| 1 | Schizophr. Res. 2000 Sep 45: 145-56 |
|---|---|
| PMID | 10978882 |
| Title | Visual search in schizophrenia: latent inhibition and novel pop-out effects. |
| Abstract | A visual search task was used to assess attentional function in a mixed group of schizophrenic patients and in normal controls. Subjects identified presence or absence of a unique shape presented with homogeneous distractors. Response time (RT) was examined as a function of prior experience with target, distractor, or both. On each trial, targets and/or distractors were either NOVel or familiar. schizophrenic patients were slower than controls in all conditions. In the test phase, three target/distractor conditions were examined (PE - target and distractors pre-exposed but reversed; NPE - target NOVel and distractors pre-exposed; NOV - NOVel target and distractors). As predicted, normal controls, but not schizophrenics, showed latent inhibition (LI: PE minus NPE). The latter finding was due to the absence of normal LI in female patients. A NOVel pop-out effect (NOV minus NPE) was obtained which did not interact with any of the other variables. The results suggest that the LI effect is indeed related to the processing of irrelevant stimuli, and that, at least female schizophrenic patients process such stimuli differently from controls. Past inconsistencies in the LI-schizophrenia literature may be the result of disproportionate gender compositions in patient and control groups. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 2 | Schizophr. Res. 2000 Sep 45: 145-56 |
| PMID | 10978882 |
| Title | Visual search in schizophrenia: latent inhibition and novel pop-out effects. |
| Abstract | A visual search task was used to assess attentional function in a mixed group of schizophrenic patients and in normal controls. Subjects identified presence or absence of a unique shape presented with homogeneous distractors. Response time (RT) was examined as a function of prior experience with target, distractor, or both. On each trial, targets and/or distractors were either NOVel or familiar. schizophrenic patients were slower than controls in all conditions. In the test phase, three target/distractor conditions were examined (PE - target and distractors pre-exposed but reversed; NPE - target NOVel and distractors pre-exposed; NOV - NOVel target and distractors). As predicted, normal controls, but not schizophrenics, showed latent inhibition (LI: PE minus NPE). The latter finding was due to the absence of normal LI in female patients. A NOVel pop-out effect (NOV minus NPE) was obtained which did not interact with any of the other variables. The results suggest that the LI effect is indeed related to the processing of irrelevant stimuli, and that, at least female schizophrenic patients process such stimuli differently from controls. Past inconsistencies in the LI-schizophrenia literature may be the result of disproportionate gender compositions in patient and control groups. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 3 | Schizophr. Res. 2000 Sep 45: 145-56 |
| PMID | 10978882 |
| Title | Visual search in schizophrenia: latent inhibition and novel pop-out effects. |
| Abstract | A visual search task was used to assess attentional function in a mixed group of schizophrenic patients and in normal controls. Subjects identified presence or absence of a unique shape presented with homogeneous distractors. Response time (RT) was examined as a function of prior experience with target, distractor, or both. On each trial, targets and/or distractors were either NOVel or familiar. schizophrenic patients were slower than controls in all conditions. In the test phase, three target/distractor conditions were examined (PE - target and distractors pre-exposed but reversed; NPE - target NOVel and distractors pre-exposed; NOV - NOVel target and distractors). As predicted, normal controls, but not schizophrenics, showed latent inhibition (LI: PE minus NPE). The latter finding was due to the absence of normal LI in female patients. A NOVel pop-out effect (NOV minus NPE) was obtained which did not interact with any of the other variables. The results suggest that the LI effect is indeed related to the processing of irrelevant stimuli, and that, at least female schizophrenic patients process such stimuli differently from controls. Past inconsistencies in the LI-schizophrenia literature may be the result of disproportionate gender compositions in patient and control groups. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 4 | Lancet 2012 Jun 379: 2063-71 |
| PMID | 22560607 |
| Title | Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis. |
| Abstract | Relapse prevention with antipsychotic drugs compared with placebo in patients with schizophrenia has not been sufficiently addressed by previous systematic reviews. We aimed to assess the association between such drugs and various outcomes in patients with schizophrenia to resolve controversial issues. We searched the Cochrane schizophrenia Group's specialised register for reports published before NOV 11, 2008; and PubMed, Embase, and ClinicalTrials.gov for those before June 8, 2011. We also contacted pharmaceutical companies and searched the reference lists of included studies and previous reviews. Randomised trials of patients with schizophrenia continued on or withdrawn from any antipsychotic drug regimen after stabilisation were eligible. Our primary outcome was relapse between 7 and 12 months. We also examined safety and various functional outcomes. We used the random effects model and verified results for the primary outcome with a fixed effects model. Heterogeneity was investigated with subgroup and meta-regression analyses. We identified 116 suitable reports from 65 trials, with data for 6493 patients. Antipsychotic drugs significantly reduced relapse rates at 1 year (drugs 27%vs placebo 64%; risk ratio [RR] 0·40, 95% CI 0·33-0·49; number needed to treat to benefit [NNTB] 3, 95% CI 2-3). Fewer patients given antipsychotic drugs than placebo were readmitted (10%vs 26%; RR 0·38, 95% CI 0·27-0·55; NNTB 5, 4-9), but less than a third of relapsed patients had to be admitted. Limited evidence suggested better quality of life (standardised mean difference -0·62, 95% CI -1·15 to -0·09) and fewer aggressive acts (2%vs 12%; RR 0·27, 95% CI 0·15-0·52; NNTB 11, 6-100) with antipsychotic drugs than with placebo. Employment data were scarce and too few deaths were reported to allow significant differences to be identified. More patients given antipsychotic drugs than placebo gained weight (10%vs 6%; RR 2·07, 95% CI 2·31-3·25), had movement disorders (16%vs 9%; 1·55, 1·25-1·93), and experienced sedation (13%vs 9%; 1·50, 1·22-1·84). Substantial heterogeneity in size of effect was recorded. In subgroup analyses, number of episodes, whether patients were in remission, abrupt or gradual withdrawal of treatment, length of stability before trial entry, first-generation or second-generation drugs, and allocation concealment method did not significantly affect relapse risk. Depot preparations reduced relapse (RR 0·31, 95% CI 0·21-0·41) more than did oral drugs (0·46, 0·37-0·57; p=0·03); depot haloperidol (RR 0·14, 95% CI 0·04-0·55) and fluphenazine (0·23, 0·14-0·39) had the greatest effects. The effects of antipsychotic drugs were greater in two unblinded trials (0·26, 0·17-0·39) than in most blinded studies (0·42, 0·35-0·51; p= 0·03). In a meta-regression, the difference between drug and placebo decreased with study length. Maintenance treatment with antipsychotic drugs benefits patients with schizophrenia. The advantages of these drugs must be weighed against their side-effects. Future studies should focus on outcomes of social participation and clarify the long-term morbidity and mortality of these drugs. German Ministry of Education and Research. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 5 | PLoS ONE 2014 -1 9: e90407 |
| PMID | 24603720 |
| Title | Association of interleukin-10 polymorphisms with schizophrenia: a meta-analysis. |
| Abstract | The involvement of cytokines in schizophrenia (SZ) has been proposed in recent years and various studies have accumulated convergent lines of evidence. Among which, the role of interleukin-10 (IL-10) in SZ has been explored in a number of studies by investigating association of single nucleotide polymorphisms (SNPs) and susceptibility of SZ. However, the results are inconsistent since its power is limited by the individual sample size. To evaluate the overall effect between them, we conducted a meta-analysis by combining all available studies. Studies were searched from the database of PubMed, PsycINFO and ISI web of Knowledge up to NOV 2013. The meta-analysis was conducted based on statement of preferred reporting items for systematic reviews and meta-analyses (PRISMA). Eleven studies including 6399 subjects (3129 cases and 3270 controls) were available for the meta-analysis. Among three investigated SNPs, rs1800872 was observed to be significantly associated with risk of SZ (AA vs. AC+CC, Pooled OR?=?1.351, P-value ?=?2.06E-04). Meanwhile, among six haplotypes of rs1800896 - rs1800871 - rs1800872, significant associations were observed in haplotype A-C-A (Pooled OR?=?1.762, P-value ?=?2.00E-03) and G-C-C (Pooled OR?=?0.649, P-value ?=?2.00E-03) for Asians. These results were still significant after adjusting for multiple comparisons. This meta-analysis demonstrated an SNP and two haplotypes of IL-10 significantly associated with SZ, suggesting that IL-10 might be a risk factor of SZ. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 6 | Lancet Psychiatry 2015 Apr 2: 305-13 |
| PMID | 26360083 |
| Title | Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): a parallel, single-blind, randomised controlled trial with a mediation analysis. |
| Abstract | Worry might be a contributory causal factor in the occurrence of persecutory delusions in patients with psychotic disorders. Therefore we postulated that reducing worry with cognitive behaviour therapy (CBT) would reduce persecutory delusions. For our two-arm, assessor-blinded, randomised controlled trial (Worry Intervention Trial [WIT]), we recruited patients aged 18-65 years with persistent persecutory delusions but non-affective psychosis from two centres: the Oxford Health National Health Service (NHS) Foundation Trust (Oxford, UK) and the Southern Health NHS Foundation Trust (Southampton, UK). The key inclusion criteria for participants were a score of at least 3 on the Psychotic Symptoms Rating Scale (PSYRATS) denoting a current persecutory delusion; that the delusion had persisted for at least 3 months; a clinical diagnosis of schizophrenia, schizoaffective disorder, or delusional disorder; and a clinically significant level of worry. We randomly assigned (1:1) eligible patients, using a randomly permuted block procedure with variable block sizes and division by four strata, to either six sessions of worry-reduction CBT intervention done over 8 weeks added to standard care (the CBT-intervention group), or to standard care alone (the control group). The assessors were masked to patient allocations and did their assessments at week 0 (baseline), 8 weeks (end of treatment), and 24 weeks, follow-up. The primary outcomes were worry measured by the Penn State Worry Questionnaire (PSWQ) and delusions measured by the PSYRATS-delusion scale; we did the analyses in the intention-to-treat population, and also did a planned mediation analysis. This trial is registered with the ISRCTN Registry (number ISRCTN23197625) and is closed to new participants. From NOV 1, 2011, to Sept 9, 2013, we recruited 150 eligible participants and randomly assigned 73 to the CBT intervention group, and 77 to the control group. 143 patients (95%) provided primary outcome follow-up data. Compared with standard care alone, at 8 weeks the CBT intervention significantly reduced worry (mean difference 6·35 [SE 1·56] PSWQ units, 95% CI 3·30-9·40; p<0·001) and persecutory delusions (2·08 [SE 0·73] PSYRATS units, 95% CI 0·64-3·51; p=0·005). The reductions were maintained to 24 weeks follow-up. The mediation analysis suggested that the change in worry accounted for 66% of the change in delusion. No patients died or were admitted to secure units during our study. Six suicide attempts (two in the CBT intervention group, and four in the control group) and two serious violent incidents (one in each group) were noted, but no adverse events were deemed related to the treatments or the assessments. To our knowledge, this is the first large trial focused on persecutory delusions. We have shown that long-standing delusions were significantly reduced by a brief intervention targeted on worry, although the limitations for our study include no determination of the key elements within the intervention. Our results suggest that worry might cause paranoia, and that worry intervention techniques might be a beneficial addition to the standard treatment of psychosis. Efficacy and Mechanism Evaluation programme, which is a UK Medical Research Council and National Institute of Health Research partnership. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 7 | Lancet Psychiatry 2015 Nov 2: 975-83 |
| PMID | 26363701 |
| Title | Efficacy of cognitive behavioural therapy for sleep improvement in patients with persistent delusions and hallucinations (BEST): a prospective, assessor-blind, randomised controlled pilot trial. |
| Abstract | Sleep disturbance occurs in most patients with delusions or hallucinations and should be treated as a clinical problem in its own right. However, cognitive behavioural therapy (CBT)-the best evidence-based treatment for insomnia-has not been tested in this patient population. We aimed to pilot procedures for a randomised trial testing CBT for sleep problems in patients with current psychotic experiences, and to provide a preliminary assessment of potential benefit. We did this prospective, assessor-blind, randomised controlled pilot trial (Better Sleep Trial [BEST]) at two mental health centres in the UK. Patients (aged 18-65 years) with persistent distressing delusions or hallucinations in the context of insomnia and a schizophrenia spectrum diagnosis were randomly assigned (1:1), via a web-based randomisation system with minimisation to balance for sex, insomnia severity, and psychotic experiences, to receive either eight sessions of CBT plus standard care (medication and contact with the local clinical team) or standard care alone. Research assessors were masked to group allocation. Assessment of outcome was done at weeks 0, 12 (post-treatment), and 24 (follow-up). The primary efficacy outcomes were insomnia assessed by the Insomnia Severity Index (ISI) and delusions and hallucinations assessed by the Psychotic Symptoms Rating Scale (PSYRATS) at week 12. We did analysis by intention to treat, with an aim to provide confidence interval estimation of treatment effects. This study is registered with ISRCTN, number 33695128. Between Dec 14, 2012, and May 22, 2013, and NOV 7, 2013, and Aug 26, 2014, we randomly assigned 50 patients to receive CBT plus standard care (n=24) or standard care alone (n=26). The last assessments were completed on Feb 10, 2015. 48 (96%) patients provided follow-up data. 23 (96%) patients offered CBT took up the intervention. Compared with standard care, CBT led to reductions in insomnia in the large effect size range at week 12 (adjusted mean difference 6.1, 95% CI 3.0-9.2, effect size d=1.9). By week 12, nine (41%) of 22 patients receiving CBT and one (4%) of 25 patients receiving standard care alone no longer had insomnia, with ISI scores lower than the cutoff for insomnia. The treatment effect estimation for CBT covered a range from reducing but also increasing delusions (adjusted mean difference 0.3, 95% CI -2.0 to 2.6) and hallucinations (-1.9, -6.5 to 2.7). Three patients, all in the CBT group, had five adverse events, although none were regarded as related to study treatment. Our findings show that CBT for insomnia might be highly effective for improving sleep in patients with persistent delusions or hallucinations. A larger, suitably powered phase 3 study is now needed to provide a precise estimate of the effects of CBT for sleep problems, both on sleep and psychotic experiences. Research for Patient Benefit Programme, National Institute for Health Research. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |