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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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Introducción: La popularización del reduccionismo neurobiológico en psicopatología conlleva la idea de que la esquizofrenia puede entenderse simplemente como el producto de alteraciones en el funcionamiento cerebral. Por otro lado, y criticando esta tradición, el enfoque fenomenológico propone que la esquizofrenia debería entenderse como un trastorno del yo. Si bien ambas tradiciones son relevantes en la actualidad, creemos que una comprensión completa del fenómeno psicótico envuelve una integración de ambas. Objetivo: Este artículo plantea que la hipótesis de la saliencia aberrante es un buen candidato para unificar la tradición fenomenológica y la neuropsiquiátrica en el estudio de la esquizofrenia. Procedimiento: Luego de examinar la hipótesis en cuestión en profundidad, exploramos la forma en que podría explicar algunos de los síntomas positivos de la esquizofrenia de forma consistente con sus descripciones fenomenológicas. Conclusiones: Finalmente, se ofrecen algunas consideraciones generales respecto de las consecuencias de nuestro análisis para el campo de la psicopatología.
Introdução: A popularização do reducionismo neurobiológico na psicopatologia traz a ideia de que a esquizofrenia pode ser entendida simplesmente como o produto de alterações na função cerebral. Por outro lado, e criticando essa tradição, a abordagem fenomenológica propõe que a esquizofrenia seja entendida como uma desordem do eu. Embora ambas as tradições sejam relevantes hoje, acreditamos que uma compreensão completa do fenômeno psicótico envolve uma integração de ambas. Objetivo: Este artigo argumenta que a hipótese da saliência aberrante é uma boa candidata para unificar as tradições fenomenológica e neuropsiquiátrica no estudo da esquizofrenia. Procedimento: Depois de examinar a hipótese em questão em profundidade, exploramos como ela pode explicar alguns dos sintomas positivos da esquizofrenia de maneira consistente com suas descrições fenomenológicas. Conclusões: Por fim, são oferecidas algumas considerações gerais sobre as consequências de nossa análise para o campo da psicopatologia.
Background: The popularization of neurobiological reductionism in psychopathology involves the idea that schizophrenia can be fully understood as the mere product of brain-functioning alterations. Criticizing this tradition, the phenomenological approach proposes that schizophrenia should be understood as a self-disturbance. Although both traditions are relevant, we believe that a comprehensive understanding of schizophrenia involves the integration of these two frameworks. Aim: This article proposes that the aberrant salience hypothesis is a good candidate for unifying the phenomenological tradition with the neuropsychiatric approach to psychosis. Methods: After examining the aberrant salience hypothesis in detail, we explore the way in which it can explain the positive symptoms of schizophrenia respecting being consistent with their phenomenological descriptions. Conclusion: we conclude with some considerations about the consequences of our analysis for the field of psychopathology.
Introduction: L'idéal du réductionnisme neurobiologique en psychopathologie implique l'idée que la schizophrénie peut être comprise simplement comme le produit d'altérations du fonctionnement cérébral. D'autre part, et critiquant cette tradition, l'approche phénoménologique propose que la schizophrénie soit comprise comme un trouble de soi. Bien que les deux traditions soient pertinentes aujourd'hui, nous pensons qu'une compréhension complète du phénomène psychotique implique une intégration des deux. Objectif: Cet article soutient que l'hypothèse de la saillance aberrante est un bon candidat pour unifier les traditions phénoménologique et neuropsychiatrique dans l'étude de la schizophrénie. Procédure: Après avoir examiné en profondeur l'hypothèse en question, nous explorons comment elle pourrait expliquer certains des symptômes positifs de la schizophrénie d›une manière cohérente avec leurs descriptions phénoménologiques. Conclusions: Enfin, quelques considérations générales sont proposées concernant les conséquences de notre analyse pour le domaine de la psychopathologie.
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Abstract Objective To assess the psychometric properties of the Thai version of the Scale for the Assessment of Positive Symptoms (SAPS-Thai). Methods Content validity was evaluated by four psychiatrists who rated the SAPS-Thai, and the content validity indexes (CVI) were also analyzed. Known-group validity was assessed by comparing the SAPS-Thai score among thirty outpatients and ten inpatients with schizophrenia. Internal consistency was calculated using the Cronbach's coefficient alpha. Results SAPS-Thai has excellent content validity, with an average-CVI of 0.92. The inpatient group had a significant higher score for both the global SAPS-Thai scores [7.4 (1.95) vs. 1.93 (1.59), p < 0.001] and total SAPS-Thai scores [21.2 (11.8) vs. 3.67 (2.87), p < 0.001] indicating good known-group validity. SAPS-Thai had a good internal consistency with a Cronbach's alpha of 0.87. Discussion SAPS-Thai provides a comprehensive measurement of positive symptoms and indicated content and known-group validity and a satisfactory level of internal consistency reliability.
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Objective To investigate the difference of Alzheimer-associated neuronal thread protein ( AD7c-NTP) level and related factors among different symptom types of schizophrenia. Methods The con-centrations of AD7c-NTP in urine of 30 patients with positive symptoms,46 patients with negative symptoms and 24 controls were detected by enzyme linked immunosorbent assay( ELISA) . Positive and negative symp-tom scale ( PANSS) was used to assess schizophrenia patients. The correlation analysis was conducted be-tween the urine AD7c-NTP and demographic factors. Results The level of AD7c-NTP in urine of patients with negative symptoms((0. 88±0. 93) ng /ml)was higher than that in the patients with positive symptoms ((0. 50±0. 22)ng/ml,P<0. 05). The level of AD7c-NTP of in urine female patients((1. 16±1. 12)ng/ml) was higher than that in the male patients((0. 57± 0. 49)ng/ml,P<0. 01). AD7c-NTP levels in patients with a course of disease of more than 100 months((0. 96±0. 96)ng/ml) were higher than those in patients with a course of disease of less than 100 months((0. 60±0. 59)ng/ml,P<0. 05). The level of AD7c-NTP in pa-tients over 35 years old((0. 94±0. 96)ng/ml) were higher than that in patients under 35 years old((0. 62±0. 62)ng/ml,P<0. 05). The level of AD7c-NTP in patients with MMSE score of 0-22 points((0. 92±0. 80) ng/ml) were higher than that in patients with score of 23-29 points((0. 62±0. 74)ng/ml,P<0. 05). Before admission(at least 2 months),the level of AD7c-NTP in patients without persisting in taking drugs((0. 99± 0.95)ng/ml) was higher than that in patients with persisting in taking drugs((0. 62±0. 65)ng/ml,P<0. 05). The level of AD7c-NTP in schizophrenic patients was positively correlated with age and course of dis-ease( r=0. 29,0. 26,P<0. 05) ,and negatively correlated with smoking history and mini-mental state exami-nation( MMSE) ( r=-0. 13,-2. 41,P<0. 05) . Conclusion There is a difference in AD7c-NTP levels be-tween patients with positive and negative symptoms of schizophrenia. Gender,age,course of disease and anti-psychotics are important factors that affect AD7c-NTP levels in patients with schizophrenia.
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ObjectiveTo investigate the relationship between the serum concentration of IL-6,S100β,NT-3 and the cognitive functions in first-episode schizophrenia characterized by positive or negative symptoms.Methods44 first-episode schizophrenic patients characterized by positive symptoms (positive group),36 first-episode schizophrenic patients characterized by negative symptoms (negative group) and 50 healthy controls (controls) were collected.The serum levels of IL-6,S100β and NT-3 were measured by enzyme-linked immunosorbent assay (ELISA).The systematic evaluation tool-MCCB was applied to assess cognitive function in patients and controls.ResultsNT-3 serum levels in positive or negative groups were lower than those in controls and the differences were significant((118.39±37.50) ng/L,(112.55±32.29) ng/L vs (141.18±29.67) ng/L) (P<0.01).IL-6 and S100β serum levels in positive or negative groups were higher than those in controls and the differences were statistically significant((5.74±1.00)ng/L,(5.07±1.17)ng/L vs (4.23±0.91)ng/L),((132.98±46.71)ng/L,(124.99±43.14)ng/L vs (103.63±31.57)ng/L)(P<0.01).IL-6 serum levels in the positive group ((5.07±1.17)ng/L) were lower than those in the negative group ((5.74±0.99)ng/L) and the difference was statistically significant (P<0.05).In MCCB test,the TMT scores in patients characterize by positive symptoms or patients characterize by negative symptoms were higher than those in healthy control group (P<0.01).BACS SC,HVLT-R WMS-Ⅲ,SS,NAB,BVMT-R,CF in patients characterize by positive symptoms or by negative symptoms were lower than those in healthy control group(P<0.01).There were no statistical difference in the MCCB scores between the patients with positive symptoms and negative symptoms.In positive group,there was a positive correlation between the IL-6 serum concentration and the general symptom scores in PANSS (P<0.05).In positive group,NT-3 serum concentration was positively correlated with the general symptom scores or total scores of PANSS (P<0.05).BVMT-R scores in MCCB were also positively correlated with IL-6 or NT-3 serum concentration in positive group (P<0.05).ConclusionThe impairment of part of cognitive functions for schizophrenic patients may be related to the serum protein factors.There may be different in pathophysiology between the first-episode schizophrenic patients characterized by positive symptoms and those characterized by negative symptoms.
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Objective To investigate the impairment of intertemporal choices in adolescents with positive and negative schizophrenic symptoms.Methods 30 adolescent schizophrenia patients with positive symptoms (positive symptoms group),30 adolescent schizophrenia patients with negative symptoms (negative symptoms group)and 30 healthy controls were selected.All the subjects were investigated with intertemporalchoice Test.Results (1) Under now conditions ((37.22±30.92)％,(19.67±16.35)％,P＜0.05)),notnow conditions ((35.74±31.69)％,(19.33± 18.07)％,P＜0.05)) and overall condition ((36.48±30.44) ％,(19.50± 13.82)％,P＜0.05)),the ratio of later-large (LL) choice in negative symptoms group were significantly higher than those in the healthy controls.Under now conditions ((37.22±30.92) ％,(20.37±22.33) ％,P＜0.05)),not-now conditions ((35.74± 31.69) ％,(22.04±22.05) ％,P＜ 0.05)) and overall condition ((36.48±30.44) ％,(21.20±21.57) ％,P＜0.05)),the ratio of LL choice in negative symptoms group were significantly higher than those in positive symptoms group.There were no differences in the ratio of LL choice between positive symptoms group and healthy controls (P＞ 0.05).(2)Pearson correlation analysis showed that the Vocabulary Fluency Test of negative symptoms group was positively correlated with LL selection ratio under now conditions (r=0.411,P=0.024).Conclusion The ability of intertemporal choices in adolescents schizophrenia patients with negative symptoms is impaired remarkably,while this kind of ability is impaired unremarkable in adolescence with negative symptoms.The ability of intertemporal choices in adolescents schizophrenic patients with negative symptoms is correlated with cognitive executive function.
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Aim To study the antipsychotic effects of l-Scoulerine ( l-SLR) . Methods NMDAreceptorantag-onist MK-801 was used to induce the positive and neg-ative symptoms of schizophrenia and cognitive impair-ment in animal models. The effects of l-SLR were eval-uated on schizophrenia induced by MK-801 and on ex-trapyramidal system. Results l-SLR (10,15 mg · kg - 1 , ip) could suppress pre-pulse inhibition damage in rats induced by MK-801 (0. 3 mg·kg - 1 , ip); l-SLR(30 mg·kg - 1 , ip) could inhibit climbing behav-iors in mice induced by apomorphine, which suggested that l-SLR had significant inhibiting effects on the posi-tive symptoms of schizophrenia by MK-801 and apo-morphine. l-SLR could also induce social contact inhi-bition and cognitive impairment induced by MK-801 (0. 2 mg · kg - 1 , ip), which proposed that l-SLR could improve the negative symptoms and cognitive im-pairment by MK-801. Catalepsy in mice could be caused by the treatment dose of haloperidol (0. 8 mg· kg - 1 , ip), not by that of l-SLR(30 mg·kg - 1 , ip). Conclusion I-SLR has significant effects on the posi-tive and negative symptoms of schizophrenia and cogni-tive impairment and, the effect of l-SLR under effective dose on extrapyramidal system is obviously much less than that of haloperidol and l-SPD.
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Background: Analysis of positive and negative symptoms of schizophrenia has been increasingly needed for a systematic management plan. Unfortunately, this type of study was lacking in Bangladesh. Aims: Th e study aims were to fi nd out the predominant symptom pattern and associating factors in schizophrenia. Methods: Th is was a cross sectional, analytical and descriptive study done in a tertiary care hospital with a sample size of 78. Th e SCID-I and pre designed socio demographic questionnaire was applied. Positive and negative symptoms were assessed by using the Positive and Negative Symptom Scale (PANSS). Statistical analysis was done through SPSS version 17. Results: Among 78 patients, schizophrenics with positive symptoms (57.7%) were predominant over schizophrenics with negative symptoms (42.3%). Delusion (64.1%) and blunted aff ect (55.1%) were the most frequent positive and negative symptoms respectively. Negative symptoms were signifi cantly associated with poverty, unemployment and lack of education. Limitations: Single centered cross sectional study with small sample size. Conclusions: Schizophrenic patients with positive symptoms visit clinicians more readily than those with negative symptoms.
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Cross-Sectional Studies , Disease Progression , Female , Humans , Male , Psychiatric Status Rating Scales , Schizophrenia/classification , Schizophrenia/diagnosis , Schizophrenia/epidemiology , Schizophrenia/statistics & numerical data , Schizophrenia/therapy , Schizophrenic PsychologyABSTRACT
Schizophreniaisacommonandseriousmentaldisorder,whichcausesgreatharmtopatientsandtheir families.Because of the complicated pathogenesis of schizophrenia , there are still many problems in its drug treatment . Stable and reliable animal models are required for preclinical studies of new drugs .In this article , we reviewed the rodent models associated with positive symptoms , negative symptoms and cognitive impairment of schizophrenia and the behavioral evaluation on these models , hoping to provide useful references of animal models for the antipsychotic drug screening and preclinical studies .
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OBJECTIVES: The goal of this study is to measure the auditory Event Related Potentials in Filipino patients with schizophrenia, their siblings and comparing them with normal controls. Specifically the P300 amplitude and latency measurements of schizophrenic patients would also be correlated to sociodemographic variables such as age, duration of illness and positive and negative symptoms of schizophrenia.METHODOLOGY: Patients with schizophrenia after consenting to participate in the study were screened using the Positive and Negative Symptom Scale. The auditory event related potentials (ERP) of the parietal electrode of these patients and their siblings as well as a control group of healthy individuals from the community were measured and compared.RESULTS: Comparison of P300 parameters among 20 patients with schizophrenia, 20 siblings and 20 controls using ANOVA showed that the P300 amplitude of schizophrenic patients was markedly reduced compared with the other 2 groups. P300 latency values were markedly prolonged in both schizophrenia and their siblings when compared to the control group. Analysis of the data revealed that P300 latency had a positive correlation with the duration of positive and negative symptoms. There was also an inverse correlation with positive symptomatology.CONCLUSION: There was a decreased P300 amplitude and prolonged P300 latency in Filipino Schizophrenic patients. P300 parameters in schizophrenic patients were correlated to age, duration of symptoms and positive and negative symptoms.
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Humans , Male , Female , Schizophrenia , Patients , PhilippinesABSTRACT
OBJECTIVES: Despite the growing research interest in the role of immunological markers in schizophrenia, a few studies, with conflicting results, have focused on the association between high sensitivity C-reactive protein (hs-CRP) levels and clinical characteristics in schizophrenia. The aim of the present study was to examine the association of serum hs-CRP with psychopathology in schizophrenia. METHODS: Fifty-five inpatients with schizophrenia or schizoaffective disorder were enrolled. Serum levels of hs-CRP were measured, and each patient was assessed with the Korean version of the Positive and Negative Syndrome Scale (PANSS). RESULTS: In correlation analysis of hs-CRP with PANSS subscales, positive subscale score has significant positive correlation (r = 0.271, p = 0.046). In independent t-test analysis, subjects with hs-CRP > 0.3 mg/dL (elevated CRP group, n = 43) had significantly higher PANSS positive subscale score (t = -3.273, df = 24.107, p = 0.003) than those with hs-CRP < or = 0.3 mg/dL (normal CRP group, n = 12). CONCLUSIONS: Elevated serum levels of high sensitivity C-reactive protein in schizophrenia are associated with the severity of psychotic symptoms.
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Humans , C-Reactive Protein , Inpatients , Psychopathology , Psychotic Disorders , SchizophreniaABSTRACT
Antipsychotic drugs are limited in their efficacy by the relatively poor response of negative and cognitive symptoms of schizophrenia as well as by the substantial variability in response between patients. Pharmacogenetic studies have sought to identify the genetic factors that underlie the individual variability in response to treatment, with a past emphasis on dopamine and serotonin receptors as candidate genes. Few studies have separated effects on positive and negative symptoms, despite the established differences in response to drug treatment between these syndromes. Where this has been done most findings are consistent with the conclusion that dopamine receptor polymorphisms relate to positive symptom response, while negative symptom improvement is influenced by polymorphisms of genes involved in 5-HT neurotransmission. A wide range of polymorphisms in other candidate genes have been investigated, with some positive findings in those genes associated with glutamatergic transmission and/or risk factors for schizophrenia. However, there remains a lack of good replicated findings; furthermore there is little evidence to support drug-specific genetic associations with treatment response. While most past studies focused on single candidate genes, technology now permits genome-wide association studies with response to antipsychotics. Although not without major limitations, these "hypothesis-free" approaches are beginning to identify further important risk factors for treatment response. Again there is little consistency between various studies, although some of the polymorphisms identified are in genes involved in neurodevelopment, which is increasingly being recognized as important in the pathophysiology of schizophrenia.
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Humans , Antipsychotic Agents , Dopamine , Genome-Wide Association Study , Neurobehavioral Manifestations , Pharmacogenetics , Polymethacrylic Acids , Receptors, Dopamine , Receptors, Serotonin , Risk Factors , Schizophrenia , Serotonin , Synaptic TransmissionABSTRACT
Para poder comprender tanto la realidad de la percepción como la de la alucinación es necesario partir de conceptos que, poniendo en cuestión los "de sentido común", hagan posible: a) reconocer la estructura psíquica esencialmente diferente de los fenómenos imaginarios alucinatorios (Henri Ey habla de: "heteronomía"), y b) comprender que esa heteronomía expresa la desorganización del acto perceptivo. Así se evidencia que la alucinación es una "falsa percepción" y no una forma de "más percepción" como se entiende en la serie de los DSM. Por eso Ey dice que la alucinación es esencialmente "fáctica" en el doble sentido de la palabra, de ser un hecho clínico y de caracterizarse por ser una irrupción de irrealidad.
To be able to understand the reality of perception as much as the reality of hallucinations, it is necessary to start from notions that, placing in doubt those of "common sense", make possible: a) recognize the psychic structure essentially different from the imaginary phenomena of hallucination (Henri Ey talks about "heteronomy"), and b) understand that heteronomy express the desorganization of the perceptive act. Thereby, it is showed that the hallucination is a "false perception" and not a way of "further perception", as it is deduced from the series of DSM.
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Humans , Hallucinations/etiology , Delirium/etiology , Perceptual Disorders , PsychopathologyABSTRACT
@#Objective To investigate the subjective quality of life(SQOL)in schizophrenia outpatients and explore the relationships among symptomology,drug-induced extrapyramidal side effects(EPS)and SQOL.Methods198 eligible subjects were recruited and interviewed using standard instruments.Multiple linear regression with stepwise method was used.ResultsEPS was found to significantly predict physical SQOL domain while anxiety and positive symptoms predicted psychological,social and environmental SQOL domains,respectively.ConclusionSQOL of schizophrenia outpatients could be improved if their anxiety and positive symptoms and EPS are effectively controlled.
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OBJECTIVES: This study investigated the validity of positive-negative dichotomy model by comparing the differences of neurocognitive function in the specific symptom subgroups of schizophrenia. METHODS: Factor analysis was performed on 14 items of the Positive and Negative Syndrome Scale (PANSS) among 71 inpatients with schizophrenia. All patients were assigned to one of specific symptom subgroups based on a ratio score and compared the neurocognitive distinction of each subgroups with normal control group, which was composed of 60 healthy persons without psychiatric illness. Neurocognitive functions include sustained attention, sensory register, executive function, attention and concentration, and verbal memory and learning obtained using Degraded Stimulus Continuous Performance Test, Span Apprehension Task, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test respectively. RESULTS: Three factors, positive, negative and disorganized, were yielded from factor analysis on 14 items of the PANSS. Three symptom subgroups showed the differential neurocognitive profiles. Disorganized symptom subgroup showed significant deficits in the sustained attention, sensory register, executive function, attention and concentration, and verbal memory and learning compared with the normal controls. Negative symptom subgroup showed significant deficits in the sustained attention, sensory register, executive function, and verbal memory and learning. Positive symptom subgroup showed significant deficits only in the sustained attention and sensory register compared with the normal controls. No significant differences were noted in the sustained attention, sensory register, attention and concentration, and verbal memory and learning among three symptom subgroups. But the disorganized symptom subgroup showed a significant deficit in the executive function compared to the positive symptom subgroup. CONCLUSIONS: These results support that three symptom dimensions including disorganization may be more valid than the positive-negative symptom dichotomy in the dimensions of schizophrenic symptoms.
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Humans , Executive Function , Factor Analysis, Statistical , Inpatients , Learning , Memory , Schizophrenia , Verbal Learning , WisconsinABSTRACT
Objective:To study the efficacy of social skill-training on the positive symptoms, negative symptoms and cognitive function of patients with chronic schizophrenia.Method:100 subjects who met with the criteria of Chinese Classification and Diagnostic Criteria of Schizophrenia were randomly assigned to the skill-training group (50 patients) and the control group (50 patients). Under the condition of stable antipsychotic medication, the skill-training group received the skill-training course offered by Liberman RP for 12 weeks. BPRS and SANS were used to evaluate every four weeks; WCST and SDSI were evaluated before and after the treatment.Result:(1) 45 patients of skill-training group and 46 patients of control group completed the study. (2) There were significant differences between skill-training group and control group in total score, anxiety depression and lacking active factor of BPRS (P
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OBJECTIVES: The aims of this study were to discriminate the clinical differences, to measure the estrogen and homovanillic acid levels. to evaluate a correlation between estrogen and homovanillic acid. and to identify an association of cognitive deficit with estrogen and homovanilli acid among male and female schizophrenics. METHODS: In addition to the structured interviews, the plasma estrogen levels by radioimmunoassay and the homovanillic acid levels by HPLC were measured in 20 male and 21 female schizophrenics as well as 10 healthy male and 9 female controls. RESULTS: 1) The plasma estrogen levels were higher in females than males, and significantly higher in female schizophenics than female controls. The homovanillic acid levels were higher in female schizophrenics than female controls, and were lower in male schizophrenics than male controls. 2) The onset age seemed to be earlier in male schizophrenics, and the frequency of admission, duration of antipsychotic drug administration. dosage of antipsychotics and duration of illnesses were more in males. The estrogen and homovanillic acid levels were significantly higher in female schizophrenics. 3) The estrogen levels had a significant positive correlation with sex, age and onset age, while the homovanillic acid levels did with sex. However, estrogen wee not correlated with homovanillic acid levels. 4) The estrogen and homovanillic acid levels were not significantly different between male and female schizophrenics with cognitive deficits. In the schizophrenic patients without cognitive deficits, the estrogen levels were significantly higher in females, while here were no significant sex differences in homovanillic acid. 5) In the male and female schizophrenics predominantly with negative symptoms, there were no significant differences in estrogen and homocanillic acid levels. In those predominantly with positive symptoms, the estrogen levels wee significantly higher in females, while there were no sex differences in homovanillic acid levels. 6) In schizophrenics with undifferentiated subtype, the estrogen and homovanillic acid levels were significantly higher in females. In those with paranoid or disorganized subtypes. the estrogen levels were significantly higher females, while there were no sex differences in the homovanillic acid levels. 7) The mean values of PANSS-negative. PANSS-total, PANSS-CF, MMSE-K and estrogen levels were significantly higher in male schizophrenics with cognitive deficits. The mean values of illness duration, CGI PANSS-positive, PANSS-negative, PANSS-total, PANSS-CF and MMSE-K were significantly higher in female schizophrenics with cognitive deficits. 8) The variables which showed significant correlation with cognitive deficits were PANSS-nagative, PANSS-total, PANSS-CF, MMSE-K and estrogen levels in male schizophrenics. The variables which showed significant correlation with cognitive deficits were subtypes, onset age, illness duration, CGI, PANSS-positive, PANSS-negative, PANSS-total, PANMSS-CF and MMSE-K in female schizophrenics. The estrogen levels were significantly correlated with admission frequencies, history of antipsychotic administration, duration of antipsychotic administration and cognitive deficits in male schizophrenics. while age were not correlated with in females. The homovanillic acid levels had a significant correlation with subtypes and onset age in male schizophrenics, while there were no correlation among variables in females. CONCLUSIONS: Although the plasma concentrations of estrogen and homovaillic acid in female schizophrenics were significantly higher than males, we could not find an association between them. Furthermore, the various factors affecting on the cognitive deficits, estrogen and homovanillic acid levels seemed to be somewhat different according to sex.
Subject(s)
Female , Humans , Male , Age of Onset , Antipsychotic Agents , Chromatography, High Pressure Liquid , Dopamine , Estrogens , Homovanillic Acid , Plasma , Radioimmunoassay , Schizophrenia , Sex CharacteristicsABSTRACT
The recent hypothesis about the pathophysiology of schizophrenia has been centered mainly on two theories, i.e. dopamine hypothesis and serotonin hypothesis. We investigate the correlations between plasma metabolite concentrations and clinical symptoms in schizophrenic patients. The purpose of our study was to examine whether the plasma levels of HVA(homovanillic acid) and 5-HIAA(hydroxyindoleacetic acid) are significantly different in schizophrenics, compared to normal controls. And, with the intention of clarifying the interaction between dopaminergic system and serotoninergic system, the ratio of HVA/5-HIAA also was measured. The second purpose was whether the basal(pre-treatment) levels of these metabolites show the correlation with clinical symptoms. Finally, third purpose was whether basal HVA and 5-HIAA levels can be held as a predictor of treatment response. We used scale for the Assessment of Positive Symptoms(SAPS) and Scale for the Assessment of Negative Symptoms(SANS) as the clinical symptom rating scales. Our results were as followed, 1) only the level of basal plasma HVA was significantly differ in schizophrenics. 5-HIAA and HVA/5-HIAA were not. 2) basal HVA showed significant correlation with SAPS score, especially delusion subscale. 3) the higher was the basal HVA level, the more improvement in clinical symptoms was observed. The basal 5-HIAA level and the HVA/5-HIAA ratio did not show any significant findings. These results support the dopamine hypothesis of schizophrenia, but fail to examine on the possible involvement of serotonin in schizophrenia.
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Humans , Delusions , Dopamine , Homovanillic Acid , Hydroxyindoleacetic Acid , Intention , Plasma , Psychopathology , Schizophrenia , Serotonin , Weights and MeasuresABSTRACT
OBJECTIVES: For the understanding and effective treatment of depressive symptoms in chronic schizophrenia, this study investigated the frequency of depressive symptoms and examined associations between depressive symptoms and positive symptoms, negative symptoms, general psychopathology in chronic schizophrenia. METHOD: The authors assessed the frequency of depressed schizophrenia with 30 or higher scores of HRSD in 135 DSM-IV chronic schizophrenia. We measured PANSS, BPRS in depressed(n=37) and non-depressed schizophrenia(n=37) who were matched in sex, age and dose of antipsychotics to compare positive, negative symptoms and other psychopathology. Also, we evaluated correlation between depressive symptoms and positive symptoms, negative symptoms, other psychopathology in depressed schizophrenic patients. RESULTS: 1) The depressive symptoms were present in 27.4% of chronic schizophrenia. 2) The positive scale of PANSS were significantly higher in depressed than in non-depressed schizophrenia(p<.01), and the negative scale of PANSS were higher in depressed schizophrenia but there were no statisical significance. Thinking disturbance and depressive-anxiety factors of BPRS were significantly higher in depressed than in non-depressed schizophrenia(p<.01, p<.01). 3) The positive and negative scale of PANSS correlated with HRSD in depressed schizophrenia(p<.01, p<.05), and thinking disturbance and depressive-anxiety factors correlated with HRSD in depressed schizophrenia(p<.01, p<.01). CONCLUSION: The depressive symptoms are relatively commom and important part of schizophrenic symptomatology, and they are more related to positive symptoms than negative symptoms of schizophrenia. Thus this study suggest that appropriate assessment and therapeutic intervention for depressive symptoms is especially necessary to the schizophrenic patients with severe positive symptoms.