Social pleasure in daily life: A meta-analysis of experience sampling studies in schizophrenia

The Effect of Different Construct Operationalizations, Study Duration, and Preprocessing Choices on Power-Based Sample Size Recommendations in Intensive Longitudinal Research

To shed light on the dynamics of psychological processes, researchers often collect intensive longitudinal (IL) data by asking people to repeatedly report on their momentary experiences in daily life. Two important decisions when designing an IL study concern the number of persons and the number of measurement occasions to be included. These sample size decisions are ideally based on statistical power considerations. When conducting statistical power analysis, it is necessary to provide the value of the effect size of interest as well as of all other model parameters. In IL research, these values have to be based on previous studies. This implies that these values are subject to large heterogeneity due to differences in study design and preprocessing choices. This between-study heterogeneity can severely impact power-based sample size recommendations. In this article, we introduce an approach to investigate the impact of study design and pre-processing of previous studies and to determine a recommended sample size to account for this impact. We demonstrate how to use this approach to investigate the effect of different construct operationalizations, study duration, and preprocessing choices. This approach paves the way for more thoughtful and robust sample-size decisions.

How Do People With Schizophrenia Manage Their Daily Life? A Qualitative Study

Due to the rising number of long-term mental health conditions, there has been a shift in therapeutic focus from curing these conditions, to living a meaningful life with them. Self-management is described as the ability to live with the emotional, life role and medical consequences of long-term conditions such as schizophrenia. However, the perspective of people with schizophrenia on self-management in current literature is missing. A lack of understanding of strategies used by people with schizophrenia to self-manage, could adversely affect the use of self-management interventions. Therefore, this study aims to identify how people with schizophrenia manage their daily life. Semi-structured interviews (n = 9) were conducted in a qualitative descriptive design. The study is reported by using the COREQ checklist. All participants, recruited through purposive sampling, have been stabilised after a schizophrenic episode and have been reintegrated into their community. The data were analysed through thematic analysis. Self-management for people with schizophrenia is an individualised process that revolves around performing day-to-day activities according to the participant's wishes. In addition, participants tried to prevent relapse by self-managing daily life. Personal-, social- and schizophrenia-related factors were seen as barriers and/or facilitators in their self-management. These barriers and/or facilitators were self-managed using daily activities. Current self-management interventions for this population often aim at improving medication adherence. Self-management interventions facilitated by health care professionals should (i) focus more on supporting patients in finding their daily structure through meaningful activities and (ii) be mindful of the duality contained within self-management of people with stabilised schizophrenia.

Sleep and physical activity patterns in relation to daily-life symptoms in psychosis: An actigraphy and experience sampling study

Sleep disturbances and reduced physical activity (PA) are important risk factors for poor physical and mental health outcomes in people with psychosis. However, the precise interrelations between sleep, PA and psychopathology remain unclear. This study combined experience sampling (ESM) and actigraphy in thirty-two patients with a schizophrenia spectrum disorder to investigate interrelations of day-to-day variations in actigraphic estimates of PA and sleep and psychotic and affective symptoms. Multilevel mixed-models show that subjects reported more positive affect on more physically active days. Unexpectedly, participants reported worse next-day negative affect and/or psychotic symptoms after nights with higher sleep continuity, as consistently indicated by sleep efficiency and the mean duration of bouts of wake and sleep. Lastly, PA was higher after nights with higher sleep continuity and shorter total sleep duration. These results highlight that modifiable lifestyle factors such as PA and sleep have an intricate, but clinically relevant relationship with psychotic and affective symptoms. Future studies are needed to further examine the complex effects of these behaviors in order to develop effective, targeted treatment strategies to improve clinical outcome in psychosis.

Social anhedonia in the daily lives of people with schizophrenia: Examination of anticipated and consummatory pleasure

Social anhedonia is a hallmark symptom of schizophrenia. Discrepancies in anticipated versus consummatory pleasure for non-social stimuli are well-documented. Thus, a similar emotional paradox may underlie social anhedonia. If so, our understanding of social anhedonia-including how to treat it in schizophrenia-could be enhanced. This project used a 5-day experience sampling method (ESM) to measure discrepancies between anticipated and consummatory pleasure for real-world social activities in people with schizophrenia and healthy controls (n = 30/group). ESM results were compared to laboratory assessments of negative symptoms and neurocognition. The schizophrenia group exhibited similar levels of anticipated and consummatory social pleasure as controls throughout daily life, and both groups were accurate in their short-term predictions of pleasure. Clinical interviews revealed those with schizophrenia showed significant deficits in long-term social pleasure prediction (i.e., a 1-week timeframe). Thus, people with schizophrenia may exhibit differences in ability to predict pleasure in the short-term versus the long-term. Negative symptoms and neurocognition were related to anticipated, but not consummatory, social pleasure, suggesting anhedonia is driven by deficits in thinking about pleasure, rather than inability to experience pleasure. Clinical implications include focusing on building upon short-term ability to predict pleasure in therapy to increase social motivation in schizophrenia.

Efficacy and safety of Xiaoyao Pill combined with Western medicine in the treatment of schizophrenia: A Meta-analysis and Systematic review

BACKGROUND

The efficacy and safety of Xiaoyao Pill combined with Western medicine in the treatment of schizophrenia are still inconclusive. This meta-analysis summarized relevant studies to compare the efficacy and safety of Xiaoyao Pill combined with Western medicine and Western medicine alone in the treatment of schizophrenia, aiming to provide guidance for clinical treatment.

METHODS

In this meta-analysis, we searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, and CBM databases from the establishment of the databases to August 2023. The study proposed to include studies that reported combination of Xiaoyao Pill with Western medicine and Western medicine alone in the treatment of schizophrenia, excluding published literature, unpublished literature, literature with incomplete or inadequate information, animal experiments, literature reviews and systematic studies. Data were analyzed using Review manager 5.3.

RESULTS

About 9 studies (6 RCTs and 3 case-control studies) were included in this meta-analysis. The sample size ranged from 60 to 128, with a total of 779 patients, including 395 in the combined treatment group and 384 in the control group. Pooled results showed that the total effective rate of combined treatment group was significantly higher than that of Western medicine alone (OR = 4.21, 95% CI: 1.50-11.83, P = .006). Positive and Negative Syndrome Scale (PANSS) (-) (MD = -2.30, 95% CI: -3.72 ~ -0.89, P = .001) and PANSS (+) (MD = -2.60, 95% CI: -3.34 ~ -1.86, P < .00001) of combined treatment group were all significantly lower than that of Western medicine alone. Additionally, PRL levels of combined treatment group was significantly lower than that of Western medicine alone (MD = -28.78, 95% CI: -42.20 ~ -15.35, P < .0001). However, there was no significant difference in BPRS and total PANSS between combined treatment group and Western medicine alone group. Notably, pooled results showed that there was no significant difference in incidence of adverse events between combined treatment group and Western medicine alone group.

CONCLUSION

The effective rate of Xiaoyao Pill combined with Western medicine in the treatment of schizophrenia is higher than that of Western medicine alone, which can effectively relieve the positive and negative symptoms of schizophrenia, and can significantly reduce the level of PRL. In the treatment of schizophrenia, clinicians can give priority to Xiaoyao Pill combined with Western medicine therapy.