A, Łojek E, Żurner N, Gawłowska-Sawosz M, Gębski P, Pawełczyk T. The correlation between white matter integrity and pragmatic language processing in first episode schizophrenia. Brain Imaging Behav 2021; 15:1068-1084. [PMID: 32710335 PMCID: PMC8032571 DOI: 10.1007/s11682-020-00314-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Objective: Higher-order language disturbances could be the result of white matter tract abnormalities. The study explores the relationship between white matter and pragmatic skills in first-episode schizophrenia. Methods: Thirty-four first-episode patients with schizophrenia and 32 healthy subjects participated in a pragmatic language and Diffusion Tensor Imaging study, where fractional anisotropy of the arcuate fasciculus, corpus callosum and cingulum was correlated with the Polish version of the Right Hemisphere Language Battery. Results: The patients showed reduced fractional anisotropy in the right arcuate fasciculus, left anterior cingulum bundle and left forceps minor. Among the first episode patients, reduced understanding of written metaphors correlated with reduced fractional anisotropy of left forceps minor, and greater explanation of written and picture metaphors correlated with reduced fractional anisotropy of the left anterior cingulum. Conclusions: The white matter dysfunctions may underlie the pragmatic language impairment in schizophrenia. Our results shed further light on the functional neuroanatomical basis of pragmatic language use by patients with schizophrenia.
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Affiliation(s)
- Agnieszka Pawełczyk
- Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland.
| | | | - Natalia Żurner
- Adolescent Ward, Central Clinical Hospital of Medical University of Łódź, Łódź, Poland
| | | | - Piotr Gębski
- Scanlab Diagnostyka Medyczna Księży Młyn, Medical Examination Centre, Medical University of Łódź, Łódź, Poland
| | - Tomasz Pawełczyk
- Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland
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Adamowicz K, Kucharska-Mazur J. Dietary Behaviors and Metabolic Syndrome in Schizophrenia Patients. J Clin Med 2020; 9:jcm9020537. [PMID: 32079084 PMCID: PMC7073719 DOI: 10.3390/jcm9020537] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/12/2020] [Accepted: 02/14/2020] [Indexed: 12/12/2022] Open
Abstract
The metabolic syndrome (MS) is highly prevalent in schizophrenia patients, resulting from both pharmacotherapy and their lifestyle. To avoid its development, the analysis of patients' eating behaviors followed by the necessary nutritional changes should become a routine element of treatment. The aim of this study is to investigate the effect of dietary habits on the course of schizophrenia and MS, cognitive performance, symptom severity, and subjective assessment of eating behaviors in schizophrenia patients. Total of 87 participants (63.2% women) aged 19 to 67 years (M = 41.67; SD = 12.87), of whom 60 met the IDF criteria for MS, completed the PANSS, the verbal fluency test, the Stroop Color-Word Test, and the digit span task, followed by a thorough nutritional interview. There were no significant differences in the dietary behaviors between investigated schizophrenia patients with and without comorbid MS. Interestingly, their eating habits compared quite favorably to those described in the literature. No associations were found between positive eating habits and other tested variables in patients with MS. They were, however, linked to lower PANSS scores in the entire sample. In addition, positive eating habits correlated with better cognitive performance and a more adequate subjective assessment of dietary habits. It would be amiss to assume that schizophrenia patients lack the ability to control their eating behaviors. Nutrition education may foster desirable dietary changes and improve the sense of agency, thus helping to reduce symptom severity and enhancing cognitive performance in this patient population.
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Jonak K, Krukow P, Jonak KE, Grochowski C, Karakuła-Juchnowicz H. Quantitative and Qualitative Comparison of EEG-Based Neural Network Organization in Two Schizophrenia Groups Differing in the Duration of Illness and Disease Burden: Graph Analysis With Application of the Minimum Spanning Tree. Clin EEG Neurosci 2019; 50:231-241. [PMID: 30322279 DOI: 10.1177/1550059418807372] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to compare neural network topology of 30 patients with first episode schizophrenia (FES) and 30 multiepisode schizophrenia (mean number of psychotic relapses =4 years, duration of illness >5 years) patients, who were assessed with graph theory methods. This comparison was designed to identify network differences, which might be assigned to the burden of a mental disease. To estimate functional connectivity, we applied the phase lag index algorithm and the minimum spanning tree (MST) for the characterization of network topology. Group comparison revealed significant between-group differences of maximal betweenness centrality and tree hierarchy in the beta-band and hierarchy in the gamma-band. MST results showed that in the beta-band the network of patients with longer duration of illness (LDI) was characterized by more centralized network, while subjects with short duration of illness (FES) showed more decentralized topology. Furthermore, in the gamma-band, our results suggest that illness duration can disturb the balance between overload prevention and large-scale integration in the brain network. A qualitative analysis proved that the topological displacement of hubs also differentiated the FES and LDI groups. Our findings suggest that the duration of illness significantly affects the topology of resting-state functional network, supporting the "disconnectivity hypothesis' in schizophrenia.
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Affiliation(s)
- Kamil Jonak
- 1 Department of Biomedical Engineering, Lublin University of Technology, Lublin, Poland.,2 Chair and I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Lublin, Poland
| | - Paweł Krukow
- 3 Department of Clinical Neuropsychiatry, Medical University of Lublin, Lublin, Lubelskie, Poland
| | - Katarzyna E Jonak
- 4 Department of Foreign Languages, Medical University of Lublin, Lublin, Lubelskie, Poland
| | - Cezary Grochowski
- 5 Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Lublin, Lubelskie, Poland
| | - Hanna Karakuła-Juchnowicz
- 2 Chair and I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Lublin, Poland.,3 Department of Clinical Neuropsychiatry, Medical University of Lublin, Lublin, Lubelskie, Poland
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Resilience, Sense of Coherence, and Coping with Stress as Predictors of Psychological Well-Being in the Course of Schizophrenia. The Study Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071266. [PMID: 30970589 PMCID: PMC6480495 DOI: 10.3390/ijerph16071266] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/03/2019] [Accepted: 04/06/2019] [Indexed: 11/17/2022]
Abstract
The main research objective was seeking for the predictive role of such personal resources as resilience, sense of coherence, and coping with stress in psychological well-being of schizophrenia patients and their treatment. The study group comprised 201 individuals with schizophrenia, aged between 18 and 62. The following instruments were used: The sense of coherence scale SOC-29, The resilience scale for adults, polish adaptation of the stress appraisal measure, semistructured clinical interview, the positive and negative syndrome scale, the mood scale, and the general health questionnaire. A stepwise regression analysis aimed at selecting a group of significant predictors for the verified factors of psychological well-being in patients suffering from schizophrenia was carried out. The results of the study demonstrated the following to be significant predictors of psychological well-being in patients with schizophrenia: Resilience (explaining significantly the level of schizophrenic symptomatology Beta = -0.30, negative symptoms Beta = -0.385, and cognitive disorders Beta = -0.303), sense of coherence, which significantly predicted mood (in the case of manageability, Beta = 0.580 for positive mood, and Beta = 0.534 for negative mood) and psychiatric symptomatology (comprehensibility, Beta = 0.311 for negative symptoms, Beta = 0.173 for excessive arousal, and Beta = 0.330 for cognitive disorganization). The level of perceived stress appraised as challenge predicted positive mood (Beta = 0.164), while stress appraisal in terms of threat served as a predictor for negative mood and depressiveness (Beta = 0.190). The study results can prove helpful in creating therapeutic and programs and psychiatric rehabilitation for patients with schizophrenia.
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Pawełczyk A, Łojek E, Żurner N, Gawłowska-Sawosz M, Pawełczyk T. Higher-order language dysfunctions as a possible neurolinguistic endophenotype for schizophrenia: Evidence from patients and their unaffected first degree relatives. Psychiatry Res 2018; 267:63-72. [PMID: 29885556 DOI: 10.1016/j.psychres.2018.05.070] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/21/2018] [Accepted: 05/26/2018] [Indexed: 12/30/2022]
Abstract
The purpose of the study was to examine the presence of pragmatic dysfunctions in first episode (FE) subjects and their healthy first degree relatives as a potential endophenotype for schizophrenia. Thirty-four FE patients, 34 parents of the patients (REL) and 32 healthy controls (HC) took part in the study. Pragmatic language functions were evaluated with the Right Hemisphere Language Battery, attention and executive functions were controlled, as well as age and education level. The parents differed from HC but not from their FE offspring with regard to overall level of language and communication and the general knowledge component of language processing. The FE participants differed from HC in comprehension of inferred meaning, emotional prosody, discourse dimensions, overall level of language and communication, language processing with regard to general knowledge and communication competences. The FE participants differed from REL regarding discourse dimensions. Our findings suggest that pragmatic dysfunctions may act as vulnerability markers of schizophrenia; their assessment may help in the diagnosis of early stages of the illness and in understanding its pathophysiology. In future research the adoptive and biological parents of schizophrenia patients should be compared to elucidate which language failures reflect genetic vulnerability and which ones environmental factors.
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Affiliation(s)
- Agnieszka Pawełczyk
- Chair of Psychiatry, Department of Affective and Psychotic Disorders, Medical University of Łódź, Poland.
| | - Emila Łojek
- Chair of Neuropsychology, Faculty of Psychology, University of Warsaw, Poland
| | - Natalia Żurner
- Chair of Psychiatry, Adolescent Ward, Central Clinical Hospital, Medical University of Łódź, Poland
| | | | - Tomasz Pawełczyk
- Chair of Psychiatry, Department of Affective and Psychotic Disorders, Medical University of Łódź, Poland
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Pawełczyk A, Kotlicka-Antczak M, Łojek E, Ruszpel A, Pawełczyk T. Schizophrenia patients have higher-order language and extralinguistic impairments. Schizophr Res 2018; 192:274-280. [PMID: 28438437 DOI: 10.1016/j.schres.2017.04.030] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/13/2017] [Accepted: 04/16/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The extralinguistic and paralinguistic aspects of the language refer to higher-order language functions such as lexical-semantic processes, prosody, indirect speech acts or discourse comprehension and production. Studies suggest that these processes are mediated by the Right Hemisphere (RH) and there is also some evidence of RH dysfunctions in schizophrenia. The aim of the paper is to investigate the extralinguistic and paralinguistic processing mediated by Right Hemisphere in schizophrenia patients using a validated and standardized battery of tests. METHODS Two groups of participants were examined: a schizophrenia sample (40 participants) and a control group (39 participants). Extralinguistic and paralinguistic processing was assessed in all subjects by the Polish version of the Right Hemisphere Language Battery (RHLB-PL), which measures comprehension of implicit information, naming, understanding humor, inappropriate remarks and comments, explanation and understanding of metaphors, understanding emotional and language prosody and discourse understanding. RESULTS Schizophrenia patients scored significantly lower than controls in subtests measuring comprehension of implicit information, interpretation of humor, explanation of metaphors, inappropriate remarks and comments, discernment of emotional and language prosody and comprehension of discourse. No differences were observed in naming, understanding metaphors or in processing visuo-spatial information. CONCLUSIONS Extralinguistic and paralinguistic dysfunctions appear to be present in schizophrenia patients and they suggest that RH processing may be disturbed in that group of patients. As the disturbances of higher-order language processes mediated by the RH may cause serious impairments in the social communication of patients, it is worth evaluating them during clinical examination.
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Affiliation(s)
- Agnieszka Pawełczyk
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Poland.
| | | | - Emila Łojek
- Department of Cognitive Neuropsychology, University of Warsaw, Poland
| | - Anna Ruszpel
- Department of Cognitive Neuropsychology, University of Warsaw, Poland
| | - Tomasz Pawełczyk
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Poland
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Kucharska-Mazur J, Tarnowski M, Dołęgowska B, Budkowska M, Pędziwiatr D, Jabłoński M, Pełka-Wysiecka J, Kazimierczak A, Ratajczak MZ, Samochowiec J. Novel evidence for enhanced stem cell trafficking in antipsychotic-naïve subjects during their first psychotic episode. J Psychiatr Res 2014; 49:18-24. [PMID: 24246416 DOI: 10.1016/j.jpsychires.2013.10.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 10/23/2013] [Accepted: 10/23/2013] [Indexed: 12/18/2022]
Abstract
In this study, we tested the novel hypothesis that stem cells and those factors that modulate their trafficking may be biological markers for acute psychosis. Twenty-eight subjects during their first nonaffective psychotic episode were investigated before and after antipsychotic treatment and were compared with 35 healthy controls (CG); the psychotic group (PG) was divided into "schizophrenic" (SG) and "non-schizophrenic" (NG) subgroups. We examined the number of circulating Lin(-)/CD45(-)/CD34(+) and Lin(-)/CD45(-)/CD133(+) very small embryonic-like stem cells (VSELs), which express markers of the neural lineage, and also the plasma levels of factors that modulate their trafficking: the C3a, C5a, and C5b-9 activated complement cascade components, stromal-derived factor 1, and sphingosine-1-phosphate (S1P). We found that the mean numbers of Lin(-)/CD45(-)/CD34(+) VSELs and the plasma levels of S1P prior to treatment differ between the CG and PG and that these cells express markers of neural lineage. The number of Lin(-)/CD45(-)/CD133(+) VSELs in peripheral blood differed between the SG and NG prior to treatment. Using logistic regression analysis, we found that C3a and S1P are the best predictors of risk and are potential markers for the first psychotic episode. Furthermore, in the SG, the number of circulating Lin(-)/CD45(-)/CD34(+) VSELs and the S1P plasma level are the best predictors of risk and are proposed as novel markers for the first "schizophrenic" episode of psychosis.
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Affiliation(s)
| | - Maciej Tarnowski
- Department of Physiology, Pomeranian University of Medicine, Szczecin, Poland
| | - Barbara Dołęgowska
- Department of Medical Analytics, Pomeranian University of Medicine, Szczecin, Poland
| | - Marta Budkowska
- Department of Medical Analytics, Pomeranian University of Medicine, Szczecin, Poland
| | - Daniel Pędziwiatr
- Department of Physiology, Pomeranian University of Medicine, Szczecin, Poland
| | - Marcin Jabłoński
- Department of Psychiatry, Pomeranian University of Medicine, Szczecin, Poland
| | | | | | - Mariusz Z Ratajczak
- Department of Physiology, Pomeranian University of Medicine, Szczecin, Poland; Stem Cell Biology Program at the James Graham Brown Cancer Center, University of Louisville, Louisville, KY 40202, USA
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian University of Medicine, Szczecin, Poland.
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A lack of positive effect of enhanced vegetative nervous system tonus on mobilization of hematopoietic stem and progenitor cells in patients suffering from acute psychotic syndromes. Leukemia 2012. [PMID: 23207520 DOI: 10.1038/leu.2012.349] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Remberk B, Namysłowska I, Rybakowski F. Cognition and communication dysfunctions in early-onset schizophrenia: effect of risperidone. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:348-54. [PMID: 22819848 DOI: 10.1016/j.pnpbp.2012.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 07/02/2012] [Accepted: 07/09/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cognitive impairment and formal thought disorder, also referred to as communication disturbances, are considered the core symptoms of schizophrenia, strongly affecting social functioning and long-term outcome. Several studies in adult patients suggest improvement of both functions after the treatment with atypical antipsychotic drugs. Such medications are also used as first line treatment in early-onset schizophrenia, however their efficacy in cognitive and communication domains in this population have not been systematically assessed. AIM OF THE STUDY Evaluation of risperidone efficacy at psychopathological symptoms, cognitive impairment and formal thought disorder in adolescents with schizophrenia spectrum diagnosis. MATERIAL AND METHOD Psychopathological symptoms, cognitive functioning and formal thought disorder were evaluated in 32 hospitalized adolescent patients with schizophrenia spectrum diagnosis at the beginning of risperidone treatment and after clinical improvement and compared to the results of matched healthy control group. RESULTS Risperidone treatment was associated with reduction of symptom severity and moderate improvement of formal thought disorder and some aspects of executive functions. Working memory and verbal fluency were not improved. There were few correlations between psychopathological symptoms and results of cognitive tests, mainly between negative symptoms and executive functions. DISCUSSION In early-onset schizophrenia spectrum disorders atypical antipsychotic treatment is associated with alleviation of symptoms and only selective and moderate cognitive and communication improvement.
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Affiliation(s)
- Barbara Remberk
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland.
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Linden M, Scheel T, Rettig K. Validation of the factorial structure of the Positive and Negative Syndrome Scale in use by untrained psychiatrists in routine care. Int J Psychiatry Clin Pract 2007; 11:53-60. [PMID: 24941276 DOI: 10.1080/13651500600884419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background. The Positive and Negative Syndrome Scale (PANSS) can be called the standard for the assessment of schizophrenic disorders. It is well-known and routinely used. In scientific studies and clinical practice extensive training of raters in the use of the scale can often not be provided. The question is whether under such conditions psychometric properties of the scale can be guaranteed. Method. In a 2-year drug utilization study on risperidone, 1895 schizophrenic outpatients were assessed by their treating psychiatrists, who were working under conditions of routine care, using a modified version of the Positive and Negative Symptom Scale (PANSS/m). Physicians could not be trained in the use of the scale. The results of these ratings were analysed, comparing means and internal consistency with the original Kay et al. results (Kay et al. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261), and by factor analysis for the total sample and split halves. Results. Means for the positive subscale were similar (6.5 and 6.4, respectively) and means for the negative subscale (11.9 and 8.0, respectively) slightly higher than the original Kay et al. results. Internal consistency of the positive and negative subscales (0.80 and 0.87, and 0.73 and 0.83, respectively) were similar to Kay et al. The same clear factorial solution was found for the total sample and the subsamples. Discussion. Scores for the subscales reflect the predominance of negative symptoms in schizophrenic outpatients. The factorial solution supports the positive and negative subscales of the PANSS. The PANSS/m was easy to use under conditions of routine treatment and is a good and robust scale.
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Affiliation(s)
- Michael Linden
- Research Group Psychosomatic Rehabilitation at the Charité, University Medicine Berlin and the Rehabilitation Centre Seehof, Teltow/Berlin, Germany
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