Caracterización de la Aplicación del Test MINI para Evaluar Salud Mental. Cuenca - Ecuador, 2017 / Characterization of the MINI Test Application to Evaluate Mental Health. Cuenca-Ecuador, 2017

INTRODUCCIÓN: La evaluación de la salud mental en los servicios de salud no se realiza de forma regular, generando un subregistro diagnóstico que afecta la planificación y distribución de recursos. El Test Mini Entrevista Neuropsiquiátrica Internacional es una entrevista breve y estructurada que permite diagnosticar los principales trastornos psiquiátricos; su confiabilidad es alta al compararla pruebas similares. El presente estudio tuvo como objetivo caracterizar la aplicación de éste instrumento entre la población que acude a las unidades de primer nivel de atención. MÉTODOS: Estudio descriptivo-transversal con una muestra de 155 personas que acudieron a los centros de primer nivel de las parroquias urbanas y rurales del cantón Cuenca en el mes de abril de 2017. Se aplicó el test Mini Entrevista Neuropsiquiátrica Internacional y una encuesta para recolectar información relacionada con las variables estudiadas. Los resultados fueron analizados en SPSS versión 25.0 RESULTADOS: El tiempo promedio de aplicación del Test fue 21.6 minutos sin diferencia importante entre sexo, edad e instrucción; y 20.93 minutos en quienes presentaron trastornos psiquiátricos. La depresión mayor fue la patología más frecuente, presente mayormente en personas viudas, sin instrucción y con discapacidad. CONCLUSIÓN: No existe diferencia importante entre el tiempo de aplicación del Test considerando las distintas variables demográficas respecto al modelo estándar; se lo considera como una herramienta útil para ser utilizado en el primer nivel de atención.(au)

BACKGROUND: The evaluation of mental health in health services is not carried out on a regular basis. This led to an underreport diagnosis that affected the planning and distribution of resources. The Mini-International Neuropsychiatric Interview is a brief and structured interview that allows diagnosing the main psychiatric disorders with high reliability when compared similar evaluations. The aim of this study was to characterize the application of this instrument in the population that went to the first level care units. METHODS: Cross-sectional descriptive study with a sample of 155 people who attended the first level centers of the urban and rural communities in Cuenca. The Mini-International Neuropsychiatric Interview and a survey were applied to collect additional information related to the studied variables. The results were analyzed in SPSS 25.0. RESULTS: The average time of application of the test was 21.6 minutes without significant difference between sex, age and instruction; and 20.93 minutes in those with psychiatric disorders. Depressive disorder was the most frequent and it was present in widowed, uneducated and disabled people. CONCLUSION: No significant difference was found between the test application times considering the different demographic variables with respect to the standard model, so it is considered as a useful tool to be used in the first level of care.(au)

Effect of Shugan Jieyu capsule on depression in patients with schizophrenia / 中国基层医药

Objective To investigate the effect of Shugan Jiayu capsule on depression in patients with schizophrenia.Methods From January 28,2016 to January 24,2017,82 schizophrenic patients in Wenling Psychiatric Rehabilitation Hospital were selected in the study.All the patients had depressive symptoms and were divided into two groups by random number table method,with 41 cases in each group.Both two groups were treated with routine therapy.The control group was treated with quetiapine,and the observation group was given Shugan Jieyu capsule.The improvement of the disease and the occurrence of adverse events in the two groups were observed.Results At two weeks and one month after treatment,the Hamilton Depression Scale (HAMD) scores of the observation group [(16.97 ± 2.23) points and (12.53 ± 1.88) points] were lower than those of the control group (t =3.06,5.52,all P ＜ 0.05).After one week,two weeks and one month of treatment,the Brief Psychiatric Rating Scale (BPRS) scores of the observation group[(30.29 ±2.41)points,(25.47 ±2.59) and (21.03 ±2.77)points] were lower than those of the control group (t =6.17,6.60,10.20,all P ＜ 0.05).After one week,two weeks and one month of treatment,the Positive and Negative Symptom Scale(PANSS) scores of the observation group were (72.76 ± 3.83)points,(41.50 ±3.46) points and (33.94 ± 2.89) points,respectively,which were better than those of the control group (t =4.02,12.25,13.40,all P ＜ 0.05).The incidence rate of adverse events in the observation group [4.88％ (2/41)] was obviously lower than that in the control group[19.51％ (8/41)] (x2 =4.10,P ＜ 0.05).The recurrence rates of the observation group after 3 months and 6 months were 7.32％ (3/41) and 12.20％ (5/41),respectively,which were lower than those of the control group[26.83％ (11/41) and 34.15％ (14/41)] (x2 =5.51,5.55,P＜0.05).Conclusion Shugan Jieyu capsule can effectively improve the depressive symptoms of schizophrenia patients.

Analysis of efficacy of L-apigenin A in the treatment of Alzheimer's disease / 中国基层医药

Objective To evaluate the effects L-apigenin A on Alzheimer's disease(AD),and analyze the correlation between MMSE and ADAS-cog scores.Methods From January 2009 to December 2014,34 patients with AD were selected in Qinhuangdao Military Industry Hospital.They were treated with celery seed extract L-apigenin.The MMSE scores and ADAS-cog scores were evaluated before treatment and 18,36 and 72 d after treatment.The correlation between MMSE scores and ADAS-cog scores was analyzed.Results There were statistically significant differences in the MMSE scores between 72d after treatment [(22.59 ± 1.13)points] and before treatment [(20.53 ±1.42) points],18d after treatment [(20.44 ± 1.24) points] and 36d after treatment [(20.97 ± 1.17) points] (t =6.619,7.473,5.807,all P ＜ 0.05).There were statistically significant differences in ADAS-Cog scores between 72d after treatment[(17.09 ± 1.53) points] and before treatment [(20.47 ± 2.85) points],18d after treatment [(20.18 ± 2.34) points] and 36d after treatment [(20.18 ± 2.49) points] (t =6.093,6.445,6.165,all P ＜ 0.05).The MMSE score and ADAS-Cog score had negative correlation by Pearson analysis (r =-0.259,P =0.000).Conclusion L-apigenin A can significantly improve the cognitive function of patients with AD.There is significant negative correlation between the MMSE scores and ADAS-cog scores.

Effect of Shugan Jieyu capsule on depression in patients with schizophrenia / 中国基层医药

Objective@#To investigate the effect of Shugan Jiayu capsule on depression in patients with schizophrenia.@*Methods@#From January 28, 2016 to January 24, 2017, 82 schizophrenic patients in Wenling Psychiatric Rehabilitation Hospital were selected in the study.All the patients had depressive symptoms and were divided into two groups by random number table method, with 41 cases in each group.Both two groups were treated with routine therapy.The control group was treated with quetiapine, and the observation group was given Shugan Jieyu capsule.The improvement of the disease and the occurrence of adverse events in the two groups were observed.@*Results@#At two weeks and one month after treatment, the Hamilton Depression Scale(HAMD) scores of the observation group[(16.97±2.23)points and (12.53±1.88)points] were lower than those of the control group (t=3.06, 5.52, all P<0.05). After one week, two weeks and one month of treatment, the Brief Psychiatric Rating Scale(BPRS) scores of the observation group[(30.29±2.41)points, (25.47±2.59) and (21.03±2.77)points] were lower than those of the control group (t=6.17, 6.60, 10.20, all P<0.05). After one week, two weeks and one month of treatment, the Positive and Negative Symptom Scale(PANSS) scores of the observation group were (72.76±3.83)points, (41.50±3.46)points and (33.94±2.89)points, respectively, which were better than those of the control group(t=4.02, 12.25, 13.40, all P<0.05). The incidence rate of adverse events in the observation group[4.88%(2/41)] was obviously lower than that in the control group[19.51%(8/41)](χ2=4.10, P<0.05). The recurrence rates of the observation group after 3 months and 6 months were 7.32%(3/41) and 12.20%(5/41), respectively, which were lower than those of the control group[26.83%(11/41) and 34.15%(14/41)](χ2=5.51, 5.55, P<0.05).@*Conclusion@#Shugan Jieyu capsule can effectively improve the depressive symptoms of schizophrenia patients.

Analysis of efficacy of L-apigenin A in the treatment of Alzheimer's disease / 中国基层医药

Objective@#To evaluate the effects L-apigenin A on Alzheimer＇s disease(AD), and analyze the correlation between MMSE and ADAS-cog scores.@*Methods@#From January 2009 to December 2014, 34 patients with AD were selected in Qinhuangdao Military Industry Hospital.They were treated with celery seed extract L-apigenin.The MMSE scores and ADAS-cog scores were evaluated before treatment and 18, 36 and 72 d after treatment.The correlation between MMSE scores and ADAS-cog scores was analyzed.@*Results@#There were statistically significant differences in the MMSE scores between 72d after treatment[(22.59±1.13)points]and before treatment[(20.53±1.42)points], 18d after treatment[(20.44±1.24)points]and 36d after treatment[(20.97±1.17)points](t=6.619, 7.473, 5.807, all P<0.05). There were statistically significant differences in ADAS-Cog scores between 72d after treatment[(17.09±1.53)points]and before treatment[(20.47±2.85)points], 18d after treatment[(20.18±2.34)points]and 36d after treatment[(20.18±2.49)points](t=6.093, 6.445, 6.165, all P<0.05). The MMSE score and ADAS-Cog score had negative correlation by Pearson analysis (r=-0.259, P=0.000).@*Conclusion@#L-apigenin A can significantly improve the cognitive function of patients with AD.There is significant negative correlation between the MMSE scores and ADAS-cog scores.

Association between Thyroid Dysfunction and Severity, Treatment Response in Schizophrenic Inpatients

OBJECTIVES: Thyroid hormone deficiency during the neurodevelopmental period can impair brain development and induce psychiatric symptoms. This study examined the association between thyroid dysfunction and the severity of symptoms in schizophrenia patients, and the treatment response of patients with schizophrenia. METHODS: Three hundred thirty-eight schizophrenia patients, with no prior history of thyroid disease or taking medication associated with it, were studied. We assessed the blood thyroid hormone level, the Brief Psychiatric Rating Scale (BPRS) scores on the day of admission and discharge, admission period, dose of administered antipsychotics, and the number of antipsychotic combinations. The collected data were subsequently analyzed using the Kruskal-Wallis test and Pearson's chi-square test. RESULTS: The percentage of schizophrenia patients who presented with abnormal thyroid hormone level was 24.6%. High total triiodothyronine (TT3) (p = 0.003), low TT3 (p = 0.001), and high free thyroxine (fT4) (p < 0.001) groups showed a higher BPRS score on admission than did the normal thyroid hormone group, while thyroid stimulating hormone (TSH) levels were not significantly correlated with the severity of symptoms. Furthermore, thyroid hormone was not associated with the treatment response assessed by the rate of BPRS score reduction, admission days, use of clozapine, and dose of antipsychotics. CONCLUSIONS: The TT3 and fT4 hormone levels were significantly associated with the severity of symptoms in schizophrenia patients. These relations suggested that thyroid dysfunction may be associated with the severity of schizophrenia. And hence, further analysis of the results of the thyroid function test, which is commonly used in cases of psychiatric admission, is required.

Antidepressants Use in Schizophrenia: Clinical Correlates and Prescription Profiles / 신경정신의학

OBJECTIVES: To identify recent prescription patterns, as well as the demographic and clinical correlates of antidepressants (ADs) usage in schizophrenic patients. METHODS: A total of 297 patients diagnosed with schizophrenia enrolled at Seoul National Hospital in 2013. Brief Psychiatric Rating Scale (BPRS) was used to evaluate current psychiatric symptoms. Bivariate comparisons were used to assess the usage of concomitant psychotropics, demographic and clinical characteristics of ADs users compared with non-users. Multivariate analysis of covariance was performed consecutively. RESULTS: The rate of ADs usage was 26.3% and the most commonly used ADs were selective serotonin reuptake inhibitors. ADs users more often took benzodiazepine than ADs non-users (p=0.005), whereas there were no significant demographic and other clinical difference between the two groups. Regarding BPRS, somatic concern (p=0.022), anxiety (p=0.001) and depressive mood (p=0.009) scores were higher, and excitement (p=0.006) and hostility (p=0.04) scores were lower among ADs users compared to non-users, although there was no significant difference in the other scores of BPRS between the two groups. Moreover, among 5 components of BPRS, scores of affective symptoms (p < 0.001) were significantly higher, and scores of activation symptoms (p=0.014) were significantly lower in ADs users compared to non-users. CONCLUSION: This study suggests that the usage of ADs could be related to affective symptoms regardless of positive and negative symptoms of schizophrenia. Further studies are required in order to confirm the clinical correlates of ADs usage and the interactions between affective symptoms and psychotic symptoms.

Aggressive behavior during the first 24 hours of psychiatric admission / Comportamento agressivo durante as primeiras 24 horas de internação psiquiátrica

OBJECTIVE: To investigate the association between aggression in the first 24 hours after admission and severity of psychopathology in psychiatric inpatients. METHODS: This cross-sectional study included psychiatric patients admitted to Hospital Universitário de Santa Maria, in Santa Maria, southern Brazil, from August 2012 to January 2013. At their arrival at the hospital, patients were interviewed to fill in the Brief Psychiatric Rating Scale (BPRS) form, and any aggressive episodes in the first 24 hours after admission were recorded using the Overt Aggression Scale (OAS). The Mann-Whitney U test was used to compare patients according to aggressiveness: aggressive versus non-aggressive, hostile versus violent, and aggressive against others only versus self-aggressive. RESULTS: The sample was composed of 110 patients. Aggressive patients in general had higher BPRS total scores (p = 0.002) and individual component scores, and their results showed more activation (p < 0.001) and thinking disorders (p = 0.009), but less anxious-depression (p = 0.008). Violent patients had more severe psychomotor agitation (p = 0.027), hallucinations (p = 0.017) and unusual thought content (p = 0.020). Additionally, self-aggressive patients had more disorientation (p = 0.011) and conceptual disorganization (p = 0.007). CONCLUSIONS: Aggression in psychiatric patients in the first 24 hours after admission is associated with severity of psychopathology, and severity increases with severity of patient psychosis and agitation (AU)

OBJETIVO: Avaliar a relação entre agressividade nas primeiras 24 horas após admissão e a gravidade da psicopatologia de pacientes psiquiátricos. MÉTODOS: Este estudo transversal foi realizado no Hospital Universitário de Santa Maria, na região sul do Brasil, com pacientes admitidos entre agosto de 2012 e janeiro de 2013. Ao chegar ao hospital, os pacientes foram entrevistados para completar a Escala Breve de Avaliação Psiquiátrica (BPRS), e todos os episódios de agressão nas primeiras 24 horas após a admissão foram registrados usando a Escala de Agressividade Declarada (OAS). O teste U de Mann-Whitney foi usado para as comparações entre pacientes agressivos e não-agressivos, hostis e violentos, e agressivos contra outros apenas ou autoagressivos. RESULTADOS: A amostra tinha 110 pacientes. Em geral, pacientes agressivos tiveram escores mais altos na escala BPRS (p = 0.002) e nos itens individuais, e exibiram mais ativação (p < 0.001) e distúrbios de pensamento (p = 0.009), mas menos ansiedade-depressão (p = 0.008). Os pacientes violentos tiveram escores mais altos para excitação (p = 0.027), comportamentos alucinatórios (p = 0.017) e alteração de conteúdo do pensamento (p = 0.020). Além disso, os pacientes autoagressivos mostraram maior desorientação (p = 0.011) e desorganização conceitual (p = 0.007). CONCLUSÕES: A agressão em pacientes psiquiátricos nas primeiras 24 horas da admissão é relacionada a gravidade da psicopatologia, a qual aumenta à medida que a gravidade da psicose e a excitação do paciente aumentam (AU)

Acute psychosis induced by topiramate.

Topiramate (TPM) is a new potent antiepileptic drug (AED) used as add-on therapy for generalized and partial seizures that are resistant to the other AEDs; or as a mood stabilizer, and for reducing weight gain associated with olanzapine and clozapine in patients with bipolar disorder or schizophrenia. However, there is a higher risk of psychosis with TPM in patients with a past history of psychiatric disorder. This case report highlights emergence of psychosis that was related to TPM which resolved on discontinuation.

Suicide risk and associated risk factors in adult patients with epilepsy / 中华神经科杂志

Objective To investigate the relationships of suicide risk and its associated risk factors in adult patients with epilepsy.Methods All 211 adult patients with epilepsy from the epilepsy clinic of the Second Affiliated Hospital,Zhejiang University School of Medicine,were enrolled to evaluate the presence of suicide risk and depressive disorder by using the suicide module and the depressive disorder module of the Mini International Neuropsychiatric Interview (MINI).Demographic variables for age,gender,employment status,marital status,years of education,and seizure factors for age of onset,types of seizure,seizure frequency and epilepsy duration,result of MRI and types of antiepileptic drugs were also recorded.We compared the differences of risk factors between the two groups with or without suicide risk and investigated the relationships between the depressive disorder and suicide risk.Results The suicide risk of the patients was 21.3％ (45/211),and 17.1％ (36/211) of the patients had depressive disorder.The suicide risk of the epilepsy patients associated with depressive disorder was 75.0％ (27/36),and the suicide risk of the epilepsy patients associated with no depressive disorder was 10.3％ (18/175).There was statistical difference between the two groups (x2 =74.525,P ＜ 0.01).About 60.0％ (27/45) of the patients with suicide risk was accompanied with depressive disorder.As suicide risk increased,the proportion of concurrent depressive disorder elevated.There was significant statistical difference in the rates of depressive disorder among the different suicide risk groups.Conclusions The patients with epilepsy have suicide risk.The suicide risk is higher in patients with depressive disorder.

Fate of Dyspeptic or Colonic Symptoms After Laparoscopic Cholecystectomy

BACKGROUND/AIMS: Gallbladder diseases can give rise to dyspeptic or colonic symptoms in addition to biliary pain. Although most biliary pain shows improvement after cholecystectomy, the fates of dyspeptic or colonic symptoms still remain controversial. This study assessed whether nonspecific gastrointestinal symptoms improved after laparoscopic cholecystectomy (LC) and identified the characteristics of patients who experienced continuing or exacerbated symptoms following surgery. METHODS: Sixty-five patients who underwent LC for uncomplicated gallbladder stones or gallbladder polyps were enrolled. The patients were surveyed on their dyspeptic or colonic symptoms before surgery and again at 3 and 6 months after surgery. Patients' mental sanity was also assessed using a psychological symptom score with the Symptom Checklist-90-Revised questionnaire. RESULTS: Forty-four (67.7%) patients showed one or more dyspeptic or colonic symptoms before surgery. Among these, 31 (47.7%) and 36 (55.4%) patients showed improvement at 3 and 6 months after surgery, respectively. However, 18.5% of patients showed continuing or exacerbated symptoms at 6 months after surgery. These patients did not differ with respect to gallstone or gallbladder polyps, but differed in frequency of gastritis. These patients reported lower postoperative satisfaction. Patients with abdominal symptoms showed higher psychological symptom scores than others. However, poor mental sanity was not related to the symptom exacerbation. CONCLUSIONS: Elective LC improves dyspeptic or colonic symptoms. Approximately 19% of patients reported continuing or exacerbated symptoms following LC. Detailed history-taking regarding gastritis before surgery can be helpful in predicting patients' outcome after LC.

Clinical Correlates and Description Profiles of Antipsychotic Polypharmacy for Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Despite increasing use of antipsychotic polypharmacy (APP), few studies have investigated APP for Korean patients with schizophrenia. The aim of this study was to identify the sociodemographic and clinical correlates and recent prescription profiles of APP in schizophrenia patients. METHODS: A total of 297 schizophrenia patients were recruited and interviewed using standardized assessment instruments in Seoul National Hospital. Differences in demographic and clinical characteristics between APP and antipsychotic monopharmacy (APM) groups were analyzed. The prescriptions of psychotropic drugs were collected by a review of medical records. RESULTS: In comparison with the APM group, the APP group showed association with earlier onset, lower employment rate, and higher scores for Clinical Global Impression-Severity and Brief Psychiatric Rating Scale (BPRS) (p<0.001). In particular, the BPRS positive (p<0.001) and affective symptom scores (p<0.001) of the APP group were higher those of the APM group. The most frequent combination pattern of APP was second generation antipsychotics (SGA)+SGA, followed by SGA+first generation antipsychotics (FGA), and SGA+SGA+FGA. For antipsychotics, it was risperidone+quetiapine, followed by clozapine+risperidone, risperidone+sulpiride, and risperidone+haloperidol. CONCLUSION: The current study suggests that the usage of APP for schizophrenia could be related to symptom severity affected by positive and affective symptoms. The prescription profile reflects that the proportion of atypical antipsychotics on APP has increased.

Escalas de rastreamento para depressão pós-parto: uma revisão sistemática / Escalas de rastreo para depresión postparto: una revisión sistemática / Postpartum depression screening scales: a systematic review

O objetivo deste estudo foi realizar uma revisão sistemática sobre as escalas de rastreamento de Depressão Pós-Parto (DPP) aplicadas até 16 semanas após o parto em puérperas acima de 15 anos. Buscaram-se artigos em quatro bases de dados. Os artigos deveriam indicar a definição e a validação precisa dos instrumentos utilizados. Dos 424 resumos, 62 foram acessados na íntegra e, de acordo com os critérios estabelecidos, foram incluídos 18 artigos nesta revisão. O período de rastreamento de DPP variou de 2 a 10 dias pós-parto e o reteste entre 8 e 16 semanas pós-parto. A DPP foi diagnosticada entre 8,8 a 40 por cento da amostra dos estudos. A escala mais utilizada foi a Edinburg Depression Postpartum Scale (EDPS). Concluiu-se que as escalas são comumente utilizadas em pesquisas, mas podem ser uma ferramenta facilitadora para identificação de DPP na assistência às gestantes e às puérperas.

El estudio objetivó realizar una revisión sistemática sobre las escalas de rastreo de Depresión Postparto (DPP) aplicado hasta 16 semanas postparto en puérperas con más de 15 años. Se buscaron artículos en 4 bases de datos. Los artículos deberían indicar la definición y la validación exacta de los instrumentos utilizados. De los 424 resúmenes, se accedió a 62 íntegramente y de acuerdo con los criterios establecidos, se incluyeron 18 artículos en esta revisión. El período de rastreo varió de 2 a 10 días postparto y la nueva prueba entre 8 y 16 semanas postparto. La DPP fue diagnosticada entre 8,8 y 40 por ciento de la muestra de los estudios. Edinburgh Depression Postpartum Scale (EDPS) fue la escala más utilizada. Se concluyó que las escalas se usan generalmente en investigaciones pero pueden resultar una herramienta facilitadora para identificar la DPP en la atención a las gestantes y puérperas.

This study aimed at conducting a systematic review of postpartum depression (PPD) screening scales in puerperal applied until 16 weeks after delivery among women above 15 years old. Articles were searched in 4 databases. The included articles should precisely describe the definition and the validation of the used instruments. Out of the 424 abstracts found, 62 complete articles were accessed, and only 18 articles that fulfilled the above-mentioned requirements were included. PPD screening period varied from 2 to 10 days postpartum, and patients were retested between 8 to 16 weeks postpartum. PPD was diagnosed in 8.8 to 40 percent of the patients sampled in those studies. The most frequent used scale was the Edinburgh Postpartum Depression Scale (EPDS). It was concluded that scales are frequently used in research studies, and may allow the identification of PPD in gestating and puerperal patient care.

Demographic and Clinical Factors Associated With Verbal memory Performance In Patients With Schizophrenia In Hospital Universiti Sains Malaysia (HUSM), Malaysia

Objective: The present study aims to assess verbal memory performance in patients with schizophrenia attending HUSM and determine the relationship between the patients’ verbal memory performance and their demographic/clinical factors. Methods: A cross sectional study of 114 patients with schizophrenia attending HUSM psychiatric services from December 2007 to May 2008 was conducted. The schizophrenia symptoms as well as verbal memory performance were assessed using the Brief Psychiatric Rating Scale, the Malay version of the Calgary Depression Scale (MVCDS), and the Malay version of the Auditory Verbal Learning Test (MVAVLT). The relationship between verbal memory performance and demographic/clinical symptoms was evaluated using Pearson Correlation. Results: Overall MVAVLT scores in all the trials were lowered in patients with schizophrenia compared to average healthy controls. There were significant relationships between occupational status and MVAVLT performance in Trial A1-A5 Total; between educational level and MVAVLT performance in Trial A1 and Trial A1-A5 Total and between severities of illness and MVAVLT performance in all indexes except Trial A1 after controlled for occupation and educational level. Conclusions: Patient with schizophrenia in HUSM performed significantly worse than healthy controls in verbal memory with or without interference. There were significant relationships between MVAVLT performance and patient’s occupational status, educational level and severity of the illness but not depressive symptoms.

Right Caudate Volumetric Differences in Young Healthy Adults with Different Dopamine DRD2/ANKK1 Taq 1a Polymorphisms

OBJECTIVES: The aim of this study was to assess variations in caudate volume according to dopamin receptor D2/ankyin repeat and kinase domain containing 1 (DRD2/ANKK1) Taq 1a polymorphisms in young healthy adults and to evaluate the relationship between caudate volumes and psychiatric symptoms as measured by the Brief Psychiatric Rating Scale. METHODS: Genetic information regarding DRD2/ANKK1 Taq 1a and T1-weighted brain magnetic resonance images were acquired from 30 young healthy adults. Automatic segmentation of caudate was performed using the FreeSurfer program. RESULTS: Individuals with A2 homozygotes of DRD2/ANKK1 Taq 1a polymorphisms (n = 10) had greater right caudate volumes compared to those with A1 allele (s)(18.4% greater ; p = 0.019). Right caudate volumes were negatively associated with total scores of the Brief Psychiatric Rating Scale (beta=-0.50 ; p = 0.016). CONCLUSIONS: Our findings suggest the possibility that DRD2/ANKK1 Taq 1a polymorphisms may underlie the psychiatric symptoms by influencing the structure of the right caudate.

Gradual Community-based Rehabilitation for Schizophrenia in Changping Countryside: A Comparative Study / 中国康复理论与实践

@#Objective To explore the effect of gradual community-based rehabilitation on schizophrenia in the countryside. Methods 60 rural patients with schizophrenias were randomly sampled and divided into two groups: the rehabilitation group and the control group. The patients in the rehabilitation group were intervened with comprehensive rehabilitation by specialist, while those in the control group were intervened with follow-up survey. They were assessed with the Brief Psychiatric Rating Scale (BPRS), Scale for Assessment of Negative Symptoms (SANS) and Social Disability Screening Schedule (SDSS) before and 3, 6, 9, 12, 15, 20 months after the rehabilitation. Results The differences in scores of BPRS, SDSS and SANS were more significant with the time of rehabilitation. Conclusion The outcome of the community-based rehabilitation for schizophrenias may associate with the persistence in the countryside.

Designing A Culture, Language And Illness-Specific Self-esteem Scale In Bahasa Malaysia

Objective: Self-esteem is an important component of psychological health. In Malaysia, Rosenberg’s self-esteem scale remained the single most popular utilized scale for studying global self-esteem. This study aims to design a language, culture and illness specific self-esteem questionnaire. Methods: The study consisted of 2 phases. The first phase was to generate items for the new self-esteem questionnaire (SSES) in Bahasa Malaysia. Literature review on the concept of self- esteem and its’ content was conducted. This was followed by expert opinion from professional care-givers. The items were qualitatively validated by healthy subjects and patients with schizophrenia from the same locality, culture and language. The second phase consists of quantitative validation of the items. Items in the new scale were analyzed based on the responses from 165 stable schizophrenia outpatients. The validated Malay version of Rosenberg Self-Esteem scale (RSES) was used concurrently as a comparison. Results: The SSES displayed good internal consistency for its two domains (Cronbach’s alpha=0.88, 0.81) and test-retest reliability (ICC), ranged from 0.44 to 0.87. Its construct validity was confirmed by confirmatory factor analysis. The concurrent validity of SSES and RSES using Pearson correlation was 0.77. The Cronbach’s alpha for the validated Malay version of RSES is 0.67. Conclusion: This study presents a new self-esteem questionnaire (SSES) which has high concurrent validity with the standard RSES and confirms the reliability and validity of SSES in Malay patients with Schizophrenia.

The Assessment Tools in Palliative Medicine / 한국호스피스완화의료학회지

The assessment of patient status in palliative medicine is essential for determining treatments and for clinical outcomes. The objective of assessment tools is to raise the quality of care for individual patients and their families. There are a number of tools available to assess pain, non-pain symptoms and quality of life. The tools are either uni-dimensional or multi-dimensional measures. Unfortunately, however, no single tool is recommended to be a superior to others in symptoms or quality of life assessment. Therefore, to select an appropriate assessment tool, one should consider the time frame and unique characteristics of tools depending on purpose and setting. The combination of prognostic index is highly recommended in prognostication, and web-based prognostic tools are available. Recently, a new objective prognostic score has been constructed through multicenter study in Korea. It does not include clinicalestimates of survival, but includes new objective prognostic factors, therefore, anyone can easily use it. For beginners in palliative medicine, relatively easy-to-use tools would be convenient. We recommend Eastern Cooperative Oncology Group performance status to assess functional status, numeric rating scale for pain assessment and the Korean version of brief pain inventory for initial pain assessment. Asking directly with numeric rating scale or the Korean version of MD Anderson Symptom Inventory would be desirable to assess various symptoms together. We think that European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care is good to assess the quality of life, while Objective Prognostic Score is convenient as prognostic index for beginners.

Clinical characters correlate with cranial MRI lesion in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy / 中华神经科杂志

Objective To assess retinal arteriole stenosis in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and to evaluate the relationship between retinal arteriole stenosis with cranial MRI changes and clinical features. Methods Sixteen CADASIL patients (mean age was (43.4±8.1)years, mean duration was(4.7±3.4)years)and sixteen age matched healthy individuals were enrolled. Mini-Mental State Examination (MMSE) and modified Rankin scale scoring were performed in 16 patients. Cranial MRl with Coulthard scores was assessed on CADASIL patients as well. Retinal examinations for arteriole stenosis were done for each subject. Bivariate correlations (Kendall's tau-b) were used to assess the relationship among the grade of retinal stenosis, MMSE, modified Rankin seale, cranial MRI with Coulthard scores and age. Results Retinal arteriole stenosis presented in 15 cases. in whom 4 cases showed mild arterio-venous nicking. while it only presented in 2 controls. Grade 0.Ⅰ, and Ⅲ of retinal arteriole stenosis are noted in 1/16,4/16,7/16 and 4/16cases respectively. Coulthard scores of cerebral MRl were 6.0.19.0.25.1 and 29.8 respectively from Grade 0 toⅢ of retinal arteriole stenosis. The correlation coefficient of retinal arteriole stenosis and cranial MRI scores was 0.743(P＜0.001＝,MMSE-0.429(P＜0.05＝,modified Rankin scale 0.437(P＞0.05).and age 0.299(P＞0.05).Conclusion Retinal arteriole stenosis is significantly correlated with lesion in cranial MRI and dementia.

Acupuncture Treatment for Refractory Auditory Hallucination in Schizophrenia Patients——A Report of 50 Cases / 中医杂志

Objective To observe the effect and safety of acupuncture treatment on refractory auditory hallucination in schizophrenia patients. Methods The 100 patients clinically diagnosed as refractory auditory hallucination of schizophrenia were randomized into test group and control group with 50 in each. The control group was treated with risperidone alone while the test group was treated with acupuncture on the basis of TCM syndrome differentiation in addition to risperidone. One month was one course,totally 3 courses of treatment was given. The clinical effect of both groups was observed. The effect in different courses of disease and the effect in different syndromes of the test group were compared respectively. Before and after treatment the brief psychiatric rating scale (BPRS),specific auditory hallucination scale(SAHS),and treatment emergent symptom scale (TESS) were adopted to score the patients of both groups. Results In the test group,there were 3 cases lost,the total effective rate was 72.34%; while in the control group,there was 1 case lost,the total effective rate was 38.78%,the difference being significant (P 0.05). The difference in BPRS and SHRS scores at the same period of time after 2nd and 3rd courses of treatment of the two groups was significant (P