Function In Schizophrenic Patients Research Articles

Training of Affect Recognition impacts electrophysiological correlates of facial affect recognition in schizophrenia: Analyses of fixation-locked potentials

Objectives. Training of Affect Recognition (TAR) is a useful approach to restoring cognitive function in schizophrenic patients. Along with improving visual exploration of faces and altering central information processing in relevant brain areas, TAR attenuates impairments in facial affect recognition. In the present study, we investigate the effects of TAR on early electrophysiological correlates of facial affect recognition in schizophrenia. Methods. The study population comprised 12 schizophrenic patients and 14 healthy controls. In each individual, we carried out EEG, concomitant measurements of scanning eye movements and fixation-based low resolution electromagnetic tomography (sLORETA) analyses of brain electric activity. All analyses were performed at baseline and after participation in TAR. Results. In patients, brain activation patterns significantly changed after completing the TAR. Functional improvements were particularly pronounced in the superior parietal and inferior parietal lobes, where trained patients showed a larger increase in activation than untrained healthy controls. Conclusions. The TAR activates compensatory brain processes involved in the perception, attention and evaluation of emotional stimuli. This may underlie the established behavioral effects of the TAR in schizophrenic patients, which include improvements in facial affect recognition and alterations of visual exploration strategies.

Computer-assisted cognition training for schizophrenic patients

Objective To investigate the effect of computer-assisted cognition training on the cognitive functioning of schizophrenic patients. Methods One hundred and four persons with schizophrenia were randomly divided into a research group of 51 cases and a control group of 53. The former were given computerized cognition training covering attention, memory and executive functions. The training lasted 2 months. The controls received regular occupational and recreational therapy. Before and after the treatment the 2 groups were evaluated using the Positive and Negative Syndrome scale (PANSS), the Trail Making tests A and B (TMTs), Wechsler's memory scale (WMS) and the Wisconsin card sorting test (WCST). Results The average total PANSS score of the research group declined significantly from (70.23±7.62) before treatment to (59.82±8.41) after treatment; so did that of the control group from (68.32±10.14) to (59.45±9.05). The average negative symptoms scale score of the treatment group and the control group also decreased significantly for (21.46±3.26) before treatment to (16.67±3.20), and from (20.82±4.21) to (17.08±3.23) respectively, but there was no significant difference between the groups in the magnitude. The research group's average TMT A and TMT B scores also decreased from(51.76±21.18) and (114.31±35.76) to (44.14±17.51) and (96.47±34.43), while no significant difference was observed before and after the treatment in the control group. The WMS recognition and regeneration scores of the research group improved significantly from (5.83±3.12) and (8.63±3.45) to (8.21±3.96) and (10.24±3.52) after intervention, while no improvement was found in the control group. The same trend was observed in the total test number, the continuous error numbers, the correct numbers and the classification number scores in the WCST. Conclusion Computerized cognition training can improve the cognition of persons with schizophrenia to some extent. Key words: Schizophrenia; Cognitive therapy; Computer-assisted therapy; Cognitive disorders

Role of Cognitive Rehabilitation in Patients Suffering From Schizophrenia with a Comorbid Addiction to Amphetamine and Cannabis

Introduction An important element of the rehabilitation in schizophrenia is cognitive rehabilitation, aimed at the greatest possible reduction in deficits. Objective The aim of this study was to examine cognitive functioning in schizophrenic patients with a comorbid addiction to psychoactive substances participating in a cognitive rehabilitation program. Methods All recruited patients were men, aged between 20 and 45 years. They were examined in the initial period of the stay at the treatment center and after 4-7 weeks of hospitalization, after the stabilization of acute psychotic symptoms. During this time patients participated in the cognitive rehabilitation program. Cognitive function were assessed: Trail Making Test (TMT A & B), Stroop Test, and Verbal Fluency Test. Patients were divided into two groups according to abused substances: a) amphetamine users (n = 15), b) cannabis users (n = 11). As for the medication – 25 of 26 patients were treated with second generation antipsychotics. Results After the process of rehabilitation of cognitive functions of all gained patients gained a significant improvement. The type of abused psychoactive substance did not significantly affect cognitive functioning. However, amphetamine-dependent patients achieved better results in some of the cognitive tests. Cognitive rehabilitation does not affect the reduction of psychopathological symptoms. However, in patients addicted to amphetamines a decrease in the severity of these symptoms was found. Conclusions Cognitive rehabilitation exerts a positive effect on cognitive functioning of schizophrenic patients with concomitant dependence on psychoactive substances.

Investigation of Theory of Mind in Schizophrenia Based On Positive and Negative Symptoms, Gender, Type of Delusions and Episodes

Objectives Deficit in the ability to understand others' mental conditions, opinions, beliefs, fantasies and desires have been reported among schizophrenic patients so far. However, fewer studies have examined the type of positive/negative symptoms and delusions on their social cognition abilities. The main purpose of this study was to investigate the theory of mind (ToM) performance in schizophrenic patients and compare it with healthy controls. Methods This cross-sectional study conducted at Ibn-e-Sina psychiatric hospital in Mashhad, included 28 schizophrenic patients, aged between 18 and 50, based on DSM-IV-TR criteria and 14 healthy subjects. Evaluation of symptoms was performed by positive and negative syndrome scale (PANSS) test and the ToM assessed by the 'Reading the Mind in the Eyes” Test. Results Analysis of variance showed a significant impaired ToM in schizophrenic patients as compared with the healthy controls (p=0.00). But the ToM deficits did not differ in positive and negative symptoms (p=0.951), genders (p=0.286) and the frequency of episodes (p= 0.470). The delusions of persecution and grandeur showed a significant lower ToM performance as compared with the delusions of control (p=0.041). Conclusion Although the ToM abilities impairment in schizophrenia has been proved, its relationship with types of symptoms and delusions, and the duration of illness require further investigations. This may help to improve the possible treatments and prevention potentials in future.

Hypothalamic-Pituitary-Adrenal (HPA) Axis Functioning among Patients with Schizophrenia: A Cross Sectional Comparative Study

Objectives: Higher perceived stress and maladaptive coping strategies seems to play an important role in the course and outcome of schizophrenia. The biological effects of stress are mediated by the hypothalamic-pituitary-adrenal (HPA) axis functioning (reflected by cortisol and DHEAS ratio). The aim of this study were, first to compare serum cortisol, DHEA-S concentration and their molar ratio in schizophrenic patients with healthy subjects, and secondly to determine their correlation with psychopathology of schizophrenia. Methods: One hundred clinically established male patients with schizophrenia and fifty ages matched healthy controls participated in this study. Fasting serum cortisol and DHEAS levels were measured by Chemiluminescence Immunoassay (CLIA). Psychopathology was assessed by using the Positive and Negative Syndrome Scale (PANSS). Sociodemographic characteristics, data regarding onset of illness, disease duration and medication history were recorded in self designed semi-structured proforma. The data collected on above tools, were analyzed by z test and Pearson Correlation Coefficient. Results: Serum cortisol levels and cortisol to DHEAS molar ratio were significantly higher in schizophrenic patients [(z=-4.457; p<0.001) (z=-3.787; p<0.001)] than in healthy comparison subjects, while no significant differences were seen in the DHEAS levels. These hormonal indices were not significantly associated with severity of psychopathology, onset of illness and disease duration in schizophrenia patients. Conclusions: Our findings suggest that besides the elevated cortisol level, cortisol to DHEAS ratio might reflect abnormal HPA axis functions in schizophrenic patients. Persistent stress vulnerability in these patients may lead to increased sensitivity to brain insults and in turn dysregulated neurotransmission, resulting in progressive deterioration in cognitive, emotional and psychosocial functions.

Remediation of context-processing deficits in schizophrenia: preliminary data with ambiguous sentences.

BackgroundProcessing of contextual information is essential for the establishment of good interpersonal relations and communicational interactions. Nevertheless, it is known that schizophrenic patients present impairments in the processing of contextual information. The aim of this study is to explore the influence of the remediation of context processing in schizophrenic patients.MethodsThirty-one schizophrenic patients and 28 matched healthy participants were included in this study. All participants were assessed on verbal knowledge (Mill-Hill test) and depression intensity (Beck Depression Scale 21 items). Schizophrenic patients were also assessed on thought, language, and communication disorders (Thought, Language and Communication scale). All participants completed a disambiguation task with two different levels of contextualization (high or low context) and a context-processing remediation task containing social scenarios that included ambiguous words and were presented with two different types of instruction: with or without context explanation.ResultsFor the disambiguation task, results showed no effect of group, but a main effect of context, with better performances in the high-context than the low-context condition. For the context-processing remediation task, results showed a main effect of group: The performance of schizophrenic patients who had received explanations differed from that both of healthy participants and of schizophrenic patients who had not received explanations.ConclusionThis study revealed that for all participants, the structuring of context had a positive effect on the contextual integration of ambiguous words. Concerning the remediation task, explanations about the strategies that could be used to take context into account improved the schizophrenic patients’ performances. This allows us to consider new methods of remediation that could improve social interaction in schizophrenia.

Effects of repetitive transcranial magnetic stimulation with theta burst stimulation paradigm on the executive function of schizophrenia patients

Objective To evaluate the effect of theta burst stimulation(TBS) paradigm of repetitive transcranial magnetic stimulation(rTMS) on the treatment of schizophrenia through assessing executive function. Methods 60 patients met with DSM-4 and ICD-10 for schizophrenia disorders criteria were enrolled in this study. The group was divided into theta burst stimulation group(research group, n=30) and sham intervention group(control group, n=30). The research group and control group were assessed with the Wisconsin card sorting test(WCST) and the go/no-go task by event-related potential(ERPs) before and after 4 weeks treatment. Each test results of all groups before and after treatment were compared with each other respectively. Results Regarding the WCST test, compared with the baseline, the post-rTMS state of the TBS group showed a decrease in the error selection percentage((59.8±14.7)%), the preservative error number(55.3±18.0) and the preservative error percentage(71.3±12.6)%, but the percentage of conceptual level(71.3±12.6)% increased in the TBS group(P 0.05). Conclusions Theta burst stimulation paradigm of rTMS can improve the executive function in schizophrenic patients. Key words: Repetitive Transcranial magnetic stimulate; Theta burst stimulation paradigm; Schizophrenia; Executive function; Event-related potential

Efficacité et tolérance à court terme de la lurasidone dans la prise en charge de la schizophrénie

Lurasidone is a new second-generation antipsychotic approved in October 2010 by the Food and Drug Administration and in March 2014 by the European Medicines Agency for the treatment of schizophrenia. Like other second-generation antipsychotics, lurasidone is an antagonist of D2 dopamine and 5HT2A serotonin receptors, but differs from the other second-generation antipsychotics in its action profile for certain receptors. Lurasidone is the second-generation antipsychotic with the greatest affinity for 5HT7 receptors and has a low affinity for α1 and α2C-adrenergic and 5HT2C serotonin receptors, and no affinity for histaminergic H1 or muscarinic M1 receptors. Lurasidone has demonstrated its efficacy in several short-term studies in acute schizophrenia with significantly reducing total scores of Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) compared with placebo. Early improvement was observed by days 3-7 for the 80-160 mg/day doses. Two studies with several methodological limitations showed that lurasidone might be involved in the improvement of cognitive performance in schizophrenic patients. Post hoc analysis of four pooled short-term studies showed significantly better effects on improving depressive symptoms associated with schizophrenia in patients treated with lurasidone as compared to patients treated with placebo. Lurasidone differs from the other second-generation antipsychotics by a good tolerability profile, in particular in terms of metabolic and cardiovascular profiles. Although results of the preclinical studies suggested that lurasidone had a low potential for causing clinically significant extrapyramidal symptoms, these were observed with a higher frequency than expected. It seems to have a significant though moderate link with the occurrence of akathisia, extrapyramidal symptoms, and hyperprolactinemia during initiation of treatment. This new tolerance profile greatly broadens the scope of second-generation antipsychotics and supports the view of some authors that the term second-generation antipsychotic is now outdated. Other therapeutic perspectives of lurasidone have been assessed, in particular in bipolar depression.

Intracellular Signaling and Approaches to the Treatment of Schizophrenia and Associated Cognitive Impairment

Schizophrenia is a pervasive neuropsychiatric disorder affecting over 1% of the world's population. Dopamine system dysfunction is strongly implicated in the etiology of schizophrenia. Data support the long-standing concept of schizophrenia as a disease characterized by hyperactivity within midbrain (striatal D2) dopamine systems. In addition, there is now considerable evidence that glutamate neurotransmission, mediated through NMDA-type receptors, is deficient in schizophrenic patients and that hypoactivity in cortical dopamine and glutamate pathways is a key feature of the schizophrenic brain. While current antipsychotic medications-typically dopamine D2 antagonists-adequately address positive symptoms of the disease, such as the acute hallucinations and delusions, they fail to substantially improve negative features, such as social isolation, and can further compromise poor cognitive function in schizophrenic patients. In fact, cognitive impairment is a core feature of schizophrenia. The treatment of cognitive impairment and other residual symptoms associated with schizophrenia, therefore, remains a significant unmet medical need. With current cell-surface receptor-based pharmacology falling short of addressing these core symptoms associated with schizophrenia, more recent approaches to treatment development have focused on processes within the cell. In this review, we discuss the importance of a number of intracellular targets, including cyclic nucleotide phosphodiestereases, and non-phosphodiesterase approaches such as ITI-007, which have been proposed to regulate hyperdopaminergic function, hypoglutamatergic function and/or the delicate balance of the two associated with cognitive deficits in schizophrenia. We also discuss the challenge facing those developing drugs to target specific pathways involved in psychopathology without involving other systems that produce concomitant side effects.

EPA-0417 – Gender-specific neurocognitive differences among schizophrenia patients

According to the data from literature the neurocognitive changes in schizophrenia are mild to moderate and are modestly related to negative symptoms. Cognitive deficits in schizophrenia are regarded by many psychiatrist as an important symptom, which requires appropriate treatment and rehabilitation. There are different conditions, which may have an influence cognitive impairment in schizophrenic patients. One the factors differentiating subgroups of schizophrenic patients when neuropsychological functioning is analyzed is sex. This Review was focused on cognitive functioning of schizophrenic patients of different sexes. In order to achieve this result PubMed was searched using following terms: cognitive functions, schizophrenia, gender differences, sex hormones, memory, attention, neuropsychological, psychopatological symptoms. Most of the analyzed papers reflecting the cognitive differences between men and women suffering from schizophrenia postulate a worse performance in neuropsychological test by male patients. However according to some authors there are no gender differences in cognitive functioning in schizophrenic patients or those differences are not clinically significant. The above analysis shows that there is a number of studies, according to which differences between men and women among schizophrenic patients are present, however the problem of sex-specific differences in cognitive functioning in patients in schizophrenia needs further investigation.

EPA-0619 - Tai-chi exercises for schizophrenia

Background The benefits of Tai-chi on relaxation, mental focus, motor coordination, balance, and stress reduction may help improve symptoms control and physical functioning in schizophrenic patients. The study aims at evaluating the effects of Tai-chi and developing this mind-body exercise in residential care of schizophrenia in long term. Method The RCT included a pilot trial and an on-going 3-arm main study. A pilot trial with 30 participants randomly allocated into a 12-session (6-week) Tai-chi program and control group was conducted. Gross motor coordination, negative symptoms and functional disabilities were assessed at baseline, 1 week and 6 weeks post-intervention. Recruitment of 150 participants for the main study was conducted at the same hostel. They were randomly allocated into Tai-chi group, exercise group and wait-list control group. The study is still in progress and will be reported in the presentation. Results For the pilot trial, participants in the control group showed marked deteriorations in the above areas throughout the study period. Tai-chi showed a protective effect from deteriorations in gross motor coordination (Z=-2.28; p=.023), and interpersonal functioning which could be sustainable for 6 weeks after the program (Z=(2.56; p=.01). Preliminary results of the main study will be presented in the conference. Conclusion The pilot trial demonstrated the positive effects of Tai-chi on promoting movement coordination and alleviating functional disabilities. The group exercise format encourages socialization and interpersonal functioning. Tai-chi emphasizes movement rhythm and inner calmness which may further help symptoms control. The main study will confirm the results of the pilot trial.

16. Processing of nociceptive input in schizophrenic patients: Preliminary results

According to previous studies schizophrenic patients have a reduced perception of pain. We aimed at assessing pain thresholds and nociceptive pathway function in schizophrenic patients by using Quantitative Sensory Testing (QST) and Laser Evoked Potentials (LEPs). We planned to enroll 30 patients with a diagnosis of schizophrenia and 30 age and sex matched healthy controls. At present we collected 8 schizophrenic patients and 10 healthy control. All subjects underwent QST and right hand LEPs. Although QST parameters did not show statistical significance between schizophrenic patients and normal controls, the cold pain threshold approached the statistical significance ( P = 0.08, unpaired t -test). Conversely the amplitude of all LEP components was significantly lower in patients than in controls ( P < 0.05). These preliminary data suggest that schizophrenic patients have an abnormal processing of nociceptive input. These abnormalities might reflect a dopaminergic dysfunction.

Effects of cabergoline on hyperprolactinemia, psychopathology, and sexual functioning in schizophrenic patients.

Antipsychotic medications are associated to different degrees with sexual dysfunction mainly through their potential to induce hyperprolactinemia. Prolactin (PRL) secretion is mainly regulated by the hypothalamic dopaminergic systems. We conducted this 6-month, parallel-group study to prospectively investigate the effects of the dopamine agonist cabergoline on sexual dysfunction in clinically stable patients with schizophrenia (DSM-IV, AP 194) and hyperprolactinemia (PRL > 20 ng/ml for men and PRL > 25 ng/ml for women). In total 80 patients were enrolled; 33 were receiving risperidone, 17 haloperidol, 11 amisulpride, and 8 risperidone microspheres long acting. Based on PRL levels (< 50, 50-99, or > 100 ng/ml), patients were assigned in 3 cabergoline doses (0.25, 0.5, and 1 mg/day in 38, 23, and 19 patients, respectively). The psychopathology was evaluated using the Positive and Negative Syndrom Scale (PANSS), and sexual dysfunction was evaluated using the Arizona Sexual Experiences Scale (ASEX). PRL levels were reduced in all patients, from 73.3 (± 46.8) to 42.0 (± 27.8) at Month 3 and 27.1 (± 20.4) at Month 6 (p < .001). ASEX scores declined from 19.1 (± 5.1) to 17.6 (± 5.5) at Month 3 and 15.0 (± 6.5) at Month 6 (p < .001). PANSS scores were reduced in the third and in the sixth month (p = .001 at 6 month vs. baseline). The decrease in PRL was not statistically different between groups. Our data suggest that cabergoline administration to clinically stable patients with schizophrenia may improve sexual functioning without adversely affecting their psychopathologic status, provided that the dose has been suited to the severity of the hyperprolactinemia.

Brain-derived neurotrophic factor gene G196A polymorphisms and the cognitive function of schizophrenia: a case-control study

Objective To explore the relationships between brain-derived neurotrophic factor gene G196A polymorphisms and psychopathology and the cognitive function in schizophrenic patients. Methods 224 patients and 220 normal controls were examined with polymerase chain reaction(PCR), denaturing polyacrylamide gel electrophoresis and silver staining to determine genotype and allele of G196A.Clinical symptoms were assessed with the Positive and Negative Symptom Scale (PANSS). Cognitive function was assessed with Wisconsin card sorting test(WCST)and Trail Making Test(CPT). To analyse the differences of the scores of Scale for the Assessment of Positive Symptoms(SAPS) and Scale for the Assessment of Negative Symptoms(SANS) among the patients with the genotype G/G, G/A and A/A.At the same time, the differences of the performance of WCST and CPT were analyzed. Results ①There were no significant differences of the genotypes G/G, G/A and A/A and allele G and A between patients and controls.②There were significant differences of the genotypes A/A between patients with Positive Symptoms and patients with Negative Symptoms(χ2=4.558, P 0.05). Conclusion BDNF gene G196A polymorphisms are not associated with schizophrenia and the cognitive function but are associated with positive symptoms of schizophrenia. Key words: Schizophrenia; Brain-derived neurotrophic factor; Cognitive function; Gene polymorphism

A randomized, 12-week study of the effects of extended-release paliperidone (paliperidone ER) and olanzapine on metabolic profile, weight, insulin resistance, and β-cell function in schizophrenic patients

To compare matched paliperidone-ER- and olanzapine-treated schizophrenic patients on measures of glucose and lipid metabolism. Eighty hospitalized patients with schizophrenia (DSM-IV) were randomly assigned to treatment with paliperidone ER or olanzapine for a period of 12weeks. At baseline and every 4weeks, we assessed weight, subcutaneous fat, waist and hip circumferences, fasting glucose, insulin, glycohemoglobin A1, cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, and prolactin. We also assessed at every time point body mass index (BMI), homeostasis insulin resistance (HOMA-IR), and homeostasis β-cell function (HOMA-B). Thirty-three patients randomly assigned to paliperidone ER and 23 patients randomly assigned to olanzapine groups completed the entire 12-week treatment. Within-group analyses showed that fasting measures in both groups increased for weight, BMI, waist circumferences, hip circumference, subcutaneous fat, cholesterol, triglycerides, and prolactin. In contrast, fasting glucose, LDL, and HOMA-B increased during treatment only in the olanzapine group. We also detected significantly different serum prolactin levels at all time point between the paliperidone ER- and olanzapine-treated groups, as well as a statistical trend for HOMA-B to increase more in the olanzapine compared to paliperidone-ER group over the 12weeks of the trial. We did not detect, however, differential drug effects over the 12weeks of the trial on fasting measures of BMI, glucose, glycohemoglobin A1, insulin, HDL, LDL, cholesterol, triglyceride, or HOMA-IR. This study reinforces the necessity of regularly monitoring metabolic parameters in patients with schizophrenia taking atypical antipsychotics, including paliperidone ER.

1609 – How first- and second-generation antipsychotics differentially improve anterior cingulate cortex (ACC) function in schizophrenic patients - an event-related potential study

Introduction/objectives Second-generation antipsychotics (SGAs) are a frequently and effectively used treatment in schizophrenia and psychotic disorders. Other than First-generation antipsychotics (FGAs), which mainly exert their pharmacologic effect in subcortical dopaminergic systems, SGAs additionally affect partly serotonergically innervated structures within prefrontal areas, such as the Anterior Cingulate Cortex (ACC). However, only few controlled, randomized studies have so far investigated direct and indirect effects of SGAs on the ACC. Aims The present study investigated differential effects of one SGA (quetiapine) and one FGA (flupentixol) on the human action monitoring system. Methods ACC function in 18 quetiapine-medicated patients and 13 flupentixol-treated patients suffering from schizophrenia was assessed by means of the error-related negativity (ERN), a neurophysiological marker of ACC function, in a pre-post design. Results Between-group comparisons revealed different effects of quetiapine and flupentixol on ACC function despite similar improvement in psychopathology, cognitive performance and quality of life. Whereas SGA treatment was associated with an increase in amplitudes over time, there were prolonged ERN peak latencies in patients treated with the FGA. Moreover, treatment effects depended on baseline PFC function in both groups. Conclusions We conclude that both flupentixol and quetiapine improve prefrontal function especially in patients with weak initial ACC function which might be due to their shared affinity for 5HT-receptors in frontal brain regions. However, since this affinity is more pronounced for SGAs, patients treated with quetiapine seemed to profit more evidently concerning PFC function compared to patients of the flupentixol group, who exhibited a compensatory prolongation of processes.

Comparing the influences of age and disease on the Brief Assessment of Cognition in Schizophrenia in Japanese patients with schizophrenia

BackgroundThe Brief Assessment of Cognition in Schizophrenia (BACS) is an evaluation of cognitive function that can be completed with more cases. However, there are few studies that compare which factor, disease or aging, is a better determinant of performance on the BACS. The present study aimed to investigate the influences of disease and aging on BACS performance in schizophrenic patients using subjects with a wide range of ages.MethodsSchizophrenic patients (n = 165) and a comparison group (n = 171) were recruited as subjects. All participants completed the Japanese language version of the BACS (BACS-J), and the influences of disease and aging on performance in the BACS were examined with the use of multiple regression analysis.ResultsThere was a significant influence of diagnosis and level of education on all six tasks of the BACS and the performance and composite scores. In addition, age was found to influence five tasks and the composite score, the duration of illness influenced four tasks and the composite score, and gender influenced one task and the composite score.ConclusionThe present study suggests that performance on the BACS was impaired not only by disease but also by level of education and aging.

564 – Effects of paliperidone extended-release tablets (paliperidone er) and olanzapine on metabolic profile, weight, insulin resistance and β-cell function in schizophrenic patients: a randomized 12-week study

Metabolic syndrome induced by atypical antipsychotics is more prevalence in schizophrenic patients. Much less is known regarding paliperidone ER. The objective of this study was to compare matched paliperidone-ER- and olanzapine-treated schizophrenic patients on measures of glucose and lipid metabolism. Eighty hospitalized patients with schizophrenia (DSM-) were randomly assigned to treatment with paliperidone ER or olanzapine for 12 weeks. At baseline and every 4 weeks, we assessed weight, subcutaneous fat, waist and hip circumferences, fasting glucose, insulin, glycohemoglobin A1, cholesterol, triglycerides, high density level (HDL) cholesterol, low density level (LDL) cholesterol and prolactin. And we also evaluate the body mass index (BMI), homeostasis insulin resistance (HOMA-IR) and homeostasis β-cell function (HOMA-B). 33 patients randomly assigned to paliperidone ER and 23 patients randomly assigned to olanzapine completed the entire 12-week treatment. Within-group overall analysis showed that the fasting measures were increased in weight, BMI, waist circumferences, hip circumferences, subcutaneous fat, cholesterol, triglyceride and prolactin for two groups, and fasting glucose, LDL and HOMA-B were increased for olanzapine group. There was significantly difference in serum prolactin between paliperidone ER and olanzapine group. And there was a trend for HOMA-B to increase in olanzapine group over 12 weeks compared to paliperidone ER group. However, there were no overall differential drug effects over 12 weeks on the fasting measures of BMI, glucose, glycohemoglobin A1, insulin, HDL, LDL, cholesterol, triglyceride and HOMA-IR. The study further reinforces the necessity of regular monitoring the metabolic parameters in schizophrenic patients with atypical antipsychotics including paliperidone ER.

2020 – Neuropsychological evaluation of executive functionsin schizophrenic “psychosocial care center” users in cabedelo / PB

Schizophrenia is a complex mental disorder of unknown origin, which has stimulated scholars to want to fully understand it. Through neuropsychological testing it has been possible to delimit areas and brain functions; executive functions have been increasingly studied since studies with people with schizophrenia have shown that its impairment can be related to the person's social and occupational dysfunction. This work aimed to evaluate the executive functions of schizophrenic patients of the CAPS I(a Psychosocial Care Center) in the city of Cabedelo in the state of Paraiba. This study was based on a sample of 20 patients with schizophrenia according to the DSM IV, which were later on tested with the Block Design subtest of Wechsler Adult Intelligence Scale (WAIS-III), the Wisconsin Card Sorting Test (WCST) and a socio-demographic questionnaire. The results showed possible involvement in executive functions, indicated by poor performance in the WCST, showing mainly a high level of preservative errors, few administered trials and a small number of categories completed. As for the performance in the block subtest, it was also possible to indicate levels of cognitive impairment established by a high number of below average test scores. Both results were significant in testing the executive function impairment, which may be one of the premises of socio-occupational dysfunction, found within the socio-demographic data. It is concluded that there is loss of executive functions in individuals with schizophrenia.

Association between oxytocin receptor gene polymorphisms and self-rated 'empathic concern' in schizophrenia.

The nonapeptide oxytocin (OXT) and its receptor (OXTR) have been implicated in social cognition, empathy, emotion and stress regulation in humans. Previous studies reported associations between OXT and OXTR genetic polymorphisms and risk for disorders characterized by impaired socio-emotional functioning, such as schizophrenia and autism. Here we investigate the influence of two single nucleotide polymorphisms (SNPs) within the OXTR gene on a measure of socio-emotional functioning in schizophrenic patients. OXTR SNPs that were previously investigated in other studies were genotyped in 145 patients diagnosed with schizophrenia according to DSM-IV and 145 healthy controls matched for age and gender. The Interpersonal Reactivity Index (IRI) was used to assess cognitive (‘perspective taking’), affective (‘empathic concern’) and self-related (‘personal distress’) dimensions of empathy. No group differences in genotype frequencies were observed. MANCOVA revealed a significant main (F [1,282] = 10.464; p<0.01) and interaction effect (genotype by diagnosis: F [1,282] = 4.329; p<0.05) of OXTR SNP rs2254298(A>GG) with ‘empathic concern’. Within the schizophrenia group, linear regression analysis determined OXTR rs2254298 genotype, PANSS negative and general symptom score, and age of disease onset as being significantly associated with ‘empathic concern’. OXTR rs2254298 significantly impacted PANSS general psychopathology scores. No associations were found for OXTR rs53576, IRI ‘perspective taking’ or ‘personal distress’ ratings. Our preliminary findings support hypotheses about an involvement of OXTR rs2254298 in emotional empathy in schizophrenic and healthy individuals, warranting independent replication.