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Kubota R, Ikezawa S, Oi H, Oba MS, Izumi S, Tsuno R, Adachi L, Miwa M, Toya S, Nishizato Y, Haga D, Iwane T, Nakagome K. Valuable interaction with cognitive remediation and optimal antipsychotics for recovery in schizophrenia (VICTORY-S): study protocol for an interventional, open-label, randomized comparison of combined treatment with cognitive remediation and lurasidone or paliperidone. Front Psychiatry 2024; 14:1331356. [PMID: 38380376 PMCID: PMC10877376 DOI: 10.3389/fpsyt.2023.1331356] [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: 11/01/2023] [Accepted: 12/22/2023] [Indexed: 02/22/2024] Open
Abstract
Background Cognitive impairment, a core feature of schizophrenia, is associated with poor outcomes. Pharmacotherapy and psychosocial treatment, when used alone, have inadequate effect sizes for cognitive impairment, leading to recent interest in combination interventions. A previous study examined the additive effect of cognitive remediation on lurasidone in patients with schizophrenia, which was negative. Although improvement in cognitive function was suggested for lurasidone, it was inconclusive because there was no antipsychotic control in the study. To clarify whether lurasidone has a meaningful impact on cognitive function in combination with cognitive remediation, we use paliperidone as a control antipsychotic in this study. We hypothesize that combination with lurasidone will improve cognitive and social function to a greater extent than paliperidone. Methods The valuable interaction with cognitive remediation and optimal antipsychotics for recovery in schizophrenia study is a multicenter, interventional, open-label, rater-blind, randomized comparison study, comparing the effect of lurasidone plus cognitive remediation with that of paliperidone plus cognitive remediation in patients with schizophrenia. The Neuropsychological Educational Approach to Remediation (NEAR) is used for cognitive remediation. Eligible patients will be randomized 1:1 to receive lurasidone or paliperidone combined with NEAR (6 weeks antipsychotic alone followed by 24 weeks combination antipsychotic plus NEAR). The primary endpoint is the change from baseline in the tablet-based Brief Assessment of Cognition in Schizophrenia composite T-score at the end of the NEAR combination treatment period. Secondary endpoints will include change from baseline in social function, schizophrenia symptoms, and quality of life at the end of the NEAR combination treatment period. Furthermore, change from baseline to the end of the pharmacotherapy period and change from the end of the pharmacotherapy period to the end of the NEAR combination treatment period will be assessed for all endpoints. Safety will also be evaluated. Discussion Achievement of adequate cognitive function is central to supporting social function, which is a key treatment goal for patients with schizophrenia. We think this study will fill in the gaps of the previous study and provide useful information regarding treatment decisions for patients with schizophrenia. Clinical trial registration Japan Registry of Clinical Trials ID, jRCTs031200338.
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Affiliation(s)
- Ryotaro Kubota
- Department of Forensic Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Satoru Ikezawa
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Department of Psychiatry, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Hideki Oi
- Department of Clinical Data Science, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Mari S Oba
- Department of Clinical Data Science, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shoki Izumi
- Department of Clinical Data Science, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ryoko Tsuno
- Department of Clinical Data Science, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Leona Adachi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Mako Miwa
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Shunji Toya
- CNS Group, Medical Science, Sumitomo Pharma Co., Ltd., Tokyo, Japan
| | - Yohei Nishizato
- CNS Group, Medical Science, Sumitomo Pharma Co., Ltd., Tokyo, Japan
| | | | | | - Kazuyuki Nakagome
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
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Weigel L, Wehr S, Galderisi S, Mucci A, Davis J, Giordano GM, Leucht S. The Brief negative Symptom Scale (BNSS): a systematic review of measurement properties. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:45. [PMID: 37500628 PMCID: PMC10374652 DOI: 10.1038/s41537-023-00380-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Negative symptoms of schizophrenia are linked with poor functioning and quality of life. Therefore, appropriate measurement tools to assess negative symptoms are needed. The NIMH-MATRICS Consensus defined five domains for negative symptoms, which The Brief Negative Symptom Scale (BNSS) covers. METHODS We used the COSMIN guidelines for systematic reviews to evaluate the quality of psychometric data of the BNSS scale as a Clinician-Rated Outcome Measure (ClinROM). RESULTS The search strategy resulted in the inclusion of 17 articles. When using the risk of bias checklist, there was a generally good quality in reporting of structural validity and hypothesis testing. Internal consistency, reliability and cross-cultural validity were of poorer quality. ClinROM development and content validity showed inadequate results. According to the updated criteria of good measurement properties, structural validity, internal consistency and interrater reliability showed good results, while hypothesis testing showed poorer results. Cross-cultural validity and test-retest reliability were indeterminate. The updated GRADE approach resulted in a moderate grade. CONCLUSIONS We can potentially recommend the use of the BNSS as a concise tool to rate negative symptoms. Due to weaknesses in certain domains further validations are warranted.
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Affiliation(s)
- Lucia Weigel
- Department of Psychiatry and Psychotherapy, School Of Medicine, Technical University of Munich, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675, Munich, Germany
| | - Sophia Wehr
- Department of Psychiatry and Psychotherapy, School Of Medicine, Technical University of Munich, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675, Munich, Germany
| | - Silvana Galderisi
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - Armida Mucci
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - John Davis
- Psychiatric Institute, University of Illinois at Chicago (mc 912), 1601 W. Taylor St., Chicago, Il 60612, and Maryland Psychiatric Research Center, Baltimore, MD, USA
| | - Giulia Maria Giordano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, School Of Medicine, Technical University of Munich, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675, Munich, Germany.
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Santos HC, Rodrigues A, Ferreira S, Martins JM, Baptista T, Gama Marques J, Kirkpatrick B, Prata D. The European Portuguese Version of the Brief Negative Symptom Scale. Psychopathology 2023; 57:76-80. [PMID: 37276842 DOI: 10.1159/000530705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/12/2023] [Indexed: 06/07/2023]
Abstract
Negative symptoms reflect a currently much-untreated loss of normal functioning and are frequently found in psychotic disorders. We present the first translation of the Brief Negative Symptom Scale (BNSS) to European Portuguese and evaluate its validity in a sample of Portuguese male patients with a psychotic spectrum disorder. The Portuguese BNSS showed excellent internal consistency, high convergent validity (i.e., strong correlation with the PANSS negative factor), and high discriminant validity (i.e., a lack of association with the PANSS positive factor). In sum, the present European Portuguese BNSS has shown to be reliable, thus extending this instrument's clinical availability worldwide.
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Affiliation(s)
- Henrique Castro Santos
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências da Universidade de Lisboa, Lisboa, Portugal
- Hospital Júlio de Matos, Centro Hospitalar Psiquiátrico de Lisboa, Lisboa, Portugal
| | - Alexandra Rodrigues
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências da Universidade de Lisboa, Lisboa, Portugal
- Neuroradiology Department, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
- Unidade de Neurorradiologia, Hospital Central Do Funchal, Funchal, Portugal
| | - Sara Ferreira
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências da Universidade de Lisboa, Lisboa, Portugal
| | - João Malhadas Martins
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências da Universidade de Lisboa, Lisboa, Portugal
| | - Tiago Baptista
- Departamento de Imagiologia, Hospital CUF Tejo, Lisboa, Portugal
| | - João Gama Marques
- Hospital Júlio de Matos, Centro Hospitalar Psiquiátrico de Lisboa, Lisboa, Portugal
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Brian Kirkpatrick
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Diana Prata
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências da Universidade de Lisboa, Lisboa, Portugal
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Okada H. Determinants of Recreational Outcomes in Schizophrenia: An Exploratory Study Focusing on Gender Differences. Issues Ment Health Nurs 2022; 43:376-381. [PMID: 34529525 DOI: 10.1080/01612840.2021.1975331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While recreation is impactful for recovery in schizophrenia, no study has examined the effects of schizophrenic symptoms on recreational outcomes. This study examined the determinants of recreational outcomes based on gender. We investigated the relationship between recreational outcomes, positive and negative symptoms, cognitive function, and factors such as negative self-evaluation and evaluation by others. Motivation had a significant impact on both men and women. However, participation in recreational activities was impacted by negative self-assessment for men and evaluations from others for women. The importance of matching strategies based on gender when using recreation therapeutically was emphasized.
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Affiliation(s)
- Hiroki Okada
- Department of Health Science Research, Hokkaido University, Sapporo, Hokkaido, Japan
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Okada H. Identifying subgroups based on self-assessment of ability in patients with schizophrenia and its relationship with vocational outcomes. Hong Kong J Occup Ther 2022; 35:35-43. [PMID: 35847185 PMCID: PMC9279875 DOI: 10.1177/15691861221075715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/08/2022] [Indexed: 11/21/2022] Open
Abstract
Background/Objectives People with schizophrenia have defective self-assessment of ability (i.e., loss of introspective accuracy [IA]). Although previous studies grouped people according to the degree of IA, the clinical features of these subgroups have not been clarified. Additionally, the determinants of outcomes depending on self-assessment remain unknown. We aimed to identify the clinical features that can help distinguish these subgroups and whether the determinants of vocational outcomes differed between the groups. Methods The self-assessment ability of 100 people with schizophrenia was examined and categorized as accurate, over-, or under-estimators. Multiple discriminant analysis was also performed. After demonstrating statistical validity, the relative effects of positive and negative symptoms, cognitive function, and level of IA on vocational outcomes were also examined for each subgroup. Results The symptoms that particularly explained the differences between these subgroups were positive and negative (expressing factors) symptoms: p < .001. Using the determinants of vocational outcomes in each subgroup, the over-estimator subgroup was characterized by positive symptoms: p = .025, the under-estimator group, by the underestimation of their own ability: p = .042, and the accurate estimator group, by cognitive function: p = .006. Conclusion Reduced IA can be a core mediator of various symptoms. Thus, tailoring the target and strategy of interventions for vocational outcomes according to the accuracy and quality of IA is important in clinical settings.
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Affiliation(s)
- Hiroki Okada
- Department of Rehabilitation of Sciences, Hokkaido University, Sapporo, Japan
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Rekhi G, Ang MS, Chan YH, Fernandez-Egea E, Kirkpatrick B, Lee J. Defining negative symptoms remission in schizophrenia using the Brief Negative Symptom Scale. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:3-13. [PMID: 35256070 DOI: 10.1016/j.rpsmen.2022.01.007] [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: 03/30/2021] [Accepted: 05/11/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This study aimed to propose criteria for negative symptoms remission (NSR) in schizophrenia using the Brief Negative Symptom Scale (BNSS). MATERIAL AND METHODS 274 participants were assessed on the Positive and Negative Syndrome Scale (PANSS), BNSS and Social and Occupational Functioning Assessment Scale (SOFAS). Two criteria for NSR on the BNSS were proposed - NSR based on the BNSS domains scores (NSRBNSS_DOMAINS) and NSR based on 5 key items of the BNSS (NSRBNSS_5ITEMS). A SOFAS score of 61 and above was considered as functional remission (FR). Logistic regressions were run to examine the association between FR and NSR. Receiver operating characteristic (ROC) curve analysis was performed for the NSR criteria on FR. Kappa agreement statistic was used to evaluate the agreement between the two NSR criteria. RESULTS Eighty-nine (32.5%) participants fulfilled NSRBNSS_DOMAINS criterion whereas 70 (25.6%) participants fulfilled NSRBNSS_5ITEMS criterion. The two NSR criteria had substantial agreement (Kappa statistic=0.797) with each other. Sixty-one (25.3%) participants were in FR. FR was significantly associated with NSR, irrespective of the criterion used. To predict FR, the Area Under the Curve for NSRBNSS_DOMAINS and NSRBNSS_5ITEMS were 0.761 (CI: 0.696-0.826, p<0.001) and 0.723 (CI: 0.656-0.790, p<0.001), respectively. Hence, both NSR criteria demonstrated a fair ability to discriminate between functional remitters and non-remitters. CONCLUSIONS Depending on the setting and needs, clinicians and researchers might employ either the full BNSS or an abbreviated 5-item BNSS scale to identify NSR in schizophrenia. More research is needed to further examine the validity of these criteria in schizophrenia.
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Affiliation(s)
- Gurpreet Rekhi
- Research Division, Institute of Mental Health, Singapore, Singapore.
| | - Mei San Ang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Emilio Fernandez-Egea
- Department of Psychiatry, Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Brian Kirkpatrick
- Department of Psychiatry & Behavioral Sciences, University of Nevada, Reno School of Medicine, United States
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore; North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Kubota R, Okubo R, Akiyama H, Okano H, Ikezawa S, Miyazaki A, Toyomaki A, Sasaki Y, Yamada Y, Uchino T, Nemoto T, Sumiyoshi T, Yoshimura N, Hashimoto N. Study Protocol: The Evaluation Study for Social Cognition Measures in Japan (ESCoM). J Pers Med 2021; 11:jpm11070667. [PMID: 34357134 PMCID: PMC8305726 DOI: 10.3390/jpm11070667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/07/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022] Open
Abstract
In schizophrenia, social cognitive impairment is considered one of the greatest obstacles to social participation. Although numerous measures have been developed to assess social cognition, only a limited number of them have become available in Japan. We are therefore planning this evaluation study for social cognition measures in Japan (ESCoM) to confirm their psychometric characteristics and to promote research focused on social cognition. Participants in the cross-sectional observational study will be 140 patients with schizophrenia recruited from three Japanese facilities and 70 healthy individuals. In our primary analysis, we will calculate several psychometric indicators with a focus on whether they can independently predict social functioning. In secondary analyses, we will assess the reliability and validity of the Japanese translations of each measure and conduct an exploratory investigation of patient background, psychiatric symptoms, defeatist performance belief, and gut microbiota as determinants of social cognition. The protocol for this study is registered in UMIN-CTR, unique ID UMIN000043777.
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Affiliation(s)
- Ryotaro Kubota
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo 187-8551, Japan; (R.K.); (H.O.); (Y.Y.); (T.S.); (N.Y.)
| | - Ryo Okubo
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo 187-8551, Japan; (R.K.); (H.O.); (Y.Y.); (T.S.); (N.Y.)
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan;
- Correspondence: (R.O.); (N.H.)
| | - Hisashi Akiyama
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan; (H.A.); (A.M.); (A.T.)
| | - Hiroki Okano
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo 187-8551, Japan; (R.K.); (H.O.); (Y.Y.); (T.S.); (N.Y.)
| | - Satoru Ikezawa
- Endowed Institute for Empowering Gifted Minds, University of Tokyo Graduate School of Arts and Sciences, Tokyo 153-0041, Japan;
| | - Akane Miyazaki
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan; (H.A.); (A.M.); (A.T.)
| | - Atsuhito Toyomaki
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan; (H.A.); (A.M.); (A.T.)
| | - Yohei Sasaki
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan;
| | - Yuji Yamada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo 187-8551, Japan; (R.K.); (H.O.); (Y.Y.); (T.S.); (N.Y.)
| | - Takashi Uchino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo 143-8541, Japan; (T.U.); (T.N.)
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo 143-8541, Japan; (T.U.); (T.N.)
| | - Tomiki Sumiyoshi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo 187-8551, Japan; (R.K.); (H.O.); (Y.Y.); (T.S.); (N.Y.)
- National Center of Neurology and Psychiatry, Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, Tokyo 187-8553, Japan
| | - Naoki Yoshimura
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo 187-8551, Japan; (R.K.); (H.O.); (Y.Y.); (T.S.); (N.Y.)
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan; (H.A.); (A.M.); (A.T.)
- Correspondence: (R.O.); (N.H.)
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Rekhi G, Ang MS, Chan YH, Fernandez-Egea E, Kirkpatrick B, Lee J. Defining negative symptoms remission in schizophrenia using the Brief Negative Symptom Scale. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 15:S1888-9891(21)00060-4. [PMID: 34058418 DOI: 10.1016/j.rpsm.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/11/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study aimed to propose criteria for negative symptoms remission (NSR) in schizophrenia using the Brief Negative Symptom Scale (BNSS). MATERIAL AND METHODS 274 participants were assessed on the Positive and Negative Syndrome Scale (PANSS), BNSS and Social and Occupational Functioning Assessment Scale (SOFAS). Two criteria for NSR on the BNSS were proposed - NSR based on the BNSS domains scores (NSRBNSS_DOMAINS) and NSR based on 5 key items of the BNSS (NSRBNSS_5ITEMS). A SOFAS score of 61 and above was considered as functional remission (FR). Logistic regressions were run to examine the association between FR and NSR. Receiver operating characteristic (ROC) curve analysis was performed for the NSR criteria on FR. Kappa agreement statistic was used to evaluate the agreement between the two NSR criteria. RESULTS Eighty-nine (32.5%) participants fulfilled NSRBNSS_DOMAINS criterion whereas 70 (25.6%) participants fulfilled NSRBNSS_5ITEMS criterion. The two NSR criteria had substantial agreement (Kappa statistic=0.797) with each other. Sixty-one (25.3%) participants were in FR. FR was significantly associated with NSR, irrespective of the criterion used. To predict FR, the Area Under the Curve for NSRBNSS_DOMAINS and NSRBNSS_5ITEMS were 0.761 (CI: 0.696-0.826, p<0.001) and 0.723 (CI: 0.656-0.790, p<0.001), respectively. Hence, both NSR criteria demonstrated a fair ability to discriminate between functional remitters and non-remitters. CONCLUSIONS Depending on the setting and needs, clinicians and researchers might employ either the full BNSS or an abbreviated 5-item BNSS scale to identify NSR in schizophrenia. More research is needed to further examine the validity of these criteria in schizophrenia.
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Affiliation(s)
- Gurpreet Rekhi
- Research Division, Institute of Mental Health, Singapore, Singapore.
| | - Mei San Ang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Emilio Fernandez-Egea
- Department of Psychiatry, Behavioral and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Brian Kirkpatrick
- Department of Psychiatry & Behavioral Sciences, University of Nevada, Reno School of Medicine, United States
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore; North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Okada H, Hirano D, Taniguchi T. Single versus dual pathways to functional outcomes in schizophrenia: Role of negative symptoms and cognitive function. Schizophr Res Cogn 2021; 23:100191. [PMID: 33204652 PMCID: PMC7648174 DOI: 10.1016/j.scog.2020.100191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 11/24/2022] Open
Abstract
Background The functional outcomes for many patients with schizophrenia remain poor, and the specific determinants for and pathways to functional outcomes are not well understood to date. It is unknown whether major determinants of outcomes are achieved via a motivated single pathway or by the motivation and capacity defined in dual pathways. This study investigated whether different aspects of functional outcomes, such as residential, social, and vocational outcomes, are the main determinants of the experience factors for negative symptoms or whether the experience factors and cognitive function are the determinants. Method We enrolled 107 patients with schizophrenia. The Social Functioning Scale domains were used to examine whether a single or dual pathway is appropriate for each domain based on the model fit using structural equation modeling. Results The model goodness of fit criterion showed a dual pathway for residential and vocational outcomes. In contrast, social and recreational outcomes showed a single pathway. Conclusion The major determinants were clearly different for each outcome. Therefore, we emphasize the importance of using different treatment strategies for each outcome. Irrespective of the factors approached, social and recreational outcomes should ultimately focus on motivation. The findings also suggest that interventions should be combined for vulnerable cognitive functions and motivational interventions for residential and vocational outcomes.
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Impact of Negative Symptom Domains and Other Clinical Characteristics on Functional Outcomes in Patients with Schizophrenia. SCHIZOPHRENIA RESEARCH AND TREATMENT 2021; 2021:8864352. [PMID: 33688435 PMCID: PMC7914085 DOI: 10.1155/2021/8864352] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/25/2021] [Accepted: 02/05/2021] [Indexed: 01/15/2023]
Abstract
Negative symptoms of schizophrenia have generally been defined using five factors; however, few studies have examined the relationship between these five factors and functional outcomes. In addition, there is no definitive conclusion regarding the association between negative symptoms and various aspects of functional outcomes (daily living, social, and vocational). This study is aimed at examining the relationship between these five domains of negative symptoms and different functional outcomes. Patients diagnosed with chronic schizophrenia (n = 100) were selected for the evaluation. We used the Brief Negative Symptom Scale to assess negative symptoms, the Brief Psychiatric Rating Scale to assess positive symptoms, the Schizophrenia Cognition Rating Scale to assess cognition, and the Evaluative Beliefs Scale (negative self-assessment) to assess psychological factors. We analyzed their relative impact on Social Functioning Scale domains using hierarchical multiple regression analysis. Concerning the relationship between daily living and negative symptoms, cognitive function showed the highest association with residential outcomes, such as self-care and shopping, while avolition appeared to show an additional contribution; however, for recreational outcomes, avolition showed the main association, whereas cognitive function showed no additional contribution. For social outcomes, asociality and negative self-assessment showed the main associations, while vocational outcomes were determined by both cognitive function and multiple negative symptoms, such as avolition, anhedonia, asociality, and alogia. Since negative symptom domains appear to differentially impact each outcome, specifically daily living outcome, it is important to evaluate the residential outcomes and recreational outcomes separately. Overall, the present study points to the importance of formulating psychosocial treatment strategies specific for each type of preferred outcome in patients with schizophrenia.
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Hashimoto N, Takahashi K, Fujisawa D, Aoyama K, Nakagawa A, Okamura N, Toyomaki A, Oka M, Takanobu K, Okubo R, Narita H, Kitagawa K, Udo N, Maeda T, Watanabe S, Oyanagi Y, Miyazaki A, Ito K, Kusumi I. A pilot validation study of the Japanese translation of the Positive and Negative Syndrome Scale (PANSS). Asian J Psychiatr 2020; 54:102210. [PMID: 32599543 DOI: 10.1016/j.ajp.2020.102210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, 060-8638, North 15, West 7, Sapporo, Japan.
| | | | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kumi Aoyama
- Department of Psychiatry, Yokohama City University Medical Center, Yokohama, Japan
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Atsuhito Toyomaki
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Matsuhiko Oka
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Department of Psychiatry, The Hokkaido Medical Center, Sapporo, Japan
| | - Keisuke Takanobu
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ryo Okubo
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Department of Clinical Epidemiology, Translational Medical Center, National Center for Neurology and Psychiatry, Tokyo, Japan
| | - Hisashi Narita
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kan Kitagawa
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Department of Psychiatry, Kushiro City General Hospital, Kushiro, Japan
| | - Niki Udo
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tamaki Maeda
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shinya Watanabe
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yuka Oyanagi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akane Miyazaki
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Koki Ito
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Seelen-de Lang BL, Boumans CE, Nijman HLI. Validation of the Dutch Version of the Brief Negative Symptom Scale. Neuropsychiatr Dis Treat 2020; 16:2563-2567. [PMID: 33154643 PMCID: PMC7605941 DOI: 10.2147/ndt.s269037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/19/2020] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The Brief Negative Symptom Scale (BNSS) was developed to measure negative symptoms of schizophrenia. However, the Dutch translation of this instrument, called the "Korte Schaal voor Negatieve Symptomen" (KSNS), has not yet been validated. This study investigates the validity and reliability of this Dutch version of the instrument. PATIENTS AND METHODS The Psychotic Symptom Rating Scale (PSYRATS), Calgary Depression Scale for Schizophrenia (CDSS), the Health of the Nation Scale (HoNOS) and the KSNS were used for routine outcome monitoring to measure symptoms in 28 patients with a psychotic disorder who were being treated on a long-stay ward. RESULTS The internal consistency of the KSNS is fair to good. The inter-rater reliability is excellent. The concurrent validity is moderate but acceptable. The correlations between the KSNS and scales for depression and positive symptoms were not significant, which indicate good divergent validity. CONCLUSION Despite the small sample size of the current study, we conclude that the BNSS, called the KSNS in Dutch, appears to be a reliable and valid tool for investigating negative symptoms in detail in patients with psychotic disorders.
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Affiliation(s)
| | | | - Henk L I Nijman
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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