| 1 | Depress Anxiety 2002 -1 16: 64-70 |
|---|---|
| PMID | 12219337 |
| Title | Replication and expansion of findings related to racial differences in veterans with combat-related PTSD. |
| Abstract | Racial differences in those seeking treatment at a Veterans Affairs Medical Center (VAMC) outpatient posttraumatic stress disorder (PTSD) treatment program were examined. One hundred eleven (71 Caucasian and 40 African American) veterans were compared on both self-report measures and interview measures of PTSD, depression, dissociation, and general psychopathology. Participants completed the following self-report measures: the Beck Depression Inventory, the Dissociative Experiences Scale, the Mississippi Combat PTSD Scale, and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Participants also completed the Clinician Administered PTSD Scale (CAPS-1), which is a structured interview for PTSD, and completed a non-structured clinical interview. The two groups did not differ on measured demographic variables, nor were there significant differences on self-report or interview measures of anxiety, depression, or PTSD symptomatology. Contrary to expectation, groups did not differ on self-report measures of dissociation, paranoia, or schizophrenia. African Americans were significantly more likely to endorse items of bizarre mentation from the MMPI-2. These results suggest that African American and Caucasian veterans with combat-related PTSD do not differ with regard to manifestation or severity of psychopathology. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 2 | AIDS Patient Care STDS 2003 Apr 17: 179-86 |
| PMID | 12737641 |
| Title | Adherence to HIV antiretrovirals among persons with serious mental illness. |
| Abstract | Despite the absence of empirical evidence, serious mental illness is assumed to be a high risk factor for nonadherence to HIV antiretroviral regimens. To assess antiretroviral adherence among persons with serious mental illness, we conducted a study in which adherence was observed over a 2-week period with electronic monitoring bottle CAPS and self-report. Forty-seven participants enrolled, with all but two (96%) completing the study. Psychiatric diagnoses included bipolar depression (n = 24), schizophrenia (n = 12), schizoaffective disorder (n = 5), and major depression with psychotic features (n = 6). Mean adherence (proportion of prescribed doses taken) was 66% (standard deviation [SD] = 34), as measured by electronic monitoring; 40% demonstrated at least 90% adherence, but 31% had less than 50% adherence. Self-reported adherence to psychotropics was moderately correlated with self-reported (r = 0.45, p < 0.05) and electronically monitored (r = 0.39, p < 0.05) antiretroviral adherence. Viral load (log(10)) was negatively correlated with electronically monitored (r = -0.28, p < 0.10) and self-reported (r = -0.39, p < 0.05) antiretroviral adherence, after controlling for the length of time on treatment. These findings suggest that many patients with serious mental illness are able to adhere very well to antiretroviral regimens, yet a substantial proportion of our sample displayed poor adherence, indicating the need for research to further assess the factors that influence adherence to antiretrovirals in this population. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 3 | J Consult Clin Psychol 2004 Feb 72: 121-5 |
| PMID | 14756621 |
| Title | Preliminary reliability and validity of the Clinician-Administered PTSD Scale for schizophrenia. |
| Abstract | This study provides preliminary psychometric support for a version of the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (CAPS; D. D. Blake et al., 1990) adapted for use with patients with schizophrenia (CAPS-S; J. S. Gearon. S. Thomas-Lohrman, & A. S. Bellack, 2001). Nineteen women with schizophrenia and co-occurring illicit drug use disorders were administered the CAPS-S, the Structured Clinical Interview for DSM-IV diagnoses (SCID). and scales measuring trauma-related psychopathology. The results indicate that the CAPS-S can distinguish between those with and without PTSD and that the symptom clusters measure unified constructs. Interrater and test-retest reliability were high for PTSD diagnosis and symptom clusters. Solid convergent validity was demonstrated between the CAPS-S and SCID-based PTSD diagnoses and the Impact of Event Scale. There is also preliminary evidence of discriminant validity. These results support the use of the CAPS-S in women with schizophrenia. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 4 | Child Abuse Negl 2005 Aug 29: 905-14 |
| PMID | 16125233 |
| Title | Development of anxiety disorders in a traumatized pediatric population: a preliminary longitudinal evaluation. |
| Abstract | The current study was conducted to determine if post-traumatic stress disorder (PTSD) symptomatology predicted later development of non-PTSD anxiety disorders in children and adolescents victimized by interpersonal trauma. Thirty-four children with a history of interpersonal trauma and no initial diagnosis of anxiety disorder participated in the study. Children were assessed at time one (T1) and then 12-18 months later at time two (T2). At T1, the Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA) and the Schedule for Affective Disorders and schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) were used to evaluate children's PTSD symptoms and comorbid non-PTSD anxiety disorder diagnosis. At T2, the CAPS-CA and the K-SADS-PL were repeated. The diagnosis of PTSD and PTSD symptoms in children exposed to interpersonal trauma at T1, particularly the symptoms associated with avoidance and constricted emotional expression (criteria C) as well as physiological hyperarousal (criteria D), predicted the development of other anxiety disorders at T2. Traumatized children with initial PTSD symptomatology may be at risk of later development of other anxiety disorders. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 5 | Psychiatr Serv 2007 Jun 58: 844-7 |
| PMID | 17535946 |
| Title | Validity of electronically monitored medication adherence and conventional adherence measures in schizophrenia. |
| Abstract | This study evaluated the validity of prescriber, patient, and research assistant ratings of adherence to prescribed oral antipsychotic medication among outpatients with schizophrenia or schizoaffective disorder in comparison with electronic monitoring. Adult outpatients with schizophrenia (N=35) or schizoaffective disorder (N=26) received adherence assessments via electronically monitored medication vial CAPS as well as by monthly prescriber, patient, and research assistant report for up to six months. Electronic monitoring detected greater nonadherence rates (57%) than either prescribers (7%) or patients (5%), though the research assistant ratings were 54%. No directional bias was found between electronic monitoring and assignment of adherence by research assistants, although disagreement occurred in 36% of cases. Both patients and prescribers grossly overestimated medication adherence, which may interfere with or reduce the effectiveness of diligent medication management. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 6 | JAMA 2007 Jul 298: 61-9 |
| PMID | 17609491 |
| Title | Prescription drug cost sharing: associations with medication and medical utilization and spending and health. |
| Abstract | Prescription drugs are instrumental to managing and preventing chronic disease. Recent changes in US prescription drug cost sharing could affect access to them. To synthesize published evidence on the associations among cost-sharing features of prescription drug benefits and use of prescription drugs, use of nonpharmaceutical services, and health outcomes. We searched PubMed for studies published in English between 1985 and 2006. Among 923 articles found in the search, we identified 132 articles examining the associations between prescription drug plan cost-containment measures, including co-payments, tiering, or coinsurance (n = 65), pharmacy benefit CAPS or monthly prescription limits (n = 11), formulary restrictions (n = 41), and reference pricing (n = 16), and salient outcomes, including pharmacy utilization and spending, medical care utilization and spending, and health outcomes. Increased cost sharing is associated with lower rates of drug treatment, worse adherence among existing users, and more frequent discontinuation of therapy. For each 10% increase in cost sharing, prescription drug spending decreases by 2% to 6%, depending on class of drug and condition of the patient. The reduction in use associated with a benefit cap, which limits either the coverage amount or the number of covered prescriptions, is consistent with other cost-sharing features. For some chronic conditions, higher cost sharing is associated with increased use of medical services, at least for patients with congestive heart failure, lipid disorders, diabetes, and schizophrenia. While low-income groups may be more sensitive to increased cost sharing, there is little evidence to support this contention. Pharmacy benefit design represents an important public health tool for improving patient treatment and adherence. While increased cost sharing is highly correlated with reductions in pharmacy use, the long-term consequences of benefit changes on health are still uncertain. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 7 | Rev Saude Publica 2009 Aug 43 Suppl 1: 23-8 |
| PMID | 19669061 |
| Title | Criteria for admission and continuity of health care in psychosocial healthcare services, City of Rio de Janeiro, Southeastern Brazil. |
| Abstract | To analyze the criteria used by teams for admission, referral and continuity of care among patients of the Centros de Atenção Psicossocial (CAPS - Psychosocial Care Centers). A qualitative study with participatory evaluation was conducted in three psychosocial healthcare services of the city of Rio de Janeiro, Southeastern Brazil, in 2006. A total of 15 admitted cases and 15 referred cases were selected among the patients admitted for treatment during the six months that preceded the beginning of research. Criteria pointed out by the team to admit patients for treatment or referral were analyzed from structured guidelines. Analysis of continuity of care was based on medical records and information from the team and patients and/or family members themselves, six months after patients were admitted or referred. Patients admitted had psychosis (schizophrenia), history of previous admissions, poor social functioning and a small support network, patients referred had anxiety and depressive disorders, a good level of adherence to outpatient treatment, good social functioning and presence of a social network. In terms of continuity of care, eight out of 27 patients had an unknown destination. In terms of referrals, of the 13 patients referred to the network's outpatient clinics, seven continued in treatment, two returned to the centers and four had an unknown destination. The centers admit patients who fit into the definition of severe and persistent mental disorder. Continuity of care was pointed out as a problem, probably due to the difficulty in following patients. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 8 | Cien Saude Colet 2011 Dec 16: 4635-42 |
| PMID | 22124904 |
| Title | [Adaptation of critical time intervention for use in Brazil and its implementation among users of psychosocial service centers (CAPS) in the municipality of Rio de Janeiro]. |
| Abstract | Brazilian Psychiatric Reform proposes a mental healthcare model based on the implementation of a community-based service network, in which Psychosocial Service Centers (CAPS) play a fundamental role. The report presents the results of a pilot study which aimed to adapt Critical Time Intervention to the Brazilian context, and to test its feasibility to provide it to persons with schizophrenic spectrum disorders who are enrolled in CAPS of Rio de Janeiro. The research design included three inter-related phases. Phase one consisted in carrying out qualitative and quantitative field work. This phase included mapping out the socio-demographic, clinical and service utilization data of CAPS users, as well as assessing the mental health needs of participants in the study. The second phase consisted in translation of the CTI clinical manual to include the adaptations made for use in Brazil, which were based on data collected in the first phase, as well as training individuals with moderate education as CTI intervention workers. The third phase consisted of pilot implementation of the adapted intervention among a group of individuals with schizophrenia spectrum disorders enrolled in CAPS, but with difficulties in being included in treatment. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 9 | Cien Saude Colet 2011 Dec 16: 4635-42 |
| PMID | 22124904 |
| Title | [Adaptation of critical time intervention for use in Brazil and its implementation among users of psychosocial service centers (CAPS) in the municipality of Rio de Janeiro]. |
| Abstract | Brazilian Psychiatric Reform proposes a mental healthcare model based on the implementation of a community-based service network, in which Psychosocial Service Centers (CAPS) play a fundamental role. The report presents the results of a pilot study which aimed to adapt Critical Time Intervention to the Brazilian context, and to test its feasibility to provide it to persons with schizophrenic spectrum disorders who are enrolled in CAPS of Rio de Janeiro. The research design included three inter-related phases. Phase one consisted in carrying out qualitative and quantitative field work. This phase included mapping out the socio-demographic, clinical and service utilization data of CAPS users, as well as assessing the mental health needs of participants in the study. The second phase consisted in translation of the CTI clinical manual to include the adaptations made for use in Brazil, which were based on data collected in the first phase, as well as training individuals with moderate education as CTI intervention workers. The third phase consisted of pilot implementation of the adapted intervention among a group of individuals with schizophrenia spectrum disorders enrolled in CAPS, but with difficulties in being included in treatment. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 10 | Schizophr. Res. 2012 Sep 140: 46-50 |
| PMID | 22835808 |
| Title | Visual perception during mirror gazing at one's own face in schizophrenia. |
| Abstract | In normal observers gazing at one's own face in the mirror for some minutes, at a low illumination level, triggers the perception of strange faces, a new perceptual illusion that has been named 'strange-face in the mirror'. Subjects see distortions of their own faces, but often they see monsters, archetypical faces, faces of dead relatives, and of animals. We designed this study to primarily compare strange-face apparitions in response to mirror gazing in patients with schizophrenia and healthy controls. The study included 16 patients with schizophrenia and 21 healthy controls. In this paper we administered a 7 minute mirror gazing test (MGT). Before the mirror gazing session, all subjects underwent assessment with the Cardiff Anomalous Perception Scale (CAPS). When the 7minute MGT ended, the experimenter assessed patients and controls with a specifically designed questionnaire and interviewed them, asking them to describe strange-face perceptions. Apparitions of strange-faces in the mirror were significantly more intense in schizophrenic patients than in controls. All the following variables were higher in patients than in healthy controls: frequency (p<.005) and cumulative duration of apparitions (p<.009), number and types of strange-faces (p<.002), self-evaluation scores on Likert-type scales of apparition strength (p<.03) and of reality of apparitions (p<.001). In schizophrenic patients, these Likert-type scales showed correlations (p<.05) with CAPS total scores. These results suggest that the increase of strange-face apparitions in schizophrenia can be produced by ego dysfunction, by body dysmorphic disorder and by misattribution of self-agency. MGT may help in completing the standard assessment of patients with schizophrenia, independently of hallucinatory psychopathology. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 11 | Schizophr. Res. 2012 Sep 140: 46-50 |
| PMID | 22835808 |
| Title | Visual perception during mirror gazing at one's own face in schizophrenia. |
| Abstract | In normal observers gazing at one's own face in the mirror for some minutes, at a low illumination level, triggers the perception of strange faces, a new perceptual illusion that has been named 'strange-face in the mirror'. Subjects see distortions of their own faces, but often they see monsters, archetypical faces, faces of dead relatives, and of animals. We designed this study to primarily compare strange-face apparitions in response to mirror gazing in patients with schizophrenia and healthy controls. The study included 16 patients with schizophrenia and 21 healthy controls. In this paper we administered a 7 minute mirror gazing test (MGT). Before the mirror gazing session, all subjects underwent assessment with the Cardiff Anomalous Perception Scale (CAPS). When the 7minute MGT ended, the experimenter assessed patients and controls with a specifically designed questionnaire and interviewed them, asking them to describe strange-face perceptions. Apparitions of strange-faces in the mirror were significantly more intense in schizophrenic patients than in controls. All the following variables were higher in patients than in healthy controls: frequency (p<.005) and cumulative duration of apparitions (p<.009), number and types of strange-faces (p<.002), self-evaluation scores on Likert-type scales of apparition strength (p<.03) and of reality of apparitions (p<.001). In schizophrenic patients, these Likert-type scales showed correlations (p<.05) with CAPS total scores. These results suggest that the increase of strange-face apparitions in schizophrenia can be produced by ego dysfunction, by body dysmorphic disorder and by misattribution of self-agency. MGT may help in completing the standard assessment of patients with schizophrenia, independently of hallucinatory psychopathology. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 12 | Front Hum Neurosci 2013 -1 7: 329 |
| PMID | 23847502 |
| Title | Action simulation in hallucination-prone adolescents. |
| Abstract | Theoretical and empirical accounts suggest that impairments in self-other discrimination processes are likely to promote the expression of hallucinations. Studies using a variety of paradigms involving self-performed actions argue in favor of perspective taking confusion in hallucination-prone subjects. However, our understanding of such processes during adolescence is still at an early stage. The present study thus aims (1) to delineate the neural correlates sustaining mental simulation of actions involving self-performed actions (first-person perspective; 1PP) and other-performed actions (third-person perspective; 3PP) during adolescence (2) to identify atypical activation patterns during 1PP/3PP mental simulation of actions in hallucination-prone adolescents (3) to examine whether differential risk for schizophrenia (clinical vs. genetic) is also associated with differential impairments in the 1PP/3PP mental simulation of actions during adolescence. Twenty-two typically developing controls (Control group; 6 females), 12 hallucination-prone adolescents [auditory hallucination (AH) group; 7 females] and 13 adolescents with 22q11.2 Deletion Syndrome (22q11.2DS group; 4 females) were included in the study. During the fMRI task, subjects were presented with a cue (self-other priming cues) indicating to perform the task using either a first person perspective ("you"-1PP) or a third person perspective ("best friend"-3PP) and then they were asked to mentally simulate actions based on the type of cue. Hallucination-proneness was assessed using a self-report questionnaire [Cardiff Anomalous Perception Scale (CAPS)]. Our results indicated that atypical patterns of cerebral activation, particularly in the key areas of self-other distinction, were found in both groups at risk for auditory hallucinations (AHs and 22q11.2DS). More precisely, adolescents in the AH group presented decreased activations in the right middle occipital gyrus BA19, left cingulate gyrus BA31, and right precuneus BA31 for the 3PP > 1PP contrast. Adolescents in the 22q11.2DS group presented decreased activations in the right superior occipital gyrus BA19, left caudate tail and left precuneus BA7 for the 3PP > 1PP contrast. In comparison to the Control group, only the 22q11.2DS adolescents showed a decreased activation for other-related cues (prime other > prime self contrast) in areas of visual imagery, episodic memory and social cognition. This study characterizes the neural correlates of mental imagery for actions during adolescence, and suggests that a differential risk for hallucination-proneness (clinical vs. genetic) is associated to similar patterns of atypical activations in key areas sustaining self-other discrimination processes. These observations may provide relevant information for future research and prevention strategies with regards to hallucination-proneness during adolescence. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 13 | Psychiatr Q 2013 Jun 84: 137-57 |
| PMID | 22878835 |
| Title | Assessing anomalous perceptual experiences in nonpsychiatric individuals and outpatients with psychosis in Taiwan: an investigation using the cardiff anomalous perceptions scale (CAPS). |
| Abstract | The Cardiff anomalous perceptions scale (CAPS) has been recently designed for the assessment of anomalous perceptual experiences in the general population, and includes dimensions that measure distress, intrusiveness, and frequency. The purpose of this study was to assess the psychometric properties of a Taiwanese version of the CAPS. The English version of the CAPS was translated into Taiwanese (CAPS-T) and the latter was applied to this study. We administered the questionnaire to a consecutive sample of 192 participants with (n = 106; clinical group including schizophrenia and affective psychosis) or without psychotic disorders (n = 86; non-clinical group). In addition to the CAPS-T, the Taiwanese version of the brief psychiatric symptom rating scale (BSRS) measured the severity of the psychopathology. We also tested the psychometric properties of the CAPS-T including construct validity, internal consistency, test-retest reliability, and convergent and discriminative validity. Overall, the CAPS-T showed good construct validity, internal consistency, and stability over time and correlated significantly with the psychoticism subscale of the BSRS. As predicted, the mean differences in CAPS-T scores between participants with or without a psychotic disorder were significant. Convergent and discriminative validity were satisfactory. A score of 5 was found to the best threshold in discriminating between clinical and non-clinical samples. Our findings indicate that the Taiwanese version of the CAPS is a reliable and valid instrument to measure the multidimensionality of perceptual anomalies in general and appears to complement the clinical measures of psychosis proneness in Taiwan. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 14 | Am J Manag Care 2014 Jun 20: S174-83 |
| PMID | 25180707 |
| Title | Balancing therapeutic safety and efficacy to improve clinical and economic outcomes in schizophrenia: a managed care perspective. |
| Abstract | schizophrenia is a serious mental disorder associated with high morbidity and mortality, reduced life expectancy, and increased economic burden. Antipsychotic agents used for the management of schizophrenia are often associated with undesirable adverse effects, such as weight gain and metabolic abnormalities, contributing to elevated risk of cardiovascular disease, diabetes, and mortality. Contributors to the growing economic burden of schizophrenia include direct (eg, medical care and hospitalization) and indirect costs (eg, lost productivity and mortality). Strategies to reduce these expenditures include the use of generic medications, improving treatment adherence, avoidance of switching antipsychotic therapies, reducing disease relapses, and appropriate management of cardiometabolic disease. Arguably, while pharmacy benefit and managed care strategies (eg, prior authorization, prescription CAPS, copayments and patient cost-sharing strategies, tiered formulary pricing, and gap coverage) are designed and implemented to reduce healthcare costs, they may have the unintended result of creating barriers to treatment access and thereby contribute to further adverse patient outcomes. Managed care professionals should be cognizant of the drivers of cost and the need for cardiometabolic monitoring to individualize care for patients with schizophrenia. Further, comprehensive disease management plans should be developed that include the monitoring of disease progression and treatment adherence, while factoring in medication and healthcare administration costs. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 15 | Environ. Health Perspect. 2014 Sep 122: 939-45 |
| PMID | 24901756 |
| Title | Early postnatal exposure to ultrafine particulate matter air pollution: persistent ventriculomegaly, neurochemical disruption, and glial activation preferentially in male mice. |
| Abstract | Air pollution has been associated with adverse neurological and behavioral health effects in children and adults. Recent studies link air pollutant exposure to adverse neurodevelopmental outcomes, including increased risk for autism, cognitive decline, ischemic stroke, schizophrenia, and depression. We sought to investigate the mechanism(s) by which exposure to ultrafine concentrated ambient particles (CAPS) adversely influences central nervous system (CNS) development. We exposed C57BL6/J mice to ultrafine (< 100 nm) CAPS using the Harvard University Concentrated Ambient Particle System or to filtered air on postnatal days (PNDs) 4-7 and 10-13, and the animals were euthanized either 24 hr or 40 days after cessation of exposure. Another group of males was exposed at PND270, and lateral ventricle area, glial activation, CNS cytokines, and monoamine and amino acid neurotransmitters were quantified. We observed ventriculomegaly (i.e., lateral ventricle dilation) preferentially in male mice exposed to CAPS, and it persisted through young adulthood. In addition, CAPS-exposed males generally showed decreases in developmentally important CNS cytokines, whereas in CAPS-exposed females, we observed a neuroinflammatory response as indicated by increases in CNS cytokines. We also saw changes in CNS neurotransmitters and glial activation across multiple brain regions in a sex-dependent manner and increased hippocampal glutamate in CAPS-exposed males. We observed brain region- and sex-dependent alterations in cytokines and neurotransmitters in both male and female CAPS-exposed mice. Lateral ventricle dilation (i.e., ventriculomegaly) was observed only in CAPS-exposed male mice. Ventriculomegaly is a neuropathology that has been associated with poor neurodevelopmental outcome, autism, and schizophrenia. Our findings suggest alteration of developmentally important neurochemicals and lateral ventricle dilation may be mechanistically related to observations linking ambient air pollutant exposure and adverse neurological/neurodevelopmental outcomes in humans. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 16 | Am J Psychiatry 2014 Mar 171: 350-9 |
| PMID | 24170318 |
| Title | Revisiting schizophrenia linkage data in the NIMH Repository: reanalysis of regularized data across multiple studies. |
| Abstract | The Combined Analysis of Psychiatric Studies (CAPS) project conducted extensive review and regularization across studies of all schizophrenia linkage data available as of 2011 from the National Institute of Mental Health-funded Center for Collaborative Genomic Studies on Mental Disorders, also known as the Human Genetics Initiative (HGI). The authors reanalyzed the data using statistical methods tailored to accumulation of evidence across multiple, potentially highly heterogeneous, sets of data. Data were subdivided based on contributing study, major population group, and presence or absence within families of schizophrenia with a substantial affective component. The posterior probability of linkage (PPL) statistical framework was used to sequentially update linkage evidence across these data subsets (omnibus results). While some loci previously implicated using the HGI data were also identified in the present omnibus analysis (2q36.1, 15q23), others were not. Several loci were found that had not previously been reported in the HGI samples but are supported by independent linkage or association studies (3q28, 12q23.1, 11p11.2, Xq26.1). Not surprisingly, differences were seen across population groups. Of particular interest are signals on 11p15.3, 11p11.2, and Xq26.1, for which data from families with a substantial affective component support linkage while data from the remaining families provide evidence against linkage. All three of these loci overlap with loci reported in independent studies of bipolar disorder or mixed bipolar-schizophrenia samples. Public data repositories provide the opportunity to leverage large multisite data sets for studying complex disorders. Analysis with a statistical method specifically designed for such data enables us to extract new information from an existing data resource. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 17 | Cogn Neuropsychiatry 2015 -1 20: 254-69 |
| PMID | 25798816 |
| Title | Hallucinations and inhibitory functioning in healthy young adults with high and low levels of hypomanic personality traits. |
| Abstract | Hallucinations in schizophrenia and hallucination proneness in healthy young adults are associated with a common cognitive mechanism, namely impaired inhibitory control. Hallucinatory-like experiences also seem related to hypomanic symptoms in non-clinical participants; however, the mechanisms involved are unknown. We sought to examine self-reported hallucinatory/anomalous perceptual experiences in students selected for high versus low levels of hypomanic personality traits, and whether hypomania is characterised by deficient inhibitory control. Undergraduate students with either high (n = 26) or low (n = 28) scores on the Hypomanic Personality Scale-Revised (HPS-20) were compared on: (1) the Launay Slade Hallucination Scale-Revised (LSHS-R), a measure of hallucination proneness, (2) the Cardiff Anomalous Perceptions Scale (CAPS) and (3) the Inhibition of Currently Irrelevant Memories (ICIM) task, an index of intentional inhibition. The high HPS group had higher total scores, as well as higher frequency (on CAPS only), intrusiveness and distress (CAPS) scores compared to the low HPS group. They also produced significantly more false alarms on the second run of the ICIM task than the low hypomania traits group. Frequent, intrusive and distressing perceptual anomalies and proneness to hallucinations tend to occur in healthy individuals with hypomanic personality traits and may be associated with transient difficulties with inhibitory control. Inhibitory control may be a cognitive marker of vulnerability to hallucinations across diagnostic boundaries. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 18 | JAMA Psychiatry 2015 Feb 72: 179-88 |
| PMID | 25588123 |
| Title | Changes in drug coverage generosity and untreated serious mental illness: transitioning from Medicaid to Medicare Part D. |
| Abstract | More than 1 in 5 disabled people with dual Medicare-Medicaid enrollment have schizophrenia or a bipolar disorder (ie, a serious mental illness). The effect of their transition from Medicaid drug coverage, which varies in generosity across states, to the Medicare Part D drug benefit is unknown. Many thousands make this transition annually. To determine the effect of transitioning from Medicaid drug benefits to Medicare Part D on medication use by patients with a serious mental illness and to determine the influence of Medicaid drug CAPS. In time-series analysis of continuously enrolled patient cohorts (2004-2007), we estimated changes in medication use before and after transitioning to Part D, comparing states that capped monthly prescription fills with states with no prescription limits. We used Medicaid and Medicare claims from a 5% national sample of community-dwelling, nonelderly disabled dual enrollees with schizophrenia (n?=?5554) or bipolar disorder (n?=?3675). Psychotropic treatments included antipsychotics for schizophrenia and antipsychotics, anticonvulsants, and lithium for bipolar disorder. We measured monthly rates of untreated illness, intensity of treatment, and overall prescription medication use. Prior to Part D, the prevalence of untreated illness among patients with a bipolar disorder was 30.0% in strict-cap states and 23.8% in no-cap states. In strict-cap states, the proportion of untreated patients decreased by 17.2% (relatively) 1 year after Part D, whereas there was no change in the proportion of untreated patients in no-cap states. For patients with schizophrenia, the untreated rate (20.6%) did not change in strict-cap states, yet it increased by 23.3% (from 11.6%) in no-cap states. Overall medication use increased substantially after Part D in strict-cap states: prescription fills were 35.5% higher among patients with a bipolar disorder and 17.7% higher than predicted among schizophrenic patients; overall use in no-cap states was unchanged in both cohorts. The effects of transitioning from Medicaid to Medicare Part D on essential treatment of serious mental illness vary by state. Transition to Part D in states with strict drug benefit limits may reduce rates of untreated illness among patients with bipolar disorders, who have high levels of overall medication use. Access to antipsychotic treatment may decrease after Part D for patients with a serious mental illness living in states with relatively generous uncapped Medicaid coverage. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 19 | JAMA Psychiatry 2015 Feb 72: 179-88 |
| PMID | 25588123 |
| Title | Changes in drug coverage generosity and untreated serious mental illness: transitioning from Medicaid to Medicare Part D. |
| Abstract | More than 1 in 5 disabled people with dual Medicare-Medicaid enrollment have schizophrenia or a bipolar disorder (ie, a serious mental illness). The effect of their transition from Medicaid drug coverage, which varies in generosity across states, to the Medicare Part D drug benefit is unknown. Many thousands make this transition annually. To determine the effect of transitioning from Medicaid drug benefits to Medicare Part D on medication use by patients with a serious mental illness and to determine the influence of Medicaid drug CAPS. In time-series analysis of continuously enrolled patient cohorts (2004-2007), we estimated changes in medication use before and after transitioning to Part D, comparing states that capped monthly prescription fills with states with no prescription limits. We used Medicaid and Medicare claims from a 5% national sample of community-dwelling, nonelderly disabled dual enrollees with schizophrenia (n?=?5554) or bipolar disorder (n?=?3675). Psychotropic treatments included antipsychotics for schizophrenia and antipsychotics, anticonvulsants, and lithium for bipolar disorder. We measured monthly rates of untreated illness, intensity of treatment, and overall prescription medication use. Prior to Part D, the prevalence of untreated illness among patients with a bipolar disorder was 30.0% in strict-cap states and 23.8% in no-cap states. In strict-cap states, the proportion of untreated patients decreased by 17.2% (relatively) 1 year after Part D, whereas there was no change in the proportion of untreated patients in no-cap states. For patients with schizophrenia, the untreated rate (20.6%) did not change in strict-cap states, yet it increased by 23.3% (from 11.6%) in no-cap states. Overall medication use increased substantially after Part D in strict-cap states: prescription fills were 35.5% higher among patients with a bipolar disorder and 17.7% higher than predicted among schizophrenic patients; overall use in no-cap states was unchanged in both cohorts. The effects of transitioning from Medicaid to Medicare Part D on essential treatment of serious mental illness vary by state. Transition to Part D in states with strict drug benefit limits may reduce rates of untreated illness among patients with bipolar disorders, who have high levels of overall medication use. Access to antipsychotic treatment may decrease after Part D for patients with a serious mental illness living in states with relatively generous uncapped Medicaid coverage. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 20 | Psychoneuroendocrinology 2015 Jan 51: 459-71 |
| PMID | 25456346 |
| Title | Genomic predictors of combat stress vulnerability and resilience in U.S. Marines: A genome-wide association study across multiple ancestries implicates PRTFDC1 as a potential PTSD gene. |
| Abstract | Research on the etiology of post-traumatic stress disorder (PTSD) has rapidly matured, moving from candidate gene studies to interrogation of the entire human genome in genome-wide association studies (GWAS). Here we present the results of a GWAS performed on samples from combat-exposed U.S. Marines and Sailors from the Marine Resiliency Study (MRS) scheduled for deployment to Iraq and/or Afghanistan. The MRS is a large, prospective study with longitudinal follow-up designed to identify risk and resiliency factors for combat-induced stress-related symptoms. Previously implicated PTSD risk loci from the literature and polygenic risk scores across psychiatric disorders were also evaluated in the MRS cohort. Participants (N=3494) were assessed using the Clinician-Administered PTSD Scale and diagnosed using the DSM-IV diagnostic criterion. Subjects with partial and/or full PTSD diagnosis were called cases, all other subjects were designated controls, and study-wide maximum CAPS scores were used for longitudinal assessments. Genomic DNA was genotyped on the Illumina HumanOmniExpressExome array. Individual genetic ancestry was determined by supervised cluster analysis for subjects of European, African, Hispanic/Native American, and other descent. To test for association of SNPs with PTSD, logistic regressions were performed within each ancestry group and results were combined in meta-analyses. Measures of childhood and adult trauma were included to test for gene-by-environment (GxE) interactions. Polygenic risk scores from the Psychiatric Genomic Consortium were used for major depressive disorder (MDD), bipolar disorder (BPD), and schizophrenia (SCZ). The array produced >800K directly genotyped and >21M imputed markers in 3494 unrelated, trauma-exposed males, of which 940 were diagnosed with partial or full PTSD. The GWAS meta-analysis identified the phosphoribosyl transferase domain containing 1 gene (PRTFDC1) as a genome-wide significant PTSD locus (rs6482463; OR=1.47, SE=0.06, p=2.04×10(-9)), with a similar effect across ancestry groups. Association of PRTFDC1 with PTSD in an independent military cohort showed some evidence for replication. Loci with suggestive evidence of association (n=25 genes, p<5×10(-6)) further implicated genes related to immune response and the ubiquitin system, but these findings remain to be replicated in larger GWASs. A replication analysis of 25 putative PTSD genes from the literature found nominally significant SNPs for the majority of these genes, but associations did not remain significant after correction for multiple comparison. A cross-disorder analysis of polygenic risk scores from GWASs of BPD, MDD, and SCZ found that PTSD diagnosis was associated with risk sores of BPD, but not with MDD or SCZ. This first multi-ethnic/racial GWAS of PTSD highlights the potential to increase power through meta-analyses across ancestry groups. We found evidence for PRTFDC1 as a potential novel PTSD gene, a finding that awaits further replication. Our findings indicate that the genetic architecture of PTSD may be determined by many SNPs with small effects, and overlap with other neuropsychiatric disorders, consistent with current findings from large GWAS of other psychiatric disorders. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 21 | Soc Psychiatry Psychiatr Epidemiol 2015 Feb 50: 289-98 |
| PMID | 25053149 |
| Title | Relationships of perceived public stigma of mental illness and psychosis-like experiences in a non-clinical population sample. |
| Abstract | Studies on the association between psychopathology, perceived public stigma, and labeling in mental illness have focused primarily on severe but rare mental disorders, especially schizophrenia, or other clinically defined psychotic disorders. Although evidence is mounting that psychosis-like experiences show high prevalence in the general population and lead to an increased risk of psychotic disorders, little is known about how psychosis-like experiences independently affect perceived public stigma in the non-clinical population. The aim of the present study was to examine the relationship between psychosis-like experiences and perceived public stigma in a non-clinical sample. For this cross-sectional study, we recruited 524 individuals (239 male, 285 female) who had no lifetime history of psychiatric disorder. Participants completed questionnaires that asked for sociodemographic and clinical information, a measure of perceived public stigma (Perceived Psychiatric Stigma Scale [PPSS]), and two measures of psychosis-like experiences (Peters et al. Delusions Inventory [PDI]; Cardiff Anomalous Perceptions Scale [CAPS]). Of the sociodemographic characteristics analyzed in this study-gender, age, education level, marital status, and religion-only age simultaneously influenced PPSS, PDI, and CAPS scores. As hypothesized, perceived public stigma was positively correlated with measures of psychosis-like experiences, even after controlling for age. Furthermore, the perceived stigma was more strongly associated with delusion proneness than with anomalous perceptual experiences. The association between psychopathology and perceived public stigma appears to extend beyond clinically defined psychosis to more common psychosis-like experiences in a sample drawn from the general Han Chinese population. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 22 | Behav Res Ther 2016 Mar 78: 1-12 |
| PMID | 26797658 |
| Title | Open trial of exposure therapy for PTSD among patients with severe and persistent mental illness. |
| Abstract | There are few empirical data regarding effective treatment of trauma-related symptoms among individuals with severe mental illness (SMI; e.g., bipolar disorder, schizophrenia). This under-examined clinical issue is significant because rates of trauma and PTSD are higher among individuals with SMI relative to the general population, and there are sufficient data to suggest that PTSD symptoms exacerbate the overall course and prognosis of SMI. 34 veterans with SMI received prolonged exposure (PE) for PTSD using an open trial study design. Data suggest that PE is feasible to implement, well-tolerated, and results in clinically significant decreases in PTSD severity in patients with SMI. Mean CAPS scores improved 27.2 points from baseline to immediate post [95% CI for mean change: -44.3, - 10.1; p = 0.002, paired t-test, and treatment gains were maintained at 6 months [mean change from baseline to 6-months, -16.1; 95% CI: -31.0, -1.2; p = 0.034, paired t-test]. The current data support the use of exposure-based interventions for PTSD among individuals with SMI and highlight the need for rigorous randomized efficacy trials investigating frontline PTSD interventions in this patient population. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 23 | Clin Schizophr Relat Psychoses 2016 Jan -1: -1 |
| PMID | 26780602 |
| Title | Post - traumatic stress disorder in first episode psychosis: prevalence and related factors. |
| Abstract | Introduction The experience of psychosis or related treatment can be conceptualized as a traumatic event, which might lead to Post Traumatic Stress Disorder (PTSD) or PTSD syndrome which is defined as the presence of PTSD symptoms irrespective of the DSM - IV Criterion A definition of a traumatic event as an actual or threatened harm. Few studies explored the subject so far. Methods This cross - sectional study included 52 clinically stabilized patients who were hospitalized for a first psychotic episode during the two years preceding the study. Sociodemographic and clinical information were collected including past trauma history and drug and alcohol use. Patients were administered the Clinician - Administered PTSD Scale (CAPS), The Major Depression Inventory (MDI), the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning scale (GAF), and the Brief COPE. Results A total of 22 patients (42.3%) met full PTSD criteria and 36 patients (69.2%) met PTSD syndrome criteria. Full PTSD as well as PTSD syndrome were both associated with physical restraint, higher scores on the MDI and on the maladaptive coping scales. The most distressing symptoms were paranoid delusions, and the most distressing treatment experiences involved physical restraint and problems with other hospitalized patients. Discussion/conclusions Our figures showed high rates of psychosis related PTSD. To prevent PTSD, conditions of hospitalization should be optimized and the use of coercive treatments should be limited. Subjects with recent onset psychosis should be screened for PTSD symptoms. Improving coping abilities with a well fitted therapy would be useful in these patients. |
| SCZ Keywords | schizophrenia, schizophrenic |