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Tidsskrift For Den Norske Laegeforening... Feb 2019
Topics: Cataract; Cataract Extraction; Coercion; Humans; Informed Consent; Involuntary Treatment; Mental Disorders; Schizophrenia, Paranoid; Schizophrenic Psychology
PubMed: 30754946
DOI: 10.4045/tidsskr.18.0553 -
Consortium Psychiatricum Mar 2021Associations of disturbances in innate and adaptive immunity during the clinical course of schizophrenia have been found in a number of studies. Yet, the relationship of...
INTRODUCTION
Associations of disturbances in innate and adaptive immunity during the clinical course of schizophrenia have been found in a number of studies. Yet, the relationship of immune parameters and systemic inflammation in relation to the clinical course of the disease and its prognosis, remains poorly understood, which highlights an interesting topic for further research. The goal of this study was to research the immuno-inflammatory changes in patients with clinical continuous and episodic paranoid schizophrenia, to assess the pathogenetic significance of these changes.
METHODS
Thirty-six patients with paranoid schizophrenia, of which 20 had episodic symptoms and 16 had continuous symptoms, consented to participate in the study, together with 30 healthy volunteers. In the study we assessed the parameters of innate immune response (serum levels of key pro-inflammatory and anti-inflammatory cytokines, C-reactive protein) and the adaptive immune response, including humoral-mediated immunity (serum immunoglobulins IgA, IgM, IgG, circulating immune complexes), as well as the cell link of adaptive immunity (key lymphocyte subpopulations). Positive and negative symptoms were assessed with the positive and negative symptoms scale; frontal dysfunction was assessed by Frontal Assessment Battery (FAB).
RESULTS
Both patient groups had higher than normal levels of C-reactive protein and IL-8. There was a significant elevation of circulating immune complexes among patients with continuous symptoms of schizophrenia, compared to patients with episodic symptoms and healthy controls. Levels of CD45+CD3+ lymphocytes (T-cells) differed between clinical groups, with higher values identified among patients with episodic symptoms and lower values among those with continuous symptoms. In addition, patients with episodic symptoms had significantly increased levels of CD45+CD3+CD4+CD25+CD127- regulatory T-cells. Finally, the level of CD45+CD3-CD19+ B-cells was significantly higher among patients with continuous symptoms vs. patients with episodic symptoms and the control groups. Markers of activation of humoral immunity were associated with the severity of frontal disorders in these patients.
DISCUSSION
Comprehensive data on the serum level of cytokines and the parameters of adaptive immunity among individuals with continuous schizophrenia, by comparison with patients with episodic schizophrenia, are practically absent in the literature. We have shown that among those with continuous schizophrenia, there are signs of systemic inflammation and chronic activation of the adaptive humoral immune response, while among patients with episodic symptoms of the disease, there are signs of systemic inflammation and certain activation of cell-mediated immunity, without significant changes in the humoral link of adaptive immunity.
CONCLUSION
More studies are needed, but the data obtained in this study are important for subsequent clinical studies of new treatment methods, based on various immunophenotypes of schizophrenia.
PubMed: 38601098
DOI: 10.17816/CP66 -
Biological Psychiatry. Cognitive... Nov 2022Persecutory delusions are among the most common delusions in schizophrenia and represent the extreme end of the paranoia continuum. Paranoia is accompanied by...
BACKGROUND
Persecutory delusions are among the most common delusions in schizophrenia and represent the extreme end of the paranoia continuum. Paranoia is accompanied by significant worry and distress. Identifying cognitive mechanisms underlying paranoia is critical for advancing treatment. We hypothesized that aberrant belief updating, which is related to paranoia in human and animal models, would also contribute to persecutory beliefs in individuals with schizophrenia.
METHODS
Belief updating was assessed in 42 participants with schizophrenia and 44 healthy control participants using a 3-option probabilistic reversal learning task. Hierarchical Gaussian Filter was used to estimate computational parameters of belief updating. Paranoia was measured using the Positive and Negative Syndrome Scale and the revised Green et al. Paranoid Thoughts Scale. Unusual thought content was measured with the Psychosis Symptom Rating Scale and the Peters et al. Delusions Inventory. Worry was measured using the Dunn Worry Questionnaire.
RESULTS
Paranoia was significantly associated with elevated win-switch rate and prior beliefs about volatility both in schizophrenia and across the whole sample. These relationships were specific to paranoia and did not extend to unusual thought content or measures of anxiety. We observed a significant indirect effect of paranoia on the relationship between prior beliefs about volatility and worry.
CONCLUSIONS
This work provides evidence that relationships between belief updating parameters and paranoia extend to schizophrenia, may be specific to persecutory beliefs, and contribute to theoretical models implicating worry in the maintenance of persecutory delusions.
Topics: Humans; Paranoid Disorders; Schizophrenia; Delusions; Anxiety; Surveys and Questionnaires
PubMed: 35430406
DOI: 10.1016/j.bpsc.2022.03.013 -
Schizophrenia Bulletin Apr 2020
Topics: Adult; Female; Humans; Interpersonal Relations; Schizophrenia, Paranoid
PubMed: 30753633
DOI: 10.1093/schbul/sbz006 -
PloS One 2016Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000...
BACKGROUND
Schizophrenia spectrum disorders result in enormous individual suffering and financial burden on patients and on society. In Germany, there are about 1,000,000 individuals suffering from schizophrenia (SZ) or schizoaffective disorder (SAD), a combination of psychotic and affective symptoms. Given the heterogeneous nature of these syndromes, one may assume that there is a difference in treatment costs among patients with paranoid SZ and SAD. However, the current the national system of cost accounting in psychiatry and psychosomatics in Germany assesses all schizophrenia spectrum disorders within one category.
METHODS
The study comprised a retrospective audit of data from 118 patients diagnosed with paranoid SZ (F20.0) and 71 patients with SAD (F25). We used the mean total costs as well as partial cost, i.e., mean costs for medication products, mean personal costs and mean infrastructure costs from each patient for the statistical analysis. We tested for differences in the four variables between SZ and SAD patients using ANCOVA and confirmed the results with bootstrapping.
RESULTS
SAD patients had a longer duration of stay than patients with SZ (p = .02). Mean total costs were significantly higher for SAD patients (p = .023). Further, we found a significant difference in mean personnel costs (p = .02) between patients with SZ and SAD. However, we found no significant differences in mean pharmaceutical costs (p = .12) but a marginal difference of mean infrastructure costs (p = .05) between SZ and SAD. We found neither a common decrease of costs over time nor a differential decrease in SZ and SAD.
CONCLUSION
We found evidence for a difference of case related costs of inpatient treatments for paranoid SZ and SAD. The differences in mean total costs seem to be primarily related to the mean personnel costs in patients with paranoid SZ and SAD rather than mean pharmaceutical costs, possibly due to higher personnel effort and infrastructure.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Electronic Health Records; Female; Germany; Health Care Costs; Humans; Male; Mental Health Services; Middle Aged; Psychiatry; Psychophysiologic Disorders; Psychotic Disorders; Retrospective Studies; Schizophrenia, Paranoid; Young Adult
PubMed: 27391238
DOI: 10.1371/journal.pone.0157635 -
Tijdschrift Voor Psychiatrie 2013Clinical zoanthropy is a rare delusion in which a person believes himself or herself to be an animal. (Review)
Review
BACKGROUND
Clinical zoanthropy is a rare delusion in which a person believes himself or herself to be an animal.
AIM
To assess the clinical and scientific relevance of this classical diagnostic category.
METHOD
A search was conducted in the classical and scientific literature and in PubMed, Embase, and Ovid.
RESULTS
Only 56 cases of clinical zoanthropy could be found in the international scientific literature. Since specific studies have yielded a relatively large numbers of cases in the past, it can be concluded that the disorder is probably more prevalent than is suggested in the literature. These cases may well be not only primary types, based on mental or unclear causes, but also secondary types, mediated by aberrant somatosensory sensations. Treatment of the underlying condition (in most cases a psychotic or mood disorder) has proved to be increasingly successful over time.
CONCLUSION
Because of the possible co-occurrence of zoanthropy and alterations in coenesthesis, i.e. the sensation of physical existence, mental health workers should be on the lookout for cases of clinical zoanthropy in clinical practice and avoid treating them in the same way as they would treat other delusions. All cases that occur should be subjected to extra somatic investigations – including an EEG and neuroimaging – and treatment should be adjusted in accordance with the findings.
Topics: Animals; Humans; Mental Disorders; Prevalence; Schizophrenia, Paranoid
PubMed: 23696338
DOI: No ID Found -
Shanghai Archives of Psychiatry Jun 2015The human brain is a complex network of regions that are structurally interconnected by white matter (WM) tracts. Schizophrenia (SZ) can be conceptualized as a...
BACKGROUND
The human brain is a complex network of regions that are structurally interconnected by white matter (WM) tracts. Schizophrenia (SZ) can be conceptualized as a disconnection syndrome characterized by widespread disconnections in WM pathways.
AIMS
To assess whether or not anatomical disconnections are associated with disruption of the topological properties of inter- and intra-hemispheric networks in SZ.
METHODS
We acquired the diffusion tensor imaging data from 24 male patients with paranoid SZ during an acute phase of their illness and from 24 healthy age-matched male controls. The brain FA-weighted (fractional anisotropy-weighted) structural networks were constructed and the inter- and intra-hemispheric integration was assessed by estimating the average characteristic path lengths (CPLs) between and within the left and right hemisphere networks.
RESULTS
The mean CPLs for all 18 inter-and intra-hemispheric CPLs assessed were longer in the SZ patient group than in the control group, but only some of these differences were significantly different: the CPLs for the overall inter-hemispheric and the left and right intra-hemispheric networks; the CPLs for the interhemisphere subnetworks of the frontal lobes, temporal lobes, and subcortical structures; and the CPL for the intra- frontal subnetwork in the right hemisphere. Among the 24 patients, the CPL of the inter-frontal subnetwork was positively associated with negative symptom severity, but this was the only significant result among 72 assessed correlations, so it may be a statistical artifact.
CONCLUSIONS
Our findings suggest that the integrity of intra- and inter-hemispheric WM tracts is disrupted in males with paranoid SZ, supporting the brain network disconnection model (i.e., the (')connectivity hypothesis(')) of schizophrenia. Larger studies with less narrowly defined samples of individuals with schizophrenia are needed to confirm these results.
PubMed: 26300598
DOI: 10.11919/j.issn.1002-0829.215036 -
Psychiatria Polska Apr 2018The purpose of the study was to investigate the dependence between the sense of coherence (SOC) and symptomatic improvement as it is the determinant of recovery process...
OBJECTIVES
The purpose of the study was to investigate the dependence between the sense of coherence (SOC) and symptomatic improvement as it is the determinant of recovery process of patients with schizophrenia spectrum disorders.
METHODS
The group of 134 patients was surveyed. 118 of them suffered from paranoid schizophrenia and 16 suffered from schizoaffective disorders, all were hospitalized in psychiatric clinics. Mean age was 36.22 years (SD = 8.51). Research was based on the Orientation to Life Questionnaire by A. Antonovsky. The level of psychopathological symptoms intensity was investigated twice, at the start and at the end of hospitalization with the Positive and Negative Syndrome Scale (PANSS). The rate of recovery was the margin between psychopathological symptoms intensification at the beginning and at the end of hospitalization.
RESULTS
The analysis show that higher sense of comprehensibility (SOCCOM) favors lesser intensity of negative symptoms and overall psychiatric symptomatology in PANSS while starting the hospitalization. Also patients with higher level of sense of coherence (SOC) show less negative symptoms escalation during hospital admission. Results show that higher level of sense of coherence (SOC) and higher level of sense of comprehensibility (SOCCOM) coexist with lesser difference in the intensification of psychopathological symptoms.
CONCLUSIONS
This article tries to show the role of sense of coherence in the recovery process among people with schizophrenic disorders. Coexistence of higher sense of coherence with greater negative symptoms and psychopathological symptoms can be perceived as an insight to the illness, which can be recognized as an expression of recovery.
Topics: Adaptation, Psychological; Adult; Female; Humans; Male; Quality of Life; Schizophrenia; Schizophrenic Psychology; Sense of Coherence; Surveys and Questionnaires; Young Adult
PubMed: 29975362
DOI: 10.12740/PP/OnlineFirst/69697 -
Psychiatria Danubina 2023Misattribution of motivational salience to non-salient (neutral) stimuli could be viewed as a hallmark of psychosis in schizophrenia. Studies have recently revealed...
BACKGROUND
Misattribution of motivational salience to non-salient (neutral) stimuli could be viewed as a hallmark of psychosis in schizophrenia. Studies have recently revealed increased subjective experience of emotional arousal (EA) to neutral social stimuli in paranoid schizophrenia psychosis, suggesting a misattribution of emotional salience to them. We examined this phenomenon directly by quantifying the level of EA subjectively attributed to low-arousal, neutral-valenced faces.
SUBJECTS AND METHODS
Patients with remitted schizophrenia (PG) (n=26), first-degree relatives of schizophrenic patients (RG) (n=25), and healthy controls (HCG) (n=36) were compared in terms of oxidative stress parameters -serum Superoxide Dismutase, Catalase, Glutathione Peroxidase (GPx), Nitrite, Nitrate, Malondialdehyde, and Total Glutathione levels-, social cognition measured by the Reading the Mind in the Eyes Test and working memory measured by the N-back Task. Groups were compared, assuming that HCG had a genetically lower risk of schizophrenia compared to PG and RG.
RESULTS
HCG performed significantly better than PG and RG, who were genetically at high risk, in terms of social cognition (respectively p=0.000, p=0.014), working memory (respectively p=0.001, p=0.003), and had statistically lower Glutathione Peroxidase (GPX) level than the PG and RG (both p:0.000). After controlling for the effect of the general intellectual abilities measured by the Raven Standard Progressive Matrices Test and working memory the differences between groups on the Eyes Test disappeared (p=0.057). However, this value tended to be significant.
CONCLUSION
It was concluded that social cognition and working memory and GPx level may be used as endophenotypes and social cognition, working memory, and general intellectual skills are different but strongly related constructs. Endophenotypes guide treatment targets even after the disease has developed. The results of our study showed that in addition to psychopharmacological treatments, interventions to reduce oxidative stress and approaches to improve cognitive skills will have a positive impact on the disease's progression.
Topics: Humans; Social Cognition; Psychotic Disorders; Cognition; Schizophrenia, Paranoid; Oxidative Stress; Glutathione Peroxidase; Neuropsychological Tests
PubMed: 37992097
DOI: 10.24869/psyd.2023.523 -
Metabolites Sep 2022Several studies have shown that patients with schizophrenia are at high risk for metabolic syndrome (MetS) and bioenergetic dysfunction. Because acylcarnitines are...
Several studies have shown that patients with schizophrenia are at high risk for metabolic syndrome (MetS) and bioenergetic dysfunction. Because acylcarnitines are involved in bioenergetic pathways and reflect the functioning of mitochondria, we hypothesized that these compounds are biomarkers of MetS in schizophrenia. The aim of this work was to quantify acylcarnitines and branched-chain amino acids in patients with schizophrenia comorbid with MetS. The study included 112 patients with paranoid schizophrenia treated with antipsychotics. Among them, 39 subjects met criteria of MetS. Concentrations of 30 acylcarnitines and three amino acids in dry serum spots were measured by liquid chromatography coupled with tandem mass spectrometry. MetS patients were found to have higher levels of valeryl carnitine (C5), leucine/isoleucine, and alanine as compared with patients without MetS, indicating possible participation of these compounds in the pathogenesis of metabolic disorders in schizophrenia. In patients with paranoid schizophrenia with or without MetS, lower levels of carnitines C10, C10:1, C12, and C18 were recorded as compared with the healthy individuals (n = 70), implying deterioration of energy metabolism. We believe that this finding can be explained by effects of antipsychotic medication on an enzyme called carnitine-palmitoyl transferase I.
PubMed: 36144254
DOI: 10.3390/metabo12090850