Long-term Schizophrenia Research Articles

Comparison of somnolence associated with asenapine, olanzapine, risperidone, and haloperidol relative to placebo in patients with schizophrenia or bipolar disorder

BackgroundPatients with schizophrenia or bipolar disorder (BPD) may be differentially sensitive to antipsychotics. This study assessed the median time to onset, duration, and rate of somnolence associated with asenapine and other antipsychotics in both indications.MethodsTen clinical trials (n = 4786) were analyzed as five cohorts pooled according to indication and study design.ResultsIn the short-term schizophrenia cohort, the incidence of somnolence was 13.1%, 19.1%, 8.5% 5.2%, and 6.9% with asenapine, olanzapine, risperidone, haloperidol, and placebo, respectively. Median time to onset of somnolence was 2 days for asenapine and olanzapine, and 6, 3, and 7 days for risperidone, haloperidol, and placebo, respectively. Median duration was 15 days for asenapine and olanzapine, and 3, 22.5, and 4.5 days for risperidone, haloperidol, and placebo, respectively. In the long-term schizophrenia cohort, the incidence, time to onset, and duration of somnolence with asenapine and olanzapine were 18.4% versus 19.6%, 9.0 days versus 12 days, and 22 days versus 21 days, respectively. In schizophrenia with persistent negative symptoms, the incidence, median time to onset, and duration of somnolence with asenapine and olanzapine were 18.5% versus 21.1%, 9.0 days versus 7.5 days, and 25.0 days versus 41.5 days, respectively. In the monotherapy for BPD cohort, the incidence of somnolence with asenapine, olanzapine, and placebo was 23.8%, 26.4%, and 6.4%, respectively. Median time to onset and duration of somnolence with asenapine, olanzapine, and placebo were 1, 2, and 2 days, respectively, and 7, 8.5, and 5 days. In the adjunctive therapy for BPD cohort, the incidence, median time to onset, and duration of somnolence with asenapine and placebo were 24.0% versus 10.2%, 1.5 days versus 2 days, and 12.5 days versus 7 days, respectively.ConclusionIn the short-term schizophrenia cohort, time to onset and duration of somnolence with asenapine was similar to that with olanzapine and haloperidol. Only asenapine and olanzapine had significantly higher rates of somnolence relative to placebo. The time to onset, duration, and incidence of somnolence with asenapine and olanzapine was similar in patients with long-term schizophrenia and those with BPD. Patients with BPD were more sensitive than those with schizophrenia to asenapine and olanzapine.

Long‐ and short‐term inpatients with schizophrenia in China: Implications for community‐based service development

There is an increasing interest in the patterns of mental health care of people with serious mental illnesses in China, where outpatient and community-based care are not fully developed and long-term hospitalization is still not uncommon. Comparison of sociodemographic and clinical characteristics of long-term and short-term inpatients diagnosed with schizophrenia can be informative about pattern of treatment and their relationship to services needs. Seventy-three long-term schizophrenia inpatients (current length of stay of more than 5 years) were compared to 116 short-term schizophrenia inpatients (current length of stay of 30 days or less) assessed with the Individual Background Questionnaire, the Positive and Negative Syndrome Scale (PANSS) and the Social Support Rating Scale (SSRS). There was no significant difference between the groups on the total PANSS symptom score but the short-term inpatients scored significantly higher than their long-term counterparts on the Positive Syndrome sub-scale and the SSRS and lower on the Negative Syndrome sub-scale. Differences in symptomatology and social functioning may be related to better medication adherence and more extended social isolation among long-term inpatients while the increased positive symptoms are likely to reflect more acute disease process in short-term inpatients, and possibly poorer medication adherence. These differences may be especially pronounced in developing countries like China in which community-based services need to be more fully developed to facilitate medication adherence and prevent relapse, and to support community adjustment of socially isolated patients who otherwise require hospitalization.

DAI-10 is as good as DAI-30 in schizophrenia

Drug attitude inventory (DAI-30) is considered to be the best predictor of poor adherence in first-episode schizophrenia. We compared the short version (DAI-10) with DAI-30 in long-term schizophrenia, documented if DAI was associated with poor insight, PANSS and GAF and constructed DAI-10 percentiles. DAI-30 and DAI-10 were homogenous (r=0.82 and 0.72, respectively) with good test–retest reliability (0.79). The correlation between the DAI versions was high (0.94). Percentile scores of DAI-10 were computed. DAI is an easy-to-use self-report instrument seemingly assessing a unique clinical dimension relevant to non-adherence. DAI-10 might be preferred for its simplicity and good psychometric properties.

Caregiving Experiences of Families Living with Patients with Schizophrenia: a Systematic Review.

Review question/objective The objective of the review is to determine the meaningfulness of caregiving experiences of families living with patients with schizophrenia. The specific review question is: - What are the experiences of caregivers who live with patients with schizophrenia? Inclusion criteria Types of participants The review will consider studies that include the family of person (18 years and older) with schizophrenia diagnosed for at least six months by any criteria based on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Third Edition Revised (DSM-III-R), the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV TR), the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD-10), or confirmed by their attending psychiatrists. Non-schizophrenic patients such as patients with psychosis, depression, bipolar, dementia, alcoholism, and substance-related disorders will be excluded. The family is defined as key persons who live or who are in close contact with the patient or who provide care or have taken on role as the main caregivers for a family member with schizophrenia. The caregivers should be at least 18 years old who can be parents, siblings, spouses, children, or other relatives. This review will consider studies in any culture. Studies that explore experiences of patients with schizophrenia will be excluded. Caregiving experiences are defined as any subjective data that families expressed or shared about their feelings and perceptions related to their caring or living with their schizophrenia member including caring tasks, feeling or attitudes or beliefs, needs, coping or help seeking behaviours or ways to solve problems. Types of intervention(s)/phenomena of interest The review will consider qualitative studies that explore caregiving experiences of families of patients with schizophrenia that related to their caring or living with their schizophrenia member including caring tasks, feeling or attitudes or beliefs, needs, coping or help seeking behaviours or ways to solve problems. This review will include studies conducted in either hospital or community settings. TRUNCATED TO 350 WORDS.

Increased plasma levels of thioredoxin-1 in patients with first episode psychosis and long-term schizophrenia

Excessive level of radicals and/or dysfunctional antioxidant response, oxidative stress, is implicated in the pathogenesis of schizophrenia. A condition of oxidative stress has been detected in the brain, peripheral tissues and fluids including plasma. Plasma thioredoxin-1 (Trx1) is well characterized and a putative marker for oxidative stress and recently shown to be increased in plasma at the onset of schizophrenia. The present study aimed to explore whether Trx1 can be used as a marker to identify schizophrenic patients at the time-point when patients have their first episode of psychosis as compared to patients with long-term schizophrenia and mentally healthy patients, respectively. Plasma samples obtained from 18 patients at first episode of psychosis, from 49 long-term schizophrenic patients and from 20 mentally healthy controls (admitted with minor physical injury to the general ward) where analyzed by ELISA for Trx1. The patients with first episode of psychosis were diagnosed at least 6 months later and shown to constitute various psychotic syndromes, including schizophrenia, or affective disorder. The concentration of Trx1 in the patients with first episode of psychosis was 1.5 ± 1.0 ng/ml and 0.8 ± 0.6 ng/ml in controls. In the long-term schizophrenic patients the plasma concentration was 1.5 ± 0.7. The differences between the groups of acute psychotic or long-term schizophrenia patients to controls were significant (p < 0.016 and p < 0.001, respectively). Our data indicate that Trx1 may not be used as an early marker to identify schizophrenic patients in a mixed population of first episode psychotic patients. Further, Trx1 did not discriminate with reliable accuracy patients with psychotic disorder from mentally healthy controls on an individual basis due to overlap in levels of Trx1. However, our observations show that psychotic patients in general are in a significant long-term condition of oxidative stress, with possible implications for the profound morbidity and mortality found in this patient population.

Dietary antigens, epitope recognition, and immune complex formation in recent onset psychosis and long-term schizophrenia

Peptides derived from dietary antigens such as bovine milk caseins are opioid receptor ligands and contribute to schizophrenia-associated hyperpeptidemia and hyperpeptiduria. The IgG antibody response to bovine caseins is increased in schizophrenia and recent onset psychosis. To identify specific casein peptide sequences that are antigenic in patients vs controls, we measured serum IgG binding to 10–26 amino acid long linear epitopes of casein with immunoassays for the entire group (n = 95 recent onset psychosis; n = 103 long-term schizophrenia; n = 65 control), and with peptide microarray libraries in a casein-sensitive subset (n = 14 recent onset; n = 10 control). In the entire group, we compared anti-casein peptide IgG vs anti-whole casein IgG and evaluated whether peptide immune complexes contributed to IgG binding results. Anti-whole casein IgG levels correlated with anti-casein peptide IgG in controls only (R 2 = 0.17–0.25, p ≤ 0.002–0.03). In recent onset psychosis, IgG binding to linear peptide sequences was significantly decreased 3.8–5.7-fold compared to controls in immunoassays (OR 0.18–0.26, p ≤ 0.0001–0.001). In peptide microarrays, recent onset patients again showed significantly reduced IgG binding and fewer epitopes than controls (p ≤ 0.00001–0.05). Anti-peptide IgG levels did not differ between patients with long-term schizophrenia and controls. Finally, significantly more recent onset individuals had casein peptide-IgG immune complexes than controls (OR 4.96, p ≤ 0.001). These findings suggest an immunological specificity that differs in early vs later stages of neuropsychiatric diseases and an IgG saturation by casein-derived peptides that may in part explain the reduced IgG binding to small linear epitopes observed in these patients.

Esquire Trial

To compare the efficacy and adverse effect profiles of 2 widely used atypical antipsychotics in the short-term phase of first-episode schizophrenia in patients who were treatment-naive. A secondary objective was to establish the effective dose of these drugs in this context. A total of 72 patients with a first episode of schizophreniform psychosis (schizophrenia spectrum disorder) with less than 2 weeks of exposure to antipsychotic medication were randomized to quetiapine or risperidone in a single-blind 12-week controlled trial. Psychopathologic diagnoses and adverse effects were assessed by blinded raters at 4 weekly intervals. Medication was administered by a specialized clinical team following dosing guidelines. Data were analyzed using an intention-to-treat paradigm. Both quetiapine and risperidone were associated with a reduction in immediate symptoms and relatively few adverse effects other than weight gain. There was no statistically significant difference between the 2 compounds in adverse effects, relative efficacies, or adherence to treatment. The median (SD) time to cessation for patients randomized to quetiapine was 65.3 (41.85) days and that for risperidone was 82.5 (44.88) days. There was no statistically significant difference between time to discontinuation for the 2 compounds. The mean daily doses prescribed were 375 mg of quetiapine and 2.72 mg of risperidone. Quetiapine and risperidone are both effective treatments in first-episode schizophrenia at doses lower than those used in patients with long-term schizophrenia and are similar in efficacy and the incidence of adverse effects.

Study on cognitive fuction of long-term schizophrenia in captivity

Objective To investigate the cognitive function the long-term Schizophrenic patients in captivity.Methods We sive the Wechsler Intelligence Test(WAIS)and controlled study between 100Patients with long-term schizophrenia in captivity and 100 healthy human.Results The comparisons of the two groups found that patients with long-term schizophrenia in captivity full IQ(FIQ),verbal IQ(VIQ)and performance IQ(PIQ)were significantly lower than the control group.97%of patients FIQ is lower than normal,79% of patients with mental defects.Conclusion The deficit of lognitive function of the long-term schizophrenic patients in captivity is serious,extensive and difficult to change. Key words: Captivity; Schizophrenia; Cognitive function

Subunit and whole molecule specificity of the anti-bovine casein immune response in recent onset psychosis and schizophrenia

Previous studies show increased antibody levels to bovine casein in some individuals with schizophrenia. The immunogenicity of specific domains of bovine casein varies among people with milk sensitivities and thus could vary among different neuropsychiatric disorders. Using ELISAs and immunoblotting, we characterized IgG class antibody specificity to whole bovine casein and to the αs, β, and κ subunits in individuals with recent onset psychosis (n=95), long-term schizophrenia (n=103), and non-psychiatric controls (n=65). In both patient groups, we found elevated IgG to casein proteins, particularly to whole casein and the αs subunit (p≤0.0001). Odds ratios of casein seroprevalence for recent onset psychosis (age-, gender-, race-, smoking-adjusted) were significant for whole casein (8.13, p≤0.0001), and the αs (7.89, p≤0.0001), β (5.23, p≤0.001) and κ (5.70, p≤0.0001) subunits. Odds ratios for long-term schizophrenia were significant for whole casein (7.85, p≤0.0001), and the αs (4.78, p≤0.003) and κ (4.92, p≤0.004) subunits. Within the recent onset group, odds ratios were particularly significant for a subgroup of people with psychotic disorders that included major depressive disorders (8.22–16.48, p≤0.0001). In a different recent onset subgroup (schizophrenia-spectrum disorders), PANSS scores for negative symptoms were correlated with casein antibody levels for the αs and κ subunits (p≤0.001–0.01). Immunoblotting patterns also exhibited group specificity, with κ predominant in recent onset and αs in schizophrenia (Fisher's Exact Test, p≤0.001). The elevated IgG and unique patterns of antibody specificity to bovine casein among diagnostic groups provide a rationale for clinical trials to evaluate efficacies of dietary modifications in individuals with neuropsychiatric diseases.

The experiences of carers in Taiwanese culture who have long‐term schizophrenia in their families: a phenomenological study

Schizophrenia is a severe illness with little hope of recovery and requires long-term care. The purpose of this study was to explore the experiences of carers who live with someone with long-term schizophrenia, within the cultural context of Taiwan. The study was conducted in a community setting in central Taiwan. A qualitative phenomenological approach was used to explore the experiences of carers. Purposive sampling was used by selecting the carers who were close relatives of the clients, had lived with the clients for at least 1 year and bore most of the responsibilities. Semi-structured face-to-face interviews were conducted to collect the data and narratives were analysed using Colaizzi's (1978) seven-step method. Data saturation was achieved after interviewing 10 carers. Three themes and eight sub-themes were identified: burdens of caring (helping clients' illness, lack of professional support and family conflicts), emotional burdens (sadness, worry and fear) and strategies of coping (cognitive and religious coping strategies). Our study supported the importance for nurses to understand the cultural aspects of mental illness, particularly the widespread cultural beliefs and patterns of help seeking behaviours, in order to provide culturally sensitive health care.

QTc interval in a sample of long-term schizophrenia inpatients

This naturalistic study attempted to determine the prevalence of prolonged QTc interval in a relatively large population of inpatients hospitalized with chronic schizophrenia, and to explore QTc relationship with demographic variables, metabolic parameters and prescribed treatments. All inpatients from a Spanish long-term psychiatric hospital were cross-sectionally investigated to determine the prevalence of QTc prolongation and metabolic syndrome. The sample with a DSM-IV diagnosis of schizophrenia included 171 Caucasian inpatients, all of Spanish origin. A prolonged QTc interval was defined as >450 ms in men and >470 ms in women. The relationships between QTc and other continuous variables were assessed using a linear regression model with QTc as the dependent variable. Only 10 patients (6%) had a prolonged QTc interval; one case was possibly explained by hypokalemia. Three patients (2%) had a QTc > 500 ms. Gender, old age (≥50 years old), current smoking, systolic blood pressure, HDL cholesterol and history of arrhythmia were found to have significant effects on QTc interval in a linear regression analysis. After controlling for significant variables, the mean QTc interval was not significantly influenced by antipsychotic dose, type of antipsychotic treatment, the use of depot antipsychotics, or the number of different antipsychotics prescribed. Our study focused on long-term schizophrenia inpatients with frequent antipsychotic polypharmacy and high antipsychotic doses, and suggested that after excluding the case with hypokalemia length of QTc was associated with history of arrhythmias and with metabolic factors, while the effects of antipsychotic compound or class were not so evident.

Improving the treatment of schizophrenia in real world mental health services

Over the past decades, the therapeutic goal for schizophrenia has become more and more ambitious, shifting from that of controlling violent episodes to aim of ameliorating patients' symptoms, to the extent that individuals with schizophrenia can achieve a relative degree of social and relational remission. Indeed, thanks to more recent pharmacological and psychosocial forms of intervention, once pessimistic attitudes toward long-term schizophrenia outcomes are transforming gradually into guarded optimism. Evidence of the efficacy of various forms of treatment now make it possible for researchers and clinicians to consider both the remission of severe symptoms for long periods of time and good social functioning potential goals.

Haloperidol both prevents and reverses quinpirole-induced nonregulatory water intake, a putative animal model of psychogenic polydipsia

Polydipsia is a severe complication of long-term schizophrenia and, despite its unknown pathogenesis, is empirically treated with typical or atypical antipsychotics. In the rat, nonregulatory water intake is induced by repeated administration of amphetamine-like compounds or by the D2/3 agonist, quinpirole. This study is aimed at determining the potential activity of antipsychotic compounds with different affinities for D2 receptors in preventing and/or reversing quinpirole-induced polydipsia. Male Sprague-Dawley rats were treated with five injections of quinpirole (0.5 mg/kg i.p.) to induce polydipsia. The oral effects of haloperidol, olanzapine, clozapine, and ST2472 on QNP-induced polydipsia were analyzed in the following two schedules. In the preventive schedule, haloperidol (0.2, 0.4, and 0.8 mg/kg), olanzapine (1.5, 3, and 6 mg/kg), ST2472 (1 and 2 mg/kg), and clomipramine (5, 10, and 20 mg/kg) were given in combination with quinpirole from day 1 to day 5. In the reversal schedule, rats showing quinpirole-induced polydipsia on the third day received haloperidol (0.4 mg/kg), olanzapine (1.5 and 3 mg/kg), clozapine (10, 20, and 40 mg/kg), ST2472 (1, 2, 5, and 10 mg/kg), and clomipramine (5, 10, and 20 mg/kg) before quinpirole on days 4 and 5. Haloperidol both prevented and reversed quinpirole-induced polydipsia, whereas olanzapine and ST2472 only reversed it. Clomipramine prevented but did not reverse quinpirole-induced polydipsia, and clozapine did not reverse it either. We suggest that, once developed, polydipsia is governed by dopaminergic D2 mechanisms. In contrast, either an increase in the serotoninergic tone or an inhibition of D2 receptors can modulate the development of quinpirole-induced excessive drinking.

An alternative support to the medical model of medication for long-term schizophrenia

This article is concerned with debates around schizophrenia. Some historical background to schizophrenia is also outlined. The theory is that alternative support, like long-term clinical hypnotherapy and long-term CBT plus psychotherapy and counselling, is effective in helping some schizophrenics to reduce their medications to improve their qualityof life. The main biographical source is a book by Rosalind Hewitt entitled ‘Moving On:A guide to good health and recovery for people with a diagnosis of schizophrenia’(Karnac Books, January, 2007). The other inspiration was an article in ‘The Psychologist’, September, 2005, called ‘The NHS has got it wrong’. The analysis criteria is my evidence medically of my lifetime recovery in terms of my qualityof life with my long-standing schizophrenia for over 26 years. I have discovered these alternative therapies personally and I now report a temporary improvement in my condition.The conclusion is that the alternative therapies experience is at least effective in reducing my medication for schizophrenia to the international minimum recommended dosage level by the Medical Model and sofor me is an effective support mechanism to the Medical Model. Currently I am trying a medication dosage below any recommended minimum dosage levels but I am still in a stage of transition; the results are not finalised at this point in time.The key phrases are that long-term clinical hypnotherapy, long-term CBT, long-term counselling and long-term psychotherapy – in combination – have never been medically documented before; this is a first international clinical trial of its kind

Social role behaviour of patients with long-term schizophrenia in the community during sharp decline in number of psychiatric beds

Objective: Social role behaviour (SRB) was studied among patients with long-term schizophrenia living in the community when the number of psychiatric beds was decreasing.Methods: A representative national sample of 2502 schizophrenia patients discharged from mental hospitals in 1986, 1990 and 1994 in Finland were interviewed three years after discharge. During the study period, the number of psychiatric beds decreased from 3.3 to 1.2 beds per 1000 people. Social role behaviour (SRB) was evaluated at follow-up and predicted with data at discharge.Results: More than four-fifths of patients had considerable problems in at least one area of SRB. In the majority of SRB areas, men had more problems than women. Later discharge years associated with poor SRB at follow-up, although the effects of other (confounding) factors were taken into account. Being married and having good psychosocial functioning and ability to work, as well as having paranoid schizophrenia, associated with fewer problems in SRB at follow-up.Conclusions: SRB of long-term schizophrenia patients in the community is extensively damaged. Decrease in psychiatric beds is associated with increase in SRB of long-term schizophrenia patients. Men have more SRB problems than women. The situation at discharge strongly predicts patient's SRB also in the community.

Body mass index and functioning in long-term schizophrenia: Results of the DSP project

Objective The study evaluates the association of body mass index (BMI) with functioning in male and female patients with long-term schizophrenia. Method 722 long-term schizophrenia patients were interviewed three years after discharge from hospital. Their weight and height were recorded and data on their background, illness history, psychosocial functioning (Global Assessment Scale; GAS), health behaviour, daily doses of neuroleptics, and psychiatric symptoms were collected. Results BMI correlated significantly with GAS scores in male ( r = 0.202, p = 0.000) but not in female patients. In male patients, BMI associated significantly ( p = 0.005) with GAS scores even when the effects of psychiatric symptoms and other confounding variables were taken into account. Conclusions In male but not in female long-term patients with schizophrenia, low BMI associates with poor functioning. It is suggested that among male schizophrenia patients, low BMI may be an indicator of poor functioning.

Patientenautonomie bei fraglicher Urteilsfähigkeit. Psychiatrische Palliativpatientin verweigert onkologische Therapie. Wer entscheidet über das "beste Wohl"?

Decision making concerning patients with end stage cancer is a challenging process. Since quality of life is a very important issue for patients with short-term life expectancy, benefits of antitumor therapy and possible negative side effects have to be considered carefully. The patient's desires play a pivotal role in the final decision. Informed consent becomes even more difficult when the competence of a patient in choosing treatment is questionable. In this case report, a 60 year old female patient with exulcerating breast cancer, brain metastases and long-term untreated schizophrenia refuses antitumor treatment. How can the palliative care team make the best possible decision on her behalf? Medical, ethical and legal aspects are discussed.

Subjective Life Satisfaction and Living Situations of Persons in Finland With Long-Term Schizophrenia

This study measured subjective life satisfaction among patients with long-term schizophrenia who were living in the community. A representative national sample of 2,221 persons with schizophrenia who were discharged from psychiatric hospitals in Finland in 1986, 1990, and 1994 were interviewed three years after discharge. Subjective life satisfaction was measured; patients were asked about their current level of satisfaction and the level of satisfaction they recalled having at the time of discharge. Patients tended to report more satisfaction at follow-up if they were female, had good psychosocial functioning, had several confidants, or were living in group homes or dormitories. Patients tended to be less satisfied at follow-up if they were divorced or had mental and physical symptoms. Patients with depressive symptoms or with low psychosocial functioning and those who were currently hospitalized reported the smallest changes in levels of satisfaction between the two time points. Patients with low psychosocial functioning who were living with their parents, in group homes or dormitories, or in institutions were relatively satisfied, whereas patients with good psychosocial functioning were more satisfied if they lived with their spouse or partner. Being female and having good psychosocial functioning, confidants, good physical health, and living arrangements in the community that offer support corresponding to the patient's psychosocial state are important factors of life satisfaction among patients with long-term schizophrenia.

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.

Cigarette smoking in long-term schizophrenia

Purpose. – Cigarette smoking is a great health problem and prevalent among subjects with schizophrenia. Our aim was to investigate the prevalence and associations of cigarette smoking in patients with long-term schizophrenia. Methods. – Seven hundred and sixty schizophrenia patients were interviewed and their cigarette smoking was recorded. Results. – Smoking was more prevalent men than in women patients. In logistic regression analysis, male gender, duration of illness (DUI) from 10 to 19 years, being divorced or separated, lower education and high daily doses of neuroleptics (DDN) associated significantly with regular smoking. Heavy smoking associated, in men, with hospital treatment. Conclusions. – In schizophrenia patients, smoking is associated with long DUI, high DDN and institutional care. Interventions for cessation and/or reduction of cigarette smoking should be a part of the treatment for patients with schizophrenia.