Observation Scale For Inpatient Evaluation Research Articles

Study on the clinical efficacy of painting therapy of patients with anxiety disorders.

This study analyzed the application value of drug combined painting therapy for patients with anxiety disorder by observing the changes in patients' mental and social functions. 400 cases with anxiety disorder were recruited, and randomly divided into the experimental group and the control group with 200 cases in each group. Patients in the control group received drug therapy alone, while experimental group was combined with painting treatment on the basis of control group. The Nurses Observation Scale for Inpatient Evaluation (NOSIE) was used for the evaluation of mental and social functioning. Clinical efficacy was evaluated according to the degree of reduction in the Hamilton Depression Scale (HAMD) score. After 8 weeks of treatment, the experimental group had a lower HAMD score than those in the control group. After 8 weeks of treatment, mental and social functions in both groups improved significantly. And the social competence, social interest and personal cleanliness of the experimental group were better than those of the control group, and the degree of irritability, retardation and depression were lower than those of the control group. In comparison with the control group, the experimental group had a higher cure rate and remarkable response rate. Painting therapy combined with drug therapy can relieve anxiety symptoms of patients with anxiety disorder, improve their mental and social functions, and improve clinical efficacy.

Sleep Misperception and Associated Factors in Patients With Anxiety-Related Disorders and Complaint of Insomnia: A Retrospective Study.

PurposeData on sleep parameters by polysomnography (PSG) in patients with anxiety-related disorders are limited. Although the disturbance and risk factors of sleep misperception have been implicated in psychopathology, its role in anxiety-related disorders remains unclear. This retrospective study aimed to explore the characteristics and sleep parameters in patients with anxiety-related disorders and different sleep perception types, and to explore the associated factors for sleep misperception.MethodsPatients with anxiety-related disorders who had complaint of insomnia for more than 3 months were collected at Wuhan Mental Health Center between December 2019 and July 2021. Patients underwent a two-night PSG monitoring and completed a self-reported sleep questionnaire. Behaviors were assessed using 30-item Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30). Patients were divided into normal sleep perception (NSP), positive sleep perception abnormality [PSPA; overestimation of total sleep time (TST) >60 min], and negative sleep perception abnormality (NSPA; underestimation of TST >60 min) groups. PSG indicators and NOSIE-30 scores were compared among groups using the one-way analysis of variance and the Kruskal-Wallis test. Multiple linear regression analysis was performed to determine the associated factors for misperception index.ResultsThe subjective and objective TST were 5.5 ± 1.9 h and 6.4 ± 1.7 h in 305 patients, respectively. Sixty-nine (22.6%) had PSPA, 80 (26.2%) had NSP, and 156 (51.1%) had NSPA. Subjective TST and objective sleep parameters were significantly different among groups. No statistical differences in NOSIE-30 subscale and total scores were observed among groups. Sex, rapid eye movement (REM)/TST (%), sleep efficiency, number of awakenings, Non-rapid eye movement of stage 2 sleep (NREM)/TST (%), REM spontaneous arousal times, sleep latency, diagnosis, social competence, and manifest psychosis were associated with sleep misperception.ConclusionSleep misperception is common in patients with anxiety-related disorders. Various sleep perception types have different PSG profiles, but similar personal and social behaviors. These data may be helpful to conduct personalized treatment.

A new electronically based clinical pathway for schizophrenia inpatients: A longitudinal pilot study

Patients with schizophrenia, a severe chronic disorder, are characterized by resistance to therapy, lack of disease understanding, non-compliance and non-adherence, partly caused and maintained by an often poorly structured treatment strategy and polypharmacy. Treatment pathways in the sense of decision aids for professionals bring recommendations from guidelines into a clear and practice-oriented algorithm that can be a helpful tool for treatment. The aim of the present study was to assess the impact of a newly developed electronic clinical pathway (CPW) that integrates the standard computerized medical report system on symptomatic outcomes and process parameters in a population of inpatients with schizophrenia. In this randomized single-center study, 156 patients with schizophrenic disorder were treated in two groups: an experimental CPW group and a control “treatment as usual” (TAU) group. The treatment improvement was analyzed using various process parameters: the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression scale (CGI), the Personal and Social Performance scale (PSP) and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE). The CPW patients differentially showed greater improvement in psychopathology (PANSS) compared to TAU patients (t(154) = 2.030, p = 0.044). There also seems to be advantage for CPW concerning improvement in NOSIE. These results indicate a positive influence of CPW on the quality of treatment and support its implementation in daily clinical practice.

Validation of the 30-item nurses' observation scale for inpatient evaluation and mental health-care promotion.

CONTEXT:The 30-item nurses' observation scale for inpatient evaluation (NOSIE-30) developed for the behavioral and observational rating of psychiatric inpatients.AIMS:The purpose of this study was to evaluate the validation of the NOSIE-30 and mental health-care promotion.MATERIALS AND METHODS:The participants with psychiatric disorders were selected from 310 inpatients referred to the military educational hospital in Iran. This study was carried out in two phases: First, translation of the NOSIE-30 into Persian followed the stepwise, iterative procedures developed by the International Quality of Life Assessment project approach. Second, face validity, criterion-related validity and construct validity, and reliability of the Persian version were determined. The concurrent validity was assessed by using the global assessment of functioning (GAF) instrument. Data were analyzed with the SPSS software of version 22. Exploratory factor analysis, the Cronbach's alpha coefficient, and interrater agreement with intraclass correlation coefficient and Pearson's correlation coefficient were used to data analysis.RESULTS:Pearson's correlation coefficient between the NOSIE and GAF was 0.75. The interrater reliability for subscale scores and structure of the NOSIE were ranging from 0.70 to 0.94 and Cohen's kappa = 0.74. Furthermore, the internal consistency of the scale's total scores was estimated by Cronbach's alpha = 0.85.CONCLUSIONS:The finding indicated that NOSIE-30 Persian version scale has the desirable validity and reliability for evaluating the nursing care of inpatients. Thus, nurses can promote mental health care by applying this scale in the psychiatric setting.

The application of Precede-Proceed Model on medication management training in schizophrenic inpatients

Objective To evaluate the application effect of the medication management training based on Precede-Proceed Model in schizophrenic inpatients. Methods In this self-control study, 60 schizophrenic inpatients were chosen for this investigation and were undergoing the medication management training on Precede-Proceed Model with conventional nursing care. By using Insight and Treatment Attitudes Questionnaires (ITAQ), The Brief Psychiatric Rating Scale (BPRS) and Nurses′ Observation Scale for Inpatient Evaluation (NOSIE) after the first 3 months and 6 months of the intervention, in order to evaluate their results with their initial readings. Results The total scores of ITAQ, the total scores of BPRS, lacking in activity factor, reaction factor, hostile-suspiciousness factor, the total scores of NOSIE, total positive and negative factors before the intervention were (183.3±15.0) points, (71.7±10.9) points and (13.6±8.8) points; three months after intervention were (189.0±15.8) points, (75.3±11.1) points and (11.6±7.2) points; six months after intervention were (193.8 months after intervention were15.2) points, (71.8 ±9.6) points and (10.1±7.0) points. There were significant differences between the total score and the total negative factor score before and after treatment (F=43.244, 23.060, P<0.05). Conclusion The Precede-Proceed Model on medication management training in schizophrenic inpatients plays a positive role in promoting recovery and it is worth extending in clinical practice. Key words: Precede-Proceed Model; Medication management training; Schizophrenia

Intractability of Deficit Syndrome of Schizophrenia Against Adjunctive Modafinil.

Negative symptoms are a significant barrier to successful functional outcome and recovery in individuals with schizophrenia, and their management is not easy. Prior tryouts with antidepressants and some cognitive enhancers were not really encouraging, and experiments with modafinil had mixed and indecisive results. The objective of the present study was to assess modafinil's efficacy on subjective and objective aspects of negative symptoms of schizophrenia. This study was an 8-week randomized, placebo-controlled trial of modafinil, as an adjective to haloperidol, in treatment of 50 schizophrenic patients. Scale for the Assessment of Negative Symptoms (SANS) was used as the primary outcome measure, and Scale for Assessment of Positive Symptoms, Clinical Global Impressions-Severity Scale, Schedule for Assessment of Insight, Simpson Angus Scale, Psychological General Well-Being Schedule, and Nurses Observation Scale for Inpatient Evaluation were used as secondary measures. According to the findings, while more cases in the modafinil group (n = 14) showed a positive response in some of the subscales of SANS, in comparison with the placebo group (n = 6; P < 0.04), the intractability of the deficit syndrome of schizophrenia against augmentative modafinil was obvious because there was no significant decrease in the mean total score of SANS in the target group in comparison with the placebo group at the end of the assessment (P < 0.08). In addition, while no significant alteration in most of the secondary measures was evident, a significant improvement in Psychological General Well-Being Schedule (P < 0. 04) and Nurses Observation Scale for Inpatient Evaluation (P < 0. 05) was obvious at the end of the trial. According to the results, despite the fact that a remarkable influence by adjunctive modafinil was visible as regards the subjective measures, no significant improvement was evident with respect to deficit syndrome per se.

Effect and application of" Three-level Nursing Evaluation" in psychiatric department

Objective To explore the effect Three-level Nursing in psychiatric department. Methods From June 2012 to January 2013, 106 cases of in-hospitalized patients with schizophrenia were randomly divided into two groups: 50 cases of control group and 56 cases of three-level nursing evaluation group.Nurses' Observation Scale for Inpatient Evaluation (NOSIE) was applied to assess the patient's condition for 3 times: patients admitted to hospital within 48 hours, 2 weeks after treatment and before discharge. Results On the first assessment, all indicators of two groups had no significant differences (P>0.05). On the second and third time, many indicators were improved (P<0.05). Compared with the first assessment, all the indicators, except for the total negative second evaluation, were significantly improved (P<0.05) in the second and all the indicators in the third assessment were improved (P<0.05). In the second evaluation, compared with the control group, except for social skill and total negative, the remaining indicators in three-level nursing evaluation group were significantly improved (P<0.05). In the third evaluation, compared with the control group, except for social skill, social interest and depression, the remaining indicators in three-level nursing evaluation group were significantly improved (P<0.05). Compared with the control group, the indexes of hospital care and discharge care, health education, professionalism and accountability were higher (P<0.05). Conclusion Three-level Nursing in psychiatric nursing can identify patients' existing and potential care problems, appropriate care can be applied as soon as possible, which can effectively reduce various types of risk incidence and promote the recovery of patients. Key words: Three-level nursing evaluation; Psychiatric department; Effect

代币强化行为疗法对社区女性精神病人的康复研究

目的：研究代币强化行为疗法对社区女性精神病人的康复作用。方法：把100例女性精神病康复病人随机分为研究组和对照组，对研究组病人的良性行为采用“代币法”进行阳性强化训练和行为塑造，与对照组作比较，以精神病人护士观察量表(NOSIE)、精神病人康复疗效评定量表(IPROS)来评价强化的效果。结果：代币强化行为疗法对减少女性病人的病态体验、克服焦虑、抑郁、恐惧情绪，改善和强化病人适应环境的能力，恢复和重建人际交往有良好的作用。结论：代币强化行为疗法能塑造女性病人良性行为，促进病人早日康复，回归社区、回归家庭。利用有限的卫生资源，达到最大可能的社区功能水平。 Objective: To investigate the effects of token therapy on the rehabilitation of the female schizoph-renic patients in the community. Methods: 100 female patients with schizophrenia were randomly divided into the research group and the control group (n = 50, per group). The benign behavior adopted the positive intensive training and the behavior shaping with token therapy in patients of the study group. Compared with the control group, the strengthening effects were evaluated by the Nurses' Observation Scale for Inpatient Evaluation (NOSIE) and the Impatient Psychiatric Rehabil-itation Outcome Scale (IPROS). Results: Token therapy can reduce the pathological experience, overcome anxiety, depression and fear, improve and enhance the adaptive capacity of environment in the female schizophrenic patients. It also has a good effect in the recovery and reconstruction of interpersonal communication. Conclusions: Token therapy can shape benign behavior, facilitate the patients to recover and return the community and home. The optimal social functions of community could be developed by making full use of the limited sanitary resource in the female schizophrenic patients.

Neuropeptide Y, social function and long-term outcome in schizophrenia

There is a lack of biomarkers in schizophrenia and the mechanisms underlying the observed deficits in social functioning are poorly understood. This cohort study aimed to explore whether neurotransmitter neuropeptide Y (NPY) in cerebrospinal fluid (CSF) from patients with schizophrenia is correlated to social function and clinical variables. A further aim was to determine whether baseline levels of NPY were associated with subsequent 3-year outcome. Fifty-six consecutively admitted patients with schizophrenia were included and underwent lumbar puncture and symptom ratings before antipsychotic treatment. NPY levels in CSF were determined by radioimmunoassay. Social function (Social Competence and Social Interest) was assessed by Nurses' Observation Scale for Inpatient Evaluation while psychiatric symptoms were rated using the Comprehensive Psychopathological Rating Scale. Three-year outcome was assessed with the Strauss–Carpenter Outcome Scale. Cross-sectional analysis showed a correlation between level of NPY and Social Competence at index admission (rs=0.37, p<0.05). The longitudinal analysis (i.e. at the 3-year follow-up) indicated that, for each standard deviation increase in baseline NPY, there was an increased risk of being unemployed (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.07–3.82), having moderate or severe symptoms (OR 3.09, CI 1.30–7.32) or being hospitalized at least 6months the previous year (OR 3.24, CI 1.09–9.64). However, NPY was not correlated to Social Interest or clinical variables at index admission. In conclusion, NPY levels in CSF are correlated to Social Competence and seem to predict some aspects of longitudinal outcome in schizophrenia.

Application of collaborative care model in chronic stable patients with schizophrenia

Objective To evaluate the application effect of the collaborative care model （ CCM ） in chronic stable patients with schizophrenia .Methods Sixty chronic stable patients with schizophrenia were divided into the experimental and the control groups .The control group was given routine care , while the experimental group was given nursing care based on the CCM .Two groups were evaluated by the nurses’observation scale for inpatient evaluation （ NOSIE） and the social disability screening schedule （ SDSS） at the baseline and six months after the nursing care .Results The baseline scores and six-month scores of NOSIE of patients in the control group were statistically different （ t =3.75,4.34,2.57,2.98,4.01,3.87,4.56, respectively;P〈0.05）.The baseline scores and six-month scores of NOSIE of patients in the experimental group were also statistically different （t=5.67,4.98,6.34,5.23,6.09,5.98,6.10, respectively;P〈0.01）. After six months, the NOSIE scores of social competence , social interest, personal neatness, irritability, manifest psychosis, retardation and depression were （21.81 ±4.46）, （11.02 ±3.06）, （15.38 ±2.29）, （13.74 ±3.37）, （17.38 ±3.18）, （13.93 ±3.86） and （3.03 ±1.44）, respectively,in the experimental group.Those scores of patients in the control group were （18.89 ±3.36）, （9.34 ±1.98）, （11.57 ±3.02）, （13.06 ±2.95）, （18.38 ±3.71）, （13.12 ±3.45）, （4.20 ±1.53）, respectively.There were statistically significant differences between two groups （t =2.67,4.67,4.52,3.98,3.57,3.01,4.73, respectively;P〈0.05）.The scores of SDSS at baseline were （6.45 ±2.02） in the experimental group and （6.67 ±2.08） in the control group, with no statistically significant difference （t=0.416,P〉0.05）.After six month, the scores of SDSS were （5.09 ±2.03） in the experimental group and （6.37 ±2.10） in the control group, with a statistically significant difference （t=2.400,P〈0.05）.Conclusions The CCM model can improve the self-care ability, social function and quality of life for chronic stable patients with schizophrenia .It is favorable to the comprehensive rehabilitation of schizophrenia . Key words: Schizophrenia; Collaborative care model （CCM） ; Social disability screening schedule（SDSS） ; Nurses＇ observation scale for inpatient evaluation （NOSIE）

Effect of the Group Music Therapy on Brain Wave, Behavior, and Cognitive Function among Patients with Chronic Schizophrenia

The purpose of the study was to examine the effect of group music therapy on brain waves, behavior, and cognitive function among patients with chronic schizophrenia. A quasi-experimental pretest-posttest design was used with nonequivalent control group. The potential participants were recruited from inpatients in a psychiatric facility in a metropolitan city, assigned either to the experimental group (n=28) or to the control group (n=27) according to their wards to avoid treatment contamination. The experimental group participated in the group music therapy for 13 sessions over 7 weeks while continuing their standard treatment. The control group only received a standard treatment provided in the hospitals. The outcome measures include brain wave by electroencephalography, behavior by Nurses' Observation Scale for Inpatient Evaluation, and cognitive function by Mini-Mental State Examination. After participating in 13 sessions of the group music therapy, alpha waves measured from eight different sites were consistently present for the experimental group (p=.006-.045) than the control group, revealing that the participants in the music therapy may have experienced more joyful emotions throughout the sessions. The experimental group also showed improved cognitive function (F=13.46, p=.001) and positive behavior (social competence, social interest & personal neatness) while their negative behaviors was significantly less than those of the control group (F=24.04, p<.001). The group music therapy used in this study was an effective intervention for improving emotional relaxation, cognitive processing abilities along with positive behavioral changes in patients with chronic schizophrenia. Our results can be useful for establishing intervention strategies toward psychiatric rehabilitation for those who suffer from chronic mental illnesses.

The effect of empathy nursing on improvement of depressive emotion and life function in depressive patients

Objective To explore the effect of empathy nursing on depressive emotion and life function in depressive patients and to improve treatment and nurse effect. Method Sixties depressive inpatients treated with antidepressive drugs were randomly assigned to receive general nursing and health education (experimental group 31) and empathy nursing (control group 29). Hamilton Depression Scale (HAMD), Nurses'observation scale for inpatient evaluation ( NOSIE) and the hospital nursing work satisfaction questionnaire were used before and after intervention to evaluate the clinical and nursing effects of two groups. Results After interventions, the total score of HAMD was (16.7±3.2)in experimental group and (20.2±3.6)in control group, with significant difference between two groups. The social ability factor of score of NOSIE was (9.78±2.13) in experimental group and (13.32±3.22)in control group, and the scores of 3 other factors of NOSIE in experimental group was obviously lower than that in control group .The score (121.37±11.25)of nursing work satisfaction in experimental group was obviously higher than that(113.26±9.72)in control group (t=2.98). Conclusions Empathy nursing can improve depressive emotion and life function of patients with depression, and improve nursing work satisfaction. Key words: Depressive disorder; Empathy nursing; Life function; Nursing job satisfaction

Theory of mind in schizophrenia: Correlation with clinical symptomatology, emotional recognition and ward behavior

Several studies have suggested the presence of a theory of mind (ToM) deficit in schizophrenic disorders. This study examined the relationship of emotion recognition, theory of mind, and ward behavior in patients with schizophrenia. Fifty-five patients with chronic schizophrenia completed measures of emotion recognition, ToM, intelligence, Positive and Negative Syndrome Scale (PANSS) and Nurse's Observation Scale for Inpatient Evaluation (NOSIE). Theory of mind sum score correlated significantly with IQ, emotion recognition, and ward behavior. Ward behavior was linked to the duration of the illness, and even more so to theory of mind deficits. Theory of mind contributed a significant proportion of the amount of variance to explain social behavior on the ward. Considering our study results, impaired theory of mind contributes significantly to the understanding of social competence in patients with schizophrenia.

Double-blind randomized controlled study showing symptomatic and cognitive superiority of bifrontal over bitemporal electrode placement during electroconvulsive therapy for schizophrenia

BackgroundSeveral studies show that bifrontal electrode placement produces relatively fewer cognitive adverse effects than bitemporal placement during electroconvulsive therapy (ECT) in depression. There are no reports comparing these electrode placements in schizophrenia. ObjectivesThis study compared the clinical and cognitive effects of bifrontal and bitemporal electrode placements in schizophrenia patients referred for electroconvulsive therapy (ECT). Methods122 schizophrenia patients who were prescribed ECT were randomized to receive ECT with either bifrontal (BFECT; n = 62) or bitemporal (BTECT; n = 60) placement. Their concomitant anti-psychotic medications and the number of ECT sessions were not controlled. Psychopathology was assessed using the Brief Psychiatric Rating Scale (BPRS), Bush-Francis Catatonia Rating Scale (BFCRS), and the Nurse Observation Scale for Inpatient Evaluation (NOSIE). Cognitive functions were assessed 24-h after the final ECT using a battery of tests. Clinical improvement was compared using chi-square test, repeated measures ANOVA and analysis of covariance (ANCOVA). Cognitive adverse effects were compared using t-test. ResultsAt the end of 2 weeks (after 6 ECT sessions) 63% and 13.2% of BFECT and BTECT patients respectively had met the response criterion for BPRS (40% reduction in total score; OR = 20.8; 95% CI = 3.61–34.33). BFECT patients showed significantly faster clinical response on BPRS (Time × Group interaction effect: P = 0.001), BFCRS (P < 0.001) and the NOSIE total assets score (P = 0.003). ANCOVA using baseline scores as covariates and treatment-resistance status as between-subject factor showed that BFECT patients had significantly greater improvement in all measures. BFECT patients had significantly higher PGI-memory-scale total score than BTECT patients (t = 5.16; P < 0.001). They also showed superior performance in other cognitive measures. ConclusionsBFECT results in superior clinical and cognitive outcomes than BTECT in schizophrenia patients referred for ECT.

A controlled trial investigating the effect of music therapy during an acute psychotic episode

To investigate the effects of music therapy, as an adjunct to pharmacological therapy during an acute psychotic episode. Sixty participants were quasi-randomised into either a treatment or control group. Standardised psychological assessments [Brief Psychiatric Rating Scale (BPRS), Calgary Interview Guide for Depression, Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30) and Depression Anxiety Stress Scale (DASS21)] were conducted before and after the sessions to determine whether there were any significant changes in outcomes. Statistically significant changes in BPRS scores were seen in the treatment group (n = 25) compared with the control group (n = 24). No significant differences were seen in the results of the Calgary, NOSIE-30 or DASS21 scores. Despite the treatment group, having a 9.3% decrease in their length of stay in hospital as opposed to the control group, this did not reach statistical significance. No significant differences were found when comparing the two groups in their doses of antipsychotic, benzodiazepine, mood stabilising or antidepressant medication or at the 1-month follow-up assessment. Most of the variables tested in our study but one did not point at any advances of adding music therapy to pharmacological treatment. The finding of improvement in Brief Psychiatric Rating Scale could be an indicator of music therapy as a useful adjunct to pharmacotherapy during an in-patient hospital stay for the few patients amongst those suffering acute psychosis that accept to participate in music therapy.

Effect of in-hospital comprehensive rehabilitation training on schizophrene's cognitive function

Objective To investigate the effect of in-hospital comprehensive rehabilitation training schizophrene's cognitive function.Methods 80 schizophrenic patients were randomly divided into study group (n=40)and control group(n=40).Both groups received conventional treatment and care,the study group also received in-hospital comprehensive rehabilitation training such as life skills training,medication management skills training,vocational skills training and social communication traning for 12 weeks.Their cognitive function was measured with Wechsler Adult Memor(Revised)(WMS-RC),Positive and Negative Symptom Scale(PANSS),Nurses'Observation Scale for Inpatient Evaluation(NOSIE)before and after the training,respectively,and changes in cognitive function were compared.Results There was no statistically significance in WMS-RC,PANss,NOSIE scores between the study group and the cantrol group before training.There was statistically significance in WMS-RC,Calculation scores(15.09±1.57 vs 13.36±1.55,t=3.005.P=0.04),dtgit span scores(13.32±1.68 vs 12.08±1.79,t=3.124,P=0.003),number sign(8.17±2.21 vs 8.24±1.41,t=3.212,P=0.003),total sares(32.79±6.14 vs 29.78±4.58,t=3.412,P=0.001),memory quotient sares(116.25±3.94 vs 112.72±3.07,t=4.382,P=0.000)between the two groups ccfter 12 weeks;There was statistically signifieamce in PANSS,NOSIE scores between the study group and the control group after training 12 weeks.Conclusions In-hospital comprehensive rehabilitation training can improve schizophrene's cognitive function. Key words: Comprehensive rehabilitation training; Schizophrenia; Cognitive function

The effect of social functions and quality of life of self -control education in patients with first episode schizophrenia

Objective To detect the effect of social functions and quality of life of self -control education in patients with first cpisode schizophrenia. Methods A total of 116 patients with first episode schizophrenia were randomly divided into the observation group (58)and the control group (58) . Both the groups were received anti -psychotics treatment and general health education, but self-control education was given to the observation group. These patients were followed up for 1 year. All the subjects were evaluated by brief psychiatric rating scale (BPRS), nurse observation scale for inpatient evaluation -30 (NOSIE -30), social disability screening schedule (SDSS) and the generic quality of life inventory (GQOLI) . Results There were 111 subjects who had completed the trial. There were no significant differences between the two groups at the beginning ( P ＞ 0. 05 ), but were significant differences after a year (P ＜0. 01 ) . Conclusions Self-control education could improve psychiatric symptoms of patients with first episode schizophrenia, help to the recovery of social functions and improve quality of life. Key words: Self-control education; Schizophrenia; Social functions; Quality of life

Does catatonic schizophrenia improve faster with electroconvulsive therapy than other subtypes of schizophrenia?

Objective. Electroconvulsive therapy (ECT) is generally recommended for treating catatonic schizophrenia. Non-catatonic schizophrenia patients also receive ECT. We compared the speed of response to ECT among patients with catatonic and other subtypes of schizophrenia. Methods and materials. Consecutive schizophrenia patients referred for ECT within 3 months of starting antipsychotic treatment were studied (19 with catatonic and 34 with non-catatonic schizophrenia). Nurse's Observation Scale for Inpatient Evaluation (NOSIE-30) and Clinical Global Impression (CGI) were used to rate improvement. Referring psychiatrists stopped ECTs based on clinical impression of improvement. Total number of ECTs was taken as an indirect measure of speed of response. NOSIE-30 scores were compared using repeated measures analysis of variance. Results. Catatonic schizophrenia patients required significantly fewer ECTs to achieve clinically significant improvement. There was a significant group×occasion effect in NOSIE scores, suggesting faster response to ECT in the catatonia group (F=41.6; P<0.001). Survival analysis suggested that patients with catatonic schizophrenia required significantly fewer ECTs (one less session on an average) to achieve clinical improvement (Log-rank statistic =5.31; P=0.02). Conclusions. Catatonic schizophrenia responds faster to ECT than non-catatonic schizophrenia. However, the magnitude of the difference is modest.

A Double-blind Placebo-controlled Discontinuation Study of Zuclopenthixol for the Treatment of Aggressive Disruptive Behaviours in Adults with Mental Retardation – Secondary Parameter Analyses

Earlier studies showed risperidone to be effective in the treatment of aggression and self-injurious behaviour in adults with mental retardation but also having adverse side effects. This study was conducted to evaluate the effects of zuclopenthixol withdrawal. After open treatment with zuclopenthixol (n=49) responders were randomly assigned to continue (n=19) or discontinue (n=20) zuclopenthixol treatment during a 12-week double-blind, placebo-controlled period. Effects were measured using the Disability Assessment Schedule (DAS), improvement on the Clinical Global Impression Scale (CGI-I), and the Nurse's Observation Scale for Inpatient Evaluation (NOSIE). Ten patients (20%) discontinued the study due to insufficient therapeutic effect or adverse events in the open period. The superiority of zuclopenthixol over placebo among all randomized patients was supported not only by primary efficacy measure but also by the comparisons of mean scores of all secondary efficacy measures tested in a step-down-procedure (DAS, p<0.001; CGI-I, p<0.002, NOSIE, p<0.005). In both groups, one patient discontinued (5%) for adverse events. Adverse events were generally mild or moderate in severity. Zuclopenthixol proved to be safe and effective to keep a low rate of aggressive behaviour in adults with mental retardation.

Schizophrenia with prominent catatonic features (‘catatonic schizophrenia’): III. Latent class analysis of the catatonic syndrome

No reports have yet been published on catatonia using latent class analysis (LCA). This study applied LCA to a large, diagnostically homogenous sample of patients with chronic schizophrenia who also presented with catatonic symptoms. A random sample of 225 Chinese inpatients with DSM-IV schizophrenia was selected from the long-stay wards of a psychiatric hospital. Their psychopathology, extrapyramidal motor status and level of functioning were evaluated with standardized rating scales. Catatonia was rated using a modified version of the Bush–Francis Catatonia Rating Scale. LCA was then applied to the 178 patients who presented with at least one catatonic sign. In LCA a four-class solution was found to fit best the statistical model. Classes 1, 2, 3 and 4 constituted 18%, 39.4%, 20.1% and 22.5% of the whole catatonic sample, respectively. Class 1 included patients with symptoms of ‘automatic’ phenomena (automatic obedience, Mitgehen, waxy flexibility). Class 2 comprised patients with ‘repetitive/echo’ phenomena (perseveration, stereotypy, verbigeration, mannerisms and grimacing). Class 3 contained patients with symptoms of ‘withdrawal’ (immobility, mutism, posturing, staring and withdrawal). Class 4 consisted of ‘agitated/resistive’ patients, who displayed symptoms of excitement, impulsivity, negativism and combativeness. The symptom composition of these 4 classes was nearly identical with that of the four factors identified by factor analysis in the same cohort of subjects in an earlier study. In multivariate regression analysis, the ‘withdrawn’ class was associated with higher scores on the Scale of Assessment of Negative Symptoms and lower and higher scores for negative and positive items respectively on the Nurses' Observation Scale for Inpatient Evaluation's (NOSIE). The ‘automatic’ class was associated with lower values on the Simpson–Angus Extrapyramidal Side Effects Scale, and the ‘repetitive/echo’ class with higher scores on the NOSIE positive items. These results provide preliminary support for the notion that chronic schizophrenia patients with catatonic features can be classified into 4 distinct syndromal groups on the basis of their motor symptoms. Identifying distinct catatonic syndromes would help to find their biological substrates and to develop specific therapeutic measures.