| 1 | Fortschr Neurol Psychiatr 2000 Dec 68: 537-45 |
|---|---|
| PMID | 11200857 |
| Title | [Psychoeducational intervention for schizophrenic patients and subsequent long-term ambulatory care. A four-year follow-up] . |
| Abstract | A subset of schizophrenic inpatients and families participated in an eight-sessions bifocal psychoeducational intervention, followed by treatment in a corresponding outpatient department. These patients were a part of the multicenter and randomized Münchner Psychosis-Information-Project (PIP). The course of illness in 88 patients treated in the outpatient department of the Technical University of Munich has been recorded in a 4-year follow-up study. 60% of the patients continued outpatient treatment while 40% lost contact with the outpatient department. Predictors for patient drop-out were assessed and the course of illness of both groups was compared. There was no significant difference between the relapse rate of the patients who dropped out (66%) and those who continued the long-term treatment (53%). However, within the 4-year period the drop-out patients had more than twice as many hospital days compared to the patients who maintained the outpatient treatment. The improved social adjustment and quality of life of these patients, along with the 50% reduction of readmission days demonstrates the impact of the long-term treatment in this study. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 2 | J Neuropsychiatry Clin Neurosci 2001 -1 13: 492-9 |
| PMID | 11748318 |
| Title | Premorbid psychiatric risk factors for postictal psychosis. |
| Abstract | Postictal psychosis (PIP) is a common and clinically significant sequela of inpatient epilepsy monitoring. A series of 622 patients with complex partial epilepsy undergoing video-EEG evaluations as candidates for epilepsy surgery were evaluated, by structured psychiatric interview, for individual and family psychiatric histories, depression, anxiety, and features of personality disorders. No patient had psychotic symptoms at baseline. Twenty-nine developed a PIP episode during monitoring. The a priori hypotheses were that patients with PIP would have higher baseline schizotypal and paranoid personality ratings and a greater prevalence of histories of psychiatric treatment and family history of psychotic illness. However, only a higher prevalence of mood disorder among first- and second-degree relatives distinguished the patients who developed PIP on logistic regression analyses (odds ratio=3.49, P=0.001). Possible mechanisms linking vulnerability toward mood disorders and the development of psychotic symptoms in epilepsy are discussed. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 3 | Ann Gen Psychiatry 2006 -1 5: 9 |
| PMID | 16859554 |
| Title | Postictal psychosis: presymptomatic risk factors and the need for further investigation of genetics and pharmacotherapy. |
| Abstract | Postictal psychosis (PIP), an episode of psychosis occurring after a cluster of seizures, is common and may be associated with profound morbidity, including chronic psychosis. Symptoms are often pleomorphic, involving a range of psychotic symptoms, including hallucinations and disorders of thought. PIP is treatable and may be averted if presymptomatic risk factors are considered in susceptible patients and treatment is initiated. In this report, we present an illustrative case of PIP. The patient, Mr. R, presented to our emergency room with delusions and disordered thought process following a cluster of seizures. He recovered after admission, sedation and treatment with antipsychotic medication. A list of presymptomatic risk factors is established based on review of current literature. Identification of such risk factors may potentially help with prophylactic treatment; however, little empirical research exists in this area and treatment guidelines are thus far largely based on expert opinion. Further, while the neurobiology of schizophrenia is advancing at a rapid pace, largely due to advances in genetics, the pathophysiology of PIP remains largely unknown. Considering the progress in schizophrenia research in the context of the clinical features of PIP and existing studies, potential neurobiological mechanisms for PIP are herein proposed, and further genetic analyses, which may help identify those susceptible, are warranted. While PIP is an important problem that may present first to general hospital psychiatrists, as in the case presented, this topic is under-represented in the medical psychiatry literature. As discussed in this article, further research is needed to develop presymptomatic screens and treatment pathways to help prevent morbidity. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 4 | PLoS ONE 2010 -1 5: e10789 |
| PMID | 20520724 |
| Title | Epistatic and functional interactions of catechol-o-methyltransferase (COMT) and AKT1 on neuregulin1-ErbB signaling in cell models. |
| Abstract | Neuregulin1 (NRG1)-ErbB signaling has been implicated in the pathogenesis of cancer and schizophrenia. We have previously reported that NRG1-stimulated migration of B lymphoblasts is PI3K-AKT1dependent and impaired in patients with schizophrenia and significantly linked to the catechol-o-methyltransferase (COMT) Val108/158Met functional polymorphism. We have now examined AKT1 activation in NRG1-stimulated B lymphoblasts and other cell models and explored a functional relationship between COMT and AKT1. NRG1-induced AKT1 phosphorylation was significantly diminished in Val carriers compared to Met carriers in both normal subjects and in patients. Further, there was a significant epistatic interaction between a putatively functional coding SNP in AKT1 (rs1130233) and COMT Val108/158Met genotype on AKT1 phosphorylation. NRG1 induced translocation of AKT1 to the plasma membrane also was impaired in Val carriers, while PIP(3) levels were not decreased. Interestingly, the level of COMT enzyme activity was inversely correlated with the cells' ability to synthesize phosphatidylserine (PS), a factor that attracts the pleckstrin homology domain (PHD) of AKT1 to the cell membrane. Transfection of SH-SY5Y cells with a COMT Val construct increased COMT activity and significantly decreased PS levels as well as NRG1-induced AKT1 phosphorylation and migration. Administration of S-adenosylmethionine (SAM) rescued all of these deficits. These data suggest that AKT1 function is influenced by COMT enzyme activity through competition with PS synthesis for SAM, which in turn dictates AKT1-dependent cellular responses to NRG1-mediated signaling. Our findings implicate genetic and functional interactions between COMT and AKT1 and may provide novel insights into pathogenesis of schizophrenia and other ErbB-associated human diseases such as cancer. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 5 | Ther Adv Neurol Disord 2012 Nov 5: 321-34 |
| PMID | 23139703 |
| Title | Psychotic illness in patients with epilepsy. |
| Abstract | Apart from the rather rare ictal psychotic events, such as non-convulsive status epilepticus, modern epileptic psychoses have been categorized into three main types; chronic and acute interictal psychoses (IIPs) and postictal psychosis (PIP). Together, they comprise 95% of psychoses in patients with epilepsy (PWE). Four major questions, that is, "Is psychosis in PWE a direct consequence of epilepsy or schizophrenia induced by epilepsy?", "Is psychosis in PWE homogeneous or heterogeneous?", "Does psychosis in PWE have symptomatological differences from schizophrenia and related disorders?", "Is psychosis in PWE uniquely associated with temporal lobe epilepsy (TLE)?" are tried to be answered in this review with relevant case presentations. In the final section, we propose a tentative classification of psychotic illness in PWE, with special attention to those who have undergone epilepsy surgery. Psychotic disorders in PWE are often overlooked, mistreated, and consequently lingering on needlessly. While early diagnosis is unanimously supported as a first step to avoid this delay, necessity of switching from antiepileptic drugs with supposedly adverse psychotopic effects. to others is more controversial. To elucidate the riddle of alternative psychosis, we need badly further reliable data. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 6 | Pflugers Arch. 2014 Oct 466: 1885-97 |
| PMID | 24389605 |
| Title | Structural basis of PI(4,5)P2-dependent regulation of GluA1 by phosphatidylinositol-5-phosphate 4-kinase, type II, alpha (PIP5K2A). |
| Abstract | Ionotropic glutamate receptors are the most important excitatory receptors in the central nervous system, and their impairment can lead to multiple neuronal diseases. Here, we show that glutamate-induced currents in oocytes expressing GluA1 are increased by coexpression of the schizophrenia-associated phosphoinositide kinase PIP5K2A. This effect was due to enhanced membrane abundance and was blunted by a point mutation (N251S) in PIP5K2A. An increase in GluA1 currents was also observed upon acute injection of PI(4,5)P2, the main product of PIP5K2A. By expression of wild-type and mutant PIP5K2A in human embryonic kidney cells, we were able to provide evidence of impaired kinase activity of the mutant PIP5K2A. We defined the region K813-K823 of GluA1 as critical for the PI(4,5)P2 effect by performing an alanine scan that suggested PI(4,5)P2 binding to this area. A PIP strip assay revealed PI(4,5)P2 binding to the C-terminal GluA1 peptide. The present observations disclose a novel mechanism in the regulation of GluA1. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 7 | Pharmacol. Res. 2015 Sep 99: 162-73 |
| PMID | 26094781 |
| Title | Neuronal effects of a nickel-piperazine/NO donor complex in rodents. |
| Abstract | In the brain, NO is a very important molecule in the regulation of cerebral and extra cerebral cranial blood flow and arterial diameters. It is also importantly involved in many neuronal functions and innumerable roles of NO in many brain related disorders including epilepsy, schizophrenia, drug addiction, anxiety, major depression, have been postulated. The present study aimed to explore the neuronal role exerted by the metal-nonoate compound Ni(PIPNONO)Cl, a novel NO donor whose vascular protective effects have been recently demonstrated. Ni(PIPNONO)Cl showed antidepressant-like properties in the tail suspension test and antiamnesic activity in the passive avoidance test in the absence of any hypernociceptive response to a mechanical stimulus. These effects were related to the NO-releasing properties of the compound within the central nervous system as demonstrated by the increase of iNOS levels in the brain, spinal cord and dura mater. The modulation of neuronal functions appeared after acute and repeated treatment, showing the lack of any tolerance to neuronal effects. At the dose used (10 mg/kg i.p.), Ni(PIPNONO)Cl did not induce any visible sign of toxicity and experiments were performed in the absence of locomotor impairments. In addition to the NO-related neuronal activities of Ni(PIPNONO)Cl, the decomposition control compound Ni(PIP)Cl2 showed anxiogenic-like and procognitive effects. The present findings showed neuronal modulatory activity of Ni(PIPNONO)Cl through a NO-mediated mechanism. The activities of the decomposition compound Ni(PIP)Cl2 attributed to Ni(PIPNONO)Cl the capability to modulate additional neuronal functions independently from NO releasing properties extending and improving the therapeutic perspectives of the NO donor. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 8 | Eur. Psychiatry 2016 Mar 33: 9-17 |
| PMID | 26852375 |
| Title | A randomized trial to assess the efficacy of a psychoeducational intervention on caregiver burden in schizophrenia. |
| Abstract | Patient's relatives usually care for patients with schizophrenia, and as informal caregivers they experience negative consequences. The aim of the EDUCA-III trial is to test the efficacy of a psychoeducational intervention program (PIP) versus standard care to reduce the caregiver burden at post-intervention (4months), and at follow-up (8months). A two-arm, evaluator blind, multicentre, randomized controlled trial. The PIP group had 12 weekly group sessions. The control intervention group had the usual support and standard care. Primary outcomes were change scores since baseline on the Zarit Burden Interview (ZBI) and the Involvement Evaluation Questionnaire (IEQ). One hundred and nine caregivers were randomized to PIP and 114 to control condition from 23 research sites. The decrease of ZBI scores was significantly higher on the PIP arm at 4months (mean difference [MD]=-4.33; 95% CI -7.96, -0.71), and at 8months (MD=-4.46; 95% CI -7.79, -1.13). There were no significant decreases in the IEQ scores (MD at 4months=-2.80; 95% CI -6.27, 0.67; MD at 8months=-2.85; 95% CI -6.51, 0.81). The PIP condition seems to reduce caregiver burden. ISRCTN32545295. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 9 | Psychopharmacology (Berl.) 2016 Apr -1: -1 |
| PMID | 27129863 |
| Title | Potentially inappropriate psychotropic prescription at discharge is associated with lower functioning in the elderly psychiatric inpatients. A cross-sectional study. |
| Abstract | The objectives are to determine the rate of potentially inappropriate psychotropic (PIP) prescription at discharge in the elderly psychiatric inpatients and to determine whether PIP is associated with lowered functioning outcomes. Sociodemographic, clinical, and treatment data for all inpatients aged???65 years consecutively hospitalized during 1 year in 13 psychiatry departments was analyzed. PIP+/PIP- groups were defined according to the French-updated Beers criteria. Daily functioning was evaluated by the daily living (ADL) scale. Logistic regression analysis was used to estimate odds ratios for the association between PIP administration at discharge and respectively functioning and potential confounding factors. Data was obtained for 327 patients. Overall, 124 (37.9 %) patients were males, and the mean age was 73.9 years (SD?=?5.6); 163 (49.8 %) patients were diagnosed with affective disorders and 89 (27.2 %) with schizophrenia/schizotypal/delusional disorders. Overall, 249 (76.1 %) had one or more PIP medications, mainly anxiolytics (69.9 %) and hypnotics (17.2 %). In a multivariate analysis, PIP prescription at discharge has been associated with patient lowered personal care functioning, independently of age, gender, and psychiatric or somatic diagnoses (OR?=?0.88 (0.79-0.97, p?=?0.01). In the current increasingly fragmented health care systems, special attention must be given to PIP prescription in older population suffering from psychiatric disorders. Using the Beers criteria, the present study demonstrates the high prevalence of PIP prescription, which concerns a large panel of drugs but mostly anxiolytics and hypnotics independently of psychiatric or somatic diagnoses and sociodemographic characteristics. Our study has demonstrated for the first time an association between PIP prescription and lowered patient functioning. Further longitudinal studies should confirm a potential causal relation. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 10 | Psychopharmacology (Berl.) 2016 Apr -1: -1 |
| PMID | 27129863 |
| Title | Potentially inappropriate psychotropic prescription at discharge is associated with lower functioning in the elderly psychiatric inpatients. A cross-sectional study. |
| Abstract | The objectives are to determine the rate of potentially inappropriate psychotropic (PIP) prescription at discharge in the elderly psychiatric inpatients and to determine whether PIP is associated with lowered functioning outcomes. Sociodemographic, clinical, and treatment data for all inpatients aged???65 years consecutively hospitalized during 1 year in 13 psychiatry departments was analyzed. PIP+/PIP- groups were defined according to the French-updated Beers criteria. Daily functioning was evaluated by the daily living (ADL) scale. Logistic regression analysis was used to estimate odds ratios for the association between PIP administration at discharge and respectively functioning and potential confounding factors. Data was obtained for 327 patients. Overall, 124 (37.9 %) patients were males, and the mean age was 73.9 years (SD?=?5.6); 163 (49.8 %) patients were diagnosed with affective disorders and 89 (27.2 %) with schizophrenia/schizotypal/delusional disorders. Overall, 249 (76.1 %) had one or more PIP medications, mainly anxiolytics (69.9 %) and hypnotics (17.2 %). In a multivariate analysis, PIP prescription at discharge has been associated with patient lowered personal care functioning, independently of age, gender, and psychiatric or somatic diagnoses (OR?=?0.88 (0.79-0.97, p?=?0.01). In the current increasingly fragmented health care systems, special attention must be given to PIP prescription in older population suffering from psychiatric disorders. Using the Beers criteria, the present study demonstrates the high prevalence of PIP prescription, which concerns a large panel of drugs but mostly anxiolytics and hypnotics independently of psychiatric or somatic diagnoses and sociodemographic characteristics. Our study has demonstrated for the first time an association between PIP prescription and lowered patient functioning. Further longitudinal studies should confirm a potential causal relation. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 11 | Schizophr Bull 2016 Mar -1: -1 |
| PMID | 26955982 |
| Title | Psychoeducation Improves Compliance and Outcome in Schizophrenia Without an Increase of Adverse Side Effects: A 7-Year Follow-up of the Munich PIP-Study. |
| Abstract | Psychoeducation improves adherence and motivates patients to accept a maintenance therapy as recommended by the guidelines. This would mean a daily consumption of at least 300 chlorpromazine (CPZ) units in the long run and should lead to an increase of the antipsychotic dosage in comparison to patients with treatment as usual (TAU). This raises 2 important questions: whether more side effects are provoked and do the patients have a corresponding benefit with a better outcome. A total of 41 patients with a diagnosis of schizophrenic or schizoaffective disorder were randomized at study entry, either to bifocal psychoeducation (21), or to standard treatment (20). They were compared concerning compliance, type of medication, dosage (CPZ equivalents), motor side effects and number of days in hospital. The average daily antipsychotic medication 2 and 7 years after index discharge was 365 and 354 CPZ-units respectively in the intervention group (IG), but 247 and 279, respectively in the control group (CG). The extent of motor side effects was slightly smaller in the IG, but they showed a small and statistically not significant increase in the rate of tardive dyskinesia (TD) after 7 years. At the 7-year follow-up the patients in the IG had spent 74.7 days in hospital compared to 243.4 days for the patients in the CG (P < .05). The course of illness was significantly better in the IG without increasing motor side-effects. Therefore, psychoeducation should be integrated more systematically into the routine treatment. These data are part of a previous study, published 2007, with a sample size of 48 patients. Seven patients-3 of the IG and 4 of the CG-could not be included, because they were not able to complete the very complex "Computer-based kinematic analysis of motor performance." In this article all conclusions are referred to the new sample size, therefore some results are slightly different in comparison to the previous data. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 12 | Schizophr Bull 2016 Mar -1: -1 |
| PMID | 26955982 |
| Title | Psychoeducation Improves Compliance and Outcome in Schizophrenia Without an Increase of Adverse Side Effects: A 7-Year Follow-up of the Munich PIP-Study. |
| Abstract | Psychoeducation improves adherence and motivates patients to accept a maintenance therapy as recommended by the guidelines. This would mean a daily consumption of at least 300 chlorpromazine (CPZ) units in the long run and should lead to an increase of the antipsychotic dosage in comparison to patients with treatment as usual (TAU). This raises 2 important questions: whether more side effects are provoked and do the patients have a corresponding benefit with a better outcome. A total of 41 patients with a diagnosis of schizophrenic or schizoaffective disorder were randomized at study entry, either to bifocal psychoeducation (21), or to standard treatment (20). They were compared concerning compliance, type of medication, dosage (CPZ equivalents), motor side effects and number of days in hospital. The average daily antipsychotic medication 2 and 7 years after index discharge was 365 and 354 CPZ-units respectively in the intervention group (IG), but 247 and 279, respectively in the control group (CG). The extent of motor side effects was slightly smaller in the IG, but they showed a small and statistically not significant increase in the rate of tardive dyskinesia (TD) after 7 years. At the 7-year follow-up the patients in the IG had spent 74.7 days in hospital compared to 243.4 days for the patients in the CG (P < .05). The course of illness was significantly better in the IG without increasing motor side-effects. Therefore, psychoeducation should be integrated more systematically into the routine treatment. These data are part of a previous study, published 2007, with a sample size of 48 patients. Seven patients-3 of the IG and 4 of the CG-could not be included, because they were not able to complete the very complex "Computer-based kinematic analysis of motor performance." In this article all conclusions are referred to the new sample size, therefore some results are slightly different in comparison to the previous data. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |