Decrease In Social Functioning Research Articles

UK trial of pressurised intraperitoneal aerosolised chemotherapy (PIPAC) with oxaliplatin for colorectal cancer peritoneal metastases (NCT03868228).

This is the first UK trial of pressurised intraperitoneal aerosolised chemotherapy (PIPAC) for colorectal cancer peritoneal metastases. This trial aimed to assess the impact of PIPAC in combination with standard of care systemic treatment on: progression free survival (PFS); quality of life (QoL); and short-term complications. In addition, this trial set out to demonstrate that PIPAC can be performed safely in operating theatres within a National Health Service (NHS) setting. Single-centre clinical trial with prospective data collection for patients undergoing 8-weekly PIPAC with oxaliplatin at 92 mg/m2 from January 2019 till January 2022. Progression free survival was assessed using peritoneal carcinomatosis index (PCI) by CT scans and laparoscopy. Quality of life was assessed by EORTC QLQ-C30 questionnaire. Adverse events were recorded using CTCAE. Five patients underwent a total of ten PIPAC administrations (median 2, range 1-4). Median PFS was 6.0months. QoL was maintained across repeat PIPAC procedures but a decrease in social functioning and increased fatigue were evident. Three incidences of grade 3 adverse events occurred but PIPAC was well tolerated. The presented data demonstrates that PIPAC is feasible and can be safely delivered within the NHS for patients with colorectal cancer peritoneal metastases, but caution must also be exercised given a risk of adverse events. Systemic chemotherapy can be safely administered at a different unit to the PIPAC procedure if both groups have clear lines of communication and timely data sharing.

Cannabis Use and Symptomatic Relapse in First Episode Schizophrenia: Trigger or Consequence? Data From the OPTIMISE Study.

This analysis examined the relationship between cannabis use, compliance with antipsychotics and risk for relapse in patients in remission following a first episode of schizophrenia, schizophreniform, or schizoaffective disorder. Analyses were performed on data from a large European study on first episode of schizophrenia, schizophreniform, or schizoaffective disorder (OPTiMiSE). After 10 weeks of antipsychotic treatment, 282/446 patients (63%) met criteria for symptomatic remission; of whom 134/282 (47.5%) then completed a 1-year follow-up. Cross-lagged models and mediation models investigated the temporal relationships between cannabis use, compliance with antipsychotics, social functioning, and symptomatic worsening/relapse. Compared to nonusers, cannabis use increased risk for relapse, adjusted hazard ratio (HR) = 3.03 (SE = 0.32), P < .001, even in patients who were compliant with antipsychotic medication, adjusted HR = 2.89, (SE = 0.32), P < .001. Cannabis use preceded symptomatic worsening and was followed by worsening of Positive and Negative Syndrome Scale total score at the 1-year end-point (standardized β = 0.62, SE = 0.19, P = .001) and by worsening of social functioning (coef = -0.66, P ≤ .001). In patients in remission from their first episode of schizophrenia, schizophreniform, or schizoaffective disorder, cannabis use increases the rate of relapse in both compliant and noncompliant individuals. Importantly, the temporal relationship between cannabis and relapse was that cannabis use preceded later relapse, noncompliance, and decrease in social functioning, and not that patients began to relapse, then used cannabis. Further research with a precision psychiatry approach might identify those patients in particular danger of relapse when using cannabis.

Is change over time in psychotic symptoms related to social functioning?

In psychosis, treatment often focuses on symptom reduction whereas social functioning is also essential. In this study, we investigate positive psychotic symptoms and medication use in relation to social functioning over a 3-year time-period in 531 patients diagnosed with psychosis. Furthermore, relations of positive symptoms with needs for care and quality of life were also investigated. Using repeated measures analysis, changes were measured over time. Hereafter, mixed model analyses were performed to determine the associations of social functioning, needs for care, and quality of life with psychotic symptoms and patient characteristics. Finally, we assessed differences in symptoms and medication dose between those with an increase and those with a decrease in social functioning. Patients significantly improved in social functioning, while psychotic symptoms increased. Improvement in social functioning was associated with younger age, higher IQ, and lower social functioning at T1, but not with positive symptoms. Also, improvement in social functioning was found to be related to a decrease in the dose of clozapine. Improvement in social functioning occurs despite worsening of positive symptoms. The findings suggest the need to further explore the relation between symptomatology, social functioning, and medication use. In the treatment of psychotic disorders, one should reconsider the strong focus on reducing psychotic symptoms. The current focus needs to shift much more toward improving functional outcome, especially when the patient expresses a desire for change in this respect.

Social adaptive potential of mentally ill patients with concomitant pathology

The paper presents the results of research devoted to determination of social-adaptive potential of schizophrenic patients with concomitant somatic pathology by analyzing the parameters of socio-personal functioning, quality of life and compliance. The analysis of social and personal functioning of patients was carried out according to the results of the PSP scale (Personal and Social Performance Scale), which allowed to assess the social status of patients and their functioning in certain areas of life.&#x0D; The quality of life of patients with schizophrenia in the surveyed groups was assessed using the results of the health questionnaire The 36-Item Short Form Survey (SF-36). According to the results of the research, it was found that when schizophrenia is combined with somatic disorders, there is a decrease in the level of socio-personal functioning, quality of life and compliance of patients. The social and personal functioning of patients with schizophrenia in its combination with somatic disorders was especially complicated in the areas of socially useful activities and self-care (in schizophrenia with obesity) and in the field of social relations and restless/aggressive patterns of behavior (in schizophrenia with DM 2).&#x0D; According to the assessment of quality of life in certain areas, it was found that in patients with schizophrenia with CVD and obesity, there was a decrease in physical functioning and limitation of daily functioning due to physical condition, as well as mental depression (the presence of severe depression and anxiety); in patients with schizophrenia with DM 2 - a decrease in daily functioning, due to emotional state; and in patients with obesity - also a decrease in social functioning; and a general decline in general health that was common to all patients with somatic disorders. The decrease in the level of compliance of patients with schizophrenia with somatic disorders was due to insufficient formation of factors related to the patient (perception and awareness of the disease, features and severity of symptoms, relapses, features of social functioning and adaptation) and attitudes towards treatment. According to the data obtained, the most dangerous in focus of social functioning it was the combination of schizophrenia with obesity.&#x0D; The results of the study show that the combination of schizophrenia with somatic diseases is associated with a decrease in social functioning, quality of life and compliance with patients, which leads to a negative social prognosis and requires the attention of clinicians.

Sex differences in social functioning of patients with schizophrenia depending on the age of onset and severity of the disease.

Schizophrenia manifests differently in women and men. This disease starts at a young age, leads to disability at working age. The aim of our work was to study sex differences, association between social factors and different parameters of the clinical picture and the course of the disease. This study was performed using population of Russian patients (men: 345, women: 310). Patients were examined using DSM-V, Bush-Francis catatonia rating scale (BFCRS), Positive and Negative Syndrome Scale (PANSS), 4-Items Negative Symptoms Assessment (NSA-4) and Frontal Assessment Battery (FAB). Sex differences were mainly shown through negative symptoms, which were more severe in male patients. Men were shown to experience a decrease in social functioning and earlier age of onset. A positive family history further influenced negative symptoms and age of onset. When comparing scores before and after inpatient treatment (4 weeks), sex differences were not so pronounced. Female patients and patients with high levels of education, no conflictual relationship with family and active labour activity showed a later age of onset of the prodromal events and manifestation age. The decrease in the number of social contacts correlated with lower age of disability. The association between social factors and the severity of psychotic symptoms was shown across DSM-V, PANSS, NSA-4 and FAB, but not for BFCRS. Social factors were associated with negative symptoms of schizophrenia, but not with positive. For successful treatment of patients with schizophrenia, the discussed factors must be considered and schizophrenia treatment methods should be primarily aimed at improving social functioning.

The dynamics of the quality of life of primary schoolchildren with different cognitive success

Objective: of the study was to study the quality of life of younger students in the dynamics of their education in primary school.Materials and methods: 573 children of primary schools of Rostov-on-Don were examined. Th e study of quality of life was carried out using the PedsQL 4.0 questionnaire. Depending on the level of cognitive development, children were divided into 2 groups: 82 children with high cognitive development made up the I (main) group and 491 children with an average level of cognitive development made up the II (control) group. Cognitive development was evaluated by the D. Wexler test, the Stanford-Binet intelligence scale with IQ coeffi cients, and E. Torrens creativity test.Results: primary schoolchildren with high cognitive abilities show a dynamic decrease in physical functioning with the lowest rates in the 4th grade, lower indicators of emotional functioning, characterized by an excessive reaction to failure, an increased level of anxiety and emotional instability. A decrease in social functioning is revealed, manifested by communicative problems in the process of interpersonal communication. Higher school functioning values were observed. From the 2nd grade, schoolchildren with high cognitive abilities showed statistically signifi cantly lower indicators of the overall quality of life score as compared with children of average intellectual development.Conclusions: among primary schoolchildren of high cognitive development, there is an imbalance in various aspects of the quality of life, which requires additional measures to optimize indicators.

The relationship between theory of mind and social functioning within the schizophrenia spectrum

IntroductionCurrent research shows that subjects with disorders belonging to the schizophrenia spectrum have a poor social functioning. There are several factors that can influence social functioning, social cognition being one of them.ObjectivesAssessing the ability to identify emotions and its role in the social functioning of subjects with a schizophrenia spectrum diagnosis.PurposeIncreasing the social functioning of subjects with a schizophrenia spectrum diagnosis.MethodWe evaluated 31 subjects who were at their first admission to the Timisoara psychiatric clinic and who met the diagnostic criteria for a schizophrenia spectrum disorder (a diagnosis of F20, F22 or F25 according to ICD 10). The following parameters were monitored: sociodemographic (gender, age of onset, educational level, marital and professional status), theory of mind (Reading the Mind in the Eyes Test) and social functioning (GAF Scale). The subjects were evaluated during periods of remission. The acquired data was statistically processed.ResultsThe results of the sociodemographic parameters analysis were similar to those in international literature. Most subjects showed a lack of theory of mind (a mean score of 18, standard deviation 5.84). All subjects experienced a decrease in social functioning (a mean score of 64.7 on the GAF Scale). There is a direct correlation between the ability to identify emotions and social functioning (Spearman R = 0.386, P &lt; 0.05).ConclusionsA decreased ability to identify emotions is directly correlated with decreased social functioning in subjects with schizophrenia spectrum disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Parental mental health moderates the efficacy of exercise training on health-related quality of life in adolescents with congenital heart disease.

To evaluate the moderating influence of parental variables on changes in health-related quality of life (HRQoL) in adolescents with Tetralogy of Fallot (ToF) or a Fontan circulation after participation in standardized exercise training. A multicenter randomized controlled trail in which 56 patients, aged 10-15, were randomly allocated (stratified by age, gender, and congenital heart disease) to a 12-week period with either: (a) 3 times per week standardized exercise training or (b) care-as-usual (randomization ratio 2:1). Adolescents and their parents filled in online questionnaires at baseline and at 12-week follow-up. In this randomized controlled trail, primary analyses involved influence of parental mental health and parental social support for exercise on changes in the TNO/AZL Child Quality of Life Questionnaire Child Form at follow-up. Secondary analyses concerned comparing levels of parental characteristics with normative data. Compared with controls, adolescents in the exercise group reported a decrease in social functioning when their parents had more anxiety/insomnia or severe depression themselves. Adolescents also reported a decrease in social functioning when their parents showed poorer overall mental health themselves. Parents reported comparable or even better mental health compared with normative data. The effect of a standardized exercise program on HRQoL changes in adolescents with ToF or a Fontan circulation is moderated by parental mental health, more specifically by parental anxiety/insomnia and severe depression. The trial registration number of this article is NTR2731 ( www.trialregister.nl ).

Prevalence of Familial Misbehaviour at Mania and Schizophrenia Patients

Psychiatric illness is one of the major causes of disability and decrease in social functioning. Today in most communities due to lack of resources a significant part of the responsibility to care and maintenance of psychiatric patients affected in the responsibilities of the families. One of the most important health issues and problems is Familial misbehavior. Therefore, this study conducted with an aim to determine the prevalence of familial misbehavior at mania and schizophrenia patients hospitalized in Taft psychiatric center. Simple randomized method conducted this descriptive study between 122 selected patients. Data collected by questionnaire in two parts; demographic (9 questions) physical and psychological misbehavior (22 questions) by a general medicine in the interview. Data were analyzed in SPSS-11 by using the descriptive statistics and chi-square test in (α=0.05). Mean age of Patients was 35.22±12.29 years, 69 persons (56.5%) were male, 53 persons (43.5%) women. 59 persons (48.4%) manic disease and 63 persons (51.6%) had a schizophrenia. 80 persons (65.6%) have experienced physical misbehavior, 96 persons (78.7%) psychological, 109 persons (89.3%) physical and psychological, only 13 persons (10.7%) did not experience any misbehavior. Householder patients, manic and men mostly experienced physical misbehavior. Prevalence of physical and psychological misbehavior was 89.3 percent. Importance of attention and adopting a necessary educational preventive approach in family .

Importance of Awareness of Perioperative Social and Physical Situations of Living Donors for Liver Transplantation

IntroductionTransplantation in Japan still depends on living donors even after the new revised law. We must pay attention to protect living donors. Patients and MethodsPerioperative qualities of life after living donation for liver transplantation were assessed with questionnaires including the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 (SF36-v2). Nonparametric Mann-Whitney tests were used to determine statistical significance. P values <.05 were considered significant. ResultsThirty-one among 33 donors answered questionnaires (93.9%). The 15 men and 16 women of average age of 39.7 years had a median hospital stay of 16 days and median duration after surgery of 78 months. Ten of 33 (35.7%) donors considered themselves to be the only possibility. The decision to a donor was established prior to informed consent in 23 donors (74.1%). Six months were required for them to experience a full recovery after donor surgery. Hamilton depression/anxiety score was significantly increased among donors who considered themselves to be the only possibility or those who had decided prior to informed consent. SF36-v2 revealed a significant decrease in social functioning among donors who did not have sufficient time to decide before surgery. General health was significantly decreased among donors who required more than 6 months for full recovery. Perioperative management of pain influenced general health, physical role, bodily pain, and physical functioning. ConclusionWe must pay attention to depression and anxiety among living donors. More care should be focused on pain control and sharing of information of postoperative courses.

Changes In Health Status and Quality of Life In Adults with Thalassemia: Year 1 Report of the Thalassemia Longitudinal Cohort Study.

AbstractAbstract 1533 Background:Advances in treatment of thalassemia have led to increased life expectancy for patients, making outcomes such as health related quality of life (HRQOL) an important consideration of therapy. However little has been published about the HRQOL of patients living with thalassemia, especially as it may change over time. Our study reports changes in patient-reported HRQOL from baseline to year 1 in the Thalassemia Clinical Research Networks (TCRN) Thalassemia Longitudinal Cohort (TLC) study. Methods:The TCRN is an NIH sponsored network of 16 major thalassemia centers in the US, Canada and London. We report here on the results from 220 patients (approximately 80% of the total cohort) over the age of 14 who completed baseline and year 1 assessments. HRQOL was measured by self-report with the Medical Outcomes Study 36-Item Short Form Health Survey version 2 (SF36v2). We defined a clinically significant change as a difference of at least 2 points on any SF-36 subscale. Results:Overall the patients were 46% male with a mean age of 29 years at baseline (range 14–58).Across the TLC population, mean self-reported HRQOL showed little change over the 1 year study period, with only social functioning showing a significant increase (p=0.04). However in each SF-36 domain over 50% of patients reported a signficant change in scores (an increase or decrease of more than 2 points) (Figure 1). All patients had a significant change on at least one domain, with a mean of 7 domains affected.Overall a small majority of patients (56%) reported that their health in general was “about the same” at year 1 as at baseline; 14% reported it was somewhat worse, 19% somewhat better, and 11% much better. Forty-nine % of patients reported requiring fewer transfusions in year 1, while 34% needed more, and 17% had no change. Most patients (82%) made no change in their chelator, although 8% changed from deferoxamine (DFO) to an oral chelator, fewer than 1% changed from oral to DFO, and 3% each stopped and started chelation. Most patients (61%) reported the same general adherence rate, although taken together there was slightly better reported adherence in year 1. Almost half of patients (47%) reported no change in chelator side effects, although again there was a slight overall decrease in reported side effects across the group. Most patients (92%) reported no new secondary complications in year 1.As expected, increasing age was associated with decreased HRQOL in the following domains: physical function, bodily pain, vitality, social function, mental health, and physical summary scales, although only bodily pain showed a clinically significant change (+2.1 points). Gender, race, change in number of transfusions, and change in chelator were not associated with change in HRQOL, although there was a trend towards improved general health in patients who made any change in chelation. A decrease in reported side effects from chelation was associated with an improvement in physical functioning (+2.8) and the mental summary score (+3.48), while development of a new complication during the one year study period was associated with a decrease in role-emotional (-8.2). Surprisingly an increase in reported adherence was associated with a decrease in social functioning (-5.1), role emotional (-7.7) and the mental summary score (-5.4). Conclusions:As a population, the TLC showed overall stability in clinical status and SF-36 scores over the 1 year study period. However individual patients reported significant changes, both positive and negative, in an average of 7 SF-36 domains. HRQOL appears to be most affected by age, with some association with changes in chelator, secondary complications, side effects and adherance. Further analysis is needed in order to fully understand these associations. [Display omitted] Disclosures:Neufeld: Novartis, Inc: Research Funding; Ferrokin, Inc: Research Funding.

Chronic URB597 treatment at adulthood reverted most depressive-like symptoms induced by adolescent exposure to THC in female rats

We have recently shown that chronic THC administration in adolescent female rats induces subtle but lasting alterations in the emotional circuit ending in depressive-like behaviour at adulthood. Here we describe other relevant depressive-like symptoms present in these animals. Adult female rats pretreated with THC display passive coping strategy towards acute stressful situations as demonstrated by their behaviours in the first session of the forced swim test, develop a profound anhedonic state as demonstrated by the reduced consumption of palatable food and present a decrease in social functioning. Besides the emotional symptoms, adolescent exposure to THC induced a significant deficit in object recognition memory. Since it has been reported that deficits in adult hippocampal neurogenesis may underlie the cognitive dysfunction seen in depression, we then survey cell proliferation in the dentate gyrus of the hippocampus. Adolescent THC exposure significantly reduced the number of BrdU-positive cells in THC-treated rats as well as hippocampal volume. We suggest that this complex depressive-like phenotype is triggered by a long-lasting decrease in CB1 receptor functionality in specific brain regions. To test whether an increase in the endocannabinoid signalling could ameliorate the depressive phenotype, adult female rats pre-exposed to THC were injected with URB597 (0.3mg/kg ip) and then tested in behavioural assays. URB597 was able to reverse most depressive-like symptoms induced by adolescent THC exposure such as the passive coping strategy observed in THC exposed animals in the forced swim test as well as anhedonia and the reduced social activity.These results support a role for the endocannabinoid system in the neurobiology of depression and suggest the use of URB597 as a new therapeutic tool with antidepressant properties.

Clinical depression among narcotic addicts maintained on methadone in the community.

In a study of 106 predominantly young, lower-social-class men participating in a methadone maintenance program, the authors found that about one-third were moderately to severely depressed as assessed on standard rating scales of depression. The depressive symptoms were associated with a decrease in social functioning, increase in stress in the past 6 months, and a history of alcohol abuse. Because the combination of depression and drug addiction creates a high risk for suicide, depressive symptoms require early detection and treatment. The authors point to the need for more research on treatment approaches, particularly the use of psychotropic drugs.