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Metabolites Mar 2023Metabolic syndrome (MetS) is a common comorbidity of schizophrenia and significantly shortens life expectancy of the patients. Intercellular (ICAM), vascular (VCAM), and...
Metabolic syndrome (MetS) is a common comorbidity of schizophrenia and significantly shortens life expectancy of the patients. Intercellular (ICAM), vascular (VCAM), and neural (NCAM) cell adhesion molecules (CAMs) mediate neuroinflammatory processes, and their soluble forms (e.g., sICAM) in plasma are present in parallel with their cell-bound forms. In this study, their serum levels were examined in 211 white Siberian patients with paranoid schizophrenia (82 patients with and 129 without MetS according to the 2005 International Diabetes Federation criteria). Serum levels of CAMs were determined with Magpix and Luminex 200 (Luminex, Austin, TX, USA) using xMAP Technology. The level of sICAM-1 was significantly higher and that of sVCAM-1 significantly lower in patients with MetS compared to patients without MetS. Levels of NCAM did not differ between the groups. More pronounced Spearman's correlations between CAMs, age, duration of schizophrenia, and body-mass index were observed among patients without MetS than among patients with MetS. Our results are consistent with MetS's being associated with endothelial dysfunction along with other components of inflammation. Through these endothelial components of peripheral inflammatory processes, MetS might induce intracerebral neuroinflammatory changes, but further investigation is needed to confirm this.
PubMed: 36984816
DOI: 10.3390/metabo13030376 -
Epidemiologia E Servicos de Saude :... Mar 2023to investigate sociodemographic and clinical characteristics of users of atypical antipsychotics receiving care via the Specialized Component of Pharmaceutical...
OBJECTIVE
to investigate sociodemographic and clinical characteristics of users of atypical antipsychotics receiving care via the Specialized Component of Pharmaceutical Assistance (Componente Especializado da Assistência Farmacêutica - CEAF), for the treatment of schizophrenia in Brazil, between 2008 and 2017.
METHODS
this was a retrospective cohort study using records of the authorizations for high complexity procedures retrieved from the Outpatient Information System of the Brazilian National Health System, from all Brazilian states.
RESULTS
of the 759,654 users, 50.5% were female, from the Southeast region (60.2%), diagnosed with paranoid schizophrenia (77.6%); it could be seen a higher prevalence of the use of risperidone (63.3%) among children/adolescents; olanzapine (34.0%) in adults; and quetiapine (47.4%) in older adults; about 40% of children/adolescents were in off-label use of antipsychotics according to age; adherence to CEAF was high (82%), and abandonment within six months was 24%.
CONCLUSION
the findings expand knowledge about the sociodemographic and clinical profile of users and highlight the practice of off-label use.
Topics: Adolescent; Child; Female; Humans; Aged; Male; Antipsychotic Agents; Schizophrenia; Brazil; Cohort Studies; Retrospective Studies
PubMed: 36946832
DOI: 10.1590/S2237-96222023000300015 -
Saudi Pharmaceutical Journal : SPJ :... Feb 2023Subjective views of clozapine treatment among patients with schizophrenia in the Middle East and North African MENA Region have not previously been assessed. Globally,...
Subjective views of clozapine treatment among patients with schizophrenia in the Middle East and North African MENA Region have not previously been assessed. Globally, few studies have assessed the views of carers to clozapine treatment. We conducted a cross-sectional survey, using a clinician administered structured interview, of patients with schizophrenia/schizoaffective disorder prescribed clozapine in Qatar, and their primary carers. Participants were asked to rate clozapine against prior their antipsychotic treatment in terms of specific benefits and side effects. Forty-two patients and 33 carers participated in the study. Of the patients, two thirds were male, approximately half were Qatari and the mean age was 33.9 years. Patients and carers rated clozapine as superior to prior antipsychotic treatment on all 7 potential benefits inquired about. The greatest perceived benefit was improved mood. Patients rated clozapine as less likely to cause extrapyramidal side effects but more likely to cause 18 other potential side effects compared to prior antipsychotic treatment, with the greatest difference being for nocturnal salivation, increased appetite, and constipation Nearly half of patients (48 %) and two thirds of carers (64 %) stated that they would have preferred to start clozapine earlier in their illness. Sixty percent of patients and 37 % of carers regarded the information that they had received from health professionals on clozapine as inadequate. Less than half of patients and approximately-two thirds of carers had adequate knowledge of haematological monitoring for clozapine. Generally, there were significantly positive correlation between patients and carers regarding the overall side effects of clozapine treatment. Likewise, improvement in hearing voices paranoid thoughts correlated with improved quality of life. In summary, the results show that patients and carers appreciate the benefits of clozapine despite its side effects being problematic. The results support clozapine being offered earlier in treatment and services providing more information on clozapine to patients and carers.
PubMed: 36942276
DOI: 10.1016/j.jsps.2022.12.005 -
Tijdschrift Voor Psychiatrie 2023Clozapine is the most effective treatment for people with treatment-resistant schizophrenia. However, it is prescribed less often than guidelines indicate. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Clozapine is the most effective treatment for people with treatment-resistant schizophrenia. However, it is prescribed less often than guidelines indicate.
AIM
To personalize clozapine treatment, we investigated the efficacy of clozapine as first- or second-line treatment and investigated whether there are factors that were associated with efficacy and side effects.
METHOD
We collected a unique cohort of over 800 clozapine users diagnosed with a schizophrenia spectrum disorder. We meta-analyzed factors that were associated with response during clozapine treatment. Additionally, we conducted genetic association analyses to investigate the relations between side effects and symptom severity during clozapinetreatment.
RESULTS
From our meta-analyses, we found that clozapine was more effective when used as a first- or second-line treatment. Furthermore, we found that younger age, less negative symptoms and the paranoid subtype of schizophreniawere associated with a better clozapine response. Several specific locations on genes (loci) were associated with clozapine-induced agranulocytosis and neutropenia, while polygenic risk scores were associated with symptom severity.
CONCLUSION
We found that clozapine could be effective earlier in treatment and identified factors that could aid the prediction of< response to clozapine treatment in the future. These finding could contribute to the start of a personalized clozapine treatment.
Topics: Humans; Antipsychotic Agents; Clozapine; Neutropenia; Precision Medicine; Schizophrenia
PubMed: 36912056
DOI: No ID Found -
Schizophrenia Bulletin Jul 2023Game theory paradigms, such as the Prisoner's Dilemma Game (PDG), have been used to study nonclinical paranoia, though research using clinical populations has been...
BACKGROUND AND HYPOTHESIS
Game theory paradigms, such as the Prisoner's Dilemma Game (PDG), have been used to study nonclinical paranoia, though research using clinical populations has been scarce. We test our novel theoretical model that schizophrenia leads to competitiveness in interpersonal interactions, and that this link is serially mediated by trait paranoia, state paranoia, and distrust.
STUDY DESIGN
In this quasi-experimental study, individuals with schizophrenia spectrum diagnoses with current persecutory delusions (n = 46) and a nonclinical control group (n = 43) played the PDG, and completed measures of trait paranoia, state paranoia, and distrust.
STUDY RESULTS
Individuals with schizophrenia competed more in the PDG than the control group. Supporting our theoretical model, all direct effects were significant: schizophrenia was associated with higher trait paranoia (H1); trait paranoia predicted state paranoia in the PDG (H2); state paranoia in the PDG predicted distrust of the opponent in the PDG (H3); and distrust predicted competition in the PDG (H4). The hypothesized indirect effect of schizophrenia on competition in the PDG via trait paranoia, state paranoia, and distrust was supported in a serial mediation model (H5).
CONCLUSIONS
The findings make clear theoretical and methodological contributions. We provide the first evidence for a theoretical process model by which schizophrenia leads to competitiveness in interpersonal interactions via trait paranoia, state paranoia, and distrust. Game theory paradigms, and the PDG in particular, are important for advancing theory and research on paranoia as it occurs in both clinical and nonclinical populations.
Topics: Humans; Schizophrenia; Paranoid Disorders; Delusions; Interpersonal Relations
PubMed: 36912015
DOI: 10.1093/schbul/sbad021 -
Psychiatry Research May 2023While recent studies have prompted re-evaluation of the term "schizophrenia," few have examined the use of terms to describe persecutory ideation (PI) or paranoia. This...
While recent studies have prompted re-evaluation of the term "schizophrenia," few have examined the use of terms to describe persecutory ideation (PI) or paranoia. This study examines the preferences and terms used by a cross-diagnostic population of individuals (N = 184) with lived experience using an online survey. Participants most commonly described their PI in terms of the perceived source of threat, followed by clinical language, most commonly variants of "paranoia" and "anxiety." Of five selected terms assessed quantitatively - "anxiety," "paranoia," "persecutory thoughts," "suspiciousness," and "threat thoughts" - participants were more likely to report that "anxiety" aligned with their experience of PI, followed by "suspiciousness." Endorsement of terms more specific to PI was associated with self-report PI severity, while a preference for "anxiety" over other terms was both associated with less severe PI and lower scores on a measure of stigma. These results suggest that the heterogeneity of terms used by individuals with lived experience support a person-centered approach to language describing such experiences.
Topics: Humans; Terminology as Topic; Anxiety; Paranoid Disorders; Male; Female; Adolescent; Young Adult; Adult; Middle Aged; Aged; Surveys and Questionnaires; Life Change Events
PubMed: 36881949
DOI: 10.1016/j.psychres.2023.115129 -
Psychopharmacology Bulletin Feb 2023This study aimed to explore the relationship between Captagon usage and the development of delusions of infidelity. The study sample; 101 male patients, was recruited... (Review)
Review
This study aimed to explore the relationship between Captagon usage and the development of delusions of infidelity. The study sample; 101 male patients, was recruited from patients admitted to Eradah Complex for Mental Health and addiction, Jeddah, Saudi Arabia, with the diagnosis of amphetamine (Captagon) induced psychosis during the period from September 2021 to March 2022. All patients underwent an extensive psychiatric interview; including interview with patients' families; a demographic sheet, a drug use questionnaire, the structured clinical interview for DSM-IV (SCID 1), routine medical investigation, and urine screening for drugs. Patients' ages ranged from 19 to 46 years old with Mean ± SD 30.87 ± 6.58. 57.4 % were single, 77.2% have finished their high school, and 22.8% had no work. Captagon using age ranged from 14-40 years old, and regular daily dose ranged from 1-15 tablet, while maximum daily dose ranged from 2-25 tablets. Twenty-six patients (25.7%) of the study group have developed infidelity delusions. A higher divorce rate was present among patients who developed infidelity delusions (53.8%) in comparison to patients who developed other types of delusions (6.7%). Infidelity delusions are common among patients diagnosed with Captagon induce psychosis, and they harmfully influence their social lives.
Topics: Humans; Male; Young Adult; Adult; Middle Aged; Adolescent; Jealousy; Schizophrenia, Paranoid; Psychotic Disorders; Amphetamine
PubMed: 36873918
DOI: No ID Found -
Psychiatry and Clinical Neurosciences May 2023
Rapidly responding Geschwind syndrome comorbid with Othello syndrome in a case of post-stroke dementia and post-stroke epilepsy: A case report and a brief systematic review of classical and atypical cases.
Topics: Humans; Comorbidity; Dementia; Epilepsy; Schizophrenia, Paranoid; Stroke
PubMed: 36856332
DOI: 10.1111/pcn.13539 -
Journal of Clinical Medicine Jan 2023(1) Background: Schizophrenia is a severe mental disorder characterized by various symptom groups that tremendously affect health-related quality of life (HRQoL). We...
Correlation of Health-Related Quality of Life with Negative Symptoms Assessed with the Self-Evaluation of Negative Symptoms Scale (SNS) and Cognitive Deficits in Schizophrenia: A Cross-Sectional Study in Routine Psychiatric Care.
(1) Background: Schizophrenia is a severe mental disorder characterized by various symptom groups that tremendously affect health-related quality of life (HRQoL). We aimed to specify whether negative symptoms and cognitive deficits of schizophrenia correlate and can predict HRQoL. (2) Methods: Patients diagnosed with paranoid schizophrenia were invited to participate in the study. Participants were evaluated using the Montreal Cognitive Assessment (MoCA) and the Brief Psychiatric Rating Scale (BPRS) and were asked to fill out the Self-evaluation of Negative Symptoms scale (SNS) and the Medical Outcomes Short Form Survey (SF-36). Pearson's and Spearman's correlations were used to calculate the correlations between cognitive deficits and negative symptoms. We performed the receiver operating characteristic (ROC) analysis for the variables correlated with SF-36 scores. (3) Results: HRQoL correlated significantly with the negative symptoms; however, it did not correlate with cognitive deficits. ROC analysis showed that the abulia subscore of the SNS showed the most significant predictive potential of HRQoL. (4) Conclusions: Negative symptoms correlate more significantly with the HRQoL than cognitive symptoms. The SNS offers the possibility of predicting the HRQoL of patients with schizophrenia and is useful as a screening tool in clinical practice.
PubMed: 36769548
DOI: 10.3390/jcm12030901 -
International Journal of Environmental... Jan 2023The study aimed to assess the impact of clinical symptoms and cognitive impairment on disability in patients with paranoid schizophrenia (PS).
UNLABELLED
The study aimed to assess the impact of clinical symptoms and cognitive impairment on disability in patients with paranoid schizophrenia (PS).
METHODS
108 patients with schizophrenia were included (66 male and 42 female). Their average age was 38.86 ± 10.02 years and the disease duration was 12.80 ± 8.20 years, with mean disease onset of 24 years. Clinical symptoms were assessed with the PANSS, and cognitive performance was measured using a seven-item neurocognitive battery. The disability level of the subjects was assessed using the World Health Organization-Disability Assessment Schedule 2.0 (WHO-DAS 2.0). The relation between the variables studied was assessed using Spearman's rank correlation coefficient () at a probability level of < 0.05.
RESULTS
An increase in symptom severity resulted in worsening of the "participation in society" ( = 0.56, < 0.01), "life activities-household" ( = 0.55, < 0.01), and "getting along with people" ( = 0.59, < 0.01) WHO-DAS 2.0 domains. Positive symptoms (13.89 ± 3.48) correlated strongly with "getting along with people" ( = 0.55, < 0.01), "life activities-household" ( = 0.58, < 0.01), and "participation in society" ( = 0.62, < 0.01), and negative symptoms (14.25 ± 4.16) with "participation in society" ( = 0.53, < 0.01) and "life activities-household" ( = 0.48, < 0.01). Symptoms of disorganization (15.67 ± 4.16) had the highest impact on "life activities-household" ( = 0.81, < 0.01), "getting along with people" ( = 0.56, < 0.05), and "participation in society" ( = 0.65, < 0.01). Episodic memory ( = -0.28, < 0.01) was remotely related to comprehension and communication. The information processing speed ( = 0.38, < 0.01), visual memory ( = -0.30, < 0.01), and focused executive functions showed moderate correlations with all domains on the WHO-DAS 2.0 scale ( = 0.38, < 0.01). Attention ( = -0.33, < 0.01) was moderately related to community activities. Semantic ( = -0.29, < 0.01) and literal ( = -0.27, < 0.01) verbal fluency demonstrated weak correlations with "cognition-understanding", "getting along with people", and "participation in society".
CONCLUSION
Symptoms of disorganization and disturbed executive functions contribute most to disability in patients with schizophrenia through impairment of real-world functioning, especially in social interactions and communication. Severe clinical symptoms (negative and disorganization-related ones) as well as deficits in executive function, verbal memory, and verbal fluency cause the biggest problems in the functional domains of interaction with other people and participation in society.
Topics: Humans; Male; Female; Adult; Middle Aged; Schizophrenia, Paranoid; Bulgaria; Cognition Disorders; Neuropsychological Tests; Cognitive Dysfunction; Cognition
PubMed: 36767826
DOI: 10.3390/ijerph20032459