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":"11 2","pages":"95-102"},"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":"11 3","pages":"133-142"},"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":"11 1","pages":"49-57"},"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":"11 1","pages":"39-48"},"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

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

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":"184 1","pages":"185-188"},"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

Efficacy of the Social Cognition Training Program in a Sample of Outpatients with Schizophrenia. 社会认知训练方案对精神分裂症门诊患者的疗效观察。

Clinical Schizophrenia and Related Psychoses Pub Date : 2016-10-12 DOI: 10.3371/1935-1232.10.3.154

David Gil-Sanz, M. Fernández-Modamio, Rosario Bengochea-Seco, Marta Arrieta-Rodríguez, Gabriela Pérez-Fuentes

{"title":"Efficacy of the Social Cognition Training Program in a Sample of Outpatients with Schizophrenia.","authors":"David Gil-Sanz, M. Fernández-Modamio, Rosario Bengochea-Seco, Marta Arrieta-Rodríguez, Gabriela Pérez-Fuentes","doi":"10.3371/1935-1232.10.3.154","DOIUrl":"https://doi.org/10.3371/1935-1232.10.3.154","url":null,"abstract":"OBJECTIVE\u0000Social cognition is recognized to be a deficit in individuals suffering from schizophrenia. Numerous studies have explored the relationship between social cognition and social functioning in outpatients with schizophrenia through the use of different social cognition training programs. This study examines the efficacy of the Social Cognition Training Program (PECS in Spanish) in adults with a diagnosis of schizophrenia.\u0000\u0000\u0000METHODS\u0000Data were derived from a sample of 44 non-hospitalized adult patients who presented with a DSM-IV-TR Axis I diagnosis of schizophrenia and 39 healthy controls. The 44 patients were divided into an experimental group (n=20) and a control task group (n=24) that received cognitive training. Healthy controls did not receive any treatment. Sociodemographic and clinical variables correlates were computed. The 2-way ANOVA was conducted to examine differences between groups in pre- and post-treatment measures. Intragroup differences were explored using the paired-samples t-test.\u0000\u0000\u0000RESULTS\u0000At the end of the training, patients in the experimental group showed a higher performance compared to patients in the control task group in the Hinting Task Test and in the emotion recognition of sadness, anger, fear, and disgust.\u0000\u0000\u0000CONCLUSIONS\u0000The PECS proved to be effective in the improvement of some areas of theory of mind and emotion recognition in outpatients with schizophrenia. The PECS is one of the first programs developed in Spanish to train social cognition, and the data obtained support the importance of expanding the social cognition programs to non-English language samples.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":"56 1","pages":"154-162"},"PeriodicalIF":0.0,"publicationDate":"2016-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81561675","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

A Guide to the Management of Clozapine-Related Tolerability and Safety Concerns. 与氯氮平相关的耐受性和安全性问题管理指南》。

Clinical Schizophrenia and Related Psychoses Pub Date : 2016-07-25 DOI: 10.3371/CSRP.SACI.070816

Leslie Citrome, Joseph P McEvoy, Stephen R Saklad

{"title":"A Guide to the Management of Clozapine-Related Tolerability and Safety Concerns.","authors":"Leslie Citrome, Joseph P McEvoy, Stephen R Saklad","doi":"10.3371/CSRP.SACI.070816","DOIUrl":"10.3371/CSRP.SACI.070816","url":null,"abstract":"Clozapine is a highly effective antipsychotic medication, which provides a range of significant benefits for patients with schizophrenia, and is the standard of care for treatment-resistant schizophrenia as well as for reducing the risk of suicidal behaviors in schizophrenia and schizoaffective disorder. However, clozapine is widely underutilized, largely because prescribing clinicians lack experience in prescribing it and managing its adverse events (AEs). Clozapine is associated with 3 uncommon but immediately dangerous AEs, agranulocytosis, myocarditis/cardiomyopathy, and seizures, as well as AEs that may become dangerous if neglected, including weight gain, metabolic syndrome and constipation, and others that are annoying or distressing such as sedation, nighttime enuresis and hypersalivation. Because of the risk of agranulocytosis, clozapine formulations are available only through restricted distribution via a patient registry, with mandatory, systematized monitoring for absolute neutrophil count using a specific algorithm. We identified articles on managing clozapine-associated AEs by searching PubMed using appropriate keywords and search techniques for each topic. A review of the prevalence and clinical characteristics of clozapine-associated AEs shows that these risks can be managed efficiently and effectively. The absolute risks for both agranulocytosis and myocarditis/cardiomyopathy are low, diminish after the first 6 months, and are further reduced with appropriate monitoring. Weight gain/metabolic disorders and constipation, which develop more gradually, can be mitigated with regular monitoring and timely interventions. Sedation, hypersalivation, and enuresis are common but manageable with ameliorative measures and/or medications.","PeriodicalId":40019,"journal":{"name":"Clinical Schizophrenia and Related Psychoses","volume":" ","pages":"None"},"PeriodicalIF":0.0,"publicationDate":"2016-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34701263","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

Myocarditis in a patient on Clozapine: What did it? 一名服用氯氮平的患者出现心肌炎：是什么引起的？

Clinical Schizophrenia and Related Psychoses Pub Date : 2016-07-25 DOI: 10.3371/CSRP.MUFE.070816

Sahil Munjal, Stephen Ferrando

引用次数: 0