| 1 | J. Nerv. Ment. Dis. 2000 Aug 188: 530-6 |
|---|---|
| PMID | 10972573 |
| Title | Dissociative experience in hypothetically psychosis-prone college students. |
| Abstract | The relationship between dissociative experiences and psychosis proneness was investigated in a sample of 523 college undergraduates. Participants were administered the Dissociative Experiences Scale (DES), the Perceptual Aberration Scale, the Magical Ideation Scale, the Social Anhedonia Scale, and the Physical Anhedonia Scale. As hypothesized, the Perceptual Aberration and Magical Ideation Scales were positively correlated with the DES. The Social Anhedonia Scale had a moDESt correlation with the DES, but this relationship was largely mediated by the Perceptual Aberration and Magical Ideation Scales. The Physical Anhedonia Scale was uncorrelated with the DES. Exploratory factor analysis of the psychosis-proneness scales and the DES subscales resulted in a three-factor solution: dissociative experiences, positive schizotypy, and negative schizotypy. The DES depersonalization subscale loaded on both the dissociation and positive schizotypy factors. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 2 | Neurology 2002 May 58: 1400-3 |
| PMID | 12011289 |
| Title | Jules Cotard (1840-1889): his life and the unique syndrome which bears his name. |
| Abstract | Dr. Jules Cotard (1840-1889) was a Parisian neurologist who first DEScribed the délire DES négations. Cotard's syndrome or Cotard's delusion comprises any one of a series of delusions ranging from the fixed and unshakable belief that one has lost organs, blood, or body parts to believing that one has lost one's soul or is dead. In its most profound form, the delusion takes the form of a professed belief that one does not exist. Encountered primarily in psychoses such as schizophrenia and bipolar disorder, Cotard's syndrome has also been DEScribed in organic lesions of the nondominant temporoparietal cortex as well as in migraine. Cotard's delusion is the only self-certifiable syndrome of delusional psychosis. Jules Cotard, a Parisian neurologist and psychiatrist and former military surgeon, was one of the first to induce cerebral atrophy by the experimental embolization of cerebral arteries in animals and a pioneer in studies of the clinicopathologic correlates of cerebral atrophy secondary to perinatal and postnatal pathologic changes. He was the first to record that unilateral cerebral atrophy in infancy does not necessarily lead to aphasia and was also the pioneer of studies of altered conscious states in diabetic hyperglycemia. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 3 | Schizophr. Res. 2002 Sep 57: 5-13 |
| PMID | 12165371 |
| Title | Historical aspects of the dichotomy between manic-depressive disorders and schizophrenia. |
| Abstract | The history of psychiatric classification is highly complex and this presentation must be restricted to a simplified overview. Guislain [Guislain, J., 1833. Traité DES phrénopathies ou doctrine nouvelle DES maladies mentales. Etablissement Encyclopédique, Brussels] and Zeller [Beil. Med. Corresp.-Bl. Würtemb. Arztl. Ver. 7 (1837) 321] established a unitarian concept of psychiatric disorder, permutations of which have survived until the present day. Kraepelin's [Kraepelin, E., 1899. Psychiatrie. Ein Lehrbuch für Studierende und Arzte (6th edn.). Johann Ambrosius Barth, Leipzig] dichotomy between "manic-depressive insanity" and dementia praecox was built mainly on Kahlbaum's [Kahlbaum, K., 1863. Die Gruppirung der Psychischen Krankheiten und die Eintheilung der Seelenstörungen. AW Kafemann, Danzig] classification, which took clinical symptoms, course and outcome into account. Kraepelin's well-accepted approach sought to provide a basis for diagnosis, prognosis, choice of treatment and causal research. Kraepelin's dichotomy came to be questioned on several grounds: (1) doubts about his unification of bipolar disorder [Gaz. Hôp. 24 (1851) 18] with melancholia, (2) doubts about the significance of Kraepelin's diagnostic groups for causal research [Z. Gesamte Neurol. Psychiatr. 12 (1912) 540], illustrated best by the work of Bonhoeffer [Bonhoefferm, K., 1912. Die symptomatischen Psychosen im Gefolge akuter Infektionen, Allgemeinerkrankungen und innerer Krankheiten. In: Aschaffenburg, G. (Ed.), Handbuch der Psychiatrie, 3. Abt., 1. Hälfte. Deuticke, Leipzig Wien], (3) the complex psychopathological DEScriptions and classifications of numerous subgroups of psychoses by Kleist [Monatsschr. Psychiatr. Neurol. 125 (1953) 526] and Leonhard [Leonhard, K., 1968. Aufteilung der endogenen Psychosen (4th edn.). Akademie Verlag, Berlin] and (4) DEScription of the psychoses between affective and schizophrenic disorders (intermediate psychoses, mixed psychoses, schizo-affective psychoses) beginning with Kehrer and Kretschmer [Kehrer, F., Kretschmer, E., 1924. Die Veranlagung zu seelischen Störungen. (Monographien aus dem Gesamtgebiete der Neurologie 40) Springer, Berlin] and persisting up to the modern findings of a continuum between the two major groups of psychiatric disorders. Kraepelin's simplification has so far been more successful than the Kleist-Leonhard approach, but the modern and more DEScriptive trend in psychiatric classification favours the syndromal concept of Hoche and the concepts of continua between affective and schizophrenic disorders and between normal and pathological behaviour. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 4 | Schizophr. Res. 2002 Sep 57: 5-13 |
| PMID | 12165371 |
| Title | Historical aspects of the dichotomy between manic-depressive disorders and schizophrenia. |
| Abstract | The history of psychiatric classification is highly complex and this presentation must be restricted to a simplified overview. Guislain [Guislain, J., 1833. Traité DES phrénopathies ou doctrine nouvelle DES maladies mentales. Etablissement Encyclopédique, Brussels] and Zeller [Beil. Med. Corresp.-Bl. Würtemb. Arztl. Ver. 7 (1837) 321] established a unitarian concept of psychiatric disorder, permutations of which have survived until the present day. Kraepelin's [Kraepelin, E., 1899. Psychiatrie. Ein Lehrbuch für Studierende und Arzte (6th edn.). Johann Ambrosius Barth, Leipzig] dichotomy between "manic-depressive insanity" and dementia praecox was built mainly on Kahlbaum's [Kahlbaum, K., 1863. Die Gruppirung der Psychischen Krankheiten und die Eintheilung der Seelenstörungen. AW Kafemann, Danzig] classification, which took clinical symptoms, course and outcome into account. Kraepelin's well-accepted approach sought to provide a basis for diagnosis, prognosis, choice of treatment and causal research. Kraepelin's dichotomy came to be questioned on several grounds: (1) doubts about his unification of bipolar disorder [Gaz. Hôp. 24 (1851) 18] with melancholia, (2) doubts about the significance of Kraepelin's diagnostic groups for causal research [Z. Gesamte Neurol. Psychiatr. 12 (1912) 540], illustrated best by the work of Bonhoeffer [Bonhoefferm, K., 1912. Die symptomatischen Psychosen im Gefolge akuter Infektionen, Allgemeinerkrankungen und innerer Krankheiten. In: Aschaffenburg, G. (Ed.), Handbuch der Psychiatrie, 3. Abt., 1. Hälfte. Deuticke, Leipzig Wien], (3) the complex psychopathological DEScriptions and classifications of numerous subgroups of psychoses by Kleist [Monatsschr. Psychiatr. Neurol. 125 (1953) 526] and Leonhard [Leonhard, K., 1968. Aufteilung der endogenen Psychosen (4th edn.). Akademie Verlag, Berlin] and (4) DEScription of the psychoses between affective and schizophrenic disorders (intermediate psychoses, mixed psychoses, schizo-affective psychoses) beginning with Kehrer and Kretschmer [Kehrer, F., Kretschmer, E., 1924. Die Veranlagung zu seelischen Störungen. (Monographien aus dem Gesamtgebiete der Neurologie 40) Springer, Berlin] and persisting up to the modern findings of a continuum between the two major groups of psychiatric disorders. Kraepelin's simplification has so far been more successful than the Kleist-Leonhard approach, but the modern and more DEScriptive trend in psychiatric classification favours the syndromal concept of Hoche and the concepts of continua between affective and schizophrenic disorders and between normal and pathological behaviour. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 5 | Psychol Psychother 2002 Mar 75: 33-51 |
| PMID | 12006198 |
| Title | Psychometric validation of the State Scale of Dissociation (SSD). |
| Abstract | Although dissociative phenomena are often transient features of mental states, existing measures of dissociation are DESigned to measure enduring traits. A new present-state self-report measure, sensitive to changes in dissociative states, was therefore developed and psychometrically validated. Fifty-six items were formulated to measure state features, and sorted according to seven subscales: derealization, depersonalization, identity confusion, identity alteration, conversion, amnesia and hypermnesia. The State Scale of Dissociation (SSD) was administered with other psychiatric scales (DES, BDI, BAI, SCI-PANSS) to 130 participants with DSM-IV major depressive disorder schizophrenia, alcohol withdrawal, dissociative disorders and controls. In these sample populations, the SSD was demonstrated as a valid and reliable measure of changes in and the severity of dissociative states. Discriminant validity, content, concurrent, predictive, internal criterion-related, internal construct and convergent validities, and internal consistency and split-half reliability were confirmed statistically. Clinical observations of dissociative states, and their comorbidity with symptoms of depression and psychotic illness, were confirmed empirically. The SSD, an acceptable, valid and reliable scale measuring state features of dissociation at the time of completion, was obtained. This is a prerequisite for further investigation of correlations between changes in dissociative states and concurrent physiological parameters. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 6 | Behav Neurol 2003 -1 14: 63-74 |
| PMID | 14757982 |
| Title | The association between negative and dysexecutive syndromes in schizophrenia: a cross-cultural study. |
| Abstract | This paper examined the relationship between the 'negative syndrome' (NS) and the neuropsychological 'dysexecutive syndrome' (DES) in schizophrenia. The study also examined whether any relationship that exists between the NS and the DES holds equally for British and Japanese subjects. We compared 26 Japanese with 17 British schizophrenic patients, divided into 'mild' and 'severe' NS groups, on the basis of performance on neuropsychological tests, including the 'Behavioural Assessment of Dysexecutive Syndrome' (BADS). We found that patients with severe NS showed more everyday executive deficits than those with mild NS. The severity of NS was correlated with executive competence. The association between NS and the BADS performance was closer than that between NS and other conventional executive measures. These findings were not influenced by cultural differences between Japanese and British subjects, and, hence, suggested the existence of culture-neutral neurobehavioural processes. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 7 | Behav Neurol 2003 -1 14: 63-74 |
| PMID | 14757982 |
| Title | The association between negative and dysexecutive syndromes in schizophrenia: a cross-cultural study. |
| Abstract | This paper examined the relationship between the 'negative syndrome' (NS) and the neuropsychological 'dysexecutive syndrome' (DES) in schizophrenia. The study also examined whether any relationship that exists between the NS and the DES holds equally for British and Japanese subjects. We compared 26 Japanese with 17 British schizophrenic patients, divided into 'mild' and 'severe' NS groups, on the basis of performance on neuropsychological tests, including the 'Behavioural Assessment of Dysexecutive Syndrome' (BADS). We found that patients with severe NS showed more everyday executive deficits than those with mild NS. The severity of NS was correlated with executive competence. The association between NS and the BADS performance was closer than that between NS and other conventional executive measures. These findings were not influenced by cultural differences between Japanese and British subjects, and, hence, suggested the existence of culture-neutral neurobehavioural processes. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 8 | Schizophr. Res. 2003 Mar 60: 87-90 |
| PMID | 12505142 |
| Title | Childhood abuse and dissociative symptoms in adult schizophrenia. |
| Abstract | Dissociative symptoms, occurring in many psychiatric disorders including schizophrenia, are often preceded by traumatic experience. We hypothesized that various types of childhood trauma would correlate with levels of dissociative symptomatology in adult patients. Twenty-six patients completed the Dissociative Experiences Scale (DES) and the Childhood Trauma Questionnaire (CTQ). Dissociation was significantly correlated with emotional abuse (r=0.84, one-tailed p<0.001), and physical abuse (r=0.55, p<0.01). We suggest that emotional abuse may play an important role in the etiology of dissociation in schizophrenia. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 9 | Neurophysiol Clin 2003 Jun 33: 138-47 |
| PMID | 12909392 |
| Title | [Effects of a subanaesthetic dose of ketamine on emotional and behavioral state in healthy subjects]. |
| Abstract | schizophrenic patients suffer from positive (delusions, hallucinations) and negative signs (social withdrawal) as well as emotional disturbance that included quantitative (blunted affect) and qualitative impairments (discordance of emotional level). Ketamine, a phencyclidine derivative, is a non competitive N-methyl-D-aspartate (NMDA) glutamate receptor antagonist. In healthy subjects its administration induces some positive symptoms (perceptual distortions.), negative symptoms (emotional deficit, apathy, social withdrawal) and cognitive changes (memory impairments and perseverations) that resemble some aspects of the symptoms of schizophrenia. A double blind cross over, placebo controlled was performed in 12 normal subjects with 2 sessions separated by one week of wash-out to determine ketamine-induced effects on behavioral and emotional responses. During each session, subjects received either ketamine or placebo (saline) infusion. A subanesthetic dose of ketamine (0,5 mg/kg) was administered by constant perfusion over 60 min. Behavioral and cognitive responses were assessed using positive and negative symptoms scales (BPRS, items from SAPS and SANS), vigilance and mood visual analog scale, subjective feelings using the Addiction Research Center Inventory (ARCI) and the Profile of Mood States (POMS). Using Philippot's method, emotions were elicited by films segments which induce a diversity of predictable emotions (fear, anger, sadness, joy, disgust and neutral state) and emotional responses were assessed by the Differential Emotions Scale (DES Izard). Low dose of ketamine induced significant effects on 7-items BPRS score (positive and negative items) and significant effects on positive and negative symptoms from SANS and SAPS. This was associated with emotional blunting of visually-induced responses that resemble aspects of schizophrenic emotional impairments. Ketamine impaired ARCI subscales (benzedrine subscale, pentobarbital-chlorpromazine subscale and LSD subscale). The recent findings of ketamine's pharmacology and imaging studies allow to draw several hypothesis related to neurotransmitter systems (glutamate, dopamine, serotonin interactions) and cerebral areas (particularly prefrontal cortex, anterior cingulate cortex, hippocampus) underlying some of these ketamine-induced effects. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 10 | Neurophysiol Clin 2003 Jun 33: 138-47 |
| PMID | 12909392 |
| Title | [Effects of a subanaesthetic dose of ketamine on emotional and behavioral state in healthy subjects]. |
| Abstract | schizophrenic patients suffer from positive (delusions, hallucinations) and negative signs (social withdrawal) as well as emotional disturbance that included quantitative (blunted affect) and qualitative impairments (discordance of emotional level). Ketamine, a phencyclidine derivative, is a non competitive N-methyl-D-aspartate (NMDA) glutamate receptor antagonist. In healthy subjects its administration induces some positive symptoms (perceptual distortions.), negative symptoms (emotional deficit, apathy, social withdrawal) and cognitive changes (memory impairments and perseverations) that resemble some aspects of the symptoms of schizophrenia. A double blind cross over, placebo controlled was performed in 12 normal subjects with 2 sessions separated by one week of wash-out to determine ketamine-induced effects on behavioral and emotional responses. During each session, subjects received either ketamine or placebo (saline) infusion. A subanesthetic dose of ketamine (0,5 mg/kg) was administered by constant perfusion over 60 min. Behavioral and cognitive responses were assessed using positive and negative symptoms scales (BPRS, items from SAPS and SANS), vigilance and mood visual analog scale, subjective feelings using the Addiction Research Center Inventory (ARCI) and the Profile of Mood States (POMS). Using Philippot's method, emotions were elicited by films segments which induce a diversity of predictable emotions (fear, anger, sadness, joy, disgust and neutral state) and emotional responses were assessed by the Differential Emotions Scale (DES Izard). Low dose of ketamine induced significant effects on 7-items BPRS score (positive and negative items) and significant effects on positive and negative symptoms from SANS and SAPS. This was associated with emotional blunting of visually-induced responses that resemble aspects of schizophrenic emotional impairments. Ketamine impaired ARCI subscales (benzedrine subscale, pentobarbital-chlorpromazine subscale and LSD subscale). The recent findings of ketamine's pharmacology and imaging studies allow to draw several hypothesis related to neurotransmitter systems (glutamate, dopamine, serotonin interactions) and cerebral areas (particularly prefrontal cortex, anterior cingulate cortex, hippocampus) underlying some of these ketamine-induced effects. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 11 | Eur. J. Neurol. 2004 Aug 11: 563-6 |
| PMID | 15272903 |
| Title | The Cotard syndrome. Report of two patients: with a review of the extended spectrum of 'délire des négations'. |
| Abstract | The Cotard syndrome is characterized by the delusion where an individual insists that he has died or part of his body has decayed. Although DEScribed classically in schizophrenia and bipolar disorder, physical disorders including migraine, tumour and trauma have also been associated with the syndrome. Two new cases are DEScribed here, the one associated with arteriovenous malformations and the other with probable multiple sclerosis. The delusion has been embarrassing to each patient. Study of such cases may have wider implications for the understanding of the psychotic interpretation of body image, for example that occurring in anorexia nervosa. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 12 | Minerva Pediatr. 2004 Aug 56: 445-51 |
| PMID | 15457142 |
| Title | Dissociative disorder in children. A case study. |
| Abstract | Dissociative disorder is well-known in adulthood but in many cases it begins in childhood where it is usually not taken into consideration, rarely diagnosed, and often mistaken with borderline disorders. In childhood dissociation is well-defined: in a dimensional way by the presence of the dissociation symptoms over 2 SD and in a categorial view by the presence of primary symptoms. We made a psychiatric assessment on a child aged 11 years and 7 months, who said he heard "voices in his head". The assessment included: Children Dissociative Checklist (CDC), Adolescent Dissociative Experience Scale (A-DES), Children Depression Inventory (CDI), Wechsler Intelligence Scales for Children-Revised (WISC-R), Strength and Difficulties Questionnaire (SDQ), Children Behaviour Check-list (CBCL), (Scale Disturbi Attenzione Genitori, parent attention deficit scale, SDAG), Parent Conners Questionnaire, free conversation, a drawing, a neurological examination, an EEG-Holter and a semistructured psychiatric interview: K-SADS PL 1.0. SDQ, CDI and CBCL showed pathological scores in every area. K-SADS PL 1.0 excluded schizophrenia and showed: attention deficit, disthymic disorder, generalized anxiety disorder, oppositive-defiant disorder and conduct disorder with rage episoDES, like borderline disorder. I.Q. was 76, SDAG (total 46) and Conners (mean points 1.81) showed a high score, simulating Attention Deficit with Hyperactivity disorder (ADHD). The presence of primary symptoms, like dissociative amnesia and very high scores in CDC (23, mean score for MPD) and in A-DES (85, mean 4.2) are useful for diagnoses. Dissociative disorder also exists in childhood, but it should be differentiated from ADHD and borderline disorder. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 13 | J Neural Transm (Vienna) 2004 Jun 111: 691-701 |
| PMID | 15168216 |
| Title | Pioneers of movement disorders: Georges Gilles de la Tourette. |
| Abstract | Georges Albert Edouard Brutus Gilles de la Tourette (1857-1904), a French neurologist and pupil of Jean Martin Charcot at the Salpêtrière hospital in Paris, has gained common recognition through his DEScription of the 'Maladie DES Tics'. This complex neuropsychiatric disorder, later known as the 'Tourette's syndrome', nowadays is accepted as a specific entity of movement disorders. Gilles had started working under Charcot (1825-1893), the first physician to occupy a DESignated chair of neurology of neuropsychiatric history, in 1884. Then the Salpêtrière hospital was a centre of intensive research with an emphasis on hysteria and hypnosis. Tourette took an interest in hysteria, but also dedicated himself to various other neuropsychiatric disorders and to neuropathology. He published scientific works on epilepsia, neurasthenia and syphilitic myelitis. Although he devoted much time to his neuropsychiatric research and the publication of articles in medical journals, his career did not make significant progress, DESpite Charcot's unrestricted support. One reason was, that he disregarded questions, answers and problems, which were outside his interest fields. Hence, he was accused for having acquired an extremely filtered and one-sided knowledge. Also, his alienated and critical behaviour, which had not helped him to find many friends over the years, prevented him from professional promotion. In 1893 an assassination attempt on Gilles de la Tourette raised considerable public interest: Gilles was shot in his appartement in the Rue de l'Université 39 by a young woman, who had been his patient in the Salpêtrière and who claimed that she had been hypnotized without her agreement and thereby had lost her mental health. However, the patient was diagnosed with a disease nowadays called paranoid schizophrenia and therefore hypnosis was not attributed to any part of the disease. Due to episoDES of melancholia and phases of delusions of grandeur and megalomania Gilles de la Tourette was forced to leave his hospital appointment in 1901. These symptoms and the corresponding neurological signs were attributed to the paretic neurosyphilis. He was institutionalized to the psychiatric hospital Cery near Lausanne, Switzerland. In the course of the following three years he became increasingly psychotic and demented, suffered from epileptic seizures and finally died in hospital on 22nd May 1904. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 14 | J. Nerv. Ment. Dis. 2005 Nov 193: 722-7 |
| PMID | 16260925 |
| Title | Replication of dissociation-psychosis link in New Zealand students and inmates. |
| Abstract | To assess the relationship between dissociative and psychotic experiences, New Zealand university students (N = 119) and prison inmates (N = 42) were administered the Dissociative Experiences Scale (DES) and Symptom Checklist-90-Revised (SCL-90-R). Strong correlations were found between DES scores and the psychoticism and paranoid ideation subscales of the SCL-90-R (students: r = .520, .517, respectively; inmates: r = .637, .649, respectively). While other correlations were also significant (but smaller), these results are consistent with previous studies that have used a range of measures of psychosis or schizotypy with a variety of clinical and nonclinical populations. Such consistent findings in the face of methodological diversity offer strong support for the validity of a link between the concepts of dissociation and psychosis. While this relationship has previously been interpreted indirectly, as dissociative experiences predisposing to psychotic symptoms, we suggest a direct route: that dissociative experiences of various forms may underlie some (or even all) psychotic symptoms. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 15 | Pharmacoeconomics 2005 -1 23 Suppl 1: 17-33 |
| PMID | 16416759 |
| Title | Modelling the treated course of schizophrenia: development of a discrete event simulation model. |
| Abstract | In schizophrenia, modelling techniques may be needed to estimate the long-term costs and effects of new interventions. However, it seems that a simple direct link between symptoms and costs does not exist. Decisions about whether a patient will be hospitalized or admitted to a different healthcare setting are based not only on symptoms but also on social and environmental factors. This paper DEScribes the development of a model to assess the dependencies between a broad range of parameters in the treatment of schizophrenia. In particular, the model attempts to incorporate social and environmental factors into the decision-making process for the prescription of new drugs to patients. The model was used to analyse the potential benefits of improving compliance with medication by 20% in patients in the UK. A discrete event simulation (DES) model was developed, to DEScribe a cohort of schizophrenia patients with multiple psychotic episoDES. The model takes into account the patient's sex, disease severity, potential risk of harm to self and society, and social and environmental factors. Other variables that change over time include the number of psychiatric consultations, the presence of psychotic episoDES, symptoms, treatments, compliance, side-effects, the lack of ability to take care of him/herself, care setting and risk of harm. Outcomes are costs, psychotic episoDES and symptoms. Univariate and multivariate sensitivity analyses were performed. Direct medical costs were considered (year of costing 2002), applying a 6.0% discount rate for costs and a 1.5% discount rate for outcome. The timeframe of the model is 5 years. When 50% of the decisions about the patient care setting are based on symptoms, a 20% increase in compliance was estimated to save 16,147 pounds and to avoid 0.55 psychotic episoDES per patient over 5 years. Sensitivity analysis showed that the costs savings associated with increased compliance are robust over a range of variations in parameters. DES offers a flexible structure for modelling a disease, taking into account how a patient's history affects the course of the disease over time. This approach is particularly pertinent to schizophrenia, in which treatment decisions are complex. The model shows that better compliance increases the time between relapses, decreases the symptom score, and reduces the requirement for treatment in an intensive patient care setting, leading to cost savings. The extent of the cost savings depends on the relative importance of symptoms and of social and environmental factors in these decisions. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 16 | Pharmacoeconomics 2005 -1 23 Suppl 1: 3-16 |
| PMID | 16416758 |
| Title | Pharmacoeconomics of long-acting risperidone: results and validity of cost-effectiveness models. |
| Abstract | Relapse is the primary cost driver in schizophrenia and is closely related to levels of adherence (compliance) with therapy. Both atypical antipsychotic agents and depot preparations have been shown to be useful in improving therapeutic adherence compared with oral conventional antipsychotic agents. Long-acting risperidone is a new formulation of an atypical antipsychotic agent that combines the pharmacological advantages of the atypical drugs with those of its mode of administration. The likelihood of improved compliance compared with existing treatment regimens implies that the higher acquisition costs would be offset by reduced rates of relapse. Economic models, which represent the health and economic outcomes of patients or populations under a variety of scenarios, are used to evaluate the economic implications of schizophrenia treatment. These models need to reflect clinical reality while simultaneously remaining as simple as possible. The assumptions and results need to be made transparent; data quality must be DEScribed explicitly; areas of uncertainty must be comprehensively explored through sensitivity analysis; and individual models must be validated, for example by comparing them with others in the therapeutic area. In this article, cost-effectiveness models of long-acting risperidone developed for different countries are discussed in terms of DESign, data sources and robustness, and the implications of the results for the treatment of schizophrenia are also reviewed. A discrete event simulation (DES) model that was developed using UK cost and treatment assumptions, in order to provide a 'proof of concept', is DEScribed. Country-specific models forthe United States, Canada, Germany, the Netherlands, France, Belgium, Italy and Portugal, using either DES or decision analytical structures, are then discussed. Comprehensive sensitivity analyses were conducted to assess the robustness of the results. In each case, long-acting risperidone produced additional clinical benefit and cost savings compared with other treatment strategies, DESpite significant variations in cost effectiveness and therapeutic approaches. In particular, improved adherence arising through the use of long-acting risperidone proviDES a cost-effective strategy for treating patients with schizophrenia, irrespective of the country analysed. The information generated in this analysis therefore proviDES one potential method for improving resource allocation and reducing the health burden related to schizophrenia. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 17 | Psychopathology 2006 -1 39: 236-42 |
| PMID | 16778454 |
| Title | The role of trauma and PTSD-related symptoms for dissociation and psychopathological distress in inpatients with schizophrenia. |
| Abstract | To investigate the relationship between dissociative experiences, psychopathological distress, a history of trauma and posttraumatic symptoms in adult schizophrenia. Eighty-seven schizophrenic inpatients returned self-questionnaires [Dissociative Experience Scale (DES); Symptom Checklist (SCL-90-R); PTSD Symptom Scale (PDS)]. Based upon this self-rating, 14 of the participants fulfilled the cut-off definition of PTSD according to DSM-IV criteria, 43 had a history of trauma without a self-rated diagnosis of PTSD. DES scores were also compared to a convenience sample of 297 non-clinical controls. We found no significant impact of trauma alone but a significant influence of posttraumatic symptomatology on the level of current psychopathological distress (GSI) and the DES subscale absorption. However, in logistic regression, posttraumatic symptomatology was associated with GSI but not with DES. schizophrenic patients even without trauma or posttraumatic symptoms had significantly higher scores in all three DES subscales than non-clinical controls. Pronounced posttraumatic symptoms in schizophrenia are associated with severe additional psychopathological distress whereas the increase in dissociation (absorption) in this group of patients may be secondary to the increase in symptom load. However, schizophrenia itself seems to be associated independently from trauma and pathological posttraumatic conditions with a broad range of dissociative symptoms. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 18 | Psychopathology 2006 -1 39: 236-42 |
| PMID | 16778454 |
| Title | The role of trauma and PTSD-related symptoms for dissociation and psychopathological distress in inpatients with schizophrenia. |
| Abstract | To investigate the relationship between dissociative experiences, psychopathological distress, a history of trauma and posttraumatic symptoms in adult schizophrenia. Eighty-seven schizophrenic inpatients returned self-questionnaires [Dissociative Experience Scale (DES); Symptom Checklist (SCL-90-R); PTSD Symptom Scale (PDS)]. Based upon this self-rating, 14 of the participants fulfilled the cut-off definition of PTSD according to DSM-IV criteria, 43 had a history of trauma without a self-rated diagnosis of PTSD. DES scores were also compared to a convenience sample of 297 non-clinical controls. We found no significant impact of trauma alone but a significant influence of posttraumatic symptomatology on the level of current psychopathological distress (GSI) and the DES subscale absorption. However, in logistic regression, posttraumatic symptomatology was associated with GSI but not with DES. schizophrenic patients even without trauma or posttraumatic symptoms had significantly higher scores in all three DES subscales than non-clinical controls. Pronounced posttraumatic symptoms in schizophrenia are associated with severe additional psychopathological distress whereas the increase in dissociation (absorption) in this group of patients may be secondary to the increase in symptom load. However, schizophrenia itself seems to be associated independently from trauma and pathological posttraumatic conditions with a broad range of dissociative symptoms. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 19 | Psychiatry Res 2007 Oct 153: 111-8 |
| PMID | 17570534 |
| Title | Schizoidia in schizophrenia spectrum and personality disorders: role of dissociation. |
| Abstract | Dissociation was one of the roots of the nosopoetic construct "schizophrenia", and a link seems to exist between psychotic and dissociative phenomena. We explored the relationship between dissociation and schizoidia as defined by the Dissociative Experiences Scale (DES) total score and the schizoidia subscale of the Munich Personality Test (MPT), respectively. The study comprised 43 outpatients diagnosed with schizophrenia spectrum disorders in remission, 47 outpatients with personality disorders and 42 non-patients. BesiDES the DES and the MPT, all participants also completed parts of the Symptom Checklist (SCL-90-R) and theTrauma Questionnaire (TQ). In the final multivariable logistic model, a set of five variables was identified as the strongest contributors to the occurrence of schizoida. The model included TQ broken home, MPT neuroticism, schizophrenia spectrum and personality disorder diagnoses, and SCL aggressivity; it did not include any dissociation variable. The purported relationship between dissociation and schizoidia could not be confirmed; the existence of schizophrenia-inherent dissociation appears questionable. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 20 | J. Nerv. Ment. Dis. 2007 Sep 195: 769-72 |
| PMID | 17984778 |
| Title | The dissociative experiences taxon is related to fantasy proneness. |
| Abstract | Some authors have argued that nonpathological dissociation should be distinguished from a taxon form of pathological dissociation, which is indexed by the Dissociative Experiences Scale Taxon (DES-T). We tested to what extent DES-T scores are independent from fantasy immersion and whether DES-T scores are uniquely related to trauma self-reports. To this end, subsamples of undergraduate students (n = 930), healthy adults (n = 20), schizophrenic patients (n = 22), borderline personality disordered patients (n = 20), patients with mood disorder without psychosis (n = 19), and women with a history of childhood sexual abuse (n = 55) completed the Dissociative Experiences Scale and a measure of fantasy immersion. DES-T scores were related to absorption and fantasy immersion to a lesser extent than the original DES. However, the fact that nontrivial percentages within all groups, except for the healthy adults, were classified as taxon members casts doubts on the assumption that DES-T is a reliable index of pathological dissociation. Also, we found that the DES-T was not exclusively related to reports of childhood sexual abuse. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 21 | Neuropeptides 2008 Jun 42: 301-9 |
| PMID | 18359517 |
| Title | Effect of D(3) dopamine receptors blockade on the cognitive effects of angiotensin IV in rats. |
| Abstract | Our previous studies showed that D(1) and D(2) dopamine receptors are indispensable for the cognitive effects of angiotensin IV (Ang IV) and its DES-Phe(6) derivative DES-Phe(6)-Ang IV to occur. As most neuroleptics currently used in the treatment of schizophrenia have variable D(2)/D(3) dopaminolytic selectivity, in this study we searched for the role of the D(3) dopamine receptors in facilitating learning and improving memory actions of Ang IV and DES-Phe(6)-Ang IV in rats. For this purpose, we evaluated the recall of the passive avoidance (PA) behaviour, object recognition (OR) memory, and the spatial working memory (WM) in rats treated with the intraperitoneal (i.p.) nafadotride (N[(n-butyl-2-pyrrolidinyl)methyl]-1-methoxy-4-cyanonaphtalene-2-carboxamide), a highly selective D(3) receptor blocker and then by an intracerebroventricular (i.c.v.) Ang IV or DES-Phe(6)-Ang IV. Separate groups of rats receiving the same treatments were run to check for the possible participation of unspecific motor (open field) or emotioned (elevated "plus" maze) effects of our treatments in the results of the cognitive tests. The results revealed Ang IV to express its improving recall of PA, OR memory and WM action roughly similarly in all groups showing only minor or null significance of the D(3) receptors blockade. Interestingly, in the nafadotride pretreated rats, DES-Phe(6)-Ang IV beneficial effect on the recall of the PA was weaker than that of Ang IV. Improvement of the spatial WM in an eight-arm radial maze, similar after Ang IV and DES-Phe(6)-Ang IV, was not significantly affected by nafadotride. There were no motor and only minor anxiogenic effects of Ang IV and DES-Phe(6)-Ang IV abolished by nafadotride in the former case. In conclusion, this study points to the minor significance of the D(3) dopamine receptors in the cognitive effects of Ang IV and to the interesting, though unexplained, inhibition by nafadotride of the DES-Phe(6)-Ang IV effects. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 22 | Med. Sci. Monit. 2008 Oct 14: CR499-504 |
| PMID | 18830188 |
| Title | Dissociative symptoms and neuroendocrine dysregulation in depression. |
| Abstract | Dissociative symptoms are traditionally attributed to psychological stressors that produce dissociated memories related to stressful life events. Dissociative disorders and dissociative symptoms including psychogenic amnesia, fugue, dissociative identity-disorder, depersonalization, derealization and other symptoms or syndromes have been reported as an epidemic psychiatric condition that may be coexistent with various psychiatric diagnoses such as depression, schizophrenia, borderline personality disorder or anxiety disorders. According to recent findings also the somatic components of dissociation may occur and influence brain, autonomic and neuroendocrine functions. At this time there are only few studies examining neuroendocrine response related to dissociative symptoms that suggest significant dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. The aim of the present study is to perform examination of HPA axis functioning indexed by basal cortisol and prolactin and test their relationship to psychic and somatoform dissociative symptoms. Basal cortisol and prolactin and psychic and somatoform dissociative symptoms were assessed in 40 consecutive inpatients with diagnosis of unipolar depression mean age 43.37 (SD=12.21). The results show that prolactin and cortisol as indices of HPA axis functioning manifest significant relationship to dissociative symptoms. Main results represent highly significant correlations obtained by simple regression between psychic dissociative symptoms (DES) and serum prolactin (R=0.55, p=0.00027), and between somatoform dissociation (SDQ-20) and serum cortisol (R=-0.38, p=0.015). These results indicate relationship between HPA-axis reactivity and dissociative symptoms in unipolar depressive patients that could reflect passive coping behavior and disengagement. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 23 | Eur Arch Psychiatry Clin Neurosci 2008 Jun 258 Suppl 2: 3-11 |
| PMID | 18516510 |
| Title | The work of Emil Kraepelin and his research group in München. |
| Abstract | Emil Kraepelin is well known due to his development of the psychiatric classification. The ICD-10 and DSM-IV classification is based on the dichotomy of endogenous psychoses into affective psychoses and schizophrenia as early as 1899. Moreover, beside his classification system he put enormous impact on the development of psychiatry to an empirical field of science. The research activities of Kraepelin and his coworkers show that he was not only the most active researcher in the field of psychiatry in his time but also that his research activities included a lot of clinical and experimental work in different disciplines of psychiatry, including psychology, pharmacology and natural sciences as 'Hilfswissenschaften'. Due to his extraordinary position also in his time he brought together important researchers of this time, in particular after the foundation of a psychiatric research institute. Alois Alzheimer, Franz Nissl, Robert Gaupp, or Korbinian Brodman are only a few of his well known coworkers. Kraepelin tried to bring foreward the empirical knowledge in psychiatry, he did not want to have cessation in psychiatry in general and in the classification of psychiatric disorders in particular. He discussed and partly revisted his view and his theoretical approach in the different editions of his textbook according to the state of his empirical knowledge. This is also true for the dichotomy. More than twenty years after the 6th edition of his textbook, he wrote in an essay 'Die Erscheinungsformen DES Irreseins' ('The manifestations of insanity') regarding the dichotomy: "No experienced diagnostician would deny that cases where it seems impossible to arrive to a clear decision, DESpite extremely careful observation, are unpleasantly frequent." and "....therefore, the increasingly obvious impossibility to separate the two respective illnesses satisfactorily should raise the suspicion that our question is wrong". This contribution shows that Kraepelin himself questioned his dichotomy of dementia praecox and manic depressive insanity, a discussion which is lively still today--more than 80 years later. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 24 | Value Health 2008 Dec 11: 1007-21 |
| PMID | 18489517 |
| Title | The cost-effectiveness of atypicals in the UK. |
| Abstract | In 2002, the National Institute for Health and Clinical Excellence (NICE), recommended atypical antipsychotics over conventional ones for first-line schizophrenia treatment, based on their lower risk of extrapyramidal symptoms. To estimate the incremental cost-effectiveness of atypical relative to conventional antipsychotics for the treatment of schizophrenia in the UK. A discrete event simulation (DES) model was adopted to reflect the treatment of schizophrenia in the UK. The model estimates symptoms (using the Positive and Negative Symptom Score [PANSS]), psychiatrist visits, pharmacological treatment and treatment location, number and duration of psychotic relapses, level of compliance, quality-adjusted life-years (QALYs), and side effects over a 5-year time period. Probabilistic sensitivity analyses were carried out. Following NICE's "atypical" recommendation, the cost-effectiveness of atypical versus conventional antipsychotics was estimated in a scenario analysis, assuming both groups differ only in side-effect profile. When comparing conventional and atypical antipsychotics, the model predicts that the latter would decrease 5-year costs by 1633 Pound per patient and result in a QALY gain of 0.101. The probabilistic sensitivity analysis suggests these results are robust. The sensitivity analyses indicate that incremental costs and effects are most sensitive to the differential efficacy of atypicals and conventionals, as measured by PANSS. When it is assumed that the only differences between atypicals and conventionals are found in side-effect profiles, the incremental cost-effectiveness ratio of the atypicals is 45,000 Pound per QALY gained. According to this DES model for schizophrenia, atypical antipsychotics are cost-effective compared to the conventional antipsychotics. The assumptions used in the model need further validation through large naturalistic based studies with reasonable follow-up to determine the real-life differences between atypicals and conventional antipsychotics. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 25 | Appl Health Econ Health Policy 2008 -1 6: 189-97 |
| PMID | 19382819 |
| Title | A pharmacoeconomic analysis of compliance gains on antipsychotic medications. |
| Abstract | Compliance among patients with schizophrenia is typically poor. Consequently, treatments that are equally efficacious under trial-based conditions but face different compliance rates in clinical practice (e.g. due to adverse-effect profile, ease of use, reputation) may have differences in effectiveness not observed during trials. This study analyses the impact of differences in compliance with atypical antipsychotics using a pharmacoeconomic discrete-event simulation (DES) model, adapted to the Swedish treatment setting. An existing 5-year DES model was adapted to reflect a Swedish setting; the analysis was conducted from a third-party payer perspective, with only direct costs included. The two treatment arms were identical except for percentage of compliant patients. Non-compliant patients experienced shorter time between relapses and had inferior symptom control than their compliant counterparts. The difference in compliance rates was varied from 0% to 15%, and incremental costs and effects were recorded and analysed. With a 5%, 10% and 15% difference in compliance rate, incremental effects increased to 0.021, 0.037 and 0.062, respectively, while generating cost savings of Swedish kronor (SEK)31 500, SEK62 000 and SEK104 500, respectively (SEK9.25 = 1, Euro year 2007 values). Hence, each percentage point of compliance gain is predicted to roughly result in a cost saving of SEK6000 and a QALY gain of 0.004. On average, the model predicts that, with a 15% increase in compliance, 0.5 relapses are prevented, the average Positive And Negative Syndrome Scale (PANSS) score decreases by 3.3 points and patients spend 22 fewer days in hospital over 5 years. The DES model predicts that increases in compliance may lead to considerable cost savings and health improvements. Therefore, when determining the cost effectiveness of a new antipsychotic, efficacy rates from clinical trials should not be taken at face value, but should be interpreted in tandem with expectations concerning compliance, in light of product characteristics such as adverse effects. These results further suggest that efforts to improve compliance among patients with schizophrenia are expected to prove cost effective if compliance gains and the resulting health improvements and cost savings are in balance with the additional costs. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 26 | BMC Health Serv Res 2009 -1 9: 32 |
| PMID | 19226465 |
| Title | A pharmaco-economic analysis of patients with schizophrenia switching to generic risperidone involving a possible compliance loss. |
| Abstract | As schizophrenia patients are typically suspicious of, or are hostile to changes they may be reluctant to accept generic substitution, possibly affecting compliance. This may counteract drug costs savings due to less symptom control and increased hospitalization risk. Although compliance losses following generic substitution have not been quantified so far, one can estimate the possible health-economic consequences. The current study aims to do so by considering the case of risperidone in Germany. An existing DES model was adapted to compare staying on branded risperidone with generic substitution. Differences include the probability of non-compliance and medication costs. Incremental probability of non-compliance after generic substitution was varied between 2.5% and 10%, while generic medication costs were assumed to be 40% lower. Effect of medication price was assessed as well as the effect of applying compliance losses to all treatment settings. The probability of staying on branded risperidone being cost-effective was calculated for various outcomes of a hypothetical study that would investigate non-compliance following generic substitution of risperidone. If the incremental probability of non-compliance after generic substitution is 2.5%, 5.0%, 7.5% and 10% respectively, incremental effects of staying on branded risperidone are 0.004, 0.007, 0.011 and 0.015 Quality Adjusted Life Years (QALYs). Incremental costs are euro757, euro343, -euro123 and -euro554 respectively. Benefits of staying on branded risperidone include improved symptom control and fewer hospitalizations. If generic substitution results in a 5.2% higher probability of non-compliance, the model predicts staying on branded risperidone to be cost-effective (NICE threshold of 30,000 per QALY gained). Compliance losses of more than 6.9% makes branded risperidone the dominant alternative. Results are sensitive to the locations at which compliance loss is applied and the price of generic risperidone. The probability that staying on branded risperidone is cost-effective would increase with larger compliance differences and more patients included in the hypothetical study. The model predicts that it is cost-effective to keep a patient with schizophrenia in Germany on branded risperidone instead of switching him/her to generic risperidone (assuming a 40% reduction in medication costs), if the incremental probability of becoming non-compliant after generic substitution exceeds 5.2%. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 27 | J Med Syst 2010 Oct 34: 799-808 |
| PMID | 20703629 |
| Title | Prediction of the period of psychotic episode in individual schizophrenics by simulation-data construction approach. |
| Abstract | Although schizophrenia can be treated, most patients still experience inevitable psychotic episoDES from time to time. Precautious actions can be taken if the next onset can be predicted. However, sufficient information is always lacking in the clinical scenario. A possible solution is to use the virtual data generated from limited of original data. Data construction method (DCM) has been shown to generate the virtual felt earthquake data effectively and used in the prediction of further events. Here we investigated the performance of DCM in deriving the membership functions and discrete-event simulations (DES) in predicting the period embracing the initiation and termination time-points of the next psychotic episode of 35 individual schizophrenic patients. The results showed that 21 subjects had a success of simulations (RSS) ?70%. Further analysis demonstrated that the co-morbidity of coronary heart diseases (CHD), risks of CHD, and the frequency of previous psychotic episoDES increased the RSS. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 28 | J Med Syst 2010 Oct 34: 799-808 |
| PMID | 20703629 |
| Title | Prediction of the period of psychotic episode in individual schizophrenics by simulation-data construction approach. |
| Abstract | Although schizophrenia can be treated, most patients still experience inevitable psychotic episoDES from time to time. Precautious actions can be taken if the next onset can be predicted. However, sufficient information is always lacking in the clinical scenario. A possible solution is to use the virtual data generated from limited of original data. Data construction method (DCM) has been shown to generate the virtual felt earthquake data effectively and used in the prediction of further events. Here we investigated the performance of DCM in deriving the membership functions and discrete-event simulations (DES) in predicting the period embracing the initiation and termination time-points of the next psychotic episode of 35 individual schizophrenic patients. The results showed that 21 subjects had a success of simulations (RSS) ?70%. Further analysis demonstrated that the co-morbidity of coronary heart diseases (CHD), risks of CHD, and the frequency of previous psychotic episoDES increased the RSS. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 29 | J Med Syst 2010 Oct 34: 799-808 |
| PMID | 20703629 |
| Title | Prediction of the period of psychotic episode in individual schizophrenics by simulation-data construction approach. |
| Abstract | Although schizophrenia can be treated, most patients still experience inevitable psychotic episoDES from time to time. Precautious actions can be taken if the next onset can be predicted. However, sufficient information is always lacking in the clinical scenario. A possible solution is to use the virtual data generated from limited of original data. Data construction method (DCM) has been shown to generate the virtual felt earthquake data effectively and used in the prediction of further events. Here we investigated the performance of DCM in deriving the membership functions and discrete-event simulations (DES) in predicting the period embracing the initiation and termination time-points of the next psychotic episode of 35 individual schizophrenic patients. The results showed that 21 subjects had a success of simulations (RSS) ?70%. Further analysis demonstrated that the co-morbidity of coronary heart diseases (CHD), risks of CHD, and the frequency of previous psychotic episoDES increased the RSS. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 30 | Appl Health Econ Health Policy 2010 -1 8: 327-41 |
| PMID | 20804225 |
| Title | Cost effectiveness of long-acting risperidone in Sweden. |
| Abstract | In Sweden, risperidone long-acting injectable (RLAI) is generally used in a population of schizophrenia patients who are at a high risk of being non-compliant. However, RLAI might also be suitable for use in the general schizophrenia population. To analyse the clinical and economic effects of RLAI in the Swedish treatment practice using a discrete-event simulation (DES) model. Treatment outcomes and direct costs were analysed for both the high-risk non-compliant patient population and the general schizophrenia population. An existing DES model was adapted to simulate the treatment of schizophrenia in Sweden. Model inputs were based on literature research and supplemented with expert opinion. In the high-risk non-compliant schizophrenia population, RLAI was compared with haloperidol LAI. The analysis was built upon differences in symptom reduction, time between relapses, compliance and adverse effect profile between the two drugs. Main outcomes were the predicted incremental (discounted) costs (?) and effects (QALYs). In the general schizophrenia population, RLAI was compared with oral olanzapine. This analysis was built upon differences in compliance and adverse effects between the drugs. Multivariate probabilistic sensitivity analyses (PSA) were carried out to assess the sensitivity of the results of the two analyses. In the high-risk non-compliant patient population, RLAI was predicted to generate 0.103 QALYs per patient over 3 years while realizing cost savings of ?5013 (year 2007 values) compared with haloperidol LAI. The main driver of the cost effectiveness of RLAI was the difference in Positive and Negative Syndrome Scale (PANSS) reduction between the two drugs, followed by the difference in adverse effects. The PSA showed that, in this setting, RLAI had a probability of 100% of being cost effective at a willingness-to-pay (WTP) threshold of ?43,300 per QALY gained, compared with haloperidol LAI. The probability that RLAI combines additional effectiveness with cost savings compared with haloperidol LAI was estimated at 94%. When analysing RLAI in the general schizophrenia population, it was predicted to generate 0.043 QALYs and save ?239 per patient over 5 years compared with olanzapine. Compliance was the main driver of the cost effectiveness of RLAI in this scenario. In the PSA it was shown that RLAI had a probability of 78% of being cost effective at a WTP threshold of ?43,300 per QALY gained, compared with olanzapine. The estimated probability that RLAI combines additional effectiveness with cost savings was 50% and the probability that RLAI is less effective and more costly than olanzapine was negligible (0.2%). Treatment with RLAI is suggested to result in improved QALYs combined with cost savings compared with haloperidol LAI among the Swedish, high-risk non-compliant schizophrenia patient population. In the general schizophrenia population, RLAI also resulted in positive incremental QALYs and cost savings, when compared with olanzapine. However, the estimates used in the model for compliance and symptom reduction need further validation through naturalistic-based studies with reasonable follow-up to more definitely establish the real-life differences between RLAI and the comparators in the considered patient populations and to further reduce the uncertainty of these parameters. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 31 | Psychiatry Res 2010 May 177: 37-40 |
| PMID | 20381169 |
| Title | Dissociative symptoms and interregional EEG cross-correlations in paranoid schizophrenia. |
| Abstract | Recent findings indicate that binding and synchronization of distributed activities are crucial for the mechanism of consciousness, and there is increased evidence that disruptions in feature binding produce disintegration of consciousness in schizophrenia. These data suggest that the disrupted binding and disintegration of consciousness could be related to dissociation, which is historically linked to Bleuler's concept of splitting in schizophrenia. In the present study we aimed to investigate relations among electroencephalogram (EEG) activities of cortical sites and used psychometric measures of positive and negative schizophrenia symptoms (Positive and Negative Syndrome Scale) and the Dissociative Experiences Scale (DES) in 58 patients with paranoid schizophrenia. The results show statistically significant Spearman correlations of the DES with cross-correlation function in nine (of 16) EEG pairs. Positive symptoms display significant Spearman correlation with mean of cross-correlation function in only one EEG pair (F4-C4). Results of the Mann-Whitney test between patients with higher (DES > or = 30) and lower dissociation show statistically significant differences between the groups for cross-correlations in nine EEG pairs. The results of this study provide the first supportive evidence for a negative relationship between cross-correlation indices and symptoms of dissociation in schizophrenia. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 32 | J. Med. Chem. 2013 Jun 56: 4671-90 |
| PMID | 23675993 |
| Title | Synthesis and biological investigation of coumarin piperazine (piperidine) derivatives as potential multireceptor atypical antipsychotics. |
| Abstract | The discovery and synthesis of potential and novel antipsychotic coumarin derivatives, associated with potent dopamine D2, D3, and serotonin 5-HT1A and 5-HT2A receptor properties, are the focus of the present article. The most-promising derivative was 7-(4-(4-(6-fluorobenzo[d]isoxazol-3-yl)-piperidin-1-yl)butoxy)-4-methyl-8-chloro-2H-chromen-2-one (17m). This derivative possesses unique pharmacological features, including high affinity for dopamine D2 and D3 and serotonin 5-HT1A and 5-HT2A receptors. Moreover, it possesses low affinity for 5-HT2C and H1 receptors (to reduce the risk of obesity associated with chronic treatment) and hERG channels (to reduce the incidence of torsade DES pointes). In animal models, compound 17m inhibited apomorphine-induced climbing behavior, MK-801-induced hyperactivity, and the conditioned avoidance response without observable catalepsy at the highest dose tested. Further, fewer preclinical adverse events were noted with 17m compared with risperidone in assays that measured prolactin secretion and weight gain. Acceptable pharmacokinetic properties were also noted with 17m. Taken together, 17m may constitute a novel class of drugs for the treatment of schizophrenia. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 33 | Br J Psychiatry 2013 Jun 202: 447-53 |
| PMID | 23661768 |
| Title | Evaluating the impact of a quality of life assessment with feedback to clinicians in patients with schizophrenia: randomised controlled trial. |
| Abstract | Quality of life (QoL) measurements are increasingly considered to be an important evaluation of the treatment and care provided to patients with schizophrenia. However, there is little evidence that assessing QoL improves patient outcomes in clinical practice. To investigate the impact of a QoL assessment with feedback for clinicians regarding satisfaction and other health outcomes in patients with schizophrenia. We conducted a 6-month, prospective, randomised and controlled open-label study. Patients with schizophrenia were assigned to one of three groups: standard psychiatric assessment; QoL assessment with standard psychiatric assessment; and QoL feedback with standard psychiatric assessment. The primary outcome was patient satisfaction at 6 months. The local ethics committee (Comité de Protection DES Personnes Sud-Méditerranéee V, France, trial number 07 067) and the French drug and device regulation agency (Agence Française de Sécurité Sanitaire DES Produits de Santé, France, trial number A01033-50) approved this study. We randomly assigned 124 patients into groups. Quality of life feedback significantly affected patient satisfaction. Global satisfaction was significantly higher in the QoL feedback group (72.5% of patients had a high level of satisfaction) compared with the standard psychiatric assessment (67.5%) and QoL assessment groups (45.2%). DESpite trends towards decreased severity for all clinical outcomes and increased changes to medication in the QoL feedback group at 6-month follow-up, these effects were not significant. Quality of life feedback positively influences patient satisfaction, which confirms the relevance of measuring QoL in clinical practice. The absence of a significant effect of QoL feedback on clinical outcomes also suggests that clinicians did not use these data optimally. Our findings suggest a nocebo effect of QoL assessment without feedback that should be considered by researchers and clinicians. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 34 | Schizophr. Res. 2013 Mar 144: 93-8 |
| PMID | 23352775 |
| Title | Psychometric properties of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in Korean patients with schizophrenia. |
| Abstract | DESpite increasing interest in the relationship between childhood trauma and psychosis, measures used to assess early trauma have not had their psychometric properties extensively tested among individuals with serious mental illness. This study investigated the reliability and validity of one of the most widely-used self-reports of early adversity, the Childhood Trauma Questionnaire, Short Form (CTQ), among patients with schizophrenia. The CTQ was administered to 100 patients (52 inpatients and 48 outpatients) diagnosed with schizophrenia in three training hospitals. Internal consistency, four-week test-retest reliability and validity were calculated. Participants also completed the Trauma Antecedents Questionnaire (TAQ), the Impact of Events Scale-Revised (IES-R), and the Dissociative Experiences Scale-Taxon (DES-T). Our analysis indicated high test-retest reliability (Spearman ?=0.75) and internal consistency (Cronbach ?=0.89). Concurrent validity was confirmed as each type of childhood trauma was significantly correlated with the corresponding subscales of the TAQ. In addition, the CTQ was positively related to post-traumatic stress symptoms and pathological dissociation, demonstrating the convergent validity of the scale. The CTQ is a reliable and valid self-report measure for assessing childhood trauma in both inpatients and outpatients with schizophrenia. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 35 | Nucl. Med. Biol. 2013 Apr 40: 395-402 |
| PMID | 23294899 |
| Title | Synthesis and evaluation of new radioligands [(11)C]A-833834 and [(11)C]A-752274 for positron-emission tomography of ?7-nicotinic acetylcholine receptors. |
| Abstract | ?7-nicotinic acetylcholine receptor (?7-nAChR) is one of the major neuronal nAChR subtypes. ?7-nAChR is involved in variety of neuronal processes and disorders including schizophrenia and Alzheimer's disease. A number of ?7-nAChR PET radioligands have been developed, but a quality radiotracer remains to be discovered. High binding affinity ?7-nAChR ligands A-833834 and A-752274 were radiolabeled with (11)C. Baseline and blockade biodistribution studies in the mouse brain of [(11)C]A-833834 (5-(6-(5-[(11)C]methylhexahydropyrrolo[3,4-c]pyrrol-2(1H)-yl)pyridazin-3-yl)-1H-indole) and [(11)C]A-752274 (2-(6-[(11)C]methyl-3,6-diazabicyclo[3.2.0]heptan-3-yl)-7-(6-methyl-3,6-diazabicyclo[3.2.0]heptan-3-yl)-9H-fluoren-9-one) were performed. [(11)C]A-752274 was evaluated in a baseline baboon PET study. [(11)C]A-833834 and [(11)C]A-752274 were synthesized by radiomethylation of corresponding DES-methyl precursors. The radioligands were prepared with radiochemical yield of 12%-32%, high specific radioactivity (330-403GBq/?mol) and radiochemical purity>95%. Dissection studies with [(11)C]A-833834 demonstrated low specific ?7-nAChR binding in the mouse brain. [(11)C]A-752274 specifically (~50%) labeled ?7-nAChR in the mouse thalamus. However, [(11)CA-752274 exhibited low brain uptake in baboon (%SUV<100). Two novel ?7-nAChR ligands radioligands were synthesized and studied in animals. Specific binding of [(11)C]A-833834 in the mouse brain is low due to the insufficient binding affinity of the radioligand. The very high binding affinity [(11)C]A-752274 exhibited good specific binding in the ?7-nAChR-rich mouse brain regions. The low uptake of [(11)C]A-752274 in the baboon brain is due to its high hydrophilicity, rapid metabolism or other properties. Future development of ?7-nAChR PET radioligands will be based on compounds with high binding affinities and good blood-brain barrier permeability. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 36 | Encephale 2014 Dec 40: 447-56 |
| PMID | 25127895 |
| Title | [Assessment of mental states at risk of psychotic transition: validation of the French version of the CAARMS]. |
| Abstract | This article aims to present the validation study of the French version of the Comprehensive Assessment of at risk mental states (CAARMS), an interview that seeks to determine whether young adults criteria for at-risk (AR) mental states, or psychosis. We assessed 40 young subjects, 15 were considered as "prodromal" (Prd) and 10 as experiencing a first episode of psychosis (PEP) by our expert clinician at the center - centre d'évaluation DES jeunes adultes et adolescents, University Hospital Centre, Paris - and 15 were healthy controls matched for age and sex. When assessed with the CAARMS, 73 % (n=11) of the prodromal subjects reached the criteria for AR mental state, four subjects did not reach the criteria for AR, nor psychosis (P) and 100 % of the PEP reached the criteria for P. The three groups were significantly different on CAARMS total score (P<0.001) and subscores ; Prd subjects had intermediate scores between PEP (P<0.001) and controls (P<0.001) scores, PEP showing the highest scores. Post-hoc analysis showed that Prd significantly differed from Controls on each subscale (P<0.001) and that Prd differed from PEP on the "positive symptoms" subscale (P<0.001), as well as on "behavioural change" (P=0.021), owing to difference on the item "impaired role function". We used the brief psychiatric rating scale 24 items with anchor (BPRS24-EA) in addition to with the CAARMS, the AR group showed intermediate scores between controls and P subjects. Total scores of both scales were correlated (r=0.408 ; P=0.043) and the BPRS24-EA "positive symptoms" score was correlated with CAARMS' scores on the "Positive symptoms" subscale (r=0.456, P=0.022), "emotional disturbance" (r=0.506, P=0.01), and "behavioural change" (r=0.666 P=0.001). We found no correlation between BPRS negative and depression subscales and any of the CAARMS' subscales. When looking at its reliability, reliability coefficients (Cronbach's alpha) showed excellent reliability for "positive symptoms", "emotional disturbance", "behavioural change" and "general psychopathology" (respectively r=0.82, 0.75, 0.78, 0.84, 0.83) and moderate reliability for "cognitive change", "negative symptoms" and "motor/physical change" (respectively r=0.39, 0.59, 0.43). Overall, analysis of the results of construct validity, concurrent validity and reliability of the CAARMS indicates that the French version is valid and reliable. It is now available to develop and implement early detection programs in French speaking countries. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 37 | Encephale 2014 Jun 40 Suppl 2: S91-S102 |
| PMID | 24948480 |
| Title | [Disclosure of a mental disorder in the workplace and work accommodations: two factors associated with job tenure of people with severe mental disorders]. |
| Abstract | Job tenure for people with severe mental disorders (e.g., schizophrenia) remains a stumbling-block to their work integration. However, the length of job tenure can vary according to the workplace (e.g., provided resources) and the work context (e.g., regular market, social firms). This gap can be explained in part by diverse organisational components, particularly the implementation of work accommodations, which is related to the disclosure of the mental disorder in the workplace. Indeed, in the scientific literature, the principal reason associated with disclosure is in regards to requesting work accommodations. The main objective of this paper is to increase our understanding of the relationships between these three concepts - disclosure of a mental disorder, work accommodations and natural supports, and job tenure - by reviewing the specialized literature and presenting the work of the authors of this paper. To do so, the authors will address the following questions: How do we define 'disclosure' of a mental disorder in the workplace and what are the strategies to consider before disclosing? What is the decision-making process related to disclosure in the workplace? How are the three concepts - disclosure of the mental disorder in the workplace, work accommodations and job tenure - intertwined? Finally, how can employment specialists facilitate the work integration of people with severe mental disorders by considering the three concepts mentioned above? Results from a review of the literature show that disclosure of a mental disorder is a dialectical process that goes beyond the question: to tell or not to tell? In fact, it is not a single binary decision. Several components are associated with the disclosure concept, and can be summarized by the questions: What, how, when and to whom to disclose his/her mental condition? Reasons for disclosing his/her mental disorder in the workplace are numerous, characterized by personal, interpersonal and work environmental factors, on one hand. On the other hand, disclosure has potential consequences, both positive (e.g., to obtain work accommodations) and negative (e.g., stigma). A decision-making process takes place when people with a severe mental disorder think about the possibility of disclosing their mental condition in the workplace - a complex decisional process involving the need to evaluate different aspects (i.e. individual, interpersonal and work environmental factors). Also, the literature supports the fact that requiring work accommodations is often related to the disclosure of the mental disorder, when natural supports in the workplace are not available. The literature is scarce regarding the correlations between the concepts of disclosure, implementation of work accommodations and job tenure; however, a more recent study demonstrated this significant relationship, in which the supervisor and co-worker supports are crucial. Employment specialists or counselors recognise the importance of planned disclosure as a means to obtain access to work adjustments in the workplace and to prevent stigma. The employment specialist working in supported employment programs for instance, could adopt with his/her clients a plan for managing the pros and cons of disclosure of the mental disorder in the workplace; this plan is entitled: Managing personal information. It consists of several steps - for example, to collect details of any sensitive information such as diagnosis, to identify work restrictions with the client, to have a common agreement (employment specialists and clients together) on terms to DEScribe work restrictions - to help clients feel empowered and more confident as productive and valued workers. This plan allows employment specialists to work through the disclosure concept, often negatively connoted, and to adopt a more normalising strategy. Furthermore, additional tools for supporting the management of personal information plan could be used such as the Decision-Making About Disclosure Scale, the Barriers to Employment and Coping Efficacy Scale, and the Work Accommodation and Natural Support Scale, to name a few. To conclude, job tenure for people with severe mental disorders is not a pious vow, several pragmatic ingredients for intervening on this issue are now available. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 38 | Iran J Psychiatry Behav Sci 2014 -1 8: 13-8 |
| PMID | 24995025 |
| Title | Reviewing the Dissociative Symptoms in Patients With Schizophreniaand their Association With Positive and Negative Symptoms. |
| Abstract | The present study aimed to clarify dissociative symptoms in patients with schizophrenia and its association with negative and positive symptom of schizophrenia. Based on the 4(th) edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria, 80 schizophrenic subjects were randomly selected from patients who referred to the clinics of psychiatry hospital in Kerman, Iran. Eighty non-schizophrenic patients were chosen as the control group. Both groups were evaluated for dissociation symptom using the Dissociative Experience Scale (DES). Positive and Negative Syndrome Scale (PANSS) score was also used in the case group for determination of positive and negative symptom of schizophrenia. The prevalence of dissociation symptom was 13% and 4% among schizophrenic and control groups, respectively (p = 0.02). In addition, there was a statistical significant association between DES score and positive symptom in schizophrenia (p = 0.02). The association between dissociative symptom and schizophrenia was significant and dissociative symptoms were associated with positive symptoms of schizophrenia. None. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 39 | Iran J Psychiatry Behav Sci 2014 -1 8: 13-8 |
| PMID | 24995025 |
| Title | Reviewing the Dissociative Symptoms in Patients With Schizophreniaand their Association With Positive and Negative Symptoms. |
| Abstract | The present study aimed to clarify dissociative symptoms in patients with schizophrenia and its association with negative and positive symptom of schizophrenia. Based on the 4(th) edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria, 80 schizophrenic subjects were randomly selected from patients who referred to the clinics of psychiatry hospital in Kerman, Iran. Eighty non-schizophrenic patients were chosen as the control group. Both groups were evaluated for dissociation symptom using the Dissociative Experience Scale (DES). Positive and Negative Syndrome Scale (PANSS) score was also used in the case group for determination of positive and negative symptom of schizophrenia. The prevalence of dissociation symptom was 13% and 4% among schizophrenic and control groups, respectively (p = 0.02). In addition, there was a statistical significant association between DES score and positive symptom in schizophrenia (p = 0.02). The association between dissociative symptom and schizophrenia was significant and dissociative symptoms were associated with positive symptoms of schizophrenia. None. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 40 | BMC Psychiatry 2014 -1 14: 298 |
| PMID | 25438678 |
| Title | Long-acting olanzapine versus long-acting risperidone for schizophrenia in Spain - a cost-effectiveness comparison. |
| Abstract | In schizophrenia, medication adherence is critical to achieve better patient outcomes and to avoid relapses, which are responsible for a significant proportion of total healthcare costs for this chronic illness. The aim of this study was to assess the cost-effectiveness of olanzapine long-acting injection (OLAI) compared with risperidone long-acting injection (RLAI) in patients with schizophrenia in Spain. A discrete event simulation (DES) model was developed from a Spanish healthcare system perspective to estimate clinical and economic outcomes for patients with schizophrenia over a five-year period. Patients who had earlier responded to oral medication and have a history of relapse due to adherence problems were considered. Identical model populations were treated with either OLAI or RLAI. In the absence of a head-to-head clinical trial, discontinuation and relapse rates were obtained from open-label studies. The model accounted for age, gender, risks of relapse and discontinuation, relapse management, hospitalization, treatment switching and adverse events. Direct medical costs for the year 2011 and outcomes including relapse avoided, life years (LYs), and quality-adjusted life years (QALYs) were discounted at a rate of 3%. When comparing RLAI and OLAI, the model predicts that OLAI would decrease 5-year costs by ?2,940 (Standard Deviation between replications 300.83), and result in a QALY and LY gains of 0.07 (SD 0.019) and 0.04 (SD 0.025), respectively. Patients on OLAI had fewer relapses compared to RLAI (1.392 [SD 0.035] vs. 1.815 [SD 0.035]) and fewer discontinuations (1.222 [SD 0.031] vs. 1.710 [SD 0.039]). Sensitivity analysis indicated that the study was robust and conclusions were largely unaffected by changes in a wide range of parameters. The present evaluation results in OLAI being dominant over RLAI, meaning that OLAI represents a more effective and less costly alternative compared to RLAI in the treatment of patients with schizophrenia in the Spanish setting. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 41 | Psychiatr Q 2014 Dec 85: 417-26 |
| PMID | 24942906 |
| Title | Clinical correlates of childhood trauma and dissociative phenomena in patients with severe psychiatric disorders. |
| Abstract | In this present study, we aim to investigate the possibility of a link between psychotic disorders and traumatic experiences in a group of female patients diagnosed with psychotic disorders by comparing childhood trauma exposure with a group of non-psychotic psychiatric disorder attending the same pschiatric clinic. Secondary purpose of this study is to examine the clinical correlates of trauma exposure, dissociative phenomena and psychiatric symptomatology between these two group of patients. Two psychiatric sample groups, those with psychotic disorders-mostly schizophrenic-(n = 54), and those with a non-psychotic severe psychiatric disorders (n = 24), were recruited. Data were collected for demographic, psychiatric and trauma histories and psychiatric symptomatology for all patients. In this study, high prevalance rates of childhood traumatic experiences and dissociative phenomena were found in both groups. Total scores of childhood trauma questionnaire in favor of the non-psychotic group were found to be close to significance (p = 0.052). DES scores of non-psychotic group were also higher although not statistically significant. 54.2 % of nonpsychotic cases had DES scores >20 on the other hand, that percentage of psychotic cases were found to be as 38.9 %. Furthermore, psychiatric patients who have suffered childhood traumatic experiences are far more likely to try to kill themselves than psychiatric patients who have not experienced such abuse. The high rates of childhood traumatic events in our present samples of both schizophrenia-spectrum patients and nonpsychotic patients confirm the need for clinicans to take trauma histories routinely. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 42 | Psychiatr Q 2014 Dec 85: 417-26 |
| PMID | 24942906 |
| Title | Clinical correlates of childhood trauma and dissociative phenomena in patients with severe psychiatric disorders. |
| Abstract | In this present study, we aim to investigate the possibility of a link between psychotic disorders and traumatic experiences in a group of female patients diagnosed with psychotic disorders by comparing childhood trauma exposure with a group of non-psychotic psychiatric disorder attending the same pschiatric clinic. Secondary purpose of this study is to examine the clinical correlates of trauma exposure, dissociative phenomena and psychiatric symptomatology between these two group of patients. Two psychiatric sample groups, those with psychotic disorders-mostly schizophrenic-(n = 54), and those with a non-psychotic severe psychiatric disorders (n = 24), were recruited. Data were collected for demographic, psychiatric and trauma histories and psychiatric symptomatology for all patients. In this study, high prevalance rates of childhood traumatic experiences and dissociative phenomena were found in both groups. Total scores of childhood trauma questionnaire in favor of the non-psychotic group were found to be close to significance (p = 0.052). DES scores of non-psychotic group were also higher although not statistically significant. 54.2 % of nonpsychotic cases had DES scores >20 on the other hand, that percentage of psychotic cases were found to be as 38.9 %. Furthermore, psychiatric patients who have suffered childhood traumatic experiences are far more likely to try to kill themselves than psychiatric patients who have not experienced such abuse. The high rates of childhood traumatic events in our present samples of both schizophrenia-spectrum patients and nonpsychotic patients confirm the need for clinicans to take trauma histories routinely. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 43 | Neuropsychiatr Dis Treat 2014 -1 10: 487-91 |
| PMID | 24672239 |
| Title | Dissociation in schizophrenia and borderline personality disorder. |
| Abstract | Dissociation likely plays a key role in schizophrenia and borderline personality disorder (BPD), although empirical studies that compare specific manifestations of these symptoms in schizophrenia and BPD are rare. In this context, the purpose of this study was to compare the occurrence of dissociative and other psychopathological symptoms in these disorders, and to assess the possible influence of antipsychotic medication on the dissociative symptoms. We assessed 31 patients with schizophrenia and 36 patients with BPD. Dissociative symptoms were measured by the Dissociative Experiences Scale (DES), symptoms related to stress and traumatic experiences were assessed using the Trauma Symptom Checklist-40 (TSC-40), and other psychopathological symptoms were measured with the Health of the Nation Outcome Scales (HoNOS). We also assessed actual daily doses of antipsychotic medication in chlorpromazine equivalents in all participants. The results show that symptoms of traumatic stress measured by the TSC-40 had significantly higher scores in the BPD group. The data also show that dissociative symptoms (DES) were significantly correlated with symptoms of traumatic stress (TSC-40) and with symptoms assessed by the HoNOS. Remarkably significant correlations were found between levels of antipsychotic medication and the DES and between antipsychotic medication and the depersonalization/derealization component of the DES in BPD patients. The results support an important role of dissociative processes in schizophrenia and BPD and suggest a significant relationship between manifestations of dissociative symptoms in BPD and antipsychotic medication. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 44 | Encephale 2015 Jun 41: 244-50 |
| PMID | 25864036 |
| Title | [Differences in psychiatric expertise of responsibility: Assessment and initial hypotheses through a review of literature]. |
| Abstract | Forensic psychiatric assessment regarding liability ensures a balance between justice and psychiatry. In France, criminal assessment is not contradictory. The psychiatric expert is commissioned by judges to determine whether or not the accused has a mental disorder and specify whether it affects discernment and control of actions at the time of offense. Its mission focuses on the mental element required to constitute an offense, and is structured around Article 122-1 of the Criminal Code. This article, composed of two paragraphs, distinguishes the framework of the abolition of discernment ? a cause of non-imputability and therefore of a statement of lack of criminal responsibility due to mental disorder ? and the framework of the alteration of discernment. Nowadays expertise seems to meet discomfort, with criticism focusing on possible differences among psychiatric experts, without specific studies having been conducted to confirm it. Our objective was to identify the main points of disagreement between psychiatric experts and to propose explicative hypotheses. For this, we carried out a literature review on PubMed, Science Direct and Cairn, and studied the report of the 2007 public hearing on forensic psychiatric assessment with contributions from different authors. The keywords were: forensic psychiatry, psychiatric court report, psychiatric expertise, differences among experts, legal responsibility, and discernment. We defined differences as disagreements between experts, or as a mismatch in conclusions and approaches of experts. The differences among experts concerned mainly forensic interpretation, i.e. the discussion of the relationship between pathology and offense, particularly in contexts that involve a larger forensic discussion, including interruption of medication, use of drugs, association with antisocial personality, premeditation, denial of facts, especially when the accused suffers from a mental illness (especially schizophrenia). For a finding of abolition of discernment, an expert must consider two requirements, one temporal (the mental disease must be active during offense) and the other causal that involves seeking a direct and exclusive relationship between the offence and the mental state, according to expert jurisprudence. Some experts do not comply with these two requirements or this jurisprudence, whence differences. There were also diagnostic differences and disputes relating to the concept of "alteration of discernment". Disagreements appeared to be related primarily to personal ideologies or different schools of thought that influenced interpretations and conclusions of experts, e.g. accountability as a therapeutic response for the psychotic person. Then, the lack of clarity of expert mission regarding necessary causal relationship ? between any disease and crime ? to demonstrate to conclude an abolition of discernment, could also contribute to differences. Moreover, time available to achieve the mission is too short and the expert would not devote enough time to an expert examination, which could lead to less good expertise and differences; especially as observed clinical examination in expertise is sometimes difficult, misleading, due to pathological reticence of accused mentally ill but also sometimes due to possible simulations. Finally, the low quality of some expert reports ? due in part to the less well-trained experts, but also the particular conditions of achievement of expertise, especially in prisons ? were mentioned by some authors as causes of differences. It appears from this review of literature that differences mainly concern forensic interpretation and are mainly explained by ideologies. This synthesis is a preliminary work prior to a study among psychiatric experts. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 45 | Psychiatry Investig 2015 Jul 12: 397-401 |
| PMID | 26207135 |
| Title | Multivariate Analysis of Relationship between Childhood Trauma and Psychotic Symptoms in Patients with Schizophrenia. |
| Abstract | The aim of this study was to examine the relationship between childhood trauma and psychotic symptoms in schizophrenic patients after controlling for the possible confounding factors, such as depression and dissociative symptoms. Ninety-eight schizophrenic inpatients participated. Childhood trauma was examined using the Childhood Trauma Questionnaires (CTQ), which consists of physical abuse (PA), sexual abuse (SA), emotional abuse (EA), physical neglect (PN), and emotional neglect (EN). Positive and Negative Syndrome Scale (PANSS), Dissociative Experience Scale (DES), and Beck's Depression Inventory (BDI) were also administered. Data were analyzed by partial correlation and general linear model. The total score of CTQ was positively correlated with positive, general, and total scores of PANSS. All five types of childhood trauma were associated with dissociative symptoms. EA and EN were positively correlated with depressive symptoms. Only SA significantly predicted positive symptoms of schizophrenia after controlling for age, sex, BDI, and DES scores, with a dose-response relationship between SA and positive symptoms. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 46 | Sante Ment Que 2015 -1 40: 257-74 |
| PMID | 26559219 |
| Title | [Treatment of sleep disorders in children with a psychiatric diagnosis]. |
| Abstract | Health sciences suffer from insomnia: experts too often concentrate their efforts on the wake state. Fortunately enough, some of them have taken the road towards the "Dark Third of Life": sleep. This article gives an historical account of the development of the first Canadian sleep disorders laboratory and clinic specifically and selectively DESigned for children and adolescents with a psychiatric diagnosis. It then stresses the importance of sleep in children bearing a psychiatric diagnosis and summarizes therapeutic strategies. Data-on-file and selective review of literature. An innovative scheme matching sleep psychologists and psychiatrists with expertise in neurodevelopmental disorders led to the creation of a sleep research laboratory on mental health disorders. The initial research projects on the sleep and dreams of patients with schizophrenia and persons with autism are summarized. The Sleep Disorders Clinic for Children and Adolescents was then created at the Hôpital Rivière-DES-Prairies, leading to much needed activities focused on youth. Indeed, sleep disorders show a high prevalence in children with a psychiatric diagnosis and the literature shows that these children have an increased sensitivity for diurnal effects of poor sleep. The main sleep-relevant issues at stake are reviewed, including the high frequency of sleep disorders in pedopsychiatric patients. Clinical challenges are DEScribed and the operating mode of the Sleep Disorders Clinic is illustrated. Sleep disorders and their effects on daytime functioning need to be assessed in children with a psychiatric diagnosis in order to generate a full clinical picture. Appropriate tools and know-how are readily available in order to achieve this goal. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 47 | Psychiatry Investig 2015 Jul 12: 397-401 |
| PMID | 26207135 |
| Title | Multivariate Analysis of Relationship between Childhood Trauma and Psychotic Symptoms in Patients with Schizophrenia. |
| Abstract | The aim of this study was to examine the relationship between childhood trauma and psychotic symptoms in schizophrenic patients after controlling for the possible confounding factors, such as depression and dissociative symptoms. Ninety-eight schizophrenic inpatients participated. Childhood trauma was examined using the Childhood Trauma Questionnaires (CTQ), which consists of physical abuse (PA), sexual abuse (SA), emotional abuse (EA), physical neglect (PN), and emotional neglect (EN). Positive and Negative Syndrome Scale (PANSS), Dissociative Experience Scale (DES), and Beck's Depression Inventory (BDI) were also administered. Data were analyzed by partial correlation and general linear model. The total score of CTQ was positively correlated with positive, general, and total scores of PANSS. All five types of childhood trauma were associated with dissociative symptoms. EA and EN were positively correlated with depressive symptoms. Only SA significantly predicted positive symptoms of schizophrenia after controlling for age, sex, BDI, and DES scores, with a dose-response relationship between SA and positive symptoms. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 48 | Neuropsychobiology 2015 -1 71: 218-24 |
| PMID | 26279454 |
| Title | Schizophrenia-like symptoms in narcolepsy type 1: shared and distinctive clinical characteristics. |
| Abstract | The occurrence of psychotic symptoms in narcolepsy type 1 (NT1) has been reported as responsible for delayed diagnosis due to the misdiagnosis of schizophrenia. This study aimed to identify shared and distinctive clinical characteristics between NT1 and schizophrenia, with the focus on psychotic symptoms. A total of 28 NT1 and 21 schizophrenia patients were included. Hallucination characteristics and PANSS (Positive and Negative Syndrome Scale), HRSD (Hamilton Rating Scale for Depression), DES (Dissociative Experiences Scale), and STAI (State-Trait Anxiety Inventory) scores were collected. Symptom overlap was investigated by ?(2), Fisher's or t tests and multiple logistic regression models. Hallucinations and illusions frequently occurred in both diseases. Unimodal hallucinations were more common in schizophrenia (p = 6.30e-07) and multimodal hallucinations in NT1, but no clear difference was identified in their sensory modality. Hypnagogic/hypnopompic hallucinations were typical of NT1 (p = 5.22e-07), and 25% of NT1 patients exhibited some degree of insight deficit. Hypnagogic/hypnopompic hallucinations, unimodal hallucinations and PANSS score were the most distinctive clinical characteristics. Clinical overlap was found in the dissociative and anxiety domains, while higher depressive scores were observed in schizophrenia. The overlap between NT1 and schizophrenia should be further investigated under a clinical and pathogenetic point of view to improve diagnostic and therapeutic approaches. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 49 | J Trauma Dissociation 2015 -1 16: 577-91 |
| PMID | 26156749 |
| Title | Reliability and Validity of the Dissociative Experiences Scale Among South Korean Patients With Schizophrenia. |
| Abstract | The Dissociative Experiences Scale (DES) is the most widely used self-report tool for use with the general population and various clinical entities, including those with schizophrenia. This preliminary study tested the reliability of the DES, especially temporal stability and validity, in patients diagnosed with schizophrenia receiving inpatient or outpatient treatment. The DES was administered at a university-affiliated training hospital in South Korea to a total of 68 patients (39 inpatients and 29 outpatients) whose diagnosis of schizophrenia was confirmed using the Structured Clinical Interview for DSM-IV Axis Disorders. Internal consistency, 4-week test-retest reliability, and validity were calculated. Participants also completed the Childhood Trauma Questionnaire, the Beck Depression Inventory, and the Symptom Checklist-Posttraumatic Stress Disorder Scale. Four-week test-retest reliability was moderate (r = .69) and internal consistency was good (Cronbach's ? = .95). Total score on the DES was correlated with childhood trauma (r = .69, p < .001), posttraumatic symptoms (r = .50, p < .001), and depression (r = .52, p < .001), demonstrating the convergent validity of the scale. Our study confirms the psychometric soundness of the DES among patients with schizophrenia after the acute stage of illness (e.g., 3 weeks after admission), supporting use of the scale for screening and evaluating dissociative symptoms within this population. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 50 | Encephale 2015 Jun 41: 251-9 |
| PMID | 25240938 |
| Title | [Measuring impairment of facial affects recognition in schizophrenia. Preliminary study of the facial emotions recognition task (TREF)]. |
| Abstract | The impairment of social cognition, including facial affects recognition, is a well-established trait in schizophrenia, and specific cognitive remediation programs focusing on facial affects recognition have been developed by different teams worldwide. However, even though social cognitive impairments have been confirmed, previous studies have also shown heterogeneity of the results between different subjects. Therefore, assessment of personal abilities should be measured individually before proposing such programs. Most research teams apply tasks based on facial affects recognition by Ekman et al. or Gur et al. However, these tasks are not easily applicable in a clinical exercise. Here, we present the Facial Emotions Recognition Test (TREF), which is DESigned to identify facial affects recognition impairments in a clinical practice. The test is composed of 54 photos and evaluates abilities in the recognition of six universal emotions (joy, anger, sadness, fear, disgust and contempt). Each of these emotions is represented with colored photos of 4 different models (two men and two women) at nine intensity levels from 20 to 100%. Each photo is presented during 10 seconds; no time limit for responding is applied. The present study compared the scores of the TREF test in a sample of healthy controls (64 subjects) and people with stabilized schizophrenia (45 subjects) according to the DSM IV-TR criteria. We analysed global scores for all emotions, as well as sub scores for each emotion between these two groups, taking into account gender differences. Our results were coherent with previous findings. Applying TREF, we confirmed an impairment in facial affects recognition in schizophrenia by showing significant differences between the two groups in their global results (76.45% for healthy controls versus 61.28% for people with schizophrenia), as well as in sub scores for each emotion except for joy. Scores for women were significantly higher than for men in the population without psychiatric diagnosis. The study also allowed the identification of cut-off scores; results below 2 standard deviations of the healthy control average (61.57%) pointed to a facial affect recognition deficit. The TREF appears to be a useful tool to identify facial affects recognition impairment in schizophrenia. Neuropsychologists, who have tried this task, have positive feedback. The TREF is easy to use (duration of about 15 minutes), easy to apply in subjects with attentional difficulties, and tests facial affects recognition at ecological intensity levels. These results have to be confirmed in the future with larger sample sizes, and in comparison with other tasks, evaluating the facial affects recognition processes. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 51 | Encephale 2015 Feb 41: 25-31 |
| PMID | 24815790 |
| Title | [Influence of resistance to voices on depression]. |
| Abstract | Beliefs about voices and reactions to voices have been proposed as important variables influencing the course of depression in schizophrenia. Consequences of auditory hallucinations are different according to identity, goals, omnipotence, omniscience, and meanings attributed to voices by the client. Ten to 15 % of the general population experience auditory hallucinations during lifetime without any distress or need for medical care. In addition, neither frequency of voices, nor their topography, influence the emotional consequences of auditory hallucinations experiences, but the relationships to voices. The Revised Belief about Voices Questionnaire analyzes voices along 5 dimensions: malevolence, benevolence, omnipotence, resistance, and engagement. Malevolent voices are related to depression, whereas benevolent voices engender more positive emotions. Subjects usually engage with benevolent voices, and resist to malevolent voices. But resistance strategies are barely efficient and often backfire. Patients resisting to their voices consider them more malevolent and present with more depressive symptoms. This research aims at studying the influence of resistance to auditory hallucinations on depression in a group of patients suffering from schizophrenia and experiencing auditory hallucinations, using the Revised Beliefs About Voices Questionnaire (BAVQ-R). It also proviDES a study of the psychometrics properties of the French language version of the BAVQ-R. Thirty-eight patients suffering from paranoid schizophrenia, undifferentiated schizophrenia or schizoaffective disorder, have been tested with the French versions of the Revised Beliefs About Voices Questionnaire (BAVQ-R), the Positive and Negative Syndrome Scale (PANSS), and the Calgary Depression Scale for schizophrenia (CDSS). Each patient presented with auditory hallucinations during the week before evaluation, with a minimum score of 3 on P3 item of PANSS. Mean age was 39.39 years (SD 11.33); mean duration of symptoms was 13.92 years (SD 10.81), and patients' mean history of hospitalizations was 7.66 (SD 9.24). Each patient was receiving an antipsychotic medication at the time of evaluation, with a mean chlorpromazine equivalent dose of 806.69 mg/d (ET 539.51); 18.5 % of patients were receiving serotonin reuptake inhibitor, and 31.57 % once committed a suicide attempt. The French version of the BAVQ-R presents with a satisfying internal consistency (Cronbach's alpha=0.74). Similar to the original version, Malevolence and Resistance, and Benevolence and Engagement dimensions are strongly correlated (r=0.73, and r=0.90, P<0.05, respectively). The BAVQ-R scores correlate with the CDSS (r=0.40, P<0.05) and the PANSS General Psychopathology subscale scores (r=0.44, P<0.05), but not with the Positive and Negative subscales. (r=0.17, and r=0.13, P>0.05, respectively). Correlations and forced entry multiple regressions analyses show that Resistance and Malevolence are both strongly correlated to depression, but Resistance is the only dimension that influences depression. Moreover, clients presenting with depressive symptoms resist more to their auditory hallucinations. Finally, emotional resistance, in comparison to behavioral resistance, is responsible for depression in people suffering from auditory hallucinations. Emotional resistance to auditory hallucinations constitutes the most important variable influencing depression in schizophrenia comparing to what the voices say or are supposed to know, their malevolence or benevolence. Demonstration of the influence of resistance to voices on depression would help the development of new therapeutic practices. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 52 | Can J Occup Ther 2016 May -1: -1 |
| PMID | 27246199 |
| Title | Participation in daily life of people with schizophrenia in comparison to the general population: Comparaison de la participation à la vie quotidienne des personnes atteintes de schizophrénie à celle de la population générale. |
| Abstract | Participation in occupations is a basic human right. Although people with schizophrenia commonly experience restrictions in participation, there is a paucity of research in this area. This study aimed to compare the participation patterns of people with schizophrenia to people without mental illness (control group). A total of 140 people of similar age and sex completed the Adults Subjective Assessment of Participation and provided demographic and health-related data. People with schizophrenia tend to participate in fewer activities and to participate alone. However, they participate with similar intensity as those in the control group. The participation patterns of people with schizophrenia are both unique and similar to those of the general population. The differences in participation raise concerns due to signs of restriction and social exclusion. However, it appears that people with schizophrenia benefit from occupation and community-based services that promote and support participation with others in diverse activities. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |
| 53 | Compr Psychiatry 2016 Jul 68: 201-8 |
| PMID | 27234203 |
| Title | Dissociation in patients with schizophrenia spectrum disorders: What is the role of different types of childhood adversity? |
| Abstract | Our study aimed to explore the effects of different types of adverse childhood experiences (e.g. domestic violence, early loss, parental dysfunction, sexual and physical abuse) as well as experiences of sexual and physical abuse in adulthood on dissociative symptoms in adult patients with schizophrenia-spectrum disorders. 145 patients were examined for psychotic symptoms with the Positive and Negative Syndrome Scale (PANSS), for dissociative symptoms with the German version of the Dissociative Experiences Scale (DES) and for adverse experiences in childhood and adulthood with the Structured Trauma Interview (STI). Childhood physical abuse was reported by 32%, childhood sexual abuse by 17% of the patients. Other forms of childhood adversity were also quite common; 18% had witnessed domestic violence, 26% reported early loss, and nearly half of patients reported at least one condition potentially related to parental dysfunction. The DES total score was significantly associated with childhood sexual abuse, witnessing of domestic violence and paternal dysfunction, as well as with physical violence in adulthood. In the final regression model, reports of paternal dysfunction and sexual abuse in childhood were independently associated with adult dissociation. Variance in dissociative symptoms was mainly explained by paternal dysfunction (18%). Substantial rates of childhood adversity were found and specific associations were evident with adult dissociation amongst psychosis patients who reported sexual abuse or paternal dysfunction in childhood. Therefore, it is important that patients with schizophrenia-spectrum disorders are routinely asked about a broad range of possible adverse childhood experiences in order to provide appropriate interventions. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypy, schizophrenias, schizotypal |