Schizophrenic Disorders Research Articles

A Systematic Review and Meta-Analysis of the Effectiveness of Adherence Therapy and Its Treatment Duration in Patients with Schizophrenia Spectrum Disorders.

Adherence therapy (AT) is an intervention for improving medication adherence of people with schizophrenia spectrum disorders, but no systematic reviews have yet summarized the effectiveness and minimum treatment duration of AT. We here aimed to systematically examine the effectiveness of AT in improving outcomes versus treatment as usual (TAU) and its minimum effective duration for people diagnosed with schizophrenia spectrum disorders. Eligible randomized controlled trials were identified from four databases (Web of Science, PubMed, CINAHL and Cochrane Library) for the period 1 January 2006 to 1 January 2023. Of 1087 retrieved candidate studies, five studies with a total of 726 participants met the inclusion criteria. The search terms consisted of adherence therapy, compliance therapy, schizophrenia, schizoaffective disorder, schizophrenic disorder, medication adherence, and medication compliance (combined with OR and AND). Two investigators independently selected studies, extracted data, and conducted bias risk assessments. Random-effects models were used to analyze the pooled data. Meta-analysis of the five selected studies showed that AT had a significantly greater positive effects than TAU on psychiatric symptoms, but no significant effects on adherence behaviors and attitudes. The AT had limited effects in terms of improving the attitudes and behaviors of people with schizophrenia spectrum disorders with respect to medication adherence, but did improve patients' psychiatric symptoms. The therapy should be performed by trained staff for maximum benefit, and the recommended duration of the intervention is 12 hours.

The era of the Dawn of Mendelian research in the field of psychiatry: Rüdin's 1922 review paper "regarding the heredity of mental disturbances".

On September 27, 1922, Ernst Rüdin gave an address to the Annual Conference of the German Society of Genetics entitled "Regarding the Heredity of Mental Disturbances." Published in a 37-page article, Rüdin reviewed the progress in the field of Mendelian psychiatric genetics, then hardly more than a decade old. Topics included (a)the status of Mendelian analyses of dementia praecox and manic-depressive insanity which had expanded to include two and three locus and early polygenic models and sometimes included, respectively, schizoid and cyclothymic personalities; (b) a critique of theories for the explanation of co-occurrence of different psychiatric disorders within families; and (c) a sharp methodologic critique of Davenport and Rosanoff's contemporary work which emphasized Rüdin's commitment to careful, expert phenotyping, a primary focus on well-validated psychiatric disorders and not broad spectra of putatively inter-related conditions, and an emphasis on rigorous statistical modeling as seen in his continued collaboration with Wilhelm Weinberg.

A preliminary study on similarities and dissimilarities of Neurological Soft Signs in schizophrenic and obsessive-compulsive disorders suggests a common maldevelopmental model.

Neurological Soft Signs (NSS) represent minor neurological signs related to non-specific cerebral alterations. They have been documented in many psychiatric disorders including schizophrenia (SCZ) and obsessive-compulsive disorder (OCD). Aim of this study was to determine and compare the incidence and severity of NSS in patients with SCZ, in patients with OCD, and healthy control subjects (HCs). Using the Neurological Evaluation Scale (NES), this study investigated NSS in 15 SCZ patients, 14 OCD patients, and 15 HCs. PANSS and Y-BOCS were used to evaluate clinical picture in both groups. Patients with SCZ showed significantly higher scores compared to HCs in the NES total and each of the three NES subscales (Integrative Sensory Function, Motor Coordination, and Sequencing of Complex Motor Acts). Patients with OCD also showed significantly higher scores compared to HCs in the NES total, Motor Coordination and Sequencing of Complex Motor Acts, but not in Integrative Sensory Function. No significant differences emerged in the NES total and the various subscales scores between the two patients' groups. Our results seem to confirm the presence of NSS in both SCZ and OCD. The different types of NSS presented by the two patients' groups versus HCs further supports the findings of widespread cerebral alterations in SCZ, on the other hand, with a preferential involvement of prefrontal and frontal cortex in OCD.

The Boy in the Borstal: Gene Hunting, Dopaminergic Dogma, and the Science of Schizophrenia

The Boy in the Borstal: Gene Hunting, Dopaminergic Dogma, and the Science of Schizophrenia

Risk of parental psychiatric disorders among adolescents with major depressive disorder according to response to antidepressant treatment: does the type of antidepressant matter?

The genetic load for major depressive disorder (MDD) may be higher in people who develop MDD earlier in life. This study aimed to investigate whether the parents of adolescents with MDD were more likely to have MDD, bipolar disorder (BD), schizophrenic disorder (SZ), alcohol use disorder, or substance use disorder than the parents of adolescents without MDD. We also examined whether the response to antidepressant treatment predicted the likelihood of parental psychiatric disorders. In all, 1,758 adolescents aged 12-19 years with antidepressant-resistant depression, 7,032 (1:4) age-/sex-matched adolescents with antidepressant-responsive depression and 7,032 (1:4) age-/sex-matched controls were included. Parental psychiatric disorders of individuals enrolled were assessed. The parents of the adolescents with MDD were more likely to be diagnosed with MDD, BD, SZ, alcohol use disorder, or substance use disorder than the parents of the control group. The parents of adolescents who were antidepressant resistant and the mothers of adolescents who were either treatment resistant or treatment responsive were more likely to be diagnosed with a psychiatric disorder. Our study demonstrated that parents of adolescents with MDD may be more likely to be diagnosed with MDD, BD, SZ, alcohol use disorder, or substance use disorder than parents of adolescents without MDD, suggesting the within-disorder transmission and cross-disorder transmission of these psychiatric disorders. Furthermore, the parent's sex and the response to antidepressant treatment may affect the within-disorder transmission of MDD.

An impact of the COVID-19 pandemia on the onset and course of mental disorders in elderly

To study the impact of COVID-19 on the onset and course of mental disorders in hospitalized elderly patients. We studied 67 inpatients, aged 50 to 95 years, with various mental illnesses in accordance with the ICD-10 criteria, who underwent COVID-19 from February 2020 to December 2021. Forty-six people were previously mentally ill, in 21 cases the disease developed for the first time. The group of primary diseased patients was dominated by depressive episodes (F32, (42.9%), including psychotic episodes (9.5%). In 28.6% of cases, organic disorders were diagnosed in the form of emotional lability (F06.6), organic depression (F06.3), mild cognitive impairment (F06.7) and delirium (F05.86). In 23.8% of patients, neurotic disorders were observed in the form of depressive reactions (F43), panic (F41.0) and generalized anxiety disorder (F41.1). In one case (4.8%), acute polymorphic psychosis with symptoms of schizophrenia (F23.1) was diagnosed. The diagnoses of the previously mentally ill group were: affective disorders (F31, F32, F33 - 45.7%); organic disorders, including dementia (F06.3, F06.7, F00.1, F00.2 - 26.1%); schizophrenia spectrum disorders (F25, F21, F22, F20.01 - 19.6%), and neurotic somatoform disorders (F45 - 8.7%). In the acute and subacute periods of COVID-19 (≤3 months), acute psychotic states (APS) developed in both groups of patients (in 23.3% and 30.4%, respectively) in the form of delirium, psychotic depression, or polymorphic psychosis. APS were more common in mentally ill patients with organic (50%) and schizophrenia spectrum (33.3%) disorders with a predominance of delirium. In the long-term period of COVID-19, mentally ill patients more often than primary diseased patients (60.9% and 38.1%) developed cognitive impairment (CI), especially in schizophrenic (77.8%) and organic (83.3%) disorders. CI developed twice as often after APS (89.5% and 39.6%, p<0.001), reaching the degree of dementia in 15.8% of cases. APS were significantly associated (p<0.05) with the development of CI (0.567733), the age of patients (0.410696) and the presence of previous cerebrovascular insufficiency (0.404916). The age-related features of the mental consequences of COVID-19 are the occurrence of APS in the acute period of infection and the deterioration of cognitive activity at a remote stage. The mentally ill, especially those of the organic and schizophrenia spectrum, were found to be more vulnerable to the effects of COVID-19. In them, the occurrence of APS was a risk factor for the development of dementia, while in primary diseased, affective and neurotic patients, CI was reversible or had the character of a mild cognitive disorder.

Experience of clinical use of fluvoxamine for the treatment of comorbid depression in childhood and adolescence

To identify the frequency of administration of fluvoxamine, to determine the main targets of the drug and the expediency of its use in depression of various genesis in children and adolescents. To assess the frequency of prescribing fluvoxamine, 195 medical histories of patients who were inpatients in the children's department of the Mental Health Research Center in 2023 were analyzed. To assess the dynamics of depression during treatment with fluvoxamine, a clinical group was formed of 12 patients aged 10 to 15 years (age 13.1±3.6 years) who received fluvoxamine for the treatment of depression with comorbid obsessive-compulsive and anxiety-phobic disorders. Clinical and psychopathological, psychometric (Hamilton Depression Rating Scale - HDRS) and statistical research methods were used. In total, in 2023, fluvoxamine was received by 20% (n=37) of all inpatient patients of child age (from 7 to 16 years). All patients received combination therapy. The therapeutic targets were comorbid depressive, obsessive-compulsive and anxiety symptoms developing in the structure of nosologically heterogeneous states, with the dominance of schizophrenic spectrum disorders. Against the background of the use of the drug fluvoxamine for 4 weeks in the clinical group, there was a significant reduction in depressive symptoms on the HDRS. Adverse events during complex therapy were observed in 20% of patients, but were not severe, did not require discontinuation of therapy and were unreliably associated with the use of fluvoxamine. The use of the fluvoxamine provides reduction of depressive symptoms within the framework of various nosologies, and is characterized by sufficient safety. The variety of therapeutic targets of the fluvoxamine, including antidepressant, anti-anxiety, cognitive effects, is certainly a significant advantage of the studied fluvoxamine for use in childhood.

Реорганизация психиатрической службы и антипсихотическая терапия больных шизофренического спектра

The article discusses the trends in the use of antipsychotic drugs in the treatment of patients with schizophrenic spectrum disorders (RSHS) in the context of the reorganization of the psychiatric service on the example of Moscow. The reform of the psychiatric service (2012-2020) has radically changed the structure of psychiatric care, the system for evaluating its effectiveness and the economic basis. While the number of inpatient beds decreased by more than 3 times, the number of places in day hospitals increased by more than 2 times, the number of visits to a psychiatrist in the outpatient network increased by 2.5 times during the year. During the period under review, the number of repeated hospitalizations of patients with RS in psychiatric hospitals has also significantly decreased. At the same time, stable indicators of the incidence of RS during the considered period of time remain. Simultaneously with the reform of the psychiatric service, there was an increase in the consumption of antipsychotics from 7.6 million Defined Daily Dose (DDD) in 2013 to 12.3 million DDD in 2021, including conventional (KA) and atypical antipsychotics (AA) from 17% to 30% with an outstripping increase in the use of prolonged injectable antipsychotics (primarily AA). If in 2013-2016 AA of prolonged action made up an insignificant part of the total array of prolonged drugs (5-9%), then there was a consistent increase in their use. In 2021 they accounted for 36% of the total volume of prolonged-acting drugs (an increase of 400%), with a general increase in the use of prolonged forms by about 3 times. There was a sevenfold increase in the proportion of injectable forms from the total volume of AA – from 3% (2016) to 23%, and a twofold overall increase in the volume of AA use from 2.5 million DDD (2013) to 5.8 million DDD (2021). It is stated that there has been a stabilization of the system of providing psychiatric care to patients with RSHS with a shift of emphasis to the outpatient link and the widespread introduction of prolonged AA. To the greatest extent, these trends are found in the increasing use of risperidone-const and prolonged forms of paliperidone. It is concluded that the psychiatric service is on the threshold of a new stage of development, which represents a way of personalizing psychiatric care based on an individual approach to the patient.

Selfhood and alterity: schizophrenic experience between Blankenburg and Tatossian.

This paper presents a critical comparison between two phenomenological accounts of schizophrenic experience: on the one side, Blankenburg's seminal work on the basal disturbance (Grundstörung) of schizophrenia as loss of natural self-evidence (Natürlichen Selbstverständlichkeit); on the other side, Tatossian's insight, briefly elaborated in a lecture presented in Heidelberg in 1994 and largely forgotten by the relevant literature. Whereas the former mainly develops an intersubjective reading of schizophrenia, the latter suggests an intrasubjective understanding. Indeed, for Blankenburg, schizophrenic experience can be broadly characterized as a progressive impoverishment of our rootedness in the social world, leading to derealization and depersonalization. In this respect, Tatossian takes schizophrenic autism not as the effect of a loss of originary sociality but as the result of a deeper disproportion. For Tatossian, schizophrenia is characterized, ultimately, by a basic self-disorder or alteration that consists in the breakdown of the twofold dimension of transcendental subjectivity, encompassing both constituting consciousness and phenomenologizing onlooker. In this sense, his interpretation of schizophrenic disorders is closer to the ipseity-disturbance model. I show that while Blankenburg and Tatossian share a dialectical understanding of schizophrenia by pointing to basic modifications of the "transcendental organization" of experience, their divergence originates from a different reading of the phenomenological epoché. Except for the clinical perspective, the point of contention between Blankenburg and Tatossian seems to concern their use of internal resources of the Husserlian phenomenology. By presenting the philosophical presuppositions of their analyses, I discuss two key figures of phenomenological psychopathology by showing how their debate on the meaning of schizophrenic experience can be reframed by looking at the relationship between transcendental subjectivity and intersubjectivity in Husserl's phenomenology.

LONG-ACTING INJECTABLE ANTIPSYCHOTICS IN SCHIZOPHRENIA

Antipsychotics serve as the cornerstone of pharmacological treatment for schizophrenic disorders, including both the management of acute episodes and the prevention of relapse. Longacting injectable antipsychotics (LAIAs) are intended to improve treatment compliance, thereby reducing the risk of relapse and hospitalization. The marketing of LAIAs has increased over the past few years, consequently expanding the range of active substances and extending dosing intervals (bi-weekly, monthly, quarterly and semi-annually). This new situation represents a qualitative change in the available therapeutic approaches for schizophrenia, although a risk/benefit assessment is required, and the prescribing efficiency from an overall patient health perspective needs to be studied.

Psychosis and conduct disorder in Greek forensic patients found not guilty by reason of insanity: Differences between patients with and those without a history of conduct disorder in childhood or adolescence

Much epidemiological evidence converges in identifying distinct types of individuals suffering from schizophrenia who exhibit aggressive behavior: those with and those without a history of conduct disorder (CD) in childhood or adolescence. In this study a sample of Greek forensic patients suffering from psychotic disorders was examined regarding demographic, clinical, legal and psychometric characteristics. All patients had committed a crime and were found not guilty by reason of insanity (NGRIs) in a court of law. This study aims to clarify whether history of conduct disorder leads to greater violence or shapes the index offense in some way. It also aims to examine new parameters, such as psychopathology, personality traits, substance abuse and risk assessment, not included in the relevant literature so far, and whether they are relevant and why in this specific group of patients. The sample was divided in two groups depending on the history of CD or not, and subsequently statistically significant differences were explored between the groups. The research aimed to highlight specific characteristics of both groups with the ultimate goal of making more accurate prognosis regarding risk assessment, as well as determining different needs for treatment in each group (e.g. drug abuse). Overall, 78 forensic psychiatric records of NGRI offenders were identified throughout a five-year period in the Psychiatric Hospital of Thessaloniki (January 2015 to January 2020), who were divided into two groups depending on the history of conduct disorder in childhood or adolescence (N = 30) or not (N = 48). The two groups were compared regarding hostility and aggression (with the Hostility and Direction of Hostility Questionnaire-HDHQ and the Aggression Questionnaire), personality traits (with the Zuckerman- Kuhlman Personality Questionnaire-ZKPQ), dangerousness (with the Historical, Clinical and Risk Management 20- HCR-20 scale), addiction (with the Addiction Severity Index-ASI), previous violent behavior or convictions (with a semi-structured tool), and psychopathology current and at the time of the index (with the Positive And Negative Syndrome Scale-PANSS). Comparing the two groups (with CD history vs. without CD history) we found that patients with a history of conduct disorder had significantly higher compulsory hospitalization rates up to the time of the perpetration of the offense and a significantly higher rate of illicit drug use. While they were more likely to exhibit violent behavior before the index offense, it was noted that they committed fewer crimes against life. They were younger at the index offense and they presented with more severe positive symptomatology at the time of the research and a steadily high risk assessment score. Our findings underline the importance of diagnosing CD in early life and subsequently raising awareness when this individual develops schizophrenic disorder, thus emphasizing the need for appropriately targeted interventions in each case. Our research also illustrates that forensic patients with both schizophrenia and a history of conduct disorder before the age of 15 exhibit more severe psychopathology after the index crime even after long hospitalization and treatment. Our findings illustrate that the diagnosis of CD in psychotic offenders found not guilty by reason of insanity affects their dangerousness in general, but not the severity of the crimes committed.

Adult abuse and poor prognosis in Taiwan, 2000–2015: a cohort study

BackgroundTo investigate the risk of poor prognosis regarding schizophrenic disorders, psychotic disorders, suicide, self-inflicted injury, and mortality after adult violence from 2000 to 2015 in Taiwan.MethodsThis study used data from National Health Insurance Research Database (NHIRD) on outpatient, emergency, and inpatient visits for two million people enrolled in the National Health Insurance (NHI) from 2000 to 2015. The case study defined ICD-9 diagnosis code N code 995.8 (abused adult) or E code E960-E969 (homicide and intentional injury of another). It analyzed first-time violence in adults aged 18–64 years (study group). 1:4 ratio was matched with injury and non-violent patients (control group). The paired variables were sex, age (± 1 year), pre-exposure to the Charlson comorbidity index, and year of medical treatment. Statistical analysis was conducted using SAS 9.4 and Cox regression for data analysis.ResultsIn total, 8,726 individuals experienced violence (case group) while34,904 did not experienced violence (control group) over 15 years. The prevalence of poor prognosis among victims of violence was 25.4/104, 31.3/104, 10.5/10,4 and 104.6/104 for schizophrenic disorders, psychotic disorders, suicide or self-inflicted injury and mortality, respectively. Among adults, the risks of suicide or self-inflicted injury, schizophrenic disorders, psychotic disorders, and mortality after exposure to violence (average 9 years) were 6.87-, 5.63-, 4.10-, and 2.50-times (p < 0.01), respectively, compared with those without violence. Among males, the risks were 5.66-, 3.85-, 3.59- and 2.51-times higher, respectively, than those without violence (p < 0.01), and they were 21.93-, 5.57-, 4.60- and 2.46-times higher than those without violence (p < 0.01) among females.ConclusionThe risk of poor prognosis regarding schizophrenic disorders, psychotic disorders, suicide, or self-inflicted injury and mortality after adult violence was higher than in those who have not experienced a violent injury. Adults at the highest risk for violent suicide or self-inflicted injuries due to exposure to violent injuries —males were at risk for schizophrenia and females were at risk for suicide or self-inflicted injuries. Therefore, it is necessary for social workers and medical personnel to pay attention to the psychological status of victims of violence.

Exploring Inflammasome/Cytokine/Insulin cascade as converging landscape for AD, Schizophrenia(SCHIZO), and COVID‐19 syndrome: synthesis of evidence and Post‐hoc analysis of Ginsans‐115 RCT in treatment‐resistant‐schizophrenia

AbstractBackgroundAmid COVID‐19 pandemic, issue is raised: 1) whether AD and Very‐late‐onset‐schizophrenia‐like psychosis(VLOSL): “dementia praecox” have higher COVID‐19 risk;2)whether dysregulated cross‐talk of immunity and inflammation, in Inflammasome‐Cytokine‐insulin signaling cascade (IFCI) is the missing link for AD, VLOSL and COVID‐19.MethodOur objective is : 1) to conduct Pub‐med search for crucial role of inflammasome‐cytokine‐insulin cascade(IFCI) in AD, VLOSL and COVID‐10 burden; 2a)to examine using RCT data whether in schizophrenia, cognitive impairment correlates with insulin resistance(IR) and cardio‐metabolic risks (CMR);2b)whether Panax Ginseng, as prime executioner of IFCI, modifies IR,CMR in TRS.ResultIn Part1: our Pubmed search concludes Dementia syndrome carries higher mortality risk. A meta‐analysis of 634,338 COVID‐19 patients from 16 studies reveals that schizophrenia, and dementia, significantly increased risk of COVID‐19 mortality and severity. Cardio‐metabolic risk factors modify the link. A large Swedish cohort study and systematic review of 17studies found evidence of VLOSL carries higher risk of dementia. Aberrant IFCI correlated with COVID‐19 severity, but very few data is available for Long‐COVID‐19 syndrome. Effect sizes cannot be calculated due to sample heterogeneity. In Part 2: post‐hoc analysis of Ginsana‐115 (Boehringer‐Ingelheim‐Pharmaton,Switzerland) of 8‐week placebo‐controlled parallel group design in TRS subjects . Log‐IR(insulin resistance) scores significantly correlated with spatial processing (p = 0.017). Framingham‐Risk‐score correlated inversely with visual perception p = 0.040) and spatial processing (p = 0.029) and neurocognitive index (p = 0.090). Systolic blood pressure (sBP) correlated significantly and inversely with visual perception (p = 0.032),speed (p = 0.010),and spatial processing (p = 0.034), HDL correlated with memory score:p = 0.008. Brief‐Psychiatric‐Rating‐Scale:BPRS correlated significantly with executive reasoning (p = 0.047),memory (p = 0.021), and mental inflexibility (p = 0.026). Ginsana‐115 at 100‐mg/200‐mg significantly reduced FRS by 24.1% compared with 16.1%(P&lt;0.05) and systolic blood pressure (P&lt;0.05) and significantly improved lipid profile in raising HDL and lowering LDL. Ginsana‐115 : 100 mg and 200 mg oral dosage, significantly improved negative symptom of apathy akin to AD.ConclusionInflammasome‐Cytokine‐Insulin signaling (IFCI) appears to be the heuristic model integrating COVID‐19 syndrome, late‐onset schizophrenia overlapping with AD. Longitudinal studies are warranted to validate IFCI as the prime driver. The positive findings of Ginsana‐115 in TRS highlight the therapeutic Pandora box of Diet, drug leads and Exercise targeting specifically the IFCI landscape in COVID‐19 syndrome, AD and VLOSL.

Multi-dimensional recording of long-term treatment of patients with schizophrenic disorders compared to patients with major depression measured with the ASSESS battery

BackgroundThe aim of the study was to validate the course and outcome of treatment in patients with schizophrenic disorders and to compare it with those of patients with depression using a multidimensional assessing approach measuring psychopathological, social and cognitive levels of functioning. MethodsWe recruited N = 86 chronically ill patients, n = 41 with schizophrenic disorders and n = 45 with depression and examined them by means of the ASSESS battery with 5 measuring points within one year. ResultsPsychopathological symptoms and cognitive functioning changed over time, but still remained. Furthermore, changes in functional ability in the psychosocial area were observed in the overall collective. The course of the patients with schizophrenic disorders differed especially from that of the patients with depression in relation to the domain personal relationships. In both groups, symptoms of the disease correlated negatively with cognition and psychosocial functioning. Cognitive deficits were associated with a reduced level of psychosocial functioning. DiscussionThe ASSESS battery proved to be a practicable measuring instrument for complex assessment of the course of the disease in patients with schizophrenic disorders as well as depression. The stable course of symptoms in both disorders as well as psychosocial differences would have to be further confirmed in long term studies to derive necessary treatment recommendations.

'Acquired idiotism', by Frederik Lange (1883).

The little-known writing by Frederik Lange translated in this Classic Text belongs to what can be called the prolegomenal history of the construction of the concept of schizophrenia. It describes one effort to capture the convergence of certain words of diverse coinage (dementia praecox, acquired idiocy, hebephrenia, heboidophrenia, etc.) with some newly accepted concepts (e.g. the temporalization of madness and the view that adolescence was an independent period of life), and with some old behaviours (which for centuries had been called madness, the portmanteau soon to be rebaptized as psychosis). This convergence culminated in the work of Kraepelin, who was to call it 'dementia praecox'. Lange's transitional efforts and pangs can be sensed as he struggles to describe a new form of madness that affects young people.

Application of Antipsychotic Medication: Gender Differences in Tolerance and Medication Response

This paper covers the role of gender factor in the efficacy and tolerance of antipsychotic therapy in patients with schizophrenic spectrum disorders. The author describes phenomenology of definitions that characterizes differences between male and female sexes. The authors give the data on biological basis of gender differences, frequency of occurrence and clinical features of neuroendocrine dysfunctions (NED) in patients with schizophrenic spectrum disorders during the therapy by first and second generations antipsychotics. It is shown that female patients are more “vulnerable” for some NED. It is emphasized that the problem of tolerance is now more relevant and significant in comparison with the efficacy of antipsychotics, because intolerance or poor tolerance are one of the most common reasons for non-adherence to therapy up to the complete abandonment of it.

Prevalence and Predictors of Relapse among Patients with Schizophrenia at Psychiatric Healthcare Institutions in North-Western Nigeria

Background: Nigerians with Schizophrenic disorder are experiencing multiple relapses during the course of the illness. Relapse is disabling and distressing, associated with progressive functional deterioration as well as worsening treatment response and clinical prognosis.&#x0D; Aim: Thestudy aims to assess the prevalence and predictors of relapse among patients with Schizophrenia in North-western Nigeria.&#x0D; Methods: A cross-sectional descriptive design was employed to conduct the study in Federal Neuro-Psychiatric Hospital Kaduna, Kano State Psychiatric Hospital Dawanau, and Federal Neuro-Psychiatric Hospital Kware, Sokoto States. The Population of the study constitutes all patients with schizophrenia attending the outpatient units of the Hospitals with a sample size of 464 patients a crossed the facilities. A purposive sampling technique was used in the study to recruit respondents. Self -structure Questionnaire was the instrument for data collection. Data collected were analyzed using SPSS Version 23 and presented using mean, standard deviation, frequency, and percentages. Regression analysis was used at a 0.05 level of significance to determine predictors of relapse..&#x0D; Results: Findings revealed that from the year 2018 to 2020, the prevalence of relapse among patients with schizophrenia is very high in the year 2020 with 71% relapse in Kano state, 40% relapse in Sokoto state, and 14% relapse in Kaduna state. The study shows that co-morbid illness, stressful life events, and inadequate mental health services are predictors of relapse (p&lt;0.05).&#x0D; Conclusion: The study concludes that personal, social, and health facility factors are predictors of relapse among patients with Schizophrenia in North-west Nigeria.&#x0D; Recommendations: Emotional and social support like halfway home, assertive community therapy, self -help groups should be provided to patients with schizophrenia, as these can play a vital role in their response to the ailment thereby reducing relapse and the prevalence of the disease.

De l’aliénation mentale de l’enfant et de l’adolescent à la pédopsychiatrie dans les communications à la Société Médico-Psychologique de 1852 à 1937

In 1848, the Société Médico-Psychologique was founded. Its aims is to promote the study and improvement of mental pathology. During the 19th century, François Arnaud (1858–1927), Claude-Etienne Bourdin (1815–1886), Michel Catsaras (1860–1939), Louis Delasiauve (1804–1893), Eugène Dally (1833–1887), Jules Fournet (1812–1888), Paul Garnier (1848–1905), Valentin Magnan (1835–1916), Jacques-Joseph Moreau De Tours (1805–1884), Emmanuel Régis (1855–1918), Paul Sollier (1861–1933), Edouard Toulouse (1865–1947), Auguste Voisin (1829–1898) and Jules Voisin (1844–1920) were the alienists or not, French or foreigners who succeeded at the chair of the Société Médico-Psychologique. This later presented observations of children or teenagers. The communications and discussions but also the issues raised by the alienists, neuro-psychiatrists then child psychiatrists will contribute to the reflections of members of the Société Médico-Psychologique over the course of the last century. But, they also forced us to take a more perceptive look at the child's mental health. Its communications and their authors belong to their time and to a time or even a place where they emerged. Apart from to looking into the topics pursued (deficiency, dementia praecox, epidemic encephalitis, autism, etc.) concerning the infantojuvenile psychiatry, we will carry out a work of communications contextualization focused on the child's mental health at the Société Médico-Psychologique during 170 years.

Rüdin's 1916 Monograph: On the Inheritance and Primary Origin of Dementia Praecox.

In 1916, Ernst Rüdin published the first modern family study in the history of psychiatric genetics, the major goal of which was to test whether the pattern of risk in the siblings of dementia praecox (DP) probands followed Mendelian expectations. He utilized systematic ascertainment of probands and multisourced diagnostic assessments of probands and relatives, applying the narrow Kraepelinian concept of DP. In a novel step, he collaborated closely with a statistical geneticist-Wilhelm Weinberg-and applied his sibling, proband, and age correction methods. In his key sample-701 sibships when neither parent had DP-the morbid risk for DP in siblings was 4.48%, much lower than 25% expected for a recessive disorder. Risk for DP was increased by alcoholism or other mental disorders in parents. Other non-DP psychoses were common in both siblings and parents of DP probands. Rüdin discussed several alternative genetic models for DP including a 2-locus recessive, incomplete penetrance, and an oligogenic model. The high rates of other psychoses and psychopathic personalities in relatives might arise, he suggested, because these disorders shared genetic risks with DP. Rüdin established that DP, when carefully studied, ran in families, did not have a simple Mendelian genetic transmission pattern, and appeared likely to be genetically related to other non-DP psychotic disorders and perhaps some kinds of psychopathic personalities. This study, the most important in Rüdin's career, should be viewed in the context of his later extensive support of and collaboration with Nazi eugenic policies.

Hermann Hoffmann's 1921 Monograph: "The Offspring of Endogenous Psychoses: Genealogical-Characterological Examinations".

Five years after the publication of Rüdin's major sibling study, Hermann Hoffmann, working with Rüdin, performed the first systematic study of the risk for dementia praecox (DP) in offspring of DP probands. Field work was limited to 3 months. Hoffmann ascertained families with at least one parent with certain DP, after Kraepelin, with children the youngest of whom were at least 30 years old. These families contained 103 offspring 30 years or older of whom 7 had definite DP and two possible DP for an estimated risk of 6.8%-8.7%. Hoffmann assessed schizoidia in these children, reporting the quite high risk figure of 47.6%. Hoffmann explored a wide range of two and three locus recessive models in his modest sample. He finds Rüdin's two locus recessive model at the boundary of his results and then reviews three additional more complex models. The simplest is a three-locus recessive model which fits his data better. He also explores an oligogenic three locus model with risk classes of individuals with 1 to 6 risk alleles and an epistatic model where two loci form a di-recessive model for schizoidia, and the third locus is a dominant required for the expression of psychosis. Hoffman questioned whether DP was a "unit-character" appropriate for Mendelian analysis and advocated for a much larger study of offspring. His work should be appreciated in light of his enthusiastic endorsement of Nazi eugenic goals.