Caregiver Burden in Schizophrenia and Autism Spectrum Disorders: A Comparative Study

Objective@#There is no study comparing schizophrenia and autism spectrum disorders (ASD) in terms of caregiver burden. This study aims to compare the caregiver burden among family members of the patients with schizophrenia and ASD and investigate the predictive factors. @*Methods@#A cross-sectional study with the family members living with and/or providing care to their patients was carried out. A sociodemographic form, the Beck Depression Inventory, the Self-Stigma Inventory for Families, and the Zarit Caregiver Burden Scale were utilized. Regression analyses were conducted to determine the predictive factors for higher burden. @*Results@#Caregiver burden in ASD was significantly higher than in schizophrenia. Regression analysis showed that the predictors of high caregiver burden were the need for self-care (OR=3.6), self-destructive behaviors (OR=3.4), self-stigma (OR=1.1), depression (OR=1.1), and level of income (OR=1.0) for all family members. When the diagnosis was removed from the equation, the factors determining the high burden did not change. @*Conclusion@#This study suggests that characteristics of the illness are stronger predictors than family members’ characteristics in explaining high caregiver burden for both illnesses. Psychological, social, and economic supports should be provided for families to help alleviate their caregiving burden.

Is There Any Association Between Childhood Traumatic Experiences, Dissociation and Psychotic Symptoms in Schziophrenic Patients?

OBJECTIVE: The aim of this study was to investigate the rates childhood traumatic experiences (CTEs) of schizophrenia patients and to examine relationship between childhood traumatic experiences, dissociation and psychotic symptoms. METHODS: One hundred schizophrenia patients who had 5 or 5 points below in Clinical Global Impression-Severity (CGI-S) and who were not in active psychotic episode and 50 healthy siblings who grew up in the same environment with the patients were included to the study. Structured Clinical Interview for DSM IV, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Dissociative Experiences Scale (DES), CGI-S, Global Assessment of Functioning Scale and Childhood Trauma Questionnaire (CTQ-28) applied to the patients. RESULTS: Childhood abuse subscales and DES scores were statistically higher in the patient group (p<0.001). We determined moderately significant positive correlation between CTQ-28 and DES. We determined moderately significant positive correlation between CTQ total scores and persecutory delusions, delusions of reference, ability to feel intimacy and closeness; relationship with friends and peers. Also, there was a significant positive correlation between persecutory delusions and CTQ-total, DES-total and all subscales of CTQ-28. CONCLUSION: Clinicians should inquire about CTEs to develop comprehensive formulations and treatment plans among schizophrenia.

The Factors Affecting the Relationship between Remission Status and Employment in Chronic Schizophrenia Patients

OBJECTIVE: Symptomatic remission have substantial effects in long-term schizophrenia outcome, but exact determinants of the employment. In this study, the relationship between employment and symptomatic remission in chronic schizophrenia patients and other factors related to employment were investigated.METHODS: 100 patients interviewed were evaluated by the Positive and Negative Syndrome Scale (PANSS), Functional Recovery Scale in Schizophrenia (FROGS), Global Assessment of Functioning (GAF), Quality of Life Scale (QoL) and Subjective Recovery Assessment Scale (SubRAS). Sociodemographic variables, clinical features, antipsychotic dose and past working history obtained from patient interviews were investigated.RESULTS: The patients of 40% who participate in the study were symptomatic remission, but only 53.5% of these patients weren’t employed. Young age, especially, -regardless of the onset of illness- working a job in the past, low and moderate use CPED (equivalent doses according to chlorpromazine), shorter disease duration, symptomatic remission was found to be closely related to employment. While QoL, FROGS, GAF, and SubRAS total scores of employment group were higher than the unemployment group, PANSS total scores in the unemployment group were higher than that of the employment group. There was a high correlation between the scales and employment status.CONCLUSION: Employment status was closely related with the remission status. This study supports that symptomatic remission alone is not decisive for employment. It was found that younger age, past working history (before or after the disease), low and intermediate CPED antipsychotic use and shorter duration of disease were closely related to employment with symptomatic remission.

Assessment of carotid body tumor and its association with tetralogy of fallot: Effect of the chronic hypoxia

This is a rare combined presentation of Tetralogy of Fallot and carotid body tumor [CBT]. Hypotheses and further discussion provides data for the development of CBT as a response to chronic hypoxemia. This present study demonstrates and discusses such an occurrence

Effects of swimming training and free mobilization on bone mineral densities of rats with the immobilization-induced osteopenia

To investigate the possible effects of regular swimming exercise on bone mineral density [BMD] compared with free activity after cast immobilization of rats. We carried out the study from April 2005 to June 2005 at the Department of Sports Medicine, Medical School of Suleyman Demirel University, Isparta, Turkey. The study included a total of 24 female Wistar rats. The rats were randomized to control [n = 6] swimming training [ST] n = 9, and free mobilization [FM] n = 9 groups. We measured Bone mineral densities of femur and vertebra of all rats with a total body scanner using software specifically designed for small animals, before study started and at weeks 3 and 7. Timepoints corresponded to basal, after cast removal [ACIM], and after 3 weeks of free mobilization [AFM] or swimming training [AST]. We immobilized the right hindlimb of each ST and FM animal with a cast while the left hindlimbs were kept free. After 3 weeks, the casts were removed. Then we allowed the rats to move freely in their cage for one week, after which the animals in ST group started to swim for 5 days a week for 3 weeks for 30 minutes per day. The group FM rats moved freely in the cage. Bone mineral density of the femur and vertebra after cast immobilization was significantly decreased compared with both their basal and age-matched control group. After mobilization, significant increases occurred in both groups according to ACIM. Similar but milder changes were observed in free limbs femur BMD of rats. Interestingly, vertebra BMD of swimming group was also higher than its age-matched control group [P<0.05]. Our study showed that swimming exercise had a significant rehabilitative effect on BMD loss associated with immobilization. Further studies are needed to investigate the effects of swimming on other bone properties

Evaluation of the effect of trimetazidine on Tc-99m methoxyisobutyl isonitrile gated scintigraphy in patients with coronary artery ectasia

Coronary artery ectasia [CAE] is the abnormal dilatation of a segment of the coronary artery to a diameter of at least 1.5 times that of normal adjacent segments. Symptoms are variable, and its prognosis and treatment modalities are unclear. The aim of this study is to evaluate the effect of trimetazidine [TMZ] on ischemic left ventricular function by rest-stress Tc-99m methoxyisobutyl isonitrile [Tc-99m MIBI] myocardial scintigraphy in symptomatic patients with CAE. We included patients with ectasia admitted to our Cardiology Department, Turkey, between 2003 and 2004 in this study. All patients underwent coronary angiography and diagnosed with CAE, before and 4 weeks after TMZ administration. Seventeen patients [9 men, 8 women] underwent gated single-proton emission tomographic [SPECT] using Tc-99m MIBI. We performed quantitative global and regional ventricular functional analysis using quantitative gated SPECT software. The global ejection fraction increased from 59.9% +/- 8.9% to 62.6% +/- 8.3% after therapy [p=0.033]. In addition, the end systolic volume and the end diastolic volume decreased after therapy [101.7 +/- 23.5 ml to 95.1 +/- 22.9 ml, p=0.002; from 41.1 +/- 14.3 to 36.4 +/- 13.6, p=002]. In all segments, we observed significant post-therapy increases in relative tracer uptake. Percentage of MIBI uptake was 71.2 +/- 15.3 at baseline stress and 73.2 +/- 15 post-TMZ [p=0.001]. As global function parameters, the total wall motion normal areas changed significantly [67-74% p=0.01] after therapy, but the total wall thickness did not changed significantly [49-45%, p=0.21]. The results of this study demonstrate that TMZ improves myocardial function by rest-stress Tc-99m MIBI gated SPECT during stress-induced ischemia in patients with CAE. Also, the outcomes revealed improvement in functional parameters, and percentage of MIBI uptake post TMZ administration. We can use this procedure to monitor the effect of TMZ in CAE patients