Positive And Negative Syndrome Scale General Subscale Research Articles

Variations to plasma H2O2 levels and TAC in chronical medicated and treatment-resistant male schizophrenia patients: Correlations with psychopathology

Accumulating evidence suggests that imbalanced oxidative stress (OS) may contribute to the mechanism of schizophrenia. The aim of the present study was to evaluate the associations of OS parameters with psychopathological symptoms in male chronically medicated schizophrenia (CMS) and treatment-resistant schizophrenia (TRS) patients. Levels of hydrogen peroxide (H2O2), hydroxyl radical (·OH), peroxidase (POD), α-tocopherol (α-toc), total antioxidant capacity (TAC), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinases-1 (TIMP-1) were assayed in males with CMS and TRS, and matched healthy controls. Schizophrenia symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). The results demonstrated significant differences in the variables H2O2 (F = 5.068, p = 0.008), ·OH (F = 31.856, p < 0.001), POD (F = 14.043, p < 0.001), α-toc (F = 3.711, p = 0.027), TAC (F = 24.098, p < 0.001), and MMP-9 (F = 3.219, p = 0.043) between TRS and CMS patients and healthy controls. For TRS patients, H2O2 levels were correlated to the PANSS positive subscale (r = 0.386, p = 0.032) and smoking (r = −0,412, p = 0.021), while TAC was significantly negatively correlated to the PANSS total score (r = −0.578, p = 0.001) and POD and TAC levels were positively correlated to body mass index (r = 0.412 and 0.357, p = 0.021 and 0.049, respectively). For patients with CMS, ·OH levels and TAC were positively correlated to the PANSS general subscale (r = 0.308, p = 0.031) and negatively correlated to the PANSS total score (r = −0.543, p < 0.001). Furthermore, H2O2, α-toc, and ·OH may be protective factors against TRS, and POD was a risk factor. Patients with CMS and TRS exhibit an imbalance in OS, thus warranting future investigations.

Healthcare Provider Engagement with a Novel Dashboard for Tracking Medication Ingestion: Impact on Treatment Decisions and Clinical Assessments for Adults with Schizophrenia.

PurposeSchizophrenia is a severe, chronic condition accounting for disproportionate healthcare utilization. Antipsychotics can reduce relapse rates, but the characteristics of schizophrenia may hinder medication adherence. A phase 3b open-label clinical trial used aripiprazole tablets with sensor (AS; includes pills with ingestible event-marker, wearable sensor patches and smartphone application) in adults with schizophrenia. This post hoc analysis explored how healthcare providers’ (HCPs) usage of a dashboard that provided medication ingestion information impacted treatment decisions and clinical assessments.Patients and MethodsParticipants used AS for 3–6 months. HCPs were instructed to check the dashboard regularly, identify features used, and report impact on treatment decisions. After stratifying HCPs by frequency of dashboard checks and resulting treatment decisions, changes from baseline were calculated for Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression (CGI)–Severity of Illness and CGI-Improvement (CGI-I), and Personal and Social Performance (PSP), and compared using Mann–Whitney U-tests and rank-biserial correlation coefficient (r) effect sizes.ResultsTo ensure sufficient opportunity for AS engagement, 113 participants who completed ≥3 months on study were analyzed. HCPs most often accessed dashboard data regarding medication ingestion and missed doses. HCPs recommended adherence counseling and participant education most often. Participants whose HCPs used the dashboard more and recommended adherence counseling and participant education (n=61) improved significantly more than participants with less dashboard-active HCPs (n=49) in CGI-I mean score (2.9 versus 3.4 [p=0.004]), total PANSS (mean change: −9.2 versus −3.1 [p=0.0002]), PANSS positive subscale (−3.2 versus −1.5 [p=0.003]), PANSS general subscale (−4.3 versus −1.2 [p=0.02]), and Marder factor for negative symptoms (−1.9 versus 0.0 [p=0.03]). Most HCPs found the dashboard easy to use (74%) and helpful for improving conversations with participants about their treatment plan and progress (78%).ConclusionThis provider dashboard may facilitate discussions with patients about regular medication-taking, which can improve patient outcomes.

Gender differences of neurocognitive functioning in patients with first-episode schizophrenia in China

AimsTo investigate the gender differences in neurocognitive functioning in patients with first-episode schizophrenia (FES) in China. MethodsA total of 449 Chinese patients with FES (210 males, 239 females) were included in this study. Participants’ psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Neurocognitive functioning was assessed by 10 neuropsychological tests from a battery. Neurocognitive test scores were converted to scale scores and t-scores using normative data from Chinese populations. ResultsMales were younger and less likely to be married, had an earlier age of illness onset and a longer duration of untreated psychosis (DUP), and scored higher on the PANSS negative, general and total scales than females. After controlling for potential confounders, females performed better than males in the verbal learning and memory domain (p=0.016). While most neurocognitive domains were correlated with PANSS negative scores for male patients with FES, for female patients with FES, negative associations were found between scores on the PANSS general subscales and neurocognitive domains. We also performed a case-control comparison with a group of patients with clinically stable schizophrenia (CSS) (n=60) who were matched by age, sex and education years with patients with FES (n=58). After controlling for potential confounders, no significant differences were found between patients with FES and patients with CSS in all neurocognitive domains. Female patients still performed better in the verbal learning and memory domain (t=2.14, p=0.034). No interaction effects of gender and disease were found. ConclusionsGender was an independent influence factor for the verbal learning and memory domain. Both female patients with first-episode schizophrenia and female patients with clinically stable schizophrenia performed better than male patients.

Efficacy and safety of oxytocin augmentation therapy for schizophrenia: an updated systematic review and meta-analysis of randomized, placebo-controlled trials.

The aim of this study was to perform a systematic review and an updated and comprehensive meta-analysis of oxytocin augmentation therapy in patients with schizophrenia who received antipsychotic agents. Data published up to 07/11/2015 were obtained from PubMed, PsycINFO, and Cochrane Library databases. We conducted a systematic review and meta-analysis of patients' data from randomized controlled trials (RCTs) comparing oxytocin with placebo. Relative risk (RR), standardized mean difference (SMD), and 95% confidence intervals (95% CI) based on the random-effects model were calculated. We included seven RCTs; the total sample size was 206 patients. Oxytocin was superior to placebo for decreasing the Positive and Negative Syndrome Scale (PANSS) general subscale scores (SMD=-0.44, 95% CI -0.82 to -0.06, p=0.02, I (2)=0%, N=4, n=112); however, it was not different from placebo for total symptoms (SMD=-0.46, 95% CI -1.20 to 0.28, p=0.22, I (2)=80%, N=6, n=162), positive symptoms (SMD=-0.18, 95% CI -0.87 to 0.51, p=0.60, I (2)=81%, N=6, n=192), and negative symptoms (SMD=-0.34, 95% CI -0.76 to 0.08, p=0.12, I (2)=55%, N=7, n=214). However, a sensitivity analysis including only oxytocin administration on consecutive days studies was superior to placebo in negative symptoms (SMD=-0.44, 95% CI -0.87 to -0.01, p=0.04, I (2)=51%, N=6 n=192). There were no significant differences for all-cause discontinuation (RR=1.02) and individual side effects such as headache and dizziness between oxytocin and placebo. Oxytocin may improve PANSS general subscale scores in schizophrenia and seems to be well tolerated. However, because the number of studies in the current analysis was small, further study will be required using larger sample sizes.

Efficacy and tolerability of minocycline augmentation therapy in schizophrenia: a systematic review and meta-analysis of randomized controlled trials.

This study aimed to perform a comprehensive meta-analysis of minocycline augmentation therapy in patients with schizophrenia receiving antipsychotic agents. Data published up to 2 June 2014 were obtained from the PubMed, PsycINFO, Google Scholar, and Cochrane Library databases.We conducted a systematic review and meta-analysis of patient data from randomized controlled trials (RCTs) comparing minocycline with placebo. Relative risk (RR), standardized mean difference (SMD), and 95% confidence intervals were calculated. We included four RCTs. The total sample included 330 patients. Minocycline was superior to placebo for decreasing Positive and Negative Syndrome Scale (PANSS) total scores (SMD=0.70), PANSS negative subscale scores (SMD=0.86), and PANSS general subscale scores (SMD=-0.50) but was not different from placebo for PANSS positive subscale scores (SMD=0.26) and depressive symptoms (SMD=0.28). Minocycline was equivalent to placebo for all-cause discontinuation (RR=1.10), discontinuation due to inefficacy (RR=0.42), discontinuation due to adverse events (RR = 1.56), and discontinuation due to death (RR = 3.18). Minocycline was superior to placebo for extrapyramidal side-effect scores (SMD=0.32). Minocycline may improve the psychopathology of schizophrenia, especially the negative symptoms, and seems to be well tolerated.

Impacto de la conducta suicida en el trastorno delirante: descripción de una serie de 44 casos

Background and objectiveSuicidal behaviour in delusional disorder (DD) has been poorly studied. This study aimed to describe the prevalence of clinically significant depression, suicidal ideation and behaviour in these patients, and to relate them with psychotic or depressive symptoms. Patients and methodA cross-sectional study including 44 outpatients with DD (DSM-IV-TR) was conducted. Demographic and clinical data, as well as scores in clinical assessment scales: Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale, Hamilton Depression Rating Scale (17-item version) and Columbia Suicide Severity Rating Scale, were recorded. The sample was divided into 2 groups according to presence or absence of comorbid depression (CD). ResultsFifteen patients (34.1%) had CD, 14 (31.8%) suicidal ideation and 7 (15.9%) suicidal behaviour in the previous 2 years. Patients with CD had an earlier age at onset and for a first psychiatric appointment, and had higher scores on the PANSS general subscale (p=0,043) and in intensity of suicidal ideation (p=0,001). ConclusionsIn our sample, patients with DD and CD have more frequently suicidal ideation and behaviour than those without CD.