Clinical Schizophrenia and Related Psychoses最新文献_第10页

Clinical Correlates of Initial Treatment Disengagement in First-Episode Psychosis. 首发精神病初始治疗脱离的临床相关因素。

Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 Epub Date: 2014-11-03 DOI: 10.3371/CSRP.MYBH.103114

Neely Myers, Sanaa Bhatty, Beth Broussard, Michael T Compton

{"title":"Clinical Correlates of Initial Treatment Disengagement in First-Episode Psychosis.","authors":"Neely Myers, Sanaa Bhatty, Beth Broussard, Michael T Compton","doi":"10.3371/CSRP.MYBH.103114","DOIUrl":"https://doi.org/10.3371/CSRP.MYBH.103114","url":null,"abstract":"Aim: Early engagement in care is thought to reduce disabling social losses related to the duration of untreated psychosis (DUP), such as school dropout, homelessness, and incarceration, which contribute to chronic disability. Early-intervention services that promote recovery will not be effective if eligible persons drop out of treatment after an initial hospitalization for a psychotic disorder. We had the unique opportunity to examine the treatment disengagement rate of patients with early psychosis after an initial hospitalization.Methods: In a predominantly male, African-American, and socioeconomically disadvantaged group of 33 participants with first-episode psychosis assessed at initial hospitalization and six months after discharge, we compared clinical characteristics (medication adherence attitudes and behaviors, knowledge about schizophrenia, insight, symptom severity, and persistence of alcohol and drug use) among those who disengaged and people who engaged in care.Results: More than half (18, 54.5%) attended <3 outpatient appointments in the six months after hospital discharge and, of those, nearly all (15, 83.3%) attended no outpatient appointments. Disengaged people were much less adherent to medications in the past month and six months, and scored lower on medication adherence attitudes, knowledge about psychosis, and insight. They had greater positive symptom severity and a higher likelihood of continuing drug use. Clinical Relevancy: Initial treatment disengagement is very common among young people with first-episode psychosis and is associated with poorer clinical status. More research is needed on the causes of disengagement during this critical period and ways to improve initial treatment engagement among people with first-episode psychosis.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32789121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Can Transcranial Direct Current Stimulation Improve Cognitive Functioning in Adults with Schizophrenia? 经颅直流电刺激能改善成人精神分裂症患者的认知功能吗?

Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 Epub Date: 2014-11-03 DOI: 10.3371/CSRP.SCST.103114

David J Schretlen, Joseph J van Steenburgh, Mark Varvaris, Tracy D Vannorsdall, Megan A Andrejczuk, Barry Gordon

{"title":"Can Transcranial Direct Current Stimulation Improve Cognitive Functioning in Adults with Schizophrenia?","authors":"David J Schretlen, Joseph J van Steenburgh, Mark Varvaris, Tracy D Vannorsdall, Megan A Andrejczuk, Barry Gordon","doi":"10.3371/CSRP.SCST.103114","DOIUrl":"https://doi.org/10.3371/CSRP.SCST.103114","url":null,"abstract":"Cognitive impairment is nearly ubiquitous in schizophrenia. First-degree relatives of persons with schizophrenia often show similar but milder deficits. Current methods for the treatment of schizophrenia are often ineffective in cognitive remediation. Since transcranial direct current stimulation (tDCS) can enhance cognitive functioning in healthy adults, it might provide a viable option to enhance cognition in schizophrenia. We sought to explore whether tDCS can be tolerated by persons with schizophrenia and potentially improve their cognitive functioning. We examined the effects of anodal versus cathodal tDCS on working memory and other cognitive tasks in five outpatients with schizophrenia and six first-degree relatives of persons with schizophrenia. Each participant completed tasks thought to be mediated by the prefrontal cortex during two 30-minute sessions of tDCS to the left and right dorsolateral prefrontal cortex (DLPFC). Anodal stimulation over the left DLPFC improved performance relative to cathodal stimulation on measures of working memory and aspects of verbal fluency relevant to word retrieval. The patient group showed differential changes in novel design production without alteration of overall productivity, suggesting that tDCS might be capable of altering self-monitoring and executive control. All participants tolerated tDCS well. None withdrew from the study or experienced any adverse reaction. We conclude that adults with schizophrenia can tolerate tDCS while engaging in cognitive tasks and that tDCS can alter their performance.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32789126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

A Review of the Impact of Exclusion Criteria on the Generalizability of Schizophrenia Treatment Research. 排除标准对精神分裂症治疗研究概括性影响的综述。

Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 DOI: 10.3371/1935-1232-11.1.49

Keith Humphreys

{"title":"A Review of the Impact of Exclusion Criteria on the Generalizability of Schizophrenia Treatment Research.","authors":"Keith Humphreys","doi":"10.3371/1935-1232-11.1.49","DOIUrl":"https://doi.org/10.3371/1935-1232-11.1.49","url":null,"abstract":"Treatment research studies employ criteria that determine which patients are eligible to participate and which are not. When such exclusion criteria produce a treatment research sample that is a small and unrepresentative subset of all patients with a particular disease, clinicians may be hesitant to apply the research results in front-line clinical practice. Accordingly, the present paper reviews the English-language literature on exclusion criteria in schizophrenia treatment research and draws initial conclusions about their impact. Empirically derived estimates of the rate of exclusion vary widely (31.0-98.2%), but the best available evidence suggests that about 4 in 5 patients with schizophrenia would be ineligible to enroll in a typical treatment research study. Women are particularly likely to be excluded from schizophrenia treatment research, which is problematic from both a clinical and social justice viewpoint. Excluded patients also tend to be older than eligible patients, and, though it has been examined in only a few studies, they also tend to have more severe problems at baseline and different outcomes over time than patients who are allowed to participate in research. More limited use of exclusion criteria in schizophrenia treatment research would be beneficial in terms of increasing generalizability, but would also potentially involve costs, particularly a need for larger samples. More modest steps that would improve treatment outcome research reports include requiring a full description of the rationale for, and nature of, any exclusion criteria, and, having a designated place in the discussion section which draws attention to the proper scope of generalization.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35033362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

Genetic Variation of the Mu Opioid Receptor (OPRM1) and Dopamine D2 Receptor (DRD2) is Related to Smoking Differences in Patients with Schizophrenia but not Bipolar Disorder. 缪阿片受体（OPRM1）和多巴胺 D2 受体（DRD2）的遗传变异与精神分裂症患者的吸烟差异有关，但与躁郁症无关。

Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 DOI: 10.3371/1935-1232-11.1.39

Mika Hirasawa-Fujita, Michael J Bly, Vicki L Ellingrod, Gregory W Dalack, Edward F Domino

{"title":"Genetic Variation of the Mu Opioid Receptor (OPRM1) and Dopamine D2 Receptor (DRD2) is Related to Smoking Differences in Patients with Schizophrenia but not Bipolar Disorder.","authors":"Mika Hirasawa-Fujita, Michael J Bly, Vicki L Ellingrod, Gregory W Dalack, Edward F Domino","doi":"10.3371/1935-1232-11.1.39","DOIUrl":"10.3371/1935-1232-11.1.39","url":null,"abstract":"It is not known why mentally ill persons smoke excessively. Inasmuch as endogenous opioid and dopaminergic systems are involved in smoking reinforcement, it is important to study mu opioid receptor (OPRM1) A118G (rs1799971), dopamine D2 receptor (DRD2) Taq1A (rs1800497) genotypes, and sex differences among patients with schizophrenia or bipolar disorder. Smokers and nonsmokers with schizophrenia (n=177) and bipolar disorder (n=113) were recruited and genotyped. They were classified into three groups: current smoker, former smoker, and never smoker by tobacco smoking status self-report. The number of cigarettes smoked per day was used as the major tobacco smoking parameter. In patients with schizophrenia, tobacco smoking prevalence was greater in males than in females as expected, but women had greater daily cigarette consumption (p<0.01). Subjects with schizophrenia who had the OPRM1 *G genotype smoked more cigarettes per day than the AA allele carriers with schizophrenia (p<0.05). DRD2 Taq1A genotype differences had no effect on the number of cigarettes smoked per day. However, female smokers with schizophrenia who were GG homozygous of the DRD2 receptor smoked more than the *A male smokers with schizophrenia (p<0.05). In bipolar patients, there were no OPRM1 and DRD2 Taq1A genotype differences in smoking status. There also were no sex differences for smoking behavior among the bipolar patients. The results of this study indicate that single nucleotide polymorphism (SNP) of the less functional mu opioid receptor increases tobacco smoking in patients with schizophrenia. Alteration of DRD2 receptor function also increased smoking behavior in females with schizophrenia.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366347/pdf/nihms669565.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35033364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical News. 临床的消息。

Clinical Schizophrenia and Related Psychoses Pub Date : 2017-01-01 DOI: 10.3371/CSRP.BU.100817

Peter F Buckley

引用次数: 0

Cardiac Arrest with Clozapine and Olanzapine: Revealing Long QT Syndrome. 服用氯氮平和奥氮平导致心脏骤停：揭示长 QT 综合征。

Clinical Schizophrenia and Related Psychoses Pub Date : 2016-12-20 DOI: 10.3371/CSRP.WOWH.112316

Edward Woloszyn, Nishant Whig, Eileen Trigoboff, Jeffery J Grace

{"title":"Cardiac Arrest with Clozapine and Olanzapine: Revealing Long QT Syndrome.","authors":"Edward Woloszyn, Nishant Whig, Eileen Trigoboff, Jeffery J Grace","doi":"10.3371/CSRP.WOWH.112316","DOIUrl":"10.3371/CSRP.WOWH.112316","url":null,"abstract":"The authors describe a rare case of \"concealed\" congenital Long QT Syndrome (LQTS) Type 3 in a patient with treatment resistant schizophrenia and no known personal or family history of cardiac disease. The patient in this Case Report had a hidden genetic condition revealed only following the essential administration of antipsychotics. As a result, this patient experienced an aborted cardiac arrest and a total of five episodes of ventricular tachycardia (VT) requiring cardioversion. Successful control of the VT occurred with an Automatic Internal Defibrillator (AID), judicious use of antipsychotic medications, and anti-arrhythmic medications. Risk factors for this rare anomaly include history of syncopy, unexplained ventricular arrhythmias, history of sudden cardiac death in a young family member, unusual reaction to initial dosages of medication known to prolong QTc which includes antipsychotics (particularly in combination). The work-up for those with risk factors would be a thorough family history of sudden cardiac death, baseline ECG, electrolytes, cardiology and electrophysiological consultation, and when indicated a genetic analysis for the Long QT Syndrome (LQTS). Monitoring includes ongoing patient assessment for symptoms, ECGs and electrolytes when indicated such as when medication and dosages are adjusted, AID interviewing, and cardiac and electrophysiological follow-up.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78431882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developmental Coordination Disorder Plus Oculomotor and Visuospatial Impairment as Neurodevelopmental Heralds of Psychosis Proneness. 发育协调障碍加上眼球运动和视觉空间障碍是精神病易感性的神经发育先兆。

Clinical Schizophrenia and Related Psychoses Pub Date : 2016-12-20 DOI: 10.3371/CSRP.POGE.112316

Michele Poletti, Eva Gebhardt, Andrea Raballo

{"title":"Developmental Coordination Disorder Plus Oculomotor and Visuospatial Impairment as Neurodevelopmental Heralds of Psychosis Proneness.","authors":"Michele Poletti, Eva Gebhardt, Andrea Raballo","doi":"10.3371/CSRP.POGE.112316","DOIUrl":"10.3371/CSRP.POGE.112316","url":null,"abstract":"Aiming at preventing transitions to more severe psychopathology and boosted by the availability of operational criteria to identify help-seeking subjects at increased risk for psychosis, research into the early prodromal phases of psychosis is attracting a growing clinical interest. Furthermore, the focus of early detection is gradually shifting from prodromal syndromes to the premorbid period. Although mainly driven by clinical-pragatic aims, such a shift is coherent with the neurodevelopmental hypothesis of schizophrenia that might offer a unifying, developmentally informed conceptual framework for early detection. Psychotic experiences, indeed, while overtly manifested in adolescence/early-adulthood, are often antedated by subtle expressions of biological vulnerability already presenting in the early years of life and indexing a putatively altered neurodevelopmental process. Concretely, unspecific premorbid symptoms that may be present since infancy and childhood may lead to early clinical consultancy in child-adolescent mental health services, which could be considered the primary clinical setting to implement early detection. We herewith present a clinical vignette of a child with severe Developmental Coordination Disorder presenting an Attenuated Psychosis Syndrome. The vignette illustrates the intertwining between possible early neurodevelopmental disorders and clinical psychosis proneness in childhood.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86907551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Problem of Missed Mental Healthcare Appointments. 错过心理保健预约的问题。

Clinical Schizophrenia and Related Psychoses Pub Date : 2016-12-20 DOI: 10.3371/CSRP.MIAM.112316

M. Miller, D. M. Ambrose

引用次数: 8

Unusual psychotic presentation after discontinuation of treatment in a patient with Wilson's disease: a case report. 威尔逊氏病患者停止治疗后出现异常精神病表现：病例报告。

Clinical Schizophrenia and Related Psychoses Pub Date : 2016-12-20 DOI: 10.3371/CSRP.LAJA.112316

Andreas S Lappas, Fiesal Jan

引用次数: 0

Brain Natriuretic Peptide as a Biomarker of Asymptomatic Clozapine-Related Heart Dysfunction: A Criterion for a More Cautious Administration. 脑钠肽作为无症状氯氮平相关心功能障碍的生物标志物:一个更谨慎用药的标准。

Clinical Schizophrenia and Related Psychoses Pub Date : 2016-12-20 DOI: 10.3371/CSRP.PRMO.112316

V. Prisco, P. Monica, G. Fiore, A. Tridente, A. La Rocca, F. Catapano, M. Fabrazzo

{"title":"Brain Natriuretic Peptide as a Biomarker of Asymptomatic Clozapine-Related Heart Dysfunction: A Criterion for a More Cautious Administration.","authors":"V. Prisco, P. Monica, G. Fiore, A. Tridente, A. La Rocca, F. Catapano, M. Fabrazzo","doi":"10.3371/CSRP.PRMO.112316","DOIUrl":"https://doi.org/10.3371/CSRP.PRMO.112316","url":null,"abstract":"Clozapine-related pericarditis is a rare side effect of the drug. We reported the clinical cases of two women, aged 22 and 28 years, affected by schizophrenia with pericarditis symptoms related to clozapine treatment of 200 mg/day. Clozapine was discontinued in both patients, resulting in normalization of the ECG changes, and echocardiography confirmed the progressive disappearance of the pericardial effusion. Interestingly, while inflammatory indices and pro-brain natriuretic peptide (pro-BNP) plasma levels were high in both patients, only one of them showed tachycardia, subjective chest pain, shortness of breath and dyspnea, with a clinical symptomatology suggesting a cardiac involvement. BNP is a vasoactive peptide synthetized by the ventricular myocardium which splits in two fragments: BNP and the N-terminal (pro-BNP). Both are considered valuable biomarkers in clinical practice for the prediction of disease state and prognosis in patients with suspected heart failure. Pro-BNP acts as a key regulator in the homeostasis of water and salt excretion and in the maintenance of blood pressure, mainly by inhibiting the renin-angiotensin-aldosterone axis and blocking the sympathetic nervous activity. In our cases, pro-BNP plasma levels proved to be a profitable way to identify subjects with asymptomatic cardiac impairment who could benefit from a therapy preventing progression to heart failure.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85452754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4