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Schizophrenia as a disorder of communication. 精神分裂症是一种沟通障碍。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2013-01-01 Epub Date: 2013-05-12 DOI: 10.1155/2013/952034
Margaret A Niznikiewicz, Marek Kubicki, Christoph Mulert, Ruth Condray
The first characterizations of schizophrenia invoked the concept of disordered thought and broken mind as central to its clinical presentation [1, 2]. Interestingly, Bleuler's characterization of schizophrenia was couched in terms of four A's association, with its focus on disordered language, affectivity, ambivalence, and autism, all of which implicate different aspects of social function [3]. Bleuler captured much that is still relevant to the study of cognitive dysfunction in schizophrenia and, in fact, covers quite well the topic of social communication dysfunction highlighted in this issue. The research that followed these early characterizations firmly established the link between abnormal brain structure and function, mediated by genetics, and many clinical and cognitive manifestations of this devastating disease [4–6]. Over the last several years, great progress has been achieved in the understanding of mechanisms of schizophrenia [7–10]. And while a comprehensive theory of schizophrenia is still elusive, many compelling accounts of schizophrenia pathology have been put forward and generated valuable insights [8, 9, 11–15].
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引用次数: 10
Empirically Based Psychosocial Therapies for Schizophrenia: The Disconnection between Science and Practice. 精神分裂症的基于经验的社会心理治疗:科学与实践之间的脱节。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2013-01-01 Epub Date: 2013-04-23 DOI: 10.1155/2013/792769
Glenn D Shean

Empirically validated psychosocial therapies for individuals diagnosed with schizophrenia were described in the report of the Schizophrenia Patient Outcomes Research Team (PORT, 2009). The PORT team identified eight psychosocial treatments: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. PORT listings of empirically validated psychosocial therapies provide a useful template for the design of effective recovery-oriented mental health care systems. Unfortunately, surveys indicate that PORT listings have not been implemented in clinical settings. Obstacles to the implementation of PORT psychosocial therapy listings and suggestions for changes needed to foster implementation are discussed. Limitations of PORT therapy listings that are based on therapy outcome efficacy studies are discussed, and cross-cultural and course and outcome studies of correlates of recovery are summarized.

精神分裂症患者结果研究小组(PORT, 2009)的报告中描述了经经验验证的精神分裂症患者的社会心理治疗。PORT小组确定了八种社会心理治疗:果断的社区治疗、支持就业、认知行为治疗、基于家庭的服务、象征性经济、技能培训、酒精和物质使用障碍的社会心理干预以及体重管理的社会心理干预。PORT清单的经验验证心理社会疗法提供了一个有用的模板,有效的康复导向的精神卫生保健系统的设计。不幸的是,调查表明,PORT清单尚未在临床环境中实施。本文讨论了实施PORT心理社会治疗清单的障碍以及促进实施所需的改变建议。本文讨论了基于治疗结果疗效研究的PORT治疗清单的局限性,并总结了与康复相关的跨文化、过程和结果研究。
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引用次数: 9
Grasping the world: object-affordance effect in schizophrenia. 把握世界:精神分裂症的客体可视性效应。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2013-01-01 Epub Date: 2013-12-09 DOI: 10.1155/2013/531938
Jessica Sevos, Anne Grosselin, Jacques Pellet, Catherine Massoubre, Denis Brouillet

For schizophrenic patients, the world can appear as deprived of practical meaning, which normally emerges from sensory-motor experiences. However, no research has yet studied the integration between perception and action in this population. In this study, we hypothesize that patients, after having controlled the integrity of their visuospatial integration, would nevertheless present deficit in sensory-motor simulation. In this view, we compare patients to control subjects using two stimulus-response compatibility (SRC) tasks. Experiment 1 is performed to ensure that visuo-spatial integration is not impaired (Simon Effect). Experiment 2 replicates a study from Tucker and Ellis (1998) to explore the existence of sensory-motor compatibility between stimulus and response (Object Affordance). In control subjects, the SRC effect appears in both experiments. In schizophrenic patients, it appears only when stimuli and responses share the same spatial localization. This loss of automatic sensory-motor simulation could emerge from a lack of relation between the object and the subject's environment.

对于精神分裂症患者来说,世界似乎被剥夺了实际意义,而实际意义通常是由感觉运动体验产生的。然而,目前还没有研究研究这一人群的感知和行动之间的整合。在这项研究中,我们假设患者在控制了视觉空间整合的完整性之后,仍然会出现感觉-运动模拟的缺陷。在这个观点中,我们使用两个刺激-反应相容性(SRC)任务来比较患者和对照组。实验1是为了确保视觉空间整合不受损(西蒙效应)。实验2重复了Tucker和Ellis(1998)探索刺激和反应之间存在感觉-运动相容性(Object Affordance)的研究。在对照组中,SRC效应在两个实验中都出现。在精神分裂症患者中,只有当刺激和反应具有相同的空间定位时,它才会出现。这种自动感觉运动模拟的丧失可能是由于物体和主体环境之间缺乏联系。
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引用次数: 11
The Effect of an Educating versus Normalizing Approach on Treatment Motivation in Patients Presenting with Delusions: An Experimental Investigation with Analogue Patients. 教育与规范化方法对妄想患者治疗动机的影响:一项模拟患者的实验研究。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2013-01-01 Epub Date: 2013-10-23 DOI: 10.1155/2013/261587
Eva Lüllmann, Tania M Lincoln

Until recently a widespread recommendation for clinicians was not to respond to the content of patients' delusions but to stress at an early time point that the patient has a mental illness (educating approach). An opposed recommendation is to validate the patients' symptoms and normalize them (normalizing approach). This study used an experimental design to compare the impact of these two approaches on treatment motivation (TM). A cover story about a person who develops persecutory delusions was used to guide a sample of 81 healthy participants who served as analogue patients into imagining experiencing delusions. This was followed by a random assignment to either an educating or a normalizing consultation with a fictive clinician. Consultations only differed in content. Finally, we assessed the participants' motivation to accept medication (Medication TM), psychological treatment (Psychological TM), and treatment offered by this particular clinician independent of the kind of treatment (Clinician-related TM). Participants in the normalizing condition showed higher Clinician-related and Psychological TM than those in the educating condition. Medication TM was unaffected by condition. Following our results using a normalizing approach seems to be advisable in a first-contact situation with patients with delusions and favourable to a simple educating approach.

直到最近,对临床医生的广泛建议是,不要对患者妄想的内容作出反应,而是在早期强调患者患有精神疾病(教育方法)。相反的建议是确认患者的症状并使其正常化(正常化方法)。本研究采用实验设计比较这两种方法对治疗动机(TM)的影响。一个关于一个患有受迫害妄想症的人的封面故事被用来引导81名健康的参与者,他们作为模拟病人,想象自己正在经历妄想。随后是随机分配到一个有效的临床医生进行教育或正常咨询。磋商只是在内容上有所不同。最后,我们评估了参与者接受药物治疗(medication TM)、心理治疗(psychological TM)的动机,以及该特定临床医生提供的独立于治疗类型的治疗(与临床医生相关的TM)。规范化组的临床相关TM和心理TM均高于教育组。用药TM不受病情影响。根据我们的结果,在与妄想患者的首次接触情况下,使用正常化方法似乎是可取的,并且有利于简单的教育方法。
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引用次数: 15
A high-fidelity virtual environment for the study of paranoia. 研究偏执的高保真虚拟环境。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2013-01-01 Epub Date: 2013-12-17 DOI: 10.1155/2013/538185
Matthew R Broome, Eva Zányi, Thomas Hamborg, Elmedin Selmanovic, Silvester Czanner, Max Birchwood, Alan Chalmers, Swaran P Singh

Psychotic disorders carry social and economic costs for sufferers and society. Recent evidence highlights the risk posed by urban upbringing and social deprivation in the genesis of paranoia and psychosis. Evidence based psychological interventions are often not offered because of a lack of therapists. Virtual reality (VR) environments have been used to treat mental health problems. VR may be a way of understanding the aetiological processes in psychosis and increasing psychotherapeutic resources for its treatment. We developed a high-fidelity virtual reality scenario of an urban street scene to test the hypothesis that virtual urban exposure is able to generate paranoia to a comparable or greater extent than scenarios using indoor scenes. Participants (n = 32) entered the VR scenario for four minutes, after which time their degree of paranoid ideation was assessed. We demonstrated that the virtual reality scenario was able to elicit paranoia in a nonclinical, healthy group and that an urban scene was more likely to lead to higher levels of paranoia than a virtual indoor environment. We suggest that this study offers evidence to support the role of exposure to factors in the urban environment in the genesis and maintenance of psychotic experiences and symptoms. The realistic high-fidelity street scene scenario may offer a useful tool for therapists.

精神障碍会给患者和社会带来社会和经济成本。最近的证据突出了城市教育和社会剥夺在偏执和精神病的起源中所构成的风险。由于缺乏治疗师,通常不提供基于证据的心理干预。虚拟现实(VR)环境已被用于治疗心理健康问题。虚拟现实可能是一种了解精神病病因过程和增加其治疗的心理治疗资源的方法。我们开发了一个城市街景的高保真虚拟现实场景,以测试虚拟城市暴露能够产生与室内场景相当或更大程度的偏执狂的假设。参与者(n = 32)进入虚拟现实场景四分钟,之后评估他们的偏执程度。我们证明了虚拟现实场景能够引起非临床健康人群的偏执,并且城市场景比虚拟室内环境更有可能导致更高程度的偏执。我们认为,这项研究提供了证据,支持暴露于城市环境中的因素在精神病经历和症状的发生和维持中的作用。逼真的高保真街景场景可能为治疗师提供有用的工具。
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引用次数: 25
Utility of Two PANSS 5-Factor Models for Assessing Psychosocial Outcomes in Clinical Programs for Persons with Schizophrenia. 两种PANSS五因素模型在精神分裂症患者临床项目中评估社会心理结果的效用。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2013-01-01 Epub Date: 2013-12-05 DOI: 10.1155/2013/705631
Jeanette M Jerrell, Stephanie Hrisko

Using symptom factors derived from two models of the Positive and Negative Syndrome Scale (PANSS) as covariates, change over time in consumer psychosocial functioning, medication adherence/compliance, and treatment satisfaction outcomes are compared based on a randomized, controlled trial assessing the effectiveness of antipsychotic medications for 108 individuals diagnosed with schizophrenia. Random effects regression analysis was used to determine the relative performance of these two 5-factor models as covariates in estimating change over time and the goodness of fit of the regression equations for each outcome. Self-reported psychosocial functioning was significantly associated with the relief of positive and negative syndromes, whereas patient satisfaction was more closely and significantly associated with control of excited/activation symptoms. Interviewer-rated psychosocial functioning was significantly associated with relief of positive and negative symptoms, as well as excited/activation and disoriented/autistic preoccupation symptoms. The VDG 5-factor model of the PANSS represents the best "goodness of fit" model for assessing symptom-related change associated with improved psychosocial outcomes and functional recovery. Five-factor models of the syndromes of schizophrenia, as assessed using the PANSS, are differentially valuable in determining the predictors of psychosocial and satisfaction changes over time, but not of improved medication adherence/compliance.

使用来自阳性和阴性综合征量表(PANSS)两种模型的症状因素作为协变量,根据随机对照试验评估抗精神病药物对108名精神分裂症患者的有效性,比较了消费者心理社会功能、药物依从性/依从性和治疗满意度结果随时间的变化。使用随机效应回归分析来确定这两个5因素模型作为协变量在估计随时间变化和回归方程对每个结果的拟合优度方面的相对性能。自我报告的社会心理功能与阳性和阴性综合征的缓解显著相关,而患者满意度与兴奋/激活症状的控制更为密切和显著相关。访谈者评价的社会心理功能与阳性和阴性症状的缓解以及兴奋/激活和定向障碍/自闭症症状显著相关。PANSS的VDG 5因素模型代表了评估与改善的社会心理结局和功能恢复相关的症状相关变化的最佳“拟合优度”模型。使用PANSS评估的精神分裂症综合征的五因素模型在确定心理社会和满意度随时间变化的预测因子方面具有不同的价值,但在改善药物依从性/依从性方面则没有价值。
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引用次数: 20
Do people with schizophrenia lack emotional intelligence? 精神分裂症患者缺乏情商吗?
IF 2.4 Q1 PSYCHIATRY Pub Date : 2012-01-01 Epub Date: 2012-12-13 DOI: 10.1155/2012/495174
Sara Dawson, Lisa Kettler, Cassandra Burton, Cherrie Galletly
Social cognition is a domain of cognitive function that includes the ability to understand and manage social interactions. Emotional intelligence (EI) has been identified as a component of social cognition and is defined as the ability to identify, use, understand, and manage emotions. Neurocognitive impairments are known to be associated with poorer social function in people with schizophrenia, but less is known about the relationships between EI, neurocognition, and social function. The current study assessed EI using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) in 20 people with schizophrenia and 20 controls. The schizophrenia group had significantly lower scores on all measures of EI and demonstrated poorer neurocognition and social functioning than controls. The difference between schizophrenia and control groups was greatest for the Understanding Emotions Branch of the MSCEIT. The neurocognition score and total EI score accounted for 18.3% of the variance in social function in the control group and 9.1% of the variance in social function in the schizophrenia group. Our results suggest that a total EI score is not a useful predictor of overall social function and it may be more clinically useful to develop an individual profile of social cognitive abilities, including EI, to form a remediation program.
社会认知是认知功能的一个领域,包括理解和管理社会互动的能力。情商(EI)被认为是社会认知的一个组成部分,被定义为识别、使用、理解和管理情绪的能力。众所周知,精神分裂症患者的神经认知障碍与较差的社会功能有关,但对情商、神经认知和社会功能之间的关系知之甚少。目前的研究使用Mayer-Salovey-Caruso情绪智力测试(MSCEIT)对20名精神分裂症患者和20名对照组进行了情商评估。精神分裂症组在所有情商指标上的得分都明显较低,神经认知和社会功能也比对照组差。精神分裂症组和对照组在MSCEIT的理解情绪分支上的差异最大。神经认知评分和EI总分分别占对照组社会功能方差的18.3%和精神分裂症组社会功能方差的9.1%。我们的研究结果表明,EI总分并不是整体社会功能的有效预测指标,在临床上,建立包括EI在内的个人社会认知能力概况,以形成补救方案可能更有用。
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引用次数: 28
The PPARα Agonist Fenofibrate Reduces Prepulse Inhibition Disruption in a Neurodevelopmental Model of Schizophrenia. ppara激动剂非诺贝特在精神分裂症神经发育模型中减少脉冲前抑制中断。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2012-01-01 Epub Date: 2012-05-15 DOI: 10.1155/2012/839853
Benjamin Rolland, Kevin Marche, Olivier Cottencin, Régis Bordet

Oxidative stress has been implicated in neurodevelopmental theories of schizophrenia. Antioxidant Peroxysome Proliferator-Activated Receptors α (PPARα) agonist fenofibrate has neuroprotective properties and could reverse early preclinical infringements that could trigger the illness. We have evaluated the neuroprotective interest of fenofibrate in a neurodevelopmental rat model of schizophrenia. The oxidative lesion induced by Kainic Acid (KA) injection at postnatal day (PND) 7 has previously been reported to disrupt Prepulse Inhibition (PPI) at PND56 but not at PND35. In 4 groups of 15 male rats each, KN (KA-PND7 + normal postweaning food), KF (KA-PND7 + fenofibrate 0.2% food), ON (saline-PND7 + normal food), and OF (saline + fenofibrate food), PPI was recorded at PND35 and PND56. Three levels of prepulse were used: 73 dB, 76 dB, and 82 dB for a pulse at 120 dB. Four PPI scores were analyzed: PPI73, PPI76, PPI82, and mean PPI (PPIm). Two-way ANOVAs were used to evaluate the effects of both factors (KA + fenofibrate), and, in case of significant results, intergroup Student's t-tests were performed. We notably found a significant difference (P < 0.05) in PPIm between groups KN and KF at PND56, which supposes that fenofibrate could be worthy of interest for early neuroprotection in schizophrenia.

氧化应激与精神分裂症的神经发育理论有关。抗氧化过氧体增殖物激活受体α (PPARα)激动剂非诺贝特具有神经保护特性,可以逆转可能引发疾病的早期临床前侵害。我们已经评估了非诺贝特在精神分裂症神经发育大鼠模型中的神经保护作用。此前有报道称,产后7天(PND)注射Kainic Acid (KA)诱导的氧化损伤会破坏PND56的预脉冲抑制(PPI),但不会破坏PND35。4组雄性大鼠,每组15只,分别为KN (KA-PND7 +断奶后正常食物)、KF (KA-PND7 +非诺贝特0.2%食物)、ON(盐- pnd7 +正常食物)和of(盐+非诺贝特食物),在PND35和PND56时记录PPI。预脉冲使用三个级别:73 dB, 76 dB和82 dB的脉冲在120 dB。分析四个PPI评分:PPI73、PPI76、PPI82和平均PPI (PPIm)。采用双因素方差分析来评估这两个因素(KA +非诺贝特)的影响,如果结果显著,则进行组间学生t检验。我们发现,在PND56时,KN组和KF组的PPIm有显著差异(P < 0.05),这表明非诺贝特可能值得对精神分裂症的早期神经保护感兴趣。
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引用次数: 19
Sex differences in facial, prosodic, and social context emotional recognition in early-onset schizophrenia. 早发性精神分裂症患者面部、韵律和社会情境情绪识别的性别差异。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2012-01-01 Epub Date: 2012-03-01 DOI: 10.1155/2012/584725
Julieta Ramos-Loyo, Leonor Mora-Reynoso, Luis Miguel Sánchez-Loyo, Virginia Medina-Hernández

The purpose of the present study was to determine sex differences in facial, prosodic, and social context emotional recognition in schizophrenia (SCH). Thirty-eight patients (SCH, 20 females) and 38 healthy controls (CON, 20 females) participated in the study. Clinical scales (BPRS and PANSS) and an Affective States Scale were applied, as well as tasks to evaluate facial, prosodic, and within a social context emotional recognition. SCH showed lower accuracy and longer response times than CON, but no significant sex differences were observed in either facial or prosody recognition. In social context emotions, however, females showed higher empathy than males with respect to happiness in both groups. SCH reported being more identified with sad films than CON and females more with fear than males. The results of this study confirm the deficits of emotional recognition in male and female patients with schizophrenia compared to healthy subjects. Sex differences were detected in relation to social context emotions and facial and prosodic recognition depending on age.

本研究的目的是确定精神分裂症患者在面部、韵律和社会情境情绪识别方面的性别差异。38例患者(SCH, 20名女性)和38例健康对照(CON, 20名女性)参加了研究。应用临床量表(BPRS和PANSS)和情感状态量表,以及评估面部、韵律和社会情境下情绪识别的任务。在面部识别和韵律识别方面,SCH组的准确率较CON组低,反应时间较CON组长,但性别差异不显著。然而,在社会情境情绪方面,两组女性都比男性表现出更高的同理心。据报道,男性比男性更喜欢悲伤电影,女性比男性更喜欢恐惧电影。本研究结果证实,与健康受试者相比,男性和女性精神分裂症患者存在情绪识别缺陷。在社会背景、情绪、面部和韵律识别方面,性别差异取决于年龄。
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引用次数: 15
Gender differences in remission and recovery of schizophrenic and schizoaffective patients: preliminary results of a prospective cohort study. 精神分裂症和分裂情感性患者缓解和恢复的性别差异:一项前瞻性队列研究的初步结果。
IF 2.4 Q1 PSYCHIATRY Pub Date : 2012-01-01 Epub Date: 2012-01-16 DOI: 10.1155/2012/576369
Bernardo Carpiniello, Federica Pinna, Massimo Tusconi, Enrico Zaccheddu, Francesca Fatteri

The aim of the paper was to evaluate rates of clinical remission and recovery according to gender in a cohort of chronic outpatients attending a university community mental health center who had been diagnosed with schizophrenia and schizoaffective disorder according to DSM-IV-TR. A sample of 100 consecutive outpatients (70 males and 30 females) underwent comprehensive psychiatric evaluation using the Structured Clinical Interview for Diagnosis of Axis I and II DSM-IV (SCID-I and SCID-II, Version R) and an assessment of psychopathology, social functioning, clinical severity, subjective wellbeing, and quality of life, respectively by means of PANSS (Positive and Negative Syndrome Scale), PSP (Personal and Social Performance), CGI-SCH (Clinical Global Impression-Schizophrenia scale), SWN-S (Subjective Well-being under Neuroleptics-scale), and WHOQOL (WHO Quality of Life). Rates of clinical remission and recovery according to different criteria were calculated by gender. Higher rates of clinical remission and recovery were generally observed in females than males, a result consistent with literature data. Overall findings from the paper support the hypothesis of a better outcome of the disorders in women, even in the very long term.

本论文的目的是评估根据DSM-IV-TR诊断为精神分裂症和分裂情感性障碍的大学社区精神卫生中心慢性门诊患者按性别的临床缓解率和恢复率。连续100年门诊病人的样本(70男性和30岁女性)进行了全面的精神评估使用结构化的临床访谈轴I和II dsm - iv诊断(SCID-I SCID-II,版本R)和精神病理学的一个评估,社会功能,临床严重程度、主观幸福感,和生活质量,分别通过数值(积极的和消极的综合征)规模,PSP(个人和社会绩效),CGI-SCH(临床总体印象-精神分裂症量表)、SWN-S(神经抑制药主观幸福感量表)和WHOQOL (WHO生活质量)。按性别计算不同标准的临床缓解率和恢复率。女性的临床缓解和恢复率通常高于男性,这一结果与文献数据一致。这篇论文的总体发现支持了这样一种假设:即使从很长一段时间来看,对女性来说,这种紊乱会有更好的结果。
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引用次数: 54
期刊
Schizophrenia Research and Treatment
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