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Impairment of insight is considered as the hallmark of schizophrenia. Insight is a multidimensional and dynamic construct which appears to have intricate links with other symptom dimensions of the psychotic illness. A better appreciation of insight in psychosis could help us in gaining knowledge about etiology, prognosis and treatment-related facets of the disorder. This paper reviews researches on insight of schizophrenia. It focuses on the biological basis, assessment methods of insight, influencing factors and treatment methods. And outlook on future research direction.
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Objective:By analyzing the norm data results of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-Ⅳ) in China,to prove the validity of the procedure and methods during the norming development.Methods:The whole process of the revision of WAIS-Ⅳ,the development of computer-assisted system and norm sampling plan,were introduced in more detail,and the distribution of actual norm data of 1757 cases was analyzed.Results:For area distribution,compared with planned sampling number,the number from North and Northeast China was statistically significant different (x2 =78.02,P ＜0.01).For age stages distribution,most of cases conformed to the requirements of sampling,except that some cases including high-level educational cases aged 16-17 years and above 65 years,and low-level educational cases aged 30-34 years were less than the planned sampling number.For gender distribution,male subjects were more,but there was no statistically significant difference between male and female subjects (x2 =228,P =0.131).For educational degree distribution,the sampling conformed to the requirements of sampling plan (x2 =2.74,P =0.603).For occupation,resident years and registered permanent residence,and the sample was basically representative.Conclusion:The process of the revision of the Chinese version of WAIS-Ⅳ is appropriate,and actual norm sampling basically conforms to planned sample distribution,providing the sufficient representativeness and reliability for national norm data of WAIS-Ⅳ.
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Objective:To compare the results of two different measures assessing prospective memory (PM) in elderly schizophrenia,and explore their diagnostic validity.Methods:Fifty patients who were diagnosed as schiz-ophrenia according to the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ)and 50 normal elderly people were enrolled in the study.Laboratory paradigm prospective memory task and the Chinese version of the Cambridge prospective memory Test (C-CAMPROMPT)were administered to measure thelevel of EBPM and TBPM.The Wechsler Adult Intelligence Scale-Fourth Edition,Continuous Performance Test-I-dentical Pairs were used to evaluate IQ and attention.Results:Whether in the laboratory paradigm or C-CAM-PROMPT,schizophrenia group performed worse than normal controls on PM total scores[7(0,16)vs.12(0,16),14 (4,34)vs.25(11,36)],EBPM[3(0,8)vs.6(0,8),7(2,16)vs.14(4,18)]and TBPM [3(0,8)vs.6(0,8),6(2,18) vs.12(4,18)],and patients had comparable performances in PM subtypes[-1.0(-2.2,1.0)vs. -1.0(-2.1, 0.8),-1.9(-3.4,0.8)vs. -1.8(-2.9,1.6)].In the C-CAMPROMPT,the scores of EBPM and TBPM were negatively related to age(r=-0.36 --0.40,P<0.001 ),but there was no significant relationship between PM performance and age in the laboratory paradigm task.The area under ROC curve of the laboratory paradigm and C-CAMPROMPT were 0.73 and 0.85.While 8 and 19 as the cut off value,the sensitivity were 0.60 and 0.74,and the specificity were 0.76 and 0.90,respectively.Conclusion:The two measures have confirmed that the elderly schizophrenia have comparable performances in EBPM and TBPM.Both the C-CAMPROMPT and the laboratory paradigm have moderate level of diagnostic validity,but the former is slightly higher and more susceptible to aging.
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Objectives To compare prospective memory (PM) deficits with retrospective memory (RM) deficits and to explore the correlation between PM and RM in chronic schizophrenia. Methods Fifty chronic schizophrenia pa?tients and fifty healthy controls were recruited. The PM performance [event-based PM (EBPM) and time-based PM (TB?PM)] were evaluated by the Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT); working memory (WM) was evaluated by the digital span subtest (DS);immediate auditory logical memory (IALM), delayed audito?ry logical memory (DALM), immediate visual reproduction memory (IVRM) and delayed visual reproduction memory (DVRM) were evaluated by the logical memory and visual reproduction subtest. The score of each test was transformed to comparable standard score. Results Patients performed significantly worse on EBPM [(7.9 ± 3.4) vs. (13.7 ± 2.9)], TBPM [(6.9±3.6) vs. (13.0±3.2)], DS [sequence:(5.8±2.0) vs. (7.5±2.2);backward:(6.5±1.9) vs. (8.2±2.8)], IALM [(8.3±3.1) vs. (11.9 ± 2.5)], DALM [(7.4 ± 3.7) vs. (11.8 ± 2.6)], IVRM [(8.0 ± 2.7) vs. (11.2 ± 3.8)], and DVRM [(7.7 ± 3.5) vs. (10.8 ± 2.7)] scores than controls (P0.05). The performance of PM in chronic schizophrenia was significantly related to DS (sequence and backward), IALM, DALM and DVRM (P<0.05), but not IVRM (P=0.155). Conclusion:There are greater prospective memory deficits than retrospective memory deficits in chron?ic schizophrenia and the prospective memory deficits are correlated with the retrospective memory deficits in chronic schizophrenia.
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Objective To explore the reliability and validity of the computerized Chinese version of Cambridge Prospective Memory Test (C-CAMPROMPT) for assessment of prospective memory (PM) in chronic schizophrenia patients. Methods 50 patients and 50 healthy controls formed the study sample. PM performance was measured with computerized C-CAMPROMPT, while the Wechsler Adult Memory Scale-Forth Edition (WMS-IV), Wisconsin Card Sorting Test (WCST) and Category Fluency Test (CFT) were administered to assess logical memory (LM), visual representation (VR), executive function and processing speed. Results The test-retest reliability (0.981, P<0.001), split half reliability (0.627, P<0.001) and internal consistency reliability (0.742) of C-CAMPROMPT were satisfied. The scores of C-CAM-PROMPT and its subtest in schizophrenia were lower than that in healthy control (P<0.001). The performance of PM in patients with schizo-phrenia closely related to the scores of LM, VR, WCST-CC and CFT (r=0.34~0.89, P<0.05). The sensitivity (86%) and specificity (92%) of the scale were satisfied. Factor analysis extracted 2 factors. Conclusion The computerized C-CAMPROMPT shows a good reliability and validity for assessment of PM function in chronic schizophrenia, and is a sensitive, adaptable, stable instrument.
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Objective To explore the relationship between prospective memory (PM), retrospective memory (RM) and social function in old patients with schizophrenia. Methods 54 old patients with schizophrenia and 54 healthy controls were evaluated with logical memory (LM)IQ, LMIIQ of Wechsler Memory Scale-Fourth Edition (WMS-IV), Chinese Cambridge Prospective Memory Test (C-CAMPROMPT), University of California at San Diego (UCSD) Performance-based Skills Assessment-brief (UPSA-B), and Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Results The scores of LMIQ, LMIIQ, event-based prospective memory (EBPM), time-based prospective memory (TBPM), IQ, and UPSA-B were poorer in the patients than in the controls (P<0.001). The score of UPSA-B was positively correlat-ed with LMIQ (r=0.524, P<0.001), LMIIQ (r=0.427, P<0.001), EBPM (r=0.437, P<0.001), TBPM (r=0.479, P<0.001) and IQ (r=0.709, P<0.001). Linear regression analysis indicated that TBPM (β=0.811, P=0.007), IQ (β=0.610, P<0.001) were contributing factors for the score of UPSA-B. Conclusion Schizophrenics may complicate the impairment of PM and RM, and the former may be independent fluence to their social function.
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Objective: To develop the mental health knowledge questionnaire in order to know about the awareness of mental health knowledge in non-psychiatric clinicians. Methods: A sample of the 641 non-psychiatric clinicians from 2 tertiary general hospitals, 2 second-class general hospitals, and 1 community hospital were used for item analysis and internal consistency test; 38 cases were selected for the re-test interval of 2 weeks to test the test-retest reliability. And totally 99 psychiatrists finished the survey as controls. The awareness rates between the non-psychiatric and psychliatric clinicians were compared. Results: The questionnaire included 46 items and consis-ted of 6 subscales, involving anxiety, schizophrenia, depression, dyssomnia and psychological counseling, or-ganic brain disorder, and recognition for mental health service situation in general hospital The results of confirma-tory factor analysis showed that the ratio of chi-square and degree of freedom was below 3. The fitting indexes except GFI and AGFI were more than 0.90. The Cronbach's alpha coefficients ranged from 0.73 to 0.89, and test-retest Pearson correlation coefficient of reliabifity ranged from 0.59 to 0.78. Awareness rate was 47.6% in general hospital and 90.9% in psychiatric hospitals. Conclusion: The mental health knowledge questionnaire has good psychometric properties and may be applied in clinical studies.
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Objective To explore cognitive change in schizophrenic patients with concomitant metabolism syndrome,and to provide theory basis for early intervention and treatment.Methods According to inclusion standard,56 schizophrenic inpatients with metabolism syndrome and 56 schizophrenic inpatients without metabolism syndrome were included.The matrics consensus cognitive battery(MCCB),stroop test,digit span,UPSA-B were used to assess the cognitive function.Results There were significant differences for test scores of symbol coding subtest,verbal memory subtest,digit sequence subtest,Maze subtest,continue performance among MCCB between schizophrenic patients with and without metabolism syndrome(27.07±10.46 vs 32.18±12.12,16.04±5.07 vs18.71±6.02,13.39±5.18 vs 15.79±5.48,1.38±0.66 vs 1.7±0.68,all P＜0.05),as well as stroop test and digit span test(31.14±11.68 vs 36.57±13.32,13.77±3.64 vs 15.82±4.38,P＜0.05 for both).Conclusion The schizophrenic patients with metabolism syndrome have severer cognitive impairment than those without metabolism syndrome.
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Objective To explore the effect of relaxation response on mental health in physically heath subjects.Methods The literatures on relaxation response published in recent 20 years were searched.Those using Symptom Checklist 90(SCL-90)and meeting inclusive criteria were analyzed with meta analysis.Results Nine literatures including 975 subjects were enrolled.The mean weight change(WMD)of SCL-90 Was 0.10 to 0.24.In overall effect test, Z value was 3.64 to 9.64(all P＜0.05).Conclusion Relaxation response may help to improve mental health of Chinese population.
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The psychological and psychiatric impact of great natural disasters are beginning to be understood leading to new methods of prevention, intervention and mitigation. There is limited data from the Asian continent, however, which has been the location of some of the greatest disasters of recent times. In this paper, we outline the psychosocial intervention efforts from nine Asian nations when confronted with large-scale natural catastrophic events. These include reports from situations where local services have some capacity to respond as well as those where services are destroyed or overwhelmed. From this it is possible to draw some general principles of psychosocial disaster intervention: (1) Assessment of disaster, extant service systems and incoming resources. (2) Assessment of help-seeking pathways and cultural models of illness. (3) Facilitation and support for family reunion, identification of the dead and cultural and religious practices to address death and grief. (4) Foster and bolster community group activities where possible. (5) Psychosocial training of community, aid and health workers using a train the trainer model to promote case identification, psychoeducation and intervention, with specific emphasis on vulnerable groups, especially children. (6) Promote general community psychoeducation. (7) Train medical and health staff in basic psychiatric and psychological assessment and intervention for post-traumatic stress, mood and anxiety disorders. (8) Minimise risk factors for psychiatric morbidity such as displacement and loss of gainful activity. (9) Reshape mental health systems recognising the long-term psychiatric sequelae of disaster. The collective learnt experience from Asian natural disasters may be constructively used to plan strategies to respond appropriately to the psychosocial consequences of disaster both within Asia and in the rest of the world.
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Objective:To explore the central mechanism of working memory impairments experienced by patients with schizophrenia.Methods:Using block-design,ten normal and twenty patients with schizophrenia perform digital recognition(remember two or five digitals simultaneous and make judgment about whether the digital presented latter is that appeared before)and direction judgment of arrows(toward to left or right)while proceeding blood-oxygen level dependent contrast functional magnetic resonance imaging(BOLD-fMRI).Results:On the condition of same cognitive load,abnormal activation of basal ganglia occurred in schizophrenics.Comparing to normal control,patients with schizophrenia exhibited a tendency of more activation in dorsolateral prefrontal cortex.Conclusion:Abnormal activity of basal ganglia and dorsolateral prefrontal cortex may be the critical cause of working memory deficit experienced by patients with schizophrenia.
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Objective:to compare traditional method of applying clinical memory scale with computerized multimedia method.Method:50 volunteers were tested with the two methods in a random sequence.Result:there was no difference in MQ(memory quotation) and results of 5 subscales got by the two methods.Conclusion:results of computerized multimedia applying of clinical memory test are consistent with that got by the traditional way.
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Objective:To explore the utility of psychiatric service of clients having online counseling for anxiety or depression. Methods:The anxiety group was consisted of clients (n=107) who were positive in the Self-rating Anxiety Scale (SAS) online, similarly the depression group was consisted of clients (n=102) with positive results in Self-rating Depression Scale (SDS) online screening. Both groups were investigated with the questionnaires include issues related to the clinical features, diagnostic categories and treatment vs professional advice on clients. Results:In the anxiety group (male 69/female 38), the average age was 28+8, 88(82.2%) with more than 15 years education. In the depression group (male 57 vs. female 45), the average age was 29+8, 81(79.4%) with more than 15 years education. None was illiterate. For the age, sex, education and occupation, there was no significant difference between the two groups. 81(79.4%) clients in the anxiety group and 89(87.2%) clients in the depression group were advised to visit psychiatrists or psychologists. A few were advised to counseling online only and there was no significant difference between the two groups. The main diagnoses were mood disorders, neurosis and psychogenic disorders. Actually, 29(27.1%) in the anxiety group were treated with anxiolitics, 31(30.2%) in the depression group were treated with antidepressants at local clinics. Conclusion:Most of the clients should visit psychiatrists or psychologists, and a few may have their psychological counseling online only. Health education and psychological counseling online may be helpful to improve the rate of diagnosis and treatment of mental disorders in local clinics.
