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Adherence to Typical Antipsychotics among Patients with Schizophrenia in Uganda: A Cross-Sectional Study. 乌干达精神分裂症患者对典型抗精神病药物的依从性:一项横断面研究。
IF 3.6 Q1 PSYCHIATRY Pub Date : 2023-02-03 eCollection Date: 2023-01-01 DOI: 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.

背景:在治疗精神分裂症方面,最近出现了从典型抗精神病药物向非典型抗精神病药物过渡的趋势。这是因为服用典型抗精神病药物的患者会出现急性副作用,导致患者不坚持治疗。然而,使用典型抗精神病药物的治疗成本更低(低收入环境中的首选),而且非典型抗精神病药物在有效性、疗效、停药率或副作用症状负担方面没有差异。本研究旨在确定在乌干达农村三级医疗机构精神科门诊就诊的精神分裂症患者对典型抗精神病药物不依从的发生率及相关因素:对乌干达一家农村三级医疗机构的 135 名服用典型抗精神病药物至少六个月的精神分裂症患者(平均年龄为 39.7 岁 (±11.9),55.6% 为女性)进行横断面研究。收集的数据涉及社会人口学、依从性、对精神病的洞察力、对典型抗精神病药物的态度、副作用、对药物的满意度以及医护人员对药物和副作用的解释。采用逻辑回归法确定与不依从性相关的因素:不坚持服药的比例为 16.3%,穷人(月收入低于贫困线)不坚持服药的可能性更大。然而,能量减少与降低不坚持服药的可能性有关:结论:不依从的发生率低于许多以前获得的发生率,与不依从非典型抗精神病药物的发生率相当。然而,为了减少不依从性,我们需要所有利益相关者(如政府、保险公司和护理人员)帮助贫困患者获得药物治疗。
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引用次数: 0
Investigating Body Mass Index and Body Composition in Patients with Schizophrenia: A Case-Control Study 调查精神分裂症患者的身体质量指数和身体成分:一项病例对照研究
IF 2.4 Q1 PSYCHIATRY Pub Date : 2022-02-27 DOI: 10.1155/2022/1381542
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.
背景:抗精神病药物会产生代谢副作用,长期服用抗精神病药物会导致体重和肌肉成分的变化。然而,关于精神分裂症患者身体成分变化的报道有限。本研究旨在比较印度尼西亚精神分裂症患者与健康人的身体质量指数和身体成分。方法共招募195例精神分裂症患者(男148例,女47例)和195名按性别匹配的健康人。采用生物电阻抗分析方法,测量参与者的身体成分。结果与健康个体相比,患者组表现出更高的体重不足率,以及更低的超重和肥胖率。多元回归分析证实了身体质量指数与所有测量的身体成分之间的关联。此外,精神分裂症的诊断与较低的肌肉量、较低的骨量、较高的基础代谢率、较老的代谢年龄和较高的全身水分显著相关。结论精神分裂症患者身体成分中某些成分质量较差的风险较大。应该优先研究如何提高病人的体力活动水平。
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引用次数: 3
Cigarette Smoking and Schizophrenia: Etiology, Clinical, Pharmacological, and Treatment Implications. 吸烟与精神分裂症:病因学、临床、药理学和治疗意义。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2021-12-13 eCollection Date: 2021-01-01 DOI: 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.

最近的数据表明,精神分裂症患者的吸烟率仍然很高。虽然有报告表明吸烟会增加患精神分裂症的风险,但吸烟在这种关系中的潜在致病作用还需要进一步调查。与不吸烟的精神分裂症患者相比,吸烟的精神分裂症患者更有可能出现更强烈的阳性症状和更低的认知功能,但锥体外系副作用的强度更低。与不吸烟者相比,他们也更有可能表现出攻击性行为,这可能表明他们的基线攻击性水平更高。与定期烟草支出相关的巨额费用可能减损对关键领域的投资。大规模试验表明,药物治疗戒烟是有效的,与安慰剂相比,不会加重神经精神症状的风险。精神分裂症患者中电子烟的使用率很高,并且有新出现的证据支持其有效性。未来的改进包括评估精神分裂症患者使用电子烟的效用、有效性和安全性的大规模试验。
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引用次数: 11
Comparison of Efficacy and Safety between Long-Acting Injectable Antipsychotic Monotherapy and Combination of Long-Acting Injectable and Oral Antipsychotics in Patients with Schizophrenia. 精神分裂症患者长效注射抗精神病药物单药治疗与长效注射口服抗精神病药物联合治疗的疗效和安全性比较。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2021-11-25 eCollection Date: 2021-01-01 DOI: 10.1155/2021/8403986
Thanompong Sathienluckana, Pornyupa Tiangpattanawong, Karnpreena Chaiyasukthananoan, Pannapat Jittayanan, Hathaipat Sawetwangsing, Punyawee Puchsaka

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.

背景:长效注射(LAI)抗精神病药物被用作精神分裂症患者的单药治疗。然而,在临床实践中,LAI与口服抗精神病药物的联合使用是常用的,尽管与LAI抗精神病药物单一治疗相比,这种联合使用的有效性和安全性的研究非常有限。目的:比较LAI单药治疗精神分裂症患者与LAI联合口服抗精神病药物治疗的疗效和安全性。方法:本研究采用回顾性队列研究,将符合条件的患者分为LAI抗精神病单药组和LAI联合口服抗精神病药组。主要结局是两组间的住院情况。研究的持续时间为2年。结果:共86例患者完成研究并进行分析(LAI抗精神病单药治疗组:n = 25;LAI联合口服抗精神病药组:n = 61)。两组住院率差异无统计学意义(P = 1.000)。其他结局方面,两组全因停药(P = 0.667)和药物不良反应(P = 0.732)均无显著差异。结论:LAI单药治疗精神分裂症患者的疗效和安全性与LAI联合口服抗精神病药物相似。因此,临床上常用的LAI与口服抗精神病药物联合使用可能没有必要。
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引用次数: 3
Homocysteine in Schizophrenia: Independent Pathogenetic Factor with Prooxidant Activity or Integral Marker of Other Biochemical Disturbances? 同型半胱氨酸与精神分裂症:具有促氧化活性的独立致病因子还是其他生化紊乱的整体标志?
IF 2.4 Q1 PSYCHIATRY Pub Date : 2021-10-13 eCollection Date: 2021-01-01 DOI: 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。
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引用次数: 6
Suicide Behavior and Its Predictors in Patients with Schizophrenia in Ethiopia. 埃塞俄比亚精神分裂症患者的自杀行为及其预测因素。
IF 3.6 Q1 PSYCHIATRY Pub Date : 2021-04-01 eCollection Date: 2021-01-01 DOI: 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.

背景:精神分裂症(PWS)患者的自杀风险更大。然而,PWS 患者的自杀行为往往被忽视,特征描述不充分,也没有被持续纳入治疗中。尽管埃塞俄比亚存在这种负担和后果,但有关 PWS 患者自杀行为的研究却十分匮乏。因此,本研究旨在评估埃塞俄比亚PWS中自杀行为的严重程度及其预测因素:方法:采用基于机构的横断面研究。研究采用结构化访谈问卷的形式,从 Amanuel 精神专科医院(AMSH)的 300 名 PWS 抽样中收集数据。修订版自杀行为问卷(SBQ-R)用于评估精神病患者的自杀行为。数据收集时间为2019年3月1日至30日。在95%的置信水平下,进行二元逻辑回归以确定自杀行为的独立预测因素。统计显著性以P值结果为准:共有 300 名精神分裂症患者参与了研究。在 203 名参与者中,超过三分之二(67.7%)为男性,116 名参与者(38.7%)的年龄在 28 岁至 37 岁之间。我们发现,PWS 患者的自杀行为发生率为 30.3%。失业(AOR = 3.65,CI = 1.32,10.05)、自杀家族史(AOR = 3.16,CI = 1.38,7.23)、药物使用(AOR = 2.51,CI = 1.13,5.59)、当前阳性精神病症状(幻觉(AOR = 6.39, CI = 2.86, 14.29)和妄想(AOR = 4.15, CI = 1.95, 14.29)以及合并抑郁症(AOR = 4.81, CI = 1.98, 11.68)是PWS患者自杀行为的独立显著预测因素:结论:PWS 中自杀行为的发生率很高。因此,设计早期筛查和干预策略是预防PWS自杀的最关键策略。
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引用次数: 0
Impact of Negative Symptom Domains and Other Clinical Characteristics on Functional Outcomes in Patients with Schizophrenia. 消极症状领域和其他临床特征对精神分裂症患者功能结果的影响。
IF 3.6 Q1 PSYCHIATRY Pub Date : 2021-02-20 eCollection Date: 2021-01-01 DOI: 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.

精神分裂症的阴性症状一般用五个因素来定义,但很少有研究对这五个因素与功能结果之间的关系进行研究。此外,关于阴性症状与各方面功能结果(日常生活、社交和职业)之间的关系也没有明确的结论。本研究旨在探讨阴性症状的这五个方面与不同功能结果之间的关系。我们选择了被诊断为慢性精神分裂症的患者(n = 100)进行评估。我们使用简明阴性症状量表来评估阴性症状,使用简明精神病评定量表来评估阳性症状,使用精神分裂症认知评定量表来评估认知,使用评价性信念量表(阴性自评)来评估心理因素。我们采用分层多元回归分析法分析了它们对社会功能量表各领域的相对影响。关于日常生活与消极症状之间的关系,认知功能与居住结果(如自理和购物)的关联度最高,而逃避似乎有额外的贡献;然而,对于娱乐结果,逃避显示了主要的关联,而认知功能没有显示额外的贡献。在社交结果方面,非社会性和消极的自我评估显示出主要的关联,而职业结果则取决于认知功能和多种消极症状,如逃避、失乐症、非社会性和焦虑症。由于阴性症状领域似乎对每种结果(尤其是日常生活结果)都有不同的影响,因此必须分别评估居住结果和娱乐结果。总之,本研究表明,针对精神分裂症患者偏好的每种治疗结果制定专门的心理社会治疗策略非常重要。
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引用次数: 0
Polygenic Risk Scores for Subtyping of Schizophrenia. 精神分裂症亚型的多基因风险评分。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2020-07-23 eCollection Date: 2020-01-01 DOI: 10.1155/2020/1638403
Jingchun Chen, Travis Mize, Jain-Shing Wu, Elliot Hong, Vishwajit Nimgaonkar, Kenneth S Kendler, Daniel Allen, Edwin Oh, Alison Netski, Xiangning Chen

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.

精神分裂症是一种复杂的疾病,有许多合并症。在这项研究中,我们使用来自精神分裂症和共病特征的多基因风险评分(PRSs)来探索精神分裂症患者中一致的聚类结构。我们在两个数据集(MGS和SSCCS)中发现了10个共病特征的稳定的4簇结构。当相同的特征和参数应用于抗精神病药物临床试验的患者时,CATIE研究,观察到一个5簇结构。在MGS和SSCCS中发现的4个簇中的一个在CATIE中进一步分成两个簇,而其他3个簇保持不变。对于5个CATIE集群,我们评估了它们在入组基线和I期试验结束期间与临床症状、神经认知功能和实验室测试变化的相关性。I类患者对治疗有反应,总症状、阳性症状和阴性症状显著减少(p分别= 0.0001、0.0099和0.0028),认知功能改善(警惕性,p = 0.0099;处理速度,p = 0.0006;工作记忆,p = 0.0023;推理,p = 0.0015)。II类患者阳性症状轻度减轻(p = 0.0492),处理速度更快(p = 0.0071)。IV类患者的阴性症状明显减少(p = 0.0111),所有测试领域的认知能力均有适度改善。有趣的是,IV类也与淋巴细胞计数减少和中性粒细胞计数增加有关,这是持续炎症或免疫功能障碍的指示。相比之下,III类和V类没有症状减轻,但磷水平较高。总的来说,我们的研究结果表明,精神分裂症的PRSs和共病特征可以用来将患者分为具有不同临床特征的亚型。这种基于遗传易感性的亚型可能有助于促进更有效的治疗和预后预测。
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引用次数: 6
Two Thalamic Regions Screened Using Laser Capture Microdissection with Whole Human Genome Microarray in Schizophrenia Postmortem Samples. 用全基因组微阵列激光捕获显微解剖筛选精神分裂症死后样本的两个丘脑区域。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2020-05-31 eCollection Date: 2020-01-01 DOI: 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.

我们使用全人类基因组微阵列筛选来自精神分裂症患者和对照组死后样本的两个丘脑区域的高度富集的神经元群,以确定大脑区域特异性基因表达变化和可能的转录靶点。丘脑前核与前扣带相互连接,前扣带是受精神分裂症影响的皮质区域,也被认为是受精神分裂症影响的;另一个丘脑区域则不是。在同一受试者中使用两个区域来确定疾病相关基因表达差异是新颖的,并且减少了结果的受试者间异质性。我们发现与miRNA-137和其他sz相关的microrna、ELAVL1、BDNF、DISC-1、MECP2和YWHAG相关的发现、突触和受体相关的基因表达差异。手动管理我们的数据可能支持转录抑制。
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引用次数: 2
The Prevalence and Correlates of Social Anxiety Symptoms among People with Schizophrenia in Ethiopia: An Institution-Based Cross-Sectional Study. 埃塞俄比亚精神分裂症患者社交焦虑症状的患病率及其相关因素:一项基于机构的横断面研究
IF 2.4 Q1 PSYCHIATRY Pub Date : 2020-03-24 eCollection Date: 2020-01-01 DOI: 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.

背景:社交焦虑障碍的合并症在精神分裂症患者中非常常见,几乎影响所有年龄组。这种社交焦虑障碍对精神分裂症患者的生活质量、药物依从性和治疗结果产生负面影响。它在临床环境中没有得到很好的认识。因此,评估社交焦虑症状及其相关因素对埃塞俄比亚精神分裂症患者的早期干预和管理具有重要意义。方法:在埃塞俄比亚亚的斯亚贝巴的Amanuel精神专科医院进行了一项基于机构的横断面研究。数据采集人员采用系统抽样法随机抽取423例精神分裂症患者。采用面对面访谈问卷收集数据。采用标准化Liebowitz社交焦虑量表(LSAS)评估个体社交焦虑症状。我们计算了双变量和多变量二元逻辑回归来确定与社交焦虑症状相关的因素。p < 0.05,差异有统计学意义。结果:社交焦虑症状的患病率为36.2% (95% CI: 31.50, 40.80)。男性(AOR = 2.03, 95% CI: 1.20, 3.44)、精神分裂症发病年龄(AOR = 1.91, 95% CI:1.17, 3.12)、阳性症状(AOR = 0.75, 95% CI:0.67, 0.83)、抑郁/焦虑症状(AOR = 1.29, 95% CI: 1.18, 1.41)、住院次数(AOR = 2.80, 95% CI:1.32, 5.80)和自杀意念(AOR = 0.44, 95% CI: 0.26, 0.74)是与社交焦虑症状显著相关的因素,p < 0.05。P < 0.05。结论:精神分裂症患者存在较高的社交焦虑症状。需要及时治疗阳性症状和抑郁/焦虑症状,并进行自杀风险评估和干预,以管理这些问题。
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引用次数: 2
期刊
Schizophrenia Research and Treatment
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