Symptom Profiles Of Patients Research Articles

Small subdural hemorrhages: Does size of intracranial hemorrhage impact symptoms after discharge?

Patients with small intracranial hemorrhage at initial presentation (ICHi) have a relatively uneventful hospital course, as compared with larger ICHi. In this study, we tested the null hypothesis that ICHi does not impact the symptom profile of patients with traumatic brain injury (TBI) after discharge. In this retrospective study, TBI patients over 18 years of age with a head CT at initial presentation and at least one follow-up visit between 2015 and 2018 were included. Those with vascular risk factors, major psychiatric comorbidities, neurologic disorders, and TBI / CT evidence of ICH within five years were excluded. Patients were stratified based on the presence or absence of ICHi. Symptom profiles were characterized during early (0-3 months post-TBI) and late follow up (4-12 months post-TBI). An adapted 15-question Post-Concussion Symptom Scale and a vestibulo-oculomotor (VOM) exam were assessed by a TBI specialist. We compared the age adjusted clinical symptom profiles between those with and without ICHi. 69 patients met inclusion/exclusion criteria. 26 (37.8%) had ICHi and 43 (62.32%) did not have ICH. The severity of measured symptoms or VOM findings were not more severe in those with ICHi. Age-adjusted analyses did not show any effect on these outcomes. ICHi does not impact the symptom profile of patients with TBI in either short or long term.

Distinct Subgroups of Patients With Lung Cancer Receiving Chemotherapy: A Latent Transition Analysis.

ObjectivesTo identify subgroups of patients with lung cancer receiving chemotherapy based on the severity dimension of symptom experience, and to examine changes in membership between these subgroups over time.MethodsPatients who were scheduled to receive chemotherapy completed the Chinese version of the MD Anderson Symptom Inventory and the revised lung cancer module with a total of 19 symptom items. Data were collected at three time points: two weeks before chemotherapy (T1), after chemotherapy cycle 1 (T2), and after chemotherapy cycle 3 or above (T3). The latent profile analysis and latent transition analysis were used to identify underlying subgroups and describe changes in subgroup membership over time.ResultsFrom the total sample (N = 195), 160 patients completed the symptom assessment at T1, T2, and T3. Two distinct latent symptom profiles of patients could be identified at T1, T2, and T3, which were classified as “Mild” and “Moderate-Severe” profiles. From T1 to T2 and T3, members in the Mild profile were more likely to move to the Moderate-Severe profile. Chemotherapy protocols, prior surgery treatment, and level of education can predict the transitions.ConclusionResults provide a better understanding of the patient’s different symptom experiences and characteristics. These could help clinicians to anticipate symptom patterns and develop interventions in lung cancer patients who were scheduled to receive chemotherapy for the first time.

Effects of Automatic Abdominal Massage Device in Treatment of Chronic Constipation Patients: A Prospective Study.

Manual abdominal massage has been shown to effectively treat slow-transit constipation, but it is labor-intensive. To offer an alternative treatment option for constipation, the Bamk-001 automatic abdominal massage device was developed. The aim of this study was to assess the effect of the Bamk-001 device on symptom profiles and colon transit time (CTT) in patients with chronic constipation. Thirty-seven patients with chronic functional constipation diagnosed using the Rome IV criteria were enrolled prospectively from December 2018 to February 2019. All patients received device-assisted automatic abdominal massage for 15min twice daily, once in the morning before breakfast and once at night, for 14days. CTT was measured before and at the end of the study period. Slow-transit constipation and very-slow-transit constipation were defined as CTT ≥ 48h and ≥ 72h, respectively. Patients' symptom profiles regarding overall defecation satisfaction and device-related adverse events were analyzed. Among the 37 patients, the mean age was 40.1 ± 11.8, and 5.4% (n = 2) were men. The Bamk-001 device significantly improved CTT from 54.0 (33.6-75.6) to 28.8 (18.0-52.8)h (p = 0.001) in patients with chronic constipation. In subgroup analysis, CTT improved significantly from 54.0 (33.6-75.6) to 28.8 (18.0-52.8)h (p = 0.003) and from 88.2 (74.4-124.8) to 45.6 (27.3-74.1)h (p = 0.005) in the slow-transit and very-slow-transit constipation groups, respectively (p = 0.001). Moreover, all patient symptoms were alleviated after treatment. No serious adverse events were reported. The Bamk-001 automatic abdominal massage device showed significant care efficacy, including the improvement in CTT and symptom profiles in patients with slow-transit constipation. The use of an automatic abdominal massage device as an adjunct in the management of constipation is a potentially beneficial intervention for patients with slow-transit constipation.

Symptom Profiles of a Convenience Sample of Patients with COVID-19 - United States, January-April 2020.

Coronavirus disease 2019 (COVID-19) was first detected in the United States in January 2020 (1), and by mid-July, approximately 3.4 million cases had been reported in the United States (2). Information about symptoms among U.S. COVID-19 patients is limited, especially among nonhospitalized patients. To better understand symptom profiles of patients with laboratory-confirmed COVID-19 in the United States, CDC used an optional questionnaire to collect detailed information on a convenience sample of COVID-19 patients from participating states. Symptom data were analyzed by age group, sex, hospitalization status, and symptom onset date relative to expansion of testing guidelines on March 8, 2020 (3). Among 164 symptomatic patients with known onset during January 14-April 4, 2020, a total of 158 (96%) reported fever, cough, or shortness of breath. Among 57 hospitalized adult patients (aged ≥18 years), 39 (68%) reported all three of these symptoms, compared with 25 (31%) of the 81 nonhospitalized adult patients. Gastrointestinal (GI) symptoms and other symptoms, such as chills, myalgia, headache, and fatigue, also were commonly reported, especially after expansion of testing guidelines. To aid prompt recognition of COVID-19, clinicians and public health professionals should be aware that COVID-19 can cause a wide variety of symptoms.

Effect of functional endoscopic sinus surgery on the symptom profile in chronic rhinosinusitis cases

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis (CRS) is a common chronic disease, that have considerable impact on quality of life, functional and emotional impairments of affected beings. Post-surgical improvement of quality of life indicates the surgical success. Functional endoscopic sinus surgery (FESS) is the dominating surgical procedure for CRS. This study was designed to assess the symptom profile of patient before and after surgery and the complications after FESS in the post-operative period.</p><p class="abstract"><strong>Methods:</strong> A total of 50 cases attending ENT outpatient department with clinical features and investigations suggestive of chronic sinusitis with infective pathology were randomly considered for this study. Cases were assessed for CRS symptoms pre and post operatively using grading symptoms. </p><p class="abstract"><strong>Results:</strong> Common major symptom was nasal obstruction (93.3%, N=28) followed by post nasal drip (83.33%, N=25), purulent nasal discharge (76.66%, N=23), facial pain/pressure (66.66%, N=20) and hyposmia (60%, N=18). None of the patients reported fever and facial congestion or fullness. Post operatively, cases with nasal obstruction (92.8%), purulent nasal discharge (86.9%), facial pain or pressure (85%), headache (81.8%), post nasal drip (84%), ear pain or fullness or pressure (92.8%) and hyposmia (61.1%) showed improvement after FESS at the end of three follow-up.</p><p class="abstract"><strong>Conclusions:</strong> The most common symptom pre operatively was nasal obstruction which also responded best to FESS, along with all the other minor symptoms including headache. The results of this study confirm that FESS is an excellent method of treatment in patients with CRS refractory to medical treatment.</p>

Clinical Profile of Non-Motor Symptoms in Patients with Essential Tremor: Impact on Quality of Life and Age-Related Differences

Clinical Profile of Non-Motor Symptoms in Patients with Essential Tremor: Impact on Quality of Life and Age-Related Differences

Clinical Profile of Non-Motor Symptoms in Patients with Essential Tremor: Impact on Quality of Life and Age-Related Differences.

BackgroundIdentifying the clinical phenotypes of non-motor symptoms (NMSs) of essential tremor (ET) among different populations is necessary due to their impact on the quality of life (QoL). This study aimed to investigate the clinical phenotype and impact of NMSs on QoL in Egyptian patients with ET.MethodsThirty ET patients were compared to 30 matched controls. Subjects were evaluated by the Fahn-Tolosa-Marin Tremor Rating Scale, Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment, Hamilton Anxiety Rating Scale, Beck Depression Inventory, Pittsburgh Sleep quality Index, and the Short Form 36 Health Survey Questionnaire. Both groups were divided into two subgroups of younger (<45 years, 14 patients) and older age (>45 years, 16 patients) groups, to investigate age-related differences.ResultsET patients showed significantly worse cognition, depression, anxiety, sleep and NMSS domains (p < 0.001), compared to controls, that negatively affected and predicted QoL. Older patients had more cognitive impairment (p = 0.003) and worse sleep/fatigue (p = 0.032) and sexual functions (p = 0.006), compared to younger group.DiscussionThe study supports that NMSs are integral part of ET, negatively affect QoL, and similarly affect younger and older patients. Therefore, NMSs should be explored for proper care of ET patients.

A Retrospective Analysis of Surgical Outcomes and Risk Factors for Persistent Postoperative Symptoms Following Synthetic Mid Urethral Sling Revision.

The purpose of our study was to describe the symptom profile of patients who presented to a tertiary care hospital for sling revision, define the efficacy of sling removal/revision in alleviating symptoms and identify what factors, if any, contribute to favorable surgical outcomes. We retrospectively reviewed the records of patients who underwent revision of a synthetic mid urethral sling at our institution between 2004 and 2016. Patients with a history of vaginal mesh for pelvic organ prolapse were excluded from analysis. The outcomes assessed were the AUASI (American Urological Association Symptom Index) score, the M-ISI (Michigan Incontinence Symptom Index) score, pad use, post-void residual urine volume, examination findings and subjective improvement. A total of 430 patients met study inclusion criteria, of whom 182, 172 and 40 received a transobturator tape, a retropubic mid urethral sling and a mini-sling, respectively. Patients presented with 4 primary complaints, including mesh exposure or erosion, pain or dyspareunia, incontinence and/or bladder outlet obstruction. Of the patients 77% presented with at least 2 categories of symptoms. Average followup was 15 months. Postoperatively the AUASI score decreased from 19.0 to 14.7 (p <0.001) and the bother score decreased from 5.0 to 3.4 (p <0.001). The M-ISI also improved from total and bother scores of 15.7 and 4.4 to a postoperative average of 13.2 and 3.1 (p = 0.002 and <0.001, respectively). During this time approximately 40% of patients who presented with pain had persistent postoperative discomfort, in 20% with obstruction that condition failed to resolve and recurrent mesh complaints developed in 5% with mesh exposure or erosion. On multivariate analysis preoperative narcotic use was a significant risk factor for persistent postoperative pain (OR 6.9). Despite complex patient presentations subjective and objective urological symptom measures significantly improve following mid urethral sling revision.

PainPREDICT: first interim data from the development of a new patient-reported pain questionnaire to predict treatment response using sensory symptom profiles

Objective: Sensory symptom patterns may be useful for predicting treatment response, and, thus, improve individual therapy in patients suffering from neuropathic pain (NeP). Existing screening questionnaires focus predominately on neuropathic mechanisms without consideration of nociceptive mechanisms or mixed pain states. This study aimed to develop a new questionnaire, painPREDICT, using a wide set of patient-reported descriptors potentially associated with neuropathic and nociceptive pain mechanisms, and to explore sensory symptom patterns.Methods: PainPREDICT was constructed based on exploratory (n = 27 patients) and cognitive debriefing interviews (n = 49 patients and nine physicians), across five NeP conditions. The pilot questionnaire was then administered in a non-interventional, cross-sectional, multi-center study to 840 pain patients across the US and Germany. The identification of a sensory symptom pattern was based on hybrid clustering resulting from items standardization followed by principal component analysis.Results: The final questionnaire included 20 items covering: pain intensity, location of pain, course of pain, and sensory symptoms. Most patients participating in the cross-sectional study suffered either from painful diabetic polyneuropathy (n = 330) or radiculopathy (n = 349), fewer from central pain (n = 61) or other types of NeP (n = 100). The hybrid clustering of the new questionnaire data identified three different characteristic sensory symptom profiles in patients with NeP: “Irritable nociceptors”, “deafferentation pain”, and “pain attacks with nociceptive component”. Although some differences in the distribution of the sensory profiles were found, all profiles were represented in all NeP etiology groups.Conclusions: This study set the ground of painPREDICT and showed promising results for its use to categorize patients according to sensory symptom patterns.

Symptom profile of patients receiving antibiotics for upper respiratory tract infections in general practice: an observational study using smartphone technology.

Upper respiratory tract infections (URTIs) are a common presentation in general practice and are linked to high rates of inappropriate antibiotic prescription. There is limited information about the trajectory of patients with this condition who have been prescribed antibiotics. To document the symptom profile of patients receiving antibiotics for URTIs in Australian general practice using smartphone technology and online surveys. In total, 8218 patients received antibiotics after attending one of the 32 general practice clinics in Australia from June to October 2017: 4089 were identified as URTI presentations and were the cohort studied. Patients completed the Wisconsin Upper Respiratory Symptom Survey (WURSS-24) 3 and 7 days after visiting their general practitioner (GP). Six hundred fourteen URTI-specific patients responded to at least one symptom survey (RR 15%). The majority of patients reported moderate to mild symptoms at 72 hours [median global symptom severity score 37 (IQR 19, 59)] post-GP visit which reduced to very mild symptoms or not sick by day 7 [11 (IQR 4, 27)]. Patients receiving antibiotics for URTI reported the same level of symptom severity as patients in previous studies receiving no treatment. The recovery of most patients within days of receiving antibiotics for URTI mimics the trajectory of patients with viral URTIs without treatment. Antibiotics did not appear to hasten recovery. Monitoring of patients in this context using smart phone technology is feasible but limited by modest response rates.

Is there a role for melatonin in fibromyalgia?

Fibromyalgia, characterised by persistent pain, fatigue, sleep disturbance and cognitive dysfunction, is a central sensitivity syndrome that also involves abnormality in peripheral generators and in the hypothalamic pituitary adrenal axis. Heterogeneity of clinical expression of fibromyalgia with a multifactorial aetiology has made the development of effective therapeutic strategies challenging. Physiological properties of the neurohormone melatonin appear related to the symptom profile exhibited by patients with fibromyalgia and thus disturbance of it’s production would be compatible with the pathophysiology. Altered levels of melatonin have been observed in patients with fibromyalgia which are associated with lower secretion during dark hours and higher secretion during daytime. However, inconsistencies of available clinical evidence limit conclusion of a relationship between levels of melatonin and symptom profiles in patients with fibromyalgia. Administration of melatonin to patients with fibromyalgia has demonstrated suppression of many symptoms and an improved quality of life consistent with benefit as a therapy for the management of this condition. Further studies with larger samples, however, are required to explore the potential role of melatonin in the pathophysiology of fibromyalgia and determine the optimal dosing regimen of melatonin for the management of fibromyalgia.

Study of symptom profile of patients of large bowel malignancies presenting as acute obstruction attending tertiary care institute

Study of symptom profile of patients of large bowel malignancies presenting as acute obstruction attending tertiary care institute

Symptom Profile of Patients with Psychotic Disorders

Introduction: According to WHO, schizophrenia is a severe mental disorder affecting about 23 million people worldwide. Psychoses, including schizophrenia, are characterized by distortions in thinking, perception, emotions, language, sense of self and behavior. The impacts of these disorders are severe, with approximately 1 million people committing suicide annually. There is also an increase in co morbidity of these different conditions. So, this study was carried out to assess the symptom profile of patients with schizophrenia and other psychotic disorders (excluding mood disorders, substance induced psychotic disorders, organic psychotic disorders).&#x0D; Material and Method: Discharge record sheets of all cases admitted (Total 86) to the psychiatric ward over the study period were reviewed. Cases diagnosed as schizophrenia and other psychotic disorders were enrolled. Major symptoms were listed from the discharge papers.&#x0D; Results: Out of the total number of patients enrolled in the research, 68.6% were male while 31.4% were female. The mean age of the patients was found to be 31.03 years with a minimum age of 16 years and maximum 63 years. Most were from lower middle class family, Hindu by religion and unmarried. Among 86 cases, 26(30.2%) were diagnosed as Unspecified nonorganic psychosis, 24(27.9%) as Schizophrenia, 19(22.1%) as Schizoaffective disorder, 14(16.3%) as Acute &amp; Transient Psychotic Disorder, 3(3.5%) as Persistent delusional disorder. Delusion of persecution was present in 46 cases (53.5%), Delusion of reference in 33 cases (38.4%) and Hallucinations in 32 cases (37.2%). Out of the 86 patients enrolled in the study, 15 (17.4%) had at least one suicidal attempt.&#x0D; Conclusion: Significant number of patients were diagnosed as Schizophrenia which is itself a chronic, debilitating illness. Hallucinations and delusions were present in most of the cases.

Respiratory Failure, Noninvasive Ventilation, and Symptom Burden: An Observational Study

BackgroundNoninvasive ventilation (NIV) is commonly used to manage acute respiratory failure due to decompensated cardiorespiratory disease. We describe symptom burden in this population. MeasuresFifty consecutive, consenting, English-speaking, cognitively intact patients, admitted to wards other than the intensive care unit in a tertiary teaching hospital and treated with NIV for hypercapnic respiratory failure, were recruited. The 14-item Condensed Memorial Symptom Assessment Scale was used to assess physical and psychological symptoms within 36 hours of commencing NIV. Breathlessness (using Borg score), pain location and intensity using a numerical rating scale, and four symptoms potentially prevalent in patients undergoing NIV (cough, sputum, gastric bloating, and dry eyes) were also assessed. OutcomesPatients reported a median of 10 symptoms (IQR 9–13). A median of five symptoms (IQR 3–7) were rated as severe. Breathlessness was the most prevalent and most distressing symptom, with participants reporting a mean maximum Borg score of 7.55 over the 24 hours before admission. Dry mouth, lack of energy, cough, sputum, difficulty sleeping, and psychological symptoms were prevalent. Pain, when reported, was of moderate intensity and contributed to distress. Conclusions/Lessons learnedThis study describes the patient-reported symptoms occurring during an episode of acute respiratory failure. Understanding the symptom profile of patients in this setting may allow clinicians to target symptom relief while simultaneously managing respiratory failure, enhancing care.

Patients' perspective of the effectiveness and acceptability of pharmacological and non-pharmacological treatments of fibromyalgia.

Background and aims Fibromyalgia is a complex condition characterised by widespread pain, sleep disturbance, fatigue and cognitive impairment, with a global mean prevalence estimated at 2.7%. There are inconsistencies in guidelines on the treatment of fibromyalgia leading to dissatisfaction from patients and healthcare professionals. This study investigated patient-reported outcomes of pharmacological and non-pharmacological treatment usage and effectiveness with an assessment of acceptability. Methods Nine hundred and forty-one participants completed a self-administered anonymous questionnaire giving quantitative data of demographics, treatment usage and treatment outcomes. Participant-reported effectiveness and side effects were compared in the following treatment classes: analgesics, antidepressants, gabapentinoids, gastrointestinal treatments, activity interventions, dietary-based treatments, and psychological, physical and alternative therapies. Participants also reported whether they knew about or had tried different treatments. Results The results from the online survey indicated that the range of mean effectiveness ratings were similar for pharmacological and non-pharmacological treatments, whereas non-pharmacological treatments had lower side effects ratings and higher acceptability relative to pharmacological treatments. Participants were not aware of some treatment options. Conclusions The results show lower side effects ratings and higher acceptability for non-pharmacological treatments compared to pharmacological treatments despite similar effectiveness ratings. Implications This article presents results from a large online survey on fibromyalgia patient perspectives of pharmacological and non-pharmacological treatments. Results will inform healthcare professionals and patients about optimal treatments based on ratings of effectiveness, side effects and acceptability that are tailored to patient symptom profiles. Some participants were unaware of treatment options highlighting the importance of patient education allowing collaboration between patients and healthcare professionals to find optimal treatments.

S129. DOES TREATMENT RESISTANT SCHIZOPHRENIA PRESENT A CHARACTERISTIC SYMPTOMATIC SIGNATURE?

BackgroundTreatment-resistant schizophrenia (TRS) may underlie a specific biological signature among patients with schizophrenia. The main lines of evidence suggest a glutamatergic rather than dopaminergic dysfunction in TRS, with lower levels of striatal dopamine and higher levels of glutamate in anterior cingulate. Whether this biological signature relates to a distinct symptomatic profile remains unclear. Our objective is to define a symptom profile of patients with TRS.MethodsWe used two samples of patients with schizophrenia. First, we followed a discovery sample of inpatients (n=203) to prospectively identify TRS predictors, then we tested the predictors in a replication sample of outpatients (n=207). The samples were collected independently. All patients were assessed with the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impressions-Severity Scale (CGI-S) and the Global Assessment of Functioning Scale (GAF). Diagnosis was confirmed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). TRS was defined according the criteria of the Schizophrenia Algorithm of the International Psychopharmacology Algorithm Project (IPAP). Initially, we tested if patients with disorganized subtype were more likely to be TRS, and grouped the patients into disorganized or non-disorganized schizophrenia according to SCID-I. Then, we checked which PANSS items at the baseline predicted TRS at the follow-up through multiple logistic regression analyses. A receiver operating characteristic (ROC) curve with the best items was performed at the follow-up.ResultsTRS was more common in disorganized schizophrenia in the inpatient sample (73.8% vs 22.4%, P < 0.001) and in the outpatient sample (68.2% vs 28.2%, P < 0.001) in comparison to non-disorganized schizophrenia. They also presented worse scores on PANSS, CGI-S and GAF (P < 0.001). In the second step, three PANSS items, P2 (conceptual disorganization), N5 (difficulty in abstract thinking) and G9 (unusual thought content), predicted TRS with 78.4% accuracy (P = 0.011, P = 0.010 and P <0.001). The ROC analysis using the sum of PE+N5G+G9 predicted TRS with a sensitivity of 72.3%, and a specificity of 82.4%. In the outpatient sample, logistic regression analysis of the model P2+N5+G9 discriminated TRS with 69.3% accuracy (P <0.001).DiscussionNon-paranoid clinical presentations, specially disorganized characteristics, may consist in clinical markers of TRS. Further Cross-validation of such clinical findings and biological features may improve prediction of TRS

Electroconvulsive therapy combined with antipsychotic therapy in the treatment of acute schizophrenia inpatients: symptom profile of the clinical response

ABSTRACTOBJECTIVE: The aim of the study was to examine the efficacy of electroconvulsive therapy (ECT) combined with antipsychotic (AP) medication on symptom profile in patients with a diagnosis of schizophrenia who had received acute psychiatric inpatient treatment.METHODS: In this prospective study, patients were evaluated for inclusion in the study who were diagnosed with schizophrenia according to DSM-IV diagnostic criteria and were to receive ECT. The patients were evaluated using the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), and Clinical Global Impression – Improvement (CGI-I) sub-scale before the first session ECT, once following every two subsequent sessions and after the final session.RESULTS: The patients showed significant improvements in BPRS scores at each evaluation compared with their scores at baseline, and a significant clinical improvement was found on the CGI-I sub-scale at the end o...

Neuropsychiatric Symptoms in Patients with Idiopathic Rapid Eye Movement Sleep Behavior Disorder

Background and Objective Idiopathic rapid eye movement sleep behavior disorder (IRBD) is a strong predictor of the development of synucleinopathies, including Parkinson’s disease. Neuropsychiatric symptoms are common in patients with Parkinson’s disease but have not been properly evaluated in IRBD. We used the Symptom Checklist-90-Revision (SCL-90-R) to evaluate the symptom profile of patients with drug-naïve IRBD. Methods Consecutive drug-naïve patients with video-polysomnography-confirmed IRBD that visited Kyung Hee University Hospital at Gangdong sleep clinic January 2009–November 2016 were reviewed. Age- and sex-matched healthy volunteers served as controls. Questionnaires evaluating sleep [Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI)] and depression [beck depression inventory-II (BDI-II)] were conducted with the SCL-90-R in IRBD patients and controls. Results Twenty patients with IRBD and 20 age- and sex-matched controls were analyzed. In IRBD patients, the mean age was 59.5, 55% were male, and the mean disease duration was 55.1 months. PSQI scores (5.7 ± 2.2 vs. 3.2 ± 1.4, p < 0.0001) and ISI scores (11.2 ± 8.7 vs. 4.1 ± 3.4, p < 0.0001) were higher in patients with IRBD than in the controls. Three IRBD patients (15%) had abnormal SCL-90-R T-scores over 70. The T-scores for phobic anxiety (p=0.009), interpersonal sensitivity (p = 0.011), psychoticism (p = 0.013), hostility (p = 0.014), anxiety (p = 0.020), and depression (p = 0.049) were higher in the patients. After adjusting for age, BDI-II scores were positively correlated with RBD disease duration (r = 0.484, p = 0.042) in IRBD patients. Conclusions The results of our study demonstrate that neuropsychiatric distress is more severe in patients with IRBD with no comorbidities than in otherwise healthy individuals. Key words: REM sleep behavior disorder, Neuropsychiatric symptom, SCL-90-R.

Factor analysis of symptom dimensions (psychotic, affective and obsessive compulsive symptoms) in schizophrenia

To carryout factor analysis of symptom profile of patients with schizophrenia assessed by using positive and negative syndrome scale (PANSS), Calgary depression rating scale (CDSS), Young mania rating scale (YMRS) and YBOCS checklist. 181 patients of schizophrenia were assessed on PANSS, CDSS, YMRS and YBOCS checklist. Factor analysis of PANSS yielded 3 factor structure (positive, negative, anxiety). When the items of CDSS were added to the PANSS items, total number of factors increased to 4 with depression emerging as a separate factor. Addition of YMRS to PANSS and CDSS led to emergence of 5 factor model. Further addition of YBOCS checklist led to emergence of a 7 factor model (positive, depressive, obsessive compulsive, negative, manic, anxiety and obsessive compulsive-2), which explained 49.85% variance of the data. Positive symptoms emerged as the factor-1. Depressive symptoms loaded on the factor-2, negative symptoms loaded on to factor-4, manic symptoms loaded onto factor-5 and anxiety symptoms loaded onto factor-6. OC symptoms loaded onto factor 3 and 7. Present study suggests that when multiple scales are used for assessment of various symptoms of schizophrenia, the symptoms separate out into 7 factors. This finding suggests that clinical assessment of schizophrenia should not be limited to core psychotic symptoms only and structured instruments must be used to elicit other symptoms too while monitoring the clinical picture of patients with schizophrenia.

Sensory Symptom Profiles of Patients With Neuropathic Pain After Spinal Cord Injury.

Individuals experiencing neuropathic pain (NP) after spinal cord injury (SCI) present with a variety of pain descriptors in different combinations and at different intensities. These sensory features form distinct patterns, known as sensory symptom profiles. In the present cross-sectional study, we have used a multivariate statistical method (multiple correspondence analysis) to categorize the sensory symptom profiles of a cohort of 338 patients with at-level or below-level NP after SCI. We also investigated possible associations between positive neuropathic symptoms and features of the neurological lesion. The majority of participants had a combination of pain descriptors, with 59% presenting with 3 or 4 pain subtypes. No significant associations were found between specific pain profiles and etiology or clinical degree of the neurological lesion. Furthermore, similar symptom profiles were seen in patients with at-level and below-level NP. The most frequent pattern observed in patients with cervical SCI consisted predominantly of electric shocks and tingling, without burning, pressure pain, or allodynia. Classification of SCI-NP patients into the 5 groups identified in the present study based on their distinct sensory symptom profiles may allow identification of those most likely to respond to a specific analgesic approach.