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BACKGROUND: The relationship between childhood trauma (CT) and psychotic symptoms in patients with schizophrenia (SCZ), and subthreshold psychotic experiences in non-clinical populations is well-established. However, little is known about the relationship between subtypes of trauma and specific symptoms in patients, their siblings, and controls. It is also not clear which variables mediate the relationship between trauma and psychotic symptoms. METHODS: Seven hundred and forty-two patients with SCZ, 718 of their unaffected siblings and 1039 controls from three EU-GEI sites were assessed for CT, symptom severity, and cognitive schemas about self/others. CT was assessed with the Childhood Trauma Questionnaire, and cognitive schemas were assessed by The Brief Core Schema Scale. RESULTS: Patients with psychosis were affected by CT more than their siblings and controls in all domains. Childhood emotional abuse and neglect were more common in siblings than controls. CT was related to negative cognitive schemas toward self/others in patients, siblings, and controls. We found that negative schemas about self-mediated the relationship between emotional abuse and thought withdrawal and thought broadcasting. Approximately 33.9% of the variance in these symptoms was explained by the mediator. It also mediated the relationship between sexual abuse and persecutory delusions in SCZ. CONCLUSIONS: Our findings suggest that childhood abuse and neglect are more common in patients with schizophrenia than their siblings and healthy controls, and have different impacts on clinical domains which we searched. The relationship between CT and positive symptoms seems to be mediated by negative cognitive schemas about self in schizophrenia.
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Transtornos Psicóticos , Esquizofrenia , Irmãos , Humanos , Feminino , Masculino , Irmãos/psicologia , Adulto , Transtornos Psicóticos/psicologia , Pessoa de Meia-Idade , Experiências Adversas da Infância/estatística & dados numéricos , Psicologia do Esquizofrênico , Estudos de Casos e Controles , Cognição , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
PURPOSE: This study aims to assess the diagnostic power of brain asymmetry indices and neuropsychological tests for differentiating mesial temporal lobe epilepsy (MTLE) and schizophrenia (SCZ). METHODS: We studied a total of 39 women including 13 MTLE, 13 SCZ, and 13 healthy individuals (HC). A neuropsychological test battery (NPT) was administered and scored by an experienced neuropsychologist, and NeuroQuant (CorTechs Labs Inc., San Diego, California) software was used to calculate brain asymmetry indices (ASI) for 71 different anatomical regions of all participants based on their 3D T1 MR imaging scans. RESULTS: Asymmetry indices measured from 10 regions showed statistically significant differences between the three groups. In this study, a multi-class linear discriminant analysis (LDA) model was built based on a total of fifteen variables composed of the most five significantly informative NPT scores and ten significant asymmetry indices, and the model achieved an accuracy of 87.2%. In pairwise classification, the accuracy for distinguishing MTLE from either SCZ or HC was 94.8%, while the accuracy for distinguishing SCZ from either MTLE or HC was 92.3%. CONCLUSION: The ability to differentiate MTLE from SCZ using neuroradiological and neuropsychological biomarkers, even within a limited patient cohort, could make a substantial contribution to research in larger patient groups using different machine learning techniques.
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Epilepsia do Lobo Temporal , Imageamento por Ressonância Magnética , Testes Neuropsicológicos , Esquizofrenia , Humanos , Feminino , Epilepsia do Lobo Temporal/diagnóstico por imagem , Adulto , Imageamento por Ressonância Magnética/métodos , Esquizofrenia/diagnóstico por imagem , Análise Discriminante , Diagnóstico Diferencial , Pessoa de Meia-Idade , Imageamento Tridimensional , Estudos de Casos e ControlesRESUMO
BACKGROUND: The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally. METHODS: This study evaluated whether the psychometric properties of a short-form version, DISC-Ultra Short (DISCUS) (11-item), could be replicated in a sample of people with a wide range of mental disorders from 21 sites in 15 countries/territories, across six global regions. The frequency of experienced discrimination was reported. Scaling assumptions (confirmatory factor analysis, inter-item and item-total correlations), reliability (internal consistency) and validity (convergent validity, known groups method) were investigated in each region, and by diagnosis group. RESULTS: 1195 people participated. The most frequently reported experiences of discrimination were being shunned or avoided at work (48.7%) and discrimination in making or keeping friends (47.2%). Confirmatory factor analysis supported a unidimensional model across all six regions and five diagnosis groups. Convergent validity was confirmed in the total sample and within all regions [ Internalised Stigma of Mental Illness (ISMI-10): 0.28-0.67, stopping self: 0.54-0.72, stigma consciousness: -0.32-0.57], as was internal consistency reliability (α = 0.74-0.84). Known groups validity was established in the global sample with levels of experienced discrimination significantly higher for those experiencing higher depression [Patient Health Questionnaire (PHQ)-2: p < 0.001], lower mental wellbeing [Warwick-Edinburgh Well-being Scale (WEMWBS): p < 0.001], higher suicidal ideation [Beck Hopelessness Scale (BHS)-4: p < 0.001] and higher risk of suicidal behaviour [Suicidal Ideation Attributes Scale (SIDAS): p < 0.001]. CONCLUSIONS: The DISCUS is a reliable and valid unidimensional measure of experienced discrimination for use in global settings with similar properties to the longer DISC. It offers a brief assessment of experienced discrimination for use in clinical and research settings.
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Transtornos Mentais , Humanos , Reprodutibilidade dos Testes , Transtornos Mentais/diagnóstico , Estigma Social , Psicometria , Ideação Suicida , Inquéritos e QuestionáriosRESUMO
BACKGROUND: There is evidence that environmental and genetic risk factors for schizophrenia spectrum disorders are transdiagnostic and mediated in part through a generic pathway of affective dysregulation. METHODS: We analysed to what degree the impact of schizophrenia polygenic risk (PRS-SZ) and childhood adversity (CA) on psychosis outcomes was contingent on co-presence of affective dysregulation, defined as significant depressive symptoms, in (i) NEMESIS-2 (n = 6646), a representative general population sample, interviewed four times over nine years and (ii) EUGEI (n = 4068) a sample of patients with schizophrenia spectrum disorder, the siblings of these patients and controls. RESULTS: The impact of PRS-SZ on psychosis showed significant dependence on co-presence of affective dysregulation in NEMESIS-2 [relative excess risk due to interaction (RERI): 1.01, p = 0.037] and in EUGEI (RERI = 3.39, p = 0.048). This was particularly evident for delusional ideation (NEMESIS-2: RERI = 1.74, p = 0.003; EUGEI: RERI = 4.16, p = 0.019) and not for hallucinatory experiences (NEMESIS-2: RERI = 0.65, p = 0.284; EUGEI: -0.37, p = 0.547). A similar and stronger pattern of results was evident for CA (RERI delusions and hallucinations: NEMESIS-2: 3.02, p < 0.001; EUGEI: 6.44, p < 0.001; RERI delusional ideation: NEMESIS-2: 3.79, p < 0.001; EUGEI: 5.43, p = 0.001; RERI hallucinatory experiences: NEMESIS-2: 2.46, p < 0.001; EUGEI: 0.54, p = 0.465). CONCLUSIONS: The results, and internal replication, suggest that the effects of known genetic and non-genetic risk factors for psychosis are mediated in part through an affective pathway, from which early states of delusional meaning may arise.
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Transtornos Psicóticos , Esquizofrenia , Humanos , Transtornos Psicóticos/etiologia , Transtornos Psicóticos/genética , Alucinações/etiologia , Alucinações/genética , Esquizofrenia/etiologia , Esquizofrenia/genética , Herança Multifatorial , Risco , Delusões/diagnósticoRESUMO
BACKGROUND: This study attempted to replicate whether a bias in probabilistic reasoning, or 'jumping to conclusions'(JTC) bias is associated with being a sibling of a patient with schizophrenia spectrum disorder; and if so, whether this association is contingent on subthreshold delusional ideation. METHODS: Data were derived from the EUGEI project, a 25-centre, 15-country effort to study psychosis spectrum disorder. The current analyses included 1261 patients with schizophrenia spectrum disorder, 1282 siblings of patients and 1525 healthy comparison subjects, recruited in Spain (five centres), Turkey (three centres) and Serbia (one centre). The beads task was used to assess JTC bias. Lifetime experience of delusional ideation and hallucinatory experiences was assessed using the Community Assessment of Psychic Experiences. General cognitive abilities were taken into account in the analyses. RESULTS: JTC bias was positively associated not only with patient status but also with sibling status [adjusted relative risk (aRR) ratio : 4.23 CI 95% 3.46-5.17 for siblings and aRR: 5.07 CI 95% 4.13-6.23 for patients]. The association between JTC bias and sibling status was stronger in those with higher levels of delusional ideation (aRR interaction in siblings: 3.77 CI 95% 1.67-8.51, and in patients: 2.15 CI 95% 0.94-4.92). The association between JTC bias and sibling status was not stronger in those with higher levels of hallucinatory experiences. CONCLUSIONS: These findings replicate earlier findings that JTC bias is associated with familial liability for psychosis and that this is contingent on the degree of delusional ideation but not hallucinations.
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Transtornos Psicóticos , Esquizofrenia , Viés , Tomada de Decisões , Delusões/psicologia , Alucinações , Humanos , Transtornos Psicóticos/psicologia , Esquizofrenia/genéticaRESUMO
Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ. Patients showed medium to large deficits across all functions (ES range = -0.45 to -0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = -0.14 to -0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = -0.88 to -0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically significant, albeit reduced by half (ES range = -0.13 to -0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = -0.21 to -0.43, p < 0.01). Deficits in verbal knowledge, and working memory may specifically index familial, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders.
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Transtornos Psicóticos , Irmãos , Adulto , Idoso , Cognição , Estudos Transversais , Humanos , Testes NeuropsicológicosRESUMO
INTRODUCTION: Different influences of ovarian hormones in schizophrenia (SCZ) have been reported, but no study to date has assessed their effects on the brain dynamics at rest. The present study aimed to examine the hormonal and clinical changes related to the menstrual cycle and alterations in the resting-state functional connectivity (RS-FC) depending on cycle phase and/or hormonal fluctuations in SCZ. METHOD: This study was conducted based on both between- and within-subject experimental designs, including 13 clinically stable female patients with SCZ (32 ± 7.7 years) and 13 healthy women (30 ± 7.3 years). RS-functional magnetic resonance imaging (fMRI) scanning, as well as hormonal and clinical assessments, was applied to each participant twice during two cycle phases: early follicular and mid-luteal. RESULTS: A difference in mid-luteal progesterone levels was found between groups, with a large effect size (Cohen's d) of 0.8 (p < 0.05). Also, the estradiol levels negatively correlated with the negative symptom severity of the patients during their mid-luteal phase. In the patients, estrogen positively correlated with the auditory network connectivity in the left amygdala during the early follicular phase. In the controls, progesterone had positive correlations with the connectivity of the posterior default mode and the left frontoparietal networks in the bilateral precuneus during the early follicular phase and had a negative correlation with the executive control network connectivity in the mid-luteal phase. CONCLUSION: The present study showed hormonal differences between groups and suggested that the levels of cycle-dependent hormones might be associated with the changes in clinical symptom severity and the RS-FC in the groups. Our RS-fMRI findings warrant further investigation.
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Imageamento por Ressonância Magnética , Esquizofrenia , Estrogênios , Feminino , Humanos , Ciclo Menstrual , Progesterona , Esquizofrenia/diagnóstico por imagemRESUMO
OBJECTIVES: The Self-Evaluation of Negative Symptoms Scale (SNS) is a self-report scale that evaluates a patient's subjective experience on all five domains of the negative symptoms. This study aimed to present the adaptation and validation study of the Turkish version of SNS(SNS-TR). METHODS: Seventy-five patients and 50 controls were recruited for this study. After the approval of the translation, participants were asked to fill out SNS-TR by themselves. They were interviewed with the Brief Negative Symptoms Scale (BNSS), Positive and Negative Syndrome Scale (PANSS), and Calgary Depression Scale for Schizophrenia (CDSS). RESULTS: SNS-TR showed good internal consistency in the reliability analysis with Cronbach's alpha= 0.873. Subscale-total score correlation coefficients were significant (p < 0.01). In the validity analyses, the total and subscale scores of SNS-TR showed positive correlations with the total and subscales of BNSS, with only one exception of BNSS lack of distress subscales. The total score of SNS-TR demonstrated a significant correlation with PANSS-total, PANSS-negative subscale, PANSS-general subscale, and CDSS scores. Confirmatory factor analysis showed acceptable values for the five-factor structure, similar to the original version. CONCLUSION: To conclude, our study indicates that SNS-TR is an easily applicable self-evaluation tool with good psychometric properties for assessing negative symptoms. KEY POINTSSNS is a novel and easily applicable self-report scale for examining negative symptoms in schizophrenia patients, allowing them to evaluate their subjective experience on all five domains of the negative symptoms.It shows good internal consistency (α= 0.873) which is similar to the original version (α = 0.867).Confirmatory factor analysis scores were found in acceptable ranges and SNS-TR confirm the five-factor structure.Using this scale in clinical practice would empower both the physician's examinations and patient participation through treatment and follow-up course.
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Autoavaliação Diagnóstica , Esquizofrenia , Humanos , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Esquizofrenia/diagnóstico , PsicometriaRESUMO
In the current study, a questionnaire to evaluate satisfaction levels and related factors upon discharge was completed by 100 patients receiving care for mental illness in a tertiary care hospital in Turkey. The relationships among sociodemographic variables, nonpharmacological interventions, and participants' views about the treatment course and quality of care they received were investigated. Overall satisfaction levels of participants were good. Older participants reported more positive opinions. Involuntary hospitalization, use of restraints/seclusion, or electroconvulsive therapy did not change overall satisfaction. Participants who were hospitalized for the first time were more afraid of other patients, which may imply that this population needs special care from the treatment team. Spending an adequate amount of time and providing necessary information about their treatment plan impact patients' treatment experience positively. [Journal of Psychosocial Nursing and Mental Health Services, 59(4), 38-47.].
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Pacientes Internados , Serviços de Saúde Mental , Satisfação do Paciente , Humanos , Inquéritos e Questionários , Centros de Atenção Terciária , TurquiaRESUMO
BACKGROUND: First-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes. METHODS: We conducted, using two different samples for discovery (n = 336 controls and 649 siblings of patients with psychotic disorder) and replication (n = 1208 controls and 1106 siblings), an analysis of association between PRS on the one hand and psychopathological and cognitive intermediate phenotypes of schizophrenia on the other in a sample at average genetic risk (healthy controls) and a sample at higher than average risk (healthy siblings of patients). Two subthreshold psychosis phenotypes, as well as a standardised measure of cognitive ability, based on a short version of the WAIS-III short form, were used. In addition, a measure of jumping to conclusion bias (replication sample only) was tested for association with PRS. RESULTS: In both discovery and replication sample, evidence for an association between PRS and subthreshold psychosis phenotypes was observed in the relatives of patients, whereas in the controls no association was observed. Jumping to conclusion bias was similarly only associated with PRS in the sibling group. Cognitive ability was weakly negatively and non-significantly associated with PRS in both the sibling and the control group. CONCLUSIONS: The degree of endophenotypic expression of schizophrenia polygenic risk depends on having a sibling with psychotic disorder, suggestive of underlying gene-environment interaction. Cognitive biases may better index genetic risk of disorder than traditional measures of neurocognition, which instead may reflect the population distribution of cognitive ability impacting the prognosis of psychotic disorder.
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Interação Gene-Ambiente , Herança Multifatorial , Transtornos Psicóticos/genética , Esquizofrenia/genética , Irmãos , Adulto , Estudos de Casos e Controles , Endofenótipos , Europa (Continente) , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/psicologia , Fatores de Risco , Psicologia do Esquizofrênico , Adulto JovemRESUMO
PURPOSE: The aim of the study was to assess efficacy and safety of paliperidone palmitate (PP) in schizophrenic patients using real-life data. METHODS: This national, multicenter, retrospective, and mirror-image study was performed reviewing the medical records of patients in 18 centers. Adult schizophrenic patients receiving PP treatment (n = 205) were enrolled. Patients' data covering the last 12 months before the initial PP injection and the period until the end of study with at least 12 months after the initial PP injection were evaluated. Patients' characteristics, scale scores, and adverse events were recorded. RESULTS: Nonadherence to prior medication was the most frequent reason for switching to PP treatment. Comparing with the period before PP treatment, the rate of patients visiting the hospital for relapse (79.5% vs 28.9%, P < 0.001) and the median number of hospitalizations (2 vs 0, P < 0.001) were lower during PP treatment. During PP treatment, the Positive and Negative Syndrome Scale score decreased by 20% or more (response to treatment) in 75.7% of the patients. The frequency of adverse events did not differ between the period before and during PP treatment. Improvement in functionality was higher in those with disease duration of 5 years or less. CONCLUSIONS: Paliperidone palmitate is effective and safe in treatment of schizophrenic patients and in switching to PP treatment in patients with schizophrenia, which reduced the percentage of patients admitted to the hospital for relapse and the median number hospitalization, and has positive effects on functionality.
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Antipsicóticos/farmacologia , Hospitalização/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Palmitato de Paliperidona/farmacologia , Esquizofrenia/tratamento farmacológico , Adolescente , Adulto , Idoso , Antipsicóticos/administração & dosagem , Antipsicóticos/efeitos adversos , Preparações de Ação Retardada , Substituição de Medicamentos , Feminino , Seguimentos , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Palmitato de Paliperidona/administração & dosagem , Palmitato de Paliperidona/efeitos adversos , Recidiva , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Adulto JovemRESUMO
OBJECTIVE: Negative symptoms in schizophrenia have been assessed by many instruments. However, a current consensus on these symptoms has been built and new tools, such as the Brief Negative Symptom Scale (BNSS), are generated. This study aimed to evaluate reliability and validity of the Turkish version of BNSS. METHODS: The scale was translated to Turkish and backtranslated to English. After the approval of the translation, 75 schizophrenia patients were interviewed with BNSS, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS) and Extrapyramidal Symptom Rating Scale (ESRS). Reliability and validity analyses were then calculated. RESULTS: In the reliability analysis, the Cronbach's alpha coefficient was 0.96 and item-total score correlation coefficients were between 0.655-0.884. The intraclass correlation coefficient was 0.665. The inter-rater reliability was 0.982 (p < 0.0001). In the validity analysis, the total score of BNSS-TR was correlated with PANSS Total Score, Positive Symptoms Subscale, Negative Symptoms Subscale, and General Psychopathology Subscale. CDSS and ESRS were not correlated with BNSS-TR. The factor structure of the scale was consisting the same items as in the original version. CONCLUSIONS: Our study confirms that the Turkish version of BNSS is an applicable tool for the evaluation of negative symptoms in schizophrenia.
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Escalas de Graduação Psiquiátrica/normas , Esquizofrenia/diagnóstico , Esquizofrenia/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , TurquiaRESUMO
BACKGROUND: Response to antipsychotic treatment is better in the early stages of schizophrenia. AIMS: The primary objective of this non-randomized, single-arm, multicenter clinical trial was to explore the response to treatment and safety of a flexible dose of paliperidone (mean = 6.42 mg/day) in patients with recent onset schizophrenia (< 3 years after the first episode/hospitalization). METHODS: Severity of clinical symptoms was evaluated by the Positive and Negative Syndrome Scale (PANSS), functioning was assessed using the Global Assessment of Functioning (GAF) scale and the Personal and Social Performance Scale (PSP). RESULTS: In a total of 85 patients enrolled, 80 patients were eligible. Total PSP score at baseline (50.2 ± 11.6) increased at all visits. Total PSP score was 65.4 ± 12.1 at month 12 (P < 0.001). GAF scores were significantly higher at all visits compared with baseline (P = 0.001). It was 62.4 ± 12.5 with an increase of 42.9% at month 12 (P < 0.001). PANSS Positive and Negative subscales and General psychopathology subscale scores showed significant reductions beginning with month 3 and were 11.9 ± 3.8 (29.3%; P < 0.001), 13.7 ± 5.6 (27.3% P < 0.001) and 27.8 ± 7.1 (23.2%; P < 0.001) at month 12, respectively. Twelve patients (14.3%) had a serious adverse event. The most common adverse events were insomnia (17.9%), nausea (8.3%), akathisia (4.8%), anxiety (4.8%) and depression (4.8%). Body weight values at the end of the study were significantly higher compared with baseline. CONCLUSION: The present study demonstrates that flexible dose of paliperidone resulted in a significant improvement in functioning and reduction in symptoms in patients with recent onset schizophrenia.
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Antipsicóticos/uso terapêutico , Palmitato de Paliperidona/uso terapêutico , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Adulto , Antipsicóticos/efeitos adversos , Preparações de Ação Retardada , Relação Dose-Resposta a Droga , Substituição de Medicamentos , Feminino , Humanos , Análise de Intenção de Tratamento , Masculino , Palmitato de Paliperidona/efeitos adversos , Escalas de Graduação Psiquiátrica , Esquizofrenia/diagnósticoRESUMO
UNLABELLED: BACKROUND AND AIM: The Subjective Well-Being under Neuroleptics Scale, short form (SWNS), is a self-report measure that evaluates the states of well-being of schizophrenia patients using antipsychotic drugs independently from psychopathology of disease. This study examined the factor structure of the Turkish version of the scale using high-level statistical analyses. METHODS: The SWNS was translated into Turkish and applied to 103 schizophrenic patients. A type of multi-trait-multi-method (MTMM) confirmatory factor analysis was conducted to determine the factor structure of the Turkish version of the scale. RESULTS: The results of factor analysis of the SWNS were incompatible with the factor structure of the original scale. A set of MTMM analyses showed distinct method effects for both positive and negative item wording in the scale. In light of these findings, the factor structure of the SWNS was determined as having a one-dimensional structure, with bias due to item wording. CONCLUSIONS: The results of the present investigation indicated that the sub-factors of the SWNS failed to emerge from the data. This study is the first to show that there is an urgent need for further examination of the factor structure of the SWNS with regard to method effects. This issue has important implications for the use of sub-factors by both researchers and practitioners.
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Antipsicóticos/uso terapêutico , Atitude Frente a Saúde , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Adulto , Assistência Ambulatorial , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Psicometria , Autorrelato , Tradução , TurquiaRESUMO
BACKGROUND: The aim of this study is to investigate the effects of obsessive-compulsive symptoms (OCS) on quality of life (QoL) and to identify the OCS with a particular effect on QoL, and whether there are any such symptoms for patients with schizophrenia. METHODS: We studied three groups of patients with schizophrenia. One group of patients (n = 45) without OCS or obsessive-compulsive disorder (OCD), one group with OCS, not fulfilling the diagnostic criteria for OCD (n = 31), and one group with OCD as a comorbid condition (n = 24). Severity of clinical symptoms was evaluated with the Positive and Negative Symptom Scale and OCS was examined using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Symptom Checklist. We also administered the Y-BOCS. The patients' QoL was assessed using the Quality of Life Scale (QLS). RESULTS: QLS interpersonal relationships subscale scores of those with OCS were lower than those without OCS. There was no difference among OCS, non-OCS, and OCD groups in terms of QoL. There was no relationship between QLS scores and symmetry, contamination and causing harm obsessions, but those with cleaning and repeating compulsions had lower QoL. CONCLUSIONS: Questioning of comorbid OCS and treatment with specific medication in schizophrenia patients may increase QoL.
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Transtorno Obsessivo-Compulsivo/epidemiologia , Qualidade de Vida/psicologia , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Adulto , Comorbidade , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Escalas de Graduação Psiquiátrica , Avaliação de Sintomas/psicologia , Turquia/epidemiologia , Adulto JovemRESUMO
Face and emotion recognition are crucial components of social cognition. We aimed to compare them in patients diagnosed with schizophrenia (SCZ), ultra-high risk for psychosis (UHR), unaffected siblings of schizophrenia patients (SIB), and healthy controls (HC). METHODS: One hundred sixty-six participants (45 SCZ, 14 UHR, 45 SIB, and 62 HC) were interviewed with the Structured Clinical Interview for DSM-5 (SCID-5). Positive and Negative syndrome scale (PANSS), PennCNB Facial Memory (CPF), and Emotion Recognition Task (ER40) were applied. RESULTS: In CPF, SCZ performed significantly lower than SIB and HC. SIB was also significantly lower than HC for total correct responses. The sample size of the UHR group was small, and the statistical comparisons did not reach a significance, however, a trend towards decreased performance between the SCZ and SIB was found. In ER40, SCZ performed significantly lower than HC and SIB in all domains, except for the insignificant findings for angry ER between SIB and SCZ. SIB also performed significantly lower than HC for angry, negative, and total ER. UHR was similar to SCZ for happy and sad ER and performed significantly lower than HC for happy ER. The effect of SCZ diagnosis on the efficiency of CPF and ER40 was significant when corrected for age and education. For SCZ, PANSS also significantly affected the CPF and ER40. CONCLUSION: Our findings suggest varying levels of face and emotion recognition deficits in individuals with SCZ, UHR, and SIB. Face and emotion recognition deficits are promising schizophrenia endophenotypes related to social cognition.
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BACKGROUND: Help-seeking from traditional healers (TH) is common in patients with severe mental illness. However, the differences between patients with schizophrenia and bipolar disorder are not well-known. Although internalized stigma is also common in patients with severe mental illness, its impact on help-seeking from TH is not studied. AIM: To investigate help-seeking from TH and the relationship between help-seeking from TH and internalized stigma in patients with schizophrenia and bipolar disorder. METHODS: In this cross-sectional study, we collected information about help-seeking from TH and clinical characteristics by using a semi-structured interview form from 310 patients with schizophrenia and bipolar disorder in two sites with different socio-cultural backgrounds. We measured internalized stigma by using The Internalized Stigma of Mental Illness (ISMI) scale. RESULTS: We found that 47% of the patients visited TH in any phase of their illness, and 46% of them sought help from TH before their first contact with a psychiatrist. Those who grew up in rural areas, were less educated, who attempted suicide before, with resistance to treatment, and with a family member who also admitted to TH were more frequent among the help-seekers from TH. This group also had more hospitalizations and higher Clinical Global Impression scores. Internalized stigma was found to be higher in the schizophrenia group, and it was related to help-seeking from TH and delay in admission to psychiatric facilities. CONCLUSION: Our findings suggest that help-seeking from TH is common both in patients with schizophrenia and bipolar disorder, and it has socio-cultural, illness-related, and stigma-related predictors.
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OBJECTIVES: Lifetime co-occurring substance use disorders are common at the time of presentation for the treatment of primary psychosis. Our aim was to investigate the clinical characteristics of adolescents with early-onset schizophrenia/schizoaffective disorder (EOS), categorized as either with (EOS + SUD) or without SUD (non-SUD/EOS), in a multi-center sample. METHODS: Between 2016 and 2022, 255 patients were evaluated across three tertiary-care inpatient units. Diagnoses were confirmed by the treating physician according to the DSM-5 during the hospital stay. The severity of symptoms was measured using the Positive and Negative Syndrome Scale (PANSS). RESULTS: The EOS + SUD group exhibited a higher illness onset, fewer years of education, longer duration of untreated psychosis (DUP), a higher frequency of male gender, more frequent hospitalizations, increased use of clozapine and zuclopenthixol LAI, along with higher rates of post-traumatic stress disorder and conduct disorder. Notably, differences in DUP, clozapine use, and the number of hospitalizations did not persist in the multivariate logistic regression model. CONCLUSIONS: Our findings support the notion of SUD playing a role in modifying the course of illness in EOS. Future studies should emphasize exploring treatment responses to medications and interventions among youth with dual diagnoses.
RESUMO
Cued version of the continuous performance test (AX-CPT) assesses sustained attention, working memory and cognitive control processes, which have been reported as impaired in schizophrenia. This study investigated visual P3 event-related potential elicited during cued CPT in patients with schizophrenia and in individuals who were at clinical or genetic high risk for psychosis to determine whether any abnormality may provide a marker of vulnerability for psychosis. Visual P3 elicited during cued CPT have not been reported in individuals at high risk for psychosis. Visual Go and NoGo P3 potentials were assessed in 34 antipsychotic-naive patients with first-episode schizophrenia (FES), 25 clinically unaffected siblings of these patients (familial high-risk for psychosis, FHR), 49 antipsychotic-naive individuals at ultra-high risk for psychosis (UHR) and 37 healthy control (HC) participants. FES patients had overall smaller P3 amplitudes than all other groups. P3 amplitude of the UHR participants was in-between the HC participants and FES patients. The anteroposterior P3 topography differed between the groups, with FES patients and FHR participants showing a more frontally distributed P3 compared with the HC participants. These findings suggest that the reduction in visual P3 amplitude may provide a vulnerability marker for psychosis in individuals who are at clinical high risk for psychosis and that a more frontally distributed visual P3 may be a marker of genetic liability for psychosis.
Assuntos
Antipsicóticos , Transtornos Psicóticos , Esquizofrenia , Humanos , Esquizofrenia/genética , Irmãos , Transtornos Psicóticos/genética , Fatores de RiscoRESUMO
This study investigates the relationship between minor physical anomalies (MPA) and treatment resistance in schizophrenia (TRS). We evaluated 137 patients and 100 healthy controls by using a modified Waldrup MPA scale. Thirteen MPA items were found more frequently in the schizophrenia group than in the controls. The total MPA score was higher in TRS, and MPAs in the eye and mouth regions were more frequent in TRS (n = 57) than in non-TRS. Total MPA score was correlated to Brief Psychiatric Rating Scale-Expanded (BPRS-E) total and BPRS-positive scores in TRS. Our findings suggest that MPA might contribute to treatment resistance in schizophrenia.