Effect of Valpar occupational assessment training system on cognitive dysfunction in schizophrenia / 中华行为医学与脑科学杂志

Objective To explore the effect of Valpar occupational assessment training system on cognitive dysfunction in schizophrenia. Methods Sixty patients with schizophrenia were randomly assigned into Valpar therapy group ( experiment group, n=30) and traditional rehabilitation therapy group ( control group, n=30) according to the order number. The duration of the treatment was six weeks. The brief assess?ment of cognition in schizophrenia ( BACS) and Wisconsin card sorting test ( WCST) were conducted as pre?and post?treatment assessment. Results There were significant differences between scores of BASC in pre?and post?treatment assessment in experiment group. More specifically, the BASC scores in symbol coding (37.50±6.50, t=-4.60, P<0.01),token movement(60.80±8.72, t=-2.54, P=0.017),verbal memory (44.40±11.29, t=-2.19, P=0.037)),and word fluency(14.23±4.35, t=-3.39, P=0.002) were signifi?cantly different when comparing pre?and post?treatment assessment outcomes. In control group,the only sig?nificant difference was found in word fluency (14.23±4.35, t=-3.39, P=0.002).In addition,response errors (57.80±10.35, t=-3.06, P=0.005) and repeat errors (34.67±6.96, t=3.41, P=0.002) in WCST in exper?iment group were significantly different in pre?and post?treatment assessment while only repeat errors (34.30 ±7.01, t=4.36, P=0.000) was different in control group. It was further discovered that scores in in symbol cod?ing( t=2.010, P=0.048),token movement ( t=2.124, P=0.038),response errors ( t=2.413, P=0.020) and repeat errors( t=2.009, P=0.047) in WCST were different between two groups. Conclusion Valpar professional evaluation train?ing system can significantly improve the cognitive function of people with schizophrenia.

Faux Pas Test in schizophrenic patients / Teste de Faux Pas em pacientes com esquizofrenia

ABSTRACT Objective The aim of this study is to validate the adult version of “Faux Pas Recognition Test” created by Stone and colleagues (1998) as a reliable instrument assess and discriminate social cognition among schizophrenia patients and healthy controls. Methods This is a cross-sectional study with a total of 196 participants (mean age = 26.45; CI (95%) [25.10; 27.83]) 51% male. From those, 44 (22.4%) patients with schizophrenia and 152 (77.6%) healthy controls. The participants answered a short version of the Faux Pas Recognition Test, composed by 10 stories. Results Significant differences were found between both groups regarding their scores on Faux Pas Recognition Test (p = 0.003). Patients with schizophrenia had lower score, compared to healthy controls. Story 14 was the best to distinguish both groups, and Story 16, the worst. Among the questions of Faux Pas stories, the one related to intuition presented the most significant difference between the groups (p = 0.001), followed by the one related to understanding (p = 0.003). Conclusion The Brazilian version of the Faux Pas Recognition Test is a valid test to assess social cognition in schizophrenia and can be an important instrument to be used on the clinical practice.

RESUMO Objetivo O objetivo deste estudo é validar a versão brasileira da versão adulta do Teste de Reconhecimento de Faux pas criado por Stone e colaboradores (1998) como um instrumento confiável para avaliar e discriminar a cognição social entre pessoas com esquizofrenia e controles saudáveis. Métodos Trata-se de um estudo transversal com um total de 196 participantes (idade média = 26,45; IC (95%) [25,10; 27,83]), sendo 51% homens; destes, 44 (22,4%) eram pessoas com esquizofrenia e 152 (77,6%), controles saudáveis. Os participantes responderam a uma versão reduzida do Teste de Reconhecimento de Faux Pas, contendo 10 histórias. Resultados Foram encontradas diferenças significativas entre grupos no Teste de Reconhecimento de Faux Pas (p = 0,003). Pessoas com esquizofrenia obtiveram menor pontuação comparadas com o grupo controle. A história 14 foi a mais eficiente para distinguir os grupos, ao passo que a história 16 foi a pior. Quanto às questões das histórias Faux Pas, aquela referente à intuição foi a que apresentou maior diferença entre grupos (p = 0,001) seguida por compreensão (p = 0,003). Conclusão A versão brasileira do Teste de Reconhecimento de Faux Pas é um instrumento válido para avaliar a cognição social em esquizofrenia e pode ser um instrumento importante a ser usado na prática clínica.

Toxocara Seroprevalence in Schizophrenic Patients in Turkey

PURPOSE: To investigate the seroprevalence of toxocariasis in patients diagnosed as schizophrenia. PATIENTS AND METHODS: Ninety-eight schizophrenic patients hospitalized at The Elazig Psychiatric Hospital were included in the study. Anti-Toxocara IgG and/or IgM antibodies were determined by using commercial Toxocara canis IgG and/or IgM ELISA kit. RESULTS: Seropositivity for T. canis was detected in 45 (45.9%) of 98 patients and 2 (2.0%) of 100 control subjects the difference was statistically significant (p 0.05). CONCLUSION: In conclusion, the schizophrenic state seems to present a high risk for Toxocara infection in Turkey.

The Effects of Solution-focused Group Counseling Program for the Families with Schizophrenic Patients / 간호학회지

PURPOSE: This study was designed to examine the effects of a solution-focused group counseling program on the family burden, active coping, expressed emotion, and family support in schizophrenic patients and their families. METHOD: The subjects consisted of 48 schizophrenic patients and 56 families. Twenty-four schizophrenic patients and 28 families were assigned to both the experimental and control groups. The solution-focused group counseling program was conducted for the families of the experimental group, but not for the control group or the patients of the experimental group. RESULT: There was a significant greater decrease in scores of family burden and expressed emotion in the experimental groups than the control groups. There was a larger increase in active coping scores in the experimental groups than the control groups, but it was not significant. There was no significant difference between the two groups in family support scores. CONCLUSION: This program may be an effective nursing intervention program for families with schizophrenic members.

The Effectiveness of a Vocational Rehabilitation Program Developed for Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Despite growing interest in the area of vocational rehabilitation for persons with psychiatric disabilities, there exist few specialized vocational training facilities nor programs for schizophrenic patients in Korea. This study was intended to develop and evaluate a vocational rehabilitation program geared to improving personal factors identified to be the most significant barriers to schizophrenics' vocational rehabilitation. METHODS: The effects of program were evaluated using experimental/control pretest-posttest design. An experimental group received the vocational training two sessions a week for three months and a control group received same day treatment except the vocational training. RESULTS: The results indicated that the score of a training group was significantly increased compared to those of a control group on 'The assertive job hunting survey' and 'The job related problemsolving skill assessment'. The score of a training group on the PANSS was not significantly changed compared to those of a control group. CONCLUSION: The data provide useful information about the potential role of the program on assertiveness in job hunting activity and job related problem-solving skill. Although the impact of training on symptom reduction was not significant, the program seemed to suggest an important intervention method for schizophrenic patients' rehabilitation.

The study of risk factors for re-admission in schizophrenic patients at Siriraj Hospital 1992-1996.

A retrospective study of eighty - three in - patients with schizophrenia re-admitted to Siriraj Hospital between 1992 and 1996 was carried out to determine what risk factors had accounted for their re-admission. Of the 83 patients, 44 (53%) had previously been admitted at least twice, while 39 (47%) had been treated once. Only the duration of illness was found to be significantly different between these two groups. This was more prominent in those who had been ill for more than five years. When a comparison was made between patients who relapsed within one year and those with a longer remission period, there were significant differences in their occupation, childhood history and their family responsibilities. Patients with a remission period of one-year or less appeared to have a worse prognosis and tended to be have chronic disease, be more depedent and we found that in childhood they had been brought up by their own parent.

Efficacy and safety of olanzapine in the treatment of Thai schizophrenic patients.

Olanzapine is a thienobenzodiazepine derivative which displays efficacy in patients with schizophrenia and related psychoses. It has structural and pharmacological properties resembling those of atypical antipsychotic (clozapine) and an improved tolerability profile compared with the classical antipsychotic drugs. The purpose of this study was to evaluate the efficacy, tolerability and safety of olanzapine in chronic schizophrenic patients. In an open label study, 10 patients with schizophrenia (DSM-IV), who met the inclusion criteria (CGI score of at least 3, 18 to 65 years of age, no serious unstable medical illnesses), were assigned to receive olanzapine for six weeks after a wash-out period of at least these drugs. Dosages were started at 10 mg/day for at least five days and then adjusted according to each patient’s response, but not increased to no more than 20 mg/day. Treatment efficacy, safety and tolerabi-lity were evaluated with several well-known rating scales and blood chemistry. Olanzapine significantly reduced the severity of psychotic symptoms (score on clinical global improvement, brief psychiatric rating scale, and positive and negative syndrome scales) from baseline. At the end point, all the subjects were found to have clinically improved (a reduction in total positive and negative syndrome scale and reduction of 40.38 - 76.22 percent in Clinical global improvement). The only side-effects of Olanzapine appeared to be weight gain and drowsiness that was mild in severity with no reports of extrapyramidal side- effects. It was concluded that Olanzapine was well tolerated and effective in treating either positive or negative symptoms in patients with schizophrenia.

The Effect of Haloperidol on Regional Cerebral Blood Flow Assessed with 99m-Tc-ECD SPECT In Schizophrenic Patients / 신경정신의학

OBJECTIVES: Regional cerebral blood flow(rCBF)in schizophrenics is confounded by various factors including medication status. Previously, there have been numerous studies regarding the effects of antipsychotics on rCBF. However, these works have shown contradictory and inconsistent findings due to the different of type, dose and exposed duration of antipsychotics. The aim of this study was to observe the effect of antipsychotic medication on rCBF and exposed duration of antipsychotics under control. METHODS: Eighteen drug-naive schizophrenics and 19 schizophrenics medicated with haloperidol were included in the study. Regional cerebral blood flow was assessed with the singlephoton emission computed tomography(SPECT)under a resting state. Relative rCBF was compared between two groups. Haloperidol was selected as the antipsychotic drug as it has relatively selective action at the D2 receptor and less active metabolites. Exposed duration was limited from one to three weeks. RESULTS: Haloperidol-medicated schizophrenic patients had a significantly greater increase of relative cerebral perfusion in the right inferior temporal lobe, left inferior frontal lobe, both basal ganglia, left thalamus, both parieto-occipital lobes, and right parietal lobe than drug-naive schizophrenic patients. Haloperidol-medicated schizophrenic patients had a significant decrease of relative cerebral perfusion in left inferior temporal lobe. However, no significant differences in relative rCBF were found between drug-naive and haloperidol-medicated schizophrenic patients in right inferior frontal lobe, right thalamus, both superior temporal lobes, both superior frontal lobes, and left parietal lobe. CONCLUSION: These findings suggest that antipsychotics affect regional cerebral blood flow, and antipsychotic medication status must be considered in the relative rCBF studies of schizophrenic patients.

A Study of Murder in Schizophrenic Patients Characteristics of the murders of family and nonfamily homicides / 대한법의학회지

Sixty schizophrenia patients who committed homicide and detained after January 1, 1993 were divided in two groups, depending on whether their victim was a family member or not. Below conclusions were deduced from the comparison of the two groups in terms including demographic characteristics, onset and duration of illness, IQ score, suicidal attempts, history of alcohol/drug abuse or past crime, neuropsychiatric ward admission history, living circumstance, conflict with the victim, and adolescent conducting behavior. 1. More in the family homiciding patients (FHP) group lived alone due their unmarried, divorced, or separated marital status than those in the non-family homiciding patients (NFHP) group. More in the FHP group were in married state than those in NFHP group. 2. More in the NFHP group stayed alone apart from their family, while more in the FHP group lived with their family. 3. Those in the NFHP group show more frequent suicidal attempts than those in the FHP group, implying they have difficulties in the control of their impulsive behaviors. 4. To prevent the crime, it is essential for the government to practice the systematic support and care of the schizophrenia patients who are living alone, especially those without relative.

Clozapine treatment in 12 chronic-resistant schizophrenic patients.

Schizophrenia is a chronic disease and has been treated by typical antipsychotic drugs which act on dopamine receptor antagonists. The result of treatment is usually 1/3 response and 2/3 partial response or non-response. Clozapine is a typical anti-psychotic drug which act on serotonin and dopamine receptor antagonists. Between 40 and 80 percent of chronic resistant schizophrenia cases respond to clozapine. The effect was studied of clozapine on 12 chronic resistant schizophrenia cases, five males (41.7 percent) and seven females (58.3 percent); with a mean age of 36.6 years; average duration of illness 15.8 years; average dose 100 mg/day; duration of follow-up 231.6 days. Ten cases (83.3 percent) showed improvement, while two cases showed mild or no improvement.

99m-Tc-ECD SPECT Study of Differences on Relative Cerebral Blood Flow between Drug-Naive and Drug-Free Schizophrenic Patients / 신경정신의학

OBJECTIVES: In schizophrenics, regional cerebral blood flow(rCBF) are affected by various confounding variables, i.e., age, sex, duration of illness, and clinical status. The pharmacological condition of patients is also a particular important variable to be taken into consideration. However, few data are available regarding the differences between the relative rCBF findings in drug-free and drug-naive schizophrenic patients. Currently, numerous studies have included drug-free and drug-naive schizophrenic patients in the same 'unmedicated' group under the assumption that the rCBF is identical between drug-free and drug-naive cases. Therefore, the aim of this study was to compare the rCBF between a group of drug-free schizophrenic patients and a group of drug-naive schizophrenic patients about the effects of age, sex, duration of illness, and clinical status(positive and negative symptoms) under control. METHODS: Eighteen drug-naive schizophrenics and fifteen drug-free schizophrenics were in-cluded in the study. Regional cerebral blood flow was studied with the single-photon emission computed tomography(SPECT) under resting state. Symptoms were assessed with Positive and Negative Syndrome Scale(PANSS). Regions of interest were both inferior temporal lobe, inferior frontal lobe, superior temporal lobe, thalamus, basal ganglia, parieto-occipital lobe, superior frontal lobe, and parietal lobe. RESULTS: No significant differences of relative rCBF were found between drug-free and drug-naive schizophrenic patients in left inferior temporal lobe, right inferior frontal lobe, both superior temporal lobe, both thalamus, both basal ganglia, right parieto-occipital lobe, and both superior frontal lobe. But, drug-free schizophrenic patients had a significant increase of perfusion in the right inferior temporal lobe and left inferior frontal lobe and a significant decrease of perfusion in both parietal lobes and left parieto-occipital lobe. CONCLUSIONS: Relative rCBF in drug-free schizophrenic patients is different from that in drug-naive schizophrenic patients. So, in the relative rCBF studies of schizophrenic patients, it must be considered whether the patients were previously medicated or not.

Comparison of the Treatment Effect Between Higher and Lower Plasma Homovanillic Acid Groups in Schizophrenic Patients / 대한정신약물학회지

This study explored the differences of clinical response, plasma homovanllic acid concentration, haloperidol and reduced haloperidol concentration after 4 weeks haloperidol treatment between higher and lower baseline homovanllic acid concentration groups of schizophrenic patients. After a 2-weeks washout period, they entered the 4 week haloperidol treatment period. The psychopathology was assessed at baseline just before haloperidol trial and then at 1, 2, 4 week using Positive and Negative Syndrome Scale(PANSS). Also the measurement of plasma homovanillic acid(HVA), haloperidol(HP) and reduced haloperidol(RHP) levels were assessed with high performance liquid chromatography at the same time of PANSS assessments. There were no significant differences on the positive, negative, general symptom score of PANSS, haloperidol and reduced haloperidol levels at the end of 4-week between higher plasma HVA group(bsaeline pHVA> or =12.69ng/ml, 10 subjects) and lower plasma HVA group(bsaeline pHVA<12.69ng/ml, 9 subjects). In higher group, the treatment response mainly occured in 2 weeks after treatment, but in lower group, that occured therough 4 weeks. And in higher group, pHVA decresed constantly, but in lower group, pHVA did not changed in 4 weeks. There was significant correlation between plasma haloperidol levels and the clinical improvement(persentile improvement of PANSS positive, general symptom, total score) at the end of 4 week. But no significant correlation were found between plasma reduced haloperidol and RHP/HP ratio and clinical improvement. These results suggest that baseline HVA level is not a valuable therapeutic predictor but it is able to suggest that higher baseline pHVA group and lower group may have different pathophysiology.