Personal And Social Performance Scale Research Articles

Music therapy group for women outpatients with major depressive disorder under treatment as usual in a psychiatric institution: non-randomized pilot trial

Major Depressive Disorder (MDD) is a prevalent mental illness in the world. Pharmacological treatment is typically the first choice, but Humanistic Music Therapy (HMT) may offer additional benefits when added to Treatment As Usual (TAU). This single-arm pilot study aimed to assess the effectiveness of Group HMT as an intervention for adult women diagnosed with MDD, in a psychiatric institution. The study comprised 12 outpatient women with MDD who received more than one year of pharmacological treatment. A pre-test/post-test design using the Hamilton Depression (HAM-D-21), Personal and Social Performance (PSP), and Global Assessment of Functioning (GAF) scales were employed to evaluate symptom severity and patient changes. Results indicated a significant decrease in HAM-D scores from 15.7 to 6.6 (p ≤ .005), a notable improvement in personal and social functioning (PSP scale) (p ≤ .05), and an increase in global activity level (GAF scale) (p ≤ .05). In conclusion, adult women with MDD receiving TAU in a psychiatric institution experienced a significant reduction in depressive symptoms and enhancement in global activity, personal, and social functioning when HMT was added to their treatment regimen. This study is limited by being non-randomized, unblinded, and, with a small population. A randomized controlled trials are required to confirm the benefits of HMT.

Eveningness chronotype influences social functioning by deteriorating depressive symptoms in remitted patients with schizophrenia

ABSTRACT Sleep and circadian rhythm disruption (SCRD) is common in schizophrenia patients, who also typically experience impaired social functioning. While various factors influence social functioning in schizophrenia, the specific impact of sleep and circadian rhythm disruption remains unclear. This study aimed to investigate the connection between chronotype and social functioning in remitted schizophrenia patients, examining the mediating roles of depression and sleep quality. The study included 185 patients diagnosed with schizophrenia based on DSM-5 criteria. After categorizing the patients into morningness, eveningness, or intermediate chronotypes using the Morningness-Eveningness Questionnaire(MEQ), they were assessed with the Positive and Negative Syndrome Scale(PANSS), Calgary Depression Scale for Schizophrenia(CDSS), Personal and Social Performance Scale(PSPS) and Pittsburgh Sleep Quality Index(PSQI). The eveningness chronotype group showed higher CDSS and PSQI scores and lower PWBS and PSPS-Total scores than the other groups (p < 0.05). A hierarchical linear regression model assessed MEQ, PSQI, and CDSS scores’ effects on PSPS total scores. MEQ scores’ significance diminished when CDSS scores were included. Eveningness chronotype, particularly with increased depressive symptoms, negatively impacts social functioning in remitted schizophrenia patients.These findings contribute to the understudied area of chronotype in schizophrenia and its impact on social functioning, including its interaction with sleep..

Improvement of social functioning in patients with first-episode schizophrenia using blonanserin treatment: a prospective, multi-centre, single-arm clinical trial.

This clinical trial primarily aimed to investigate the effects of blonanserin on social functioning in patients with first-episode schizophrenia. In this prospective, multi-centre, single-arm clinical trial study, blonanserin (flexible oral dose ranging from 8mg to 24mg per day) was given 26 weeks. Outcome measures included the Personal and Social Performance (PSP) scale for evaluating social functioning, the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) for measuring neurocognitive performance, and the Positive and Negative Syndrome Scale (PANSS) for assessing symptom severity. The primary endpoint was social function improvement evaluated by PSP scale at the end of blonanserin treatment. And the secondary endpoint was to validate the efficacy and neurocognitive effects of blonanserin. Adverse drug reactions (ADRs) were also recorded and analysed. A total of 96 patients with first-episode schizophrenia were recruited and proceeded to analysis. Fifty-one participants (53.1%) completed the PSP scale measurements at baseline and week 26. Following 26 weeks of blonanserin treatment, all outcome measurements demonstrated significant improvement during the follow-up period. Notably, PSP scores exhibited a continuous increase up to 68.1% ± 103.7% at the end of the treatment (46.6 ± 14.6 at baseline, 69.4 ± 17.4 at week 26, p<0.001), indicating positive effects on social functioning that were already noticeable by week 8. Blonanserin treatment exhibited favourable effects on social functioning in individuals with first-episode schizophrenia. The results suggest that blonanserin was effective treatment options for patients with schizophrenia encountering functional impairments.

Long-term efficacy and safety of paliperidone 6-month formulation: An open-label extension of a double-blind study in adult patients with schizophrenia

IntroductionPaliperidone palmitate 6-month (PP6M), administered twice-yearly, demonstrated non-inferiority to paliperidone palmitate 3-month (PP3M) in preventing relapse in patients with schizophrenia in a phase-3 randomized, double-blind (DB) global study.1 We report results of a 2-year single-arm, open-label extension (OLE) of this study (NCT04072575).ObjectivesTo assess long-term efficacy and safety of PP6M in patients with schizophrenia.MethodsPatients who completed DB study without relapse were enrolled and followed up every 3 months for up to 2 years. Patients received 4 PP6M injections (700/1000 mg eq.) at baseline, 6-month, 12-month, and 18-month visits. Efficacy endpoints included relapse rate, Positive and Negative Syndrome Scale (PANSS) total score, Personal and Social Performance (PSP) score, and Clinical Global Impression-Severity (CGI-S) scale change from baseline. Safety was assessed by treatment-emergent adverse events (TEAEs), physical examinations and laboratory tests.ResultsOf 178 patients, 154 (86.5%) completed the study; mean age: 40.4 years; 70.8% were men. Mean duration of PP6M exposure was 682.1 days. Overall, 7/178 (3.9%) patients relapsed between 20 to 703 days after enrolment. Mean (SD) change from baseline to endpoint: PANSS total score, 0.7 (8.22); CGI-S, 0.0 (0.51); PSP Scale, 0.5 (7.47). Overall, 111/178 patients (62.4%) reported ≥1 TEAE; most common (&gt;10%) TEAEs were headache (13.5%) and blood prolactin increased (10.7%). Total, 7/24 patients withdrew due to TEAEs, and 8/178 (4.5%) patients experienced serious TEAEs; no deaths were reported.ConclusionsRelapse rate with PP6M was very low (&lt;4%). Clinical improvements in PANSS, CGI-S, and PSP scales demonstrated in DB study were maintained during this 2-year OLE study and no new safety concerns were identified.Reference1. D. Najarian et al. Int J Neuropsychopharmacol. 2022 Mar 17;25(3):238-251.Disclosure of InterestD. Najarian Shareolder of: Johnson &amp; Johnson, Employee of: Janssen Research &amp; Development, LLC, I. Turkoz Shareolder of: Johnson &amp; Johnson, Employee of: Janssen Research &amp; Development, LLC, S. Galderisi Consultant of: Janssen, Gedeon Richter-Recordati, Angelini, Speakers bureau of: Angelini, Gedeon Richter-Recordati, Janssen, Lundbeck, Sunovion, Recordati, H. Lamaison Grant / Research support from: Novartis, Eli Lilly, Lundbeck, Servier, AstraZeneca, Wyeth, Pfizer, Otsuka, Takeda, Sunovion, Roche, Janssen Pharmaceutical, Speakers bureau of: Servier, Abbot, Raymonds, Raffo, Temis Lostalo and Janssen Pharmaceutical, P. Zalitacz: None Declared, S. Aravind Shareolder of: Johnson &amp; Johnson, Employee of: Advarra, Inc. USA, U. Richarz Shareolder of: Johnson &amp; Johnson, Employee of: Janssen Research &amp; Development-Cilag, Switzerland.

The Raven’s Standard Progressive Matrices Performance is Associated with Premorbid Intelligence, Functioning or Adjustment in Patients with Schizophrenia

Objective: The assessment of premorbid intelligence and adjustment/functioning in schizophrenia is quite important for clinical evaluation. Several methods can be used to estimate premorbid functioning. However, these methods may be affected by retrospective bias, verbal skills, and the disorder itself. This study aimed to investigate whether the Raven’s Standard Progressive Matrices Test (RSPM) performance is related to premorbid intelligence/functioning, or adjustment in schizophrenia. Methods: Schizophrenia patients (n=31) and healthy controls (n=30) were included in the study. The Premorbid Adjustment Scale (PAS), the Positive and Negative Syndrome Scale (PANSS), and the Personal and Social Performance Scale (PSPS) were applied to patients with schizophrenia, while the WAIS-R and the RSPM were applied to all participants. Results: No statistically significant differences were observed between the groups in terms of age, sex, and total years of education (p=0.86, p=0.06 and p=0.10, respectively). Healthy controls performed significantly better than the patient group in terms of intellectual abilities as measured by the RSPM and the WAIS-R. The RSPM performance was correlated with all WAIS-R scores, total years of education, and the academic subscale of the PAS, while it was not correlated with the PAS-developmental scores or the PSPS and PANSS scores of patients with schizophrenia. Conclusion: The results of the study support the validity of the RSPM which is an easily applied tool that is not affected by verbal skills as a good measure of premorbid intelligence, and adjustment/ functionality in patients with schizophrenia.

Premorbid features of youth depression patients with attenuated schizophrenic symptoms

To establish the premorbid features in youth depression patients with attenuated symptoms of schizophrenia (ASS) and in a comparison group, with an analysis of the course of age crises, signs of personality disorders, level of premorbid functioning and their relationship with the level of functioning after five-year follow-up. Two hundred and nineteen youth depression patients with ASS (according to ICD-10: F32.1, F32.2, F32.28, F32.8) (main group) and 52 patients with «pure» adolescent depression without ASS (comparison group) were examined. A total of 124 patients from the main group and 27 patients from the comparison group were examined in 5-year follow-up. The Perceptual Awareness Scale (PAS) was used to assess premorbid functioning and the Personal and Social Performance (PSP) scale was used to determine function at the time of the follow-up. The method of χ2 was used to analyze qualitative data. The correlation analysis was performed with Spearman's rank correlation coefficient. Results are presented as median values [Q1; Q3]. The main group of patients with ASS have worse psychopathological symptoms compared with the comparison group (χ2=4.74; p=0.029). Premorbid functioning was also lower in the period 12-15 years (0.4 [0.33; 0.5]) and 16-18 years (0.47 [0.385; 0.585]) than in the comparison group (0.3 [0.23; 0.43] and 0.37 [0.23; 0.462], respectively, (p<0.05)). Negative correlation has been established between average PAS scores in the age of 12-15 and 16-18 years and the five-year follow-up on the PSP scale (r=-0.276, p<0.05 and r=-0.359, p<0.05 respectively). Similar characteristics of the premorbid period in childhood and an increase in differences starting from the pubertal period reflect the pathogenetic significance of the pubertal crisis and suggest compensatory mechanisms that, in patients with youth depression with ASS, are able to restrain the development of the endogenous process for a certain time, but subsequently become exhausted, which leads to persistence of psychopathological symptoms in intercrisis periods and serves as the first clinical marker of the onset of schizophrenia.

Internet gaming as a coping method among schizophrenic patients facing psychological distress.

Background and aimsPatients with schizophrenia are known to use potentially addictive psychoactive substances as self-medication and to ease psychological distress. Other potentially addictive behaviors such as online gaming are also used to self-medicate and ease psychological distress. However, the role of online gaming and problematic gaming (in the form of internet gaming disorder [IGD]) has not previously been investigated for patients with schizophrenia facing distress.MethodsOne hundred and four participants diagnosed with schizophrenia were recruited and completed a number of psychometric scales including the Personal and Social Performance Scale (PSPS), Internet Gaming Disorder Scale-Short Form (IGDS-SF9), Self-Stigma Scale-Short (SSS-S), and Depression, Anxiety, Stress Scale (DASS-21).ResultsThe results showed significant negative associations between PSPS, IGDS-SF9, and DASS-21, and significant positive correlations between the IGDS-SF-9, SSS-S and DASS-21. Moreover, IGD did not mediate the association between self-stigma and depression. However, IGD significantly mediated the association between self-stigma and anxiety, and the association between self-stigma and stress. In addition, (i) age and self-stigma were significant predictors for IGD; (ii) social function and self-stigma were significant predictors for depression; (iii) social function, self-stigma, and IGD were significant predictors for anxiety; and (iv) self-stigma and IGD were significant predictors for stress.ConclusionThe findings suggest that online gaming may be a coping strategy for individuals with schizophrenia with psychological stress and self-stigma and that for some of these individuals, their gaming may be problematic.

Evaluation of paliperidone palmitate long-acting injectable antipsychotic therapy as an early treatment option in patients with schizophrenia.

AimThis exploratory post hoc analysis of a randomized, double‐blind (DB), multicentre, non‐inferiority study (NCT01515423) evaluated the effects of the long‐acting injectable antipsychotic therapies once‐monthly paliperidone palmitate (PP1M) and once‐every‐3‐months paliperidone palmitate (PP3M) on symptom severity and functional remission in patients with schizophrenia with differing durations of illness (≤5, 6‐10 and >10 years).MethodsEndpoints included Personal and Social Performance (PSP) scale and Positive and Negative Syndrome Scale (PANSS) total scores during the DB phase (DB baseline and DB endpoint) and the proportion of patients meeting PSP or PANSS remission criteria at any time during the open‐label (OL) or DB phases that were maintained for ≥3, ≥6, ≥9 or ≥12 months.ResultsIn both the OL and DB phases, significant improvements in PSP scale and PANSS scores were observed from baseline in all duration‐of‐illness groups, with significantly greater improvements observed in the ≤5‐year and 6‐10‐year groups compared with the >10‐year group. The proportion of patients who maintained PSP or PANSS remission criteria for ≥3, ≥6, ≥9 and ≥12 months was higher in the ≤5‐year and 6‐10‐year groups than in the >10‐year group. Safety profiles were similar across duration‐of‐illness groups in the DB phase.ConclusionsSymptomatic and functional improvements were observed with PP1M/PP3M in patients with differing durations of schizophrenia, but the magnitude of the effects was greater in those with early illness vs chronic illness. These findings advocate implementation of PP1M and PP3M in all stages of schizophrenia, including early illness.

Tratamento em regime compulsivo ambulatório: estudo de follow-up após um ano em Portugal

Enquadramento: Não existem evidências suficientes relativamente ao impacto do tratamento em regime compulsivo ambulatório (TCA). Objetivos: Avaliámos o impacto do TCA ao longo de um ano em sintomas, funcionamento pessoal e social, insight e cognição. Métodos: Análise naturalística, longitudinal, no início e no follow-up após um ano, de 15 pacientes seguidos numa consulta especializada de TCA. Os pacientes foram submetidos a avaliação estandardizada com o Positive and Negative Syndrome Scale (PANSS) (Escala Positiva e Negativa do Síndroma), Personal and Social Performance Scale (PSP) (Escala de Desempenho Pessoal e Social), Berrios-Markova Scale to Assess Unawareness in Mental Disorder (SUMD) (Escala de Avaliação da Falta de Consciência no Distúrbio Mental), Trails A e B, Digit Span, e o Controlled Oral Word Association Test (COWA) (Teste de Associação Verbal Controlada). Resultados: No follow-up houve melhorias significativas no funcionamento pessoal e social (PSP inicial total: média=46,9; follow-up: média=59,3), e nomeadamente nas atividades socialmente úteis incluindo trabalho e estudos (p=0,012) e relações pessoais e sociais (p=0,033). Três pacientes (20%) pontuaram =&gt;69 no PSP, um bom nível de funcionamento. Porém, não verificámos melhorias significativas nos sintomas (PANSS=56,8), insight subjetivo ou objetivo (Berrios-Markova=10,0 e SUMD=11,0), ou desempenho cognitivo. Conclusões: No follow-up após um ano, os pacientes em TCA revelaram melhorias significativas no funcionamento pessoal e social, especificamente nas atividades socialmente úteis incluindo trabalho e estudos e nas relações pessoais e sociais, mas não registaram melhorias nos sintomas, insight e funcionamento cognitivo.

Paliperidone palmitate once-monthly maintains improvement in functioning domains of the Personal and Social Performance scale compared with placebo in subjects with schizoaffective disorder

ObjectiveEvaluate the effect of paliperidone palmitate once-monthly (PP1M) injectable on the specific functioning domains of the Personal and Social Performance (PSP) scale in patients with schizoaffective disorder (SCA) participating in a long-term study. MethodsThis study (NCT01193153) included both in- and outpatient subjects with SCA experiencing an acute exacerbation of psychotic and mood symptoms. Subjects were treated with PP1M either as monotherapy or in combination with antidepressants or mood stabilizers during a 25-week open-label (OL) phase. Stabilized subjects were randomly assigned 1:1 (PP1M or placebo) into a 15-month double-blind (DB) relapse-prevention period. Functioning of the randomized subjects during OL and DB phases was evaluated using the PSP scale (four domains: socially useful activities, personal/social relationships, self-care, and disturbing/aggressive behaviors). Three statistical approaches were utilized to analyze PSP scores to assess robustness and consistency of findings. No adjustments were made for multiplicity. Results334 of 667 enrolled subjects were stabilized with PP1M, randomly assigned to PP1M (n=164) or placebo (n=170) in the DB phase, and included in this analysis. Improvements in all PSP domain scores were observed during the OL phase and were maintained during the DB phase with PP1M, but decreased with placebo. Differences compared to placebo were significant in all four PSP domains during the DB phase (P≤0.008). ConclusionThe analysis in this study showed that PP1M improves functioning, as measured by the four PSP domain scores, in symptomatic subjects with SCA. Functioning was maintained compared with placebo.

Effects of paliperidone extended release on hostility among Thai patients with schizophrenia.

ObjectiveThis open-label prospective study investigated the effects of paliperidone extended release (ER) on hostility in Thai patients with schizophrenia.BackgroundPatients diagnosed with schizophrenia may be hostile or exhibit aggressive behavior, which can occasion their admission to psychiatric hospital. Antipsychotic medications are often used to treat hostility and aggression in such patients. Paliperidone ER is effective and well tolerated in the treatment of schizophrenia. However, there are no data available for paliperidone ER with regard to its efficacy on hostility and aggression among Thai patients. This study was a part of the PERFEcT study, a 6-month, open-label, multicenter, multicountry, prospective trial to explore the safety, efficacy, and functionality of paliperidone ER tablets. The current study included only the data obtained from Thai participants.Materials and methodsFlexible dosing of paliperidone ER in a range of 3–12 mg/day was used, allowing investigators to adjust the dosage of each subject individually. The 199 Thai patients had a stable Clinical Global Impression – severity score before enrollment. Demographic data were collected at enrollment, and assessments took place at 1, 2, 3, and 6 months postbaseline. The Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) scale were used to evaluate efficacy. In this analysis, we report the findings for the specific PANSS factor P7 (hostility) and the PSP subscale disturbing and aggressive behavior. Data were analyzed using paired t-test method to investigate changes in mean PANSS and PSP total and subscale scores. The significance level was set at P<0.05.ResultsFrom a total of 199 Thai patients, 148 patients (74.4%) participated in all visits. There was a significant reduction in mean scores for all total PANSS measures from 1 month onward compared with baseline, as well as ongoing significant reductions in scores from visit to visit. There was a significant reduction in mean hostility score at 2 months (P<0.05), 3 months (P<0.05), and 6 months (P<0.01) (n=148). For the PSP scale, there was a significant across-the-board reduction of mean scores from 3 months onward, including in the disturbing and aggressive behavior subscale (P<0.001) (n=148).ConclusionSwitching from previously unsuccessful antipsychotic treatments to paliperidone ER may be a useful option to reduce hostility and disturbing behavior in patients with schizophrenia. This study in Thai patients is in line with findings in other countries and cultures concerning the management of hostility in patients with schizophrenia.

Effects of aripiprazole once-monthly on domains of personal and social performance: Results from 2 multicenter, randomized, double-blind studies

ObjectiveTo assess the effects of maintenance therapy with aripiprazole once-monthly 400mg on personal and social functioning. MethodsData were analyzed from 2 randomized, double-blind trials of patients with schizophrenia requiring chronic antipsychotic treatment. One study was a 52-week trial of aripiprazole once-monthly 400mg versus placebo; the other was a 38-week trial of aripiprazole once-monthly 400mg, oral aripiprazole (10–30mg daily), and aripiprazole once-monthly 50mg (subtherapeutic dose to test assay sensitivity). Functioning was assessed using the Personal and Social Performance (PSP) scale, comprising 4 domain subscales. ResultsIn the 52-week study, 403 patients stabilized on aripiprazole once-monthly 400mg were randomized to receive aripiprazole once-monthly 400mg (n=269) or placebo (n=134). In the 38-week study, 662 patients stabilized on oral aripiprazole were randomized to receive aripiprazole once-monthly 400mg (n=265), oral aripiprazole (n=266), or aripiprazole once-monthly 50mg (subtherapeutic dose; n=131). In the 52-week study, mean changes from baseline were significantly worsened with placebo compared with aripiprazole once-monthly 400mg for PSP total score (P<0.001) and domain scores for Personal and Social Relationships (P<0.001), Self-Care (P<0.01), and Disturbing and Aggressive Behavior (P<0.0001). In the 38-week study, mean changes from baseline were significantly worsened with aripiprazole once-monthly 50mg compared with aripiprazole once-monthly 400mg for PSP total score (P<0.05) and the Personal and Social Relationships domain score (P<0.05). ConclusionPatient functioning, assessed using the PSP scale, was maintained in stabilized patients treated with aripiprazole once-monthly in 2 pivotal relapse studies.

The development of a self-reported scale for measuring functionality in patients with schizophrenia—Self-reported version of the graphic Personal and Social Performance (SRG-PSP) scale

BackgroundThe Personal and Social Performance (PSP) scale is used for the assessment of patient function by mental health professionals. This study aimed to evaluate the internal reliability and validity of a self-reported graphic version of the PSP (SRG-PSP) scale and its correlations with psychiatric symptoms, daily life ability and quality of life. MethodsThe SRG-PSP scale was developed following the four PSP domains: socially useful activities, personal and social relationships, self-care, and disturbing and aggressive behavior. In total, 108 patients with schizophrenia were enrolled. All participants completed the SRG-PSP, the Activities of Daily Living Rating Scale II (ADLRS-II), and the World Health Organization Quality of Life-BREF (WHOQOL). They were also assessed using the PSP and the Positive and Negative Syndrome Scale (PANSS). Spearman's ρ was used to examine the correlations between SRG-PSP scores and other variables. ResultsThe results of the SRG-PSP were significantly correlated to those of their corresponding criteria on the PSP. The global score of the SRG-PSP and the scores of three domains, socially useful activities, personal and social relationships, and self-care, were positively correlated with most sub items of the ADLRS-II and WHOQOL, and were negatively correlated with the PANSS scores. The disturbing and aggressive behavior domain of the SRG-PSP was negatively correlated with most sub items of the ADLRS-II and WHOQOL (ρ=−0.19 to −0.36, all p<0.05) and positively correlated with the PANSS (ρ=0.24–0.30, all p<0.05), with the exception of negative symptoms (ρ=0.09, p=0.40). ConclusionThe SRG-PSP is a valid self-reported scale for the assessment of functionality in patients with schizophrenia.

Correlation between the Personal and Social Performance scale (PSP) and the Positive and Negative Syndrome Scale (PANSS) in a Greek sample of patients with schizophrenia.

BackgroundPsychosocial dysfunction is one of schizophrenia’s core features, often leading to a deprecation of independent living and significant failure to maintain a competent quality of life. Cognitive and occupational performance as well as psychosocial functioning is moreover recognized as determinants of treatment response. Therefore, the elaboration of measures regarding social performance besides scales that assess psychopathology is essential. The Personal and Social Performance (PSP) scale has been found to be as much valid as reliable for assessing social functioning in the acute and stable stage of schizophrenia. The aim of this study was to estimate the correlation between the PSP and Positive and Negative Syndrome Scale (PANSS) (convergent validity) in patients with schizophrenia during routine clinical practice.MethodsA longitudinal study with a six-month follow-up is presented. Correlation between the PSP scale and the Positive and Negative Syndrome Scale (PANSS) was conducted in a Greek sample of 2010 patients with schizophrenia in outpatient setting in two successive visits. PANSS and PSP scales were used for the assessment of psychopathological symptoms and social and personal functioning.ResultsThe PSP subscales scores were well correlated with each other with Spearman correlation coefficients (r) ranging from 0.56 to 0.76 on both visits in three out of the four main areas, whereas in the category of “disturbing and aggressive behavior” the correlations were lower but still significant. Furthermore, total PSP score showed high association to PANSS total score in the first (r = -0.59) as well as in the second visit (r = -0.50). Regression analysis showed that one point decrease of PANSS’s total score is associated with a 0.42 points increase on the PSP scale. PSP and PANSS scales exhibited high convergent validity.ConclusionsThe PSP could provide additional valuable information in the assessment of schizophrenia related social functioning and treatment response.

Clinical effectiveness and resource utilization of paliperidone ER for schizophrenia: Pharmacoepidemiologic International Longitudinal Antipsychotic Registry (PILAR)

Objective:To document prescribing patterns in clinical practice and assess long-term outcomes related to initiation of paliperidone ER and other oral antipsychotics among patients with schizophrenia in a naturalistic setting.Research design and methods:An international, non-interventional, naturalistic study of adult patients (≥18 years) with schizophrenia. Patients were assigned to the relevant treatment group (paliperidone ER or ‘all other oral antipsychotics’) after switching to, or initiating, oral antipsychotic treatment. Retrospective 12 month data collection was followed by 12 month prospective data collection, with 3-monthly assessments. The primary endpoint was time to all-cause discontinuation of new medication. Secondary endpoints included Clinical Global Impression–Severity (CGI-S) score, Clinical Global Impression–Schizophrenia (CGI-SCH) score, Personal and Social Performance (PSP) score, health-related quality of life (HR-QoL) and quality of sleep, evaluation of healthcare resource utilization and patient’s treatment satisfaction.Results:A total of 4051 patients were included in the intent-to-treat (ITT) analysis set. All-cause study discontinuation rates were comparable between the paliperidone ER group (16.8%) and the ‘all other oral antipsychotics’ group (15.5%). There was no difference in the time to discontinuation of newly initiated antipsychotic treatments between paliperidone ER and ‘all other oral antipsychotics’ groups. Paliperidone ER was associated with greater improvements from baseline to endpoint in both the PSP scale score (+14.2 vs +13.1, p = 0.041) and the physical component of quality of life (SF-12 Physical scores; +3.9 vs +2.9, p = 0.003) compared to ‘all other oral antipsychotics’. Improvements in mean CGI-S score, CGI-SCH score, HR-QoL, quality of sleep and daytime drowsiness, as well as patients’ treatment satisfaction were comparable between treatment groups. The incidence of adverse events was comparable between groups.Conclusions:This study provides valuable data on the prescribing habits and treatment outcomes associated with use of paliperidone ER in everyday clinical practice, and supports previous findings of the favorable functional improvement and treatment satisfaction associated with paliperidone ER.Clinical trial registration:NCT00696813; R076477SCH4015 (Register of German Association of Research-based Pharmaceutical Companies [VFA] http://www.vfa.de/de/arzneimittel-forschung/datenbanken-zu-arzneimitteln/nisdb).

The effects of art therapy carried out with schizophrenic patients and their relatives, on symptoms, personal and social skills

Objective: We aimed to investigate the effects of art therapy on symptoms, personal and social skills of schizophrenic patients. Methods: Group was consisted of nine patients and seven patients’ relatives. Except for two patients, all patients’ relatives were also included. Group setting was ended after 17 sessions. Before and after the study all patients were applied Positive and Negative Syndrome Scale (PANNS), Calgary Depression Scale for Schizophrenia (CDSS), Personal and Social Performance Scale (PSPS); whereas all patients’ relatives were applied, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Zarit Burden Interview (ZBI). Results: Decreases in the scores of PANNS negative and general, CDSS, and decreases in the scores of BDE, BAE, ZBI in the patient’s relatives group were observed at the end of sessions compared to the beginning of the sessions. The scores of PSPS were increased in the patient group after the sessions. Conclusion: This study demonstrates that art therapy can ameliorate negative symptoms, particularly social functioning and depressive symptoms of schizophrenic patients in which antipsychotics are not helpful.

Reliability and validity of the Personal and Social Performance scale in patients with schizophrenia

ObjectiveThe construct validity and test–retest reliability of the Personal and Social Performance (PSP) scale were used to assess social functioning in a cohort of ethnically diverse UK patients with schizophrenia. MethodsA total of 73 patients with schizophrenia took part in the study. At baseline, the PSP, two symptomatology scales and two other functioning scales were administered. A subset of the sample (N=40) took part in a retest where the Clinical Global Impression—Severity (CGI-S) and PSP scales were administered 8–10days later. ResultsPSP significantly correlated with all other measures, Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF) and Quality of Life Scale (QLS) at baseline (p<0.02) and with CGI-S at follow-up (p<0.01). In addition, the PSP scale was moderately sensitive to the severity of illness. Test–retest reliability for the PSP score was 0.45 and the scale was able to discriminate between known groups (mild and severe patients). ConclusionThe PSP was easy to administer in this predominantly inpatient cohort and was moderately correlated with all other functioning measures tested. Due to patient homogeneity, the test–retest reliability statistic of the PSP was lower than that observed in other studies.

Comparison of Self- and Clinician’s Ratings of Personal and Social Performance in Patients with Schizophrenia: The Role of Insight

Background: Patients with schizophrenia are often markedly impaired in their social functioning, partly independent of symptom severity. Few studies have examined patients’ self-reporting of their social functioning, how a patient’s self-perspective differs from third-party ratings, and whether or not the patients’ self-rating of social functioning is influenced by their awareness of illness. Sampling and Methods: Based on the Personal and Social Performance (PSP) scale as a clinician-administered scale, a PSP self-rating scale for patients was developed. The study included 42 inpatients with schizophrenia. Instruments were the PSP scale, the PSP self-rating scale, the Clinical Global Impression-Severity Scale, and the Scale to Assess Unawareness of Mental Disorder. Results: A significant correlation was found between PSP self- and clinician’s rating for ‘socially useful activities’, whereas the other PSP subdimensions as well as the total score were not significantly correlated. For patients with high insight, a significantly positive association emerged with ‘disturbing and aggressive behaviour’, while there was no significant correlation between PSP self- and clinician’s ratings for the patients with poor insight into their disorder. Conclusions: Patients and clinicians only marginally converge on their judgments concerning the patients’ psychosocial functioning. Patients’ insight may have a moderating role on the approximation of agreement between self- and third-party ratings. Results are discussed in line with the present literature regarding the accuracy of self-awareness in schizophrenia.

Effects of paliperidone extended release on the symptoms and functioning of schizophrenia

BackgroundWe aimed to explore relations between symptomatic remission and functionality evaluation in schizophrenia patients treated with paliperidone extended-release (ER), as seen in a normal day-to-day practice, using flexible dosing regimens of paliperidone ER. We explored symptomatic remission rate in patients treated with flexibly dosed paliperidone ER by 8 items of Positive and Negative Syndrome Scale (PANSS) and change of Personal and Social Performance (PSP) scale.MethodThis was a 12-week multicenter, open-label, prospective clinical study conducted in in-patient and out-patient populations. Flexible dosing in the range 3-12 mg/day was used throughout the study. All subjects attended clinic visits on weeks 0, 4, 8, and 12 as usual clinical practice for the 12-week observation period. Data were summarized with respect to demographic and baseline characteristics, efficacy measurement with PANSS scale, PSP, and social functioning score, and safety observations. Descriptive statistics were performed to identify the retention rate at each visit as well as the symptomatic remission rate. Summary statistics of average doses the subjects received were based on all subjects participating in the study.ResultsA total of 480 patients were enrolled. Among them, 426 patients (88.8%) had evaluation at week 4 and 350 (72.9%) completed the 12-week evaluation. Patients with at least moderate severity of schizophrenia were evaluated as "mild" or better on PANSS scale by all 8 items after 12 weeks of treatment with paliperidone ER. There was significant improvement in patients' functionality as measured by PSP improvement and score changes. Concerning the other efficacy parameters, PANSS total scale, PSP total scale, and social functioning total scale at the end of study all indicated statistically significant improvement by comparison with baseline. The safety profile also demonstrated that paliperidone ER was well-tolerated without clinically significant changes after treatment administration.ConclusionsAlthough the short-term nature of this study may limit the potential for assessing improvements in function, it is noteworthy that in the present short-term study significant improvements in patient personal and social functioning with paliperidone ER treatment were observed, as assessed by PSP scale.Trial RegistrationClinical Trials. PAL-TWN-MA3

Intercorrelations Between the Personal and Social Performance Scale, Cognitive Function, and Activities of Daily Living

The aim of this study was to evaluate the intercorrelation between the Personal and Social Performance (PSP) score, cognitive function, and activities of daily living (ADLs). Twenty patients with chronic schizophrenia were recruited; the PSP and ADL scales and psychological assessments including the Wisconsin Card Sorting Test, the Wechsler Memory Scale-Revised (WMS-R), and the Continuous Performance Test (CPT) were administered. Positive correlations between the total PSP scale score and performance in the WMS-R, CPT, and ADL scores were identified. The PSP score was found to be of good reliability for cognitive function and ADL evaluation.