The Role of Family Variables in the Length of Stay of Psychiatric In-patients.

BACKGROUND: In Japan, the number of beds and average length of stay in a psychiatric ward are greater than in other developed countries. OBJECTIVE: The present study aimed to investigate the association between family variables and the length of stay of patients with mental and behavioural disorders in a private psychiatric hospital in Japan. METHODS: The medical records of patients discharged during a one-year period (n=56: men 50.0% excepting 27 patients discharged due to death were re-examined regarding age, laundry type (self-washing of clothes, family washing or supplier washing), number of family visits per one month while hospitalised, and family structure prior to hospitalisation. A length of stay greater than six months was considered the cut-off point for a long hospital stay. Bivariate logistic regression analyses were conducted to identify factors independently associated with the length of stay, adjusted for sex, age, and mental and/or behavioural disorders according to the criteria of the International Statistical Classification of Diseases and Related Health Problems. RESULTS: The bivariate-adjusted odds ratio (95% confidence intervals) for in-patients hospitalised for more than six months was 0.08 (0.01, 0.48) for those who used family washing (p = 0.006) compared with those who used supplier washing. The number of visits per month and family structures before hospitalisation were not significantly associated. CONCLUSION: These results suggest that within a private psychiatric hospital in Japan, family washing is associated with shortened stays and frequency of family visits, while family structure is not associated with these factors.

Volume reduction of the amygdala in patients with schizophrenia: a magnetic resonance imaging study.

The amygdala is known to be involved in the pathology of schizophrenia. While only a limited number of studies in schizophrenia have measured the amygdala as a single structure. The aim of this study was to examine the hypothesis that patients with schizophrenia would show reduced volumes in the amygdala compared with normal controls. We investigated amygdala volume in 40 patients with schizophrenia (20 males, 20 females) and 40 age- and gender-matched normal controls using three-dimensional magnetic resonance imaging (MRI). Whole volumes of both the amygdala and the temporal lobe were measured on consecutive coronal 1-mm slices. The amygdala volume was significantly smaller in schizophrenia patients than in controls. Considering gender differences, male patients had significantly smaller volumes in the bilateral amygdala than male controls; female patients had a significantly reduced right amygdala compared with female controls. Furthermore, a significant left-smaller-than-right volumetric asymmetry of the amygdala was detected in male patients with schizophrenia. The results may be important for understanding the role of the amygdala in the pathophysiology of schizophrenia and the anatomical substrates of gender difference in the expressions of the illness.

Neuropsychological profile in patients with schizotypal personality disorder or schizophrenia.

Neuropsychological impairments have been consistently reported in patients with schizophrenia. As little is known whether subjects with schizotypal personality disorder exhibit neurocognitive dysfunction similar to that in schizophrenia, we assessed the neuropsychological profile of 15 subjects with schizotypal personality disorder and compared it with that for 15 patients with schizophrenia and for 15 psychiatrically normal volunteers. All participants were administered a standard neuropsychological battery assessing language ability, spatial ability, visuomotor function, verbal memory, visual memory, auditory attention, visual attention, and executive function. Performance on most of the cognitive domains was impaired in patients with schizotypal personality disorder but less than patients with schizophrenia. Specifically, impairment in verbal memory and visuomotor ability in patients with schizotypal personality disorder and patients with schizophrenia were comparable, while patients with schizophrenia performed worse on the test of executive function than did patients with schizotypal personality disorder. As a whole, cognitive deficits in patients with schizotypal personality disorder were qualitatively similar to, but quantitatively milder than, those for patients with schizophrenia. The results suggest that cognitive abilities related to frontotemporal lobe function are disturbed across these schizophrenia-spectrum disorders.

Lack of self-control as assessed by a personality inventory is related to reduced volume of supplementary motor area.

The present study was performed to examine the relationship between schizophrenia-related personality and brain morphometry. Magnetic resonance (MR) imaging and schizophrenia-related personality scales extracted from the Minnesota Multiphasic Personality Inventory (MMPI) were administered to 42 university students. Analysis of the relationships between the gray matter segmented from the MR images on a voxel-by-voxel basis through the use of the statistical parametric mapping technique and the schizophrenia-related personality subscale scores from the MMPI revealed that lack of self-control subscale scores were negatively related to the gray matter volume of the supplementary motor area (SMA). Furthermore, it was suggested that self-control including self-inhibition is associated with the density of the SMA, the precuneous and the cerebellar vermis, which govern voluntary movements and motor imagery. These results provide important clues to the neural basis for the disturbance of self commonly observed in schizophrenia spectrum disorders.