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Elevated serum levels of homocysteine as an early prognostic factor of psychiatric disorders in children and adolescents. 血清同型半胱氨酸水平升高是儿童和青少年精神疾病的早期预后因素。
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2012-10-02 DOI: 10.1155/2012/373261
Laura Kevere, Santa Purvina, Daiga Bauze, Marcis Zeibarts, Raisa Andrezina, Arnis Rizevs, Sergejs Jelisejevs, Linda Piekuse, Madara Kreile, Indulis Purvins

Background and Goal. The aim was to examine the serum levels of homocysteine (Hcy) and their associations with the methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism in patients with schizophrenia and mood disorders as well as controls. Materials and Methods. There were 198 patients: 82 with schizophrenia spectrum disorders, 22 with mood disorders, and 94 controls. The level of Hcy was determined by an isocratic high-performance liquid chromatography system. MTHFR C677T polymorphism was analysed using the restriction fragment length polymorphism-polymerase chain reaction method. Results. The average level of Hcy was 11.94 ± 5.6 μmol/L for patients with schizophrenia, 11.65 ± 3.3 μmol/L for patients with affective disorders, versus 6.80 ± 2.93 μmol/L in a control. The highest level of Hcy has been observed in patients with episodic-recurrent course of schizophrenia (11.30 ± 7.74 μmol/L), paranoid schizophrenia continuous (12.76 ± 5.25 μmol/L), and in patients with affective disorders (11.65 ± 3.26 μmol/L). An association between the MTHFR gene C677T polymorphism and Hcy level was found by linear regression analysis (r = 1.41, P = 0.029). Conclusions. The data indicate a link between Hcy levels and schizophrenia and mood disorders. No associations between the level of Hcy in patients with schizophrenia and mood disorders and the MTHFR C677T polymorphism were found.

背景和目标。目的是检测同型半胱氨酸(Hcy)的血清水平及其与精神分裂症和情绪障碍患者以及对照组中亚甲基四氢叶酸还原酶(MTHFR)基因C677T多态性的关系。材料与方法。共有198名患者:82名患有精神分裂症谱系障碍,22名患有情绪障碍,94名对照组。采用等压高效液相色谱法测定Hcy含量。采用限制性内切片段长度多态性-聚合酶链反应法分析MTHFR C677T多态性。结果。精神分裂症患者的Hcy平均水平为11.94±5.6 μmol/L,情感性障碍患者的Hcy平均水平为11.65±3.3 μmol/L,对照组为6.80±2.93 μmol/L。Hcy水平在发作-复发型精神分裂症患者(11.30±7.74 μmol/L)、偏执型精神分裂症持续性患者(12.76±5.25 μmol/L)和情感性障碍患者(11.65±3.26 μmol/L)中最高。线性回归分析发现MTHFR基因C677T多态性与Hcy水平存在相关性(r = 1.41, P = 0.029)。结论。数据表明,Hcy水平与精神分裂症和情绪障碍之间存在联系。未发现精神分裂症和心境障碍患者的Hcy水平与MTHFR C677T多态性之间存在关联。
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引用次数: 24
Jumping to conclusions is associated with paranoia but not general suspiciousness: a comparison of two versions of the probabilistic reasoning paradigm. 妄下结论与偏执狂有关,但与一般多疑症无关:两种版本概率推理范式的比较。
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2012-10-18 DOI: 10.1155/2012/384039
Steffen Moritz, Niels Van Quaquebeke, Tania M Lincoln

Theoretical models ascribe jumping to conclusions (JTCs) a prominent role in the pathogenesis of paranoia. While many earlier studies corroborated this account, some newer investigations have found no or only small associations of the JTC bias with paranoid symptoms. The present study examined whether these inconsistencies in part reflect methodological differences across studies. The study was built upon the psychometric high-risk paradigm. A total of 1899 subjects from the general population took part in an online survey and were administered the Paranoia Checklist as well as one of two different variants of the probabilistic reasoning task: one variant with a traditional instruction (a) and one novel variant that combines probability estimates with decision judgments (b). Factor analysis of the Paranoia Checklist yielded an unspecific suspiciousness factor and a psychotic paranoia factor. The latter was significantly associated with scores indicating hasty decision making. Subjects scoring two standard deviations above the mean of the Paranoia Checklist showed an abnormal data-gathering style relative to subjects with normal scores. Findings suggest that the so-called decision threshold parameter is more sensitive than the conventional JTC index. For future research the specific contents of paranoid beliefs deserve more consideration in the investigation of decision making in schizophrenia as JTC seems to be associated with core psychosis-prone features of paranoia only.

理论模型认为,妄下结论(JTC)在妄想症的发病机制中起着重要作用。虽然许多早期研究证实了这一说法,但一些较新的调查发现,JTC偏差与偏执症状没有关联或关联很小。本研究探讨了这些不一致是否部分反映了不同研究在方法上的差异。本研究以心理测量高风险范式为基础。共有 1899 名来自普通人群的受试者参加了在线调查,并接受了妄想症检查表以及概率推理任务两种不同变体中的一种:一种是传统指令变体(a),另一种是将概率估计与决策判断相结合的新型变体(b)。妄想症检查表的因子分析得出了一个非特异性多疑因子和一个精神病性妄想因子。后者与表明决策草率的得分有明显关联。妄想症检查表得分高于平均值两个标准差的受试者与得分正常的受试者相比,表现出异常的数据收集风格。研究结果表明,所谓的决策阈值参数比传统的 JTC 指数更加敏感。在未来的研究中,由于 JTC 似乎只与偏执狂的核心精神病易发特征相关,因此在研究精神分裂症患者的决策制定时,应更多地考虑偏执信念的具体内容。
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引用次数: 0
Where Does Evidence from New Trials for Schizophrenia Fit with the Existing Evidence: A Case of the Emperor's New Clothes? 精神分裂症新试验的证据与现有证据在哪里相符:皇帝新衣的案例?
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2012-04-08 DOI: 10.1155/2012/625738
Mahesh Jayaram, Ranganath D Rattehalli, Clive E Adams

Advent of "atypical" antipsychotics has spawned new trials in the recent years and the number of such trial reports has been increasing exponentially. As clinicians we have been led to believe that "atypicals" are better than "typicals" despite the odd dissenting voice in academic and clinical circles. This has been largely ignored until the publication of two landmark, independent, pragmatic trials, Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) and Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS), which proved that thoughtfully chosen "typical" antipsychotics were as good as the newer "atypicals." We pooled "leaving the study early data" from Cochrane Reviews that existed before CATIE and CUtLASS and added data from CATIE and CUtLASS to the pool for a "before and after" comparison. Addition of CATIE and CUtLASS data only led to narrowing of the already existing confidence intervals, merely increasing precision, and decreasing the risk of Type II error. Perhaps surprisingly, CATIE and CUtLASS when pooled with the already existing data showed us that we had chosen to turn a blind eye to findings that already existed. This leads clinicians to question as to whether, in future, we need to feel less guilty about crying out early on that the emperor has no clothes on.

近年来,“非典型”抗精神病药物的出现催生了新的试验,此类试验报告的数量呈指数级增长。作为临床医生,我们一直被引导相信“非典型”比“典型”好,尽管在学术和临床圈子里有奇怪的反对声音。这在很大程度上被忽视了,直到两项具有里程碑意义的、独立的、实用的试验——精神分裂症研究中最新抗精神病药物的干预有效性临床抗精神病药物试验(CATIE)和成本效用(CUtLASS)的发表,证明了精心选择的“典型”抗精神病药物与较新的“非典型”抗精神病药物一样好。我们汇集了在CATIE和CUtLASS之前存在的Cochrane综述中的“早期离开研究数据”,并将CATIE和CUtLASS的数据加入到“前后”比较池中。CATIE和CUtLASS数据的增加只导致已经存在的置信区间的缩小,仅仅增加了精度,并降低了II型错误的风险。也许令人惊讶的是,当CATIE和CUtLASS与已经存在的数据结合在一起时,我们发现我们选择了对已经存在的发现视而不见。这让临床医生提出了一个问题:在未来,我们是否需要对过早地大喊“皇帝没穿衣服”感到不那么内疚?
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引用次数: 2
Progesterone and Cerebral Function during Emotion Processing in Men and Women with Schizophrenia. 精神分裂症患者情绪加工过程中黄体酮与脑功能的关系
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2012-02-15 DOI: 10.1155/2012/917901
Julie Champagne, Nadia Lakis, Josiane Bourque, Emmanuel Stip, Olivier Lipp, Adrianna Mendrek

Schizophrenia has been associated with disturbed levels of sex-steroid hormones, including estrogen and testosterone. In the present study we have examined the implication of a less studied hormone progesterone. Forty-three patients with schizophrenia (21 women) and 43 control participants (21 women) underwent functional MRI while viewing emotionally positive, negative, and neutral images. Blood samples were taken prior to the scanning session to evaluate progesterone levels. Simple regression analyses between levels of progesterone and brain activations associated with emotion processing were performed using SPM5. A positive correlation was found between progesterone levels and brain activations during processing of emotionally charged images in both healthy and schizophrenia men, but no significant relationship was revealed in women. These preliminary results indicate that progesterone is significantly associated with brain activations during processing of positive and negative affect in healthy and schizophrenia men, but not in women. Further investigation is warranted.

精神分裂症与性类固醇激素水平紊乱有关,包括雌激素和睾酮。在目前的研究中,我们研究了一种较少研究的激素黄体酮的含义。43名精神分裂症患者(21名女性)和43名对照参与者(21名女性)在观看情绪上积极、消极和中性的图像时进行了功能性MRI检查。在扫描前采集血液样本以评估孕酮水平。使用SPM5对孕激素水平和与情绪处理相关的大脑激活进行简单回归分析。在健康男性和精神分裂症男性中,黄体酮水平与处理充满情绪的图像时的大脑激活之间存在正相关,但在女性中没有发现显著的关系。这些初步结果表明,孕酮与健康男性和精神分裂症男性在处理积极和消极情绪时的大脑激活显著相关,但与女性无关。有必要进一步调查。
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引用次数: 22
Evaluation of factors affecting continuous performance test identical pairs version score of schizophrenic patients in a Japanese clinical sample. 日本临床样本中精神分裂症患者连续表现测试同对版本得分影响因素的评价。
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2012-04-02 DOI: 10.1155/2012/970131
Takayoshi Koide, Branko Aleksic, Tsutomu Kikuchi, Masahiro Banno, Kunihiro Kohmura, Yasunori Adachi, Naoko Kawano, Tetsuya Iidaka, Norio Ozaki

Aim. Cognitive impairment in schizophrenia strongly relates to social outcome and is a good candidate for endophenotypes. When we accurately measure drug efficacy or effects of genes or variants relevant to schizophrenia on cognitive impairment, clinical factors that can affect scores on cognitive tests, such as age and severity of symptoms, should be considered. To elucidate the effect of clinical factors, we conducted multiple regression analysis using scores of the Continuous Performance Test Identical Pairs Version (CPT-IP), which is often used to measure attention/vigilance in schizophrenia. Methods. We conducted the CPT-IP (4-4 digit) and examined clinical information (sex, age, education years, onset age, duration of illness, chlorpromazine-equivalent dose, and Positive and Negative Symptom Scale (PANSS) scores) in 126 schizophrenia patients in Japanese population. Multiple regression analysis was used to evaluate the effect of clinical factors. Results. Age, chlorpromazine-equivalent dose, and PANSS-negative symptom score were associated with mean d' score in patients. These three clinical factors explained about 28% of the variance in mean d' score. Conclusions. As conclusion, CPT-IP score in schizophrenia patients is influenced by age, chlorpromazine-equivalent dose and PANSS negative symptom score.

的目标。精神分裂症的认知障碍与社会结果密切相关,是一个很好的内表型候选者。当我们准确测量药物疗效或与精神分裂症相关的基因或变异对认知障碍的影响时,应考虑可能影响认知测试得分的临床因素,如年龄和症状的严重程度。为了阐明临床因素的影响,我们使用连续表现测试同对版本(CPT-IP)的分数进行多元回归分析,该分数通常用于衡量精神分裂症的注意/警觉性。方法。我们对126名日本精神分裂症患者进行了CPT-IP(4-4位数),并检查了临床信息(性别、年龄、受教育年限、发病年龄、病程、氯丙嗪当量剂量和阳性和阴性症状量表(PANSS)评分)。采用多元回归分析评价临床因素的影响。结果。年龄、氯丙嗪当量剂量和panss阴性症状评分与患者的平均d'评分相关。这三个临床因素解释了大约28%的平均d' score差异。结论。综上所述,精神分裂症患者CPT-IP评分受年龄、氯丙嗪当量剂量和PANSS阴性症状评分的影响。
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引用次数: 7
Psychosis and gender. 精神病和性别。
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2012-04-18 DOI: 10.1155/2012/694870
Susana Ochoa, Judith Usall, Jesús Cobo, Javier Labad, Jayashri Kulkarni
Psychosis, mainly schizophrenia, is a heterogeneous disorder with a great variability in its clinical presentation. This heterogeneity may be explained by the role of gender; thus a gender-based approach could help us to better define the disease. Gender differences in social functioning, age of onset, course of the illness, and other domains have been described by several authors, showing better functioning and improved outcome in women with schizophrenia. Moreover, several treatments are gender sensitive, with differences in treatment response depending upon gender. The estrogen hypothesis is one of the most interesting explanations for this gender difference. Estrogens could be useful for understanding the pathophysiology of the illness or tailoring specific gender-related treatments.
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引用次数: 3
High order linguistic features such as ambiguity processing as relevant diagnostic markers for schizophrenia. 高阶语言特征如歧义处理作为精神分裂症的相关诊断标记。
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2012-12-11 DOI: 10.1155/2012/825050
Daniel Ketteler, Anastasia Theodoridou, Simon Ketteler, Matthias Jäger

Due to the deficits of schizophrenic patients regarding the understanding of vague meanings (D. Ketteler and S. Ketteler (2010)) we develop a special test battery called HOLF (high order linguistic function test), which should be able to detect subtle linguistic performance deficits in schizophrenic patients. HOLF was presented to 40 schizophrenic patients and controls, focussing on linguistic features such as ambiguity, synonymy, hypero-/hyponymy, antinomy, and adages. Using the HOLF test battery we found that schizophrenic patients showed significant difficulties in discriminating ambiguities, hypero- and hyponymy, or synonymy compared to healthy controls. Antonyms and adages showed less significant results in comparing both groups. The more difficult a linguistic task was, the more confusion was measured in the schizophrenic group while healthy controls did not show significant problems in processing high order language tasks.

由于精神分裂症患者在模糊意义理解方面的缺陷(D. Ketteler and S. Ketteler(2010)),我们开发了一种特殊的测试电池,称为HOLF(高阶语言功能测试),它应该能够检测精神分裂症患者的微妙语言表现缺陷。对40名精神分裂症患者和对照组进行了HOLF研究,重点关注语言特征,如歧义、同义词、上下义、二律背反和格言。使用HOLF测试,我们发现与健康对照相比,精神分裂症患者在区分歧义、高义和低义或同义词方面表现出明显的困难。反义词和格言在两组比较中结果不显著。语言任务越困难,精神分裂症患者组的困惑程度越高,而健康对照组在处理高阶语言任务时没有表现出明显的问题。
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引用次数: 13
Intervention to prevent child custody loss in mothers with schizophrenia. 预防精神分裂症母亲丧失子女监护权的干预措施。
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2011-11-01 DOI: 10.1155/2012/796763
Mary V Seeman

Depending on jurisdiction, time period studied, and specifics of the population, approximately 50 percent of mothers who suffer from schizophrenia lose custody of their children. The aim of this paper is to recommend interventions aimed at preventing unnecessary custody loss. This paper reviews the social work, nursing, psychology, psychiatry, and law literature on mental illness and custody loss, 2000-2011. Recommendations to mothers are to (a) ensure family health (b) prevent psychotic relapse, (c) prepare in advance for crisis, (d) document daily parenting activities, (e) take advantage of available parenting resources, and f) become knowledgeable about legal issues that pertain to mental health and custody. From a policy perspective, child protection and adult mental health agencies need to dissolve administrative barriers and collaborate. Access to appropriate services will help mothers with schizophrenia to care appropriately for their children and allow these children to grow and develop within their family and community.

根据管辖权、研究时间和人口的具体情况,大约50%患有精神分裂症的母亲失去了孩子的监护权。本文的目的是建议干预措施,旨在防止不必要的监护损失。本文回顾了2000-2011年有关精神疾病和监护权丧失的社会工作、护理、心理学、精神病学和法律文献。对母亲的建议是:(a)确保家庭健康(b)防止精神病复发,(c)提前为危机做好准备,(d)记录日常养育活动,(e)利用现有的养育资源,以及f)了解与精神健康和监护有关的法律问题。从政策角度看,儿童保护机构和成人心理健康机构需要消除行政障碍,开展合作。获得适当的服务将有助于患有精神分裂症的母亲适当照顾她们的孩子,并使这些孩子能够在家庭和社区中成长和发展。
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引用次数: 60
Integrated treatment to achieve functional recovery for first-episode psychosis. 综合治疗以实现首发精神病的功能恢复。
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2012-05-10 DOI: 10.1155/2012/962371
Marcelo Valencia, Francisco Juarez, Hector Ortega

This study describes an integrated treatment approach that was implemented to enhance functional recovery in first-episode psychotic patients. Patients were randomized to two treatment conditions: either to an integrated treatment approach: pharmacotherapy, psychosocial treatment, and psychoeducation (experimental group: N = 39) or to medication alone (control group: N = 34). Patients were evaluated at baseline and after one year of treatment. Functional recovery was assessed according to symptomatic and functional remission. At the end of treatment, experimental patients showed a 94.9% of symptomatic remission compared to 58.8% of the control group. Functional remission was 56.4% for the experimental group and 3.6% for the control group, while 56.4% of the experimental group met both symptomatic and functional remission criteria and were considered recovered compared to 2.9% of the control group.

本研究描述了一种综合治疗方法,用于增强首发精神病患者的功能恢复。患者被随机分配到两种治疗条件:一种是综合治疗方法:药物治疗、社会心理治疗和心理教育(实验组:N = 39),另一种是单独用药(对照组:N = 34)。在基线和治疗一年后对患者进行评估。根据症状和功能缓解评估功能恢复。在治疗结束时,实验组患者症状缓解率为94.9%,而对照组为58.8%。实验组的功能缓解率为56.4%,对照组为3.6%,而实验组中56.4%的人同时满足症状和功能缓解标准,被认为已经康复,而对照组的这一比例为2.9%。
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引用次数: 33
Cognitive control and discourse comprehension in schizophrenia. 精神分裂症患者的认知控制与话语理解。
IF 2.4 Q3 Medicine Pub Date : 2012-01-01 Epub Date: 2012-04-08 DOI: 10.1155/2012/484502
Megan A Boudewyn, Cameron S Carter, Tamara Y Swaab

Cognitive deficits across a wide range of domains have been consistently observed in schizophrenia and are linked to poor functional outcome (Green, 1996; Carter, 2006). Language abnormalities are among the most salient and include disorganized speech as well as deficits in comprehension. In this review, we aim to evaluate impairments of language processing in schizophrenia in relation to a domain-general control deficit. We first provide an overview of language comprehension in the healthy human brain, stressing the role of cognitive control processes, especially during discourse comprehension. We then discuss cognitive control deficits in schizophrenia, before turning to evidence suggesting that schizophrenia patients are particularly impaired at processing meaningful discourse as a result of deficits in control functions. We conclude that domain-general control mechanisms are impaired in schizophrenia and that during language comprehension this is most likely to result in difficulties during the processing of discourse-level context, which involves integrating and maintaining multiple levels of meaning. Finally, we predict that language comprehension in schizophrenia patients will be most impaired during discourse processing. We further suggest that discourse comprehension problems in schizophrenia might be mitigated when conflicting information is absent and strong relations amongst individual words are present in the discourse context."There is no "centre of Speech" in the brain any more than there is a faculty of Speech in the mind.The entire brain, more or less, is at work in a man who uses language"William JamesFrom The Principles of Psychology, 1890"The mind in dementia praecox is like an orchestra without a conductor"Kraepelin, 1919.

在精神分裂症中一直观察到广泛领域的认知缺陷,并与不良的功能结果有关(Green, 1996;卡特,2006)。语言异常是其中最突出的,包括语言紊乱和理解缺陷。在这篇综述中,我们的目的是评估精神分裂症的语言处理障碍与领域一般控制缺陷的关系。我们首先概述了健康人脑中的语言理解,强调了认知控制过程的作用,特别是在话语理解过程中。然后,我们讨论了精神分裂症的认知控制缺陷,然后转向证据表明,精神分裂症患者在处理有意义的话语方面特别受损,这是控制功能缺陷的结果。我们的结论是,精神分裂症患者的领域-一般控制机制受损,而在语言理解过程中,这很可能导致在话语层面语境的处理过程中出现困难,这涉及到整合和维持多层次的意义。最后,我们预测精神分裂症患者的语言理解将在语篇加工中受到最大的损害。我们进一步认为,当话语语境中不存在相互冲突的信息,并且单个词语之间存在强烈的联系时,精神分裂症的话语理解问题可能会得到缓解。大脑中没有“语言中心”,正如心灵中没有语言能力一样。“在一个会使用语言的人身上,整个大脑或多或少都在工作。”威廉·詹姆斯摘自《心理学原理》,1890年“早发性痴呆患者的大脑就像一支没有指挥的管弦乐队”,克雷佩林,1919年。
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引用次数: 25
期刊
Schizophrenia Research and Treatment
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