Gender, age at onset, and duration of being ill as predictors for the long-term course and outcome of schizophrenia: an international multicenter study.

BACKGROUND: The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia. METHODS: Twenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 ± 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects. RESULTS: There was a 3-year later age at onset for females (P < .001) and lower rates of negative symptoms (P < .01) and higher depression/anxiety measures (P < .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages (P = .001). No significant effects were found concerning duration of illness. DISCUSSION: Our results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples.

[Social anxiety and the use of environmental self-regulation strategies].

INTRODUCTION: The prevention of social anxiety alone and in the prevention of comorbid diseases is key. In the present research, we examine subclinical-level social anxiety from a previously understudied perspective, in its asso ciation with environmental self-regulatory strategies. We use the theory of favorite places to describe environmental self-regulatory processes. The aim of the research is to determine how subclinical level social anxiety is related to the environmental self-regulatory processes taking place in favorite places. METHODS: In the study, we conducted an online questionnaire survey of 483 adults who were clinically healthy - 329 women (68.11%) and 154 men (31.88%). Respondents' social anxiety was assessed with the Fear of Negative Evaluation Questionnaire (BFNE-S), while environmental self-regulatory strategies were assessed with the Favorite Places Questionnaire. RESULTS: The extent of social anxiety was correlated with visiting favorite places in positive and negative emotional states, as well as the level of recovering and distressing experiences in the favorite place. Within the subsample characterized by elevated social anxiety, the pattern that visiting a favorite place helps a person regain his or her emotional balance primarily through the regulation of negative experiences was more characteristic. However, we found no correlation between the type of favorite place (e.g., place of residence, natural place) and the person's level of social anxiety. CONCLUSION: The research highlights that individuals with subclinical-level social anxiety are particularly active in using environmental self-regulatory processes to achieve their emotional balance. In prevention and clinical practice, it is worthwhile to monitor environmental self-regulatory processes and support for related needs, with particular emphasis on place use patterns.

Modeling psychological function in patients with schizophrenia with the PANSS: an international multi-center study.

BACKGROUND: The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model. METHODS: Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed. RESULTS: The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage. CONCLUSIONS: The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct "cores" of schizophrenia, the "Positive" and the "Negative," while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.

[Bipolar aff ective disorder - Perspectives on Developmental Psychopathology]. / Bipoláris affektív zavar ­ fejlodéspszichopatológiai szempontok.

The prevalence of bipolar affective disorder is 3% in the general population, with a first occurrence around the age of 20-30. The first symptoms are usually rather mild, thus it is difficult to reach a decision about the diagnosis within the first years. In the past years bipolar affective disorder received increased attention because of the relatively high lifetime prevalence. Nowadays experts in the field try to reach a consensus in understanding the earlier phases of the syndrome, as earlier therapeutic interventions tend to have a better result. General developmental psychopathological factors, and gene-environment interactions or evolutionary theories can greatly contribute to early recognition and understanding of the syndrome. The main aim of our article is to explore the possible developmental psychopathological background of bipolar affective disorder through overview of the literature on general developmental psychopathology factors, gene-environment interaction, and the evolutionary approach, which can contribute to more effective methods of treatment.

Staging of Schizophrenia With the Use of PANSS: An International Multi-Center Study.

INTRODUCTION: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. METHODS: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. RESULTS: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. DISCUSSION: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.

[The importance of relationship satisfaction and the questionnaire techniques of its measurement]. / A párkapcsolati elégedettség jelentosége és mérésének kérdoives technikái.

The quality of marriage or partnership has an impact on many areas of life. Consequently, a good working relationship can be a significant resource to cope with difficult life situations and stress, and may contribute to partners' well-being and healthy lifestyle. Therefore, its investigation has particular relevance. Relationship satisfaction is a complex concept which is confirmed by both diversity and multidimensionality of its definition. The aim of this study is to provide an overview of the importance of relationship satisfaction, inter- and intrapersonal factors influencing its development, its changes over family life cycles and the gender differences that may manifest in relationship satisfaction. In addition, this review summarizes the questionnaire techniques of measuring relationship satisfaction which are also reflected within the complexity and the diversity of the concept. Given the fact that the degree of relationship satisfaction plays a salient role in many aspects of life, the empirical research findings which emphasize the importance of this conception can serve as an alternative to aim the mobilization of its practical work.