| 1 | Int. J. Clin. Pract. 2008 Dec 62: 1943-6 |
|---|---|
| PMID | 18795967 |
| Title | The Information Technology Aided Relapse Prevention Programme in Schizophrenia: an extension of a mirror-design follow-up. |
| Abstract | Decreasing a number of hospital admissions is important for improving outcomes for people with schizophrenia. The Information Technology Aided Relapse Prevention Programme in schizophrenia (ITAREPS) programme enables early pharmacological intervention in psychosis by identification of prodromal symptoms of relapse using home telemonitoring via a phone-to-PC SMS platform. This study was a 1-year extension of a previously published mirror-design follow-up evaluation of programme clinical effectiveness. In total, 73 patients with psychotic illness (45 patients from original sample and 28 newly added subjects) collaborating with 56 family members participated in the clinical evaluation. There was a statistically significant 77% decrease in the number of hospitalisations during the mean 396.8 +/- 249.4 days of participation in ITAREPS, compared with the same time period before participation in ITAREPS (Wilcoxon-signed ranks test, p < 0.00001), as well as significantly reduced number of hospitalisation days when in the ITAREPS (2365 hospitalisation days before and 991 days after ITAREPS enrolment respectively, Wilcoxon-signed ranks test, p < 0.003). The ITAREPS programme represents an effective tool in the long-term treatment of patients with psychotic disorders. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 2 | Schizophr. Res. 2008 Jan 98: 312-7 |
| PMID | 17920245 |
| Title | ITAREPS: information technology aided relapse prevention programme in schizophrenia. |
| Abstract | ITAREPS presents a mobile phone-based telemedicine solution for weekly remote patient monitoring and disease management in schizophrenia and psychotic disorders in general. The programme provides health professionals with home telemonitoring via a PC-to-phone SMS platform that identifies prodromal symptoms of relapse, to enable early intervention and prevent unnecessary hospitalizations. Its web-based interface offers the authorized physician a longitudinal analysis of the dynamics and development of possible prodromes. This work presents preliminary findings from a one-year mirror-design follow-up evaluation of the programme's clinical effectiveness in 45 patients with psychotic illness. There was a statistically significant 60% decrease in the number of hospitalizations during the mean 283.3+/-111.9 days of participation in the ITAREPS, compared to the same time period before the ITAREPS entry (sign test, p<0.004). Variables significantly influencing the number of hospitalizations after the ITAREPS entry (medication compliance along with factors intrinsic to the ITAREPS, i.e. adherence to the programme and involvement of a family member) suggest a critical role of the programme in controlling the number of relapses and subsequent hospitalizations in psychosis. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 3 | Australas Psychiatry 2008 Oct 16: 359-62 |
| PMID | 18608151 |
| Title | The mental health literacy of rural adolescents: Emo subculture and SMS texting. |
| Abstract | This study sought to explore the mental health literacy of adolescents living in a rural area in Australia through in-depth, semi-structured interviews, with a view to identifying areas for further research and making recommendations for improved education programs around mental health. Nine Year 10 students (two boys and seven girls) from a rural secondary school in South Australia read two vignettes, one portraying depression and the other schizophrenia. Semi-structured individual interviews that focussed on the vignettes were audio-taped, transcribed and analysed for thematic content. The data yielded a number of main themes, many of which have been previously identified in the literature. Two new findings also emerged. These were the role of Emo subculture and dealing with distress, and the value of confiding in another person through short message service (SMS) texting. The impact of Emo subculture and SMS texting on mental health literacy requires further exploration. It is suggested that these two findings are not confined to rural youth, but may have national and international relevance. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 4 | Indian J Psychiatry 2008 Jul 50: 181-6 |
| PMID | 19742235 |
| Title | Schizophrenia: Impact on quality of life. |
| Abstract | The purpose of the present study was to assess quality of life (QOL) in patients with schizophrenia and to determine influence of clinical factors and socio-demographic variables on QOL of schizophrenic patients. Cross-sectional study carried out on outdoor patients attending Department of Psychiatry, SMS Medical College, Jaipur, India. Fifty patients of schizophrenia diagnosed as per ICD - 10 with minimum duration of illness being two years and attending out patient department (OPD) at psychiatric centre or psychiatric clinic at SMS medical college, hospital, Jaipur, India for maintenance treatment fulfilling the criteria given below were registered. They were evaluated using positive and negative syndrome scale (PANSS) and Quality of Life Instrument (WHO QOL - BREF). The data collected on above tools, was analyzed using descriptive and inferential statistics using Pearson correlation coefficient. Patients were having lowest QOL scores in social relationships domain of WHO QOL - BREF scale. Social relationship domain of QOL was significantly negatively correlated with occupation with employed patients reporting better QOL in this domain. There were significant positive correlation of total monthly income with social relationship domain and total QOL. There were no statistically significant correlation between QOL parameters and clinical characteristics in schizophrenics. Scores on positive subscale and total PANSS were significantly negatively correlated with physical, Psychological, social relationship domains and total QOL. Negative subscale had significant negative correlation with physical and psychological domains and total QOL. General psychopathology subscale had significant negative correlation with all subscales of QOL. This study confirms poor QOL in schizophrenia despite significant improvement with pharmacological treatment. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 5 | Indian J Psychiatry 2008 Jul 50: 181-6 |
| PMID | 19742235 |
| Title | Schizophrenia: Impact on quality of life. |
| Abstract | The purpose of the present study was to assess quality of life (QOL) in patients with schizophrenia and to determine influence of clinical factors and socio-demographic variables on QOL of schizophrenic patients. Cross-sectional study carried out on outdoor patients attending Department of Psychiatry, SMS Medical College, Jaipur, India. Fifty patients of schizophrenia diagnosed as per ICD - 10 with minimum duration of illness being two years and attending out patient department (OPD) at psychiatric centre or psychiatric clinic at SMS medical college, hospital, Jaipur, India for maintenance treatment fulfilling the criteria given below were registered. They were evaluated using positive and negative syndrome scale (PANSS) and Quality of Life Instrument (WHO QOL - BREF). The data collected on above tools, was analyzed using descriptive and inferential statistics using Pearson correlation coefficient. Patients were having lowest QOL scores in social relationships domain of WHO QOL - BREF scale. Social relationship domain of QOL was significantly negatively correlated with occupation with employed patients reporting better QOL in this domain. There were significant positive correlation of total monthly income with social relationship domain and total QOL. There were no statistically significant correlation between QOL parameters and clinical characteristics in schizophrenics. Scores on positive subscale and total PANSS were significantly negatively correlated with physical, Psychological, social relationship domains and total QOL. Negative subscale had significant negative correlation with physical and psychological domains and total QOL. General psychopathology subscale had significant negative correlation with all subscales of QOL. This study confirms poor QOL in schizophrenia despite significant improvement with pharmacological treatment. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 6 | Indian J Psychiatry 2008 Jul 50: 181-6 |
| PMID | 19742235 |
| Title | Schizophrenia: Impact on quality of life. |
| Abstract | The purpose of the present study was to assess quality of life (QOL) in patients with schizophrenia and to determine influence of clinical factors and socio-demographic variables on QOL of schizophrenic patients. Cross-sectional study carried out on outdoor patients attending Department of Psychiatry, SMS Medical College, Jaipur, India. Fifty patients of schizophrenia diagnosed as per ICD - 10 with minimum duration of illness being two years and attending out patient department (OPD) at psychiatric centre or psychiatric clinic at SMS medical college, hospital, Jaipur, India for maintenance treatment fulfilling the criteria given below were registered. They were evaluated using positive and negative syndrome scale (PANSS) and Quality of Life Instrument (WHO QOL - BREF). The data collected on above tools, was analyzed using descriptive and inferential statistics using Pearson correlation coefficient. Patients were having lowest QOL scores in social relationships domain of WHO QOL - BREF scale. Social relationship domain of QOL was significantly negatively correlated with occupation with employed patients reporting better QOL in this domain. There were significant positive correlation of total monthly income with social relationship domain and total QOL. There were no statistically significant correlation between QOL parameters and clinical characteristics in schizophrenics. Scores on positive subscale and total PANSS were significantly negatively correlated with physical, Psychological, social relationship domains and total QOL. Negative subscale had significant negative correlation with physical and psychological domains and total QOL. General psychopathology subscale had significant negative correlation with all subscales of QOL. This study confirms poor QOL in schizophrenia despite significant improvement with pharmacological treatment. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 7 | Curr. Genomics 2010 Dec 11: 607-17 |
| PMID | 21629438 |
| Title | Retinoic Acid Induced 1, RAI1: A Dosage Sensitive Gene Related to Neurobehavioral Alterations Including Autistic Behavior. |
| Abstract | Genomic structural changes, such as gene Copy Number Variations (CNVs) are extremely abundant in the human genome. An enormous effort is currently ongoing to recognize and catalogue human CNVs and their associations with abnormal phenotypic outcomes. Recently, several reports related neuropsychiatric diseases (i.e. autism spectrum disorders, schizophrenia, mental retardation, behavioral problems, epilepsy) with specific CNV. Moreover, for some conditions, both the deletion and duplication of the same genomic segment are related to the phenotype. Syndromes associated with CNVs (microdeletion and microduplication) have long been known to display specific neurobehavioral traits. It is important to note that not every gene is susceptible to gene dosage changes and there are only a few dosage sensitive genes. Smith-Magenis (SMS) and Potocki-Lupski (PTLS) syndromes are associated with a reciprocal microdeletion and microduplication within chromosome 17p11.2. in humans. The dosage sensitive gene responsible for most phenotypes in SMS has been identified: the Retinoic Acid Induced 1 (RAI1). Studies on mouse models and humans suggest that RAI1 is likely the dosage sensitive gene responsible for clinical features in PTLS. In addition, the human RAI1 gene has been implicated in several neurobehavioral traits as spinocerebellar ataxia (SCA2), schizophrenia and non syndromic autism. In this review we discuss the evidence of RAI1 as a dosage sensitive gene, its relationship with different neurobehavioral traits, gene structure and mutations, and what is known about its molecular and cellular function, as a first step in the elucidation of the mechaniSMS that relate dosage sensitive genes with abnormal neurobehavioral outcomes. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 8 | J. Med. Genet. 2010 Apr 47: 223-9 |
| PMID | 19752160 |
| Title | Array comparative genomic hybridisation of 52 subjects with a Smith-Magenis-like phenotype: identification of dosage sensitive loci also associated with schizophrenia, autism, and developmental delay. |
| Abstract | Smith-Magenis syndrome (SMS) is caused by del(17)(p11.2), including the retinoic acid induced 1 gene (RAI1), or mutation of RAI1. Haploinsufficiency of RAI1 results in developmental delay, mental retardation, sleep disturbance, self-abusive behaviors, and most features commonly seen in SMS. In this study, 52 subjects were referred for molecular analysis of RAI1 due to the presence of an SMS-like phenotype in each case. For this cohort, deletion and mutation analyses of RAI1 were negative; thus, the clinical diagnosis of SMS could not be confirmed and suggested that at least one other locus was responsible for the phenotype(s) observed. Here, we present whole-genome array comparative genomic hybridization and detailed phenotypic data of these 52 subjects. This SMS-like cohort exhibited developmental delays, sleep disturbance, self-abusive behaviors, motor dysfunction, and hyperactivity of the same type and prevalence as that of SMS. In this analysis, we identified at least 5 new loci that likely contribute to the SMS-like phenotype, including CNVs that were found in more than one subject. Genes in these regions function in development, neurological integrity, and morphology, all of which are affected in SMS. Given the phenotypic overlap between SMS and the SMS-like cases, these data may provide some insight into the function of RAI1, including the pathways in which it may be involved and the genes it may regulate. These data will improve diagnosis, understanding, and potentially treatment of these complex behavior and mental retardation syndromes. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 9 | Br J Clin Psychol 2010 Jun 49: 259-74 |
| PMID | 19735607 |
| Title | The efficacy of SMS text messages to compensate for the effects of cognitive impairments in schizophrenia. |
| Abstract | Many people with schizophrenia have severe cognitive impairments that hamper their activities. The effect of pharmacological and behavioural interventions on cognitive functioning has been demonstrated, but even after successful intervention considerable impairments can remain. Therefore, we sought for alternative ways to help patients cope with the effects of their cognitive impairments. In the present study, we have evaluated the efficacy of short message service (SMS) text messages to compensate for the effects of cognitive impairments in schizophrenia in daily life. A waiting list controlled trial was conducted: patients were quasi-randomly assigned to an A-B-A (baseline-intervention-follow-up) condition or an A-A-B-A condition that included an additional 7-week waiting list. The waiting list was included to control for the effect of time on relevant outcome. Sixty-two people with schizophrenia or related psychotic disorders were included in the study. All patients showed impaired goal-directed behaviour in daily life-situations. Patients were prompted with SMS text messages to improve their everyday functioning. The primary outcome measure was the percentage of goals achieved. The overall percentage of goals achieved increased with prompting, while performance dropped to baseline level after withdrawing the prompts. Keeping appointments with mental health workers and carrying out leisure activities increased with prompting, while medication adherence and attendance at training sessions remained unchanged. A majority of the patients enjoyed receiving the SMS text messages. Prompting can significantly improve achievement of a number of relevant goals. For other goals, combining prompting with interventions that enhance motivation seems indicated. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 10 | Psychiatry Res 2012 Dec 200: 89-95 |
| PMID | 22901437 |
| Title | A short message service (SMS)-based strategy for enhancing adherence to antipsychotic medication in schizophrenia. |
| Abstract | The aim of this study was to assess the impact of a short message service (SMS)-based strategy on adherence to antipsychotic treatment. A multicentre, randomised, open-label, controlled, 6-month study with clinically stabilised outpatients with schizophrenia was conducted. The patients assigned to the intervention received daily SMS reminders to take their medication for 3 months. Self-reported medication adherence was determined using the Morisky Green Adherence Questionnaire (MAQ). Secondary outcomes were severity of illness, attitude towards medication, insight into illness and health-related quality of life. A total of 254 patients were analysed. A significantly greater improvement in adherence was observed among patients receiving SMS text messages compared with the control group. The mean change in MAQ total score from baseline to month 3 was -1.0 (95% confidence interval (CI) -1.02, -0.98) and -0.7 (95%CI -0.72, -0.68), respectively (P=0.02). Greater improvement in negative, cognitive and global clinical symptoms at month 3 was observed. Attitude towards medication also significantly improved across the study in the intervention group versus the controls. An SMS-based intervention seems feasible and acceptable for enhancing medication adherence. Further studies are needed to confirm whether this kind of intervention could be a complementary strategy to optimise adherence in schizophrenia. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 11 | JMIR Res Protoc 2012 -1 1: e8 |
| PMID | 23611874 |
| Title | Mobile.net: Mobile Telephone Text Messages to Encourage Adherence to Medication and to Follow up With People With Psychosis: Methods and Protocol for a Multicenter Randomized Controlled Two-Armed Trial. |
| Abstract | schizophrenia is a high-cost, chronic, serious mental illness. There is a clear need to improve treatments and expand access to care for persons with schizophrenia, but simple, tailored interventions are missing. To evaluate the impact of tailored mobile telephone text messages to encourage adherence to medication and to follow up with people with psychosis at 12 months. Mobile.Net is a pragmatic randomized trial with inpatient psychiatric wards allocated to two parallel arms. The trial will include 24 sites and 45 psychiatric hospital wards providing inpatient care in Finland. The participants will be adult patients aged 18-65 years, of either sex, with antipsychotic medication (Anatomical Therapeutic Chemical classification 2011) on discharge from a psychiatric hospital, who have a mobile phone, are able to use the Finnish language, and are able to give written informed consent to participate in the study. The intervention group will receive semiautomatic system (short message service [SMS]) messages after they have been discharged from the psychiatric hospital. Patients will choose the form, content, timing, and frequency of the SMS messages related to their medication, keeping appointments, and other daily care. SMS messages will continue to the end of the study period (12 months) or until participants no longer want to receive the messages. Patients will be encouraged to contact researchers if they feel that they need to adjust the message in any way. At all times, both groups will receive usual care at the discretion of their team (psychiatry and nursing). The primary outcomes are service use and healthy days by 12 months based on routine data (admission to a psychiatric hospital, time to next hospitalization, time in hospital during this year, and healthy days). The secondary outcomes are service use, coercive measures, medication, adverse events, satisfaction with care, the intervention, and the trial, social functioning, and economic factors. Data will be collected 12 months after baseline. The outcomes are based on the national health registers and patients' subjective evaluations. The primary analysis will be by intention-to-treat. International Standard Randomised Controlled Trial Number (ISRCTN): 27704027; http://www.controlled-trials.com/ISRCTN27704027 (Archived by WebCite at http://www.webcitation.org/69FkM4vcq). |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 12 | J. Med. Internet Res. 2013 -1 15: e60 |
| PMID | 23563184 |
| Title | A comparison of two delivery modalities of a mobile phone-based assessment for serious mental illness: native smartphone application vs text-messaging only implementations. |
| Abstract | Mobile phone-based assessment may represent a cost-effective and clinically effective method of monitoring psychotic symptoms in real-time. There are several software options, including the use of native smartphone applications and text messages (short message service, SMS). Little is known about the strengths and limitations of these two approaches in monitoring symptoms in individuals with serious mental illness. The objective of this study was to compare two different delivery modalities of the same diagnostic assessment for individuals with non-affective psychosis-a native smartphone application employing a graphical, touch user interface against an SMS text-only implementation. The overall hypothesis of the study was that patient participants with sewrious mental illness would find both delivery modalities feasible and acceptable to use, measured by the quantitative post-assessment feedback questionnaire scores, the number of data points completed, and the time taken to complete the assessment. It was also predicted that a native smartphone application would (1) yield a greater number of data points, (2) take less time, and (3) be more positively appraised by patient participant users than the text-based system. A randomized repeated measures crossover design was employed. Participants with currently treated Diagnostic and Statistical Manual (Fourth Edition) schizophrenia or related disorders (n=24) were randomly allocated to completing 6 days of assessment (four sets of questions per day) with a native smartphone application or the SMS text-only implementation. There was then a 1-week break before completing a further 6 days with the alternative delivery modality. Quantitative feedback questionnaires were administered at the end of each period of sampling. A greater proportion of data points were completed with the native smartphone application in comparison to the SMS text-only implementation (? = -.25, SE=.11, P=.02), which also took significantly less time to complete (? =.78, SE= .09, P<.001). Although there were no significant differences in participants' quantitative feedback for the two delivery modalities, most participants reported preferring the native smartphone application (67%; n=16) and found it easier to use (71%; n=16). 33% of participants reported that they would be willing to complete mobile phone assessment for 5 weeks or longer. Native smartphone applications and SMS text are both valuable methods of delivering real-time assessment in individuals with schizophrenia. However, a more streamlined graphical user interface may lead to better compliance and shorter entry times. Further research is needed to test the efficacy of this technology within clinical services, to assess validity over longer periods of time and when delivered on patients' own phones. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 13 | Cochrane Database Syst Rev 2014 -1 -1: CD009960 |
| PMID | 24934254 |
| Title | Information and communication technology based prompting for treatment compliance for people with serious mental illness. |
| Abstract | Non-compliance is a significant problem among people with serious mental disorders, presenting a challenge for mental health professionals. Prompts such as telephone calls, visits, and a posted referral letter to patients are currently used to encourage patient attendance at clinics and/or compliance with medication. More recently, the use of information and communication technology (ICT)-based prompting methods have increased. Methods include mobile text message (SMS - short message service), e-mail or use of any other electronic device with the stated purpose of encouraging compliance. To investigate the effects of ICT-based prompting to support treatment compliance in people with serious mental illness compared with standard care. We searched the Cochrane schizophrenia Group's Trials Register (31(st) May 2011 and 9(th) July 2012) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. Also, we inspected references of all identified studies for further trials and contacted authors of trials for additional information. Relevant randomised controlled trials involving adults with serious mental illness, comparing any ICT-based prompt or combination of prompts by automatic or semi-automatic system compared with standard care. Review authors reliably assessed trial quality and extracted data. We calculated risk ratio (RR) with 95% confidence intervals (CI) using a fixed-effect model. For continuous outcomes, we estimated the mean difference (MD) between groups, again with 95% confidence intervals. A 'Summary of findings' table using GRADE was created, and we assessed included studies for risk of bias. The search identified 35 references, with 25 studies, but we could only include two studies with a total of 358 participants. The studies had a moderate risk of bias, and therefore risk overestimating any positive effects of ICT-based prompting. Both included studies compared semi-automatised ICT-based prompting intervention with standard care groups in mental health outpatient care. The interventions were SMS-message and an electronic assistant device. One included study reported our primary outcome, compliance.There was not any clear evidence that ICT-based prompts increase improvement in compliance (stop taking medication within six months n = 320, RR 1.11 CI 0.96 to 1.29, moderate quality evidence). There was some low quality evidence that ICT-based prompts have small effects for: mental state (average change in specific symptom scores within three months n = 251, MD -0.30 CI -0.53 to -0.07; severity of illness within three months n = 251, MD -0.10 CI -0.13 to -0.07 and six months n = 251, MD -0.10 CI -0.13 to -0.07; average change in depressive scores within six months n = 251, RR 0.00 CI -0.28 to 0.28; global symptoms within three months n = 251, MD -0.10 CI -0.38 to -0.07; negative symptoms within three months n = 251, MD -0.10 CI -0.38 to 0.18 and six months n = 251, MD -0.30 CI -0.58 to 0.02, low quality evidence). Level of insight improved more among people receiving ICT-based prompt compared with those in the control group at six months (n = 251, MD -0.10 CI -0.13 to -0.07). ICT-based prompts also increased quality of life (average change in quality of life within six months n = 251, RR 0.50 CI 0.19 to 0.81, moderate quality evidence).Based on the existing data, there is no evidence that either intervention is less acceptable than the other (n = 347, 2 RCTs, RR 1.46 CI 0.70 to 3.05, low quality evidence). Included studies did not report outcomes of service utilisation, behaviour, costs or adverse events. The evidence base on the effects of ICT-based prompts is still inconclusive. Data to clarify ICT-based prompting effects are awaited from an ongoing trial, but further well-conducted trials considering the different ICT-based prompts are warranted. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 14 | J Dual Diagn 2014 -1 10: 197-203 |
| PMID | 25391277 |
| Title | Remote "hovering" with individuals with psychotic disorders and substance use: feasibility, engagement, and therapeutic alliance with a text-messaging mobile interventionist. |
| Abstract | People with serious mental illnesses and substance abuse problems (i.e., dual diagnosis) constitute a particularly challenging and costly clinical group. This study evaluated the feasibility and acceptability of a novel model of care in which a mobile interventionist used mobile phone text messaging to remotely monitor and provide daily support to individuals with psychotic disorders and substance use. Seventeen participants with dual diagnosis were enrolled in a 12-week single-arm trial. A clinical social worker served as the mobile interventionist and sent daily text messages to participants' privately owned mobile phones to assess their medication adherence and clinical status. The mobile interventionist provided text-message feedback and support and suggested various coping strategies flexibly, in response to participants' replies to prompts. At the end of the trial, participants completed a usability and satisfaction measure and two self-rated measures of therapeutic alliance with their clinicians. In one version, participants rated their relationship with their mobile interventionist; in the second version, they rated their relationship with their community-based treatment team. Participants received an average of 139 text messages (SD = 37.5) each from the mobile interventionist over the 12-week trial. On average, participants responded to 87% of the mobile interventionist's messages that required a reply. More than 90% of participants thought the intervention was useful and rewarding and that it helped them be more effective and productive in their lives. Participants' assessments of their relationship with the mobile interventionist were positive. Paired-sample t-test found that the therapeutic alliance ratings participants provided for their mobile interventionist were significantly higher than those provided for their community-based treatment team clinicians, who they met with regularly. Our findings suggest that text-message "hovering" can be conducted successfully with individuals with psychotic disorders and substance abuse. Developing a cadre of mobile interventionists who are specifically trained on how to engage patients via mobile devices while adhering to ethical guidelines and regulatory standards may be an effective way to strengthen service delivery models, improve patient outcomes, and reduce costs. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 15 | Conf Proc IEEE Eng Med Biol Soc 2014 -1 2014: 3837-40 |
| PMID | 25570828 |
| Title | Higher dimensional analysis shows reduced dynamism of time-varying network connectivity in schizophrenia patients. |
| Abstract | Assessments of functional connectivity between brain networks is a fixture of resting state fMRI research. Until very recently most of this work proceeded from an assumption of stationarity in resting state network connectivity. In the last few years however, interest in moving beyond this simplifying assumption has grown considerably. Applying group temporal independent component analysis (tICA) to a set of time-varying functional network connectivity (FNC) matrices derived from a large multi-site fMRI dataset (N=314; 163 healthy, 151 schizophrenia patients), we obtain a set of five basic correlation patterns (component spatial maps (SMS)) from which observed FNCs can be expressed as mutually independent linear combinations, i.e., the coefficient on each SM in the linear combination is maximally independent of the others. We study dynamic properties of network connectivity as they are reflected in this five-dimensional space, and report stark differences in connectivity dynamics between schizophrenia patients and healthy controls. We also find that the most important global differences in FNC dynamism between patient and control groups are replicated when the same dynamical analysis is performed on sets of correlation patterns obtained from either PCA or spatial ICA, giving us additional confidence in the results. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 16 | Schizophr Bull 2015 May 41: 584-96 |
| PMID | 25750247 |
| Title | Modeling determinants of medication attitudes and poor adherence in early nonaffective psychosis: implications for intervention. |
| Abstract | We aimed to design a multimodal intervention to improve adherence following first episode psychosis, consistent with current evidence. Existing literature identified medication attitudes, insight, and characteristics of support as important determinants of adherence to medication: we examined medication attitudes, self-esteem, and insight in an early psychosis cohort better to understand their relationships. Existing longitudinal data from 309 patients with early Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nonaffective psychosis (83% first episode) were analyzed to test the hypothesis that medication attitudes, while meaningfully different from "insight," correlated with insight and self-esteem, and change in each influenced the others. Rosenberg Self-Esteem Scale, Birchwood Insight Scale, and Positive and Negative Syndrome Scale insight were assessed at presentation, after 6 weeks and 3 and 18 months. Drug Attitudes Inventory (DAI) and treatment satisfaction were rated from 6 weeks onward. Structural equation models of their relationships were compared. Insight measures' and DAI's predictive validity were compared against relapse, readmission, and remission. Analysis found five latent constructs best fitted the data: medication attitudes, self-esteem, accepting need for treatment, self-rated insight, and objective insight. All were related and each affected the others as it changed, except self-esteem and medication attitudes. Low self-reported insight at presentation predicted readmission. Good 6-week insight (unlike drug attitudes) predicted remission. Literature review and data modeling indicated that a multimodal intervention using motivational interviewing, online psychoeducation, and SMS text medication reminders to enhance adherence without damaging self-concept was feasible and appropriate. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 17 | Pharmacol. Biochem. Behav. 2015 Jul 134: 70-8 |
| PMID | 25661529 |
| Title | Behavioral effects of food-derived opioid-like peptides in rodents: Implications for schizophrenia? |
| Abstract | Dohan proposed that an overload of dietary peptides, such as those derived from wheat gluten and milk casein, could be a factor relevant to the development or maintenance of schizophrenia (SZ) symptoms in at least a subset of vulnerable individuals. Rodent behavioral models may offer insight into the plausibility of Dohan's exorphin hypothesis by providing a means to directly study the effects of such peptides. Accordingly, a review of the literature on the behavioral effects of food-derived opioid-like peptides in rodents was undertaken. Studies using a variety of behavioral tests to examine the effects of several classes of food-derived opioid-like peptides were identified and reviewed. Peptides derived from casein (?-casomorphins; BCMs, n=19), spinach (rubiscolins; RCs, n=4), and soy (soymorphins; SMS, n=1) were behaviorally active in various paradigms assessing nociception, spontaneous behavior, and memory. Surprisingly, only a single study evaluating a gluten-derived peptide (gliadorphin-7; GD-7, n=1) was identified and included in this review. In conclusion, food-derived peptides can affect rodent behavior, but more studies of GDs using diverse behavioral batteries are warranted. Assuming they occur in sufficient quantities during protein digestion and can access central opioid receptors (which entails crossing both the gastrointestinal and blood-brain barriers intact), these peptides may affect human behavior. Although BCMs and GDs may not be directly pathogenic in SZ, documented associations of casein and gluten sensitivity with SZ justify increased patient screening and dietary intervention where necessary. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |
| 18 | JMIR Res Protoc 2016 -1 5: e77 |
| PMID | 27125771 |
| Title | Feasibility of PRIME: A Cognitive Neuroscience-Informed Mobile App Intervention to Enhance Motivated Behavior and Improve Quality of Life in Recent Onset Schizophrenia. |
| Abstract | Despite improvements in treating psychosis, schizophrenia remains a chronic and debilitating disorder that affects approximately 1% of the US population and costs society more than depression, dementia, and other medical illnesses across most of the lifespan. Improving functioning early in the course of illness could have significant implications for long-term outcome of individuals with schizophrenia. Yet, current gold-standard treatments do not lead to clinically meaningful improvements in outcome, partly due to the inherent challenges of treating a population with significant cognitive and motivational impairments. The rise of technology presents an opportunity to develop novel treatments that may circumvent the motivational and cognitive challenges observed in schizophrenia. The purpose of this study was two-fold: (1) to evaluate the feasibility and acceptability of implementing a Personalized Real-Time Intervention for Motivation Enhancement (PRIME), a mobile app intervention designed to target reward-processing impairments, enhance motivation, and thereby improve quality of life in recent onset schizophrenia, and (2) evaluate the empirical benefits of using an iterative, user-centered design (UCD) process. We conducted two design workshops with 15 key stakeholders, followed by a series of in-depth interviews in collaboration with IDEO, a design and innovation firm. The UCD approach ultimately resulted in the first iteration of PRIME, which was evaluated by 10 RO participants. Results from the Stage 1 participants were then used to guide the next iteration that is currently being evaluated in an ongoing RCT. Participants in both phases were encouraged to use the app daily with a minimum frequency of 1/week over a 12-week period. The UCD process resulted in the following feature set: (1) delivery of text message (short message service, SMS)-based motivational coaching from trained therapists, (2) individualized goal setting in prognostically important psychosocial domains, (3) social networking via direct peer-to-peer messaging, and (4) community "moments feed" to capture and reinforce rewarding experiences and goal achievements. Users preferred an experience that highlighted several of the principles of self-determination theory, including the desire for more control of their future (autonomy and competence) and an approach that helps them improve existing relationships (relatedness). IDEO, also recommended an approach that was casual, friendly, and nonstigmatizing, which is in line with the recovery model of psychosis. After 12-weeks of using PRIME, participants used the app, on average, every other day, were actively engaged with its various features each time they logged in and retention and satisfaction was high (20/20, 100% retention, high satisfaction ratings). The iterative design process lead to a 2- to 3-fold increase in engagement from Stage 1 to Stage 2 in almost each aspect of the platform. These results indicate that the neuroscience-informed mobile app, PRIME, is a feasible and acceptable intervention for young people with schizophrenia. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics |