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Quality of life in schizophrenia patients

Monika Bullinger, Jens Kuhn, Karolina Leopold, Wolfgang Janetzky, Rita Wietfeld
Consideration of quality of life has developed into an important concept of a patient-oriented medicine in the last 50 years. With it, it should be possible to capture the subjective experience of the patients and describe its different dimensions. Today, the quality of life as a patient-reported endpoint is also an integral part of the early benefit assessment under the German Drug Market Reorganization Act. In the treatment of schizophrenic patients, however, improvement in quality of life as an accepted target criterion has only been established with delay...
December 12, 2018: Fortschritte der Neurologie-Psychiatrie
Marco Spangaro, Marta Bosia, Margherita Bechi, Mariachiara Buonocore, Federica Cocchi, Carmelo Guglielmino, Laura Bianchi, Antonella Mastromatteo, Cristina Lorenzi, Roberto Cavallaro
Cognitive deficits represent core features of schizophrenia, affecting quality of life and functioning. The excitatory amino acid transporter 2 (EAAT2) is responsible for the majority of glutamate reuptake and its activity is crucial for glutamatergic neurotransmission, prevention of excitotoxic damage and cerebral metabolism. Different studies reported that EAAT2 rs4354668 (-181 T/G) influences cognitive functions and brain structures in patients with schizophrenia. Specifically, the G allele, linked to lower EAAT2 expression, was associated with impaired prefrontal cognitive performance and reduced grey matter volumes...
December 2018: Schizophrenia Research
(no author information available yet)
BACKGROUND: Much attention has been paid to psychological factors influencing characteristics, severity, and course of mental disorders. The objective of our investigation was to examine the interrelations among quality of life (QoL), self-stigma, and coping strategies, demographics and severity of the disorder in neurotic spectrum disorders, schizophrenia, and depressive spectrum disorders. METHODS: A total of 343 clinically stable Czech outpatients with different mental disorders (153 with neurotic spectrum disorders; 81 with depression, and 109 with schizophrenia spectrum disorders) were included...
October 10, 2018: Neuro Endocrinology Letters
Taeho Greg Rhee, Robert A Rosenheck
The longitudinal association of changes in clinical status among adults with schizophrenia and changes in family caregiver burden has not been demonstrated. Using data from the NIMH-funded CATIE schizophrenia trial (n = 446 family caregivers), we examined the association of changes in patient symptoms and quality of life with changes in measures of family caregiver burden. Clinical changes in patient symptoms and quality of life were not significantly associated with changes in family caregiver burden. The weak association likely reflects that small clinical changes in chronically ill adults are insufficient to affect long established experiences of burden...
December 3, 2018: Psychiatry Research
A George Awad
Schizophrenia is a long-term psychiatric disorder that impacts important mental functions and requires indefinite treatment, as well as psychosocial and economic support. The introduction of chlorpromazine, the first antipsychotic, and the subsequent development of a long list of similar dopamine-blocking antipsychotic medications, has changed the treatment of schizophrenia as medications have become the cornerstone of clinical management. The enthusiasm that greeted the introduction of antipsychotics was soon tempered by the realisation that they induced significant side effects, such as extrapyramidal and autonomic symptoms...
December 3, 2018: CNS Drugs
Robert Howard, Elizabeth Cort, Rosie Bradley, Emma Harper, Linda Kelly, Peter Bentham, Craig Ritchie, Suzanne Reeves, Waleed Fawzi, Gill Livingston, Andrew Sommerlad, Sabu Oomman, Ejaz Nazir, Ramin Nilforooshan, Robert Barber, Chris Fox, Ajay Macharouthu, Pranathi Ramachandra, Vivek Pattan, John Sykes, Valerie Curran, Cornelius Katona, Tom Dening, Martin Knapp, Renee Romeo, Richard Gray
BACKGROUND: Very late-onset (aged ≥ 60 years) schizophrenia-like psychosis (VLOSLP) occurs frequently but no placebo-controlled, randomised trials have assessed the efficacy or risks of antipsychotic treatment. Most patients are not prescribed treatment. OBJECTIVES: The study investigated whether or not low-dose amisulpride is superior to placebo in reducing psychosis symptoms over 12 weeks and if any benefit is maintained by continuing treatment thereafter...
November 2018: Health Technology Assessment: HTA
Richard Ig Holt, Daniel Hind, Rebecca Gossage-Worrall, Michael J Bradburn, David Saxon, Paul McCrone, Tiyi A Morris, Angela Etherington, David Shiers, Katharine Barnard, Lizzie Swaby, Charlotte Edwardson, Marian E Carey, Melanie J Davies, Christopher M Dickens, Yvonne Doherty, Paul French, Kathryn E Greenwood, Sridevi Kalidindi, Kamlesh Khunti, Richard Laugharne, John Pendlebury, Shanaya Rathod, Najma Siddiqi, Stephen Wright, Glenn Waller, Fiona Gaughran, Janette Barnett, Alison Northern
BACKGROUND: Obesity is twice as common in people with schizophrenia as in the general population. The National Institute for Health and Care Excellence guidance recommends that people with psychosis or schizophrenia, especially those taking antipsychotics, be offered a healthy eating and physical activity programme by their mental health care provider. There is insufficient evidence to inform how these lifestyle services should be commissioned. OBJECTIVES: To develop a lifestyle intervention for people with first episode psychosis or schizophrenia and to evaluate its clinical effectiveness, cost-effectiveness, delivery and acceptability...
November 2018: Health Technology Assessment: HTA
Stefan Heim, Maike Dehmer, Merle Berger-Tunkel
Disorganized speech is one of the key symptoms of schizophrenia. This article provides an overview of those areas of speech and communication impaired in patients with schizophrenia. Moreover, the state of the art of behavioral interventions is summarized. In conclusion, more well-controlled speech-language therapy studies are required in order to improve participation and communication-related quality of life in schizophrenia.
November 28, 2018: Der Nervenarzt
Marc Krause, Maximilian Huhn, Johannes Schneider-Thoma, Irene Bighelli, Katharina Gutsmiedl, Stefan Leucht
Patients with schizophrenia and substance related comorbidity or substance induced psychotic disorder are difficult to treat. Although the prevalence of a comorbid substance use is approximately 40% in schizophrenia, such patients are usually excluded from clinical trials. We therefore performed a random-effects meta-analysis of all randomized controlled antipsychotic drug trials in this patient subgroup. We searched multiple databases up to May, 2018. The primary outcome was the reduction of substance user; secondary outcomes were craving, mean reduction of substance use, overall change in schizophrenia symptoms, positive and negative symptoms, response, dropouts, quality of life, social functioning, weight gain, sedation, prolactin, extrapyramidal side effects and use of antiparkinsonian medication...
November 21, 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Buranee Kanchanatawan, Sira Sriswasdi, Michael Maes
Stable phase schizophrenia is characterized by altered patterning in tryptophan catabolites (TRYCATs) and memory impairments, which are associated with PHEMN (psychosis, hostility, excitation, mannerism and negative) and DAPS (depression, anxiety and physio-somatic) symptoms. This study was carried out to examine the association between TRYCAT patterning, memory impairments, psychopathological features and health-related quality of life (HR-QoL) in schizophrenia. The World Health Organization (WHO) QoL instrument-Abbreviated version (WHO-QoL-BREF), IgA/IgM responses to TRYCATs, cognitive tests, Scale for the Assessment of Negative Symptoms (SANS), Hamilton and Depression (HAMD) and Anxiety (HAMA) Rating Scales and the Fibromyalgia and Chronic Fatigue Syndrome Rating Scale (FF) were measured in 80 schizophrenia patients and 40 controls...
November 22, 2018: Metabolic Brain Disease
Dina Bosnjak Kuharic, Porin Makaric, Ivana Kekin, Iva Lukacevic Lovrencic, Aleksandar Savic, Drazenka Ostojic, Ante Silic, Petrana Brecic, Zarko Bajic, Martina Rojnic Kuzman
OBJECTIVES: The aim of our study was to assess the differences in facial emotional recognition (FER) between patients with first-episode psychosis (FEP), patients with multi-episode schizophrenia (SCH), and healthy controls (HC) and to find possible correlations of FER with psychopathology in the two patient groups. METHODS: We performed a cross-sectional study enrolling 160 patients from two psychiatric hospitals in Croatia (80 FEP and 80 SCH) and 80 HC during the period from October 2015 until October 2017...
November 23, 2018: Journal of the International Neuropsychological Society: JINS
Abd Al-Hadi Hasan
The study identifies the correlation between the quality of life (QoL) among outpatients with schizophrenia and clinical outcomes. A cross-sectional study design was used with 157 people with schizophrenia treated in outpatient clinics. Demographic, clinical and psychosocial variables were examined for their influence on QoL. Data were analysed with descriptive statistics, Pearson product moment correlation and stepwise forward multiple linear regression. The majority of the study participants were female, single, unemployed, had secondary level of education or less and were being supported financially by family members...
October 2, 2018: Psychiatry Research
Marianne O Klein, Daniella S Battagello, Ariel R Cardoso, David N Hauser, Jackson C Bittencourt, Ricardo G Correa
The dopaminergic system plays important roles in neuromodulation, such as motor control, motivation, reward, cognitive function, maternal, and reproductive behaviors. Dopamine is a neurotransmitter, synthesized in both central nervous system and the periphery, that exerts its actions upon binding to G protein-coupled receptors. Dopamine receptors are widely expressed in the body and function in both the peripheral and the central nervous systems. Dopaminergic signaling pathways are crucial to the maintenance of physiological processes and an unbalanced activity may lead to dysfunctions that are related to neurodegenerative diseases...
November 16, 2018: Cellular and Molecular Neurobiology
A Akinsulore, T Opakunle, O Aloba, B Suleiman, O Ibigbami
BACKGROUND: Obsessive compulsive symptoms (OCS) are relatively common in schizophrenia. Their presence and severity can affect the quality of life (QoL) of schizophrenia patients. OBJECTIVE: This study aimed to determine the effect of OCS on the subjective QoL of the Nigerian outpatients with schizophrenia. It also determines the sociodemographic and clinical factors associated with OCS. METHOD: A cross-sectional study involving 232 patients with schizophrenia completed socio-demographic and clinical characteristics questionnaire...
November 2018: General Hospital Psychiatry
(no author information available yet)
Background: Cognitive behavioural therapy (CBT) for psychosis is a distinct type of psychotherapy that has been recommended together with antipsychotic drugs and comprehensive usual care in the management of schizophrenia, a complex mental health disorder associated with a high economic and societal burden. The objectives of this report were to assess the effectiveness, harms, cost-effectiveness, and lived experience of CBT for psychosis in improving outcomes for adults with a primary diagnosis of schizophrenia...
2018: Ontario Health Technology Assessment Series
G H M Pijnenborg, A E de Vos, M E Timmerman, M Van der Gaag, B E Sportel, J Arends, E M Koopmans, L Van der Meer, A Aleman
PURPOSE: The majority of people with schizophrenia has impaired insight, which is related to a poorer outcome. In this study, we evaluate a new psychosocial intervention 'REFLEX' aimed at improving insight in people with schizophrenia. REFLEX focuses on targeting stigma-sensitivity, perspective taking and self-reflection in people with schizophrenia and low insight. Primary objective is to improve insight and subsequently to improve functional outcome and symptoms. METHOD: A total of 121 people diagnosed with schizophrenia according to DSM IV criteria with impaired insight was included in 2012-2015 from seven sites in a multicenter randomized controlled trial...
November 12, 2018: Schizophrenia Research
Ben F M Wijnen, Karin Pos, Eva Velthorst, Frederike Schirmbeck, Hoi Yau Chan, Lieuwe de Haan, Mark van der Gaag, Silvia M A A Evers, Filip Smit
BACKGROUND: In schizophrenia spectrum disorders, negative symptoms (e.g. social withdrawal) may persist after initial treatment with antipsychotics, much affecting the quality of life (QOL) of patients. This health-economic study evaluated if a dedicated form of cognitive behaviour therapy for social activation (CBTsa) would reduce negative symptoms and improve QOL in an economically sustainable way. METHODS: A health-economic evaluation was conducted alongside a single-blind randomised controlled trial in two parallel groups: guideline congruent treatment as usual (TAU; n = 50) versus TAU augmented with adjunct CBTsa (n = 49)...
2018: PloS One
Petal S Abdool, T Supasitthumrong, K Patel, B H Mulsant, T K Rajji
OBJECTIVE: Antipsychotic use in older patients is associated with many adverse effects, including tardive dyskinesia and extrapyramidal symptoms, which, in turn, increase the risk of falling. Antipsychotics are also associated with metabolic syndrome and cognitive impairment in older patients. Integrated care pathways (ICPs) are designed to manage specific conditions using standardized assessments and measurement-based interventions. This study aims to compare the use of recommended tools to monitor for adverse effects associated with antipsychotics in older patients managed within an ICP and those managed under usual care conditions-i...
September 14, 2018: American Journal of Geriatric Psychiatry
Lebogang Phahladira, Laila Asmal, Sanja Kilian, Bonginkosi Chiliza, Frederika Scheffler, Hilmar K Luckhoff, Stefan du Plessis, Robin Emsley
BACKGROUND: While insight in schizophrenia improves with treatment, significant impairments often persist. The degree of persistence is not well characterised. AIMS: We assessed patient and clinician-rated changes in insight in acutely ill, minimally treated first-episode schizophrenia spectrum disorder patients over 24 months of standardised treatment with a depot antipsychotic. METHOD: This single arm open label longitudinal cohort study included 105 participants with first-episode schizophrenia, schizophreniform or schizoaffective disorder...
October 29, 2018: Schizophrenia Research
Julia Luise Magaard, Sarah Liebherz, Hanne Melchior, Alexander Engels, Hans-Helmut König, Levente Kriston, Holger Schulz, Jeanette Jahed, Anna Levke Brütt, Katrin Christiane Reber, Martin Härter
BACKGROUND: German statutory health insurances are pursuing the goal of improving treatment of chronically ill people by promoting networks of health care providers and supporting treatments that reflect the current medical knowledge. The so-called PNP program is a collaborative care program developed by a German statutory health insurance, which defines specific rules on psychiatric, neurological, psychosomatic, and psychotherapeutic treatment. It aims to strengthen provision of guideline-based outpatient treatment and collaboration between different health care providers...
October 25, 2018: BMC Psychiatry
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