Hand functions in patients with schizophrenia: A clinical comparison with bipolar disorder and healthy subjects.

OBJECTIVE: Failure to achieve expected level of motor functioning may be a significant contributor to social withdrawal and further attenuation of life quality in patients with schizophrenia. Hand functioning is one of the most crucial entities in that manner. This study aimed to reveal this question by means of comparing patients with schizophrenia and bipolar disorder who are receiving similar antipsychotic psychopharmacological agents along with healthy control subjects. METHODS: 99 patients with schizophrenia were compared to 40 patients with bipolar disorder matched according to the received pharmacotherapy comprising similar antipsychotics and 81 medication-free socio-demographically matched healthy control subjects. The materials were Hand Functional Index (HFI), Duruoz Hand Index (DHI), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS) along with clinical characteristics. RESULTS: Difference in total scores of DHI and HFI between schizophrenia, bipolar disorder and control groups were extremely significant (p < 0.001). Further post-hoc subgroup analysis revealed that patients with schizophrenia demonstrated higher scores of HFI indicating worse performance when compared to both bipolar disorder and control group. Significantly higher scores of DHI in patients with schizophrenia than healthy controls were noted. CONCLUSION: Independent from the impact of the medication use, impairment in hand functions was found to be more frequently seen in schizophrenia when compared to patients with bipolar disorder and healthy subjects. It is evident that hand function impairment is seen independent from psychopharmacological side effect, and is recommended to be assessed as a possible preventable and retractable manifestation of schizophrenia.

Thyroid status in lithium-treated bipolar disorder patients: An one-year follow-up study / Estudio de un año de seguimiento del estado de la tiroides en pacientes con trastorno bipolar tratados con litio

Objective In this follow-up study, the hormonal changes were determined in bipolar euthyroid patients who were treated with lithium for the duration of one year. Method For the study, 23 bipolar I disorder patients without any axis I co-morbidity were consecutively selected and followed up for one year. All patients were compared with 25 age- and sex-matched healthy controls in terms of thyroid hormone levels and thyroid volumes. The Sociodemographic and Clinical Characteristics Data Form, Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I and SCID-I/NP) were administered. Initial thyroid hormone levels and thyroid volumes were measured in the patients and controls. Patient and control groups were compared at baseline for thyroid volumes. Patients' lithium levels were measured at baseline, they were re-examined at six months for thyroid hormones, and at the first year for thyroid hormones and lithium levels. Results Thyroid hormone levels changed in no patients during the follow-up period. Thyroid hormone levels were measured within the normal range. No correlation was found between the final TSH levels and duration of illness, duration of lithium treatment, initial thyroid volumes, and the initial TSH levels. Conclusions Lithium can safely be used in bipolar patients who were already receiving this treatment before and not developed any thyroid problem for a substantial period.

En este estudio de seguimiento se determinarán los cambios hormonales que se producen en pacientes eutiroideos con trastorno bipolar en tratamiento con litio durante un periodo de un año. Método Para el estudio se seleccionaron de forma consecutiva 23 pacientes con trastorno bipolar tipo I sin prevalencia concomitante de otros trastornos del eje I, y fueron seguidos durante un año. En todos los pacientes se compararon los niveles de las hormonas tiroideas y el volumen de la glándula tiroides con las del grupo control sano pareado por sexo y compuesto de sujetos de 25 años de edad. La evaluación se hizo por medio de: una hoja de datos de las características sociodemográficas y clínicas, la Escala de Valoración de Hamilton para la Evaluación de la Depresión (HDRS), la Escala de Young para la Evaluación de la Manía (YMRS), Entrevistas clínicas estructuradas para los trastornos del eje I del DSM-IV (SCID-I y SCID-I/NP). A los pacientes y al grupo control se les midieron los niveles iniciales de las hormonas tiroideas y el volumen de la glándula tiroides, a la vez que se les comparó la línea base del volumen de la glándula tiroides. Al inicio del estudio se determinó la línea base de los niveles de litio en los pacientes. Al sexto mes, se reexaminaron las hormonas tiroideas y, al cabo del primer año, los niveles hormonales tiroideos y de litio. Resultados Los niveles de las hormonas tiroideas no sufrieron cambios en ningún paciente durante todo el seguimiento. Dichos niveles se midieron dentro de los intervalos normales. No se detectó ninguna correlación entre los niveles de TSH y la duración de la enfermedad, ni con la duración del tratamiento con litio, ni entre los volúmenes iniciales de las glándulas tiroideas con los niveles iniciales de TSH. Conclusión El litio puede administrarse con seguridad en pacientes bipolares que se hayan sometido antes a este tratamiento, y a los cuales no les produzca problemas tiroideos durante un periodo significativo de tiempo.