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1.
Zhonghua Yi Xue Za Zhi ; 100(5): 351-356, 2020 Feb 11.
Artigo em Chinês | MEDLINE | ID: mdl-32074778

RESUMO

Objective: To clarify the effect of cognitive impairment on social function and quality of life of chronic schizophrenia, and provide clinical cognitive strategies for improving the social function and quality of life of patients with schizophrenia. Methods: Atotal of 158 patients with chronic schizophrenia were selected from May 2017 to October 2017 in the Psychiatry Department of the Third Affiliated Hospital of Sun Yat-sen University received psychological assessments, such as, MATRICS Consensus Cognitive Battery(MCCB), the Brief Psychiatric Rating Scale(BPRS), the Personal and Social Performance scale(PSP), and Schizophrenia Quality of Life Scale(SQLS). We further explored the effects of neurocognitive and social cognitive functions on their individual and social performance and quality of life in patients with schizophrenia. Results: (1) The scores of SQLS in the group with impaired social cognitive function were higher than those with good social function(101±46 vs 76±40, P=0.002). (2) The digital sequence and continuous performance test of the socially functional group were higher than the defect group. (3) There was a significant correlation between the years of education(R(2)=0.334, F=25.542), continuous performance (R(2)=0.316, F=35.647), BPRS (R(2)=0.280, F=60.386) and social function (P<0.001). (4) BPRS (R(2)=0.486, F=228.28), and emotional management (MSCEIT) (R(2)=0.510, F=124.789), education (R(2)=0.531, F=90.161), age (R(2)=0.539, F=69.644) significantly affected the SQLS score of patients with schizophrenia(P<0.001). Conclusion: The social function and quality of life of patients with schizophrenia are significantly correlated with their years of education and disease severity. Continuous performance in neurocognition significantly affects the social function of patients with schizophrenia, and emotional management in social cognition significantly affects their quality of life. Socially functional schizophrenia patients have higher digital sequences (working memory) and continuous performance (attention/alertness) scores.


Assuntos
Transtornos Cognitivos , Esquizofrenia , Cognição , Transtornos Cognitivos/complicações , Humanos , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Esquizofrenia/complicações
2.
Nervenarzt ; 91(1): 2-9, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31559478

RESUMO

Cognitive disorders in schizophrenia are highly correlated with the psychosocial level (e.g. relationships, quality of life and work). It has been shown that healthy relatives and people at ultrahigh risk also display cognitive dysfunctions albeit to a lesser degree. The cognitive impairment increases simultaneously with an acute phase and then reverts back to baseline levels. At the psychopathological level, negative symptoms and the disorganization syndrome show the strongest associations with cognitive deficits, whereby the extent of manifestation of deficits increases with increasing symptomatology. Cognitive remediation can improve the cognitive performance through training with small to moderate effects. With respect to drug therapy there is currently no drug with a positive effect on cognitive disorders.


Assuntos
Transtornos Cognitivos , Esquizofrenia , Cognição , Transtornos Cognitivos/complicações , Humanos , Testes Neuropsicológicos , Qualidade de Vida , Esquizofrenia/complicações , Psicologia do Esquizofrênico
3.
Curr Top Behav Neurosci ; 44: 207-225, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30895531

RESUMO

Recently, the evidence of increased immune activation in patients with schizophrenia has suggested a role for the immune system in the development of psychosis. However, what is causing this increased immune activation and how this leads to the development of psychopathology remain still unclear. In this chapter we discuss the evidence about the role of childhood trauma as possible underlying cause of the increased immune activation in patients with schizophrenia. According to preclinical and clinical models, early adverse events can disrupt the homeostatic control of immune responses and lead to enduring inflammatory dysregulation at a peripheral and central level. In fact, persisting systemic inflammation may facilitate peripheral tissues damage and breach the blood-brain barrier, leading to microglia activation and to neuroinflammation.Such chronic immune dysregulation also appear to partially explain the frequent comorbidity between psychosis and metabolic abnormalities, which have previously mainly considered as side effect of antipsychotic treatment.Overall, this evidence suggests that early stress may contribute to development of schizophrenia spectrum disorders through a modulation of the peripheral and central immune system and support the immune pathways as possible future therapeutic approach for psychosis.


Assuntos
Inflamação , Transtornos Psicóticos , Esquizofrenia , Adulto , Criança , Comorbidade , Humanos , Sistema Imunitário , Transtornos Psicóticos/complicações , Transtornos Psicóticos/imunologia , Esquizofrenia/complicações , Esquizofrenia/imunologia
4.
Curr Top Behav Neurosci ; 44: 125-139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31049838

RESUMO

Most persons experience cognitive decline as they grow older. The term "cognitive aging," coined to describe milder varieties of cognitive decline, is likely to be due to multiple causes. Persistent or repeated infections of the central nervous system (whether subclinical or diagnosable) can cause damage to neurons directly or indirectly through inflammation resulting in incremental neuronal damage, thus eroding cognitive reserve. This possibility has not been considered widely. We evaluated the data linking persistent infection with herpes simplex virus type 1 (HSV-1) and cognitive aging by applying the Bradford Hill criteria. Despite inherent problems in establishing causal relations for chronic disorders, our analyses suggest plausible links. These studies are pertinent for patients with schizophrenia, who are particularly vulnerable due to disorder-related cognitive impairment. Further investigations are warranted to test a causal hypothesis, particularly prospective studies and intervention studies.


Assuntos
Transtornos Cognitivos , Envelhecimento Cognitivo , Herpes Simples , Herpesvirus Humano 1 , Esquizofrenia , Transtornos Cognitivos/complicações , Transtornos Cognitivos/imunologia , Herpes Simples/complicações , Humanos , Inflamação , Estudos Prospectivos , Esquizofrenia/complicações , Esquizofrenia/imunologia
5.
Psychiatr Danub ; 31(3): 355-357, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31596829

RESUMO

We aimed to compare processing speed (PS) and its subcomponents in schizophrenia (SC) and schizoaffective disorder (SA). Thirty-five patients were divided into two groups (SC=18; SA=17). PS tasks from the MATRICS Consensus Cognitive Battery Central/South America version were used. Additional PS subcomponents were analyzed (i.e., behavioral execution, response processing, and accuracy). SA obtained significant higher scores than SC in response processing, verbal fluency and the PS general domain. Our results indicate that PS is a potential cognitive marker to differentiate between SC and SA. Further research with larger samples must be conducted.


Assuntos
Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Transtornos Psicóticos/fisiopatologia , Transtornos Psicóticos/psicologia , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Transtornos Cognitivos/complicações , Humanos , Testes Neuropsicológicos , Projetos Piloto , Transtornos Psicóticos/complicações , Esquizofrenia/complicações
6.
Expert Opin Drug Saf ; 18(12): 1149-1160, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31564170

RESUMO

Introduction: Patients living with schizophrenia have a marked risk of clinically significant weight gain and obesity compared to the general population. The risks have been highlighted following the introduction of second-generation antipsychotics. In turn, obesity is associated with a higher prevalence of cardiovascular disease, the most common cause of premature mortality in patients with schizophrenia.Areas covered: In this review, the authors outline possible mechanisms that induce obesity in patients with schizophrenia taking antipsychotics. The authors discuss the safety and effectiveness of three main approaches for attenuating antipsychotic-associated weight gain (AAWG), including lifestyle interventions, switching antipsychotics, and augmentation with other medications.Expert opinion: When selecting antipsychotics, effective treatment of psychotic symptoms should be highest priority but obesity and related metabolic comorbidities associated with antipsychotics should not be neglected. Further research into mechanisms of weight gain associated with antipsychotics will guide future treatments for AAWG and development of antipsychotics that produce minimal metabolic adverse effects. With current strategies only producing modest weight loss in already overweight and obese individuals, clinicians should transition to an approach where they aim to prevent weight gain when initiating antipsychotic treatment.


Assuntos
Antipsicóticos/efeitos adversos , Esquizofrenia/tratamento farmacológico , Ganho de Peso/efeitos dos fármacos , Animais , Antipsicóticos/administração & dosagem , Humanos , Obesidade/epidemiologia , Obesidade/etiologia , Esquizofrenia/complicações
7.
Psychiatr Danub ; 31(Suppl 3): 261-264, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488738

RESUMO

BACKGROUND: Schizophrenia can be interpreted as a pathology involving the neocortex whose cognitive dysfunctions represent a central and persistent characteristic of the disease, as well as one of the more important symptoms in relation to the impairment of psychosocial functioning and the resulting disabilities. Given the implication of cognitive functions in everyday life, they can better predict the degree of schizophrenia. The study proposes to use Machine Learning techniques to identify the specific cognitive deficits of schizophrenia that mostly characterize the disorder, as well as to develop a predictive system that can diagnose the presence of schizophrenia based on neurocognitive tests. BACKGROUND: The study employs a dataset of neurocognitive assessments carried out on 201 people (86 schizophrenic patients and 115 healthy patients) recruited by the Neuroscience Group of the University of Bari "A. Moro". A data analysis process has been carried out, with the aim of selecting the most relevant features as well as to prepare data for training a number of "off-the-shelf" machine learning methods (Decision Tree, Random Forest, Logistic Regression, k-Nearest Neighbor, Neural Network, Support Vector Machine), which have been evaluated in terms of classification accuracy according to stratified 20-fold cross-validation. RESULTS: Among all variables, 14 were selected as the most influential for the classification problem. The variables with greater influence are related to working memory, executive functions, attention, verbal fluency, memory. The best algorithms turned out to be Support Vector Machine (SVM) and Neural Network, showing an accuracy of 87.8% and 84.8% on a test set. CONCLUSIONS: Machine Learning provides "cheap" and non-invasive methods that potentially enable early intervention with specific rehabilitation interventions. The results suggest the need to integrate a thorough neuropsychological evaluation into the more general diagnostic evaluation of patients with schizophrenia disorder.


Assuntos
Transtornos Cognitivos/complicações , Transtornos Cognitivos/diagnóstico , Disfunção Cognitiva/complicações , Disfunção Cognitiva/diagnóstico , Aprendizado de Máquina , Esquizofrenia/complicações , Esquizofrenia/diagnóstico , Cognição , Humanos , Testes Neuropsicológicos , Psicologia do Esquizofrênico
8.
Psychiatr Danub ; 31(Suppl 3): 517-519, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488783

RESUMO

BACKGROUND: In the literature we can find evidence that sex hormones are involved the alterations of cognition in schizophrenic patients. Another factor, which may have an impact on cognitive domains in this clinical group inflammatory processes. The objective of this review was to explore studies, in which the role of both immunological factors and sex hormones on cognitive functions in schizophrenia are analyzed. METHODS: The search of papers covering this topic in PubMed and Google Scholar was performed. RESULTS: Endocrine factors like: testosteron, estrogen, as well as immunomodulatory are observed to play a role in cognitive functioning in schizophrenia. CONCLUSIONS: More studies are necessary to confirm these possible co-relations.


Assuntos
Transtornos Cognitivos , Cognição , Hormônios Esteroides Gonadais , Inflamação , Esquizofrenia , Psicologia do Esquizofrênico , Transtornos Cognitivos/complicações , Transtornos Cognitivos/metabolismo , Transtornos Cognitivos/patologia , Hormônios Esteroides Gonadais/metabolismo , Humanos , Inflamação/metabolismo , Esquizofrenia/complicações , Esquizofrenia/metabolismo , Esquizofrenia/patologia
9.
Psychiatr Danub ; 31(Suppl 3): 524-529, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488785

RESUMO

BACKGROUND: Environment and culture are shown to be an important factor influencing characteristics of psychotic symptoms. Content of hallucinations and delusions is a projection of internal processes on external world. Religion plays a central role to lives of many people, but in schizophrenia religious experience and spirituality is confounded by psychotic symptoms. The aim of this study was to find how content of hallucinations and delusions interact with cultural conditions, that were changing over the decades. SUBJECTS AND METHODS: 100 of case histories from 2012 were randomly selected. From the medical record, content of hallucinations and delusion was extracted and categorized. Data from 2012 was compared with previous study by the authors, obtaining perspective of 80 years of history in the one hospital. RESULTS: Religious content of delusions and hallucinations appeared in 26% of patients. Diversity of the religious and spiritual themes in schizophrenia has been gradually decreasing. Many minor religious entities and figures such as "saints" and "angels" disappeared in 2012. Although, occurrence of contact with God and other religious figures was similar as in previous years, number of "visions" abruptly decreased. All of the religious content was culture-specific. CONCLUSIONS: Religious topics express general plasticity over a time, following cultural changes in society.


Assuntos
Evolução Cultural , Delusões/psicologia , Alucinações/psicologia , Religião e Psicologia , Esquizofrenia/complicações , Psicologia do Esquizofrênico , Delusões/complicações , Alucinações/complicações , Humanos
10.
Psychiatr Danub ; 31(Suppl 3): 608-612, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488799

RESUMO

Schizophrenic patients have traditionally suffered from high rates of cardiovascular disease and early mortality. NICE guidelines suggest that several physical health measures be monitored regularly in these patients, and particularly those on antipsychotic medication, which has a wide side-effect profile that may potentiate the risk of cardiovascular disease and other comorbidities. This general practice audit aimed to determine the rates of physical health monitoring in primary care in patients on antipsychotic medication for over a year for psychotic symptoms or schizophrenia. The search was conducted in three different general practices in March 2019, yielding 19, 8 and 30 patients respectively, with a total of 57 patients. This audit aims to record and analyse rates of monitoring of a range of physical health measures recommended by NICE guidelines over the past year. The results demonstrated that physical health monitoring was poor amongst all the practices audited, especially that of prolactin and waist circumference. We recommend that these rates of monitoring be improved, through implementing templates or the delivery of targeted education to general practitioners and nurses.


Assuntos
Antipsicóticos/efeitos adversos , Medicina Geral , Atenção Primária à Saúde , Transtornos Psicóticos/complicações , Transtornos Psicóticos/tratamento farmacológico , Esquizofrenia/complicações , Esquizofrenia/tratamento farmacológico , Antipsicóticos/administração & dosagem , Auditoria Clínica , Humanos , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/fisiopatologia
11.
Psychopathology ; 52(4): 232-239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31390645

RESUMO

BACKGROUND: Social difficulties are a hallmark of schizophrenia spectrum conditions, yet their background and exact nature remain contested. Previous pivotal studies on chronically ill patients have suggested that a position of "positive withdrawal" is associated with a decreased tendency to rehospitalization. This concept designates an essentially withdrawn but not negatively experienced position balanced by elements relating the individual to the social world. OBJECTIVES: To explore a less ill subgroup of schizophrenia spectrum patients' ways of navigating the social world and examine potential links to anomalous self-experiences by applying key insights from phenomenology and anthropology. METHOD: The present study was part of a 5-year follow-up on a group of first-admission schizophrenia spectrum patients. From this sample of 48 patients, 5 were selected for qualitative evaluation following the principles of thematic analysis. RESULTS: A "positively withdrawn" position characterizes a wider group of patients than originally reported. Further, we identified a preference for partaking in social activities in particular circumstances with clearly circumscribed goals or social roles and rules. This alleviated social discomfort and helped patients stay embedded in a social milieu. All patients experienced high levels of self-disorders. CONCLUSIONS: We suggest that certain aspects of social impairment may, in fact, reflect meaningful compensatory mechanisms, and argue that this conceptualization of social difficulties is relevant to various psychotherapeutic interventions.


Assuntos
Esquizofrenia/complicações , Comportamento Social , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
12.
Curr Top Behav Neurosci ; 41: 345-367, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31407240

RESUMO

Working memory deficits are observed in the vast majority of individuals diagnosed with schizophrenia and those at risk for the disorder. Working memory impairments are present during the prodromal stage and persist throughout the course of schizophrenia. Given the importance of cognition in functional outcome, working memory deficits are an important therapeutic target for schizophrenia. This chapter examines mechanisms underlying working memory deficits in schizophrenia, focusing on the roles of perception and attention in the encoding process. Lastly, we present a comprehensive discussion of neural oscillation and internal noise in the context of the etiology of working memory deficits in schizophrenia and introduce noninvasive treatment strategies that could improve encoding processes.


Assuntos
Transtornos da Memória , Memória de Curto Prazo , Esquizofrenia , Cognição , Humanos , Transtornos da Memória/complicações , Testes Neuropsicológicos , Esquizofrenia/complicações , Psicologia do Esquizofrênico
13.
Scand J Prim Health Care ; 37(3): 358-365, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31299863

RESUMO

Objective: Schizophrenia is associated with high mortality, somatic comorbidity and reduced life expectancy. The general practitioner (GP) plays a key role in the treatment of mental and physical multimorbidity. Nevertheless, it is unclear how much individuals with schizophrenia use primary healthcare. This study aims to investigate the yearly numbers of consultations in general practice for individuals with schizophrenia. Design and Setting: We performed a population-based matched cohort study of 21,757 individuals with schizophrenia and 435,140 age- and gender-matched references from Danish National Registers. Monthly general practice consultations were analysed using a generalized linear model with log link and assuming negative binomial distribution. Main outcome measures: Consultation rates in general practice up to17 years after index diagnosis. Results: Individuals with schizophrenia attended their GP more than references throughout the study period. The cases had 82% (95% CI: 78-87) and 76% (95% CI: 71-80) more consultations in primary care after 1 year and 5 years, respectively. Individuals with both schizophrenia and comorbid somatic illness attended even more. Conclusion: Individuals with schizophrenia are in regular contact with their GP, especially if they have comorbid illnesses. Whether an average of six consultations per year for individuals with schizophrenia is sufficient is up for debate. The study demonstrates a potential for an increased prevention and treatment of individuals with schizophrenia in general practice. KEY POINTS Schizophrenia is associated with high mortality, somatic comorbidity and reduced life expectancy. Little is known about the attendance pattern in primary care for individuals with schizophrenia. •We found high attendance rates in primary care for individuals diagnosed with schizophrenia from index diagnosis and at least 17 years after diagnosis, which suggests opportunities for earlier intervention to improve their somatic health. •We found an association between high illness comorbidity and increased risk of not attending the general practitioner. The most severely somatically and mentally ill individuals may thus be difficult to reach and support in the current healthcare system.


Assuntos
Comorbidade , Assistência à Saúde , Medicina Geral , Clínicos Gerais , Aceitação pelo Paciente de Cuidados de Saúde , Atenção Primária à Saúde , Esquizofrenia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Multimorbidade , Encaminhamento e Consulta , Esquizofrenia/complicações , Adulto Jovem
14.
Medicina (Kaunas) ; 55(7)2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31295938

RESUMO

Suicide is an important public health problem. The most frequent psychiatric illnesses associated with suicide or severe suicide attempt are mood and psychotic disorders. The purpose of this paper is to provide an educational overview of suicidal behavior in individuals with schizophrenia. A lifetime suicide rate in individuals with schizophrenia is approximately 10%. Suicide is the largest contributor to the decreased life expectancy in individuals with schizophrenia. Demographic and psychosocial factors that increase a risk of suicide in individuals with schizophrenia include younger age, being male, being unmarried, living alone, being unemployed, being intelligent, being well-educated, good premorbid adjustment or functioning, having high personal expectations and hopes, having an understanding that life's expectations and hopes are not likely to be met, having had recent (i.e., within past 3 months) life events, having poor work functioning, and having access to lethal means, such as firearms. Throughout the first decade of their disorder, patients with schizophrenia are at substantially elevated suicide risk, although they continue to be at elevated suicide risk during their lives with times of worsening or improvement. Having awareness of symptoms, especially, awareness of delusions, anhedonia, asociality, and blunted affect, having a negative feeling about, or non-adherence with, treatment are associated with greater suicide risk in patients with schizophrenia. Comorbid depression and a history of suicidal behavior are important contributors to suicide risk in patients with schizophrenia. The only reliable protective factor for suicide in patients with schizophrenia is provision of and compliance with comprehensive treatment. Prevention of suicidal behavior in schizophrenia should include recognizing patients at risk, delivering the best possible therapy for psychotic symptoms, and managing comorbid depression and substance misuse.


Assuntos
Esquizofrenia/complicações , Suicídio/psicologia , Adulto , Antipsicóticos/uso terapêutico , Comorbidade , Feminino , Humanos , Masculino , Fatores de Risco , Esquizofrenia/tratamento farmacológico , Esquizofrenia/epidemiologia , Suicídio/estatística & dados numéricos
15.
Psychiatr Danub ; 31(2): 162-171, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31291220

RESUMO

In this project, we recruited a sample of 150 patients with first episode of psychosis with schizophrenia features (FEP) and 100 healthy controls. We assessed the differences between these two groups, as well as the changes between the acute phase of illness and subsequent remission among patients over 18-month longitudinal follow-up. The assessments were divided into four work packages (WP): WP1- psychopathological status, neurocognitive functioning and emotional recognition; WP2- stress response measured by saliva cortisol during a stress paradigm; cerebral blood perfusion in the resting state (with single photon emission computed tomography (SPECT) and during activation paradigm (with Transcranial Ultrasonography Doppler (TCD); WP3-post mortem analysis in histologically prepared human cortical tissue of post mortem samples of subjects with schizophrenia in the region that synaptic alteration was suggested by WP1 and WP2; WP4- pharmacogenetic analysis (single gene polymorphisms and genome wide association study (GWAS). We expect that the analysis of these data will identify a set of markers that differentiate healthy controls from patients with FEP, and serve as an additional diagnostic tool in the first episode of psychosis, and prediction tool which can be then used to help tailoring individualized treatment options. In this paper, we describe the project protocol including aims and methods and provide a brief description of planned post mortem studies and pharmacogenetic analysis.


Assuntos
Biomarcadores/análise , Transtornos Psicóticos/genética , Feminino , Seguimentos , Estudo de Associação Genômica Ampla , Humanos , Hidrocortisona/análise , Masculino , Farmacogenética , Estudos Prospectivos , Transtornos Psicóticos/complicações , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/tratamento farmacológico , Saliva/química , Esquizofrenia/complicações
16.
PLoS One ; 14(7): e0219454, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291336

RESUMO

The association of latent toxoplasmosis with mental disorders in general and with schizophrenia in particular was noticed in the mid-1950s. In subsequent years, the role of Toxoplasma gondii was established based on its ability to survive for long periods of time in the nerve cells of the brain. The acute manifestations of the infection include psychopathic symptoms resembling those of schizophrenia. In the former USSR, and in other parts of the world, a number of studies were performed with respect to the association of latent toxoplasmosis and schizophrenia. However, with the dissolution of the USSR at the beginning of the 1990s, studies on the subject were halted due to financial problems and have resumed only recently. The reasons for the resumption of such studies in contemporary Russia are related to the progressively increasing incidence of schizophrenia over the last 25-30 years in the country. According to official data, approximately 550 000 persons reported suffering from the disease in 2014. There are reasons to believe that this is only a fraction of the real burden of the disease. Economically, it cost the state no less than approximately US $10 billion. The purpose of the study was to identify the level of toxoplasmosis seroprevalence in patients with verified diagnoses of schizophrenia in comparison to healthy people in Moscow City and in the Moscow region. A total of 155 persons constituted the patients group and 152 healthy people were in the control group. An integrated approach to the diagnosis and comparison of data from the entire spectrum of serological markers of infection was used, including the detection of specific IgM and the determination of IgG concentrations. It was found that among persons with neuropsychiatric disorders, the incidence of cases with latent toxoplasmosis was higher than in the control group. The effect of toxoplasmosis was significant and similar for men and women. Further statistical analyses revealed that among patients with a diagnosis of schizophrenia, the incidence of latent toxoplasmosis was significantly higher than in the control group. These data are in agreement with the results of similar studies in other countries.


Assuntos
Transtornos Mentais/epidemiologia , Esquizofrenia/epidemiologia , Toxoplasmose/epidemiologia , Adolescente , Adulto , Encéfalo/imunologia , Encéfalo/patologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Transtornos Mentais/sangue , Transtornos Mentais/complicações , Transtornos Mentais/imunologia , Pessoa de Meia-Idade , Moscou/epidemiologia , Neurônios/imunologia , Neurônios/patologia , Federação Russa/epidemiologia , Esquizofrenia/sangue , Esquizofrenia/complicações , Esquizofrenia/imunologia , Estudos Soroepidemiológicos , Toxoplasma/imunologia , Toxoplasma/patogenicidade , Toxoplasmose/sangue , Toxoplasmose/complicações , Toxoplasmose/imunologia , Adulto Jovem
17.
J Abnorm Psychol ; 128(7): 710-722, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31282687

RESUMO

Schizophrenia is associated with amotivation and reduced goal-directed behavior, which have been linked to poor functional outcomes. Motivational deficits in schizophrenia are often measured using effort-based decision-making (EBDM) paradigms, revealing consistent alterations in effort expenditure relative to controls. Although these results have generally been interpreted in terms of decreased motivation, the ability to use trial-by-trial changes in reward magnitude or probability of receipt to guide effort allocation may also be affected by cognitive deficits. To date, it remains unclear whether altered performance in EBDM primarily reflects deficits in motivation, cognitive functioning, or both. We applied a newly developed computational modeling approach to the analysis of EBDM data from two previously collected samples comprising 153 patients and 105 controls to determine the extent to which individuals did or did not use available information about reward and probability to guide effort allocation. Half of the participants with schizophrenia failed to incorporate information about reward and probability when making effort-expenditure decisions. The subset of patients who exhibited difficulties using reward and probability information were characterized by greater impairments across measures of cognitive functioning. Interestingly, even within the subset of patients who successfully used reward and probability information to guide effort expenditure, higher levels of negative symptoms related to motivation and avolition were associated with greater effort aversion during the task. Taken together, these data suggest that prior reports of aberrant EBDM in schizophrenia patients are related to both cognitive function and individual differences in negative symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Cognição/fisiologia , Tomada de Decisões/fisiologia , Metas , Psicologia do Esquizofrênico , Adulto , Apatia , Transtornos Cognitivos/complicações , Feminino , Humanos , Individualidade , Masculino , Pessoa de Meia-Idade , Motivação/fisiologia , Recompensa , Esquizofrenia/complicações
18.
BMJ Case Rep ; 12(6)2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31227571

RESUMO

Clozapine is an atypical antipsychotic used most frequently in the management of treatment-resistant schizophrenia, where severely unwell patients have failed to respond to standard antipsychotic therapy. Clozapine is associated with a number of risks, such as agranulocytosis and long-term cardiometabolic morbidity. Reported less frequently is the risk of severe cardiac complications. The case reported here provides an important example of chronic clozapine toxicity leading to pericarditis. This case also describes a difficult ethical dilemma, where the physical risk to a patient with a diagnosis of schizophrenia must be balanced with the potentially adverse psychiatric risk that would follow, if the patient were to be weaned off this effective antipsychotic therapy. It is frequently reported that clozapine is stopped due to its toxicity. In this case however, the mental health and functional benefit of continuing with clozapine was deemed to outweigh the physical risk of progression of the pericarditis.


Assuntos
Antipsicóticos/efeitos adversos , Clozapina/efeitos adversos , Pericardite/induzido quimicamente , Ecocardiografia , Ética Profissional , Humanos , Masculino , Pessoa de Meia-Idade , Pericardite/diagnóstico por imagem , Esquizofrenia/complicações , Esquizofrenia/tratamento farmacológico
19.
Encephale ; 45(3): 200-206, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-31178036

RESUMO

CONTEXT: Patients suffering from schizophrenia present with a risk of cardiovascular death which is two to three times as high as the general population. OBJECTIVES: Our study aims to evaluate the global cardiovascular risk according to SCORE and Framingham on patients suffering from schizophrenia who have been hospitalized in psychiatric institutions and also to assess whether being under the care of a physician affects that risk. METHODS: A prospective descriptive epidemiologic study was conducted from April 2005 to March 2016. The study population consisted of adult patients suffering from schizophrenia who were hospitalized in the psychiatric unit of the CHU de Saint-Étienne. The data was collected during the clinical admission examination. The software CARDIORISK was used to compute the global cardiovascular risk according to SCORE and Framingham. RESULTS: The average cardiovascular risk was about four times as high for males as it was for females according to the SCORE model and twice as high according to the Framingham model. According to the SCORE model, 16.5 % of the patients presented a high cardiovascular risk versus 6.6 % according to the Framingham model. There was no statistically significant difference between patients who were under the care of a physician and those who were not, both in terms of the prevalence of the risk factors and in terms of the global cardiovascular risk. CONCLUSION: Using the global cardiovascular risk approach as a primary prevention measure could allow patients suffering from schizophrenia to be admitted earlier. Also, regularly reevaluating that risk could allow initiation of behavioral changes and/or important cardiovascular treatments.


Assuntos
Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/epidemiologia , Esquizofrenia/complicações , Adulto , Idoso , Feminino , França/epidemiologia , Hospitalização , Hospitais Psiquiátricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Risco , Medição de Risco , Fatores Sexuais , Adulto Jovem
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