Positive And Negative Syndrome Scale Scores Research Articles

Neurobiological Markers for Predicting Treatment Response in Patients with Bipolar Disorder.

Predictive neurobiological markers for prognosis are essential but underemphasized for patients with bipolar disorder (BD), a neuroprogressive disorder. Hence, we developed models for predicting symptom and functioning changes. Sixty-one patients with BD were recruited and assessed using the Young Mania Rating Scale (YMRS), Montgomery-Åsberg Depression Rating Scale (MADRS), Positive and Negative Syndrome Scale (PANSS), UKU Side Effect Rating Scale (UKU), Personal and Social Performance Scale (PSP), and Global Assessment of Functioning scale both at baseline and after 1-year follow-up. The models for predicting the changes in symptom and functioning scores were trained using data on the brain morphology, functional connectivity, and cytokines collected at baseline. The correlation between the predicted and actual changes in the YMRS, MADRS, PANSS, and UKU scores was higher than 0.86 (q < 0.05). Connections from subcortical and cerebellar regions were considered for predicting the changes in the YMRS, MADRS, and UKU scores. Moreover, connections of the motor network were considered for predicting the changes in the YMRS and MADRS scores. The neurobiological markers for predicting treatment-response symptoms and functioning changes were consistent with the neuropathology of BD and with the differences found between treatment responders and nonresponders.

Violence in relation to cognitive deficits and symptom severity in a sample of Egyptian patients with schizophrenia.

Patient with schizophrenia are significantly more likely to be violent than general population; and the consequences of this violence risk are often very serious for the patients, their caregivers, and the entire community. To assess the risk of violence in patients with schizophrenia and its correlation with severity of symptoms and cognitive functions. A cross-sectional comparative study conducted in Okasha institute of psychiatry including 50 patients with schizophrenia compared to 50 healthy control group regarding violence risk as assessed by Historical, Clinical, and Risk Management-20 (HCR-20), case group was assessed using Structured Clinical Interview for DSM-IV (SCID-I), Positive and Negative Syndrome Scale (PANSS), cognitive functions were assessed by Wechsler Adult Intelligence Scale (WAIS), Trail Making Test (TMT) Part A and B, the Wisconsin Card Sorting Test (WCST), and the Wechsler Memory Scale (WMS). There was a statistically significant difference between case and control groups regarding risk of violence where 58% of the case group were found to have risk of violence compared to only 18% in the control group. There was a significant correlation between this risk of violence and period of untreated psychosis, no of episodes, and history of substance use; also was significantly correlated with PANSS and Wisconsin card sorting test subscales. Regarding logistic regression analysis for factors affecting violence risk; total PANSS score and history of substance use were significant independent factors that increase violence risk. Violence risk in patient with schizophrenia is a cardinal factor that may affect life of the patients, their family, and society; this risk can be affected by different factors including severity of symptoms, no of episodes, history of substance use, and cognitive function of the patients.

Inpatient forensic psychiatry in the time of COVID-19: a survey study of perceived mental health implications on people with schizophrenia spectrum disorder

ABSTRACT Background The aim of our study was to assess the perceived mental health impact of the COVID-19 pandemic on people with schizophrenia spectrum disorder (SSD) in an inpatient forensic psychiatric institution and to identify personal networks most crucial for the patient during the pandemic. Methods In this cross-sectional survey study, 44 patients with SSD took part in a COVID-19-specific interview. The data was correlated with the Positive and Negative Syndrome Scale (PANSS) to evaluate the patients’ psychopathology. In addition, we investigated subgroups of vaccinated and unvaccinated patients to analyze possible differences in psychopathology. Results Less contact with family members was associated with significantly higher PANSS scores (p < 0.05). Patients who reported to feel less relaxed and more stressed during the pandemic than they had been before the outbreak of the virus showed significantly higher PANSS scores (p < 0.05). Unvaccinated patients demonstrated significantly higher PANSS scores than their vaccinated controls (p < 0.05). Conclusions Social support from family members played an important role for people with SSD in inpatient forensic psychiatric institutions during the pandemic. Moreover, individuals with SSD seemed to be more emotionally vulnerable during the pandemic. A more pronounced symptomatology in patients with SSD might be a potential barrier to immunization against COVID-19.

Association between neuropeptide Y gene polymorphism and antipsychotics effect.

The pathogenesis of schizophrenia is associated with neuropeptide Y (NPY) gene polymorphism to explore the relationship between rs16141, rs16145, and rs5573 polymorphisms in the NPY gene and antipsychotics response in the Chinese population. The unrelated 228 Chinese Han patients with schizophrenia were enrolled in the present study. Genotypisation within NPY gene was performed using the KASP genotyping assays. Before treatment and on the weekends of the 2nd, 4th, and 8th weeks after treatment, the medication status of the patients was recorded and the positive and negative syndrome scale (PANSS) was used to evaluate the clinical effect. A reduction in total PANSS scores ≥50% were classified as good responders, while others were poor responders. We evaluated the association between NPY gene and antipsychotic efficacy by comparing allele and genotype distribution, correlation analysis, linkage imbalance, and five genetic models between the two groups. No significant associations were found in the rs16141, rs16145, and rs5573 of NPY and antipsychotic treatment response (all p > 0.05). There was no significant relationship between the three SNPs polymorphisms in the NPY gene and the changes of positive, negative and general psychopathology subscales scores at each stage (all p > 0.05). The distribution of genotype and allele frequencies of locus rs16141 was not statistically difference between good responders and poor responders (genotype: χ2 =4.088, p=0.043, p-correction = 0.129; allele: χ2 = 4.088, p = 0.027, p-correction = 0.081). The allele distribution of rs5573 was significantly different between groups, yet the difference was disappeared after correcting (χ2 = 4.136, p = 0.042, p-correction =0.126). The distribution frequencies of TA/TG and GG haplotypes constituted by rs16141 and rs5573 showed no statistical difference between the two groups (p > 0.05). In recessive inheritance mode, NPYrs5573 was found to be associated with antipsychotic drug response (G/G vs. A/A +A/G: p = 0.028, AIC = 197.2, BIC = 210.9). This study didn't found association between polymorphisms in the NPY gene locus (rs16141, rs16145, and rs5573) and the response to antipsychotics after Bonferroni correction. The polymorphism of NPY gene and the efficacy of antipsychotic drugs in patients with schizophrenia need further study.

Association of BDNF and MMP-9 single-nucleotide polymorphisms with the clinical phenotype of schizophrenia.

Schizophrenia is a highly polygenic psychiatric disorder; however, the complex genetic architecture underlying the pathogenesis remains elusive. Brain-derived neurotrophic factor (BDNF), a neurotrophin, and matrix metalloproteinase 9 (MMP-9), a gelatinase B, are the promising candidate genes for schizophrenia. To shed new light on the relationship between the single-nucleotide polymorphisms (SNPs) of BDNF and MMP-9 and the clinical variability of schizophrenia phenotype, this study aims to evaluate the relationship, and provide more definitive evidence for the relationship with various clinical features of schizophrenia. A case-control association study was performed, and one hundred and five subjects of Chinese Han population were enrolled, including 55 schizophrenia patients (SP) and 50 healthy controls (HC). The BDNF rs6265 196 G > A and MMP-9 rs3918242 -1562C > T SNPs were genotyped using PCR-RFLP assay. The Positive and Negative Syndrome Scale (PANSS) was used to assess the clinical symptoms of patients with schizophrenia. Compared with HC, the frequency of SP carrying BDNF rs6265 GG/GA genotype was significantly higher than HC, and the frequency of SP carrying BDNF rs6265 AA genotype was significantly lower than HC (p < 0.01). With regards to MMP-9 rs3918242 -1562C > T SNP, no significant difference was observed between the control and SP. BDNF GG genotype showed significantly higher PANSS and positive symptoms score than GA and AA genotypes (P < 0.01). MMP-9 CC genotype showed significantly higher PANSS and general score than CT and TT genotypes (P < 0.05). BDNF rs6265 196 G > A and MMP-9 rs3918242-1562C > T SNPs are related to the clinical features of schizophrenia and could be a useful biomarker for the changes, remission or deterioration of clinical status of schizophrenia.

DNA methylation levels of RELN promoter region in ultra-high risk, first episode and chronic schizophrenia cohorts of schizophrenia

The essential role of the Reelin gene (RELN) during brain development makes it a prominent candidate in human epigenetic studies of Schizophrenia. Previous literature has reported differing levels of DNA methylation (DNAm) in patients with psychosis. Therefore, this study aimed to (1) examine and compare RELN DNAm levels in subjects at different stages of psychosis cross-sectionally, (2) analyse the effect of antipsychotics (AP) on DNAm, and (3) evaluate the effectiveness and applicability of RELN promoter DNAm as a possible biological-based marker for symptom severity in psychosis.. The study cohort consisted of 56 healthy controls, 87 ultra-high risk (UHR) individuals, 26 first-episode (FE) psychosis individuals and 30 chronic schizophrenia (CS) individuals. The Positive and Negative Syndrome Scale (PANSS) was used to assess Schizophrenia severity. After pyrosequencing selected CpG sites of peripheral blood, the Average mean DNAm levels were compared amongst the 4 subgroups. Our results showed differing levels of DNAm, with UHR having the lowest (7.72 ± 0.19) while the CS had the highest levels (HC: 8.78 ± 0.35; FE: 7.75 ± 0.37; CS: 8.82 ± 0.48). Significantly higher Average mean DNAm levels were found in CS subjects on AP (9.12 ± 0.61) compared to UHR without medication (UHR(−)) (7.39 ± 0.18). A significant association was also observed between the Average mean DNAm of FE and PANSS Negative symptom factor (R2 = 0.237, ß = −0.401, *p = 0.033). In conclusion, our findings suggested different levels of DNAm for subjects at different stages of psychosis. Those subjects that took AP have different DNAm levels. There were significant associations between FE DNAm and Negative PANSS scores. With more future experiments and on larger cohorts, there may be potential use of DNAm of the RELN gene as one of the genes for the biological-based marker for symptom severity in psychosis.

Aggression in Women with Schizophrenia Is Associated with Lower HDL Cholesterol Levels.

This study assessed the association between serum lipid levels and aggression in female patients with schizophrenia. The study included female patients with schizophrenia (N = 120). The participants were subdivided into two groups (aggressive and nonaggressive), with 60 participants in each group. Serum lipids—cholesterol, triglycerides, high-density lipoproteins (HDL cholesterol), and low-density lipoproteins (LDL cholesterol)—were determined. The clinical part of the study included an evaluation using psychiatric scales: the positive and negative syndrome scale (PANSS), the aggression subscale of the PANSS scale (PANSS-AG), and the overt aggression scale (OAS). Significant differences were only observed in HDL cholesterol levels, where aggressive subjects had significantly lower values of HDL cholesterol (t = 2.540; p = 0.012), and the representation of subjects with low cholesterol values was almost three-times higher in the group of subjects with aggression (χ2 = 7.007; p = 0.008) compared to the nonaggressive group. The nominally significant predictor for HDL cholesterol in nonaggressive and aggressive participants was the total value of the PANSS scores. In subjects with aggression, suicidality was not significantly associated with HDL cholesterol levels. Our findings suggest that lower HDL cholesterol is significantly associated with aggression in women with schizophrenia.

The association between fear of COVID-19 and depression, anxiety, and psychosis among Lebanese chronic patients with schizophrenia: any moderating effect of spirituality?

To assess whether fear of coronavirus disease 2019 (COVID-19) is associated with depression, anxiety, and psychosis and to evaluate if these variables are correlated with the interaction between spirituality and fear of COVID-19. Between September and November 2020, this cross-sectional study enrolled 118 chronic schizophrenia patients. The interview with patients included Fear of COVID-19 Scale, Lebanese Anxiety Scale-10, Montgomery-Asberg Depression Rating Scale, Positive and Negative Syndrome Scale (PANSS), and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-12. The results were analyzed by using linear regressions (Enter method), with anxiety, depression, total PANSS score, positive PANSS, negative PANSS, and general psychopathology PANSS subscales as dependent variables. Spirituality, fear of COVID-19, and the interaction of spirituality with fear of COVID-19 were independents variables. Fear of COVID-19 was positively correlated with increased total PANSS scores (Beta=0.90, P=0.030). Higher spirituality was significantly associated with lower anxiety (Beta=-0.14, P=0.009), lower depression (Beta=-0.21, P=0.001), lower total PANSS score (Beta=-0.90, P=0.004), lower negative PANSS score (Beta=-0.23, P=0.009), and lower general psychopathology PANSS score (Beta=-0.61, P=0.001). In patients with high fear of COVID-19, having low spirituality was significantly associated with higher anxiety, depression, and psychotic symptoms. This study suggests a positive correlation between fear of COVID-19 and higher psychosis among inpatients with schizophrenia. The interaction of spirituality with fear of COVID-19 was correlated with reduced anxiety, depression, and psychosis.

Mitochondrial Damage of Lymphocytes in Patients with Acute Relapse of Schizophrenia: A Correlational Study with Efficacy and Clinical Symptoms.

Accumulating evidence has demonstrated that schizophrenia is associated with mitochondrial and immune abnormalities. In this pilot case-control study, we investigated the level of mitochondrial impairment in lymphocytes in patients with acute relapse of schizophrenia and explored the correlation between the level of mitochondrial damage and symptoms or treatment response. Lymphocytic mitochondrial damage was detected using mitochondrial fluorescence staining and flow cytometry in 37 patients (at admission and discharge) and 24 controls. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression Scale (CGI-S). The levels of mitochondrial damage in CD3+ T, CD4+ T, and CD8+ T lymphocytes of the patients with schizophrenia at admission were significantly higher than those of the controls (p<0.05) and did not return to normal at discharge (p>0.05). The mitochondrial damage of T cells significantly improved at discharge for responsive patients only, as compared with that at admission (P<0.05). However, no significant difference was found in mitochondrial damage in CD19+ B cells between patients and healthy controls, or between admission and discharge (p>0.05). Furthermore, the reduction in mitochondrial damage of CD3, CD4, and CD8 lymphocytes was positively correlated with the reduction of the score of the PANSS positive scale at discharge (p<0.05), while no significant correlation was found between the level of mitochondrial damage in lymphocytes and the scores of PANSS and CGI-S. Acute relapse of schizophrenia might be associated with higher levels of mitochondrial damage in peripheral blood T lymphocytes. The degree of recovery of mitochondrial impairment in the T cells may be used as a predictor of treatment response in schizophrenia. As this is a pilot study, the conclusion still needs further verification in large-scale studies.

Clinical Effectiveness of Lurasidone Monotherapy in Patients with Acute Episodes of Schizophrenia and Associated Symptoms of Depression.

We endeavored to evaluate the efficacy of Lurasidone at doses of 40-160 mg per day on symptoms of schizophrenia associated with symptoms of depression in real clinical practice in a Russian patient population. One hundred sixty eight patients aged 18-65 years old, who at the time of the start of the observation were being treated in a hospital or day hospital due to an exacerbation of paranoid schizophrenia accompanied by symptoms of depression, were prescribed lurasidone. Treatment with lurasidone and other concomitant drugs, their prescription, withdrawal, selection, and dose modifications were determined based on the indications for the use of those drugs and the recommended doses in the instructions, clinical need, and patient interests, rather than by the goals of the study. During the observation period, the severity of depressive symptoms according to the Calgary Depression Scale (CDSS) and that of psychotic symptoms according to the Positive and Negative Syndrome Scale (PANSS) were assessed six times (before the start of treatment and then on the 4th, 7th, 14th, 28th, and 42nd days). A statistically significant reduction in the severity of the symptoms was observed with the use of lurasidone in doses ranging from 40 mg to 160 mg per day. The fastest and most significant (p <0.001) reductions in the total PANSS and CDSS scores were observed with lurasidone 120 mg. A somewhat lower efficacy of lurasidone was observed at a dose of 160 mg. The largest reductions in the total PANSS and CDSS scores with lurasidone 120 mg were associated with the highest survival rate and the longest median time from treatment initiation to discontinuation or follow-up. The most commonly reported side effects with lurasidone in this study (nausea, akathisia, tremor and drowsiness) were consistent with the known safety profile of the drug. Adverse events in most cases were assessed as mild, or occasionally moderate. A six-week prospective observational study of the real-world clinical effectiveness of lurasidone in doses ranging from 40 mg to 160 mg per day established statistically and clinically significant improvements in both psychotic and depressive symptoms in patients with acute exacerbation of schizophrenia and associated symptoms of depression.

Evaluation of the Effect of Alkaloid Berberine on the Positive and Negative Symptoms of the Patients with Schizophrenia: A Double-Blind Randomized Placebo-Controlled Clinical Trial

Schizophrenia is a severe psychiatric condition that affects approximately 1% of the global population. Over the last decade, the efficacy of berberine as a complementary therapy in psychiatric diseases without significant side effects has been demonstrated. Therefore, this study assessed the effect of alkaloid berberine on the positive and negative symptoms in patients with schizophrenia. From December 2020 to March 2021, a total of 86 patients with schizophrenia who were referred to Shiraz Ebne Sina Hospital in South of Iran were divided into two groups; 42 patients with schizophrenia in the placebo group received risperidone at a dosage of 4-6 mg per day, and 44 patients in the treatment group, in addition to risperidone, received berberine at a dosage of 500 mg per day. This treatment regimen was followed for 30 days. The Positive and Negative Syndrome Scale (PANSS) was used to assess the patients’ symptoms. According to data analysis, The PANSS score in both groups showed a statistically significant decrease after 30 days (p &lt; 0.05); however, this decreasing trend was not statistically significant between the groups (p &gt; 0.05). The current study showed that complementary use of alkaloid berberine capsule with a dose of 500 mg per day did not show better outcomes compared with the placebo in patients with schizophrenia.

The serum metabolomic profile of a distinct, inflammatory subtype of acute psychosis

A range of studies suggest that a proportion of psychosis may have an autoimmune basis, but this has not translated through into clinical practice—there is no biochemical test able to accurately identify psychosis resulting from an underlying inflammatory cause. Such a test would be an important step towards identifying who might require different treatments and have the potential to improve outcomes for patients. To identify novel subgroups within patients with acute psychosis we measured the serum nuclear magnetic resonance (NMR) metabolite profiles of 75 patients who had identified antibodies (anti-glycine receptor [GlyR], voltage-gated potassium channel [VGKC], Contactin-associated protein-like 2 [CASPR2], leucine-rich glioma inactivated 1 [LGI1], N-methyl-D-aspartate receptor [NMDAR] antibody) and 70 antibody negative patients matched for age, gender, and ethnicity. Clinical symptoms were assessed using the positive and negative syndrome scale (PANSS). Unsupervised principal component analysis identified two distinct biochemical signatures within the cohort. Orthogonal partial least squared discriminatory analysis revealed that the serum metabolomes of NMDAR, LGI1, and CASPR2 antibody psychosis patients were indistinct from the antibody negative control group while VGKC and GlyR antibody patients had significantly decreased lipoprotein fatty acids and increased amino acid concentrations. Furthermore, these patients had more severe presentation with higher PANSS scores than either the antibody negative controls or the NMDAR, LGI1, and CASPR2 antibody groups. These results suggest that a proportion of patients with acute psychosis have a distinct clinical and biochemical phenotype that may indicate an inflammatory subtype.

Assessment of compliance and relapse in patients with schizophrenia before and after the onset of COVID-19 pandemic

Objective The aim of this study was to assess the frequency and correlates of relapse among patients with schizophrenia during the COVID-19 pandemic. Methods This retrospective study included 90 adults who met DSM-IV criteria for schizophrenia. The participants were evaluated using Positive and Negative Syndrome Scale (PANSS), Compliance Rating Scale (CRS) and World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0) before and after the onset of COVID-19 pandemic. Results The mean score of CRS was decreased after the onset of COVID-19 pandemic compared to before COVID 19 ( p < 0.001). The mean total score of PANSS scale and the mean positive subscale (P) score had increased after the onset of COVID-19 pandemic compared to before COVID 19 ( p < 0.001). Following up the news about COVID-19 regularly and decreased level of family support after the pandemic onset were associated with lower CRS scores and higher PANSS scores. In addition, the presence of infection or death with COVID-19 among family members and lower CRS scores were associated with higher scores on PANSS positive subscale. Conclusions The relapse rate had increased among patients with schizophrenia during COVID-19 pandemic. Non-compliance with medications and lack of family support were the main correlates of relapse in schizophrenia. Key Points Patients with schizophrenia are at high risk for relapse during Covid-19 pandemic. Non-compliance with medications, lack of family support, COVID-19-related illness or death of family members and following the news of the pandemic are correlates of relapse in patients with schizophrenia. Psychoeducation, availability of medications and mental health services and family support may help to prevent relapse in patients with schizophrenia during pandemics. Prospective studies are needed to confirm the findings of this study.

Association between cognition and color discrimination among Lebanese patients with schizophrenia

BackgroundPatients with schizophrenia (SCZ) exhibit poorer color discrimination than normal individuals. Although retinal abnormalities, as well as cortical and subcortical alterations, found in patients with SCZ have been suggested to cause this poor color discrimination, the impact of cognitive impairment remains to be determined. Dopamine (DA) and glutamate (Glu), known to be disrupted in SCZ, are also suggested to play a role in color discrimination. Our objective was to investigate the contribution of cognitive impairment to color discrimination deficits in SCZ and to examine if these deficits are correlated to SCZ symptoms.MethodsThis study includes 127 patients with SCZ between July and September 2021. The participants completed several questionnaires, specifically the Positive and Negative Syndrome Scale (PANSS), the Montreal Cognitive Assessment (MoCA) test, and the Farnsworth D-15 test, to assess the extent of SCZ symptoms, cognition, and color discrimination respectively.ResultsHigher cognition (Beta = − 0.279) was significantly associated with a lower total error score (TES). Moreover, a higher positive PANSS score (Beta = 0.217) was significantly associated with a higher TES. A multinomial regression analysis taking the type of color blindness as the dependent variable showed that female sex (ORa = 5.46) was significantly associated with a certain type of color blindness.ConclusionColor discrimination deficits in patients with SCZ may be due to the effect of cognitive impairment and/or SCZ itself.

A Retrospective Study on the Relationship Between Cognitive Function and Social Function in Patients With Schizophrenia.

BackgroundSocial dysfunction is associated with decreased activity, employment difficulties, and poor prognosis in patients with schizophrenia. Cognitive functions, such as attention and processing speed, have been implicated in the social functions of schizophrenia patients; however, the relationship between cognitive functions and social functions remains unclear. Thus, understanding the factors that influence social functioning can aid the development of therapeutic strategies for schizophrenia. Herein, we retrospectively analyzed factors that influence social functioning in patients with schizophrenia.MethodsPatient background, intelligence quotient (IQ) scores, Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS-J) scores, the dose of antipsychotic drugs, Positive and Negative Syndrome Scale (PANSS) scores, and the factors influencing each subscale of the Japanese version of the Social Functioning Scale (SFS-J) were evaluated using univariate and multivariate analyses. The Bonferroni correction was applied to evaluate the correlation between each factor in the univariate analysis. In multivariate analysis, independent variables were selected using a stepwise method. In each model, considering the sample size, the maximum number of variables extracted using the stepwise method was set to three. We then calculated the standard partial regression coefficient (standard β) between the SFS-J subscale scores and each factor.ResultsData from 36 patients were analyzed. The average age, illness duration, and total length of hospitalization were 57.8 years, 34.8 years, and 196.7 months, respectively. Of the seven significant correlations with the SFS-J subscale in the univariate analysis, only three were significant in the multivariate analysis model. According to the multivariable model, BACS-J verbal fluency positively correlated with SFS-J withdrawal, interpersonal communication, and employment/occupation. Moreover, BACS-J token motor and educational history were positively correlated with SFS-J recreation and SFS-J employment/occupation, respectively. PANSS scores, IQ scores, and doses of antipsychotic drugs did not show clear associations with SFS-J scores.ConclusionsIn conclusion, there were significant correlations between BACS-J subscale scores for cognitive functioning and SFS-J subscale scores for social functioning in patients with schizophrenia.

Asian Subgroup Analysis of the REMISSIO Study: A Long-Term Efficacy and Safety Study of Paliperidone Palmitate 3-month Formulation in Patients with Stable Schizophrenia in a Naturalistic Clinical Setting.

ObjectiveTo evaluate the long-term efficacy and safety of three-monthly paliperidone palmitate (PP3M) in Asian patients with stable schizophrenia in a naturalistic setting.MethodsAsian patients recruited between May 2016 and March 2018 from the prospective, single-arm, non-randomized, open-label, multi-national REMISSIO study were analyzed. Patients received PP3M over 12 months following ≥ 4 months of treatment with one-monthly paliperidone palmitate. The primary efficacy endpoint was the proportion of patients who achieved symptomatic remission. Other endpoints were changes in Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) total scores, hospitalization rates, and safety.ResultsA total of 71 patients (23.3%) were Asian (South Korea 33, Malaysia 21, Taiwan 17); 95.8% of patients completed the study. At LOCF, 71% of Asian patients achieved symptomatic remission compared to the overall population (n = 172/303, 56.8%). Improvements in mean (standard deviation) PANSS and PSP total scores from baseline to LOCF in Asian patients and overall population were clinically significant. A lower proportion of Asian patients had ≥ 1 psychiatric hospitalization after PP3M treatment (n = 1/70, 1.4%) than during the 12 months before (n = 12/70, 17.1%); compared with patients in the overall population after (n = 8/303, 2.6%) and before PP3M treatment (n = 37/303, 12.2%). The overall incidence of treatment-emergent adverse events across Asian patients was 62.9% compared to 53.1% in the overall population. Safety findings were consistent with the known safety profile of PP3M.ConclusionOur findings confirm existing evidence on the efficacy and tolerability of PP3M in Asian patients with stable schizophrenia over 12 months of treatment.

Efficacy of Transcranial Direct Current Stimulation to Improve Insight in Patients With Schizophrenia: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Impaired insight into the illness and its consequences is associated with poor outcomes in schizophrenia. While transcranial direct current stimulation (tDCS) may represent a potentially effective treatment strategy to relieve various symptoms of schizophrenia, its impact on insight remains unclear. To investigate whether tDCS would modulate insight in patients with schizophrenia, we undertook a meta-analysis based on results from previous RCTs that investigated the clinical efficacy of tDCS. We hypothesize that repeated sessions of tDCS will be associated with insight improvement among patients. PubMed and ScienceDirect databases were systematically searched to identify RCTs that delivered at least 10 tDCS sessions in patients with schizophrenia. The primary outcome was the change in insight score, assessed by the Positive and Negative Syndrome Scale (PANSS) item G12 following active tDCS sessions as opposed to sham stimulation. Effect sizes were calculated for all studies and pooled using a random-effects model. Meta-regression and subgroup analyses were conducted. Thirteen studies (587 patients with schizophrenia) were included. A significant pooled effect size (g) of -0.46 (95% CI [-0.78; -0.14]) in favor of active tDCS was observed. Age and G12 score at baseline were identified as significant moderators, while change in total PANSS score was not significant. Ten sessions of active tDCS with either frontotemporoparietal or bifrontal montage may improve insight into the illness in patients with schizophrenia. The effect of this treatment could contribute to the beneficial outcomes observed in patients following stimulation.

Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms.

Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms.

Gender Differences in Psychiatric Symptoms and the Social Functioning of 610 Patients with Schizophrenia in Urban China: A 10-Year Follow-Up Study.

PurposeTo explore the different outcomes between male and female patients with schizophrenia after long-term follow-up.Patients and MethodsSchizophrenia patients were participants in our study. First, two senior psychiatrists collected data on the demographic characteristics and clinical symptoms of patients from the Hospital Information System between February 2009 and January 2010. Second, two other senior psychiatrists called the patients and their guardians between February 2019 and January 2020 to get general information on the patients and assess their psychiatric symptoms and social functioning using the Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance (PSP) scale.ResultsOf the 610 participants, the 306 female participants were younger (48.32 ± 12.99 vs 49.84 ± 12.60) and had received more education (8.08 ± 3.76 vs 7.94 ±3 0.73). After 10 years, women were found to have more outpatient visits than men (20.86 ± 22.21 vs 16.11 ± 16.87, P < 0.05). However, there was no significant gender difference in number of hospitalizations (3.12 ± 5.34 vs 2.77 ± 5.84, P > 0.05). The PANSS scores were lower for both groups at the 10-year follow-up. Women had significantly lower scores than men after the 10-year period (P < 0.05). With regard to social functioning, there was a significant difference in social functioning between baseline scores and 10-year follow-up scores indicating an improvement in social functioning. PSP scores had significantly increased in women (P < 0.01) but not in men (P > 0.05).ConclusionFemale patients had significantly lower levels of psychiatric symptoms and higher levels of social functioning at 10-year follow-up than male patients. They also reported more outpatient visits, which may have contributed to the gender differences in outcomes. Family members and doctors of patients should urge patients to make regular outpatient visits for better outcomes after hospitalization.

Effect of personalized nursing based on quantitative evaluation strategies on remission of first-episode schizophrenia comparing to usual care: a systematic review and meta-analysis.

The drug control of symptoms is for now the main clinical treatment of schizophrenia, but patients' varying condition and poor compliance can also fluctuate the therapeutic effect. Personalized nursing with a quantitative evaluation strategy (PNQES) may help improve the compliance and symptoms, but there are controversies over the outcomes reported in each specific study; the meta-analysis method aims to resolve the controversies over studies, thus, we conducted this study to pooling the results of controlled clinical studies, and to systematically evaluate the effects of this nursing model. The PubMed, Medline, Embase, China National Knowledge Infrastructure, and Wanfang databases were selected and searched for relevant articles for PNQES comparing to usual care. The inclusion criteria were established according to the Participants, Interventions, Comparisons, Outcomes, and Study (PICOS) framework. The Cochrane risk of bias 2.0 tool was used to evaluate the risk of bias of the included articles. The symptom scores, treatment compliance rate, quality of life, and social function indicators of the patients after nursing were quantitatively analyzed with effect sizes of mean difference (MD) or standard mean difference (SMD). The 11 included articles comprised a total of 1,251 patients with experimental group 625 and control group 626. Of all the 11 articles, only 1 had a "low" risk of bias, while the other articles had "some concern of risk;" none of the articles had a "high" risk of bias. The meta-analysis showed that patients who received PNQES had a significantly lower Positive and Negative Syndrome Scale (PANSS) total score after care than patients who received routine care [MD =-9.95, 95% confidence interval (CI): -14.35, -5.55; P<0.00001]. Further, the treatment compliance rate of patients who received PNQES was significantly higher (odds ratio =4.44, 95% CI: 2.17, 9.09; P<0.0001), as was the quality of life (standard MD =2.40, 95% CI: 1.46, 3.34; P<0.00001). Further, the social function deficit score was significantly lower (MD =-2.25, 95% CI: -3.75, -0.76; P=0.003). Subgroup and regression analyses showed that patient age, initial PANSS score, and the quantitative method of disease severity were not the sources of heterogeneity. Different intervention approaches applied may have been the source of heterogeneity. The application of PNQES is helpful for improving patients' symptoms and disease outcomes, treatment compliance, social function, and quality of life. It is suggested to be generalized in clinical application.