Home About us Contact
|
Home About us Contact | ||
|
|
||
Schizophrenia Patients (schizophrenia + patient)
Selected AbstractsFunctional and anatomical connectivity abnormalities in left inferior frontal gyrus in schizophreniaHUMAN BRAIN MAPPING, Issue 12 2009Bumseok Jeong Abstract Functional studies in schizophrenia demonstrate prominent abnormalities within the left inferior frontal gyrus (IFG) and also suggest the functional connectivity abnormalities in language network including left IFG and superior temporal gyrus during semantic processing. White matter connections between regions involved in the semantic network have also been indicated in schizophrenia. However, an association between functional and anatomical connectivity disruptions within the semantic network in schizophrenia has not been established. Functional (using levels of processing paradigm) as well as diffusion tensor imaging data from 10 controls and 10 chronic schizophrenics were acquired and analyzed. First, semantic encoding specific activation was estimated, showing decreased activation within the left IFG in schizophrenia. Second, functional time series were extracted from this area, and left IFG specific functional connectivity maps were produced for each subject. In an independent analysis, tract-based spatial statistics (TBSS) was used to compare fractional anisotropy (FA) values between groups, and to correlate these values with functional connectivity maps. Schizophrenia patients showed weaker functional connectivity within the language network that includes left IFG and left superior temporal sulcus/middle temporal gyrus. FA was reduced in several white matter regions including left inferior frontal and left internal capsule. Finally, left inferior frontal white matter FA was positively correlated with connectivity measures of the semantic network in schizophrenics, but not in controls. Our results indicate an association between anatomical and functional connectivity abnormalities within the semantic network in schizophrenia, suggesting further that the functional abnormalities observed in this disorder might be directly related to white matter disruptions. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc. [source] Ocular motor delayed-response task performance among patients with schizophrenia and their biological relativesPSYCHOPHYSIOLOGY, Issue 1 2001Jennifer E. McDowell Schizophrenia patients and their relatives have saccadic abnormalities characterized by problems inhibiting a response. The dorsolateral prefrontal cortex and its associated circuitry ostensibly mediate inhibition and support correct delayed response performance. In this context, two components of delayed response task performance are of interest: memory saccade metrics and error saccades made during the delay. To evaluate these variables, an ocular motor delayed response task was presented to 23 schizophrenia patients, 25 of their first-degree biological relatives, and 19 normal subjects. The measure that best differentiated groups was an increased frequency of error saccades generated during the delay by schizophrenia subjects and relatives. Decreased memory saccade gain also characterized patients and relatives. The similar pattern of results demonstrated by the patients with schizophrenia and their relatives suggests that performance on ocular motor delayed response tasks, either alone or in combination with other saccadic variables, may provide useful information about neural substrates associated with a liability for developing schizophrenia. [source] Battery for assessment of neuropsychological status (RBANS) in schizophrenia: a pilot study in the Spanish population,ACTA NEUROPSYCHIATRICA, Issue 1 2009Juan C. Sanz Objectives:, The aims of this study were to research the following issues in a Spanish population of patients with schizophrenia. (a) The sensitivity and reliability of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to detect cognitive impairment in schizophrenia. (b) The convergent validity of RBANS on a larger battery of neuropsychological tests sensitive to the cognition disorders typically observed in schizophrenia. (c) The correlates of poor performance in RBANS with clinical features and illness severity. Method:, Thirty schizophrenia patients, 30 non-psychotic patients and 30 healthy participants were assessed using RBANS (form A). We administered a battery of neuropsychological tests and four scales to evaluate patient's clinical status. Results:, Schizophrenia patients and non-psychotic patients performed significantly worse than healthy controls on RBANS, and schizophrenia patients performed slightly worse than non-psychiatric controls, but this difference was not significant. Good inter-test reliability and concurrent validity were found. Only a moderate correlation between RBANS performance and illness severity was observed. Conclusions:, RBANS revealed coherence in identifying cognitive impairment in schizophrenia patients of a different cultural background, and it is shown to be a sensitive, valid and easy-to-perform tool for the neuropsychological assessment of Spanish patients with schizophrenia. [source] Low IQ scores in schizophrenia: primary or secondary deficit?ACTA NEUROPSYCHIATRICA, Issue 3 2002M. Van Beilen Background: Schizophrenia is consistently associated with lower IQ compared to the IQ of control groups, or estimated premorbid IQ. It is not likely that the IQ scores deteriorate during the prodromal phase or first psychotic episode; they are already present before the onset of the prodromal phase and have been detected in childhood. Methods: We investigated cognitive functioning and IQ levels in a group of 36 patients with schizophrenia or other psychotic disorders. Results: The IQ scores in our sample were lower than average. The IQ showed a relation with attention, memory, speed of information processing and some aspects of executive functioning. However, when IQ scores were corrected for processing speed, they were no longer below average. Conclusions:, These findings are important in considering the value of intelligence levels in schizophrenia. IQ scores should be judged in combination with cognitive functioning and school career to assess a patients capabilities in society. Cognitive functions and other variables might have a considerable influence on IQ scores. This rises the question of whether the low IQ scores are a primary or secondary deficit. Schizophrenia patients may have normal IQs, but could be less capable of making an IQ-test. [source] Ziprasidone-induced hypersensitivity syndrome in an aged schizophrenia patientINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2005Chia-Fen Tsai No abstract is available for this article. [source] Evaluation of a cognitive behaviourally oriented service for relapse prevention in schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010S. Klingberg Klingberg S, Wittorf A, Fischer A, Jakob-Deters K, Buchkremer G, Wiedemann G. Evaluation of a cognitive behaviourally oriented service for relapse prevention in schizophrenia. Objective:, There is little work demonstrating the effectiveness of cognitive behaviourally oriented interventions in routine service settings. This pragmatic trial is designed to test the impact of a group treatment service on relapse rates under the conditions of routine health care. Method:, A total of 169 schizophrenia patients were randomly allocated either to a comprehensive cognitive behaviourally oriented service (CBOS) or to treatment as usual (TAU). The primary outcome is the time until the first relapse after discharge from hospital. Relapse was defined as an increase in positive or negative symptoms as assessed with the Positive and Negative Syndrome Scale. Survival analysis has been conducted up to the 6-month assessment. Results:, The mean time to relapse after discharge from hospital in the CBOS group was significantly longer than in the TAU group (log rank test, P = 0.033). This was due to less exacerbations regarding negative symptoms in the CBOS condition (log rank test, P = 0.014). The number of social contacts was improved in the CBOS group only. Conclusion:, The CBOS intervention appears to be beneficial in reducing early negative symptom exacerbations. [source] Subjective quality of life of Nigerian schizophrenia patients: sociodemographic and clinical correlatesACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009A. O. Adewuya Objective:, Subjective quality of life (QOL) is dependent upon culture and its evaluation based on one's particular belief system. This study aimed to examine the subjective QOL of Nigerian out-patients with schizophrenia and its correlates. Method:, Out-patients with Schizophrenia (n = 99) completed the WHOQOL-BREF as a measure of their subjective QOL. Sociodemographic, illness related and medication related details were also obtained. Results:, Overall, 21 patients (21.2%) were categorised as having ,good' and 36 (36.4%) as having ,poor' subjective QOL. ,Poor' subjective QOL correlated with anxiety/depression symptoms (OR 4.88, 95% CI 2.93,11.48), comorbid medical problems (OR 4.75, 95% CI 1.43,16.33), unemployment (OR 3.75, 95% CI 1.25,11.72) and poor social support (OR 4.60, 95% CI 1.49,14.28). Conclusion:, Efforts to improve the QOL of patients with schizophrenia in this environment should encompass the identified variables. Larger, longitudinal and multi-centred studies are needed to adequately identify factors predicting QOL in this environment. [source] Prospective comparison of course of disability in antipsychotic-treated and untreated schizophrenia patientsACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009J. Thirthalli Objective:, To compare the course of disability in schizophrenia patients receiving antipsychotics and those remaining untreated in a rural community. Method:, Of 215 schizophrenia patients identified in a rural south Indian community, 58% were not receiving antipsychotics. Trained raters assessed the disability in 190 of these at baseline and after 1 year. The course of disability in those who remained untreated was compared with that in those who received antipsychotics. Results:, Mean disability scores remained virtually unchanged in those who remained untreated, but showed a significant decline (indicating decrement in disability) in those who continued to receive antipsychotics and in those in whom antipsychotic treatment was initiated (P < 0.001; group × occasion effect). The proportion of patients classified as ,disabled' declined significantly in the treated group (P < 0.01), but remained the same in the untreated group. Conclusion:, Disability in untreated schizophrenia patients remains unchanged over time. Treatment with antipsychotics in the community results in a considerable reduction in disability. [source] The metabolic syndrome and schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009J. M. Meyer Objective:, To summarize the accumulated data on metabolic syndrome prevalence in patients with schizophrenia, examine evidence for a biological contribution of the mental illness to metabolic risk and review novel options available for management of prediabetic states. Method:, A Medline search using metabolic syndrome, insulin resistance and insulin sensitivity cross-referenced with schizophrenia was performed on articles published between 1990 and May 2008. Results:, Recent evidence indicates that schizophrenia increases predisposition towards metabolic dysfunction independent of environmental exposure. Both fasting and non-fasting triglycerides have emerged as important indicators of cardiometabolic risk, while metformin, thiazolidinediones and GLP-1 modulators may prove promising tools for managing insulin resistance. Conclusion:, Because of lifestyle, disease and medication effects, schizophrenia patients have significant risk for cardiometabolic disease. Routine monitoring, preferential use of metabolically neutral antipsychotics and lifestyle education are critical to minimizing risk, with a possible role for antidiabetic medications for management of insulin resistant states that do not respond to other treatment strategies. [source] Clinical and serotonergic predictors of non-affective acute remitting psychosis in patients with a first-episode psychosisACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009B. Arranz Objective:, The study aimed to establish clinical predictors of non-affective acute remitting psychosis (NARP) and assess whether these patients showed a distinct serotonergic profile. Method:, First-episode never treated psychotic patients diagnosed of paranoid schizophrenia (n = 35; 21 men and 14 women) or NARP (n = 28; 15 men and 13 women) were included. Results:, NARP patients showed significantly lower negative symptomatology, better premorbid adjustment, shorter duration of untreated psychosis, more depressive symptomatology and a lower number of 5-HT2A receptors than the paranoid schizophrenia patients. In the logistic regression, the four variables associated with the presence of NARP were: low number of 5-HT2A receptors; good premorbid adjustment; low score in the item ,hallucinatory behaviour' and reduced duration of untreated psychosis. Conclusion:, Our findings support the view that NARP is a highly distinctive condition different from either affective psychosis or other non-affective psychosis such as schizophrenia, and highlight the need for its validation. [source] Anterior cingulate activation in antipsychotic-naïve first-episode schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2007M. Yücel Objective:, Anterior cingulate (ACC) hypo -activity is commonly observed in chronically ill schizophrenia patients. However, it is unclear whether this is secondary to persistent illness and/or medication. Method:, We examined eight antipsychotic-naïve first-episode patients and matched healthy controls undergoing PET scanning while performing the Stroop task. Results:, Group-averaged and single-subject analyses showed ACC activation in both controls and patients, albeit in different sub-regions (paracingulate and cingulate respectively). A direct comparison revealed relative under-activity of the left paracingulate cortex in patients. Conclusion:, These findings suggest that the more pervasive hypo -activation observed in chronic patients may be secondary to persistent illness and/or medication. [source] Critical evaluation of cognitive dysfunctions as endophenotypes of schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2004S. Kéri Objective:, Cognitive dysfunctions are potential endophenotypes of schizophrenia. The aim of this study was to investigate whether recent evidence indeed suggests that cognitive dysfunctions are potent indicators of specific genetic traits that represent susceptibility for schizophrenia. Method:, Studies including large, well-defined samples and controlled cognitive assessment have been reviewed. Results:, Evidence suggests that schizophrenia patients and their unaffected biological relatives are impaired in several cognitive domains, including working memory, executive functions, sustained attention, verbal episodic memory, processing of visual and auditory stimuli, and smooth pursuit eye movements. However, these impairments are present only in a limited proportion of subjects, showing low specificity and sensitivity and high variability. Linkage with specific genes is weak. Conclusion:, Although some results are promising, at present cognitive dysfunctions cannot be considered as highly sensitive and specific endophenotypes of schizophrenia. [source] Age-at-onset and schizophrenia: reversed gender effectACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2002B. N. Gangadhar Objective:,This study seeks an explanation for reversed gender effect on age-at-onset (AAO) in schizophrenia. The hypothesis is older AAO in males would be detected in a sample where higher infant mortality (IMR) prevailed. Method:,Case records of International Classification of Diseases-10 (ICD-10) schizophrenia patients from two states (n=70 each) with an IMR of 13 and 67 per thousand were reviewed and AAO was obtained by using the recorded age and duration of illness. Results:,In the sample from the state with lower IMR, AAO did not differ between the two sexes. However, men had older AAO than women in the state with fivefold higher IMR. Conclusion:,Gender differences in AAO may be a function of perinatal complications. In places where infants with perinatal complications are less likely to survive, hence high IMR, a small group of potentially youngest AAO schizophrenic males may be eliminated thus changing the gender effect on AAO. [source] The PIP5K2A and RGS4 genes are differentially associated with deficit and non-deficit schizophreniaGENES, BRAIN AND BEHAVIOR, Issue 2 2007S. C. Bakker Several putative schizophrenia susceptibility genes have recently been reported, but it is not clear whether these genes are associated with schizophrenia in general or with specific disease subtypes. In a previous study, we found an association of the neuregulin 1 (NRG1) gene with non-deficit schizophrenia only. We now report an association study of four schizophrenia candidate genes in patients with and without deficit schizophrenia, which is characterized by severe and enduring negative symptoms. Single-nucleotide polymorphisms (SNPs) were genotyped in the DTNBP1 (dysbindin), G72/G30 and RGS4 genes, and the relatively unknown PIP5K2A gene, which is located in a region of linkage with both schizophrenia and bipolar disorder. The sample consisted of 273 Dutch schizophrenia patients, 146 of whom were diagnosed with deficit schizophrenia and 580 controls. The strongest evidence for association was found for the A-allele of SNP rs10828317 in the PIP5K2A gene, which was associated with both clinical subtypes (P = 0.0004 in the entire group; non-deficit P = 0.016, deficit P = 0.002). Interestingly, this SNP leads to a change in protein composition. In RGS4, the G-allele of the previously reported SNP RGS4-1 (single and as part of haplotypes with SNP RGS4-18) was associated with non-deficit schizophrenia (P = 0.03) but not with deficit schizophrenia (P = 0.79). SNPs in the DTNBP1 and G72/G30 genes were not significantly associated in any group. In conclusion, our data provide further evidence that specific genes may be involved in different schizophrenia subtypes and suggest that the PIP5K2A gene deserves further study as a general susceptibility gene for schizophrenia. [source] Effects of brain-derived neurotrophic factor Val66Met polymorphism on hippocampal volume change in schizophreniaHIPPOCAMPUS, Issue 9 2010P. Cédric M.P. Koolschijn Abstract A functional polymorphism of the brain-derived neurotrophic factor (BDNF) gene (Val66Met) has been associated with the risk for schizophrenia and volume differences in the hippocampus. However, little is known about the association between progressive brain volume change in schizophrenia and BDNF genotype. The aim of this study was to investigate the relationship between hippocampal volume change in patients with schizophrenia and healthy control subjects and BDNF genotype. Two structural magnetic resonance imaging brain scans were acquired of 68 patients with schizophrenia and 83 healthy subjects with an interval of approximately 5 yrs. Hippocampal volume change was measured and related to BDNF genotype in patients and healthy controls. BDNF genotype was not associated with hippocampal volume change over time in patients or healthy controls, nor could we replicate earlier findings on smaller hippocampal volume in Met-carriers. However, we did find a genotype-by-diagnosis interaction at baseline demonstrating smaller hippocampal volumes in patients homozygous for the Val-allele relative to healthy Val-homozygotes. In addition, irrespective of genotype, patients showed smaller hippocampal volumes compared with healthy controls at baseline. In summary, our results suggest that the BDNF Val66Met polymorphism is not associated with hippocampal volume change over time. Nevertheless, our findings may support the possibility that BDNF affects brain morphology differently in schizophrenia patients and healthy subjects. © 2009 Wiley-Liss, Inc. [source] Magnetoencephalographic gamma power reduction in patients with schizophrenia during resting conditionHUMAN BRAIN MAPPING, Issue 10 2009Lindsay Rutter Abstract Objective: The "default network" represents a baseline condition of brain function and is of interest in schizophrenia research because its component brain regions are believed to be aberrant in the disorder. We hypothesized that magnetoencephalographic (MEG) source localization analysis would reveal abnormal resting activity within particular frequency bands in schizophrenia. Experimental Design: Eyes-closed resting state MEG signals were collected for two comparison groups. Patients with schizophrenia (N = 38) were age-gender matched with healthy control subjects (N = 38), and with a group of unmedicated unaffected siblings of patients with schizophrenia (N = 38). To localize 3D-brain regional differences, synthetic aperture magnetometry was calculated across established frequency bands as follows: delta (0.9,4 Hz), theta (4,8 Hz), alpha (8,14 Hz), beta (14,30 Hz), gamma (30,80 Hz), and super-gamma (80,150 Hz). Principle Observations: Patients with schizophrenia showed significantly reduced activation in the gamma frequency band in the posterior region of the medial parietal cortex. As a group, unaffected siblings of schizophrenia patients also showed significantly reduced activation in the gamma bandwidth across similar brain regions. Moreover, using the significant region for the patients and examining the gamma band power gave an odds ratio of 6:1 for reductions of two standard deviations from the mean. This suggests that the measure might be the basis of an intermediate phenotype. Conclusions: MEG resting state analysis adds to the evidence that schizophrenic patients experience this condition very differently than healthy controls. Whether this baseline difference relates to network abnormalities remains to be seen. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc. [source] Source-based morphometry: The use of independent component analysis to identify gray matter differences with application to schizophreniaHUMAN BRAIN MAPPING, Issue 3 2009Lai Xu Abstract We present a multivariate alternative to the voxel-based morphometry (VBM) approach called source-based morphometry (SBM), to study gray matter differences between patients and healthy controls. The SBM approach begins with the same preprocessing procedures as VBM. Next, independent component analysis is used to identify naturally grouping, maximally independent sources. Finally, statistical analyses are used to determine the significant sources and their relationship to other variables. The identified "source networks," groups of spatially distinct regions with common covariation among subjects, provide information about localization of gray matter changes and their variation among individuals. In this study, we first compared VBM and SBM via a simulation and then applied both methods to real data obtained from 120 chronic schizophrenia patients and 120 healthy controls. SBM identified five gray matter sources as significantly associated with schizophrenia. These included sources in the bilateral temporal lobes, thalamus, basal ganglia, parietal lobe, and frontotemporal regions. None of these showed an effect of sex. Two sources in the bilateral temporal and parietal lobes showed age-related reductions. The most significant source of schizophrenia-related gray matter changes identified by SBM occurred in the bilateral temporal lobe, while the most significant change found by VBM occurred in the thalamus. The SBM approach found changes not identified by VBM in basal ganglia, parietal, and occipital lobe. These findings show that SBM is a multivariate alternative to VBM, with wide applicability to studying changes in brain structure. Hum Brain Mapp, 2009. © 2008 Wiley-Liss, Inc. [source] Combining fMRI and SNP data to investigate connections between brain function and genetics using parallel ICA,HUMAN BRAIN MAPPING, Issue 1 2009Jingyu Liu Abstract There is current interest in understanding genetic influences on both healthy and disordered brain function. We assessed brain function with functional magnetic resonance imaging (fMRI) data collected during an auditory oddball task,detecting an infrequent sound within a series of frequent sounds. Then, task-related imaging findings were utilized as potential intermediate phenotypes (endophenotypes) to investigate genomic factors derived from a single nucleotide polymorphism (SNP) array. Our target is the linkage of these genomic factors to normal/abnormal brain functionality. We explored parallel independent component analysis (paraICA) as a new method for analyzing multimodal data. The method was aimed to identify simultaneously independent components of each modality and the relationships between them. When 43 healthy controls and 20 schizophrenia patients, all Caucasian, were studied, we found a correlation of 0.38 between one fMRI component and one SNP component. This fMRI component consisted mainly of parietal lobe activations. The relevant SNP component was contributed to significantly by 10 SNPs located in genes, including those coding for the nicotinic ,-7cholinergic receptor, aromatic amino acid decarboxylase, disrupted in schizophrenia 1, among others. Both fMRI and SNP components showed significant differences in loading parameters between the schizophrenia and control groups (P = 0.0006 for the fMRI component; P = 0.001 for the SNP component). In summary, we constructed a framework to identify interactions between brain functional and genetic information; our findings provide a proof-of-concept that genomic SNP factors can be investigated by using endophenotypic imaging findings in a multivariate format. Hum Brain Mapp, 2009. © 2007 Wiley-Liss, Inc. [source] Effects of antipsychotic medication on muscarinic M1 receptor mRNA expression in the rat brainJOURNAL OF NEUROSCIENCE RESEARCH, Issue 2 2008Mei Han Abstract Alterations in muscarinic M1 receptor protein and mRNA expression have been revealed in post-mortem brains of schizophrenia patients. Most patients had been treated with antipsychotics, so medication effects cannot be excluded as a possible explanation for these results. With in situ hybridization, this study investigated M1 receptor mRNA expression in rats treated with the typical antipsychotic haloperidol (0.3 mg/kg/day) and the atypical antipsychotics olanzapine (1.5 mg/kg/day) and aripiprazole (2.25 mg/kg/day) for 1 or 12 weeks. Compared with the control group, haloperidol significantly increased (,13,21%, P < 0.05) M1 mRNA expression in the CA1, CA2, and CA3 regions of the hippocampus after both 1 and 12 weeks of treatment, and it also increased (,17%, P < 0.01) M1 mRNA expression in the substantia nigra compacta after 1 week of treatment. Olanzapine significantly increased (14,22%, P < 0.05) M1 mRNA expression in the hippocampus (CA1, CA2, and CA3) and substantia nigra compacta after 12 weeks of treatment, but not after 1 week. Aripiprazole significantly increased (17%, P < 0.01) M1 mRNA expression in the hippocampus (CA1) after both 1 and 12 week treatments and increased (12%, P < 0.05) M1 mRNA expression in the nucleus accumbens after 1 week of treatment. Despite their different affinities for muscarinic M1 receptors, all three antipsychotic medications induced a similar trend of change in M1 mRNA expression in selected brain regions. These data suggest that the decreased M1 receptor protein and mRNA expression observed in schizophrenia patients is unlikely to be a consequence of drug treatments and implicates muscarinic M1 receptors in the pharmacotherapy of the disease. © 2007 Wiley-Liss, Inc. [source] Decreased density of muscarinic receptors in the superior temporal gyrusin schizophreniaJOURNAL OF NEUROSCIENCE RESEARCH, Issue 6 2005Chao Deng Abstract Recent studies have indicated that muscarinic receptors are involved in the pathophysiology in schizophrenia, particularly in cognitive deficits. The superior temporal gyrus (STG) is an area that has also been strongly implicated in the pathophysiology of schizophrenia. Therefore, in this study, we investigated the binding density of two muscarinic antagonists, [3H]pirenzepine and [3H]AF-DX384, in the STG of schizophrenia patients compared with controls. A significant decrease (44% in the superficial layers and 48% in the deep layers, P < 0.01) in binding density of [3H]pirenzepine was observed in schizophrenia patients, which suggested a reduction of muscarinic M1 and M4 receptor densities in the STG of schizophrenia patients. A tendency toward decreased [3H]AF-DX384 binding density (34%, P = 0.09) was also observed in schizophrenia patients compared with controls. Because of the positive correlation between [3H]pirenzepine and [3H]AF-DX384 binding, and, insofar as both ligands have high affinities for the M4 receptor, the involvement of M4 receptor alteration is also suggested in the STG in schizophrenia. These results suggest that changes of the muscarinic receptors M1 and M4 might contribute to the STG pathology in schizophrenia. © 2005 Wiley-Liss, Inc. [source] Non-therapeutic risk factors for onset of tardive dyskinesia in schizophrenia: A meta-analysis,,MOVEMENT DISORDERS, Issue 16 2009Diederik E. Tenback MD Abstract A meta-analysis of prospective studies with schizophrenia patients was conducted to examine whether the evidence exists for risk factors for the emergence of Tardive Dyskinesia (TD) in schizophrenia. A computer assisted Medline/PubMed and Embase search was conducted in January 2008 for the years 1985,2007. Selected were truly prospective studies of incident cases of TD in a population with at least 80% patients with schizophrenia. Measures of relative risk were collected from the individual studies, either directly or by calculating the relative risk from the cox- or logistic regression coefficient provided in the article. Hazard Ratio's and Odds Ratio's were pooled using fixed and random effect models in case of multiple studies using the same measure of risk and outcome. Only eight studies satisfied the inclusion criteria reporting on 25 different single estimate risk factors. Of 25 risk factors, six concerned replicated estimates suitable for meta-analysis. Of these, non-white ethnic group and early extrapyramidal symptoms qualified as risk factors for the emergence of TD in schizophrenia. The association with older age was suggestive but inconclusive. Despite many reported risk factors for TD in schizophrenia, little conclusive evidence exists to corroborate this. However, the fact that early EPS predicts onset of TD has important clinical and research implications. © 2009 Movement Disorder Society [source] Possible association of a cholecystokinin promoter variant to schizophrenia,AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 5 2002Zhewu Wang Abstract Several lines of research indicate a cholecystokinin (CCK) deficit in schizophrenia patients. A C to T substitution was found in the promoter region of the CCK gene. We investigated this promoter variant in patients with schizophrenia and geographically-matchedcontrols. The T allele was detected in 24% of the 85 schizophrenics and 16% of the 247 controls. No significant difference in the T allele frequency was found between patients and controls (,2,=,2.77, P,>,0.1). The schizophrenia sample was analyzed further along the dimensions of positive and negative symptoms. The patients with prominent negative symptoms presented a statistically significant association to the T allele (,2,=,4.13, P,<,0.04). However, the significance disappeared after the Bonferroni correction (P,>,0.15). Since the case-control analysis may present incorrect ethnic match between cases and controls, we applied the family-based tests to verify the above findings. Both transmission disequilibrium test (TDT; ,2,=,5.33, P,<,0.025 in 12 trios) and haplotype relative risk (HRR; ,2,=,3.844, P,<,0.05 in 60 trios) indicated a significantly high transmission of T allele to schizophrenia offspring probands from their parents. While our family-based tests seem to support the CCK involvement in schizophrenia, no definite conclusion can be drawn based on such a small sample size. This preliminary finding is subjected to future investigations. © 2002 Wiley-Liss, Inc. [source] Relationship of psychopathological symptoms and cognitive function to subjective quality of life in patients with chronic schizophreniaPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 1 2010Kenji Tomida md Aims:, The purpose of the present study was to examine the extent of the effects of psychopathological symptoms and cognitive function on quality of life (QOL) in patients with chronic schizophrenia. Methods:, Data were obtained using the Japanese Schizophrenia Quality of Life Scale (JSQLS), Positive and Negative Syndrome Scale (PANSS), Wisconsin Card-Sorting Test (WCST) Keio version, and Continuous Performance Test (CPT) for 52 schizophrenia patients. Results:, Stepwise regression analysis showed that PANSS depression/anxiety factors predicted JSQLS psychosocial conditions and motivation/energy, and that WCST Categories Achieved predicted JSQLS symptoms/side-effects. Conclusions:, Psychopathological symptoms and cognitive function affect subjective QOL in patients with schizophrenia. If the final goal is treatment that improves QOL in a manner that patients themselves are aware of, clinicians probably need to consider a treatment strategy that improves depression/anxiety symptom. [source] Hyperfrontality in patients with schizophrenia during saccade and antisaccade tasks: A study with fMRIPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2009Mai Fukumoto-Motoshita mms Aims:, Antisaccadic eye movements, requiring inhibition of a saccade toward a briefly appearing peripheral target, are known to be impaired in schizophrenia. Previous neuroimaging studies have indicated that patients with schizophrenia show diminished activations in the frontal cortex and basal ganglia. These studies used target fixation as a baseline condition. However, if the levels of brain activities at baseline are not compatible between patients and healthy subjects, between-group comparison on antisaccade-related activations is consequently invalidated. One possibility is that patients with schizophrenia may present with greater activation during fixation than healthy subjects. In order to examine this possibility, here we investigated brain activities associated with antisaccade in the two groups without using target fixation at baseline. Methods:, Functional brain images were acquired during prosaccades and antisaccades in 18 healthy subjects and 18 schizophrenia patients using a box-car functional magnetic resonance imaging design. Eye movements were measured during scanning. Results:, In the patient group, the elevated activities in the dorsolateral prefrontal cortex (DLPFC) and thalamus, normally seen in antisaccade tasks relative to saccade tasks, were no longer observed. Moreover, in normal subjects, activities in the DLPFC and thalamus were greater during the antisaccade task than during the saccade task. In patients, no such difference was observed between the two tasks, suggesting that these brain regions are likely to be highly activated even by a simple task such as fixation. In particular, the DLPFC and thalamus in patients were not activated at a level commensurate with the difficulty of the tasks presented. Conclusions:, From these results, it is suggested that schizophrenia entails dysfunctions in the fronto-striato-thalamo-cortical network associated with motor function control. [source] Risk of developing schizophrenia among Japanese high-risk offspring of affected parent: outcome of a twenty-four-year follow upPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 1 2009Atsushi Nishida phd Aims:, Prospective follow-up studies of high-risk children may help clarify the etiological factors in schizophrenia. While studies from North America, Europe and Israel have estimated the risk of schizophrenia at 7,16% in the offspring of an affected parent, no data have been reported for Asian populations. Method:, We started a follow up of the offspring of Japanese schizophrenia patients in 1978. We investigated the estimated risk of schizophrenia in 51 high-risk offspring at the 24-year follow up. The effects of the parents' status, including history of psychiatric hospitalization and social functioning, on the risk in the offspring were also investigated. Results:, The cumulative incidence of schizophrenia was 13.7 % and the lifetime prevalence was estimated to be 13.5 ± 4.8%. The association between the psychiatric hospitalization in the probands and the risk of schizophrenia in the offspring was not significant, and the Global Assessment of Functioning score was significantly lower in the probands with a history of psychiatric hospitalization than in those without such a history. Conclusions:, The risk of developing schizophrenia in Japanese high-risk offspring might be comparable with the Western results. The present study suggests that the severity of the disease or the level of social functioning may not significantly affect the risk in Japanese offspring. [source] Effect of a family psychoeducational program on relatives of schizophrenia patientsPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2008Satoko Sota Aims:, Family psychoeducational programs have been shown to be effective in terms of knowledge acquirement and relapse prevention, but few studies have looked at whether one mode of educational method is more effective than another. The aim of the present study was to compare several modes of educational approaches and to elucidate which mode of education is more effective. Methods:, A total of 110 relatives of 95 patients with schizophrenia received three types of family psychoeducational programs between January 1995 and September 2003: a small group with two sessions (P1), a large group with nine sessions (P2), and a large group with five sessions (P3). In addition to the demographic data, acquired knowledge was measured using the modified Knowledge About Schizophrenia Interview (KASI), family expressed emotion (EE), and relapse episodes. Results:, Overall there were significant increases in many KASI subcategory scores after the three programs, in mothers in particular. The change in KASI scores indicated that the low EE group was able to be highly educated and that the relatives of non-relapsers were more effectively educated. As for the mode of the family psychoeducational program, the P1 and P2 groups surpassed the P3 in terms of knowledge acquired. Conclusions:, Effects of family psychoeducation may depend not on the number of members or sessions but on the time spent on the program per member. [source] Sociodemographic and clinical factors associated with relapse in schizophreniaPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 6 2007GOBIND CHABUNGBAM md Abstract The aim of the present study was to examine sociodemographic and clinical factors associated with relapse in schizophrenia. The study group consisted of a convenience sample of 40 schizophrenia patients (20 patients each in relapse and remission). Relapse and remission were defined based on clinical criteria (ICD-10 criteria, course since last episode, and duration of remission) and psychometric criteria (scores on Socio-Occupational Functioning Assessment Scale [SOFAS] and Positive and Negative Syndrome Scale for Schizophrenia [PANSS]). The index group was evaluated after the occurrence of current relapse but within 6 months of its onset. Sociodemographic, current psychopathology (PANSS) and functioning (SOFAS), and other (mainly retrospective) variables were assessed with a specifically designed clinical profile sheet, Schedule for Affective Disorders and Schizophrenia Lifetime version, Presumptive Stressful life Events Scale, and World Health Organization Life Chart Schedule for Assessment of Course and Outcome of Schizophrenia. Patients who had relapsed were more symptomatic and exhibited greater dysfunction in comparison to remitted patients. Relapse in schizophrenia was significantly associated with unemployment, number of psychotic episodes, side-effects of medication, and life events score. The present findings suggest that a severe illness (no. psychotic episodes, unemployment), psychological stress and inappropriate treatment (side-effects of medicines) may be causally related to relapse in schizophrenia. However, the possibility that these variables may be caused by relapse or may be explained by a common underlying variable needs to be assessed prospectively. [source] How many long-stay schizophrenia patients can be discharged in Japan?PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 1 2007IWAO OSHIMA phd Abstract, The mental health-care system in Japan remains hospital-based, and has the largest number of psychiatric beds per capita in the world. However, serious discussion about deinstitutionalization has recently begun. This study attempts to determine the proportion of inpatients that would benefit from community-based programs, as judged by hospital psychiatrists, and to evaluate the need for community resources for their community placement. Inpatients with schizophrenia from 139 hospitals were randomly selected. Data on the psychiatrists' judgment of discharge and required resources for community placement were obtained for 2758 subjects. Among the subjects, 1097 (39.8%) were judged to have the possibility of being discharged using community resources (possible discharge group; PDG). Provided that the proportion of PDG was 40%, controlling for the hospital background variables, the number of schizophrenia inpatients with a hospital stay of ,1 year who could be discharged from psychiatric hospitals in Japan was estimated to be 66 000. For the PDG, the required community resources, including accommodation, daytime activity, and daily living support services, were calculated. The numbers of governmental targets for community resources, including community accommodation, daytime activities, and daily living support services may have been underestimated. [source] Factors disturbing treatment for cancer in patients with schizophreniaPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2006TAKUJI INAGAKI md Abstract Patients with schizophrenia who develop cancer often have a variety of complicated medical and psychiatric problems. Problems associated with receiving a diagnosis of cancer and with understanding or cooperating with medical treatment may develop. Research in managing and treating schizophrenia patients with cancer is scarce. Presented herein is the experience of the authors' consultation,liaison psychiatry service in treating patients with schizophrenia who have cancer, and discussion of the medical management of such cases. Fourteen patients were treated between April 1999 and March 2003 and included patients receiving consultation psychiatric services at Shimane University Hospital as well as patients referred from other psychiatric hospitals. These patients were divided into two groups based on whether they were amenable to cancer treatment or not. The treated group consisted of patients who accepted cancer treatment, and the untreated group consisted of patients who refused or interrupted the cancer treatment. The clinical course, clinical psychiatric symptoms, problems in understanding cancer, cancer treatment course and convalescence were retrospectively assessed. Psychiatric symptoms and state were measured using the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS). The mean of the duration of schizophrenia in these two groups was not significantly different. The mean scores on measures of psychiatric symptoms in each group (treated and untreated) were as follows: BPRS, 45.3 ± 15.4 and 64.9 ± 9.2 (P < 0.05); positive symptoms scores on PANSS, 14.4 ± 8.8 and 20.6 ± 6.0 (NS); negative symptoms scores on PANSS, 20.6 ± 4.7 and 33.6 ± 4.4 (P < 0.01); and total scores on PANSS, 31.7 ± 7.0 and 48.6 ± 7.4 (P < 0.01). Patients with severe negative symptoms had greater difficulty understanding and cooperating with the cancer treatment. Regarding cancer stage, when cancer was discovered, the disease had already advanced and was no longer amenable to first-line treatment. Regarding notification of the diagnosis, it was rarely possible to give sufficiently early notice to patients in the untreated group. The important role of consultation,liaison psychiatrist in treating cancer patients is suggested. Some steps are proposed for managing schizophrenia patients with cancer who are not able to give informed consent. [source] Clozapine in schizophrenia patients with recurrent catatonia: Report of two casesPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2006YI-YUNG HUNG md Abstract, Prolonged catatonia can be a source of extremely serious morbidity and mortality. Lorazepam is effective in rapidly relieving most cases of catatonia. Reports have also shown that second-generation antipsychotic drugs are also efficacious in relieving catatonia. This report describes two schizophrenia patients who demonstrated recurrent catatonic features mutism and stupor. Both patients were treated with lorazepam, diazepam or electroconvulsive therapy (ECT). Patient 1 responded well and rapidly to lorazepam each time catatonia happened; but catatonia recurred once a year under treatment with many antipsychotic drugs. Patient 2 had catatonia features associated with discontinuing or decreasing clozapine. With each recurrent episode, the duration of catatonia increased, requiring an increased dosage of benzodiazepine. The patient's response to lorazepam and ECT gradually decreased, until the patient had almost no response to lorazepam, diazepam or ECT. Both patients had no recurrence during a period of 2-year follow up with continuous clozapine therapy. [source] | |||||||||||||