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Lam L, Chang WC, Grimmer K. Treatment effects of adjunct group music therapy in inpatients with chronic schizophrenia: a systematic review. Front Psychiatry 2023; 14:1215578. [PMID: 38173705 PMCID: PMC10762796 DOI: 10.3389/fpsyt.2023.1215578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/30/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Pharmacological treatment may be effective for treating positive symptoms of schizophrenia; no evidence of clinically significant effects on negative and cognitive symptoms, social and behavioral functioning. This review investigated treatment outcomes of multiple (at least four sessions in 4 weeks) group music therapy sessions adjunct to standard care in inpatients with chronic schizophrenia. Methods A systematic review search of five electronic medical and psychological databases conducted using keywords "music therapy" and "schizophrenia" up to December 2021. Screening was performed for published articles on any adjunct multiple group music therapy (four sessions in 4 weeks minimum) adjunct to "treatment as usual" for inpatients with "chronic" schizophrenia. All study outcomes were all included. Risk of bias of all studies was assessed. Results 1160 articles were screened, and 13 randomized controlled trials (RCTs) with a total of 1,114 inpatients were included. Ten RCTs reported open group sessions with active structured music making (ASMM) combining passive music listening (PML) and/or active singing, playing instruments, and improvisations while three other studies applied PML only. Four studies reported significant outcomes for both positive and negative symptoms. Ten of the thirteen studies recorded significant improvements in negative symptoms, behavioral and social functioning. Lasting significant effects were found in a longitudinal RCT with 272 samples evaluated unguided pre-recorded PML as a coping method lasting up to six months and similar results found in another two longitudinal RCTs. Secondary outcomes measured cognition, mood, social interest and function, self-care ability, interpersonal relationships, and QoL all showed significant outcomes. The significance level for pre-post intervention and between-group measures ranged from p < 0.001 to p < 0.05. No negative effects were reported in any studies. Conclusion Evidence from this review suggests rehabilitation with adjunctive regular PML or combined ASMM in group settings may provide therapeutic engagement, contributing to improvements in social interest and participation. PML is low-cost and non-invasive therapy. Enhancing overall QoL as one type of psychosocial therapy. More rigorous longitudinal studies with larger sample sizes are needed to investigate whether regular long-term individual PML and active group music therapy have the same significant treatment effects as coping and rehabilitation strategies.
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Affiliation(s)
- Lissa Lam
- Department of Psychiatry, The University of Hong Kong, Pok fu Lam, Hong Kong SAR, China
| | - Wing Chung Chang
- Department of Psychiatry, The University of Hong Kong, Pok fu Lam, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pok fu Lam, Hong Kong SAR, China
| | - Karen Grimmer
- Division of Physiotherapy, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
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Tiles-Sar N, Habtewold TD, Liemburg EJ, van der Meer L, Bruggeman R, Alizadeh BZ. Understanding Lifelong Factors and Prediction Models of Social Functioning After Psychosis Onset Using the Large-Scale GROUP Cohort Study. Schizophr Bull 2023; 49:1447-1459. [PMID: 37104875 PMCID: PMC10686366 DOI: 10.1093/schbul/sbad046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND AND HYPOTHESIS Current rates of poor social functioning (SF) in people with psychosis history reach 80% worldwide. We aimed to identify a core set of lifelong predictors and build prediction models of SF after psychosis onset. STUDY DESIGN We utilized data of 1119 patients from the Genetic Risk and Outcome in Psychosis (GROUP) longitudinal Dutch cohort. First, we applied group-based trajectory modeling to identify premorbid adjustment trajectories. We further investigated the association between the premorbid adjustment trajectories, six-year-long cognitive deficits, positive, and negative symptoms trajectories, and SF at 3-year and 6-year follow-ups. Next, we checked associations between demographics, clinical, and environmental factors measured at the baseline and SF at follow-up. Finally, we built and internally validated 2 predictive models of SF. STUDY RESULTS We found all trajectories were significantly associated with SF (P < .01), explaining up to 16% of SF variation (R2 0.15 for 3- and 0.16 for 6-year follow-up). Demographics (sex, ethnicity, age, education), clinical parameters (genetic predisposition, illness duration, psychotic episodes, cannabis use), and environment (childhood trauma, number of moves, marriage, employment, urbanicity, unmet needs of social support) were also significantly associated with SF. After validation, final prediction models explained a variance up to 27% (95% CI: 0.23, 0.30) at 3-year and 26% (95% CI: 0.22, 0.31) at 6-year follow-up. CONCLUSIONS We found a core set of lifelong predictors of SF. Yet, the performance of our prediction models was moderate.
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Affiliation(s)
- Natalia Tiles-Sar
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry, Rob Giel Research Center, University Medical Center Groningen, University Center for Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Edith J Liemburg
- Department of Psychiatry, Rob Giel Research Center, University Medical Center Groningen, University Center for Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Lisette van der Meer
- Department of Clinical and Developmental Neuropsychology, Universityof Groningen, Groningen, The Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, Rob Giel Research Center, University Medical Center Groningen, University Center for Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Correll CU, Brieden A, Janetzky W. Symptomatic, functional and quality of life measures of remission in 194 outpatients with schizophrenia followed naturalistically in a 6-month, non-interventional study of aripiprazole once-monthly. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:80. [PMID: 37935711 PMCID: PMC10630463 DOI: 10.1038/s41537-023-00405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
An important goal in the treatment of patients with schizophrenia is remission in various domains, i.e., of symptoms, psychosocial functioning and subjective well-being. We undertook a post hoc analysis of pre-stabilized outpatients with schizophrenia and complete outcome data who had been enrolled in a 6-month non-interventional study of aripiprazole once-monthly (AOM) at 75 German sites. Key outcomes were (i) symptomatic remission (cross-sectional Andreasen et al. criteria (≤mild positive and negative key symptoms on the Brief Psychiatric Rating Scale (BPRS))); (ii) functional remission (Global Assessment of Functioning (GAF) scale score >70), and (iii) subjective well-being remission (WHO-5 scale score ≥13) at week 24. Of 242 enrolled patients, 194 (80.2%) (age = 43.9 ± 15.3 years; 51.5% male, illness duration = 14.0 ± 12.0 years) with complete data were analyzed. While 61.3% of the patients achieved symptomatic remission and 76.8% achieved remission regarding subjective well-being, only 24.7% achieved psychosocial functioning remission at 6 months. Remission rates were similar for men and women and across strata of disease duration with, on average, less remission in patients with longer illness duration. Correlations of improvements on the BPRS and GAF were weak, with the weakest correlation between the BPRS depressive mood item and the GAF scale, but similarly high correlation between BPRS subscales or the BPRS depressive mood item and subjective well-being. These findings suggest that while treatment with AOM can lead to symptomatic remission and remission regarding subjective well-being, additional interventions such as psychosocial therapy or supported employment and education may be necessary to achieve functional remission.
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Affiliation(s)
- Christoph U Correll
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA.
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA.
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.
| | - Andreas Brieden
- Universität der Bundeswehr München, Werner-Heisenberg-Weg 39, D-85577, Neubiberg, Germany
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Renemane L, Rancans E. Case report: Treatment-resistant schizophrenia with auto-aggressive compulsive behavior-Successful management with cariprazine. Front Psychiatry 2023; 14:1209077. [PMID: 37457773 PMCID: PMC10349167 DOI: 10.3389/fpsyt.2023.1209077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
The present case report describes a patient with treatment-resistant schizophrenia and auto-aggressive compulsive behavior who was effectively treated with a third-generation antipsychotic medication, cariprazine. The diagnosis was made 12 years ago, and the patient has been hospitalized 14 times and undergone various antipsychotic treatments. Despite receiving both inpatient and outpatient care, the patient's response to treatment has been only partial, and he has been classified as a treatment-resistant case. Therefore, the patient was switched to cariprazine, which led to significant improvements in both positive and negative symptoms, as well as the complete reduction of auto-aggressive compulsive behavior. These improvements contributed to the patient's overall social functioning and the achievement of remission, while also avoiding polypharmacy and eliminating the metabolic side effects associated with previous treatments.
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Affiliation(s)
- Lubova Renemane
- Riga Stradins University, Department of Psychiatry and Narcology, Riga, Latvia
- Riga Centre of Psychiatry and Addiction Disorders, Riga, Latvia
| | - Elmars Rancans
- Riga Stradins University, Department of Psychiatry and Narcology, Riga, Latvia
- Riga Centre of Psychiatry and Addiction Disorders, Riga, Latvia
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Arango C, Fagiolini A, Gorwood P, Kane JM, Diaz-Mendoza S, Sahota N, Correll CU. Delphi panel to obtain clinical consensus about using long-acting injectable antipsychotics to treat first-episode and early-phase schizophrenia: treatment goals and approaches to functional recovery. BMC Psychiatry 2023; 23:453. [PMID: 37344763 DOI: 10.1186/s12888-023-04928-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Schizophrenia is mostly a chronic disorder whose symptoms include psychosis, negative symptoms and cognitive dysfunction. Poor adherence is common and related relapse can impair outcomes. Long-acting injectable antipsychotics (LAIs) may promote treatment adherence and decrease the likelihood of relapse and rehospitalization. Using LAIs in first-episode psychosis (FEP) and early-phase (EP) schizophrenia patients could benefit them, yet LAIs have traditionally been reserved for chronic patients. METHODS A three-step modified Delphi panel process was used to obtain expert consensus on using LAIs with FEP and EP schizophrenia patients. A literature review and input from a steering committee of five experts in psychiatry were used to develop statements about patient population, adverse event management, and functional recovery. Recruited Delphi process psychiatrists rated the extent of their agreement with the statements over three rounds (Round 1: paper survey, 1:1 interview; Rounds 2-3: email survey). Analysis rules determined whether a statement progressed to the next round and the level of agreement deemed consensus. Measures of central tendency (mode, mean) and variability (interquartile range) were reported back to help panelists assess their previous responses in the context of those of the overall group. RESULTS The Delphi panelists were 17 psychiatrists experienced in treating schizophrenia with LAIs, practicing in seven countries (France, Italy, US, Germany, Spain, Denmark, UK). Panelists were presented with 73 statements spanning three categories: patient population; medication dosage, management, and adverse events; and functional recovery domains and assessment. Fifty-five statements achieved ≥ 80% agreement (considered consensus). Statements with low agreement (40-79%) or very low agreement (< 39%) concerned initiating dosage in FEP and EP patients, and managing loss of efficacy and breakthrough episodes, reflecting current evidence gaps. The panel emphasized benefits of LAIs in FEP and EP patients, with consensus that LAIs can decrease the risk of relapse, rehospitalization, and functional dysfunction. The panel supported links between these benefits and multidimensional longer-term functional recovery beyond symptomatic remission. CONCLUSIONS Findings from this Delphi panel support the use of LAIs in FEP and EP schizophrenia patients regardless of disease severity, number of relapses, or social support status. Gaps in clinician knowledge make generating evidence on using LAIs in FEP and EP patients critical.
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Affiliation(s)
- Celso Arango
- Child and Adolescent Department of Psychiatry, Institute of Psychiatry and Mental Health, IiSGM, CIBERSAM, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Andrea Fagiolini
- Department of Molecular and Developmental Medicine, Division of Psychiatry, Universita di Siena, Siena, Italy
| | - Philip Gorwood
- Université Paris Cité, INSERM U1266, GHU Paris Psychiatrie et Neurosciences (CMME), Paris, France
| | - John M Kane
- Institute of Behavioral Science, Feinstein Institutes for Medical Research-Northwell Health, New York, NY, USA
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell-Hempstead, New York, NY, USA
| | | | | | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell-Hempstead, New York, NY, USA.
- Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Thomson L, Rees C. Long-term outcomes of the recovery approach in a high-security mental health setting: a 20 year follow-up study. Front Psychiatry 2023; 14:1111377. [PMID: 37252143 PMCID: PMC10213922 DOI: 10.3389/fpsyt.2023.1111377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/15/2023] [Indexed: 05/31/2023] Open
Abstract
Background This study examined the outcomes of a descriptive, longitudinal cohort consisting of 241 patients initially examined in a population study at the high secure State Hospital for Scotland and Northern Ireland in 1992-93. A partial follow-up focusing on patients with schizophrenia was conducted in 2000-01, followed by a comprehensive 20 year follow-up that began in 2014. Aims To explore what happens to patients who required high secure care during a 20 year follow-up period. Method Previously collected data were amalgamated with newly collected information to examine the recovery journey since baseline. Various sources were employed, including patient and keyworker interviews, case note reviews, and extraction from health and national records, and Police Scotland datasets. Results Over half of the cohort (56.0%) with available data resided outside secure services at some point during the follow-up period (mean 19.2 years), and only 12% of the cohort were unable to transition out of high secure care. The symptoms of psychosis improved, with statistically significant reductions observed in reported delusions, depression, and flattened affect. Reported sadness [according to the Montgomery-Åsberg Depression Rating Scale (MADRS)] at baseline, first, and 20 year follow-up interviews was negatively correlated with the questionnaire about the process of recovery (QPR) scores at the 20 year follow-up. However, qualitative data depicted progress and personal development. According to societal measures, there was little evidence of sustained social or functional recovery. The overall conviction rate post-baseline was 22.7%, with 7.9% violent recidivism. The cohort exhibited poor morbidity and mortality, with 36.9% of the cohort dying, primarily from natural causes (91%). Conclusions Overall, the findings showed positive outcomes in terms of movement out of high-security settings, symptom improvement, and low levels of recidivism. Notably, this cohort experienced a high rate of deaths and poor physical morbidity, along with a lack of sustained social recovery, particularly among those who had negotiated a path through services and who were current residents in the community. Social engagement, enhanced during residence in low secure or open ward settings, diminished significantly during the transition to the community. This is likely a result of self-protective measures adopted to mitigate societal stigma and the shift from a communal environment. Subjective depressive symptoms may impact broader aspects of recovery.
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Affiliation(s)
- Lindsay Thomson
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland, United Kingdom
- The State Hospital, Carstairs, United Kingdom
- The Forensic Mental Health Managed Care Network, Carstairs, United Kingdom
| | - Cheryl Rees
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland, United Kingdom
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7
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Ponce-Correa F, Caqueo-Urízar A, Berrios R, Escobar-Soler C. Defining recovery in schizophrenia: A review of outcome studies. Psychiatry Res 2023; 322:115134. [PMID: 36871410 DOI: 10.1016/j.psychres.2023.115134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/07/2023]
Abstract
Schizophrenia is a chronic disorder with a heterogenous course and different ways in which recovery is measured or perceived. Recovery in schizophrenia is a complex process that it can be defined either from a clinical perspective focused on sustained symptom and functional remission, or from a patient-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. Until now, studies analysed these domains separately, without examining their mutual relations and changes over time. Therefore, this meta-analysis aimed to examine the relationship of global measures of subjective recovery with each of the components of clinical recovery such as symptom severity and functioning, in patients with schizophrenia spectrum disorders. The results showed that the association between different indicators of personal recovery and remission are weak and inverse (dIG+ = -0.18, z = -2.71, p < 0.01), however, this finding is not substantial according to the sensitivity indicators. With respect to functionality and personal recovery, there was a moderate relationship (dIG+ = 0.26, z = 7.894, p < 0.01) with adequate sensitivity indices. In addition, a low consensus exists between subjective measures that are more related to the patient's perspective and clinical measures based on experts and clinician's viewpoint.
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Affiliation(s)
- Felipe Ponce-Correa
- Programa Doctorado en Psicología, Escuela de Psicología y Filosofía, Facultad de Ciencias Sociales y Jurídicas, Universidad de Tarapacá, Avenida 18 de Septiembre N 2222, Casilla 7-D, Arica, Chile
| | | | - Raúl Berrios
- Departamento de administración, Facultad de administración y economía, Universidad de Santiago de Chile, Chile
| | - Carolang Escobar-Soler
- Programa Doctorado en Psicología, Escuela de Psicología y Filosofía, Facultad de Ciencias Sociales y Jurídicas, Universidad de Tarapacá, Avenida 18 de Septiembre N 2222, Casilla 7-D, Arica, Chile
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Shi JY, Cao YM, Luo HY, Liu S, Yang FM, Wang ZH. Effect of a group-based acceptance and commitment therapy (ACT) intervention on self-esteem and psychological flexibility in patients with schizophrenia in remission. Schizophr Res 2023; 255:213-221. [PMID: 37012184 DOI: 10.1016/j.schres.2023.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/26/2023] [Accepted: 03/18/2023] [Indexed: 04/05/2023]
Abstract
The present study explored whether acceptance and commitment therapy (ACT), a cognitive behavioral therapy approach, could improve the symptoms of schizophrenia spectrum disorders among patients with schizophrenia in remission. A pre- and post-treatment design with two evaluation time points was employed. Sixty outpatients with schizophrenia in remission were randomly divided into two groups: the ACT plus treatment as usual (ACT+TAU) and treatment as usual (TAU) groups. The ACT+TAU group participated in 10 group-based ACT interventions and TAU in the hospital, and the TAU group only received TAU interventions. General psycho-pathological symptoms, self-esteem, and psychological flexibility were assessed before intervention (baseline; pre-test) and after intervention (five weeks; post-test). Results indicated that, compared to the TAU group, the ACT+TAU group exhibited a more significant improvement in general psychopathological symptoms, self-esteem, cognitive fusion, and acceptance and action at post-test. ACT intervention could effectively decrease the general psycho-pathological symptoms and increase self-esteem level and psychological flexibility in people with schizophrenia in remission.
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Affiliation(s)
- Jun-Yan Shi
- School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, People's Republic of China; Department of Medical Psychology, Mental Health Hospital affiliated to Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Yan-Mei Cao
- School of Humanalities and Social Science, Shanxi Medical University, Taiyuan, People's Republic of China
| | | | - Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Fa-Ming Yang
- Shanxi Acupuncture and Moxibustion Hospital, Taiyuan, People's Republic of China
| | - Zhen-Hong Wang
- School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, People's Republic of China.
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Sakinyte K, Holmberg C. Psychometric and clinical evaluation of schizophrenia remission criteria in outpatients with psychotic disorders. BMC Psychiatry 2023; 23:207. [PMID: 36978160 PMCID: PMC10052840 DOI: 10.1186/s12888-023-04701-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Psychotic disorders such as schizophrenia have debilitating effects on health and functioning. Given symptomatic remission's recent emergence as a viable treatment goal, the Remission in Schizophrenia Working Group's criteria (RSWG-cr), based on eight items from the Positive and Negative Syndrome Scale (PANSS-8), are frequently used in clinical and research settings. Against that background, we sought to evaluate the PANSS-8's psychometric properties and examine the RSWG-cr's clinical validity among outpatients in Sweden. METHODS Cross-sectional register data were collected from outpatient psychosis clinics in Gothenburg, Sweden. Following confirmatory and exploratory factor analyses of PANSS-8 data (n = 1,744) to assess the PANSS-8's psychometric properties, internal reliability was evaluated using Cronbach's alpha. Next, 649 of the patients were classified according to the RSWG-cr and their clinical and demographic characteristics compared. Binary logistic regression was used to estimate odds ratios (OR) and assess each variable's impact on remission status. RESULTS The PANSS-8 showed good reliability (α = .85), and the 3D model of psychoticism, disorganization, and negative symptoms presented the best model fit. According to the RSWG-cr, 55% of the 649 patients were in remission; they were also more likely to live independently, be employed, not smoke, not take antipsychotics, and have recently received a health interview and physical examination. Patients living independently (OR = 1.98), who were employed (OR = 1.89), who were obese (OR = 1.61), and who had recently received a physical examination (OR = 1.56) also had an increased likelihood of remission. CONCLUSIONS The PANSS-8 is internally reliable, and, according to the RSWG-cr, remission is associated with variables of interest for patients' recovery, including living independently and being employed. Although our findings from a large, heterogeneous sample of outpatients reflect everyday clinical practice and reinforce past observations, the directions of those relationships need to be assessed in longitudinal studies.
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Affiliation(s)
- Karolina Sakinyte
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Christopher Holmberg
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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10
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van Dee V, Schnack HG, Cahn W. Systematic review and meta-analysis on predictors of prognosis in patients with schizophrenia spectrum disorders: An overview of current evidence and a call for prospective research and open access to datasets. Schizophr Res 2023; 254:133-142. [PMID: 36863229 DOI: 10.1016/j.schres.2023.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/23/2023] [Accepted: 02/20/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Schizophrenia spectrum disorders (SSD) have heterogeneous outcomes. If we could predict individual outcome and identify predictors of outcome, we could personalize and optimize treatment and care. Recent research showed that recovery rates tend to stabilize early in the course of disease. Short- to medium- term treatment goals are most relevant for clinical practice. METHODS We performed a systematic review and meta-analysis to identify predictors of outcome ≤1 year in prospective studies of patients with SSD. For our meta-analysis risk of bias was assessed with the QUIPS tool. RESULTS 178 studies were included for analysis. Our systematic review and meta-analysis showed that the chance of symptomatic remission was lower in males, and in patients with longer duration of untreated psychosis, more symptoms, worse global functioning, more previous hospital admissions and worse treatment adherence. The chance of readmission was higher for patients with more previous admissions. The chance of functional improvement was lower in patients with worse functioning at baseline. For other proposed predictors of outcome, like age at onset and depressive symptoms, limited to no evidence was found. DISCUSSION This study illuminates predictors of outcome of SSD. Level of functioning at baseline was the best predictor of all investigated outcomes. Furthermore, we found no evidence for many predictors proposed in original research. Possible reasons for this include the lack of prospective research, between-study heterogeneity and incomplete reporting. We therefore recommend open access to datasets and analysis scripts, enabling other researchers to reanalyze and pool the data.
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Affiliation(s)
- Violet van Dee
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, the Netherlands.
| | - Hugo G Schnack
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, the Netherlands.
| | - Wiepke Cahn
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, the Netherlands.
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Jun WH, Na H. The Mediating Role of Positive Thinking on the Relationship Between Depression and Functional Recovery in Community-Dwelling People With Schizophrenia. J Psychosoc Nurs Ment Health Serv 2023; 61:44-52. [PMID: 36322868 DOI: 10.3928/02793695-20221027-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Functional recovery as a consumer-centered approach is critical to recovery for community-dwelling people with schizophrenia. The current study investigated the mediating role of positive thinking in the relationship between depression and functional recovery in community-dwelling people with schizophrenia in South Korea. Depression, positive thinking, and functional recovery measures were completed by 158 people with schizophrenia in the community with self-reported questionnaires. Depression had a significantly negative influence on functional recovery. Positive thinking fully mediated the relationship between depression and functional recovery. An effective intervention strategy for functional recovery in this population may reinforce positive thinking and depression management. [Journal of Psychosocial Nursing and Mental Health Services, 61(2), 44-52.].
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Chai J, Liu F, Liu L, Hu N, Huang W, Wang H, Cui Y, Liu H, Li X, Li Y. The efficacy of homestyle rehabilitation on negative symptoms in chronic schizophrenia: A randomized controlled trial. Front Psychiatry 2023; 14:1138794. [PMID: 37139315 PMCID: PMC10149672 DOI: 10.3389/fpsyt.2023.1138794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Objective Schizophrenia is a debilitating mental disorder with a high disability rate that is characterized by negative symptoms such as apathy, hyperactivity, and anhedonia that can make daily life challenging and impair social functioning. In this study, we aim to investigate the effectiveness of homestyle rehabilitation in mitigating these negative symptoms and associated factors. Methods A randomized controlled trial was conducted to compare the efficacy of hospital rehabilitation and homestyle rehabilitation for negative symptoms in 100 individuals diagnosed with schizophrenia. The participants were divided randomly into two groups, each persisting for 3 months. The primary outcome measures were the Scale for Assessment of Negative Symptoms (SANS) and Global Assessment of Functioning (GAF). The secondary outcome measures included the Positive Symptom Assessment Scale (SAPS), Calgary Schizophrenia Depression Scale (CDSS), Simpson-Angus Scale (SAS), and Abnormal Involuntary Movement Scale (AIMS). The trial aimed to compare the effectiveness of the two rehabilitation methods. Results Homestyle rehabilitation for negative symptoms was found to be more effective than hospital rehabilitation, according to the changes in SANS (T = 2.07, p = 0.04). Further analysis using multiple regression indicated that improvements in depressive symptoms (T = 6.88, p < 0.001) and involuntary motor symptoms (T = 2.75, p = 0.007) were associated with a reduction in negative symptoms. Conclusion Homestyle rehabilitation may have greater potential than hospital rehabilitation in improving negative symptoms, making it an effective rehabilitation model. Further research is necessary to investigate factors such as depressive symptoms and involuntary motor symptoms, which may be associated with the improvement of negative symptoms. Additionally, more attention should be given to addressing secondary negative symptoms in rehabilitation interventions.
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Affiliation(s)
- Jiabao Chai
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Fuquan Liu
- Department of Psychiatry, Beijing Jishuitan Hospital, Beijing, China
| | - Lin Liu
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Na Hu
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Wenqian Huang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Hong Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Yonghua Cui
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children Healthy, Beijing, China
| | - Hongyan Liu
- Mental Health Center of Haidian in Beijing, Beijing, China
| | - Xiaojun Li
- Department of Psychiatry, Beijing Jishuitan Hospital, Beijing, China
- *Correspondence: Xiaojun Li, ; Ying Li,
| | - Ying Li
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children Healthy, Beijing, China
- *Correspondence: Xiaojun Li, ; Ying Li,
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13
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Gunasekaran S, Tan GTH, Shahwan S, Goh CMJ, Ong WJ, Subramaniam M. The perspectives of healthcare professionals in mental health settings on stigma and recovery - A qualitative inquiry. BMC Health Serv Res 2022; 22:888. [PMID: 35804378 PMCID: PMC9270770 DOI: 10.1186/s12913-022-08248-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health stigma is one of the most prominent barriers to recovery, and it is widely known that stigma may manifest differentially in different cultures. Healthcare professionals working closely with persons with mental illnesses (PMI) may provide important insights towards stigma that are otherwise unattainable from caregivers and consumers. However, there is a dearth of literature on healthcare professionals' perspectives on this topic. Thus, this study uses a multilevel approach to explore how stigma affects recovery from the perspectives of healthcare professionals that work closely with PMI in Singapore. METHODS Semi-structured interviews were conducted with a total of 17 healthcare professionals who were working in mental health settings in Singapore. Participants were recruited via direct email invitation or through snowball sampling. Data collected was analysed with the inductive thematic analysis method. All coding and inter-rater analyses were performed with NVivo. RESULTS The current study themes identified stigma-related factors that influence PMI's recovery from the perspectives of healthcare professionals working closely with PMI. These factors were organised into three overarching themes in a multilevel structure. The three themes were classified as Micro Factors (e.g., internalised stigma), Meso Factors (e.g., discrimination of people associated with the stigmatised group), and Macro Factors (e.g., structural stigma and stigma within healthcare settings). CONCLUSIONS The findings of this study gave us a greater understanding of how stigma influences recovery in Singapore, which could be used to guide the development and implementation of future policies and strategies to promote recovery. Importantly, our results suggest that improving mental health literacy, addressing cultural misgivings towards mental illness, implementing recovery-oriented practices, and making insurance more accessible for PMI could mitigate the deleterious impact that stigma has on recovery.
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Affiliation(s)
- Savita Gunasekaran
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore.
| | - Gregory Tee Hng Tan
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
| | - Chong Min Janrius Goh
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
| | - Wei Jie Ong
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore
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14
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Cano JF, Ortegón-Valencia J, Pedraza-Perez C, Córdoba-Rojas R, Olarte-Armenta A, Vallejo-Silva A, González-Díaz J. Functionality During the First Five Years After the Diagnosis of Schizophrenia. A Cohort Study in a Colombian Population. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:183-191. [PMID: 36154749 DOI: 10.1016/j.rcpeng.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 11/02/2020] [Indexed: 06/16/2023]
Abstract
OBJECTIVE There is a lack of studies on the natural history of the initial stages of schizophrenia in Colombia. This study aims to assess functionality in the first five years after the diagnosis of schizophrenia. METHODS Naturalistic longitudinal study of 50 patients with early schizophrenia evaluated between 2011 and 2014. Data about demographic background, symptoms, introspection, treatment and adverse reactions were collected in all patients every 3 months for at least 3-5 years. Functionality was measured with the Global Assessment of Functioning (GAF) and Personal and Social Performance (PSP) scales. RESULTS Patients were followed up for a mean of 174±62.5 weeks and showed moderate difficulties in overall functioning. This functioning was modified by polypharmacy, degree of introspection, changes in antipsychotic regimens, and the number of episodes, relapses and hospitalisations. CONCLUSIONS The results suggest that functional outcomes seem to be related to the use of polypharmacy, degree of insight, changes in antipsychotic regimens, and number of episodes, relapses and hospitalisations during the first years of schizophrenia.
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Affiliation(s)
- Juan F Cano
- UR Center for Mental Health (CeRSaMe), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia; Centro de Investigaciones del Sistema Nervioso (CISNE), Bogotá, Colombia.
| | | | | | - Rodrigo Córdoba-Rojas
- UR Center for Mental Health (CeRSaMe), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia; Centro de Investigaciones del Sistema Nervioso (CISNE), Bogotá, Colombia
| | - Ana Olarte-Armenta
- Centro de Investigaciones del Sistema Nervioso (CISNE), Bogotá, Colombia
| | - Alexie Vallejo-Silva
- UR Center for Mental Health (CeRSaMe), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia; Clínica Nuestra Señora de la Paz, Bogotá, Colombia
| | - Jairo González-Díaz
- UR Center for Mental Health (CeRSaMe), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia; Clínica Nuestra Señora de la Paz, Bogotá, Colombia
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15
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Sisman FN, Büber B, Taş F, Turan H. Randomized Controlled Trial for the Effects of an Exercise Program for Functional Remission and Weight Control in Schizophrenia: A Community Mental Health Study. Issues Ment Health Nurs 2022; 43:603-612. [PMID: 35089106 DOI: 10.1080/01612840.2021.2024630] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This research was conducted to determine the effect of an exercise program on functional remission and weight control in schizophrenia. This experimental study was conducted with pre-posttests and a control group at community mental health centers with 32 individuals with schizophrenia. The individuals participating in the program registered a more significant increase on the functional remission levels compared to the control group and a significant difference was found between the pretest/posttest BMI measures of the experimental group. The nurse-led exercise program is an effective plan that can be used in achieving functional remission.
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Affiliation(s)
- Fatma Nevin Sisman
- Nursing Department, Marmara Unıversity Health Science Faculty, Basıbuyuk, Maltepe-Istanbul, Turkey
| | - Berna Büber
- Nursing Department, Marmara Unıversity Health Science Faculty, Basıbuyuk, Maltepe-Istanbul, Turkey
| | - Fatma Taş
- Nursing Department, Marmara Unıversity Health Science Faculty, Basıbuyuk, Maltepe-Istanbul, Turkey
| | - Hatice Turan
- Nursing Department, Marmara Unıversity Health Science Faculty, Basıbuyuk, Maltepe-Istanbul, Turkey
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16
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Dinakaran D, Sreeraj VS, Venkatasubramanian G. Role of Curcumin in the Management of Schizophrenia: A Narrative Review. Indian J Psychol Med 2022; 44:107-113. [PMID: 35655971 PMCID: PMC9120991 DOI: 10.1177/02537176211033331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Nutraceutical agents and food supplements are commonly used as treatment adjuncts in neuropsychiatric disorders. Curcumin, a bioactive agent obtained from the rhizome of Curcuma longa, with its antioxidant and anti-inflammatory properties, has gained much research attention in the last few decades. In this narrative review, we intend to summarize the evidence available for curcumin as an add-on agent in the management of schizophrenia. We searched PubMed/EBSCO for both human and animal trials utilizing curcumin in the management of schizophrenia. We obtained ten articles (five preclinical and five clinical) from the focused literature search. Clinical research utilizing curcumin in schizophrenia is limited to negative and cognitive symptoms. Available preclinical studies suggest curcumin's utility in ameliorating extrapyramidal and metabolic side effects when given as an adjunct with antipsychotics. Curcumin, as an add-on agent, appears promising to improve the negative and cognitive symptoms of schizophrenia. Notably, curcumin was tolerable and safe in all the randomized human clinical trials. The poor oral bioavailability is, however, a limiting factor in its widespread use.
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Affiliation(s)
- Damodharan Dinakaran
- Dept. of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vanteemar S Sreeraj
- Dept. of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Dept. of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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17
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Batinic B, Ristic I, Zugic M, Baldwin DS. Treatment of Symptom Clusters in Schizophrenia, Bipolar Disorder and Major Depressive Disorder With the Dopamine D3/D2 Preferring Partial Agonist Cariprazine. Front Psychiatry 2021; 12:784370. [PMID: 34887792 PMCID: PMC8649660 DOI: 10.3389/fpsyt.2021.784370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/02/2021] [Indexed: 01/07/2023] Open
Abstract
Cariprazine is currently approved for the treatment of patients with schizophrenia (USA and EU), and for manic, depressive, and episodes with mixed features in bipolar I disorder (USA): several randomized controlled studies have also explored its efficacy in patients with major depressive disorder. This review summarizes its current therapeutic uses and potential advantages for treating the main symptoms of schizophrenia, bipolar I and major depressive disorder, considering its pharmacodynamic properties, efficacy, and tolerability. Its predominantly D3 receptor preferring affinity, with functional selectivity according to the prevailing neuronal environment, contributes to its efficacy across a wide array of psychopathological symptoms (including reality distortion, disorganized thought, negative symptoms, mood disturbance, anhedonia, and cognitive impairment), and to a favorable side effect profile. Cariprazine may be a "drug of choice" in patients with predominant negative and cognitive symptoms of schizophrenia, as well as those with metabolic syndrome. Further investigation of its relative efficacy when compared to aripiprazole or other active comparators is warranted. Its effectiveness in the treatment of bipolar mania, bipolar I depression and bipolar I episodes with mixed features, with minimal accompanying metabolic changes is well-established. The longer half-life and delayed time to relapse in patients diagnosed with schizophrenia when compared to other second-generation antipsychotics represent other advantages, given the high rates of non-adherence and frequent relapses seen in clinical practice. Its efficacy in overlapping symptom domains in other major psychiatric disorders appears promising.
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Affiliation(s)
- Borjanka Batinic
- Clinic of Psychiatry, University Clinical Centre of Serbia, Belgrade, Serbia
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Ivan Ristic
- Department of Epidemiology, Medical School, University of Belgrade, Belgrade, Serbia
- Department of Psychiatry, Institute of Mental Health, Belgrade, Serbia
| | - Milica Zugic
- Department of Psychiatry, Institute of Mental Health, Belgrade, Serbia
| | - David S. Baldwin
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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18
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Catalan A, Richter A, Salazar de Pablo G, Vaquerizo-Serrano J, Mancebo G, Pedruzo B, Aymerich C, Solmi M, González-Torres MÁ, Gil P, McGuire P, Fusar-Poli P. Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis. Eur Psychiatry 2021; 64:e69. [PMID: 34730080 PMCID: PMC8668449 DOI: 10.1192/j.eurpsy.2021.2246] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background To determine the proportion of patients in symptomatic remission and recovery following a first-episode of psychosis (FEP). Methods A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, and trial registries from database inception to November 5, 2020, was performed. Cohort studies and randomized control trials (RCT) investigating the proportion of remission and recovery following a FEP were included. Two independent researchers searched, following PRISMA and MOOSE guidelines and using a PROSPERO protocol. We performed meta-analyses regarding the proportion of remission/recovery (symptomatic plus functional outcomes). Heterogeneity was measured employing Q statistics and I2 test. To identify potential predictors, meta-regression analyses were conducted, as well as qualitative reporting of studies included in a systematic review. Sensitivity analyses were performed regarding different times of follow-up and type of studies. Results One hundred articles (82 cohorts and 18 RCTs) were included in the meta-analysis. The pooled proportion of symptomatic remission was 54% (95%CI [30, 49–58]) over a mean follow-up period of 43.57 months (SD = 51.82) in 76 studies. After excluding RCT from the sample, the proportion of remission remained similar (55%). The pooled proportion of recovery was 32% (95%CI [27–36]) over a mean follow-up period of 71.85 months (SD = 73.54) in 40 studies. After excluding RCT from the sample, the recovery proportion remained the same. No significant effect of any sociodemographic or clinical predictor was found. Conclusions Half of the patients are in symptomatic remission around 4 years after the FEP, while about a third show recovery after 5.5 years.
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Affiliation(s)
- Ana Catalan
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Barakaldo, Spain.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Anja Richter
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain.,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Julio Vaquerizo-Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gonzalo Mancebo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Borja Pedruzo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Claudia Aymerich
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, University of Ottawa, Ontario, Canada.,Department of Mental Health, The Ottawa Hospital, Ontario, Canada.,Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario
| | - Miguel Á González-Torres
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Barakaldo, Spain
| | - Patxi Gil
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Early Intervention Service, Bizkaia Mental Health System, Bilbao, Spain
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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19
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Sideli L, Sartorio C, Ferraro L, Mannino G, Giunta S, Giannone F, Seminerio F, Barone MV, Maniaci G, Montana S, Marchese F, La Barbera D, La Cascia C. Views of Schizophrenia Among Future Healthcare Professionals: Differences in Relation to Diagnostic Labelling, Causal Explanations, and Type of Academic Degree Program. CLINICAL NEUROPSYCHIATRY 2021; 18:260-269. [PMID: 34984069 PMCID: PMC8696287 DOI: 10.36131/cnfioritieditore20210504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Stereotyped beliefs about schizophrenia are well-established in the society and relatively common among healthcare professionals and students. The aim of this study was to investigate the opinions about the causes, treatment, and outcome of schizophrenia among healthcare students. METHOD Undergraduate nursing and psychology students completed selected items of the Opinion on Mental Illness Questionnaire after reading a clinical vignette of undiagnosed schizophrenia. RESULTS Students who labelled the description as schizophrenia were more pessimistic regarding full recovery from the disorder. Those who acknowledged greater relevance to biogenetic risk factors were more convinced of the efficacy of medications. Respondents' opinions on the efficacy of psychological interventions were more positive among psychology students than among nursing students. CONCLUSIONS The study confirmed the associations of schizophrenia labelling with prognostic pessimism and beliefs about the efficacy of pharmacological treatment among future healthcare professionals. Students' opinions were less influenced by differences between academic degree programs. Information about current recovery rate and comprehensive care for schizophrenia may support future healthcare professionals in the relationship and the clinical management of PWS.
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Affiliation(s)
- Lucia Sideli
- Department of Human Science, LUMSA University, Rome, Italy.,Corresponding author Lucia Sideli Department of Human Sciences, LUMSA University, Rome, Italy. E-mail
| | - Crocettarachele Sartorio
- Section of Psychiatry, Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Section of Psychiatry, Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | | | | | - Francesca Giannone
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Fabio Seminerio
- Section of Psychiatry, Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - M. Valentina Barone
- Section of Psychiatry, Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Giuseppe Maniaci
- Section of Psychiatry, Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Simonetta Montana
- Section of Psychiatry, Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Fulvio Marchese
- Section of Psychiatry, Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Section of Psychiatry, Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Section of Psychiatry, Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
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20
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Cano JF, Ortegón-Valencia J, Pedraza-Perez C, Córdoba-Rojas R, Olarte-Armenta A, Vallejo-Silva A, González-Díaz J. Functionality During the First Five Years After the Diagnosis of Schizophrenia. A Cohort Study in a Colombian Population. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 51:S0034-7450(20)30117-7. [PMID: 33735038 DOI: 10.1016/j.rcp.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/18/2020] [Accepted: 11/02/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE There is a lack of studies on the natural history of the initial stages of schizophrenia in Colombia. This study aims to assess functionality in the first five years after the diagnosis of schizophrenia. METHODS Naturalistic longitudinal study of 50 patients with early schizophrenia evaluated between 2011 and 2014. Data about demographic background, symptoms, introspection, treatment and adverse reactions were collected in all patients every 3 months for at least 3-5 years. Functionality was measured with the Global Assessment of Functioning (GAF) and Personal and Social Performance (PSP) scales. RESULTS Patients were followed up for a mean of 174±62.5 weeks and showed moderate difficulties in overall functioning. This functioning was modified by polypharmacy, degree of introspection, changes in antipsychotic regimens, and the number of episodes, relapses and hospitalisations. CONCLUSIONS The results suggest that functional outcomes seem to be related to the use of polypharmacy, degree of insight, changes in antipsychotic regimens, and number of episodes, relapses and hospitalisations during the first years of schizophrenia.
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Affiliation(s)
- Juan F Cano
- UR Center for Mental Health (CeRSaMe), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia; Centro de Investigaciones del Sistema Nervioso (CISNE), Bogotá, Colombia.
| | | | | | - Rodrigo Córdoba-Rojas
- UR Center for Mental Health (CeRSaMe), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia; Centro de Investigaciones del Sistema Nervioso (CISNE), Bogotá, Colombia
| | - Ana Olarte-Armenta
- Centro de Investigaciones del Sistema Nervioso (CISNE), Bogotá, Colombia
| | - Alexie Vallejo-Silva
- UR Center for Mental Health (CeRSaMe), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia; Clínica Nuestra Señora de la Paz, Bogotá, Colombia
| | - Jairo González-Díaz
- UR Center for Mental Health (CeRSaMe), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia; Clínica Nuestra Señora de la Paz, Bogotá, Colombia
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21
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Yang Z, Lee SH, Abdul Rashid NA, See YM, Dauwels J, Tan BL, Lee J. Predicting Real-World Functioning in Schizophrenia: The Relative Contributions of Neurocognition, Functional Capacity, and Negative Symptoms. Front Psychiatry 2021; 12:639536. [PMID: 33815171 PMCID: PMC8017150 DOI: 10.3389/fpsyt.2021.639536] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Neurocognition and functional capacity are commonly reported predictors of real-world functioning in schizophrenia. However, the additional impact of negative symptoms, specifically its subdomains, i.e., diminished expression (DE) and avolition-apathy (AA), on real-world functioning remains unclear. The current study assessed 58 individuals with schizophrenia. Neurocognition was assessed with the Brief Assessment of Cognition in Schizophrenia, functional capacity with the UCSD Performance-based Skills Assessment (UPSA-B), and negative symptoms with the Negative Symptom Assessment-16. Real-world functioning was assessed with the Multnomah Community Ability Scale (MCAS) with employment status as an additional objective outcome. Hierarchical regressions and sequential logistic regressions were used to examine the associations between the variables of interest. The results show that global negative symptoms contribute substantial additional variance in predicting MCAS and employment status above and beyond the variance accounted for by neurocognition and functional capacity. In addition, both AA and DE predict the MCAS after controlling for cognition and functional capacity. Only AA accounts for additional variance in employment status beyond that by UPSA-B. In summary, negative symptoms contribute substantial additional variance in predicting both real-world functioning and employment outcomes after accounting for neurocognition and functional capacity. Our findings emphasize both DE and AA as important treatment targets in functional recovery for people with schizophrenia.
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Affiliation(s)
- Zixu Yang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Soon Hong Lee
- Research Division, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Yuen Mei See
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Justin Dauwels
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Bhing Leet Tan
- Department of Occupational Therapy, Institute of Mental Health, Singapore, Singapore.,Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Psychosis, Institute of Mental Health, Singapore, Singapore
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García-Portilla MP, García-Álvarez L, González-Blanco L, Dal Santo F, Bobes-Bascarán T, Martínez-Cao C, García-Fernández A, Sáiz PA, Bobes J. Real-World Functioning in Patients With Schizophrenia: Beyond Negative and Cognitive Symptoms. Front Psychiatry 2021; 12:700747. [PMID: 34434128 PMCID: PMC8381019 DOI: 10.3389/fpsyt.2021.700747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/15/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Interest in the idea of recovery for certain patients with schizophrenia has been growing over the last decade. Improving symptomatology and functioning is crucial for achieving this. Our study aims to identify those factors that substantially contribute to real-world functioning in these patients. Methods: We carried out a cross-sectional study in stable outpatients with schizophrenia on maintenance antipsychotic monotherapy. Patients: We studied 144 outpatients with schizophrenia (DSM-IV-TR criteria) meeting the following criteria: (1) 18-65 years of age; (2) being clinically stable for at least the previous three months; (3) on maintenance antipsychotic monotherapy (prescriptions ≤ 10 mg olanzapine, ≤200 mg quetiapine, or ≤100 mg levomepromazine as hypnotics were also allowed); and (4) written informed consent. Assessment: We collected information on demographic and clinical variables by using an ad hoc questionnaire. For psychopathology, we employed the Spanish versions of the following psychometric instruments: the Positive and Negative Syndrome Scale (PANSS), the Brief Negative Symptom Scale (BNSS-Sp), and the Calgary Depression Scale (CDS). In addition, cognitive domains were assessed using the Verbal Fluency Test (VFT), the Digit Symbol Substitution Test (DSST), and the Trail Making Test, parts A and B (TMT-A and TMT-B). Finally, we employed the Spanish versions of the University of California San Diego Performance-based Skills Assessment (Sp-UPSA) and the Personal and Social Performance (PSP) for assessing functional capacity and real-world functioning, respectively. Statistical analysis: A forward stepwise regression was conducted by entering those variables significantly associated with PSP total score into the univariate analyses (Student's t-test, ANOVA with Duncan's post-hoc test, or bivariate Pearson correlation). Results: A total of 144 patients; mean age 40 years, 64% males, mean length of illness 12.4 years, PSP total score 54.3. The final model was a significant predictor of real-world functioning [F (7, 131) = 36.371, p < 0.001] and explained 66.0% of the variance. Variables retained in the model: BNSS-Sp abulia, asociality, and blunted affect, PANSS general psychopathology, Sp-UPSA transportation, TMT-B, and heart rate. Conclusion: Our model will contribute to a more efficient and personalized daily clinical practice by assigning specific interventions to each patient based on specific impaired factors in order to improve functioning.
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Affiliation(s)
- María Paz García-Portilla
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Leticia García-Álvarez
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.,Department of Psychology, Universidad de Oviedo, Oviedo, Spain
| | - Leticia González-Blanco
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Francesco Dal Santo
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Teresa Bobes-Bascarán
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.,Department of Psychology, Universidad de Oviedo, Oviedo, Spain
| | - Clara Martínez-Cao
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Ainoa García-Fernández
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Pilar A Sáiz
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Julio Bobes
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
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Lambert M, Sanchez P, Bergmans P, Gopal S, Mathews M, Wooller A, Pungor K. Effect of Paliperidone Palmitate 3-Month Formulation on Goal Attainment and Disability After 52 Weeks' Treatment in Patients with Clinically Stable Schizophrenia. Neuropsychiatr Dis Treat 2020; 16:3197-3208. [PMID: 33380797 PMCID: PMC7767727 DOI: 10.2147/ndt.s286654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/08/2020] [Indexed: 01/09/2023] Open
Abstract
PURPOSE This pragmatic clinical study aimed to assess goal attainment among patients with schizophrenia treated with paliperidone palmitate 3-monthly (PP3M) and its relation to their level of disability, and whether patients achieved symptomatic remission at the study endpoint. PATIENTS AND METHODS Goal attainment was assessed as a secondary endpoint using Goal Attainment Scaling (GAS) within a 52-week, prospective, single-arm, non-randomized, open-label, international, multicenter study evaluating the impact of transitioning stable patients with schizophrenia from paliperidone palmitate 1-monthly (PP1M) to PP3M. Additional exploratory analyses were performed to investigate the relationship between disability and functioning as measured by the World Health Organization Disability Assessment Schedule (WHODAS), Version 2.0, symptomatic remission, and goal attainment. RESULTS Overall, 305 patients were enrolled, of whom 281 (92.1%) provided GAS data at baseline. Of these, 160 achieved symptomatic remission at the last observation carried forward (LOCF) endpoint. The most common category of goals was "self" related, of which work-related was most frequent. Two-thirds of patients (67.7%) achieved at least one goal at the LOCF endpoint. Goal achievement was positively associated with lower baseline symptoms and symptomatic remission at LOCF endpoint, and with lower WHODAS scores at baseline and LOCF endpoint and greater WHODAS score improvements from baseline. Age, duration of disease, and duration of PP1M treatment before the switch did not impact goal setting and goal attainment. The proportion of patients with remunerated work status increased by 11.3% at LOCF endpoint. CONCLUSION The results of this secondary endpoint analysis indicate that continued treatment of patients with schizophrenia with PP3M following stabilization with PP1M may facilitate attainment of patients' personal goals and reduce disability, especially, but not exclusively, in patients with symptomatic remission achieved at LOCF.
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Affiliation(s)
- Martin Lambert
- Centre for Psychosis and Integrated Care, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pedro Sanchez
- Treatment Resistant Psychosis Unit, Hospital Psiquiatrico De Álava, Osakidetza, Vitoria, Spain
- School of Medicine, University of Deusto, Bilbao, Spain
| | - Paul Bergmans
- Janssen-Cilag B.V., Biostatistics, Breda, Netherlands
| | | | - Maju Mathews
- Janssen Pharma, Global Medical Affairs, New York City, NY, USA
| | | | - Katalin Pungor
- Janssen Medical Affairs EMEA, Janssen-Cilag GmbH. Johnson and Johnson Platz 1, 41470 Neuss, Germany
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24
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Mortan Sevi O, Ger M, Kaya F, Maşalı B. The effect of psychodrama sessions on psychotic symptoms, depression, quality of life, and sociometric measures in patients with chronic schizophrenia. ARTS IN PSYCHOTHERAPY 2020. [DOI: 10.1016/j.aip.2020.101719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Gökcen A, Ekici G, Abaoğlu H, Tiryaki Şen D. The healing effect of goal-oriented dance and movement therapy in schizophrenia: A rater-blinded randomized controlled trial. ARTS IN PSYCHOTHERAPY 2020. [DOI: 10.1016/j.aip.2020.101702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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26
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Gandhi S, Jose D, Desai G. Perspectives of consumers in India on factors affecting recovery from schizophrenia. Int J Soc Psychiatry 2020; 66:93-101. [PMID: 31544566 DOI: 10.1177/0020764019877425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Identifying patient perspectives about recovery may help the service providers to enhance active participation of patients in their recovery. AIM This study aimed to explore patients' perspectives about factors affecting recovery from schizophrenia. METHODS A semi-structured interview schedule was used to explore the perceptions of 18 patients diagnosed with schizophrenia. The interviews were recorded, transcribed and analysed. Codes were identified and similar codes were grouped together and main themes were identified. RESULTS Nine main themes on facilitators and barriers of recovery from schizophrenia were derived. CONCLUSION Deeper understanding of patients' perspectives of recovery from schizophrenia can help mental health professionals to plan appropriate recovery-oriented services.
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Affiliation(s)
| | - Diksy Jose
- Department of Nursing, Govt. Mental Health Centre, Thrissur, India
| | - Geetha Desai
- Department of Psychiatry, NIMHANS, Bangalore, India
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27
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Correia FD, Carvalho AM, Campbell-Allen N, Sampaio P. A new approach to organisational excellence for small and medium enterprises: the QOE-SME model. TOTAL QUALITY MANAGEMENT & BUSINESS EXCELLENCE 2020. [DOI: 10.1080/14783363.2020.1718490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Fábio Daniel Correia
- Department of Production and Systems, Braga, Portugal
- ALGORITMI Research Centre, School of Engineering – University of Minho, Guimarães, Portugal
| | - André M. Carvalho
- Department of Production and Systems, Braga, Portugal
- ALGORITMI Research Centre, School of Engineering – University of Minho, Guimarães, Portugal
| | - Nicola Campbell-Allen
- Department of Production and Systems, Braga, Portugal
- ALGORITMI Research Centre, School of Engineering – University of Minho, Guimarães, Portugal
| | - Paulo Sampaio
- Department of Production and Systems, Braga, Portugal
- ALGORITMI Research Centre, School of Engineering – University of Minho, Guimarães, Portugal
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28
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Pungor K, Bozikas VP, Emsley R, Llorca PM, Gopal S, Mathews M, Wooller A, Bergmans P. Stable patients with schizophrenia switched to paliperidone palmitate 3-monthly formulation in a naturalistic setting: impact of patient age and disease duration on outcomes. Ther Adv Psychopharmacol 2020; 10:2045125320981500. [PMID: 35186258 PMCID: PMC8851108 DOI: 10.1177/2045125320981500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 11/13/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Paliperidone palmitate 3-monthly (PP3M) is a second-generation, long-acting injectable antipsychotic formulation indicated for the maintenance treatment of adults with schizophrenia first stabilized with paliperidone palmitate 1-monthly (PP1M). This exploratory post hoc subgroup analysis of the 52-week, phase 3b REMISSIO study analysed outcomes according to patient age and disease duration in a naturalistic clinical setting. METHODS Outcomes of patients with schizophrenia were analysed according to age [<35 years (n = 123) versus ⩾35 years (n = 182)] and disease duration [⩽3 years (n = 72) versus >3 years (n = 233)]. The primary efficacy outcome was the proportion of patients achieving symptomatic remission according to the Andreasen criteria. Adverse events were monitored throughout the study. RESULTS At endpoint (last observation carried forward), 60.7% (95% CI: 51.4%, 69.4%) of younger patients and 54.1% of older patients (95% CI: 46.6%, 61.6%) achieved symptomatic remission. The proportions for patients with disease duration ⩽3 years and >3 years were similar: 57.8% (45.4%, 69.4%) versus 56.5% (49.8%, 62.9%). Functional remission was reached by 45.4% (36.2%, 54.8%) of patients aged <35 years and 36% (28.9%, 43.6%) of patients aged ⩾35 years with a similar pattern when analysed by disease duration. PP3M had a favourable safety profile and was generally well tolerated in both age groups. CONCLUSION Patients with schizophrenia, previously stabilized on PP1M, may benefit from PP3M treatment with some additional potential improvements if started early in the disease course. CLINICAL TRIALSGOV NCT02713282.
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Affiliation(s)
- Katalin Pungor
- Janssen, EMEA Medical Affairs, Johnson & Johnson Platz 1, Neuss, 41470, Germany
| | - Vasilis P Bozikas
- Second Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Robin Emsley
- Stellenbosch University, Cape Town, South Africa
| | | | - Srihari Gopal
- Department of Neuroscience, Janssen Research and Development, LLC, NJ, USA
| | - Maju Mathews
- Department of Neuroscience, Janssen Research and Development, LLC, NJ, USA
| | | | - Paul Bergmans
- Janssen Cilag, Biostatistics, Breda, The Netherlands
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29
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Barkhatova AN. [Prognostic importance of the psychopathological remission structure at the initial stage of schizophrenia]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:5-11. [PMID: 31089088 DOI: 10.17116/jnevro20191190315] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To identify main clinical and psychopathological models of remission in the initial stage of schizophrenia which were correlated with subsequent clinical and social prognosis. MATERIAL AND METHODS The sample consisted of 116 patients diagnosed with paroxysmal-progressive schizophrenia (ICD-10 items F20.01-F20.09) in remission after the first or second episode. Clinical-psychopathological, psychometric (SPI-A), statistical methods were used. The separation of remissions in the initial stage of schizophrenia was based on the principle of longitudinal observation with estimation of correlations between deficit disorders and positive symptoms. RESULTS AND CONCLUSION Depending on the predominance of one of the factors of the deficit symptom complex, the following modules were identified: remissions with domination of deficit expression factor and remissions with deficit apathy factor, which were correlated with the clinical and social prognosis.
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30
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Pozzato I, Craig A, Gopinath B, Tran Y, Dinh M, Gillett M, Cameron I. Biomarkers of autonomic regulation for predicting psychological distress and functional recovery following road traffic injuries: protocol for a prospective cohort study. BMJ Open 2019; 9:e024391. [PMID: 30948569 PMCID: PMC6500247 DOI: 10.1136/bmjopen-2018-024391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Psychological distress is a prevalent condition often overlooked following a motor vehicle crash (MVC), particularly when injuries are not severe. The aim of this study is to examine whether biomarkers of autonomic regulation alone or in combination with other factors assessed shortly after MVC could predict risk of elevated psychological distress and poor functional recovery in the long term, and clarify links between mental and physical health consequences of traffic injury. METHODS AND ANALYSIS This is a controlled longitudinal cohort study, with follow-up occurring at 3, 6 and 12 months. Participants include up to 120 mild to moderately injured MVC survivors who consecutively present to the emergency departments of two hospitals in Sydney and who agree to participate, and a group of up to 120 non-MVC controls, recruited with matched demographic characteristics, for comparison. WHO International Classification of Functioning is used as the framework for study assessment. The primary outcomes are the development of psychological distress (depressive mood and anxiety, post-traumatic stress symptoms, driving phobia, adjustment disorder) and biomarkers of autonomic regulation. Secondary outcomes include indicators of physical health (presence of pain/fatigue, physical functioning) and functional recovery (quality of life, return to function, participation) as well as measures of emotional and cognitive functioning. For each outcome, risk will be described by the frequency of occurrence over the 12 months, and pathways determined via latent class mixture growth modelling. Regression models will be used to identify best predictors/biomarkers and to study associations between mental and physical health. ETHICS AND DISSEMINATION Ethical approvals were obtained from the Sydney Local Health District and the research sites Ethics Committees. Study findings will be disseminated to health professionals, related policy makers and the community through peer-reviewed journals, conference presentations and health forums. TRIAL REGISTRATION NUMBER ACTRN12616001445460.
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Affiliation(s)
- Ilaria Pozzato
- Sydney Medical School—Northern, John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, New South Wales, Australia
| | - Ashley Craig
- Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia
| | - Bamini Gopinath
- Sydney Medical School—Northern, John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, New South Wales, Australia
- Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia
| | - Yvonne Tran
- Sydney Medical School—Northern, John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, New South Wales, Australia
| | - Michael Dinh
- Emergency Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Mark Gillett
- Emergency Department, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Ian Cameron
- Sydney Medical School—Northern, John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, New South Wales, Australia
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31
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Ohi K, Sumiyoshi C, Fujino H, Yasuda Y, Yamamori H, Fujimoto M, Sumiyoshi T, Hashimoto R. A 1.5-Year Longitudinal Study of Social Activity in Patients With Schizophrenia. Front Psychiatry 2019; 10:567. [PMID: 31447715 PMCID: PMC6697059 DOI: 10.3389/fpsyt.2019.00567] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 07/19/2019] [Indexed: 11/13/2022] Open
Abstract
Patients with schizophrenia exhibit impairments in their social activity, intelligence quotient (IQ), daily living skills, and social function. Social activity is a high-order outcome measure of their lives. Here we attempted to longitudinally evaluate the effects of IQ, daily living skills, social function, psychiatric symptoms, and medications on social activity in patients with schizophrenia. The purpose of the current study is to identify the specific factor that affects longitudinal changes in social activity. Sixty-five patients with schizophrenia were assessed at two time points [time 2 (T2, follow-up) - time 1 (T1, baseline) = 1.71 ± 0.79 years]. Social activity, IQ, daily living skills, and social function were assessed using the Social Activity Assessment (SAA; h/week), short form of the Wechsler Adult Intelligence Scale (WAIS)-III (WAIS-SF), University of California San Diego (UCSD) Performance-Based Skills Assessment (UPSA), and Social Functioning Scale (SFS), respectively. IQ, daily living skills, social function, and social activity were significantly improved between T1 and T2 (t = 2.0-4.4, p = 0.048-3.60 × 10-5). IQ, daily living skills, and social function positively correlated with social activity (lowest p = 1.27 × 10-5), and psychiatric symptoms negatively correlated with social activity over time (lowest p = 3.26 × 10-9). The longitudinal change in social activity was independently and positively correlated with a change in social function (beta = 0.35, p = 4.63 × 10-3), particularly interpersonal communication (beta = 0.35, p = 4.32 × 10-3). The longitudinal changes in other factors did not directly affect the change in social activity (p > 0.05). Based on these findings, social activity is more affected by social function than by other factors.
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Affiliation(s)
- Kazutaka Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Uchinada, Japan.,Medical Research Institute, Kanazawa Medical University, Uchinada, Japan
| | - Chika Sumiyoshi
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
| | - Haruo Fujino
- Graduate School of Education, Oita University, Oita, Japan
| | - Yuka Yasuda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomiki Sumiyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan.,Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.,Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
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32
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Gorwood P, Mallet J, Lancrenon S. Functional remission in schizophrenia: A FROGS-based definition and its convergent validity. Psychiatry Res 2018; 268:94-101. [PMID: 30015112 DOI: 10.1016/j.psychres.2018.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
Functional remission concerns only one third of schizophrenia patients who achieved symptomatic remission. We previously developed a scale devoted to functional remission, named the FROGS (Functional Remission Of General Schizophrenia). This instrument encompasses three clinically relevant dimensions. The aim of this study is to provide a threshold for functional remission relying on these three dimensions, and to compare its psychometric properties with other scales devoted to functional remission. We tested the characteristics of functional remission according to the FROGS. The FROGS was used in different European countries and compared to other valid scales (GAF, PSP and PSRS) in a sample of 295 schizophrenia patients. The association with different parameters as external validators was assessed, including clinical remission. A comparison of the classifying properties of each scale compared to the others was made. The four instruments were equally influenced by the PANSS score, the clinical remission according Andreassen's criteria, the number of past hospitalizations and the presence of a paid working activity. These findings provide a simple threshold for the FROGS, tightly linked to the definition of functional remission, with a good convergent validity. This instrument might be easily used to facilitate the assessment of functional remission in schizophrenia.
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Affiliation(s)
- Philip Gorwood
- Sainte-Anne Hospital (CMME), Paris Descartes University, Paris, France; INSERM U894, Institute of Psychiatry and Neuroscience of Paris (IPNP), Paris, France.
| | - Jasmina Mallet
- INSERM U894, Institute of Psychiatry and Neuroscience of Paris (IPNP), Paris, France; CHU Louis Mourier, Department of Psychiatry, Paris Diderot University, AP-HP, Colombes, France
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