Pub Date : 2023-02-03eCollection Date: 2023-01-01DOI: 10.1155/2023/7035893
Moses Kule, Mark Mohan Kaggwa
Background: There has been a recent transition from typical to atypical antipsychotics in managing schizophrenia. This has been attributed to the acute side effects experienced by patients on typical antipsychotics that lead to nonadherence. However, the treatment cost with typical antipsychotics is cheaper (preferred in low-income settings), and there is no difference in the effectiveness, efficacy, discontinuation rate, or side effect symptom burden with atypical antipsychotics. This study is aimed at determining the prevalence of nonadherence and the associated factors to typical antipsychotics among patients with schizophrenia attending a psychiatric outpatient clinic at a rural tertiary facility in Uganda.
Method: A cross-sectional study among 135 patients with schizophrenia for at least six months on typical antipsychotics (mean age of 39.7 (±11.9) and 55.6% were female) from a rural tertiary facility in Uganda. Data were collected regarding sociodemographics, adherence, insight for psychosis, attitude towards typical antipsychotics, side effects, satisfaction with medications, and explanations from health workers about medications and side effects. Logistic regression was used to determine the factors associated with nonadherence.
Results: The prevalence of nonadherence was 16.3%, and the likelihood of being nonadherent was more among the poor (monthly earning below the poverty line). However, having reduced energy was associated with reducing the likelihood of having nonadherence.
Conclusion: The prevalence of nonadherence was lower than many previously obtained prevalence and was comparable to nonadherence for atypical antipsychotics. However, to reduce nonadherence, we need all stakeholders (such as the government, insurance companies, and caregivers) to assist patients living in poverty with access to medication.
{"title":"Adherence to Typical Antipsychotics among Patients with Schizophrenia in Uganda: A Cross-Sectional Study.","authors":"Moses Kule, Mark Mohan Kaggwa","doi":"10.1155/2023/7035893","DOIUrl":"10.1155/2023/7035893","url":null,"abstract":"<p><strong>Background: </strong>There has been a recent transition from typical to atypical antipsychotics in managing schizophrenia. This has been attributed to the acute side effects experienced by patients on typical antipsychotics that lead to nonadherence. However, the treatment cost with typical antipsychotics is cheaper (preferred in low-income settings), and there is no difference in the effectiveness, efficacy, discontinuation rate, or side effect symptom burden with atypical antipsychotics. This study is aimed at determining the prevalence of nonadherence and the associated factors to typical antipsychotics among patients with schizophrenia attending a psychiatric outpatient clinic at a rural tertiary facility in Uganda.</p><p><strong>Method: </strong>A cross-sectional study among 135 patients with schizophrenia for at least six months on typical antipsychotics (mean age of 39.7 (±11.9) and 55.6% were female) from a rural tertiary facility in Uganda. Data were collected regarding sociodemographics, adherence, insight for psychosis, attitude towards typical antipsychotics, side effects, satisfaction with medications, and explanations from health workers about medications and side effects. Logistic regression was used to determine the factors associated with nonadherence.</p><p><strong>Results: </strong>The prevalence of nonadherence was 16.3%, and the likelihood of being nonadherent was more among the poor (monthly earning below the poverty line). However, having reduced energy was associated with reducing the likelihood of having nonadherence.</p><p><strong>Conclusion: </strong>The prevalence of nonadherence was lower than many previously obtained prevalence and was comparable to nonadherence for atypical antipsychotics. However, to reduce nonadherence, we need all stakeholders (such as the government, insurance companies, and caregivers) to assist patients living in poverty with access to medication.</p>","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"2023 ","pages":"7035893"},"PeriodicalIF":3.6,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10708942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Marthoenis, M. Martina, Rudi Alfiandi, D. Dahniar, Rini Asnurianti, H. Sari, Jacqueline Nassimbwa, S. Arafat
Background Antipsychotics exert metabolic side effects, and prolonged treatment with antipsychotics causes changes in body weight and muscle composition. Nevertheless, reports on the changes in body composition of patients with schizophrenia have been limited. This study is aimed at comparing the body mass index and body composition of patients with schizophrenia with healthy individuals in Indonesia. Methods A total of 195 patients with schizophrenia (148 males and 47 females) and 195 healthy individuals matched by gender were recruited. Using the Bioelectrical Impedance Analysis method, the participants' body compositions were measured. Results Compared to healthy individuals, the patient group exhibited a higher rate of underweight as well as a lower rate of overweight and obesity. Multiple regression analysis confirmed the associations between the body mass index and all measured body compositions. Furthermore, the diagnosis of schizophrenia is significantly associated with lower muscle mass, lower bone mass, higher basal metabolic rate, older metabolic age, and higher total body water. Conclusions The results showed that patients with schizophrenia are at a greater risk of a lower quality of certain components of body composition. Priority should be given to research that addresses increasing the patient's level of physical activity.
{"title":"Investigating Body Mass Index and Body Composition in Patients with Schizophrenia: A Case-Control Study","authors":"M. Marthoenis, M. Martina, Rudi Alfiandi, D. Dahniar, Rini Asnurianti, H. Sari, Jacqueline Nassimbwa, S. Arafat","doi":"10.1155/2022/1381542","DOIUrl":"https://doi.org/10.1155/2022/1381542","url":null,"abstract":"Background Antipsychotics exert metabolic side effects, and prolonged treatment with antipsychotics causes changes in body weight and muscle composition. Nevertheless, reports on the changes in body composition of patients with schizophrenia have been limited. This study is aimed at comparing the body mass index and body composition of patients with schizophrenia with healthy individuals in Indonesia. Methods A total of 195 patients with schizophrenia (148 males and 47 females) and 195 healthy individuals matched by gender were recruited. Using the Bioelectrical Impedance Analysis method, the participants' body compositions were measured. Results Compared to healthy individuals, the patient group exhibited a higher rate of underweight as well as a lower rate of overweight and obesity. Multiple regression analysis confirmed the associations between the body mass index and all measured body compositions. Furthermore, the diagnosis of schizophrenia is significantly associated with lower muscle mass, lower bone mass, higher basal metabolic rate, older metabolic age, and higher total body water. Conclusions The results showed that patients with schizophrenia are at a greater risk of a lower quality of certain components of body composition. Priority should be given to research that addresses increasing the patient's level of physical activity.","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"11 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2022-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90554831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-13eCollection Date: 2021-01-01DOI: 10.1155/2021/7698030
Jack Baichao Ding, Kevin Hu
Recent data suggests that the prevalence of smoking in schizophrenia remains high. While reports suggest that smoking increases the risk of developing schizophrenia, the potential causative role of smoking in this relationship needs further investigation. Smokers with schizophrenia are more likely to have more intense positive symptoms and lower cognitive function, but diminished intensity of extrapyramidal side effects than nonsmoking patients with schizophrenia. They were also more likely to exhibit aggressive behaviour compared to nonsmokers, which could suggest higher levels of baseline aggression. The significant cost associated with regular tobacco expenditure can detract from investment in key domains. Large-scale trials have shown that pharmacotherapy for smoking cessation is effective and does not worsen the risk of developing neuropsychiatric symptoms compared to placebo. Electronic cigarette use among schizophrenia patients is high, and there is emerging evidence supportive of its efficacy. Future improvements include large-scale trials assessing the utility, efficacy, and safety of electronic cigarettes in schizophrenia patients.
{"title":"Cigarette Smoking and Schizophrenia: Etiology, Clinical, Pharmacological, and Treatment Implications.","authors":"Jack Baichao Ding, Kevin Hu","doi":"10.1155/2021/7698030","DOIUrl":"https://doi.org/10.1155/2021/7698030","url":null,"abstract":"<p><p>Recent data suggests that the prevalence of smoking in schizophrenia remains high. While reports suggest that smoking increases the risk of developing schizophrenia, the potential causative role of smoking in this relationship needs further investigation. Smokers with schizophrenia are more likely to have more intense positive symptoms and lower cognitive function, but diminished intensity of extrapyramidal side effects than nonsmoking patients with schizophrenia. They were also more likely to exhibit aggressive behaviour compared to nonsmokers, which could suggest higher levels of baseline aggression. The significant cost associated with regular tobacco expenditure can detract from investment in key domains. Large-scale trials have shown that pharmacotherapy for smoking cessation is effective and does not worsen the risk of developing neuropsychiatric symptoms compared to placebo. Electronic cigarette use among schizophrenia patients is high, and there is emerging evidence supportive of its efficacy. Future improvements include large-scale trials assessing the utility, efficacy, and safety of electronic cigarettes in schizophrenia patients.</p>","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"2021 ","pages":"7698030"},"PeriodicalIF":2.4,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8687814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39750526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Long-acting injectable (LAI) antipsychotics are used as a monotherapy in patients with schizophrenia. However, the combination of LAI and oral antipsychotics is commonly used in clinical practice, despite there being very limited studies investigating the efficacy and safety of this combination compared with LAI antipsychotic monotherapy.
Objective: To study the efficacy and safety of LAI antipsychotic monotherapy compared with the combination of LAI and oral antipsychotics in patients with schizophrenia.
Methods: This study was a retrospective cohort study, which classified eligible patients into two groups: the LAI antipsychotic monotherapy group and the combination of LAI and oral antipsychotic group. The primary outcome was hospitalization between groups. The duration of the study was 2 years.
Results: In total, 86 patients completed the study and were analysed (LAI antipsychotic monotherapy group: n = 25; combination of LAI and oral antipsychotic group: n = 61). There was no significant difference in hospitalization between the two groups (P = 1.000). For other outcomes, there were also no significant differences in both all-cause discontinuation (P = 0.667) and adverse drug reactions (P = 0.732) between the two groups.
Conclusion: The efficacy and safety of LAI antipsychotic monotherapy appeared similar to the combination of LAI and oral antipsychotics in patients with schizophrenia. Therefore, the combination of LAI and oral antipsychotics, which is commonly used in clinical practice, may not be necessary.
{"title":"Comparison of Efficacy and Safety between Long-Acting Injectable Antipsychotic Monotherapy and Combination of Long-Acting Injectable and Oral Antipsychotics in Patients with Schizophrenia.","authors":"Thanompong Sathienluckana, Pornyupa Tiangpattanawong, Karnpreena Chaiyasukthananoan, Pannapat Jittayanan, Hathaipat Sawetwangsing, Punyawee Puchsaka","doi":"10.1155/2021/8403986","DOIUrl":"https://doi.org/10.1155/2021/8403986","url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable (LAI) antipsychotics are used as a monotherapy in patients with schizophrenia. However, the combination of LAI and oral antipsychotics is commonly used in clinical practice, despite there being very limited studies investigating the efficacy and safety of this combination compared with LAI antipsychotic monotherapy.</p><p><strong>Objective: </strong>To study the efficacy and safety of LAI antipsychotic monotherapy compared with the combination of LAI and oral antipsychotics in patients with schizophrenia.</p><p><strong>Methods: </strong>This study was a retrospective cohort study, which classified eligible patients into two groups: the LAI antipsychotic monotherapy group and the combination of LAI and oral antipsychotic group. The primary outcome was hospitalization between groups. The duration of the study was 2 years.</p><p><strong>Results: </strong>In total, 86 patients completed the study and were analysed (LAI antipsychotic monotherapy group: <i>n</i> = 25; combination of LAI and oral antipsychotic group: <i>n</i> = 61). There was no significant difference in hospitalization between the two groups (<i>P</i> = 1.000). For other outcomes, there were also no significant differences in both all-cause discontinuation (<i>P</i> = 0.667) and adverse drug reactions (<i>P</i> = 0.732) between the two groups.</p><p><strong>Conclusion: </strong>The efficacy and safety of LAI antipsychotic monotherapy appeared similar to the combination of LAI and oral antipsychotics in patients with schizophrenia. Therefore, the combination of LAI and oral antipsychotics, which is commonly used in clinical practice, may not be necessary.</p>","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"2021 ","pages":"8403986"},"PeriodicalIF":2.4,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8639247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39948034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-13eCollection Date: 2021-01-01DOI: 10.1155/2021/7721760
T V Zhilyaeva, A S Piatoikina, A P Bavrina, O V Kostina, E S Zhukova, T G Shcherbatyuk, A S Blagonravova, E E Dubinina, G E Mazo
<p><p>A wide range of studies have demonstrated that hyperhomocysteinemia is associated with the risk of schizophrenia, but currently available assumptions about the direct involvement of homocysteine (Hcy) in the pathogenesis of schizophrenia are hypothetical. It is possible that in vivo Hcy is only a marker of folate metabolism disturbances (which are involved in methylation processes) and is not a pathogenetic factor per se. Only one study has been conducted in which associations of hyperhomocysteinemia with oxidative stress in schizophrenia (oxidative damage to protein and lipids) have been found, and it has been suggested that the oxidative stress may be induced by the elevated Hcy in schizophrenic patients. But the authors did not study the level of reduced glutathione (GSH), as well as possible causes of hyperhomocysteinemia-disturbances of folate metabolism. The aim of this work is to analyze the association of Hcy levels with the following: (1) redox markers in schizophrenia GSH, markers of oxidative damage of proteins and lipids, and the activity of antioxidant enzymes in blood serum; (2) with the level of folate and cobalamin (В12); and (3) with clinical features of schizophrenia measured using the Positive and Negative Syndrome Scale (PANSS). 50 patients with schizophrenia and 36 healthy volunteers, matched by sex and age, were examined. Hcy in patients is higher than in healthy subjects (<i>p</i> = 0.0041), and this may be due to the lower folate level in patients (<i>p</i> = 0.0072). In patients, negative correlation was found between the level of Hcy both with the level of folate (<i>ρ</i> = -0.38, <i>p</i> = 0.0063) and with the level of B12 (<i>ρ</i> = -0.36, <i>p</i> = 0.0082). At the same time, patients showed higher levels of oxidative modification of serum proteins (<i>p</i> = 0.00046) and lower catalase (CAT) activity (<i>p</i> = 0.014). However, Hcy is not associated with the studied markers of oxidative stress in patients. In the group of patients with an increased level of Hcy (>10 <i>μ</i>mol/l, <i>n</i> = 42) compared with other patients (<i>n</i> = 8), some negative symptoms (PANSS) were statistically significantly more pronounced: difficulty in abstract thinking (N5, <i>p</i> = 0.019), lack of spontaneity and flow in conversation (N6, <i>p</i> = 0.022), stereotyped thinking (N7, <i>p</i> = 0.013), and motor retardation (G7, <i>p</i> = 0.050). Thus, in patients with schizophrenia, hyperhomocysteinemia caused by deficiency of folate and B12 is confirmed and can be considered a marker of disturbances of vitamin metabolism. The redox imbalance is probably not directly related to hyperhomocysteinemia and is hypothetically caused by other pathological processes or by an indirect effect of Hcy, for example, on the enzymatic antioxidant defence system (CAT activity), which requires further exploration. Further study of the role of Hcy in the pathogenesis of schizophrenia is relevant, since the proportion of patients with hype
广泛的研究表明,高同型半胱氨酸血症与精神分裂症的风险相关,但目前关于同型半胱氨酸(Hcy)直接参与精神分裂症发病机制的假设是假设的。在体内,Hcy可能只是叶酸代谢紊乱(涉及甲基化过程)的一个标志,本身并不是一个致病因素。只有一项研究发现高同型半胱氨酸血症与精神分裂症患者氧化应激(对蛋白质和脂质的氧化损伤)之间存在关联,并提示氧化应激可能是由精神分裂症患者Hcy升高引起的。但作者没有研究还原型谷胱甘肽(GSH)的水平,以及高同型半胱氨酸血症(叶酸代谢紊乱)的可能原因。本研究旨在分析Hcy水平与以下因素的关系:(1)精神分裂症GSH中的氧化还原标志物、蛋白质和脂质氧化损伤标志物以及血清中抗氧化酶活性;(2)叶酸和钴胺素水平(В12);(3)使用阳性和阴性症状量表(PANSS)测量精神分裂症的临床特征。研究人员对50名精神分裂症患者和36名按性别和年龄匹配的健康志愿者进行了研究。患者的Hcy高于健康受试者(p = 0.0041),这可能是由于患者的叶酸水平较低(p = 0.0072)。在患者中,Hcy水平与叶酸水平(ρ = -0.38, p = 0.0063)和B12水平(ρ = -0.36, p = 0.0082)呈负相关。同时,患者血清蛋白氧化修饰水平升高(p = 0.00046),过氧化氢酶(CAT)活性降低(p = 0.014)。然而,Hcy与所研究的患者氧化应激标志物无关。Hcy水平升高组(>10 μmol/l, n = 42)与其他组(n = 8)相比,一些阴性症状(PANSS)更明显:抽象思维困难(N5, p = 0.019)、谈话缺乏自发性和流畅性(N6, p = 0.022)、刻板思维(N7, p = 0.013)、运动迟缓(G7, p = 0.050)。因此,在精神分裂症患者中,由叶酸和B12缺乏引起的高同型半胱氨酸血症得到证实,可被认为是维生素代谢紊乱的标志。氧化还原失衡可能与高同型半胱氨酸血症没有直接关系,假设是由其他病理过程引起的,或者是由Hcy的间接作用引起的,例如,对酶抗氧化防御系统(CAT活性)的影响,这需要进一步探索。进一步研究Hcy在精神分裂症发病机制中的作用是有意义的,因为高同型半胱氨酸血症患者的比例很高,并且注意到其水平与精神分裂症阴性症状的相关性。
{"title":"Homocysteine in Schizophrenia: Independent Pathogenetic Factor with Prooxidant Activity or Integral Marker of Other Biochemical Disturbances?","authors":"T V Zhilyaeva, A S Piatoikina, A P Bavrina, O V Kostina, E S Zhukova, T G Shcherbatyuk, A S Blagonravova, E E Dubinina, G E Mazo","doi":"10.1155/2021/7721760","DOIUrl":"https://doi.org/10.1155/2021/7721760","url":null,"abstract":"<p><p>A wide range of studies have demonstrated that hyperhomocysteinemia is associated with the risk of schizophrenia, but currently available assumptions about the direct involvement of homocysteine (Hcy) in the pathogenesis of schizophrenia are hypothetical. It is possible that in vivo Hcy is only a marker of folate metabolism disturbances (which are involved in methylation processes) and is not a pathogenetic factor per se. Only one study has been conducted in which associations of hyperhomocysteinemia with oxidative stress in schizophrenia (oxidative damage to protein and lipids) have been found, and it has been suggested that the oxidative stress may be induced by the elevated Hcy in schizophrenic patients. But the authors did not study the level of reduced glutathione (GSH), as well as possible causes of hyperhomocysteinemia-disturbances of folate metabolism. The aim of this work is to analyze the association of Hcy levels with the following: (1) redox markers in schizophrenia GSH, markers of oxidative damage of proteins and lipids, and the activity of antioxidant enzymes in blood serum; (2) with the level of folate and cobalamin (В12); and (3) with clinical features of schizophrenia measured using the Positive and Negative Syndrome Scale (PANSS). 50 patients with schizophrenia and 36 healthy volunteers, matched by sex and age, were examined. Hcy in patients is higher than in healthy subjects (<i>p</i> = 0.0041), and this may be due to the lower folate level in patients (<i>p</i> = 0.0072). In patients, negative correlation was found between the level of Hcy both with the level of folate (<i>ρ</i> = -0.38, <i>p</i> = 0.0063) and with the level of B12 (<i>ρ</i> = -0.36, <i>p</i> = 0.0082). At the same time, patients showed higher levels of oxidative modification of serum proteins (<i>p</i> = 0.00046) and lower catalase (CAT) activity (<i>p</i> = 0.014). However, Hcy is not associated with the studied markers of oxidative stress in patients. In the group of patients with an increased level of Hcy (>10 <i>μ</i>mol/l, <i>n</i> = 42) compared with other patients (<i>n</i> = 8), some negative symptoms (PANSS) were statistically significantly more pronounced: difficulty in abstract thinking (N5, <i>p</i> = 0.019), lack of spontaneity and flow in conversation (N6, <i>p</i> = 0.022), stereotyped thinking (N7, <i>p</i> = 0.013), and motor retardation (G7, <i>p</i> = 0.050). Thus, in patients with schizophrenia, hyperhomocysteinemia caused by deficiency of folate and B12 is confirmed and can be considered a marker of disturbances of vitamin metabolism. The redox imbalance is probably not directly related to hyperhomocysteinemia and is hypothetically caused by other pathological processes or by an indirect effect of Hcy, for example, on the enzymatic antioxidant defence system (CAT activity), which requires further exploration. Further study of the role of Hcy in the pathogenesis of schizophrenia is relevant, since the proportion of patients with hype","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"2021 ","pages":"7721760"},"PeriodicalIF":2.4,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8545596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39567149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01eCollection Date: 2021-01-01DOI: 10.1155/2021/6662765
Mohammed Ayalew, Semira Defar, Yared Reta
Background: People with schizophrenia (PWS) are at greater risk of suicide. However, suicide behaviors that occur in PWS are often overlooked, inadequately characterized, and not consistently integrated into treatment. Despite this burden and consequences in Ethiopia, there is a dearth of studies concerning suicide behavior in PWS. Therefore, this study is aimed at assessing the magnitude of suicide behavior and its predictors among PWS in Ethiopia.
Methods: An institution based cross-sectional study was employed. Data were collected using the structured interviewer-administered questionnaire from a sample of 300 PWS at Amanuel Mental Specialized Hospital (AMSH). The revised version of Suicide Behavior Questionnaire (SBQ-R) was used to assess suicide behavior in PWS. The data was collected from March 1 to 30, 2019. Binary logistic regression was performed to identify independent predictors of suicidal behavior at 95% confidence level. Statistical significance was declared at p value <0.05.
Result: A total of 300 patients with schizophrenia participated in the study. More than two-thirds of 203 (67.7%) of the participants were males, and 116 (38.7%) participants were between the ages of 28 and 37 years. We found that the prevalence of suicide behavior among PWS was 30.3%. Being unemployed (AOR = 3.65, CI = 1.32, 10.05), family history of suicide (AOR = 3.16, CI = 1.38, 7.23), substance use (AOR = 2.51, CI = 1.13, 5.59), current positive psychotic symptoms (hallucination (AOR = 6.39, CI = 2.86, 14.29), and delusion (AOR = 4.15, CI = 1.95, 14.29) and presence of comorbid depression (AOR = 4.81, CI = 1.98, 11.68) were independent significant predictors with suicidal behavior in PWS.
Conclusion: The prevalence of suicidal behavior among PWS was found to be high. Hence, designing strategies for early screening and intervention is the most critical prevention strategy of suicide in PWS.
{"title":"Suicide Behavior and Its Predictors in Patients with Schizophrenia in Ethiopia.","authors":"Mohammed Ayalew, Semira Defar, Yared Reta","doi":"10.1155/2021/6662765","DOIUrl":"10.1155/2021/6662765","url":null,"abstract":"<p><strong>Background: </strong>People with schizophrenia (PWS) are at greater risk of suicide. However, suicide behaviors that occur in PWS are often overlooked, inadequately characterized, and not consistently integrated into treatment. Despite this burden and consequences in Ethiopia, there is a dearth of studies concerning suicide behavior in PWS. Therefore, this study is aimed at assessing the magnitude of suicide behavior and its predictors among PWS in Ethiopia.</p><p><strong>Methods: </strong>An institution based cross-sectional study was employed. Data were collected using the structured interviewer-administered questionnaire from a sample of 300 PWS at Amanuel Mental Specialized Hospital (AMSH). The revised version of Suicide Behavior Questionnaire (SBQ-R) was used to assess suicide behavior in PWS. The data was collected from March 1 to 30, 2019. Binary logistic regression was performed to identify independent predictors of suicidal behavior at 95% confidence level. Statistical significance was declared at <i>p</i> value <0.05.</p><p><strong>Result: </strong>A total of 300 patients with schizophrenia participated in the study. More than two-thirds of 203 (67.7%) of the participants were males, and 116 (38.7%) participants were between the ages of 28 and 37 years. We found that the prevalence of suicide behavior among PWS was 30.3%. Being unemployed (AOR = 3.65, CI = 1.32, 10.05), family history of suicide (AOR = 3.16, CI = 1.38, 7.23), substance use (AOR = 2.51, CI = 1.13, 5.59), current positive psychotic symptoms (hallucination (AOR = 6.39, CI = 2.86, 14.29), and delusion (AOR = 4.15, CI = 1.95, 14.29) and presence of comorbid depression (AOR = 4.81, CI = 1.98, 11.68) were independent significant predictors with suicidal behavior in PWS.</p><p><strong>Conclusion: </strong>The prevalence of suicidal behavior among PWS was found to be high. Hence, designing strategies for early screening and intervention is the most critical prevention strategy of suicide in PWS.</p>","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"2021 ","pages":"6662765"},"PeriodicalIF":3.6,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38885030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-20eCollection Date: 2021-01-01DOI: 10.1155/2021/8864352
Hiroki Okada, Dsisuke Hirano, Takamichi Taniguchi
Negative symptoms of schizophrenia have generally been defined using five factors; however, few studies have examined the relationship between these five factors and functional outcomes. In addition, there is no definitive conclusion regarding the association between negative symptoms and various aspects of functional outcomes (daily living, social, and vocational). This study is aimed at examining the relationship between these five domains of negative symptoms and different functional outcomes. Patients diagnosed with chronic schizophrenia (n = 100) were selected for the evaluation. We used the Brief Negative Symptom Scale to assess negative symptoms, the Brief Psychiatric Rating Scale to assess positive symptoms, the Schizophrenia Cognition Rating Scale to assess cognition, and the Evaluative Beliefs Scale (negative self-assessment) to assess psychological factors. We analyzed their relative impact on Social Functioning Scale domains using hierarchical multiple regression analysis. Concerning the relationship between daily living and negative symptoms, cognitive function showed the highest association with residential outcomes, such as self-care and shopping, while avolition appeared to show an additional contribution; however, for recreational outcomes, avolition showed the main association, whereas cognitive function showed no additional contribution. For social outcomes, asociality and negative self-assessment showed the main associations, while vocational outcomes were determined by both cognitive function and multiple negative symptoms, such as avolition, anhedonia, asociality, and alogia. Since negative symptom domains appear to differentially impact each outcome, specifically daily living outcome, it is important to evaluate the residential outcomes and recreational outcomes separately. Overall, the present study points to the importance of formulating psychosocial treatment strategies specific for each type of preferred outcome in patients with schizophrenia.
{"title":"Impact of Negative Symptom Domains and Other Clinical Characteristics on Functional Outcomes in Patients with Schizophrenia.","authors":"Hiroki Okada, Dsisuke Hirano, Takamichi Taniguchi","doi":"10.1155/2021/8864352","DOIUrl":"10.1155/2021/8864352","url":null,"abstract":"<p><p>Negative symptoms of schizophrenia have generally been defined using five factors; however, few studies have examined the relationship between these five factors and functional outcomes. In addition, there is no definitive conclusion regarding the association between negative symptoms and various aspects of functional outcomes (daily living, social, and vocational). This study is aimed at examining the relationship between these five domains of negative symptoms and different functional outcomes. Patients diagnosed with chronic schizophrenia (<i>n</i> = 100) were selected for the evaluation. We used the Brief Negative Symptom Scale to assess negative symptoms, the Brief Psychiatric Rating Scale to assess positive symptoms, the Schizophrenia Cognition Rating Scale to assess cognition, and the Evaluative Beliefs Scale (negative self-assessment) to assess psychological factors. We analyzed their relative impact on Social Functioning Scale domains using hierarchical multiple regression analysis. Concerning the relationship between daily living and negative symptoms, cognitive function showed the highest association with residential outcomes, such as self-care and shopping, while avolition appeared to show an additional contribution; however, for recreational outcomes, avolition showed the main association, whereas cognitive function showed no additional contribution. For social outcomes, asociality and negative self-assessment showed the main associations, while vocational outcomes were determined by both cognitive function and multiple negative symptoms, such as avolition, anhedonia, asociality, and alogia. Since negative symptom domains appear to differentially impact each outcome, specifically daily living outcome, it is important to evaluate the residential outcomes and recreational outcomes separately. Overall, the present study points to the importance of formulating psychosocial treatment strategies specific for each type of preferred outcome in patients with schizophrenia.</p>","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"2021 ","pages":"8864352"},"PeriodicalIF":3.6,"publicationDate":"2021-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25451452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Schizophrenia is a complex disorder with many comorbid conditions. In this study, we used polygenic risk scores (PRSs) from schizophrenia and comorbid traits to explore consistent cluster structure in schizophrenia patients. With 10 comorbid traits, we found a stable 4-cluster structure in two datasets (MGS and SSCCS). When the same traits and parameters were applied for the patients in a clinical trial of antipsychotics, the CATIE study, a 5-cluster structure was observed. One of the 4 clusters found in the MGS and SSCCS was further split into two clusters in CATIE, while the other 3 clusters remained unchanged. For the 5 CATIE clusters, we evaluated their association with the changes of clinical symptoms, neurocognitive functions, and laboratory tests between the enrollment baseline and the end of Phase I trial. Class I was found responsive to treatment, with significant reduction for the total, positive, and negative symptoms (p = 0.0001, 0.0099, and 0.0028, respectively), and improvement for cognitive functions (VIGILANCE, p = 0.0099; PROCESSING SPEED, p = 0.0006; WORKING MEMORY, p = 0.0023; and REASONING, p = 0.0015). Class II had modest reduction of positive symptoms (p = 0.0492) and better PROCESSING SPEED (p = 0.0071). Class IV had a specific reduction of negative symptoms (p = 0.0111) and modest cognitive improvement for all tested domains. Interestingly, Class IV was also associated with decreased lymphocyte counts and increased neutrophil counts, an indication of ongoing inflammation or immune dysfunction. In contrast, Classes III and V showed no symptom reduction but a higher level of phosphorus. Overall, our results suggest that PRSs from schizophrenia and comorbid traits can be utilized to classify patients into subtypes with distinctive clinical features. This genetic susceptibility based subtyping may be useful to facilitate more effective treatment and outcome prediction.
{"title":"Polygenic Risk Scores for Subtyping of Schizophrenia.","authors":"Jingchun Chen, Travis Mize, Jain-Shing Wu, Elliot Hong, Vishwajit Nimgaonkar, Kenneth S Kendler, Daniel Allen, Edwin Oh, Alison Netski, Xiangning Chen","doi":"10.1155/2020/1638403","DOIUrl":"https://doi.org/10.1155/2020/1638403","url":null,"abstract":"<p><p>Schizophrenia is a complex disorder with many comorbid conditions. In this study, we used polygenic risk scores (PRSs) from schizophrenia and comorbid traits to explore consistent cluster structure in schizophrenia patients. With 10 comorbid traits, we found a stable 4-cluster structure in two datasets (MGS and SSCCS). When the same traits and parameters were applied for the patients in a clinical trial of antipsychotics, the CATIE study, a 5-cluster structure was observed. One of the 4 clusters found in the MGS and SSCCS was further split into two clusters in CATIE, while the other 3 clusters remained unchanged. For the 5 CATIE clusters, we evaluated their association with the changes of clinical symptoms, neurocognitive functions, and laboratory tests between the enrollment baseline and the end of Phase I trial. Class I was found responsive to treatment, with significant reduction for the total, positive, and negative symptoms (<i>p</i> = 0.0001, 0.0099, and 0.0028, respectively), and improvement for cognitive functions (VIGILANCE, <i>p</i> = 0.0099; PROCESSING SPEED, <i>p</i> = 0.0006; WORKING MEMORY, <i>p</i> = 0.0023; and REASONING, <i>p</i> = 0.0015). Class II had modest reduction of positive symptoms (<i>p</i> = 0.0492) and better PROCESSING SPEED (<i>p</i> = 0.0071). Class IV had a specific reduction of negative symptoms (<i>p</i> = 0.0111) and modest cognitive improvement for all tested domains. Interestingly, Class IV was also associated with decreased lymphocyte counts and increased neutrophil counts, an indication of ongoing inflammation or immune dysfunction. In contrast, Classes III and V showed no symptom reduction but a higher level of phosphorus. Overall, our results suggest that PRSs from schizophrenia and comorbid traits can be utilized to classify patients into subtypes with distinctive clinical features. This genetic susceptibility based subtyping may be useful to facilitate more effective treatment and outcome prediction.</p>","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"2020 ","pages":"1638403"},"PeriodicalIF":2.4,"publicationDate":"2020-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1638403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38247839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-31eCollection Date: 2020-01-01DOI: 10.1155/2020/5176834
Kalindi Bakshi, Eileen M Kemether
We used whole human genome microarray screening of highly enriched neuronal populations from two thalamic regions in postmortem samples from subjects with schizophrenia and controls to identify brain region-specific gene expression changes and possible transcriptional targets. The thalamic anterior nucleus is reciprocally connected to anterior cingulate, a schizophrenia-affected cortical region, and is also thought to be schizophrenia affected; the other thalamic region is not. Using two regions in the same subject to identify disease-relevant gene expression differences was novel and reduced intersubject heterogeneity of findings. We found gene expression differences related to miRNA-137 and other SZ-associated microRNAs, ELAVL1, BDNF, DISC-1, MECP2 and YWHAG associated findings, synapses, and receptors. Manual curation of our data may support transcription repression.
{"title":"Two Thalamic Regions Screened Using Laser Capture Microdissection with Whole Human Genome Microarray in Schizophrenia Postmortem Samples.","authors":"Kalindi Bakshi, Eileen M Kemether","doi":"10.1155/2020/5176834","DOIUrl":"https://doi.org/10.1155/2020/5176834","url":null,"abstract":"<p><p>We used whole human genome microarray screening of highly enriched neuronal populations from two thalamic regions in postmortem samples from subjects with schizophrenia and controls to identify brain region-specific gene expression changes and possible transcriptional targets. The thalamic anterior nucleus is reciprocally connected to anterior cingulate, a schizophrenia-affected cortical region, and is also thought to be schizophrenia affected; the other thalamic region is not. Using two regions in the same subject to identify disease-relevant gene expression differences was novel and reduced intersubject heterogeneity of findings. We found gene expression differences related to miRNA-137 and other SZ-associated microRNAs, ELAVL1, BDNF, DISC-1, MECP2 and YWHAG associated findings, synapses, and receptors. Manual curation of our data may support transcription repression.</p>","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"2020 ","pages":"5176834"},"PeriodicalIF":2.4,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5176834","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38073456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-24eCollection Date: 2020-01-01DOI: 10.1155/2020/3934680
Boki Kibru, Getachew Tesfaw, Demeke Demilew, Endalamaw Salelew
Background: The comorbidity of social anxiety disorder is very common in schizophrenia patients and affects almost all age groups. This social anxiety disorder negatively impacts the quality of life, medication adherence, and treatment outcomes of people with schizophrenia. It is not well recognized in clinical settings. Therefore, assessing social anxiety symptoms and its associated factors was significant to early intervention and management of schizophrenia patients in Ethiopia.
Methods: An institution-based cross-sectional study was conducted at Amanuel Mental Specialized Hospital in Addis Ababa, Ethiopia. Data collectors randomly recruited 423 schizophrenic patients by using the systematic sampling technique. A face-to-face interviewer-administered questionnaire was used to collect data. The standardized Liebowitz Social Anxiety Scale (LSAS) was employed to assess individual social anxiety symptoms. We computed bivariate and multivariate binary logistic regressions to identify factors associated with social anxiety symptoms. Statistical significance was declared at p < 0.05.
Results: The prevalence of social anxiety symptoms was 36.2% (95% CI: 31.50, 40.80). Male sex (AOR = 2.03, 95% CI: 1.20, 3.44), age of onset of schizophrenia (AOR = 1.91, 95% CI:1.17, 3.12), positive symptoms (AOR = 0.75, 95% CI:0.67, 0.83), depression/anxiety symptoms (AOR = 1.29, 95% CI: 1.18, 1.41), number of hospitalizations (AOR = 2.80, 95% CI:1.32, 5.80), and suicidal ideation (AOR = 0.44, 95% CI: 0.26, 0.74) were factors significantly associated with social anxiety symptoms at p < 0.05. p < 0.05.
Conclusion: The prevalence of social anxiety symptoms among schizophrenia patients was found to be high. Timely treatment of positive and depression/anxiety symptoms and suicide risk assessments and interventions need to be done to manage the problems.
{"title":"The Prevalence and Correlates of Social Anxiety Symptoms among People with Schizophrenia in Ethiopia: An Institution-Based Cross-Sectional Study.","authors":"Boki Kibru, Getachew Tesfaw, Demeke Demilew, Endalamaw Salelew","doi":"10.1155/2020/3934680","DOIUrl":"https://doi.org/10.1155/2020/3934680","url":null,"abstract":"<p><strong>Background: </strong>The comorbidity of social anxiety disorder is very common in schizophrenia patients and affects almost all age groups. This social anxiety disorder negatively impacts the quality of life, medication adherence, and treatment outcomes of people with schizophrenia. It is not well recognized in clinical settings. Therefore, assessing social anxiety symptoms and its associated factors was significant to early intervention and management of schizophrenia patients in Ethiopia.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted at Amanuel Mental Specialized Hospital in Addis Ababa, Ethiopia. Data collectors randomly recruited 423 schizophrenic patients by using the systematic sampling technique. A face-to-face interviewer-administered questionnaire was used to collect data. The standardized Liebowitz Social Anxiety Scale (LSAS) was employed to assess individual social anxiety symptoms. We computed bivariate and multivariate binary logistic regressions to identify factors associated with social anxiety symptoms. Statistical significance was declared at <i>p</i> < 0.05.</p><p><strong>Results: </strong>The prevalence of social anxiety symptoms was 36.2% (95% CI: 31.50, 40.80). Male sex (AOR = 2.03, 95% CI: 1.20, 3.44), age of onset of schizophrenia (AOR = 1.91, 95% CI:1.17, 3.12), positive symptoms (AOR = 0.75, 95% CI:0.67, 0.83), depression/anxiety symptoms (AOR = 1.29, 95% CI: 1.18, 1.41), number of hospitalizations (AOR = 2.80, 95% CI:1.32, 5.80), and suicidal ideation (AOR = 0.44, 95% CI: 0.26, 0.74) were factors significantly associated with social anxiety symptoms at <i>p</i> < 0.05. <i>p</i> < 0.05.</p><p><strong>Conclusion: </strong>The prevalence of social anxiety symptoms among schizophrenia patients was found to be high. Timely treatment of positive and depression/anxiety symptoms and suicide risk assessments and interventions need to be done to manage the problems.</p>","PeriodicalId":45388,"journal":{"name":"Schizophrenia Research and Treatment","volume":"2020 ","pages":"3934680"},"PeriodicalIF":2.4,"publicationDate":"2020-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3934680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37820253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}