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Lack of Association between the IL6R Gene Asp358Ala Variant (rs2228145), IL-6 Plasma Levels, and Treatment Resistance in Chilean Schizophrenic Patients Treated with Clozapine 智利精神分裂症患者il - 6r基因Asp358Ala变异(rs2228145)、IL-6血浆水平和氯氮平治疗抵抗之间缺乏相关性
IF 2.4 Q3 Medicine Pub Date : 2019-06-25 DOI: 10.1155/2019/5601249
Álvaro Cavieres, C. Campos-Estrada, Y. Moya, Rocío Maldonado, R. González-Vargas, M. Bustamante, P. Moya
Alterations in neuroinflammatory processes have been suggested to contribute to the development of Schizophrenia (SZ); one component of the inflammatory system that has been linked to this disorder is interleukin-6 (IL-6). The minor allele of rs2228145, a functional polymorphism in the IL-6 receptor gene, has been associated to elevated IL-6 plasma levels and increased inflammatory activity, making it an interesting candidate to study as a possible factor underlying clinical heterogeneity in SZ. We studied a sample of 100 patients undergoing treatment with clozapine. Their symptoms were quantified by Brief Psychotic Rating Scale; those with the lowest scores (“remitted”) were compared with the highest (“clozapine treatment resistant”). We determined allelic frequencies for rs2228145 and IL-6 plasma levels. Our results do not support a role of IL-6 in response to treatment with clozapine. Further studies accounting for potential confounding factors are necessary.
神经炎症过程的改变被认为有助于精神分裂症的发展(SZ);与这种疾病有关的炎症系统的一个组成部分是白细胞介素-6 (IL-6)。rs2228145的次要等位基因是IL-6受体基因的一种功能多态性,与IL-6血浆水平升高和炎症活性增加有关,这使其成为SZ临床异质性的一个有趣的候选因素。我们研究了100名接受氯氮平治疗的患者。用简易精神病评定量表对患者的症状进行量化;将得分最低(“缓解”)的患者与得分最高(“氯氮平治疗抵抗”)的患者进行比较。我们测定了rs2228145和IL-6血浆水平的等位基因频率。我们的结果不支持IL-6在氯氮平治疗反应中的作用。考虑潜在的混杂因素的进一步研究是必要的。
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引用次数: 3
Attitude towards Antipsychotic Medications in Patients Diagnosed with Schizophrenia: A Cross-Sectional Study at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. 精神分裂症患者对抗精神病药物的态度:埃塞俄比亚亚的斯亚贝巴Amanuel精神专科医院的横断面研究
IF 2.4 Q3 Medicine Pub Date : 2019-05-22 eCollection Date: 2019-01-01 DOI: 10.1155/2019/5094017
Tilahun Kassew, Demeke Demilew, Addis Birhanu, Mesele Wonde, Biks Liyew, Shegaye Shumet

Background: Poor attitude towards antipsychotic drugs is high, and it is a factor for non-adherence to treatment. This increases the risk of relapse, associated healthcare utilization, and costs. This study aimed to assess attitude towards antipsychotic medication among patients with schizophrenia.

Objectives: The aim of this institution based cross-sectional study was to assess attitude towards antipsychotic medications and associated factors among patients with schizophrenia who attend the outpatient clinics at Amanuel Mental Specialized Hospital, 2018.

Methods: In a cross-sectional study, 393 schizophrenic patients from Amanuel Mental Specialized Hospital were recruited by a systematic random sampling technique. Drug Attitude Inventory (DAI-10) was used to assess attitude, experience, and belief about antipsychotics. Glasgow antipsychotic side effect scale modified version, positive and negative syndrome scale, and Birch wood's insight scale for psychosis were the instruments used to assess the associated factors. Simple and multiple linear regression analysis models were fitted, and the adjusted unstandardized beta (β) coefficient at 95% confidence interval was used.

Results: The mean score of attitude towards antipsychotic medications was 6.51 with standard deviation (SD) of 2.22. In multiple linear regression, positive symptoms (β= -0.07, 95% CI: (-0.09, -0.05)), negative symptoms (β= -0.04, 95% CI: (-0.06,-0.02)), shorter (≤5 years) duration of illness (β= -0.39, 95% CI: (-0.63, -0.15)), first generation antipsychotics (β = -0.35, 95% CI: (-0.55,-0.14)), having sedation (β= -0.28, 95% CI: (-0.52, -0.02)), and extra-pyramidal side effects (β= -0.34, 95% CI: (-0.59,-0.09)) were factors negatively associated with attitude towards antipsychotic medication treatment. Insight to illness (β= 0.24, 95% CI: (0.20, 0.27) was a factor positively associated with attitude towards antipsychotic medications.

Conclusion: The result suggests that the mean score of participants' attitude towards antipsychotic medications was good. Prevention of side effects particularly due to first generation antipsychotics is necessary.

背景:对抗精神病药物的不良态度很高,这是导致不坚持治疗的一个因素。这增加了复发的风险、相关的医疗保健利用和成本。本研究旨在评估精神分裂症患者对抗精神病药物的态度。目的:本基于机构的横断面研究旨在评估2018年在Amanuel精神专科医院门诊就诊的精神分裂症患者对抗精神病药物的态度及其相关因素。方法:采用系统随机抽样方法,对来自Amanuel精神专科医院的393例精神分裂症患者进行横断面研究。采用药物态度量表(DAI-10)评估患者对抗精神病药物的态度、经验和信念。采用改良版格拉斯哥抗精神病药物副作用量表、阳性和阴性症状量表、桦木精神病洞察力量表评估相关因素。拟合简单和多元线性回归分析模型,采用95%置信区间调整后的非标准化β (β)系数。结果:患者对抗精神病药物态度的平均得分为6.51分,标准差为2.22分。在多元线性回归中,阳性症状(β= -0.07,95%置信区间CI:(-0.09, -0.05),阴性症状(β= -0.04,95%置信区间CI:(-0.06, -0.02),(≤5年)持续时间短的疾病(β= -0.39,95%置信区间CI:(-0.63, -0.15),第一代抗精神病药物(β= -0.35,95%置信区间CI:(-0.55, -0.14)),有镇静(β= -0.28,95%置信区间CI:(-0.52, -0.02),和extra-pyramidal副作用(β= -0.34,95%置信区间CI:(-0.59, -0.09))是负面因素与态度有关抗精神病药物治疗。对疾病的认识(β= 0.24, 95% CI:(0.20, 0.27)与对抗精神病药物的态度呈正相关。结论:调查结果显示,被试对抗精神病药物的态度平均得分较好。预防副作用,特别是由于第一代抗精神病药物是必要的。
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引用次数: 10
Assessing the Relationship between Performance on the University of California Performance Skills Assessment (UPSA) and Outcomes in Schizophrenia: A Systematic Review and Evidence Synthesis. 评估加州大学表现技能评估(UPSA)与精神分裂症预后之间的关系:系统回顾和证据综合。
IF 2.4 Q3 Medicine Pub Date : 2018-12-27 eCollection Date: 2018-01-01 DOI: 10.1155/2018/9075174
Shelagh Szabo, Elizabeth Merikle, Greta Lozano-Ortega, Lauren Powell, Thomas Macek, Stephanie Cline

Objective: To perform a systematic review of the published literature to evaluate how functional capacity, as measured by the University of California at San Diego (UCSD) Performance-based Skills Assessment (UPSA), relates to other functional measures and real-world outcomes among individuals with schizophrenia.

Methods: The MEDLINE® and Embase® databases were searched to identify joint evaluations with UPSA and key functional outcomes (functional scale measures; generic or disease-specific, health-related quality of life [HRQoL]; or real-world outcomes [residential status; employment status]) in patients with schizophrenia. Pearson correlations were estimated between UPSA scores, HRQoL, other functional scale measures, and real-world outcomes, for outcomes described in at least six studies.

Results: The synthesis included 76 studies that provided 73 unique data sets. Quantitative assessment between the Specific Level of Function (SLOF) (n=18) scores and UPSA scores demonstrated a moderate borderline-significant correlation (0.45, p=0.06). Quantitative analysis of the relationship between the Global Assessment of Functioning (GAF) (n=11) and the Multidimensional Scale of Independent Functioning (MSIF) (n=6) scales revealed moderate and small nonsignificant Pearson correlations of -0.34 (p=0.31) and 0.12 (p=0.83), respectively. There was a small borderline-significant correlation between UPSA score and residential status (n=36; 0.31; p=0.08), while no correlation was found between UPSA score and employment status (n=19; 0.04; p=0.88).

Conclusion: The SLOF was the most often used functional measure and had the strongest observed correlation with the UPSA. Although knowledge gaps remain, evidence from this review indicates that there is a quantitative relationship between functional capacity and real-world outcomes in individuals with schizophrenia.

目的:对已发表的文献进行系统回顾,以评估加州大学圣地亚哥分校(UCSD)基于绩效的技能评估(UPSA)所测量的功能能力与精神分裂症患者的其他功能测量和现实世界结果之间的关系。方法:检索MEDLINE®和Embase®数据库,以确定与UPSA和关键功能结局(功能量表测量;一般或疾病特异性、与健康相关的生活质量[HRQoL];或者现实世界的结果[居住状态;精神分裂症患者的就业状况。对于至少六项研究中描述的结果,估计了UPSA评分、HRQoL、其他功能量表测量和现实世界结果之间的Pearson相关性。结果:综合包括76项研究,提供73个独特的数据集。特定功能水平(SLOF)评分(n=18)与UPSA评分之间的定量评估显示中度临界显著相关(0.45,p=0.06)。对整体功能评估(GAF) (n=11)和多维独立功能量表(MSIF) (n=6)量表之间关系的定量分析显示,中度和轻度无显著Pearson相关性分别为-0.34 (p=0.31)和0.12 (p=0.83)。UPSA评分与居住状况之间存在较小的临界显著相关性(n=36;0.31;p=0.08),而UPSA得分与就业状况无相关性(n=19;0.04;p = 0.88)。结论:SLOF是最常用的功能测量,与UPSA的相关性最强。尽管知识差距仍然存在,但本综述的证据表明,精神分裂症患者的功能能力与现实世界的结果之间存在定量关系。
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引用次数: 5
Effectiveness of Integrated Neurocognitive Therapy on Cognitive Impairment and Functional Outcome for Schizophrenia Outpatients. 综合神经认知治疗对精神分裂症门诊患者认知功能障碍的影响。
IF 2.4 Q3 Medicine Pub Date : 2018-10-21 eCollection Date: 2018-01-01 DOI: 10.1155/2018/2360697
Andreana De Mare, Miriam Cantarella, Giovanni Galeoto

Cognitive impairment is highly prevalent in patients with schizophrenia and schizoaffective disorder. Many interventions have been developed to treat cognitive deficit, since it has a strong impact on functional outcome; however, there are no integrated interventions targeting multiple neuro- and social-cognitive domains with a particular focus on the generalization of the effects of therapy on the functional outcome. Recently, a group of experts has developed a cognitive remediation group therapy approach called Integrated Neurocognitive Therapy (INT), which includes exercises to improve the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) neuro- and social-cognitive domains. This systematic review and meta-analysis aimed to assess the efficacy of this approach. We conducted a search of PubMed, Scopus, Web of Science, and PsycINFO to select primary studies evaluating INT in schizophrenic and schizoaffective patients. The primary outcomes of the meta-analysis included negative and positive symptoms and global functioning. Two randomized controlled trials met inclusion criteria. A total of 217 participants were included. Based on the results from the Positive and Negative Syndrome Scale (PANSS), a significant pooled effect size was observed for negative symptoms, which demonstrated not only an improvement in the patients treated immediately after therapy but also a permanence of positive results at a 9-12-month follow-up. On the other hand, no significant effect size was observed for positive symptoms. In addition, a significant pooled effect size was found for Global Assessment of Functioning (GAF), which shows how INT's integrated approach has lasting positive implications on patients' functional outcome. We concluded that INT might be an effective treatment for negative symptoms and global functioning in patients with schizophrenia, compared to treatment as usual (TAU).

认知障碍在精神分裂症和分裂情感性障碍患者中非常普遍。许多干预措施已经开发出来治疗认知缺陷,因为它对功能结果有很强的影响;然而,目前还没有针对多个神经和社会认知领域的综合干预措施,特别关注治疗对功能结果的推广效果。最近,一组专家开发了一种认知修复小组治疗方法,称为综合神经认知疗法(INT),其中包括改善精神分裂症神经和社会认知领域的运动(测量和治疗研究以改善认知)。本系统综述和荟萃分析旨在评估该方法的有效性。我们对PubMed、Scopus、Web of Science和PsycINFO进行了检索,以选择评估精神分裂症和分裂情感性患者INT的初步研究。荟萃分析的主要结果包括阴性和阳性症状以及整体功能。两项随机对照试验符合纳入标准。共纳入217名参与者。根据阳性和阴性症状量表(PANSS)的结果,对阴性症状观察到显著的合并效应大小,这表明不仅在治疗后立即治疗的患者有所改善,而且在9-12个月的随访中也有永久性的阳性结果。另一方面,对阳性症状没有观察到显著的效应大小。此外,我们还发现了全球功能评估(GAF)的显著综合效应量,这表明INT的综合方法对患者的功能结果具有持久的积极影响。我们的结论是,与常规治疗(TAU)相比,INT可能是治疗精神分裂症患者阴性症状和整体功能的有效方法。
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引用次数: 11
Long-Acting Injectable Second-Generation Antipsychotics Improve Negative Symptoms and Suicidal Ideation in Recent Diagnosed Schizophrenia Patients: A 1-Year Follow-up Pilot Study. 长效注射第二代抗精神病药物改善新近诊断的精神分裂症患者的阴性症状和自杀意念:一项为期1年的随访试点研究
IF 2.4 Q3 Medicine Pub Date : 2018-08-30 eCollection Date: 2018-01-01 DOI: 10.1155/2018/4834135
Valentina Corigliano, Anna Comparelli, Iginia Mancinelli, Benedetta Montalbani, Dorian A Lamis, Antonella De Carolis, Denise Erbuto, Paolo Girardi, Maurizio Pompili
Long-acting injectable second-generation antipsychotics (LAI-SGA) are typically used to maintain treatment adherence in patients with chronic schizophrenia. Recent research suggests that they may also provide an effective treatment strategy for patients with early-phase disease. The aim of this study is to evaluate clinical and psychosocial outcomes among recent and long-term diagnosed schizophrenia outpatients treated with LAI-SGA during a follow-up period of 12 months. Stable schizophrenia patients receiving LAI-SGA with 5 or less years of illness duration (n = 10) were compared to those with more than 5 years of illness duration (n = 15). Clinical data was assessed through the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), the Columbia Suicide Severity Rating Scale (C-SSRS), the Recovery Style Questionnaire (RSQ), and the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) Managing Emotion branch. Recently diagnosed patients showed greater improvement versus patients diagnosed for more than 5 years in adjusted mean GAF score, in PANSS factor score for negative and depressive symptoms, and in severity and intensity of suicidal ideation. Our preliminary findings support the hypothesis that LAI-SGA may influence the course of the illness if administered at the early phase of the illness. However, replicate studies are needed, possibly with larger samples.
长效注射第二代抗精神病药物(LAI-SGA)通常用于维持慢性精神分裂症患者的治疗依从性。最近的研究表明,它们也可能为早期疾病患者提供一种有效的治疗策略。本研究的目的是在12个月的随访期间评估近期和长期诊断为精神分裂症的门诊患者接受LAI-SGA治疗的临床和社会心理结果。接受LAI-SGA治疗的病程不超过5年的稳定精神分裂症患者(n = 10)与病程超过5年的患者(n = 15)进行比较。临床资料采用Positive and Negative Syndrome Scale (PANSS)、Global Assessment of Functioning (GAF)、Columbia自杀严重程度评定量表(C-SSRS)、康复风格问卷(RSQ)和Mayer-Salovey-Caruso情绪智力测验(MSCEIT)情绪管理分支进行评估。与确诊时间超过5年的患者相比,最近确诊的患者在GAF校正平均评分、阴性和抑郁症状的PANSS因子评分以及自杀意念的严重程度和强度方面均有更大的改善。我们的初步研究结果支持这样的假设,即如果在疾病的早期阶段给予li - sga,可能会影响疾病的病程。然而,可能需要更大样本的重复研究。
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引用次数: 19
Metabolic Syndrome among Schizophrenic Patients: A Comparative Cross-Sectional Study in the Middle Belt of Ghana. 精神分裂症患者的代谢综合征:加纳中部地带的一项跨部门比较研究。
IF 2.4 Q3 Medicine Pub Date : 2018-06-28 DOI: 10.1155/2018/6542983
Angela Owusu-Ansah, Anto Berko Panyin, Christian Obirikorang, Christian Agyare, Emmanuel Acheampong, Simon Kwofie, Enoch Odame Anto, Emmanuella Nsenbah Batu

The study determined the prevalence of MetS in patients with schizophrenia at the Psychiatric Unit of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. This comparative cross-sectional study recruited 348 schizophrenic patients comprising 236 antipsychotic-treated and 112 newly diagnosed treatment-naïve patients. The MetS prevalence was assessed based on World Health Organization (WHO), International Diabetes Federation (IDF), and the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP ATP III) criteria. The overall prevalence of MetS was 14.1%, 20.4%, and 23.6% using NCEP ATP III, WHO, and IDF criteria, respectively, compared to 7.8%, 3.9%, and 2.2% reported in the general Ghanaian population. The prevalence was significantly higher among treated psychiatric patients compared to treatment-naïve group based on NCEP ATP III (17.8% versus 6.2%; p = 0.0001), WHO (26.2% versus 8.0%; p < 0.0001), and IDF (30.3% versus 10.0%; p < 0.0001). MetS was prevalent among patients on atypical antipsychotics compared to typical antipsychotics irrespective of the criteria used (i.e., 17.1% versus 11.1% for NCEP ATP III; 29.5% versus 25.9% for WHO; and 44.3% versus 18.5% for IDF). Using logistic regression model, obesity, raised fasting blood sugar, raised total cholesterol, and decreased high density lipoprotein were observed to be significant predictors of MetS (p<0.05).The study found high prevalence of MetS in Ghanaians with schizophrenia and higher prevalence rate of MetS associated with monotherapy. Regular monitoring of cardiometabolic parameters should be an important therapeutic objective in the management of these patients.

这项研究确定了在加纳库马西Komfo Anokye教学医院(KATH)精神科精神分裂症患者中MetS的患病率。这项横断面比较研究招募了348名精神分裂症患者,包括236名接受抗精神病药物治疗的患者和112名新诊断的治疗幼稚患者。根据世界卫生组织(世界卫生组织)、国际糖尿病联合会(IDF)和国家胆固醇教育计划成人治疗小组III(NCEP ATP III)标准评估MetS患病率。根据NCEP ATP III、世界卫生组织和IDF标准,MetS的总体患病率分别为14.1%、20.4%和23.6%,而加纳普通人群中报告的发病率分别为7.8%、3.9%和2.2%。根据NCEP ATP III(17.8%对6.2%;p=0.0001)、世界卫生组织(26.2%对8.0%;p<0.0001),和IDF(30.3%对10.0%;p<0.0001)。无论使用何种标准,与典型抗精神病药物相比,非典型抗精神病药患者中MetS普遍存在(即NCEP ATP III为17.1%对11.1%;世界卫生组织为29.5%对25.9%;IDF为44.3%对18.5%)。使用逻辑回归模型,肥胖、空腹血糖升高、总胆固醇升高和高密度脂蛋白降低是MetS的显著预测因素(p
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引用次数: 9
Change in Prolactin Levels in Pediatric Patients Given Antipsychotics for Schizophrenia and Schizophrenia Spectrum Disorders: A Network Meta-Analysis. 精神分裂症和精神分裂症谱系障碍患儿服用抗精神病药物后催乳素水平的变化:一项网络荟萃分析
IF 2.4 Q3 Medicine Pub Date : 2018-04-01 eCollection Date: 2018-01-01 DOI: 10.1155/2018/1543034
Chakrapani Balijepalli, Eric Druyts, Michael J Zoratti, Ping Wu, Salmaan Kanji, Kiran Rabheru, Kevin Yan, Kristian Thorlund

Background: Treatment of schizophrenia with first- and second-generation antipsychotics has been associated with elevated prolactin levels, which may increase the risk for prolactin-related adverse events.

Methods: Randomized controlled trials (RCTs) included in a recent systematic review were considered for this analysis. A Bayesian network meta-analysis was used to compare changes in prolactin levels in pediatric patients diagnosed with schizophrenia or schizophrenia spectrum disorders treated with second-generation antipsychotics (SGAs).

Results: Five RCTs, including 989 patients combined, have evaluated the changes in prolactin for pediatric patients after 6 weeks of treatment with risperidone, quetiapine, aripiprazole, olanzapine, and paliperidone. In the overall study population, treatment with risperidone was associated with the highest increase in mean prolactin levels compared to other SGAs. Patients treated with risperidone 4-6 mg/day were found to experience the greatest increases (55.06 ng/ml [95% CrI: 40.53-69.58]) in prolactin levels, followed by risperidone 1-3 mg/day, paliperidone 3-6 mg/day, and paliperidone 6-12 mg/day.

Conclusions: This study shows that there are differences in SGAs ability to cause hyperprolactinemia. Further, there is clear evidence of safety concerns with risperidone and paliperidone treatment in adolescent schizophrenia patients.

Registration: PROSPERO CRD42014009506.

背景:使用第一代和第二代抗精神病药物治疗精神分裂症与催乳素水平升高有关,这可能增加催乳素相关不良事件的风险。方法:随机对照试验(rct)纳入最近的系统评价纳入本分析。采用贝叶斯网络荟萃分析比较了经第二代抗精神病药物治疗的精神分裂症或精神分裂症谱系障碍儿童患者催乳素水平的变化。结果:5项随机对照试验,共989例患者,评估了利培酮、喹硫平、阿立哌唑、奥氮平和帕利哌酮治疗6周后儿科患者催乳素的变化。在整个研究人群中,与其他SGAs相比,利培酮治疗与平均催乳素水平的最高升高相关。利培酮4 ~ 6 mg/d组患者催乳素水平升高幅度最大(55.06 ng/ml [95% CrI: 40.53 ~ 69.58]),其次为利培酮1 ~ 3 mg/d、帕利培酮3 ~ 6 mg/d、帕利培酮6 ~ 12 mg/d。结论:本研究表明SGAs引起高泌乳素血症的能力存在差异。此外,有明确的证据表明,利培酮和帕利培酮治疗青少年精神分裂症患者存在安全性问题。注册号:PROSPERO CRD42014009506。
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引用次数: 11
History of Suicide Attempt Is Associated with Reduced Medial Prefrontal Cortex Activity during Emotional Decision-Making among Men with Schizophrenia: An Exploratory fMRI Study. 自杀企图史与精神分裂症患者情绪决策时内侧前额叶皮层活动减少有关:一项探索性功能磁共振成像研究
IF 2.4 Q3 Medicine Pub Date : 2018-03-01 eCollection Date: 2018-01-01 DOI: 10.1155/2018/9898654
Stéphane Potvin, Andràs Tikàsz, Stéphane Richard-Devantoy, Ovidiu Lungu, Alexandre Dumais

Despite the high prevalence of suicidal ideas/attempts in schizophrenia, only a handful of neuroimaging studies have examined the neurobiological differences associated with suicide risk in this population. The main objective of the current exploratory study is to examine the neurofunctional correlates associated with a history of suicide attempt in schizophrenia, using a risky decision-making task, in order to show alterations in brain reward regions in this population. Thirty-two male outpatients with schizophrenia were recruited: 13 patients with (SCZ + S) and 19 without a history of suicidal attempt (SCZ - S). Twenty-one healthy men with no history of mental disorders or suicidal attempt/idea were also recruited. Participants were scanned using fMRI while performing the Balloon Analogue Risk Task. A rapid event-related fMRI paradigm was used, separating decision and outcome events, and the explosion probabilities were included as parametric modulators. The most important finding of this study is that SCZ + S patients had reduced activations of the medial prefrontal cortex during the success outcome event (with parametric modulation), relative to both SCZ - S patients and controls, as illustrated by a spatial conjunction analysis. These exploratory results suggest that a history of suicidal attempt in schizophrenia is associated with blunted brain reward activity during emotional decision-making.

尽管精神分裂症患者有很高的自杀念头/企图,但只有少数神经影像学研究调查了这一人群中与自杀风险相关的神经生物学差异。当前探索性研究的主要目的是通过高风险的决策任务,检查与精神分裂症患者自杀企图史相关的神经功能,以显示该人群大脑奖励区域的变化。本研究招募了32例精神分裂症门诊男性患者:13例(SCZ + S)患者和19例(SCZ - S)患者。21例健康男性,无精神障碍史或自杀企图/念头。参与者在执行气球模拟风险任务时使用功能磁共振成像进行扫描。采用快速事件相关fMRI范式,分离决策事件和结果事件,并将爆炸概率作为参数调制器。本研究最重要的发现是,与SCZ - S患者和对照组相比,SCZ + S患者在成功结果事件(参数调制)期间内侧前额叶皮层的激活减少,这一点通过空间关联分析得到了证明。这些探索性结果表明,精神分裂症患者的自杀企图史与情绪决策过程中大脑奖励活动减弱有关。
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引用次数: 19
Effect of Olanzapine on Clinical and Polysomnography Profiles in Patients with Schizophrenia. 奥氮平对精神分裂症患者临床及多导睡眠图的影响。
IF 2.4 Q3 Medicine Pub Date : 2018-02-20 eCollection Date: 2018-01-01 DOI: 10.1155/2018/3968015
Mohammad Zia Ul Haq Katshu, Sukanto Sarkar, S Haque Nizamie

Acute and short-term administration of olanzapine has a favorable effect on sleep in schizophrenia patients. This study aimed to clarify the effect of olanzapine on polysomnographic profiles of schizophrenia patients during the acute phase of illness after controlling for previous drug exposure. Twenty-five drug-naïve or drug-free schizophrenia patients were assessed at baseline and after six weeks of olanzapine treatment on Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), and Udvalg for Kliniske Undersogelser (UKU) side-effect rating scale and a whole-night polysomnography; fifteen patients completed the study. There was a significant reduction in all psychopathological variables with maximum reduction in PANSS total, BPRS total, and PANSS positive scores. A significant increase in total sleep time (TST), sleep efficiency (SE), nonrapid eye movement (NREM) stage 1 duration, stage 3 duration, stage 4 duration, and stage 4 percentage of TST, number of rapid eye movement (REM) periods, REM duration, and REM percentage of TST was observed. REM latency at baseline inversely predicted the reduction in BPRS total and PANSS total and positive scores. In summary, short-term treatment with olanzapine produced significant improvement in clinical and polysomnography profiles of patients with schizophrenia with shorter REM latency predicting a good clinical response.

急性和短期给予奥氮平对精神分裂症患者的睡眠有良好的影响。本研究旨在阐明奥氮平在控制既往药物暴露后对精神分裂症患者急性期多导睡眠图的影响。25例drug-naïve或无药物精神分裂症患者在基线和奥氮平治疗6周后进行简短精神病学评定量表(BPRS)、阳性和阴性综合征量表(PANSS)、Udvalg for Kliniske Undersogelser (UKU)副作用评定量表和通宵多导睡眠仪评估;15名患者完成了这项研究。所有精神病理变量均显著降低,其中PANSS总分、BPRS总分和PANSS阳性评分降幅最大。总睡眠时间(TST)、睡眠效率(SE)、非快速眼动(NREM)第1阶段持续时间、第3阶段持续时间、第4阶段持续时间、第4阶段TST百分比、快速眼动(REM)周期数、REM持续时间和快速眼动(REM)百分比均显著增加。基线时的REM潜伏期与BPRS总分和PANSS总分及阳性评分的下降呈负相关。综上所述,奥氮平短期治疗显著改善了精神分裂症患者的临床和多导睡眠图特征,这些患者的快速眼动潜伏期较短,预示着良好的临床反应。
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引用次数: 7
A Possible Link between Anxiety and Schizophrenia and a Possible Role of Anhedonia. 焦虑和精神分裂症之间的可能联系以及快感缺乏的可能作用。
IF 2.4 Q3 Medicine Pub Date : 2018-01-17 eCollection Date: 2018-01-01 DOI: 10.1155/2018/5917475
Luigi Grillo

In the prodromal phase of schizophrenia, severe alterations of the visual appearance of the environment have been found, accompanied by a state of intense anxiety. The present study considers the possibility that these alterations really exist in the appearance of objects, but that healthy people do not see them. The image of the world that we see is continuously deformed and fragmented by foreshortenings, partial overlapping, and so on and must be constantly reassembled and interpreted; otherwise, it could change so much that we would hardly recognize it. Since pleasure has been found to be involved in visual and cognitive information processing, the possibility is considered that anhedonia (the reduction of the ability to feel pleasure) might interfere with the correct reconstruction and interpretation of the image of the environment and alter its appearance. The possibility is also considered that these alterations might make the environment hostile, might at times evoke the sensation of being trapped by a predator, and might be the cause of the anxiety that accompanies them. According to some authors, they might also induce delusional ideas, in an attempt to restore meaning in a world that has become chaotic and frightening.

在精神分裂症的前驱期,环境的视觉外观发生了严重的改变,并伴有强烈的焦虑状态。目前的研究考虑了这样一种可能性,即这些变化确实存在于物体的外观中,但健康人看不到它们。我们所看到的世界形象,由于前缩、部分重叠等原因,不断地变形和破碎,必须不断地重新组合和解释;否则,它可能会发生很大的变化,以至于我们几乎认不出它。由于已经发现快乐与视觉和认知信息处理有关,因此人们认为快感缺乏(感觉快乐的能力降低)可能会干扰对环境图像的正确重建和解释,并改变其外观。还有一种可能性是,这些变化可能会使环境变得不友好,有时可能会引起被捕食者困住的感觉,也可能是伴随它们而来的焦虑的原因。根据一些作者的说法,它们还可能引发妄想,试图在一个已经变得混乱和可怕的世界中恢复意义。
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引用次数: 4
期刊
Schizophrenia Research and Treatment
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