Schizoaffective Disorder (schizoaffective + disorder)

Distribution by Scientific Domains


Selected Abstracts


Treatment of schizoaffective disorder , a challenge for evidence-based psychiatry

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010
M. Jäger
Objective:, Schizoaffective disorder is a common diagnosis in mental health services. The aim of the present article was to review treatment studies for schizoaffective disorder and draw conclusions for clinical decision making. Method:, We searched MEDLINE and Cochrane Library for relevant clinical trials and review articles up to the year 2008. Results:, Thirty-three studies using standardized diagnostic criteria, 14 of which were randomized controlled trials, could be identified. The comparability of studies is limited by the use of different diagnostic criteria. The studies reviewed do not permit consistent recommendations as to whether schizoaffective disorder should be treated primarily with antipsychotics, mood stabilizers or combinations of these drugs. The relevance of diverse subtypes of schizoaffective disorder for treatment recommendations is unclear. Conclusion:, The pertinent empirical database is small and heterogeneous. The lack of conclusive recommendations is related to issues of nosological status, plurality of diagnostic criteria and validity of the concept of schizoaffective disorder. [source]


Metacognition as a mediator of the effects of impairments in neurocognition on social function in schizophrenia spectrum disorders

ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010
P. H. Lysaker
Lysaker PH, Shea AM, Buck KD, Dimaggio G, Nicolò G, Procacci M, Salvatore G, Rand KL. Metacognition as a mediator of the effects of impairments in neurocognition on social function in schizophrenia spectrum disorders. Objective:, This study explored whether Mastery, a domain of metacognition that reflects the ability to use knowledge about mental states to respond to psychological challenges, mediated the effects of neurocognition on the frequency of social contact and persons' capacity for social relatedness. Method:, Participants were 102 adults with schizophrenia or schizoaffective disorder. Neurocognition was represented by a single factor score produced by a principal components analysis of a neurocognitive test battery. Mastery was assessed using the metacognitive assessment scale and social functioning by the quality of life scale. Results:, Using structural equation modeling, specifically measured-variable path analysis, a mediational model consisting of neurocognitive capacity linked to mastery and capacity for social relationships and mastery linked with frequency of social contact and capacity for social relatedness showed acceptable fit to the observed data. This persisted after controlling for negative and cognitive symptoms. Conclusion:, Results suggest that certain forms of metacognition mediate the influence of neurocognition upon function in schizophrenia. [source]


Treatment of schizoaffective disorder , a challenge for evidence-based psychiatry

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010
M. Jäger
Objective:, Schizoaffective disorder is a common diagnosis in mental health services. The aim of the present article was to review treatment studies for schizoaffective disorder and draw conclusions for clinical decision making. Method:, We searched MEDLINE and Cochrane Library for relevant clinical trials and review articles up to the year 2008. Results:, Thirty-three studies using standardized diagnostic criteria, 14 of which were randomized controlled trials, could be identified. The comparability of studies is limited by the use of different diagnostic criteria. The studies reviewed do not permit consistent recommendations as to whether schizoaffective disorder should be treated primarily with antipsychotics, mood stabilizers or combinations of these drugs. The relevance of diverse subtypes of schizoaffective disorder for treatment recommendations is unclear. Conclusion:, The pertinent empirical database is small and heterogeneous. The lack of conclusive recommendations is related to issues of nosological status, plurality of diagnostic criteria and validity of the concept of schizoaffective disorder. [source]


Amisulpride , dose, plasma concentration, occupancy and response: implications for therapeutic drug monitoring

ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009
A. Sparshatt
Objective:, To evaluate the relationships between dose, plasma concentration, pharmacological activity and clinical outcome to evaluate the appropriateness of therapeutic drug monitoring (TDM) in patients receiving amisulpride. Method:, Literature search of Embase, Medline and PubMed databases. Results:, Amisulpride plasma concentration is closely correlated with dose (r2 = 0.96, P < 0.0001), dopamine occupancy, response and with extra-pyramidal symptoms (EPS). Dose is correlated with response, dopamine occupancy and EPS. Optimal clinical response was found at doses of 400,800 mg/day, corresponding to plasma levels of approximately 200,500 ng/ml. EPS appears to be more reliably predicted by a plasma level above 320 ng/ml than by a particular dose. Conclusion:, The effects and safety of amisulpride in the treatment of schizophrenia and schizoaffective disorder are predicted by daily dose. The plasma concentration threshold for response appears to be approximately 200 ng/ml. EPS are more reliably predicted by plasma level than by dose. TDM for patients prescribed amisulpride is thus of some clinical value. [source]


Plasma Concentrations of Risperidone and Olanzapine during Coadministration with Oxcarbazepine

EPILEPSIA, Issue 5 2005
Maria Rosaria Muscatello
Summary:,Purpose: Oxcarbazepine (OZC) is a second-generation antiepileptic drug (AED) that also may be used as a mood stabilizer. Unlike carbamazepine (CBZ), which is an inducer of the cytochrome P-450 isoforms and may accelerate the elimination of several therapeutic agents, OXC seems to have only a modest inducing action. The aim of this investigation was to evaluate the effect of a treatment with OXC on plasma concentrations of the new antipsychotics risperidone and olanzapine. Methods: OXC, at a dosage of 900,1,200 mg/day, was administered for 5 consecutive weeks to 25 outpatients, 10 men and 15 women, aged 25 to 64 years, with bipolar or schizoaffective disorder. Twelve patients were stabilized on risperidone therapy (2,6 mg/day) and 13 on olanzapine (5,20 mg/day). Steady-state plasma concentrations of risperidone and its active metabolite 9-hydroxyrisperidone (9-OH-risperidone) and olanzapine were measured by high-pressure liquid chromatography (HPLC) before addition of OXC and after 5 weeks from the start of adjunctive treatment. Results: OXC caused only minimal and no significant changes in the mean plasma levels of risperidone (from 5.6 ± 3.6 ng/ml at baseline to 4.8 ± 2.6 ng/ml at week 5), 9-OH-risperidone (from 23.6 ± 7.5 to 24.7 ± 7.4 ng/ml), and olanzapine (from 26.5 ± 5.7 ng/ml at baseline to 27.8 ± 5.1 ng/ml). OXC coadministration with either risperidone or olanzapine was well tolerated. Conclusions: Our findings indicate that OXC does not affect the elimination of risperidone and olanzapine, thus confirming its weak inducing effect on hepatic drug-metabolizing enzymes. [source]


Measurement of antipsychotic-induced side effects: Support for the validity of a self-report (LUNSERS) versus structured interview (UKU) approach to measurement

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 5 2003
T. J. R. Lambert
Abstract A self-report measure of antipsychotic side effects (LUNSERS) was compared with that of an established semi-structured interview (UKU side effect rating scale). The validity and the ability of the LUNSERS to determine false positives by use of an internal ,red herring' subscale were assessed. ,Red herring' items are those which do not directly relate to known antipsychotic side effects. In an open study, 29 patients with schizophrenia and schizoaffective disorder from inpatient and outpatient settings within an Australian metropolitan mental health service were assessed for antipsychotic-induced side effects using both the LUNSERS and UKU. The LUNSERS and UKU were similar in their overall assessment of antipsychotic side effects (total score correlation of 0.58) and were correlated on a wide array of individual side effect items. Correlations between total scores and individual items were higher for those patients scoring low on the LUNSERS ,red herring' items compared with both those with high ,red herring' scores and the sample as a whole. Several LUNSERS items were identified as potentially problematic, requiring further explanation or supplementation with direct questioning. The ,red herring' scale appears to enable detection of patients that may be over-reporting symptomatology. The LUNSERS is a valuable self-report measure of antipsychotic side effects, particularly in cases where red herring scores are low. Copyright © 2003 John Wiley & Sons, Ltd. [source]


Insight, quality of life, and functional capacity in middle-aged and older adults with schizophrenia

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2008
Ashley S. Roseman
Abstract Objective The quality of life (QOL) for individuals with schizophrenia is determined by a number of factors, not limited to symptomatology. The current study examined lack of insight as one such factor that may influence subjective QOL or functional capacity. It was hypothesized that insight would significantly interact with symptom severity to influence subjective QOL. Insight was not expected to influence the relation between symptom severity and functional capacity. Methods Participants were middle-aged and older outpatients who met diagnostic criteria for schizophrenia or schizoaffective disorder, and subsyndromal depression. Insight, psychopathology, and subjective QOL were assessed via semi-structured interviews and functional capacity was assessed via performance-based measures. Results Insight interacts with negative symptom severity to predict subjective QOL. Severity of negative symptoms and insight contribute directly to functional capacity. Conclusions Individuals with intact insight may be better able to manage their symptoms, resulting in improved QOL. Treatment implications for improving the QOL of middle age and older adults with schizophrenia are discussed. Copyright © 2008 John Wiley & Sons, Ltd. [source]


RNA from Borna disease virus in patients with schizophrenia, schizoaffective patients, and in their biological relatives

JOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 4 2008
Sandra Odebrechet Vargas Nunes
Abstract Numerous interactions of the immune system with the central nervous system have been described recently. Mood and psychotic disorders, such as severe depression and schizophrenia, are both heterogeneous disorders regarding clinical symptomatology, the acuity of symptoms, the clinical course, the treatment response, and probably also the etiology. Detection of p24 RNA from Borna disease virus (BDV) by the reverse transcriptase polymerase chain reaction in patients with schizophrenia, schizoaffective disorder, and in their biological relatives was evaluated. The subjects were 27 schizophrenic and schizoaffective patients, 27 healthy controls, 20 relatives without psychiatric disease, and 24 relatives with mood disorder, who attended the Psychiatric Ambulatory of Londrina State University, Paraná, Brazil. The subjects were interviewed by structured diagnostic criteria categorized according to the Diagnostic and Statistical Manual of Mental Disorders-IV, axis I, (SCID-IV). The mean duration of illness in schizophrenic and schizoaffective patients was 15.341±1.494 years and the median age at onset was 22.4±7.371 years. There were no significant differences in gender (P=0.297), age (P=0.99), albumin (P=0.26), and body mass index (kg/m2) (p=0.28), among patients, controls, and relatives. Patients and biological relatives had significantly higher positive p24 RNA BDV detection than controls (P=0.04); however, the clinical significance of BDV remains to be clarified. J. Clin. Lab. Anal. 22:314,320, 2008. © 2008 Wiley-Liss, Inc. [source]


The impact of ethnicity on prospective functional outcomes from community-based psychosocial rehabilitation for persons with schizophrenia

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2001
Elizabeth S. Phillips
Ethnicity was examined for its relationship to prospective functional outcomes from community-based psychosocial rehabilitation for individuals with schizophrenia. Participants were 98 individuals diagnosed with schizophrenia or schizoaffective disorder who were admitted to two community-based psychosocial rehabilitation programs. Previous studies had established that these programs were effective in improving functional outcomes. Data on hospitalization, independent living, social, and work functioning were collected every 6 months for a period of 3 years. The results using hierarchical linear modeling revealed significant differences among non-minorities, African Americans, and Latinos in rehabilitative change over time in the domains of work and social functioning. Non-minorities achieved the greatest gains in both social and work functioning. African Americans showed little change in social functioning, but showed a decline in work functioning. In the domain of work, Latinos deteriorated more than African Americans, and this was most notable for Latino males. There were no cross-ethnic differences in independent living or hospitalization outcomes. Based on these findings, there is important variation among different ethnic groups in their response to psychosocial rehabilitation. Implications are discussed in terms of the need for culturally relevant rehabilitation methods, and for research on cultural constructs in community-based intervention studies. © 2001 John Wiley & Sons, Inc. [source]


The relationship between history of violent and criminal behavior and recognition of facial expression of emotions in men with schizophrenia and schizoaffective disorder

AGGRESSIVE BEHAVIOR, Issue 3 2006
Elisabeth M. Weiss
Abstract Social psychological research underscores the relation between aggression and emotion. Specifically, regulating negative affect requires the ability to appraise restraint-producing cues, such as facial signs of anger, fear and other emotions. Individuals diagnosed with major mental disorders are more likely to have engaged in violent behavior than mentally healthy members of the same communities. We examined whether violent and criminal behavior in men with schizophrenia is related to emotion recognition abilities. Forty-one men with schizophrenia underwent a computerized emotion discrimination test presenting mild and extreme intensities of happy, sad, angry, fearful and neutral faces, balanced for gender and ethnicity. History of violence was assessed by the Life History of Aggression Scale and official records of arrests. Psychopathology was rated using the Positive and Negative Symptom Scale. Criminal behavior was associated with poor emotion recognition, especially for fearful and angry facial expressions. History of aggression was also associated with more severe positive symptoms and less severe negative symptoms. These findings suggest that misinterpretation of social cues such as angry and fearful expression may lead to a failure in socialization and adaptive behavior in response to emotional situation, which may result in a higher number of criminal arrests. Aggr. Behav. 32:1,8, 2006. © 2006 Wiley-Liss, Inc. [source]


Efficacy of Cognitive Nursing Intervention for Voice Hearing

PERSPECTIVES IN PSYCHIATRIC CARE, Issue 2 2007
Margaret England PhD
PROBLEM.,Many individuals who hear negative voices are troubled by their voices even when they adhere to prescribed neuroleptic medication regimens. At the same time, recent clinical trials provide evidence that structured, cognitive intervention can reduce distress tied to refractory auditory hallucinations and other psychiatric symptoms. PURPOSE.,The purpose of this randomized controlled trial was to determine whether usual care (UC), or usual care plus 12, 90-min episodes of cognitive nursing intervention (UC + CNI) led to sustained improvement in the psychiatric symptoms and self-esteem of 65 voice hearers assigned a diagnosis of schizophrenia or schizoaffective disorder. ANALYSIS AND FINDINGS.,Analysis of covariance with repeated measures procedures indicate that the 44 participants exposed to UC + CNI, were significantly more likely than the 21 participants exposed to UC only, to sustain significant improvement in psychiatric symptoms and self-esteem 1 year following treatment. IMPLICATIONS.,These findings provide encouragement for nurses to further develop and investigate cognitive strategies to treat psychiatric symptoms of voice hearers. [source]


Healthcare resource utilization during 1-year treatment with long-acting, injectable risperidone,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 11 2004
A. Leal
Abstract Background Schizophrenia is associated with disproportionately high costs, mainly due to hospitalization rates. This study assessed healthcare resource use in patients with schizophrenia and schizoaffective disorder during treatment with long-acting risperidone. Methods Patients (n,=,397 [inpatients, 24%; outpatients, 76%]) receiving stable doses of an antipsychotic for ,4 weeks were eligible to enter this 1-year, open-label study. Following a 2-week run-in period (oral risperidone 1,6 mg/day), patients received intramuscular long-acting risperidone (25 or 50 mg modal dose) every 2 weeks. Healthcare resource use in the previous 12 weeks was assessed at baseline and 12-weekly intervals. Results Patients needing hospitalization decreased significantly and continuously from 38% during the 12 weeks before study entry to 12% during the last 12 weeks. Mean hospitalization length during the study was 30.5 days (outpatients, 4.9 days; inpatients, 110 days). This included 28 patients (7%) who remained in hospital throughout the study. During treatment, 71% of those hospitalized at baseline were discharged. Partial hospitalization decreased significantly from 7% of patients during the 12 weeks before treatment to 3% during the last 12 weeks. Outpatient consultations also decreased significantly from 70% of patients to 30% in the first 12 weeks of treatment and remained stable thereafter. Only 9% of patients required an emergency room visit; mostly for non-psychiatric conditions. Conclusion Healthcare resource use is significantly reduced in patients with stable schizophrenia or schizoaffective disorder receiving long-acting risperidone. It is highly likely that these reductions will decrease healthcare costs in patients receiving long-acting risperidone. Copyright © 2004 John Wiley & Sons, Ltd. [source]


Patterns of dysmorphic features in schizophrenia,

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 8 2001
L.E. Scutt
Abstract Congenital dysmorphic features are prevalent in schizophrenia and may reflect underlying neurodevelopmental abnormalities. A cluster analysis approach delineating patterns of dysmorphic features has been used in genetics to classify individuals into more etiologically homogeneous subgroups. In the present study, this approach was applied to schizophrenia, using a sample with a suspected genetic syndrome as a testable model. Subjects (n,=,159) with schizophrenia or schizoaffective disorder were ascertained from chronic patient populations (random, n,=,123) or referred with possible 22q11 deletion syndrome (referred, n,=,36). All subjects were evaluated for presence or absence of 70 reliably assessed dysmorphic features, which were used in a three-step cluster analysis. The analysis produced four major clusters with different patterns of dysmorphic features. Significant between,cluster differences were found for rates of 37 dysmorphic features (P,<,0.05), median number of dysmorphic features (P,=,0.0001), and validating features not used in the cluster analysis: mild mental retardation (P,=,0.001) and congenital heart defects (P,=,0.002). Two clusters (1 and 4) appeared to represent more developmental subgroups of schizophrenia with elevated rates of dysmorphic features and validating features. Cluster 1 (n,=,27) comprised mostly referred subjects. Cluster 4 (n,=,18) had a different pattern of dysmorphic features; one subject had a mosaic Turner syndrome variant. Two other clusters had lower rates and patterns of features consistent with those found in previous studies of schizophrenia. Delineating patterns of dysmorphic features may help identify subgroups that could represent neurodevelopmental forms of schizophrenia with more homogeneous origins. © 2001 Wiley-Liss, Inc. [source]


Linkage analysis of schizophrenia to chromosome 15

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 8 2001
Dr. Pablo V. Gejman
Abstract We have mapped a sample of 68 families consisting of one or more affected sibling pairs with schizophrenia or schizoaffective disorder with 20 markers spanning all of chromosome 15 to investigate whether there is a locus on chromosome 15 that confers an increased susceptibility to schizophrenia using parametric and nonparametric linkage analyses. Allele sharing identical by descent and multipoint maximum likelihood score (MLS) statistics were employed. Results show excess allele sharing for multiple markers in 15q11.2,q25, a chromosomal region previously found linked to a decrease in the normal inhibition of the P50 auditory-evoked response to the second of paired stimuli, a decrease associated with schizophrenia. Excess allele sharing was found for markers spanning about 48 cM in 15q11.2,q25 (D15S1002,D15S1023). The greatest single point allele sharing was found at D15S659 (62.6%). The multipoint MLS scores were greater than 1.0 in the 30,52 cM interval delimited by ACTC and D15S150, with a maximum value of 2.0 with GENEHUNTER PLUS near D15S1039. © 2001 Wiley-Liss, Inc. [source]


Evidence for the multigenic inheritance of schizophrenia

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 8 2001
Robert Freedman
Abstract Schizophrenia is assumed to have complex inheritance because of its high prevalence and sporadic familial transmission. Findings of linkage on different chromosomes in various studies corroborate this assumption. It is not known whether these findings represent heterogeneous inheritance, in which various ethnic groups inherit illness through different major gene effects, or multigenic inheritance, in which affected individuals inherit several common genetic abnormalities. This study therefore examined inheritance of schizophrenia at different genetic loci in a nationally collected European American and African American sample. Seventy-seven families were previously genotyped at 458 markers for the NIMH Schizophrenia Genetics Initiative. Initial genetic analysis tested a dominant model, with schizophrenia and schizoaffective disorder, depressed type, as the affected phenotype. The families showed one genome-wide significant linkage (Z,=,3.97) at chromosome 15q14, which maps within 1 cM of a previous linkage at the ,7-nicotinic receptor gene. Chromosome 10p13 showed suggestive linkage (Z,=,2.40). Six others (6q21, 9q32, 13q32, 15q24, 17p12, 20q13) were positive, with few differences between the two ethnic groups. The probability of each family transmitting schizophrenia through two genes is greater than expected from the combination of the independent segregation of each gene. Two trait-locus linkage analysis supports a model in which genetic alleles associated with schizophrenia are relatively common in the general population and affected individuals inherit risk for illness through at least two different loci. © 2001 Wiley-Liss, Inc. [source]


A genomewide linkage study of age at onset in schizophrenia,

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 5 2001
Alastair G. Cardno
Abstract There is strong evidence for a genetic contribution to age at onset of schizophrenia, which probably involves both susceptibility loci for schizophrenia and modifying loci acting independent of disease risk. We sought evidence of linkage to loci that influence age at onset of schizophrenia in a sample of 94 affected sibling pairs with DSM-IV schizophrenia or schizoaffective disorder, and age at first psychiatric contact of 45 years or less. Individuals were genotyped for 229 microsatellite markers spaced at approximately 20 cM intervals throughout the genome. Loci contributing to age at onset were sought by a quantitative maximum-likelihood multipoint linkage analysis using MAPMAKER/SIBS. A nonparametric multipoint analysis was also performed. The genomewide significance of linkage results was assessed by simulation studies. There were six maximum-likelihood LOD score peaks of 1.5 or greater, the highest being on chromosome 17q (LOD,=,2.54; genomewide P,=,0.27). This fulfils Lander and Kruglyak's [1995: Nat Genet 11:241,247] criteria for suggestive linkage in that it would be expected to occur once or less (0.3 times) per genome scan. However, this finding should be treated with caution because the LOD score appeared to be almost solely accounted for by the pattern of ibd sharing at one marker (D17S787), with virtually no evidence of linkage over flanking markers. None of the linkage results achieved genomewide statistical significance, but the LOD score peak on chromosome 13q (LOD,=,1.68) coincided with the region showing maximum evidence for linkage in the study by Blouin et al. [1998: Nat Genet 20:70,73] of categorical schizophrenia. © 2001 Wiley-Liss, Inc. [source]


Pharmacokinetics and efficacy of a direct switch from conventional depot to risperidone long-acting injection in Chinese patients with schizophrenic and schizoaffective disorders

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2009
Ying-Ching Lai md
Aims:, This 12-week open-label study was designed to investigate the pharmacokinetics and efficacy of a direct switch from a conventional depot to long-acting injectable risperidone in patients with schizophrenia and schizoaffective disorder. Methods:, Men or women from 18 to 65 years old with a diagnosis of schizophrenia or schizoaffective disorder were eligible for participation if they had been treated with conventional depot for at least 8 weeks before study entry. Intramuscular long-acting risperidone was administered starting from 25 mg, with the dose flexibly adjusted every two weeks for 12 weeks from week 4. Results:, Of the 25 patients enrolled in this study, 21 completed at least one post-baseline assessment and were thus included in the analysis. The mean serum concentration of risperidone plus 9-hydroxyrisperidone was 29.1 ng/mL at the 12th week after switching, with an average injection dose of 31.25 mg long-acting risperidone every two weeks. The levels of active moiety of risperidone seemed to be higher in Chinese patients compared to those in Caucasian patients. Positive and Negative Syndrome Scale total scores (from 67.5 to 56.4; P = 0.002), scores for negative symptoms (P = 0.006) and general symptoms (P = 0.001) were improved significantly 12 weeks after the switch. Mean Extrapyramidal Symptom Rating Scale scores were improved significantly from 20.1 to 5.5 (P < 0.001). Significantly decreased levels of cholesterol and triglyceride were found at the 12th week. The levels of fasting glucose, low-density lipoprotein, high-density lipoprotein and bodyweight remained unchanged. Conclusions:, These findings suggest that switching from conventional depot to long-acting risperidone is feasible with the advantage of symptom reduction and side-effect profile decrement. [source]


Effects of a 10-week weight control program on obese patients with schizophrenia or schizoaffective disorder: A 12-month follow up

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 1 2009
Chih-Ken Chen md
Aims:, Weight gain secondary to antipsychotic medication is associated with many serious conditions, including type II diabetes mellitus, hypertension, and coronary heart disease, and also with poor medication compliance. Weight control programs may be of benefit to outpatients with schizophrenia, but also raise an issue of cost-effectiveness. We aimed to evaluate the effectiveness of a 10-week weight control program for outpatients taking atypical antipsychotics for treatment of schizophrenia, and to follow up the effects of this weight control program in controlling weight gain after termination of the program. Methods:, A total of 33 patients with schizophrenia and antipsychotic-related obesity were enrolled in a 10-week multimodal weight control program. The patients' weights were recorded at baseline, week 4, week 8, week 10 (end of the intervention), week 12, week 24, and week 48. Secondary measures included blood sugar levels, cholesterol levels, triglyceride levels, quality of life and mental health. Results:, For those who completed the weight control program, there was a mean weight loss of 2.1 kg by the end of the intervention, 3.7 kg over 6 months, and 2.7 kg over 12 months. The mean body mass index decreased by 0.8, 1.5 and 1.1 at week 10, week 24 and week 48, respectively, all with statistical significance. Conclusions:, The 10-week weight control program was effective in terms of weight reduction among obese patients with schizophrenia or schizoaffective disorder, and the weight reduction effect lasted for up to 6 months, and up to 12 months in some cases. [source]


A Comparative Study of the Sexual Function of Institutionalized Patients with Schizophrenia

THE JOURNAL OF SEXUAL MEDICINE, Issue 10 2010
María José Acuña MD
ABSTRACT Introduction., Sexual dysfunction occurs frequently in patients with schizophrenia. Aim., To assess the sexual function of institutionalized patients with schizophrenia and compare it to both that of noninstitutionalized schizophrenic patients as well as patients without any mental illness. Methods., A cross-sectional comparative analysis between three groups: Group A: 75 patients with schizophrenia and/or schizoaffective disorder according to the International Classification of Diseases, 10th Edition (ICD-10) criteria, admitted into public psychiatric residential facilities; Group B: 41 patients with the same diagnosis who live in the community; Group C: 152 patients with no mental illness attended to by a Primary Care Medical Center. Main Outcome Measures., The Mini-International Neuropsychiatric Interview, Positive and Negative Syndrome Scale for Schizophrenia and Changes in Sexual Function Questionnaire were used to complete the study. Results., When institutionalized patients were compared to the control group, the impairment of sexual function was identified in all areas except Arousal in women and the percentage of dysfunction in Desire-Interest for both sexes. The results for noninstitutionalized schizophrenic males indicated a deficit in Pleasure and Orgasm and in Pleasure and Desire-Frequency for females, when compared with the control group. The overall subscale indicated that 71.2% of males and 57.1% of females in the institutionalized group experienced sexual dysfunction compared with 10% of males and 50% of females in the noninstitutionalized group, and only 12.7% of women in the control group. Conclusions., Most areas of sexual function are impaired among patients with schizophrenia, especially among institutionalized patients. However, their percentage of sexual dysfunction associated with sexual thoughts or fantasies was similar to that of patients without mental illness. Acuña MJ, Martín JC, Graciani M, Cruces A, and Gotor F. A comparative study of the sexual function of institutionalized patients with schizophrenia. J Sex Med 2010;7:3414,3423. [source]


An initial report of a new biological marker for bipolar disorder: P85 evoked brain potential

BIPOLAR DISORDERS, Issue 6 2009
Julie V Patterson
Objectives:, Progress toward understanding the neurobiological and genetic underpinnings of bipolar disorder has been limited by the scarcity of potential biological markers that predict its occurrence. A measure of the integrity of brain inhibitory function, sensory gating, measured using the amplitude of the evoked potential at 50 ms to the first of two paired clicks divided by the response to the second, has been characterized as a biological marker for schizophrenia. Currently, no such biological marker exists for bipolar disorder. The goal of this research was to determine how gating of an auditory brain potential at 85 ms (P85), not previously examined in sensory gating studies, differentiated control and patient groups. Methods:, P50 and P85 auditory evoked potentials were collected from individuals diagnosed with schizoaffective disorder (n = 45), paranoid schizophrenia (n = 66), and bipolar I disorder (n = 42) using DSM-IV criteria and the Structured Clinical Interview for DSM-IV; and from 56 healthy controls. Results:, The P85 gating ratio was significantly larger in the bipolar disorder group compared to each of the other groups (F3,204 = 5.47, p = 0.001, and post-hoc tests). The P50 gating ratio was significantly larger for the schizoaffective group than for the control group (F3,204 = 2.81, p = 0.040), but did not differ from the ratio for the schizophrenia, paranoid type (p = 0.08) and bipolar groups. Conclusions:, The previously unstudied P85 gating ratio may provide a new marker specific to bipolar disorder. The findings will promote further studies to investigate the unique contribution of this measure as an endophenotype. [source]


Differential working memory impairment in bipolar disorder and schizophrenia: effects of lifetime history of psychosis

BIPOLAR DISORDERS, Issue 2 2006
David C Glahn
Background:, Although bipolar disorder and schizophrenia have long been viewed as distinct illnesses, there is growing evidence that these two complex diseases share some common genes, which may manifest as overlapping neuropsychological impairments. Although working memory dysfunction has been proposed to be central to the pathophysiology of schizophrenia, it has received less attention in studies of bipolar disorder. Method:, We applied measures of working memory to patients with schizophrenia (n = 15), patients with schizoaffective disorder (n = 15), patients with psychotic (n = 11) and non-psychotic (n = 15) bipolar disorder, and demographically matched healthy subjects (n = 32), in order to determine the extent to which these groups show common or unique impairments. Results:, While patients with bipolar disorder (with and without psychotic features) and those with schizophrenia/schizoaffective disorder were impaired on backward digit span, only patients with a lifetime history of psychotic features, regardless of diagnosis, were impaired on spatial delayed response task. Conclusions:, Backward digit span performance is comparable in bipolar disorder and schizophrenia, and may be an appropriate endophenotypic marker that cuts across diagnostic categories. In contrast, spatial working memory performance clearly distinguishes non-psychotic bipolar disorder patients from patients with functional psychosis. [source]


Gabapentin withdrawal syndrome in the presence of a taper

BIPOLAR DISORDERS, Issue 3 2005
Kien T Tran
Objective:, To report a case report of a geriatric patient with a 5-year history of gabapentin use for enhanced bipolar control, who was tapered off of gabapentin over 1 week. The patient displayed unique withdrawal symptoms after the taper of gabapentin. Methods:, The patient is an 81-year-old white female with a life-long history of schizoaffective disorder with bipolar type I tendencies who had been prescribed gabapentin for 5 years. Results:, The patient displayed moderate upper respiratory tract infection symptoms and somatic complaints 1 day after termination of gabapentin. These symptoms gradually worsened until 10 days after, at which time she acutely developed severe mental status changes, severe somatic chest pain, and hypertension. Physical examination, electrolytes, electrocardiogram, computerized tomography, magnetic resonance imaging, and magnetic resonance angiography were all normal. Upon reintroduction of gabapentin, the patient returned to baseline within 1,2 days. Conclusions:, Gabapentin is widely utilized currently for the chronic treatment of recalcitrant migraines, bipolar illness, pain, and epilepsy. It has a wide therapeutic index with few side effects and drug interactions, is not hepatically metabolized, and is excreted by the kidneys. Past reports have suggested that some withdrawal symptoms can present after 1,2 days upon abrupt discontinuation of gabapentin after chronic use within young to middle-aged patients. These symptoms mimic that of alcohol and benzodiazepine withdrawal purportedly due to a similar mechanism of action. Unique to this case is that this geriatric patient developed debilitating withdrawal symptoms after a gradual, week-long taper of gabapentin along with flu-like symptoms. It is proposed herein that a gabapentin taper should follow a course similar to that of a benzodiazepine taper , slowly and over a period of weeks to months. [source]


Olfactory identification in young relatives at risk for schizophrenia

ACTA NEUROPSYCHIATRICA, Issue 3 2009
Matcheri S. Keshavan
Objective: Olfactory identification deficits (OIDs) are seen in schizophrenia, but it is unclear whether they are state- or trait-related. Methods: We examined the prevalence of OIDs, as assessed by the University of Pennsylvania Smell Identification Test (UPSIT), and their correlations with prodromal symptoms in young relatives at risk for schizophrenia or schizoaffective disorder (HR-S). Results: UPSIT scores were lower in HR- S than in healthy controls, but were non-significant after covarying the effects of age, gender and IQ. OID deficits in HR-S were correlated, after covarying out the effects of age and IQ, with prodromal disorganisation. Conclusion: The potential value of OID deficits as markers of psychopathological vulnerability in young relatives at risk for schizophrenia deserves further investigation. [source]