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BackgroundWomen may develop severe symptoms of stress disorder following childbirth， which may be exposed to a risk of developing mental health problems， and even lead to the recurrence of the illness in female patients with schizophrenia， while comparatively limited research has been undertaken concerning the clinical characteristics and treatment of puerperal schizophrenia in China. ObjectiveTo explore the clinical characteristics of puerperal schizophrenia， so as to provide references for the clinical treatment. MethodsA total of 24 patients with puerperal schizophrenia who were hospitalized in the female ward of adult psychiatry department of the Affiliated Brain Hospital of Guangzhou Medical University from 2012 to 2020 and met the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） diagnostic criteria for schizophrenia were included as puerperal group. Another 48 non-puerperal women with schizophrenia were concurrently enrolled as control group. Then the basic data， scores on Positive and Negative Symptom Scale （PANSS） and the discharge medication were recorded. ResultsThe percentages of newly onset and positive family history of psychosis in puerperal group were larger than those in control group， with statistical significance （χ2=9.321， 5.240， P<0.05 or 0.01）. Puerperal group scored higher on PANSS excitement factor （t=-2.220， P<0.05） and lower on negative factor （t=3.377， P<0.01） compared with control group. In terms of discharge medication， puerperal group reported a higher dosage of antipsychotic drugs （t=-2.095， P<0.05）， and a larger proportion of combined use of benzodiazepines or antidepressants （χ²=21.316， 5.114， P<0.05 or 0.01） compared with control group， with statistical significance. ConclusionPatients with puerperal schizophrenia display increased ratings of excitement symptoms and decreased ratings of negative symptoms， which necessitates the use of high doses of antipsychotic drugs， and combined use of benzodiazepines and antidepressants.
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To date, tachycardia and orthostatic hypotension have been reported as one of the negative cardiovascular complications of antipsychotics. The aim of this study was to report a case of sinus bradycardia caused by the addition of lurasidone. The patient, a 46-year-old bipolar disorder female, was admitted to the Affiliated Brain Hospital of Guangzhou Medical University with 28 years of alternating euphoric and dysphoria. On the basis of lithium carbonate 1,200 mg/day and sodium valproate 1,500 mg/day, the patient was given lurasidone 80 mg/day. After 5 days of medication, her heart rate (HR) became 48 beats per minute (beats/min). As a result, lurasidone treatment was held. On 5th day after discontinuing lurasidone, the HR reached 80 beats/min. This case report notifies that although the cardiovascular effects of lurasidone are not significant, it is also important to monitor HR status after the first administration of lurasidone.
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ObjectiveTo explore the component factors of anhedonia in first-episode schizophrenia patients and the relationship with clinical symptoms， cognitive and social functioning. MethodsA total of 31 patients with first-episode schizophrenia who met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） and another 33 healthy controls were enrolled. Then， the anhedonia level， mental symptoms， cognitive and social functioning were assessed using Temporal Experience of Pleasure Scale （TEPS）， Positive and Negative Syndrome Scale （PANSS）， Repeatable Battery for the Assessment of Neuropsychological Status （RBANS） and Personal and Social Performance Scale （PSP）. Thereafter， Pearson correlation was used to discuss the correlation of anhedonia level with clinical symptoms， cognitive and social functioning. ResultsThe consummatory anhedonia score in TEPS of first-episode schizophrenia patients was lower than that of healthy controls， with statistical difference ［（27.71±5.48） vs. （31.58±5.92）， t=2.705， P=0.009］. Correlation analysis showed that consummatory anhedonia had no correlation with PANSS， RBANS and PSP scores in first-episode schizophrenia patients（P>0.05）. ConclusionFirst-episode schizophrenia patients have consummatory anhedonia， and the consummatory anhedonia may be independent of clinical symptoms， cognitive and social functioning.
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Objective To identify the differences inneuropsychological characteristics between amnestic(AMCI)and vascular mild cognitive impairment(VMCI).Methods Totally 297 old community residents with mild cognitive impairment(MCI)were divided into amnestic MCI(AMCI)and vascular MCI(VMCI)subgroup from Guangzhou MCI prevalence survey.The elderly with MCI were interviewed and tested with the Chinese version of Montreal Cognitive Assessment(MoCA),the Mini-Mental state examination(MMSE),Auditory Verbal Learning Test(AVLT),the Clinical Dementia Rating scale(CDR),Functional Activity Questionnaire(FAQ),the Modified Hachinski Ischemic Scale(M-HIS),Center for Epidemiologic Studies(CES-DC)to evaluate neuropsychological characteristics.Results AMCI versus VMCI group showed that the total scores of MoCA were(9.63±5.17 vs.9.98±6.02),total scores of MMSE were(16.90±4.84 vs.16.90±6.19),AVLT immediate memory was(2.35±1.39 vs.2.91±1.84),AVLT delayed recall was(2.23±2.09 vs.2.47±2.20),AVLT delayed recognition was(7.33±3.98 vs.6.85±4.02)and total scores of CDR(0.5 vs.0.5),with no differences between the 2 groups(all P>0.05).Based on MoCA survey,AMCI versus VMCI group showed statistically significant differences(all P<0.05)in parameters of visual space and execution(0.71±1.02 vs.0.92±1.26),language function(0.34±0.56 vs.0.50±0.80)and abstract thinking(0.25±0.49 vs.0.15±0.43),but based on MMSE survey,no difference was found in the various cognitive domains between the two groups.The AMCI versus VMCI group showed statistically significant differences(all P<0.05)in parameters of CES-DC scale(1.75±4.27 vs.2.76±6.72),FAQ scale(4.42±4.66 vs.8.71±7.03),M-HIS scale(0.40±0.64 vs.7.59±3.53).Conclusions There is no significant difference in general cognitive impairment between AMCI and VMCI,but the visual space and execution,language function are more impaired in AMCI than VMCI,and the abstract thinking,social function are more impaired with more depressive symptoms in VMCI than in AMCI.
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Objective To explore the effects of integrated treatment model (psychosocial interventions combined with drug therapy) in schizophrenia and analyze the influence of medication attitude on treatment compliance and psychiatric symptoms in different intervention models.Methods A total of 170 patients with schizophrenia were enrolled from 2012 to 2015.Patients were randomly divided into two groups:the integrated treatment group (86 patients) with drug therapy and psychosocial intervention,and the conventional drug treatment group (84 patients) with only drug intervention.Dug attitude inventory (DAI),self-awareness inventor (SAI),positive and negative symptoms scale (PANSS) were used to assess medication attitude,treatment compliance and clinical psychotic symptoms for all patients in the following 3 months,6 months and 12 months.Results Compared with medication-alone group,the integrated treatment group achieved significant improvement in psychiatric symptoms,including positive symptom and general psychopathology as well as significant reduction in scores in DAI and SAI (P＜0.05).In the conventional drug treatment group,the PANSS score was positively correlated with the increased score of DAI (β=0.31,P=0.02),which was mediated by the improvement in treatment adherence (β=0.18,P=0.18).There was no significant correlation between PANSS score and the increase score of DAI in the integrated treatment group(P=0.62).However,the increased score of SAI was positively correlated with the positive symptom of PANSS scale (r=0.31,P=0.01) and with the general psychiatric symptom scale (r=0.36,P＜0.01).Conclusion This study demonstrates that medication attitude can improve the treatment of mental symptoms by increasing compliance in the medication-only group.Symptom improvement is associated with improved compliance but not with medication attitudes in the integrated treatment model.