Trends in the Study of Motivation in Schizophrenia: A Bibliometric Analysis of Six Decades of Research (1956-2017)

Psychosocial and psychological interventions for schizophrenia relapse prevention: A bibliometric analysis

Various psychosocial and psychological interventions have been developed to reduce schizophrenia relapse prevention. A better understanding of these active interventions is important for clinical practice and for meaningful allocation of resources. However, no bibliometric analysis of this area has been conducted. Studies were retrieved from the Web of Science Core Collection database. The publication outputs and cooperation of institutions were visualized with Origin 2021. Global cooperation was visualized using ArcGIS Pro3.0. VOSviewer was used to generate visualizations of network of authors and keywords. The number of annual publications generally showed a fluctuating upward trend over the past 20 years. Germany published the most relevant articles (361, 26.76%). The Technical University of Munich was the most productive institution (70, 9.86%). Leucht Stefan published the most articles (46, 6.48%) and had the highest number of citations (4,375 citations). Schizophrenia Research published the most studies (39, 5.49%). Keywords were roughly classified into three clusters: cognitive behavioral therapy (CBT), family interventions and family psychoeducation and other factors related to interventions. The findings provided the current status of research on psychosocial and psychological interventions for schizophrenia relapse prevention from a bibliometric perspective. Recent research has mainly focused on CBT, family interventions and family psychoeducation.

Positivity, daily time use, mood, and functioning in patients with schizophrenia spectrum disorders: Results from the diapason multicentric study

BACKGROUND

Positivity (POS) indicates the proclivity to see life and experiences in a positive light. There is limited research on its effects on individuals with Schizophrenia Spectrum Disorders (SSD). Very little is known about the relationship between POS and daily activities in people with SSD.

AIM

The study aims to compare the POS rated by patients with SSD with those obtained in an Italian normative sample matched by age and sex and to use the Ecological Momentary Assessment (EMA) to investigate the association between POS and daily time use (i.e. productive activities, leisure activities), functioning and mood in individuals with SSD.

METHOD

620 SSD patients were recruited from mental health services in Italy as part of the DiAPAson project. POS, symptom severity, functioning, and quality of life (QoL) were assessed. POS scores were compared to a normative sample of 5,002 Italian citizens. Additionally, a subset of 102 patients underwent 7-day assessments using mobile EMA.

RESULTS

People with SSD did not significantly differ from the Italian normative sample in POS levels (0.035, p = .190). POS showed a significant inverse association with support network (-0.586, p = .036) and symptomatology (BPRS -0.101; 95% p < .001; BNSS B = -0.113, p < .001). A significant direct association was found between POS and QoL (B = 0.310, p < .001) and functioning (B = 0.058, p < .001). In the subsample using EMA, POS ratings showed significant associations with Positive Emotions (B = 0.167, p < .001) and Negative Emotions (B = -0.201, p < .001).

CONCLUSION

People with SSD exhibited comparable levels of POS to the normative sample. Higher POS was linked to better functioning, QoL, fewer severe symptoms, and increased positive emotions. However, it did not relate to increased productivity or engagement in leisure activities. Further research is needed to understand the relationship between POS and time use in individuals with SSD.

Ecological Momentary Assessment of Social Approach and Avoidance Motivations in Serious Mental Illness: Connections to Suicidal Ideation and Symptoms

AIM

People with serious mental illness (SMI) are at an increased risk for suicide. Social approach and avoidance motivations are linked to social functioning, and social isolation is a risk factor for suicide. This study uses ecological momentary assessment (EMA) to understand social approach and avoidance motivations in relation to symptoms and suicidal ideation (SI).

METHODS

Participants (N = 128) diagnosed with schizophrenia, schizoaffective disorder, or a mood disorder with psychotic features completed assessments of SI and symptoms at baseline. They completed EMA surveys 3×/day for 10 days. EMA surveys included questions about approach and avoidance motivations and psychotic symptoms. Participants were split into four groups based on the median scores of approach and avoidance.

RESULTS

Participants with SI at baseline had higher mean social avoidance motivation, t(126) = 2.84, p = .003, and lower mean social approach motivation, t(126) = -2.44, p = .008, than participants without baseline SI. Greater baseline positive symptoms were related to greater mean avoidance, r = .231, p = .009, but not approach motivation. The low approach/high avoidance group had significantly higher current SI than those with high approach/low avoidance (p < .001). Overall, the low approach/high avoidance group reported more EMA-measured voices than the low approach/low avoidance group (p < .001) and the high approach/low avoidance group (p < .001). Similarly, the low approach/high avoidance group reported more EMA-measured suspiciousness than the low approach/low avoidance (p < .001) and the high approach/low avoidance groups (p < .001).

CONCLUSION

The results of this study point to the role of social approach and avoidance motivations in relation to SI and psychotic symptoms. Clinically, exposure therapies and cognitive behavioral therapies may help to address these social approach and avoidance processes linked to SI.

Schizophrenia and Inflammation Research: A Bibliometric Analysis

Background

Schizophrenia (SCZ) is a severe psychiatric disorder that involves inflammatory processes. The aim of this study was to explore the field of inflammation-related research in SCZ from a bibliometric perspective.

Methods

Regular and review articles on SCZ- and inflammation-related research were obtained from the Web of Science Core Collection (WOSCC) database from its inception to February 19, 2022. R package "bibliometrix" was used to summarize the main findings, count the occurrences of the top keywords, visualize the collaboration network between countries, and generate a three-field plot. VOSviewer software was applied to conduct both co-authorship and co-occurrence analyses. CiteSpace was used to identify the top references and keywords with the strongest citation burst.

Results

A total of 3,596 publications on SCZ and inflammation were included. Publications were mainly from the USA, China, and Germany. The highest number of publications was found in a list of relevant journals. Apart from "schizophrenia" and "inflammatory", the terms "bipolar disorder," "brain," and "meta-analysis" were also the most frequently used keywords.

Conclusions

This bibliometric study mapped out a fundamental knowledge structure consisting of countries, institutions, authors, journals, and articles in the research field of SCZ and inflammation over the past 30 years. The results provide a comprehensive perspective about the wider landscape of this research area.

Psychological Dimensions Relevant to Motivation and Pleasure in Schizophrenia

Motivation and pleasure deficits are common in schizophrenia, strongly linked with poorer functioning, and may reflect underlying alterations in brain functions governing reward processing and goal pursuit. While there is extensive research examining cognitive and reward mechanisms related to these deficits in schizophrenia, less attention has been paid to psychological characteristics that contribute to resilience against, or risk for, motivation and pleasure impairment. For example, psychological tendencies involving positive future expectancies (e.g., optimism) and effective affect management (e.g., reappraisal, mindfulness) are associated with aspects of reward anticipation and evaluation that optimally guide goal-directed behavior. Conversely, maladaptive thinking patterns (e.g., defeatist performance beliefs, asocial beliefs) and tendencies that amplify negative cognitions (e.g., rumination), may divert cognitive resources away from goal pursuit or reduce willingness to exert effort. Additionally, aspects of sociality, including the propensity to experience social connection as positive reinforcement may be particularly relevant for pursuing social goals. In the current review, we discuss the roles of several psychological characteristics with respect to motivation and pleasure in schizophrenia. We argue that individual variation in these psychological dimensions is relevant to the study of motivation and reward processing in schizophrenia, including interactions between these psychological dimensions and more well-characterized cognitive and reward processing contributors to motivation. We close by emphasizing the value of considering a broad set of modulating factors when studying motivation and pleasure functions in schizophrenia.

The Top 50 Most-Cited Knee Arthroscopy Studies

Purpose

To objectively identify the 50 most influential studies in knee arthroscopy and provide an analysis of their key characteristics.

Methods

The Clarivate Analytics Web of Knowledge database was used to gather data and metrics of knee arthroscopy research. The search list was sorted by the number of citations, and articles were included or excluded based on relevance to knee arthroscopy. The information extracted for each article included author name, publication year, country of origin, journal name, article type, and the level of evidence.

Results

For these 50 studies, the total number of citations was calculated to be 12,168, with an average of 243.4 citations per paper. The most-cited article was cited 1,220 times. The 50 studies included in this analysis were published between 1972 and 2013. All 50 articles were published in English and came from 10 different orthopaedic journals. The United States was responsible for the majority of articles (n = 26); however, many other countries were represented. The most prevalent study designs were case series (n = 20).

Conclusions

The 50 most influential articles in knee arthroscopy were cited a total of 12,168 times. The study designs most commonly used were case series and cohort studies. This article serves as a reference to direct orthopaedic practitioners to the 50 most influential studies in knee arthroscopy. We hope that these 50 studies and the analysis we provide help health care professionals efficiently assess consensus, trends, and needs within the field.

Clinical Relevance

This analysis of the 50 most influential studies in knee arthroscopy will provide medical students, residents, fellows, and attending physicians with a comprehensive inventory and citation analysis of the most impactful academic contributions to one of the most important fields within orthopaedic surgery.

Comprehensive Bibliometric Analysis of the Kynurenine Pathway in Mood Disorders: Focus on Gut Microbiota Research

Background: Emerging evidence implicates the dysregulated kynurenine pathway (KP), an immune-inflammatory pathway, in the pathophysiology of mood disorders (MD), including depression and bipolar disorder characterized by a low-grade chronic pro-inflammatory state. The metabolites of the KP, an important part of the microbiota-gut-brain axis, serve as immune system modulators linking the gut microbiota (GM) with the host central nervous system.

Aim: This bibliometric analysis aimed to provide a first glimpse into the KP in MD, with a focus on GM research in this field, to guide future research and promote the development of this field.

Methods: Publications relating to the KP in MD between the years 2000 and 2020 were retrieved from the Scopus and Web of Science Core Collection (WoSCC), and analyzed in CiteSpace (5.7 R5W), biblioshiny (using R-Studio), and VOSviewer (1.6.16).

Results: In total, 1,064 and 948 documents were extracted from the Scopus and WoSCC databases, respectively. The publications have shown rapid growth since 2006, partly owing to the largest research hotspot appearing since then, “quinolinic acid.” All the top five most relevant journals were in the neuropsychiatry field, such as Brain Behavior and Immunity. The United States and Innsbruck Medical University were the most influential country and institute, respectively. Journal co-citation analysis showed a strong tendency toward co-citation of research in the psychiatry field. Reference co-citation analysis revealed that the top four most important research focuses were “kynurenine pathway,” “psychoneuroimmunology,” “indoleamine 2,3-dioxygenase,” and “proinflammatory cytokines,” and the most recent focus was “gut-brain axis,” thus indicating the role of the KP in bridging the GM and the host immune system, and together reflecting the field’s research foundations. Overlap analysis between the thematic map of keywords and the keyword burst analysis revealed that the topics “Alzheimer’s disease,” “prefrontal cortex,” and “acid,” were research frontiers.

Conclusion: This comprehensive bibliometric study provides an updated perspective on research associated with the KP in MD, with a focus on the current status of GM research in this field. This perspective may benefit researchers in choosing suitable journals and collaborators, and aid in the further understanding of the field’s hotspots and frontiers, thus facilitating future research.

Schizophrenia research in India: A scientometric assessmentof India's publications during 1990-2019

The present study examined India's publications (2803) on schizophrenia, using various bibliometric indicators during 1990-2019. The study focuses on the number of publications, and citations received by the papers on schizophrenia, published by authors affiliated to Indian institutes by using Scopus data base. Additionally, an attempt was made to evaluate the performance of India's leading organizations and authors, and inter-collaborative linkages between them. Scopus database include publications of Indian Journal of Psychiatry and Indian Journal of Psychological Medicine from 2009 and 2011. Accordingly, the publications in these journals were included after these years. Analysis of the publications showed that India is globally ranked at 13^th position in number of publications on schizophrenia with 2.04 % global share, depicting 14.21 % annual growth, with 22.8 % of publications having international collaboration. Publications from India published during the period of 1990-2019, registered a citation impact per paper (CPP) of 13.3. National Institute of Mental Health and Neurosciences, Bangalore (671 papers), Post Graduate Institute of Medical Education and Research, Chandigarh (271 papers) and Central Instittue of Psychiatry, Ranchi (136 papers) were the most productive institutes. However, the most impactful organizations in terms of citation per paper (CPP) and relative citation index (RCI), Indian Institute of Science, Bangalore (77.27 CPP and 5.78 RCI), Schizophrenia Research Foundation, Chennai (31.16 CPP and 2.55 RCI) and Banaras Hindu University, Varanasi (29.21 CPP and 2.18 RCI) were at the top. In terms of Individual authors, G. Venkatasubramanian (180 papers), and B.N. Gangadhar (162 papers) were the most productive authors and R.Thara (31.87 CPP and 2.38 RCI), B.K. Thelma (24.0 CPP and 1.8 RCI), M.S. Keshavan (23.91 CPP and 1.79 RCI) were the most impactful authors, among the top 15 authors. The journals which reported comparatively higher productivity for Indian publications included Indian Journal of Psychiatry (242 papers), followed by Asian Journal of Psychiatry (214 papers) and Indian Journal of Psychological Medicine (103 papers). In terms of most impactful Indian publications, these were published in The Lancet (97.7), Progress in Neuro Psychopharmacology & Biological Psychiatry (50) and Schizophrenia Bulletin (44.67).

Perspectives on paid work among men and women with schizophrenia: The results of a two study comparison in Ireland

BACKGROUND

While research indicates that people with serious mental health conditions want to work, few studies have examined motivation and concerns associated with employment.

OBJECTIVES

This study examined the work attitudes among two samples of Irish people with psychotic conditions, primarily schizophrenia.

METHODS

Data gathered through two work related research projects was used. A self-report instrument, the work motivation scale (WMS), gathered data in two separate studies. It was possible to examine participants' motives and concerns due to the two factor structure, positive and negative, of this scale. Descriptive statistical analysis was conducted for each of the two samples individually. A sub-analysis by gender was also conducted.

RESULTS

Across the two samples, analysis showed the consistent motivators were increased coping ability, improved self-identity, and enhanced self-worth. Men particularly wanted others to see them as good workers. On the other hand, women regarded a job as a means to forget about having a mental illness. A sizeable minority in both samples expressed apprehensions such as work being boring and an expectation from others that they should work rather than them being personally motivated to do so.

CONCLUSIONS

While caution must be exercised in interpreting the results due to the small sample size, this study has extended our understanding in this under-researched but important topic.

Emotional determinants of life-space through GPS and ecological momentary assessment in schizophrenia: What gets people out of the house?

BACKGROUND

Previous research employing global positioning satellite (GPS) data and ecological momentary assessment (EMA) has shown a smaller life-space (distance traveled from home) was associated with poorer community functioning and more severe negative symptoms in people with schizophrenia. Momentary emotional experiences may influence how much time is spent outside of the home. We evaluated the associations between emotional experiences in relation to life-space among people with schizophrenia compared to healthy controls (HCs).

METHODS

105 participants with schizophrenia and 76 HCs completed in-lab assessments of symptoms, cognition, and functioning. Participants completed EMA assessments of location and emotions seven times daily for seven days at stratified random intervals. GPS coordinates were collected 24 h a day over the 7-day study period. Analyses were performed at the momentary, day, and full week level using mixed effects models and Spearman correlations.

RESULTS

For HCs, greater happiness was associated with greater concurrent distance traveled away from home as measured by GPS. For participants with schizophrenia, greater anxiety was associated with greater distance traveled away from home and being outside of the home. Less happiness, but not anxiety, was also associated with greater negative symptoms, especially outside the home.

DISCUSSION

These findings suggest diminished positive emotion is associated with the experience of leaving the home in schizophrenia, but also suggest that anxiety may contribute to avoidance of out of home mobility. Interventions targeting both positive emotions and social anxiety may improve social functioning, and life-space may provide a useful outcome for functional rehabilitation interventions in schizophrenia.

Clinical utility of the Negative Symptom Assessment-16 in individuals with schizophrenia

This study examined the clinical utility of the Negative Symptom Assessment-16 (NSA-16) in schizophrenia. 274 individuals with schizophrenia were assessed on the NSA-16, Positive and Negative Syndrome Scale (PANSS), Clinical Assessment for Negative Symptoms (CAINS), Calgary Depression Scale for Schizophrenia (CDSS), Social and Occupational Functioning Assessment Scale (SOFAS) and the Simpson-Angus Extrapyramidal Side Effects Scale (SAS). Factor analyses were conducted and Cronbach's alpha was computed. Correlations were assessed using Spearman's correlation coefficient. The 5-factor model of the NSA-16 did not give good fit statistics from our sample. Exploratory factor analysis on a randomly selected split-half of the sample followed by confirmatory factor analysis on the remaining sample supported a 4-factor structure with 12 items. The factors were: Restricted speech, Poor quality of speech, Affective blunting and Amotivation. The NSA-16 with the 12 items was termed as the NSA-12. The NSA-12 showed good internal reliability. The NSA-12 total score and global negative symptom rating had strong correlations with CAINS total and PANSS negative factor scores, suggesting good convergent validity. Weak correlations of the NSA-12 total score and global negative symptom rating with PANSS positive, CDSS and SAS scores suggested good divergent validity. The NSA-12 total score and global negative symptom rating were strongly and inversely associated with SOFAS and positively associated with NSA-12 global level of functioning. In conclusion, the NSA-12 is useful to evaluate negative symptoms in clinical and research settings in individuals with schizophrenia. Our study results also support a 4-factor structure of the NSA-12 in outpatients with schizophrenia.