Consequences Of Schizophrenia Research Articles

Érosion prématurée des télomères et schizophrénies : synthèse et hypothèses

Schizophrenia is associated with a weighted average of 14.5 years of potential life lost according to a recent meta-analysis. This is partly explained by high rates of suicide and a high prevalence of non-psychiatric comorbidity (cardiovascular diseases, diabetes, cancers…). However, all these causes could not fully explain the loss of life expectancy in people suffering from schizophrenia. Life expectancy has been strongly correlated with telomere length (TL). Telomeres are noncoding structures consisting of DNA TTAGGG tandem repeats and associated proteins located at the end of the chromosomes. Their role is to help preserve genome stability by protecting chromosomal ends from the loss of genetic material. The progressive loss of telomeric material during cell divisions has led researchers to consider telomeres as molecular clocks that measure the number of divisions left until cellular death. The fact that both shorter telomeres and schizophrenia have been associated with a decrease in life expectancy has fueled the interest in the study of TL in schizophrenia. In this article, after a detailed review of the literature on the relationships between telomere length and schizophrenia, we discuss the different pathophysiological mechanisms which might explain this association. Based on this analysis, in the last part of the article we discuss potential research, therapeutic and prevention prospects. To date, the majority of the studies and meta-analyses found a decrease in TL in subjects with schizophrenia compared to control subjects. Conversely, all the studies exploring the TL in subjects suffering from first episode psychosis (FEP) have shown no significant difference from TL in control subjects. This suggests that excessive shortening of telomeres occurs during the course of the disease, thus it seems more probable that schizophrenia (or processes associated with it) affects TL rather than telomere erosion being a cause of the disorder. Several pathophysiological, non-mutually exclusive mechanisms have been proposed to explain the observed data. A first hypothesis to explain the acceleration of the physiological process of telomere erosion in schizophrenia is the activation of inflammation processes and oxidative stress as a consequence of schizophrenia per se. However, it seems more probable that reduced TL may be a result of cumulative exposure to chronic stress related to schizophrenia. Indeed, in healthy individuals a growing body of evidence has linked chronic stress to accelerated shortening of TL. This might explain why telomere erosion is too small to be detected in FEP patients who are younger and have a shorter duration of illness than subjects with schizophrenia. Based on these both explanations, telomere alterations may be considered as a biomarker of illness progression and might be useful for illness staging. Identifying processes associated with TL reduction might improve our understanding of the increased mortality and morbidity in schizophrenia, improve reliability of diagnosis, and hopefully suggest means for prevention and/or treatment. Treatments that prevent exposure and/or vulnerability to stressful life events that ameliorate schizophrenia may also prevent or decelerate telomere erosion. In this perspective, engaging subjects suffering from schizophrenia in a healthy diet and regular activity could be both promising strategies to protect telomere maintenance and improve health span at old age. In addition, the inflammatory process and oxidative stress involved in the physiopathology in at least a subgroup of subjects with schizophrenia could also be responsible for telomere erosion. Thus, an efficient anti-inflammatory therapeutic approach that targets these specific pathways could be of interest in this subgroup to limit telomere erosion. Mindfulness-based stress reduction (MBSR) therapies have been shown to reduce telomere erosion by increasing telomerase activity, although these psychological therapies should be used carefully in psychosis. Finally, advancing our understanding of the relationship between stress, inflammation and TL is of great interest for psychiatric research and for understanding stress effects in this population.

Views of Catholic Priests Regarding Causes, Treatments and Psychosocial Consequences of Schizophrenia and Depression: A Comparative Study in Italy

This study explored views of Catholic priests about schizophrenia and depression in Italy. Participants completed a questionnaire on their views about either schizophrenia (N = 282) or depression (N = 277). The depression group was surer than the schizophrenia group that: the disorder was due to psychosocial causes; curable; non-requiring long-term pharmacotherapy; the persons with depression could participate in religious activities. The older priests were more convinced than the younger priests that: the prayer and long-term pharmacotherapy are useful; the persons with mental disorders had affective difficulties, are recognizable and kept at distance. Priests should receive education on stigma in mental disorders, particularly schizophrenia.

Pharmacologic Advancement in Schizophrenia

Schizophrenia is a disorder of mental debility characterized by abnormal social behavior in which person is unable to recognize reality. The sign and symptoms are variable and heterogeneous. Due to the diverse symptoms and variable treatment response, it is challenging to treat. Recent advancements in genomic, epidemiology and neurosciences can provide the appropriate medicines and treatments for minimizing symptoms and consequences of schizophrenia. This literature review was highlights the etiology, pathophysiology, neurotransmitter system, novel treatment and management of schizophrenia.The mainstay treatment of schizophrenic patients included antipsychotic drug with psychotherapy, social rehabilitation and job training

Polygenic analysis suggests the involvement of calcium signaling in executive function in schizophrenia patients

Cognitive deficits are increasingly recognized as a core dimension rather than a consequence of schizophrenia (SCZ). The previous evidence supports the hypothesis of shared genetic factors between SCZ and cognitive ability. The objective of this study was to test whether and to what extent the variation of disease-relevant neurocognitive function in a sample of SCZ patients from the previous clinical interventional studies can be explained by SCZ polygenic risk scores (PRSs) or by hypothesis-driven and biomedical PRSs. The previous studies have described associations of the SNAP25 gene with cognition in SCZ. Likewise, the enrichment of several calcium signaling-related gene sets has been reported by genome-wide association studies (GWAS) in SCZ. Hypothesis-driven PRSs were calculated on the basis of the SNAP-25 interactome and also for genes regulated by phorbol myristate acetate (PMA), an activator of the signal transduction of protein kinase C (PKC) enzymes. In a cohort of 127 SCZ patients who had completed a comprehensive neurocognitive test battery as part of the previous antipsychotic intervention studies, we investigated the association between neurocognitive dimensions and PRSs. The PRS for SCZ and SNAP-25-associated genes could not explain the variance of neurocognition in this cohort. At a p value threshold of 0.05, the PRS for PMA was able to explain 2% of the variance in executive function (p = 0.05, uncorrected). The correlation between the PRS for PMA-regulated genes and cognition can give hints for further patient-derived cellular assays. In conclusion, incorporating biological information into PRSs and other en masse genetic analyses may help to close the gap between genetic vulnerability and the biological processes underlying neuropsychiatric diseases such as SCZ.

Schizophrenia care: an overview considering family burden, medication adherence, and pharmacoeconomics

Schizophrenia is one of the leading causes of disability among all health problems. The discrimination and stigma are two unavoidable consequences of schizophrenia that individuals suffer most in developing countries. Management of schizophrenia has been brought out from silent asylums to community, providing them with more care and supports from family, healthcare professionals, and society. This article deals with the important aspects that one comes across while taking care of schizophrenic patients, such as family burden, medication adherence, and pharmacoeconomics. There are many interventions that should be implemented in solving problems associated with management of schizophrenia. Among them, role of psychotherapy and pharmacy-based intervention is unavoidable.

P.3.d.048 Once-monthly paliperidone palmitate versus daily oral antipsychotics delays adverse real-world consequences of schizophrenia

P.3.d.048 Once-monthly paliperidone palmitate versus daily oral antipsychotics delays adverse real-world consequences of schizophrenia

Stigma and disability in schizophrenia: Developing countries’ perspective

Background: Stigma and disability are two important consequences of schizophrenia that individuals afflicted with it experience. Sociocultural milieu can influence these. We review the literature on stigma and disability experienced by individuals with schizophrenia in the developing countries.Method: We searched English-language literature from developing countries on stigma and disability in schizophrenia using PubMed and Scopus databases. As individual studies adopted widely varying methodologies, the retrieved papers did not yield themselves for a systematic review. We present a narrative review.Results: Much of the literature on stigma and disability in schizophrenia has come from India and only a few other developing countries. Stigma associated with schizophrenia is highly prevalent across regions and across patients themselves, families, communities and professionals. Research is scanty with regard to determinants of stigma and interventions against stigma. A number of tools have been developed for assessment of disability. Preliminary evidence suggests that initiation and continuation of antipsychotic medications is associated with lesser disability. Psychosocial interventions may reduce disability further.Conclusions: Comprehensive, prospective studies evaluating the determinants of stigma and disability need to be conducted in the developing countries. Models of interventions to minimize these adverse consequences, developed based on their results, need to be tested.

Proteomics Tackling Schizophrenia as a Pathway Disorder

Proteomics Tackling Schizophrenia as a Pathway Disorder

Alexithymia in schizophrenia

Changes in emotional and social behavior are considered to be amongst the most common and debilitating consequences of schizophrenia. However, little is known of the effects of schizophrenia on alexithymia, which refers to impairment in aspects of understanding emotions. In the current study, participants with schizophrenia (n = 29) and nonclinical controls (n = 30) completed self-report and performance-based measures of this construct, in addition to measures of cognitive functioning, clinical symptomatology, and negative affect. The results indicated that individuals with schizophrenia showed increased alexithymia as indexed by the performance task, with these difficulties related to cognitive functioning, and the specific clinical symptom of alogia. However, although the correlation between self-reported alexithymia and negative affect in the schizophrenia group was congruent with prior empirical research and theory, there were no group differences in perceived levels of alexithymia. It is suggested that alexithymia may not be affected per se in schizophrenia (as indicated by the lack of group differences on the self-report measure of this construct), but that schizophrenia-related difficulties do emerge in contexts where cognitive demands are incremented.

Development and Validation of a Self-Reported Questionnaire On Users’ Opinions About Schizophrenia: a Participatory Research

Although users' involvement in mental health research has repeatedly been acknowledged as having a positive influence on research quality, this rarely happens. To develop and validate a Questionnaire on Users' Opinions (QOU) about schizophrenia, in close collaboration with 279 persons affected by this disorder. A preliminary list of items concerning the opinions of users with schizophrenia regarding causes, treatments and psychosocial consequences of the disorder was developed by 38 users with schizophrenia and 40 professionals who attended a workshop. Psychometric properties of the QOU were tested on 241 users with schizophrenia, 149 of whom were randomly assigned to a test-retest study and 92 to a face-validity study. Content and construct validity were explored in the whole sample. The final version of the QOU contains: (1) 24 items on the psychosocial consequences of schizophrenia, grouped into six subscales, whose Cronbach's alpha ranged between 0.55 and 0.74; (2) five multiple choice items on the Italian psychiatric law; (3) 12 open questions; and (4) four yes/no skipping items. Items' reliability, measured by Cohen's kappa coefficient, ranged between 0.55 and 0.92. This questionnaire may be useful to assess patients' beliefs about schizophrenia and to target psychosocial interventions for this mental disorder.

The role of insight in the process of recovery from schizophrenia: A review of three views

At present there is debate about the importance of insight, or awareness of the consequences and experiences linked with schizophrenia, for recovery. One view suggests that insight is a precondition for treatment adherence and hence wellness. Another suggests that insight may be more destructive than helpful. In this article, we will review both perspectives along with supporting evidence, and offer a third view of the role of insight in recovery in an effort to resolve some of these paradoxical findings. We will argue that one way to make sense of these conflicting accounts and findings is to conceptualize insight not as the acceptance of a certain fact or set of facts, but as a process of personally making sense of experiences and consequences linked with schizophrenia. Furthermore, we will assert that, to be adaptive, this storied account of the experiences and consequences of schizophrenia must be understandable by others and also reject stigma or prevalent stereotypes of mental illness which cast persons diagnosed with schizophrenia as incompetent or dangerous. The importance of this perspective for the development of recovery‐oriented interventions is discussed.

Évaluation de la conscience du trouble chez le schizophrène dans une cohorte de 31 patients

Insight is more than frequently altered in schizophrenia, rupture of treatment being one the most known consequences of this impairment. Two different types of scales can be used to assess consciousness: self-questionnaires directly filled-in by the patient or questionnaires assessed by a psychiatrist after an interview. AIM OF THE STUDIES: The goal of this study was first to assess insight in schizophrenic patients with these two different types of scales and then try to find a link between insight impairment and schizophrenic symptoms. The self-questionnaire was the Marks et al. Self Appraisal of Illness Questionnaire (SAIQ) [Schizophr Res 45 (2000) 203-11], 17 items finally giving four scores (consciousness of illness, consequences of schizophrenia, need for treatment and worrying about illness) plus a total score of insight. The other questionnaire was the Amador Scale for assessment of Unawareness of Mental Disease [Amador XF, Strauss DH. The scale to assess unawareness of mental disorder (SUMD). Columbia University and New-York State Psychiatric Institute;1990], consisting in an interview with a psychiatrist who finally assesses four dimensions (consciousness of illness, symptoms, need for treatment and consequences of illness) plus a total score. In addition to these scores, Amador's scale gives the opportunity to score attribution a patient gives to illness for his symptoms. Thirty-one patients whose schizophrenia diagnosis had been previously made according to DSM-IV criteria were included. Half were outpatients, half inpatients. Drug prescriptions were controlled; all of the patients being medicated with an antipsychotic, a benzodiazepine and a sleep inducer. They were all assessed by the two scales previously mentioned and the Positive And Negative Syndrome Scale [Kay SR, Opler LA, Fiszbein A. Positive and negative syndrome scale. Traduction de Lepine JL. In: Guelfi JD, éditeur. Evaluation clinique standardisée, tome II. Castres : Editions médicales Pierre Fabre;1996]. Total scores of insight scales were significantly correlated (p<0.001). For each questionnaire, the four different scores were independent from each other (p<0.001). There was no correlation found between insight scales and schizophrenic symptoms intensity. Considering symptom attribution, being unconscious of a symptom and being enable to attribute it to schizophrenia were linked, which could refer to Frith's theory of schizophrenia [Frith CD. Neuropsychologie de la schizophrénie. Psychiatrie ouverte. Paris: PUF;1996 (208p.)] and attribution impairment as a main dysfunction. The two different types of scales seem to be effective. The significant correlation between them suggests they assess the same dimension. This preliminary study will be followed by a validation study of the french translation of the SAIQ.

Beliefs about psychosocial consequences of schizophrenia and depression: a comparative study in a sample of secondary school students

Description of students' opinions about schizophrenia and depression. The study was carried out on a sample of 445 secondary school students, randomly allocated to a "schizophrenia" or a "depression" group (N = 221 and N = 224, respectively). Each respondent was asked to read a case-vignette describing a case of schizophrenia or depression, and then to fill the Questionnaire on the Opinions about Mental Illness--General Population's version (QO-GP). 35% of students in "schizophrenia" group vs. 85% in "depression" group attributed a correct diagnosis to case-vignette. 19% of students in the "schizophrenia" group vs. 39% in the "depression" group believed that these mental disorders can recover. Affective and civil rights were more frequently acknowledged to patients with depression than to those with schizophrenia. In both groups, the majority of students stated that mentally ill patients were unpredictable and socially dangerous. Students who reported TV stories on people with mentally ill were more frequently convinced on their unpredictability and social dangerousness. These results outline the need to: a) plan educational campaigns for students on mental disorders; b) alert media professionals on the impact that the way they present crimes committed by mentally ill patients may have on general population.

Can Early Detection of Psychosis Prevent Suicidal Behavior?

Can Early Detection of Psychosis Prevent Suicidal Behavior?

Can Early Detection of Psychosis Prevent Suicidal Behavior?

Can Early Detection of Psychosis Prevent Suicidal Behavior?

Behavioral rehabilitation of the "treatment-refractory" schizophrenia patient: Conceptual foundations, interventions, and outcome data.

This article describes an intensive, inpatient behavioral rehabilitation program for patients with schizophrenia who have been considered “treatment-refractory” at state hospitals. The program is a public–private partnership involving state and private hospitals and community residence providers. The essential elements of this program are described, along with the conceptual and philosophical bases of its treatment and examples of staff behaviors critical to treatment success. Outcome data are then discussed to emphasize the point that when evidence-based psychological treatment is implemented with this population, outcomes can be positive in most cases, and therefore, the number of treatment-refractory patients is actually far less than is estimated on the basis of response to medication alone. Schizophrenia is a serious mental disorder that affects approximately 1% of the population worldwide, with a current global incidence calculated at over 20 million people (Jablensky, 2000). The consequences of schizophrenia, in terms of both public health costs and effects on lives are enormous. For example, it has been estimated that as many as 10% of all disabled persons in the United States have schizophrenia (Rupp & Keith, 1993), and the disorder accounts for 75% of all mental health expenditures and approximately 40% of all Medicaid reimbursements (Martin & Miller, 1998). Among people with the disorder, only between 10%–30% are employed at any one time (Attkisson et al., 1992), and few of these people are able to maintain consistent employment (Policy Study Associates, 1989). Studies have consistently found that quality of life among people with schizophrenia is significantly poorer than among the rest of the population (Lehman, Ward, & Linn, 1982). Schizophrenia typically is diagnosed in late adolescence or early adulthood, and traditionally, approximately 50 –70% of cases are characterized by a chronic, relapsing course with high morbidity and permanent disability. In addition, rates of mortality and somatic morbidity are higher in schizophrenia than in the general population (Lieberman & Coburn, 1986), and the rate of attempted suicide equals that of major depression (Simpson & Tsuang, 1996). The economic costs of treating schizophrenia have been estimated to be $62.7 billion (e.g., including direct treatment costs and lost business productivity due to patient and family caretaker work absence; Wu et al.,

Relapse prevention in schizophrenia: does group family psychoeducation matter? One-year prospective follow-up field study

Objectives. Relapse prevention is one of the most important goals of long-term schizophrenia management, as relapse is both distressing and costly. Family intervention supplementation to standard treatment could reduce the relapse rate. This study assessed the influence of a short-term, clinically based, and profesionally led family psychoeducation programme on a 1-year relapse rate. Methods. A total of 120 patients were recruited upon discharge from two psychiatric hospitals in Prague: (1) Site A (N=86), where family psychoeducation is offered to all patients with schizophrenia, schizoaffective disorder, and acute psychotic episode with schizophrenic symptoms; and (2) Site B (N=34), where no such programme was offered. Results. Compared to nonparticipants, psychoeducation participants had a shorter average length of rehospitalization stay (5.89 vs. 17.78 days, P=0.045) in a 1-year follow-up after discharge. The probability of rehospitalization during a 1-year follow-up was higher for patients from the site that did not provide psychoeducation. Conclusions. A shorter average length of rehospitalization of psychoeducation participants, a high turnout of first-episode patients, and positive responses of psychoeducation participants suggest that family psychoeducation should be supplemented early in the course of the illness to achieve favourable treatment outcomes and minimize adverse health and the social consequences of schizophrenia.

Predictors and consequences of schizophrenia in the Northern Finland 1966 birth cohort

Des anomalies de la cognition, de la motricite fine, des emotions et du comportement sont frequentes chez les enfants apparemment sains, qui plus tard developperont une schizophrenie. Ces elements suggerent que certains facteurs favorisants setablissent bien avant que le diagnostic de psychose ne soit fait. Nous avons tente de recenser les facteurs contribuant au developpement des schizophrenies. Nous nous sommes polarises sur les facteurs genetiques, les complications de la grossesse et de l’accouchement, le developpement precoce, les performances scolaires ainsi que sur les retentissement physique et social. Ce travail est bases sur une revue des travaux scientifiques, des articles publiees et des recherches en cours concernant la cohorte nord-finlandaise de 1966.

Perception of patients’ unpredictability and beliefs on the causes and consequences of schizophrenia

The belief that mental disorders involve a high risk of unpredictable behaviours is a factor which influences negatively the social acceptance of the mentally ill. In this paper, we compare the beliefs about the causes and psychosocial consequences of schizophrenia expressed by 536 respondents who had the firm conviction that patients with schizophrenia are unpredictable and by 457 respondents who firmly believed that they are not. The survey was conducted in 30 Italian geographic areas, randomly selected taking into account their location and population density. The data were collected by the Questionnaire about Opinions on Mental Illness (QO). Respondents who believed that patients with schizophrenia are unpredictable reported more frequently factors such as use of alcohol and drugs and frequenting bad company as being involved in the development of the disorder. In addition, this group showed more restrictive opinions about patients' civil and affective rights. Low education was found to be significantly associated with perception of "unpredictability" in schizophrenia. These results suggest the need to: a). inform the general public on the main clinical characteristics of schizophrenia and on the risk of unpredictable behaviours in the acute phases of this mental disorder; b). carry out sensitisation campaigns against discrimination toward people with schizophrenia emphasising successful experiences of social integration.

Causes and psychosocial consequences of schizophrenia: the opinions of Italian population

Description of opinions on schizophrenia and its psychosocial consequences in a sample of general population. The study has been carried out in 29 GP units stratified by geographic area and population density of their catchment areas and randomly selected. Each respondent was asked to read a case-vignette describing a patient who met ICD-10 criteria for schizophrenia, and then to fill the Questionnaire on the Opinions about Mental Illness--General Population's version (QO-GP). Data on 714 respondents were collected. 21% of the sample identified a case of schizophrenia, 66% of depression/anxiety disorder, and 13% of "nervous breakdown". Factors most frequently mentioned as causes of detected disorder were stress (72%), heredity (62%), family difficulties and psychological traumas (45%). More pessimistic opinions about psychosocial consequences of schizophrenia were found among respondents with lower educational level and older age. Respondents who referred the case-vignette to schizophrenia reported more pessimistic opinions about psychosocial consequences of detected disorder. The results of this study outline the need to plan educational campaigns on mental illnesses, which take into account the socio-cultural characteristics of the target populations.