Patients Withschizophrenia Research Articles

Striatal Functional Hypoconnectivity in Patients With Schizophrenia Suffering From Negative Symptoms, Longitudinal Findings.

Negative symptoms in schizophrenia (SZ), such as apathy and diminished expression, have limited treatments and significantly impact daily life. Our study focuses on the functional division of the striatum: limbic-motivation and reward, associative-cognition, and sensorimotor-sensory and motor processing, aiming to identify potential biomarkers for negative symptoms. This longitudinal, 2-center resting-state-fMRI (rsfMRI) study examines striatal seeds-to-whole-brain functional connectivity. We examined connectivity aberrations in patients with schizophrenia (PwSZ), focusing on stable group differences across 2-time points using intra-class-correlation and associated these with negative symptoms and measures of cognition. Additionally, in PwSZ, we used negative symptoms to predict striatal connectivity aberrations at the baseline and used the striatal aberration to predict symptoms 9 months later. A total of 143 participants (77 PwSZ, 66 controls) from 2 centers (Berlin/Geneva) participated. We found sensorimotor-striatum and associative-striatum hypoconnectivity. We identified 4 stable hypoconnectivity findings over 3 months, revealing striatal-fronto-parietal-cerebellar hypoconnectivity in PwSZ. From those findings, we found hypoconnectivity in the bilateral associative striatum with the bilateral paracingulate-gyrus and the anterior cingulate cortex in PwSZ. Additionally, hypoconnectivity between the associative striatum and the superior frontal gyrus was associated with lower cognition scores in PwSZ, and weaker sensorimotor striatum connectivity with the superior parietal lobule correlated negatively with diminished expression and could predict symptom severity 9 months later. Importantly, patterns of weaker sensorimotor striatum and superior parietal lobule connectivity fulfilled the biomarker criteria: clinical significance, reflecting underlying pathophysiology, and stability across time and centers.

Neutrophil-Lymphocyte Ratio in Patients With Acute Schizophrenia.

Introduction Schizophrenia symptom severity is linked to neuroinflammation. Certain blood cell indexes such as neutrophil-lymphocyte ratio (NLR) and neutrophil-albumin ratio (NAR) have been used as biomarkers in various diseases, including schizophrenia. In acute clinical practice, it is challenging to decide whether to provide intravenous antipsychotic treatment in some cases due to the lack of objective biomarkers of psychiatric symptoms. The NLR of individuals with schizophrenia is thought to be associated with disease severity, and changes in NLR may reflect a patient's response to antipsychotic treatment. We investigated the application of NLR as a biomarker for identifying acute severity and determining acute treatment response in patients withschizophrenia. Methods We retrospectively examined 251 inpatients diagnosed with schizophrenia and classified them according to treatment (intravenous haloperidol vs. oral antipsychotic medication during the acute phase) and investigated their NLR and NAR while receiving inpatient care. Results A total of 48 inpatients were given intravenous haloperidol to manage their acute symptoms; 208 were given oral antipsychotics. The intravenous haloperidol group experienced more severe symptoms, such as agitation and disorganized thinking, during the acute phase. Further, those who received intravenous haloperidol had significantly higher Clinical Global Impression-Severity (CGI-S) scores than the oral antipsychotic group. NLR and NAR were also significantly higher in the haloperidol intravenous group. Conclusion Elevated NLR and NAR could be easily measured in patients with psychomotor agitation who should be treated at any facility. Further, they are useful biomarkers for determining disease severity and the effects of treatment on psychomotor excitement in patients who require intravenous haloperidol.

Perceived Burden and Quality of Life in Caregivers of Patients with Schizophrenia in Saudi Arabia's Eastern Province: A Cross-sectional Study.

Family Caregivers (FCGs) of patients with schizophrenia (PwS) may face unanticipated sources of stress and responsibility, which can negatively impact their quality of life (QoL). This study aimed to assess FCGs' QoL and the impact of clinical characteristics of patients and sociodemographic factors on their QoL. A cross-sectional questionnaire-based study surveyed 340 FCGs from outpatient clinics of PwS in two large psychiatric hospitals in Saudi Arabia's eastern province using a convenience sampling approach. We used the Adult Carer Quality of Life (AC-QoL) scale, which has eight subscales and 40 items, to assess QoL. AC-QoL is translated into Arabic in this study. The study included 216 FCGs, with 127 (58.8%) being men, 117 (54.2%) being over 45 years old, 91 (42.1%) being a sibling of a PwS, and 82 (38%) being a parent of a PwS. The mean score in our sample was 78.2 ± 21.24 out of 120, indicating mid-range QoL. Lower QoL was associated with more time spent in caregiving per day, a lower educational level of FCG, and recent admission of PwS to an inpatient unit. PwS FCGs have a mid-range QoL. FCGs reported a moderate financial burden and low levels of support from healthcare professionals. FCG's QoL and stress can be reduced through healthcare providers, participation in a community support group, and addressing an FCG's in an individual setting.

Structure and replicability of oral health-related quality of life networks across patients with schizophrenia and the general community.

Schizophrenia is a disabling mental disorder associated with severe social dysfunction. Individuals with long-term mental conditions have poorer Oral Health-Related Quality of Life (OHRQoL) compared to the general population, but little is known about the measurement properties of OHRQoL instruments in this group of patients. This study aimed to examine the replicability of OHRQoL networks across samples of the general community (GC) and patients with schizophrenia (PWS). Data were obtained from 603 community-dwelling participants and 627 patients with schizophrenia. OHRQoL was measured using the short form of the Oral Health Impact Profile (OHIP-14) questionnaire. A regularized partial correlation network was estimated for each sample. The number of dimensions and structural stability were assessed using Exploratory Graph Analysis. Global strength, edge weights and centrality estimates were compared. Network replicability was examined fitting the PWS data to the GC network structure. A single OHIP-14 dimension was identified in the GC sample, whereas three dimensions were detected in the PWS sample. Structural consistency was perfect in the network of GC participants (1), and considerably low in at least two dimensions of the PWS network (0.28; 0.65; 0.16). A moderate correlation for node strength estimates was observed (τ: 0.43; 95% CI: 0.13, 0.72), although edge weights were not correlated (τ: 0.025; 95% CI: -0.11, 0.16). The fit of the PWS data to the GC network structure was deemed unacceptable. Network models of OHRQoL did not replicate across samples of the general community and outpatients with schizophrenia. Prudent use of OHIP-14 to compare measures of OHRQoL between groups with significant cognitive impartment and the general population is recommended.

Factors Affecting Employability of Patients with Schizophrenia who had First Participated in Vocational Training: A Pilot Study.

While vocational training may offer financial and health benefits for patients with schizophrenia (PwS), further empirical research is required to investigate the effectiveness of this intervention for PwS, as well as the factors influencing their employability. This study aimed to (i) identify the factors affecting the employability of PwS who had participated in vocational training and (ii) examine the effectiveness of vocational training. This prospective cohort study was conducted in a community rehabilitation center attached to a psychiatric hospital in southern Taiwan that provides vocational training. The participants completed two questionnaires: (i) a pre-test that served as the study's baseline; (ii) a post-test during a follow-up 12 months later. The questionnaire was divided into three parts: (i) participants' basic information, (ii) the work performance scale, and (iii) the mental state measure. The participants included 35 males and 30 females, with the average age being 45.85 years. The significant factors affecting their employability were social support, work behavior, thinking disorder, and cognitive impairment. In other words, participants with better social support, work behavior, and fewer thought disorders and cognitive impairment were more employable. Their work attitude and ability were found to have significantly improved after having participated in vocational training for 12 months. In conclusion, when conducting vocational training in the future, it is necessary to pay attention to individual participants' social support and work behavior and reduce thinking disorders and cognitive impairments. This may help improve the employability of PwS.

Retrospective analysis of hospitalization rates in patients with schizophrenia 12 months before and 12 months after the switch on once-monthly long-acting injectable paliperidone palmitate

Background/Aim. There is no available published data about the use of long-acting injectable paliperidone palmitate (PP) in schizophrenia patients in the Republic of Serbia. The aim of this study was to assess hospitalization rates be-fore and after the switch to once-monthly long-acting injectable PP in schizophrenia patients, as well as their compliance with this drug. Methods. We conducted a retrospective cross-sectional study in which hospitalization rates were evaluated 12 months before and 12 months after the switch to once-monthly long-acting injectable PP in 113 schizophrenia patients. The age of the enrolled patients was between 18 and 66 years. Results. The average age of the enrolled patients was 38.36 ? 11.62 years. Among them, 77 (68.1%) were male, and 36 (31.9%) were female. Out of the total number of 113 patients treated with once-monthly injectable PP, 78 (69.03%) were on monotherapy, while 35 (30.97%) had one additional oral antipsychotic (risperidone, olanzapine, aripiprazole, or clozapine). Out of the total number of 113 patients, 68 (60.18%) were not hospitalized in the 12-month period before the switch to once-monthly long-acting injectable PP, while 45 (39.82%) were hospitalized in the same period. Given that 8 patients out of the total number of 113 were excluded from therapy due to an adverse event or their own decision in the period after the switch to PP, the analysis of the hospitalization rate after the switch to PP was performed for the remaining 105 patients, of which 9 (8.57%) were hospitalized in the period after the switch to PP, and 96 (91.43%) were not. Conclusion. Our results show high compliance in the treatment with once-monthly injectable PP and a positive impact of treatment with this drug on low hospitalization rate in a 12-month period in patients with schizophrenia. Considering the availability of this drug in the Republic of Serbia, these results encourage the use of once-monthly injectable PP as an important therapeutic option in schizophrenia patients.

Insomnia in Chinese patients with chronic schizophrenia: prevalence, clinical correlates and relationship with cognitive impairment.

Insomnia is a major public health concern thatoften occurs in patients with schizophrenia, complicating the treatment and prognosis of patients. This study aimed to investigate the prevalence of insomnia and its relationship with cognitive function in Chinese patients with chronic schizophrenia. We recruited patients with schizophrenia and collected their clinical and demographic data. Insomnia data were collected through a self-reported questionnaire consisting of three questions. The positive and negative syndrome scale (PANSS) was used to measure psychopathological symptoms, while the repeatable battery for the assessment of neuropsychological status (RBANS) was used to measure cognitive performance. Of 957Chinese patients with chronic schizophrenia 20.2%reported having insomnia (193/957). Male patients (107/630, 17.0%) had a lower rate of insomnia than female patients (86/327, 26.3%) (x2 = 11.60, p = 0.001). Patients with insomniaexhibited significantly higher PANSS total score and positive symptom, negative symptom, and general psychopathology scores, but significantly lower RBANS total score, language, attention and delayed memory scores compared to patients without insomnia (all p < 0.05). Logistic regression analysis showed that femalesex, high PANSS total score and the use of diazepam were independently associated with insomnia (all p < 0.05). Insomnia is relatively commonin Chinese patients with chronic schizophrenia. Some demographic dataand clinical symptoms are associated with insomnia. Patients with schizophrenia andinsomnia perform poorlyon cognition tests suggesting that insomnia and cognitive function are closely related in patientswith schizophrenia.

A review about the putative mechanisms of action of electroconvulsive therapy in schizophrenia in human research

Electroconvulsive therapy (ECT) has multiple uses in psychiatry, but its mechanisms of action (MA) in patients with schizophrenia (PS) are poorly understood. We synthesize and discuss the available evidence in this regard. We conducted a search for primary human studies and systematic reviews searching MA of ECT in PS published in PubMed/Medline, SciELO, PsycInfo, and the Cochrane Library, including 24 articles. Genetic findings are scarce and inconsistent. At the molecular level, the dopaminergic and GABAergic role stands out. The increase in brain derived neurotrophic factor (BDNF) after ECT, is a predictor of positive clinical outcomes, while the change in N-acetyl aspartate levels would demonstrate a neuroprotective role for ECT. This intervention would improve inflammatory and oxidative parameters, thereby resulting in a symptomatic improvement. ECT is associated with an increase in functional connectivity in the thalamus, right putamen, prefrontal cortex and left precuneus, structures that play a role in the neural default mode network. A decrease in connectivity between the thalamus and the sensory cortex and an enhanced functional connectivity of the right thalamus to right putamen along with a clinical improvement have been reported after ECT. Moreover a volumetric increase in hippocampus and insula has been reported after ECT. These changes could be associated with the biochemical pathophysiology of schizophrenia. Most of the included studies are observational or quasi-experimental, with small sample sizes. However, they show simultaneous changes at different neurobiological levels, with a pathophysiological and clinical correlation. We propose that the research on ECT should be carried out from neurobiological dimensions, but with a clinical perspective.

Clinical factors affecting functioning in patients with schizophrenia or schizoaffective disorder

IntroductionSchizophrenia is often associated with impaired functioning abilities due to its disabling symptoms.Objectivesto determine the clinical factors that impact the functioning in stabilized patients withschizophrenia and schizoaffective disorder.MethodsWe conducted a cross-sectional, descriptive and analytical study. It was carried out on an outpatient population with schizophrenia or schizoaffective disorder diagnosis. We used the Functional Assessment Staging Scale (FAST) to measure the functional capacity, the PANSS to assess psychosis symptom severity and the Calgary scale to screen for comorbid depression.ResultsSeventy-five patients were included with 61 males (81.3%).The mean age was 39.81 ± 9.96 years. The mean sore of the Fast scale was 33 ± 14.95. 90% of our patients scored higher than 11 on the FAST scale revealing a functioning deficiency. 18.7% scored higher than 6 on the Calgary scale revealing a comorbid depression .No significant correlations were found between the FAST score and the age of patient, the gender,the age of onset of psychosis, the duration of untreated psychosis and the number of life-time episodes. Scores of PANSS were significantly higher among patients with a functioning deficiency (p&lt;0.00).No significant correlation was found between the FAST score and the Calgary score.Conclusions Our study suggests that the severity of residual positive and negative symptoms affects negatively the functioning of patients with schizophrenia or schizoaffective disorder. Thus, targeting those symptoms in the treatment may have significant functional benefits.DisclosureNo significant relationships.

Processing of Spoken Emotions in Schizophrenia: Forensic and Non-forensic Patients Differ in Emotional Identification and Integration but Not in Selective Attention.

Patients with schizophrenia (PwS) typically demonstrate deficits in visual processing of emotions. Less is known about auditory processing of spoken-emotions, as conveyed by the prosodic (tone) and semantics (words) channels. In a previous study, forensic PwS (who committed violent offenses) identified spoken-emotions and integrated the emotional information from both channels similarly to controls. However, their performance indicated larger failures of selective-attention, and lower discrimination between spoken-emotions, than controls. Given that forensic schizophrenia represents a special subgroup, the current study compared forensic and non-forensic PwS. Forty-five PwS listened to sentences conveying four basic emotions presented in semantic or prosodic channels, in different combinations. They were asked to rate how much they agreed that the sentences conveyed a predefined emotion, focusing on one channel or on the sentence as a whole. Their performance was compared to that of 21 forensic PwS (previous study). The two groups did not differ in selective-attention. However, better emotional identification and discrimination, as well as better channel integration were found for the forensic PwS. Results have several clinical implications: difficulties in spoken-emotions processing might not necessarily relate to schizophrenia; attentional deficits might not be a risk factor for aggression in schizophrenia; and forensic schizophrenia might have unique characteristics as related to spoken-emotions processing (motivation, stimulation).

Effectiveness of Cognitive Behavioural Therapy for Suicide in Schizophrenia: A Systematic Review

Background: Suicide is probably one of the worst potential complications for people with schizophrenia. Even though the use of antipsychotic medication is essential in reducing suicidal behaviour, the use of psychological treatments seems to be in the same way necessary. Cognitive Behavioural Therapy (CBT) is an evidence-based form of psychotherapy that is constantly trying to synchronise with the latest recommendations from the research. The goal of the present work is to systematically review the scientific evidence from published studies testing the effectiveness of CBT designed to deal with suicide in patients with schizophrenia. Methods: We searched using multiple terms related to suicide prevention based on CBT in schizophrenia. Two databases (Medline and SCOPUS) were scrutinised for the electronic search, and different reference lists from previous reviews were also hand-checked. Results: We identified 5 randomised and controlled trials of CBT that included suicide-related cognitions or behaviours as a primary outcome measure. CBT focusing on suicidal cognitions and behaviours was found to be effective in reducing suicidal ideation. As the number of studies fulfilling the inclusion criteria is small, and the assessment of outcomes is heterogeneous, we did not perform a meta-analysis and present results in a narrative way. Conclusion: Research on CBT focused on suicide prevention in patients with schizophrenia is promising, but current evidence is notoriously insufficient. Although those therapies seemed to be efficacious in the prevention of suicide, scarcity of randomised clinical trials specifically focusing on suicide is probably the most important issue to be faced. Given the current evidence, clinicians should be familiar with CBT techniques focusing on suicidal cognitions. However, suicide prevention and treatment in those with schizophrenia is complex, and many other factors such as possible earlier use of clozapine, optimizing adherence to medication, and other psychosocial aspects should be addressed. A combination of different strategies appears to be mandatory.

Posterior Parietal Cortex Dysfunction is Central to Working Memory Storage and Broad Cognitive Deficits in Schizophrenia

Working memory (WM) deficiencies in patients with schizophrenia (PSZ) are thought to be caused by PFC dysfunction, but few research have looked at non-manipulated measures of WM storage. Storage capacity is more closely tied to the posterior parietal cortex (PPC) than the frontal cortex (PFC) in neurotypical people, suggesting that impairments in WM storage capacity in schizophrenia that are associated with widespread cognitive deficits may be related to neuronal activity in the PPC. While receiving fMRI, 37 PSZ and 37 matched healthy control volunteers of both sexes conducted a change detection test with varied set sizes. The assignment was created to emphasis WM storage while requiring minimal top-down management. BOLD activity correlated with the number of items kept in WM (K), as determined by task performance at a particular set size, according to whole-brain analyses. Independent of set size, K values predicted BOLD activity in the PPC, including the superior and inferior parietal lobules, intraparietal sulcus, and middle occipital gyrus, across groups. In the left PPC, whole-brain interaction analysis revealed that PSZ had much less K-dependent signal modulation than healthy control participants, a finding that could not be explained by a smaller K value range. The slope between K and PPC activation accounted for 43.4 percent of the variations in broad cognitive performance across groups. These findings suggest that PPC dysfunction is linked to WM storage abnormalities in PSZ and may play a role in schizophrenia's widespread cognitive deficiencies.

Predictors of unrecognised comorbid depression in patients with schizophrenia at Amanuel mental specialized hospital, Ethiopia: a cross-sectional study

BackgroundThe occurrence of depression in patients with schizophrenia (PWS) increases the risk of relapse, frequency and duration of hospitalisation, and decreases social and occupational functioning.ObjectiveThis study aimed to assess prevalence...

Developing Communication Book for Schizophrenia in Aceh: Prospects and Challenges

&#x0D; &#x0D; &#x0D; he lack of media information about Schizophrenia in Aceh explains caregivers’ limited understanding of mental disorders. Research on patient discharge systems found that communication media about Schizophrenia were still limited, mostly in the form of posters, flyers, or booklets. There was no specific information about the mental illness needed by the family or caregivers after the patient's discharged from the hospital. This study aims to develop and test a communication medium that can support the recovery process of post-discharge patients from the Mental Health Hospital or Rumah Sakit Jiwa (RSJ) in Aceh. This action research was carried out through focus group discussions (FGDs), interviews, and surveys to health practitioners (mental health nurses, psychiatrists, psychologists, community leaders) and family or caregivers of Patients with Schizophrenia (PWS). The study found that messages about Schizophrenia which are developed through a community-based approach are likely to be better accepted than the expert-led information.&#x0D; &#x0D; &#x0D;

Relationship Between Sense of Coherence and Social Support and Psychological Well-being Among Patients with Schizophrenia

Background: Schizophrenia is a chronic, persistent, frequently recurrent psychiatric condition that affects early brain development with a heterogeneous genetic and neurobiological history and is expressed as a mixture of psychotic symptoms such as hallucination, delusion, disorganization, and motivational and cognitive dysfunctions . The aim of this study Having a sense of coherence (SOC) and good social support is important for psychological well-being. This study aimed to investigate the nature of SOC and social support and their relationship with psychological well-being among patients with schizophrenia. Methodology: A descriptive cross-sectional research design was used to assess a convenience sample of 148 schizophrenia patients from Zagazig University Hospital. Data were collected using a questionnaire consisting of a sociodemographic datasheet, medical datasheet, SOC scale, multidimensional social support scale, and general health questionnaire (GHQ-12). Results: Significant relationships were found between some medical data and SOC and between social support and psychological well-being. The mean scores for SOC and social support were significantly correlated positively with the GHQ result. Conclusion: The highest percentage of SOC was reported on the comprehensibility subscale, social support was mainly received from others, and low psychological well-being was found to exist particularly for the positive statements. SOC and social support were significant positive predictors of GHQ results. Recommendation: endorsing the application of intervention programs for patients with schizophrenia that enhance SOC to improve their psychological well-being and recovery from disease

Transdiagnostic comparison of visual working memory capacity in bipolar disorder and schizophrenia

BackgroundImpaired working memory is a core cognitive deficit in both bipolar disorder and schizophrenia. Its study might yield crucial insights into the underpinnings of both disorders on the cognitive and neurophysiological level. Visual working memory capacity is a particularly promising construct for such translational studies. However, it has not yet been investigated across the full spectrum of both disorders. The aim of our study was to compare the degree of reductions of visual working memory capacity in patients with bipolar disorder (PBD) and patients with schizophrenia (PSZ) using a paradigm well established in cognitive neuroscience.Methods62 PBD, 64 PSZ, and 70 healthy controls (HC) completed a canonical visual change detection task. Participants had to encode the color of four circles and indicate after a short delay whether the color of one of the circles had changed or not. We estimated working memory capacity using Pashler’s K.ResultsWorking memory capacity was significantly reduced in both PBD and PSZ compared to HC. We observed a small effect size (r = .202) for the difference between HC and PBD and a medium effect size (r = .370) for the difference between HC and PSZ. Working memory capacity in PSZ was also significantly reduced compared to PBD with a small effect size (r = .201). Thus, PBD showed an intermediate level of impairment.ConclusionsThese findings provide evidence for a gradient of reduced working memory capacity in bipolar disorder and schizophrenia, with PSZ showing the strongest degree of impairment. This underscores the importance of disturbed information processing for both bipolar disorder and schizophrenia. Our results are compatible with the cognitive manifestation of a neurodevelopmental gradient affecting bipolar disorder to a lesser degree than schizophrenia. They also highlight the relevance of visual working memory capacity for the development of both behavior- and brain-based transdiagnostic biomarkers.

Resilience and Perceived Social support among Family Caregivers of Patients with Schizophrenia

Background: Psychological distress and burden among family caregivers of patients with schizophrenia can be mediated by resilience and perceived social support from family members, friends, and other significant caregivers. These are integral to bring positive changes in recovery and adaptation of family caregivers. Those reduce stress characteristics, also improve quality of life and quality of care provided for patients by family caregivers. Aim: This study aimed to determine the relationship between level of resilience and type of perceived social support among family caregivers of patients with schizophrenia. Design: A descriptive correlational design was used in this study. Setting: The study was conducted at Elmaamoura Hospital for Psychiatric Medicine in Alexandria, Egypt. Subjects: Subjects of this study consisted of 200 family caregivers of patients with schizophrenia. Tools: Three tools were used to collect necessary data namely a socio- demographic structured interview schedule, Connor-Davidson Resilience Scale (CD-RISC-10) and the Multidimensional Scale of Perceived Social Support (MSPSS). Results: Among the studied caregivers 76% had low level of resilience and most of the caregivers 82.5% had moderate perceived social support. A statistically significant positive relationship was found between resilience and total score of perceived social support & its three subscales (family social support, important people social support and friends social support). On further analysis using stepwise multiple regression, the study revealed that family social support emerged as the first predictor of resilience. Conclusion: It can be concluded that most of the studied patients had low level of resilience and moderate perceived social support. Moreover, perceived social support is related to and can predict more resilience among family caregivers.

Cognitive Profile of Patients with Schizophrenia in North Sumatera Indonesia

BACKGROUND: Cognitive dysfunction is one of the characteristics of schizophrenia traditionally experienced by elderly patients. In the past 25 years, studies have proven that the cognitive dysfunction is an early characteristic of this disease, besides introversion, drug abuse, suicidal behavior, and depressive symptoms. The mini-mental state examination is a test designed to identify functional and organic disorders in psychiatric patients. North Sumatera is often considered as “small Indonesia” due to the variety of tribes live in the province; therefore, a study in relation with the cognitive profile of patients with schizophrenia (PwS) is needed.&#x0D; AIM: We aimed to analyze cognitive function in PwS in the North Sumatera.&#x0D; METHODS: The study was a descriptive study with a cross-sectional approach of cognitive profile of PwS stressing in the age, sex, education, and illness duration of the patients.&#x0D; RESULTS: The results of the study using 200 subjects found that the most affected gender were male (62.5%), between the ages of 25–34 years (46%), with secondary school education background (55.5%), and with an illness duration &gt;1 year (64.0%). The results showed that cognitive function in schizophrenic patients was probable cognitive dysfunction (56.5%).&#x0D; CONCLUSIONS: From the results of this study, it was found that the most affected subjects were men, between 25 and 34 years, with high school education, and the illness lasted more than 1 year. Most of the schizophrenic patients experienced probable cognitive dysfunction.

Differential Effects of Psychotic Illness on Directed and Random Exploration.

Schizophrenia is associated with a number of deficits in decision-making, but the scope, nature, and cause of these deficits are not completely understood. Here we focus on a particular type of decision, known as the explore/exploit dilemma, in which people must choose between exploiting options that yield relatively known rewards and exploring more ambiguous options of uncertain reward probability or magnitude. Previous work has shown that healthy people use two distinct strategies to decide when to explore: directed exploration, which involves choosing options that would reduce uncertainty about the reward values (information seeking), and random exploration (exploring by chance), which describes behavioral variability that is not goal directed. We administered a recently developed gambling task designed to quantify both directed and random exploration to 108 patients with schizophrenia (PSZ) and 33 healthy volunteers (HVs). We found that PSZ patients show reduced directed exploration relative to HVs, but no difference in random exploration. Moreover, patients’ directed exploration behavior clusters into two qualitatively different behavioral phenotypes. In the first phenotype, which accounts for the majority of the patients (79%) and is consistent with previously reported behavior, directed exploration is only marginally (but significantly) reduced, suggesting that these patients can use directed exploration, but at a slightly lower level than community controls. In contrast, the second phenotype, comprising 21% of patients, exhibit a form of “extreme ambiguity aversion,” in which they almost never choose more informative options, even when they are clearly of higher value. Moreover, in PSZ, deficits in directed exploration were related to measures of intellectual function, whereas random exploration was related to positive symptoms. Taken together, our results suggest that schizophrenia has differential effects on directed and random exploration and that investigating the explore/exploit dilemma in psychosis patients may reveal subgroups of patients with qualitatively different patterns of exploration.

The level of tumour necrosis factor-alpha and its relationship to the cognitive function of Malayan-Mongoloid patients with schizophrenia.

Aim Schizophrenia is a mental disorder and one of the suspected causes is cytokines. One of them is tumour necrosis factor-alpha (TNF-α). Cytokines have the potential to affect cognitive function. The study aimed to find a correlation of TNF-α level with the Mini-Mental State Examination (MMSE) score in patients with schizophrenia (PwS), and comparing the level of TNF-α levels between PwS and healthy controls. Methods We conducted a cross-sectional analytic study and the study designs were correlation and comparative analysis, i.e. using a Mann-Whitney U test. A total number of 100 subjects were collected, and they were divided into two groups of PwS and control group, respectively. Results The results found that most of the PwS subjects were 39 men (78.0%), while the control group were 28 men (56.%). The differences in TNF-α levels between PwS and control groups were found to be significant p<0.001, there was no significant correlation between TNF-α level and the score of MMSE of the PwS with p = 0.938, with a very weak correlation that was r = -0.011, and a negative correlation direction. Conclusion There was a significant difference between TNF-α level of PwS and control group, i.e. PwS group had lower TNF-α level compared to the control group. The TNF-α level of PwS group had a very weak effect on the cause of cognitive dysfunction in PwS group, yet the higher level of it could reduce MMSE score in PwS group.