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1.
Asian J Psychiatr ; 61: 102680, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34000499

RESUMO

INTRODUCTION: Negative symptoms are associated with poor outcomes and functioning. Latent structure of negative symptoms is important for identifying potential intervention targets for novel treatments. Self-report instruments have been developed to measure negative symptoms. Previous findings on latent structure of negative symptoms are inconsistently and mainly rely on clinician-rated instruments. METHOD: We aimed to explore the latent structure of the Self-Evaluation of Negative Symptoms Scale (SNS) in 204 clinically-stable outpatients with schizophrenia. Confirmatory factor analysis (CFA) was used to compare the competing models (i.e., one-factor, two-factor and five-factor models), and estimated goodness-of-fit indexes. Other clinician-rated scales for psychopathology and medication side-effects were also collected. RESULTS: The CFA found the five-factor model performing best, with a comparative fit index (CFI) of > 0.95, a Tucker Lewis Index (TLI) of > 0.95, and a root mean square error of approximation (RMSEA) of < 0.06. The robust chi-square difference test for the weighted least squares with mean and variance adjusted estimation (WLSMV) also indicated a significant better fit for the five-factor model. DISCUSSION: Our preliminary findings support a five-factor latent structure of self-report negative symptoms in schizophrenia patients. Further research in this area should utilize multiple clinician-rated and self-report measures, and recruit large and homogeneous samples with schizophrenia.


Assuntos
Esquizofrenia , Análise Fatorial , Humanos , Psicometria , Reprodutibilidade dos Testes , Esquizofrenia/diagnóstico , Esquizofrenia/tratamento farmacológico , Autorrelato
2.
Eur Arch Psychiatry Clin Neurosci ; 271(8): 1503-1511, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33594521

RESUMO

Prospective memory (PM) refers to the ability to remember to carry out a delayed intention in the future. Evidence suggests that emotionally salient cues can enhance PM functions in healthy population, but whether the benefit exists in schizophrenia and bipolar patients remains unclear. This study aimed to examine and compare the potential enhancement effect of emotional PM cues in schizophrenia patients and bipolar patients. Twenty-eight clinically stable schizophrenia participants, 26 euthymic bipolar participants and 29 controls completed a computerized PM task involving PM cues with different types of valences (i.e., positive, neutral and negative). All the three groups showed better PM performance when negative PM cues were presented compared with positive and neutral PM cues. The sizes of the enhancement effects of negative PM cues were large (all Cohen's d ≥ 1.00) and comparable across three groups. Our findings suggested that patients with schizophrenia and bipolar disorders could benefit from negative PM cues to an extent similar to healthy individuals, thus extended the notion of psychosis continuum to the important area of emotion-cognition interaction.

3.
Intern Med J ; 50 Suppl 3: 6-14, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32985093

RESUMO

Aripiprazole, a dopamine partial agonist, is a second-generation anti-psychotic that is widely used for the treatment of schizophrenia and other psychotic disorders. A group of psychiatric experts in Hong Kong developed a set of consensus statements, aiming to facilitate the understanding of clinical properties and usages of aripiprazole among local physicians. Of note, because aripiprazole long-acting injectable has been available locally not long before the establishment of the consensus panel, which limited the discussion on its use in the local context, the consensus statements were focused primarily on oral aripiprazole. To draft the consensus statements, the panellists discussed the published evidence and their clinical experience regarding aripiprazole in a series of meetings based on several areas. At the final meeting, each drafted statement was voted on anonymously by all panellists based on its practicability of recommendation in Hong Kong. A set of consensus statements on the characteristics and clinical use of aripiprazole was established and accepted by the panel. These statements serve to provide a practical reference for physicians in Hong Kong, and possibly other parts of the Asia-Pacific region, on the use of aripiprazole in people with schizophrenia spectrum disorders and other psychotic problems.


Assuntos
Antipsicóticos/uso terapêutico , Aripiprazol/uso terapêutico , Esquizofrenia/tratamento farmacológico , Consenso , Hong Kong , Humanos , Esquizofrenia/diagnóstico
4.
Cogn Neuropsychiatry ; 25(2): 126-138, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31856651

RESUMO

Introduction: Evidence suggests that schizophrenia patients have olfactory dysfunctions, but the relationship between olfactory identification, hedonic judgement, and negative symptomatology remains unclear. Few studies have investigated whether co-activation of pleasant and unpleasant emotions are more prevalent in schizophrenia patients.Methods: Thirty schizophrenia outpatients with prominent negative symptoms (PNS), 30 outpatients without PNS, and 30 controls completed the University of Pennsylvania Smell Identification Test, and were asked to identify the odourants and to rate their emotions. The effects of gender and medications on olfactory function were examined.Results: Schizophrenia patients exhibited olfactory identification impairments, even after accounting for gender and medication effects. Patients with PNS demonstrated larger magnitude of deficit than those without. Patients with PNS reported less pleasure to positive-valenced odourants, and less unpleasantness to negative-valenced odourants than controls. Olfactory anhedonia in patients with PNS disappeared after controlling for medication effect. Schizophrenia patients do not exhibit affective ambivalence in olfaction.Conclusions: Schizophrenia patients with PNS exhibit deficits in olfactory identification and hedonic judgement, even after controlling for gender and medication effects. Our findings support the close relationship between olfactory dysfunctions and negative symptoms. Further studies should investigate the effect of dopamine-blocking agents on the olfactory hedonic judgment in schizophrenia patients.


Assuntos
Anedonia/fisiologia , Julgamento/fisiologia , Transtornos do Olfato/fisiopatologia , Transtornos do Olfato/psicologia , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Adulto , Emoções/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Odorantes/análise , Transtornos do Olfato/diagnóstico , Esquizofrenia/diagnóstico , Olfato/fisiologia
5.
Schizophr Bull ; 44(1): 137-146, 2018 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-28531307

RESUMO

The ability to follow spoken instructions is important to everyday functioning but has seldom been studied in patients with schizophrenia (SZ). Recent evidence suggests that action-based processing may facilitate the ability to follow instructions, which relies largely on working memory. In this study, we tested the hypothesis that SZ patients may also benefit from action-based advantages in following instructions. Forty-eight clinically stable SZ patients and 48 demographic- and IQ-matched controls completed a following spoken instruction span task involving varied encoding and recall conditions. While SZ patients were impaired in the overall performance of following spoken instructions, this deficit could be attributed to working memory impairment. More importantly, SZ patients showed action-based advantages both at the encoding and retrieval stage to the same extent as healthy controls. Specifically, both healthy controls and SZ patients showed improved memory performance when they additionally performed the actions, or watched the experimenter carrying out the actions compared with simply listening to spoken instructions during the encoding stage. During the retrieval stage, memory was improved when they recalled the instructions by physical enactment compared with oral repetition. The present study provides the first empirical evidence for the impairment in the ability to follow instructions in SZ. We have shown that involving action-based processing in the encoding and retrieval stage facilitated memory of instructions, indicating that the enactment advantage in working memory also applies to SZ patients. These findings provide useful insights for clinical interventions and cognitive remediation for SZ patients.


Assuntos
Disfunção Cognitiva/fisiopatologia , Memória de Curto Prazo/fisiologia , Rememoração Mental/fisiologia , Desempenho Psicomotor/fisiologia , Esquizofrenia/fisiopatologia , Percepção da Fala/fisiologia , Adulto , Disfunção Cognitiva/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/complicações
6.
Hong Kong Med J ; 13(1): 73-4, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17277396

RESUMO

We present a case report of a 22-year-old Chinese man with schizophrenia and dissocial personality disorder who was normoglycaemic before taking olanzapine. After commencing olanzapine he developed diabetic ketoacidosis and was managed in the intensive care unit of a general hospital. Olanzapine was stopped and replaced by haloperidol 5 mg/day. He was put on a strict 1500 kcal diabetic diet and required insulin injections to maintain a normal blood sugar level despite cessation of olanzapine for 4 months. Doctors prescribing olanzapine should be aware of the risk of diabetes mellitus. Baseline and regular monitoring of body weight, body mass index, and fasting blood glucose are essential to prevent serious consequences.


Assuntos
Antipsicóticos/efeitos adversos , Cetoacidose Diabética/induzido quimicamente , Adulto , Antipsicóticos/administração & dosagem , Benzodiazepinas/administração & dosagem , Benzodiazepinas/efeitos adversos , Cetoacidose Diabética/terapia , Dieta para Diabéticos , Hong Kong , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Masculino , Olanzapina , Esquizofrenia/tratamento farmacológico
7.
N Engl J Med ; 354(5): 472-82, 2006 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-16452559

RESUMO

BACKGROUND: The treatment of schizophrenia with multiple antipsychotic drugs is common, but the benefits and risks are not known. METHODS: In a randomized, double-blind study, we evaluated patients with schizophrenia and a poor response to treatment with clozapine. The patients continued to take clozapine and were randomly assigned to receive eight weeks of daily augmentation with 3 mg of risperidone or with placebo. This course of treatment was followed by an optional 18 weeks of augmentation with risperidone. The primary outcome was reduction in the total score for severity of symptoms on the Positive and Negative Syndrome Scale (PANSS). The secondary outcomes included cognitive functioning. RESULTS: A total of 68 patients were randomly assigned to treatment. In the double-blind phase, the mean total score for the severity of symptoms decreased from baseline to eight weeks in both the risperidone and the placebo groups. There was no statistically significant difference in symptomatic benefit between augmentation with risperidone and placebo: 9 of 34 patients receiving placebo and 6 of 34 receiving risperidone responded to treatment (P=0.38). The mean difference in the change in PANSS scores from baseline to eight weeks between those receiving risperidone and those receiving placebo was 0.1 (95 percent confidence interval, -7.3 to 7.0). The verbal working-memory index showed a small decline in the risperidone group and a small improvement in the placebo group (P=0.02 for the comparison between the two groups in the change from baseline). The increase in fasting blood glucose levels was mildly greater in the risperidone group than in the placebo group (16.2 vs. 1.8 mg per deciliter [0.90 vs. 0.10 mmol per liter], P=0.04). The incidence and severity of other side effects did not differ between the two groups. CONCLUSIONS: In this short-term study, the addition of risperidone to clozapine did not improve symptoms in patients with severe schizophrenia. (ClinicalTrials.gov number, NCT00272584).


Assuntos
Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Risperidona/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Antipsicóticos/efeitos adversos , Clozapina/efeitos adversos , Cognição/efeitos dos fármacos , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Risperidona/efeitos adversos , Psicologia do Esquizofrênico , Falha de Tratamento
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