Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study.

BACKGROUND: Antipsychotic drugs are limited in their ability to improve negative symptoms, quality of life, and medication adherence in patients with schizophrenia. The addition of nonpharmacological interventions like social skills training has a positive effect on medication adherence and decreases rehospitalization rates but is limited in improving patients' symptoms, aggressive behaviors, and quality of life. Aerobic exercise, especially Tai-chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia. However, no study has investigated the effects of social skills training plus Tai-chi on outcomes among outpatients with schizophrenia. This study analyzes the effect of antipsychotics combined with community-based integrated interventions on outcomes of schizophrenia. METHODS: In this study, a 24-session social skills training plus Tai-chi was used in community settings among patients with schizophrenia. A total of 244 patients were randomly assigned to medication treatment alone (MTA group) or community-based integrated intervention (CBII group), which accepted social skills training plus Tai-chi in addition to medication treatment. Generalized linear mixed models were used to evaluate the intervention effect (group effect), intervention effect over time (time effect), and interaction effect (group × time effect). t tests were used to evaluate between-group differences on clinical variables. Multiple linear regression analysis was used to analyze the differences between the intervention at 12 months and baseline for the Positive and Negative Syndrome Scale (PANSS) negative symptoms and quality of life-social domain. RESULTS: Compared with the MTA group, the CBII group had lower scores on PANSS (F = 17.312, p < 0.001) and negative symptoms (F = 44.909, p < 0.001), a lower risk for aggressive behavior (F = 12.382, p < 0.001), and a greater improvement in adherence to medication (F = 12.391, p < 0.001) after 1 year of intervention. The changes in PANSS total scores, negative scores, and social domain of the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF) from baseline to 12 months were significant between the two groups (PANSS total score: t = 4.839, p < 0.001; negative symptoms: t = 8.250, p < 0.001, and quality of life-social domain: t = -2.171, p = 0.031). Multiple linear regression analysis also showed that the intervention was significantly effective for changes from baseline to 12 months on PANSS total score (B = 0.804, p < 0.001), negative score (B = 0.709, p < 0.001), and social domain of quality of life (B = -0.673, p = 0.044). CONCLUSIONS: This study suggested that the community-based integrated intervention such as social skills training plus Tai-chi should be part of a rehabilitation effort for patients with schizophrenia in order to improve clinical symptoms, quality of life, and medication adherence.

Association of KCNB1 polymorphisms with lipid metabolisms and insulin resistance: a case-control design of population-based cross-sectional study in Chinese Han population.

BACKGROUND: In our previous study, we had assessed in the Chinese Han population the association of KCNB1 rs1051295 with metabolic traits indicating metabolic syndrome, and showed that KCNB1 rs1051295 genotype TT was associated with increase of waist to hip ratio (WHR), fasting insulin (FINS), triglycerides (TG) and decreased insulin sensitivity at basal condition. Here, we aimed at detecting whether there were associations between other tag SNPs of KCNB1 and favorable or unfavorable metabolic traits. METHODS: We conducted a case-control design of population-based cross-sectional study to investigate the association between each of the 22 candidates tag SNPs of KCNB1 and metabolic traits in a population of 733 Chinese Han individuals. The association was assessed by multiple linear regression analysis or unconditional logistic regression analysis. RESULTS: We found that among the 22 selected tag SNPs, four were associated with an increase (rs3331, rs16994565) or decrease (rs237460, rs802950) in serum cholesterol levels; two of these (rs237460, rs802590) further associated or were associated with reduced serum LDL-cholesterol. Two novel tag SNPs (rs926672, rs1051295) were associated with increased serum TG levels. We also showed that KCNB1 rs926672 associated with insulin resistance by a case-control study, and two tag SNPs (rs2057077and rs4810952) of KCNB1 were associated with the measure of insulin resistance (HOMA-IR) in a cross-section study. CONCLUSION: These results indicate that KCNB1 is likely associated with metabolic traits that may either predispose or protect from progression to metabolic syndrome. This study provides initial evidence that the gene variants of KCNB1, encoding Kv2.1 channel, is associated with perturbation of lipid metabolism and insulin resistance in Chinese Han population.

Comparison of dry laser printer versus paper printer in full-field digital mammography.

BACKGROUND: Paper printers have been used to document radiological findings in some hospitals. It is critical to establish whether paper printers can achieve the same efficacy and quality as dry laser printers for full-field digital mammography (FFDM). PURPOSE: To compare the image quality and detection rate of dry laser printers and paper printers for FFDM. MATERIAL AND METHODS: Fifty-five cases (25 with single clustered microcalcifications and 30 controls) were selected by a radiologist not participating in the image review. All images were printed on film and paper by one experienced mammography technologist using the processing algorithm routinely used for our mammograms. Two radiologists evaluated hard copies from dry laser printers and paper printers for image quality and detectability of clustered microcalcifications. For the image quality comparisons, agreement between the reviewers was evaluated by means of kappa statistics. The significance of differences between both of the printers was determined using Wilcoxon's signed-rank test. The detection rate of two printing systems was evaluated using receiver operating characteristic (ROC) analysis. RESULTS: From 110 scores (55 patients, two readers) per printer system, the following quality results were achieved for dry laser printer images: 70 (63.6%) were rated as good and 40 (36.4%) as moderate. By contrast, for the paper printer images, 25 scores (22.7%) were rated as good and 85 (77.3%) as moderate. Therefore, the image quality of the dry laser printer was superior to that achieved by the paper printer (P=0.00). The average area-under-the-curve (Az) values for the dry laser printer and the paper printer were 0.991 and 0.805, respectively. The difference was 0.186. Results of ROC analysis showed significant difference in observer performance between the dry laser printer and paper printer (P=0.0015). CONCLUSION: The performance of dry laser printers is superior to that of paper printers. Paper printers should not be used in FFDM.

Epidemiology of schizophrenia and risk factors of schizophrenia-associated aggression from 2011 to 2015.

Objective To investigate the risk factors associated with aggression in patients with schizophrenia. Methods Patient clinical, behavioural, and demographic information was collected and reported online to the Beijing Mental Health Information Management System by psychiatrists. We used chi-square tests to analyse information between 2011 and 2015 to determine the prevalence and incidence of schizophrenia and the rate of aggression. We used univariate and binary logistic regression to analyse risk factors of aggressive behaviours. Results The prevalence and incidence of schizophrenia, and the proportion of cases displaying aggressive behaviour, increased considerably from 2011 to 2015. Risk of aggression was associated with non-adherence to medication (odds ratio [OR]: 2.92; 95% confidence intervals [CI]: 2.08-4.11), being unmarried (OR: 1.62; 95% CI: 1.03-2.55), having physical disease (OR: 3.26; 95% CI: 2.28-4.66), and higher positive symptom scores (OR: 2.01; 95% CI: 1.06-3.81). Physical disease was a risk factor associated with committing more than one type of aggression. Conclusion We confirmed that demographic factors, treatment-related factors, and clinical symptoms were associated with aggression in patients with schizophrenia in Beijing. A focus on improving controllable factors, including medication adherence and physical health status, might help to prevent aggressive behaviour.

Comparison of paroxetine and agomelatine in depressed type 2 diabetes mellitus patients: a double-blind, randomized, clinical trial.

BACKGROUND: Comorbid depression/anxiety in type 2 diabetes mellitus (DM) patients is highly prevalent, affecting both diabetes control and quality of life. However, the best treating method for depression/anxiety in type 2 DM patients is still unclear. This study was conducted to compare the efficacy of paroxetine and agomelatine on depression/anxiety and metabolic control of type 2 DM patients. METHODS: A total of 116 depressed, type 2 DM patients were recruited for 12 weeks treatment. Patients were randomly assigned to receive either paroxetine or agomelatine. Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale were used to assess depression and anxiety, respectively. Hemoglobin A1c, fasting plasma glucose, and body mass index were assessed at baseline and at the end of the trial. RESULTS: At the end of the trial, there were 34 (60.7%) responders and 22 (39.3%) remissions in paroxetine group; and 38 (63.3%) responders and 26 (43.3%) remissions in agomelatine group. Compared to paroxetine group, lower depression scores were observed in agomelatine group. Fasting plasma glucose and body mass index were not significantly different after 12 weeks treatment between the two groups, but agomelatine group had a significantly lower final hemoglobin A1c level compared to paroxetine group. The two antidepressants had comparable acceptability. CONCLUSION: These results showed that compared to paroxetine, agomelatine might have some advantages in treating symptoms of depression/anxiety and glycemic control in depressed type 2 DM patients. The clinical applicability of agomelatine shows greater promise and should be explored further. Limited by the relatively small samples, future studies are needed to verify and support our findings.

Prevalence of disability in an arsenic exposure area in Inner Mongolia, China.

UNLABELLED: Long term exposure to arsenic can cause adverse health effects and lead to different levels of disability. The prevalence of arsenical dermatosis is as high as 40% in the Hetao Plain area of Inner Mongolia, but the association between exposure to arsenic in drinking water and the occurrence of disability has not yet been fully examined. The aim of this study was to investigate the prevalence of disability in arsenic-affected villages in Inner Mongolia, China. METHODS: A cross-sectional study was performed to examine the prevalence of disability. A total of 320 villagers in the age range of 20-39 years were interviewed and examined for disability and arsenical skin lesions. The subjects were classified into a high arsenic group (50 microg L(-1)) and a low arsenic group (<50 microg L(-1)). The relationship between levels of arsenic in drinking water and disability was analyzed using multivariate logistic regression models to estimate the odds ratios and 95% confidence intervals. RESULTS: The prevalence of disability was 6.88% in the arsenic affected area of Inner Mongolia and 24.72% in the arsenic group 50 microg L(-1). A strong correlation was found between disability and arsenical skin lesions (OR=86.39, 95%CI: 25.45-293.20). CONCLUSION: This suggests that the level of arsenic exposure is a major risk factor for disability. Further research is needed to place the results in a wider context and to determine the exact relationship between arsenic exposure and disability.