Association between functional recovery and medication adherence in schizophrenia.

AIM: Medication adherence is important for achieving functional recovery from schizophrenia and is commonly assessed using the Drug Attitude Inventory-30 (DAI-30). Subscales of the DAI-30, including "awareness of the need for medication," "awareness of the effects of psychiatric drugs," and "impression of medication," have been used to assess medication adherence. To determine which of these subscales are associated with the prognosis of schizophrenia, this study followed patients with schizophrenia to identify the prognosis and examine the subscales related to "recovery." METHODS: In total, 89 patients were recruited, 78 of whom were registered in the study. After assessing adherence using the DAI-30, Positive and Negative Syndrome Scale and Global Assessment of Functioning scores were assessed at 0 and 24 week to define the functional prognosis. RESULTS: At the end of the 24-week follow-up period, 36% of patients showed recovery from schizophrenia. A comparison of subscales revealed that the score for "impression of medication" was significantly higher in the recovery than in the non-recovery group. Logistic regression analysis identified only the "impression of medication" score as being predictive of recovery. CONCLUSION: The results indicated that among the three DAI-30 subscales, "impression of medication" was the most closely associated with recovery in patients with schizophrenia.

Associations between parental bonding during childhood and functional recovery in patients with schizophrenia.

INTRODUCTION: Schizophrenia is believed to be etiologically associated with environmental factors. Poor parental bonding, especially arising from "low care" and "overprotection," may contribute to the prognosis in patients with psychosis. In the present study, we investigated the associations between the aforementioned two different parental bonding types and the prognosis, in terms of the functional recovery, of patients with schizophrenia. METHODS: A total of 89 patients with schizophrenia were recruited, and 79 patients were registered for the study. After the parental bonding types and representative childhood adverse events were assessed, specific items on the PANSS were assessed at 0 and 24 weeks of the study period to define the functional prognosis. RESULTS: At the end of the 24-week follow-up period, 36% of the patients were judged as showing recovery from schizophrenia. The score for "overprotective attitude," but not that for "low care," was found to be significantly higher in the non-recovery (defined below) group. Exploratory logistic regression analysis identified only "overprotective attitude" of the parents as being predictive of non-recovery. Moreover, a significant negative correlation was found between "low care" and "overprotective attitude" only in the non-recovery group. CONCLUSION: In the present study, we showed that an overprotective attitude of the parents was associated with non-recovery in patients with schizophrenia.

Utility of the Neurobehavioral Cognitive Status Examination (COGNISTAT) in differentiating between depressive states in late-life depression and late-onset Alzheimer's disease: a preliminary study.

BACKGROUND: It is often difficult to differentiate between the depressive states seen in late-life depression and late-onset Alzheimer' disease (AD) in the clinical setting. METHODS: Thirty-four outpatients were recruited, all fulfilling the criteria of aged 65 years or above, scores of 14 or more on the Hamilton depression rating scale (HAM-D), and 26 or less on the Mini-Mental State Examination (MMSE). At the initial visit, they were administered the Neurobehavioral Cognitive Status Examination (COGNISTAT). At 1 month, a diagnosis of either senile depression (n = 24) or Alzheimer' disease (n = 10) was made. RESULTS: The COGNISTAT revealed that the late-life depression group showed significantly higher scores in orientation and comprehension subtests compared with the AD group. At the study endpoint (6 months after treatment), MMSE detected significant improvements in the late-life depression group (n = 15), but no changes in the late-onset AD group (n = 7). Scores for memory, similarities, and judgment on the second COGNISTAT were significantly improved in the depressed group, whereas calculation scores deteriorated significantly in the AD group. CONCLUSION: The COGNISTAT could prove useful in differentiating late-life depression from late-onset AD, despite similar scores on MMSE.

Personality traits as predictors for the outcome of lithium augmentation in treatment-resistant depression.

The NEO Personality Inventory-Revised (NEO) and the Temperament and Character Inventory (TCI) were administered to patients with treatment-resistant depression (n=21) before lithium augmentation. Analysis showed that the poor outcome group (n=11) had lower openness scores on the NEO, and lower cooperativeness scores on the TCI compared with the good outcome group (n=10). These findings may be predictors of poor responsiveness to lithium augmentation in the treatment of antidepressant-resistant depression.

Effects of Add-on Ramelteon on Cognitive Impairment in Patients with Schizophrenia: An Open-label Pilot Trial.

OBJECTIVE: This open-label study examined the effects of ramelteon on cognitive functions in 10 outpatients with schizophrenia. METHODS: Ramelteon (8 mg/day) was administered to 10 patients with schizophrenia for six months. The verbal fluency test, Trail-Making Test, the Wisconsin Card Sorting Test, the Stroop Test, the Digit Span Distraction Test, Iowa Gambling Task, the Rey Auditory Verbal Learning Test were evaluated at baseline and 6 months after treatment with ramelteon. RESULTS: Ramelteon improved significantly the scores of Rey Auditory Verbal Learning Test. Additionally, ramelteon exerted improvements in the verbal fluency and Iowa Gambling Task in 4 patients. CONCLUSION: Ramelteon could be a potential therapeutic drug, in adjunctive treatment of learning and memory deficits seen in patients with schizophrenia.