Comparison of the Effectiveness of Two Cognitive-Behavioral Group Therapy Programs for Schizophrenia: Results of a Short-Term Randomized Control Trial.

This study aimed to compare the effectiveness of two different cognitive-behavioural therapy programs in patients with schizophrenia and clarify which techniques are more effective on psychotic symptoms. With this purpose, 39 schizophrenia outpatients-assessed by independent assessors using Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms and by researchers using Psychotic Symptoms Rating Scales-were randomly assigned to routine care (RC), RC plus COPE-CBT or RC plus CBT groups. The repeated measures ANOVA results show that there was a significant reduction in the severity and frequency of hallucinations in CBT group and delusions in COPE-CBT group. Both CBT programs were found to be superior to RC group on some measures at post-treatment, as well as 3 months follow-up.

Executive function and genetic loading in nonpsychotic relatives of schizophrenia patients.

Executive functions meet the "endophenotype candidate" criteria in neuropsychological measures for schizophrenic patients. To determine which area of executive functioning has the greatest value in differentiating the so called "candidate endophenotype" of schizophrenia through comparing the effect sizes of four commonly used executive function tests. A Wisconsin Card Sorting Test, a Stroop Test, a Trail Making Test and a Verbal Fluency Test were used to evaluate executive function in two study groups: healthy relatives of schizophrenia patients from simplex and multiplex families and a healthy control group. In all four tests, study groups performed poorly in contrast to the control group. In the B time, A error and B error results of the Trail Making Test, the multiplex group performed poorly compared to the simplex group; control group did better than both study groups. Our findings support that the presence of a schizophrenia patient in a family predicts worse performance on executive function tests in a group of healthy relatives of that individual. The results of our study suggest that the Trail Making Test in particular may signify a stronger endophenotypic trait.

Lifetime hypomanic symptoms in remitted patients with schizophrenia and other psychotic disorders.

BACKGROUND: Clinical, genetic and neuroimaging studies indicated strong evidence against traditional diagnostic separation of bipolar disorder from schizophrenia. In this study, we aimed to evaluate hypomanic symptoms and influence on general functioning among psychotic patients. SUBJECTS AND METHODS: Patients with schizophrenia and other psychotic disorders were assessed between June and September 2010. Positive and Negative Symptom Scale (PANSS), Hypomania Check List-32 (HCL-32), Mood Disorders Questionnaire (MDQ) and General Assessment of Functioning Scale (GAS) were applied to all 93 patients. Answers of self-rating scales were confirmed with hospital records. RESULTS: Mean age was 35.7 ± 9.5 years, mean age of onset was 20.3 ± 5.3 years and duration of illness was 15.4 ± 9.2 years. 30.1% of the patients, had a history of mood stabilizer treatment taken at least one month while one five of the patients had different psychiatric diagnosis other than current diagnosis. 26.9% of the patients with psychotic disorders had positive scores on both MDQ and HCL-32 but there were no significant difference between patients in terms of general functioning (p = 0.82). CONCLUSIONS: As reported in this study, there is no simple, clear-cut between schizophrenia and bipolar affective disorder.

Detection of subclinical atherosclerosis and diastolic dysfunction in patients with schizophrenia.

BACKGROUND: Patients with schizophrenia have a higher risk for cardiovascular diseases, which is associated with early mortality compared with the nonschizophrenic population. Early diagnosis of cardiovascular diseases in asymptomatic periods in patients with schizophrenia would enhance their quality of life and reduce mortality. Echocardiography, carotid ultrasonography, and ankle brachial index (ABI) measurement are known to be beneficial methods of detecting subclinical cardiovascular diseases and of risk stratification. The present study investigated carotid intima media thickness (CIMT) and ABI and echocardiographic parameters measured via conventional and tissue Doppler echocardiography in patients with schizophrenia in comparison with a control group. METHODS: The present case-control study included 116 patients with schizophrenia and 88 healthy patients. Participants with any current comorbid psychiatric disorder, current or lifetime neurological and medical problems, current coronary artery disease, diabetes, hypertension, hypothyroidism, or hyperthyroidism or who were using antihypertensives, antidiabetic agents, or antiobesity drugs were excluded. High-resolution B-mode ultrasound images were used to measure CIMT. Conventional and tissue Doppler measurements were performed according to the recommendations of the American Society of Echocardiography. RESULTS: Low ABI, mitral ratio of the early (E) to late (A) ventricular filling velocities, septal E', septal S', lateral E', lateral S', septal E'/septal A', lateral E'/lateral A', and high septal A', mitral E/septal E', mitral E/lateral E', and CIMT values were observed in the schizophrenia group compared with the control group. CONCLUSION: Doppler parameters supported the hypothesis that patients with schizophrenia are at high risk for cardiovascular diseases.

Dissociative symptoms and dissociative disorder comorbidity in patients with obsessive-compulsive disorder.

The present study attempted to assess the dissociative symptoms and overall dissociative disorder comorbidity in patients with obsessive-compulsive disorder (OCD). In addition, we examined the relationship between the severity of obsessive-compulsive symptoms and dissociative symptoms. All patients admitted for the first time to the psychiatric outpatient unit were included in the study. Seventy-eight patients had been diagnosed as having OCD during the 2-year study period. Patients had to meet the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD. Most (76.9%; n = 60) of the patients were female, and 23.1% (n = 18) of the patients were male. Dissociation Questionnaire was used to measure dissociative symptoms. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Dissociative Disorders interviews and Yale-Brown Obsessive Compulsive Checklist and Severity Scale were used. Eleven (14%) of the patients with OCD had comorbid dissociative disorder. The most prevalent disorder in our study was dissociative depersonalization disorder. Dissociative amnesia and dissociative identity disorder were common as well. The mean Yale-Brown score was 23.37 ± 7.27 points. Dissociation Questionnaire scores were between 0.40 and 3.87 points, and the mean was 2.23 ± 0.76 points. There was a statistically significant positive correlation between Yale-Brown points and Dissociation Questionnaire points. We conclude that dissociative symptoms among patients with OCD should alert clinicians for the presence of a chronic and complex dissociative disorder. Clinicians may overlook an underlying dissociative process in patients who have severe symptoms of OCD. However, a lack of adequate response to cognitive-behavioral and drug therapy may be a consequence of dissociative process.