Severity Of Schizophrenic Symptoms Research Articles

Nerve growth factor serum levels in treatment-resistant schizophrenic patients following electroconvulsive therapy.

Electroconvulsive Therapy (ECT) has been widely applied to treat schizophrenia (SCZ) in the presence of resistance to pharmacotherapy. The mechanism of action of ECT in schizophrenia has not been fully clarified, though its intrinsic mechanism presents analogies with some neurobiological processes mediated by nerve growth factor (NGF). The aim of this study was to investigate in patients with treatment-resistant schizophrenia (TRS) the effect of ECT on acute and long-term NGF serum levels and the association with the clinical outcomes. Twelve male inpatients with TRS underwent eight sessions of ECT. Blood samples were collected during the first and the eighth ECT at the following time points: 5 minutes before the induction of seizure and then at 0, 5, 15 and 30 minutes after seizure. Following ECT treatment, a substantial clinical improvement in symptom severity was indicated by a significant reduction in the Positive and Negative Syndrome Scale (PANSS) total and subscales scores. Even though the baseline NGF levels showed an increase over time, there were no statistical differences in NGF at time 0 at the first and the eighth ECT session. Furthermore, no correlation was observed between the severity of schizophrenic symptoms and NGF levels. This is the first study addressing peripheral NGF during ECT treatment in TRS, as well as the first study in which NGF has been evaluated in different ECT sessions at various time points. These findings may potentiate the knowledge about the neurotrophic effects of ECT and the role of NGF in synaptic plasticity related to possible mechanisms of schizophrenia treatment.

Colour discrimination among patients with schizophrenia in Lebanon

Background: Abnormalities and contrast sensitivity have already been studied in schizophrenia. However, the relationship between symptom severity in schizophrenia and colour vision sensitivity has not been studied systematically.Aim: Our objective was to evaluate colour discrimination in patients with schizophrenia compared to controls and examine if this colour discrimination is correlated with schizophrenia symptoms’ severity.Methods: This case–control study, performed between January and April 2017, included 50 schizophrenic patients and 50 healthy controls matched for age and sex. The Positive and Negative Symptoms Scale (PANSS) was used to determine the schizophrenia symptoms’ severity. Colour discrimination was evaluated using the total error score (TES) generated using the Farnsworth D-15 test. The higher the TES, the more severe colourblindness.Results: A significantly higher mean TES was found in schizophrenics (30.32) compared to healthy patients (13.07) (p < 0.001). Colour blindness was correlated to the severity of schizophrenic symptoms only in the subgroup of patients with severe schizophrenia.Conclusion: Colour vision defect is a common feature in schizophrenia, and may be more significant when related to psychotic symptoms.KEY POINTSA significantly higher mean TES was found in schizophrenics compared to healthy patients.Colour blindness was correlated to the severity of schizophrenic symptoms only in the subgroup of patients with severe schizophrenia.Colour vision defect is a common feature in schizophrenia, and may be more significant when related to psychotic symptoms.

A case of GABAR antibodies in schizophrenia

BackgroundIn the last couple of years, schizophrenia was often discussed as autoimmune disease. Several antibodies were suspected, but so far there has been no proof of Gamma-aminobutyric acid (GABA) receptor antibodies in patients with schizophrenia.Case presentationIn this case report we present a 21-year old woman with schizophrenic symptoms, who showed anti-GABAB1 antibodies when screened by a vast recombinant neurology mosaic on Human Embryonic Kidney Cells 293 (HEK293) cells. The young woman presented with various psychotic symptoms as well as speech and motor ataxia, with the neurological signs starting in childhood.ConclusionA hypofunction of the GABAergic system is a possible cause of severe schizophrenic symptoms. Postmortem studies proved this hypothesis by showing dysfunctional GABAergic interneurons in various brain areas. Therefore one should always think of an immune-mediated pathogenesis as well memory impairment and behavioral changes co-occur with frequent seizures.

Is it love or an identity crisis?

Purpose – This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies. Design/methodology/approach – This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context. Findings – There are several striking similarities between “brand love” and “brand attachment”. The politics of marketing theory are at work in keeping these constructs away from each other, the literature under scrutiny not only suffers from amnesia, but also from some severe schizophrenic symptoms, and brand attachment and brand love are no more than the same core knowledge product offered under different brand names. Practical implications – The paper provides strategic insights and practical thinking that have influenced some of the world’s leading organizations. Originality/value – The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

Low Dose Celecoxib Combined with Clozapine for Treatment of Schizophrenia: A Double Blind Randomized Clinical Trial

Introduction: Higher levels of pro-inflammatory cytokines in schizophrenia have suggested that dysfunctions of the immune system may play a role in this disabling condition. The current study was performed to discover if low dose celecoxib combined with clozapine may improve symptoms of schizophrenia or not. Methods: In a double-blind randomized clinical trial, 40 patients with non- treatment resistance schizophrenia were allocated into two groups. The experimental group received flexible and low dose clozapine plus 200 mg/day of celecoxib for 4 weeks, while the control group received clozapine plus placebo. Experimental and control groups were similar in terms of age, gender, clozapine mean dosage and severity of schizophrenic symptoms at baseline. Main outcomes were severity of schizophrenia symptoms measured by the Positive and Negative Syndrome Scale (PANSS) at baseline followed by the second and fourth weeks. Results: Although both groups experienced significant improvement in all PANSS sub-scales in the second and fourth weeks (P 0.05). Conclusion: Our findings did not support the findings of prior studies that report a significant effect for celecoxib combined with atypical antipsychotics. Such inconsistency may be due to statistical power, drug interactions between clozapine and celecoxib, and the low dose of celecoxib used in this study. Future research is needed on the role of anti-inflammatory medications as adds-on treatments for schizophrenia. Keywords: Celecoxib, Clozapine, Schizophrenia, Randomized Controlled Trial

I may be a twin but I’m one of a kind

Purpose– The aim of this paper is to critically review the most significant writings on “two” constructs that have quickly acquired the status of “important marketing topics”; that is, brand attachment (BA) and brand love (BL).Design/methodology/approach– A profound and parallel inspection of highly influential articles along with ensuing essays by the same single authors is performed.Findings– This review reveals that: hardly a year goes by without some reinventions or retouching of these constructs’ conceptual characteristics; there are several striking similarities between them; the politics of marketing theory are at work in keeping these constructs away from each other; the literature under scrutiny not only suffers from amnesia, but also from some severe schizophrenic symptoms; and that BA and BL are nothing more than the same core knowledge product offered under different brand names.Research limitations/implications– This review is limited to considering the constructs of BA and BL.Originality/value– Because the literature on BA and BL has been essentially empirical, this paper has the potential to add a compulsory conceptual component to it. It also has the potential of instigating discussions, debates and, in due course, a deeper understanding of these “two” constructs.

Aberrant neural responses to social rejection in patients with schizophrenia

Patients with schizophrenia often show abnormal social interactions, which may explain their social exclusion behaviors. This study aimed to elucidate patients’ brain responses to social rejection in an interactive situation. Fifteen patients with schizophrenia and 16 healthy controls participated in the functional magnetic resonance imaging experiment with the virtual handshake task, in which socially interacting contents such as acceptance and refusal of handshaking were implemented. Responses to the refusal versus acceptance conditions were evaluated and compared between the two groups. Controls revealed higher activity in the refusal condition compared to the acceptance condition in the right superior temporal sulcus, whereas patients showed higher activity in the prefrontal regions, including the frontopolar cortex. In patients, contrast activities of the right superior temporal sulcus were inversely correlated with the severity of schizophrenic symptoms, whereas contrast activities of the left frontopolar cortex were positively correlated with the current anxiety scores. The superior temporal sulcus hypoactivity and frontopolar hyperactivity of patients with schizophrenia in social rejection situations may suggest the presence of mentalizing deficits in negative social situations and inefficient processes of socially aberrant stimuli, respectively. These abnormalities may be one of the neural bases of distorted or paranoid beliefs in schizophrenia.

Lexical tone and consonant perception in subtypes of Schizophrenia

Auditory hallucination is one of diagnostic criteria of schizophrenia and might negatively affect speech perception. Among subtypes of schizophrenia, the persistent delusion/hallucination (PDH) group persistently shows auditory hallucinations after 6 months of admission. This study aims to examine whether hallucinations affect lexical tone and consonant perception in Mandarin-speaking adults. Two groups of adults with chronic schizophrenia, PDH (n =15, mean age = 44 yr) and non-hallucination group (n =17, mean age = 39 yr), and age-matched control group (n = 16, mean age = 36 yr) in Taiwan were tested. For lexical tone perception, results showed that adults with schizophrenia were less accurate than typical controls on discriminating the lexical tones, and the PDH group performed poor than patients without hallucination. The lexical tone accuracy negatively correlates with the severity of schizophrenic symptoms (r = −0.559, p < 0.001, measured with Positive and Negative Syndrome Scale for schizophrenia). For consonant perception, patient groups showed poor perceptual organizations for affricates than control group. Moreover, the perceptual organization of PDH group is more distorted than non-hallucination group. In brief, adults with chronic schizophrenia exhibit speech perception deficits, and these deficits might be the result of a distorted perceptual organization.

Lay Diagnoses and Views on Causes, Coping Strategies, and Treatment for Schizophrenia

We aimed to clarify the relationship between lay diagnoses and perspectives on schizophrenia regarding causes, coping strategies, treatments, prognosis with and without the help of specialists. Our study sample was 500 adults in Japan. Participants read a vignette that depicted moderate to severe schizophrenic symptoms and yielded lay diagnoses. They also expressed their perspectives on the cause of the status in the vignette and coping strategies. We examined the relationship between lay diagnoses and the perspectives. Participants labeled the vignette as 'stress' held low expectations for the effectiveness of mental health professionals and psychiatric treatment. To enhance mental health literacy, it is important to help people distinguish a mental illness from mere stress. Lay diagnoses do not necessary have to be detailed, as long as people recognize a situation as an illness.

Relationship between heart rate variability and the severity of psychotic symptoms in schizophrenia.

Kim J-H, Ann J-H, Lee J. Relationship between heart rate variability and the severity of psychotic symptoms in schizophrenia.Objective: The relationship between autonomic neurocardiac function and schizophrenia remains elusive. This study investigated the relationship between the heart rate variability (HRV) parameters and the severity of psychotic symptoms in schizophrenic patients.Methods: Twenty-one patients receiving risperidone monotherapy and 21 matched normal control subjects were evaluated for HRV analysis. The severity of schizophrenic symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS) and a five-factor model of the PANSS was used.Results: The value of the ratio of low-to-high frequency spectral power was significantly higher in the patient group. The patient group also showed a significantly lower value of approximate entropy. After controlling the dosage of risperidone, the PANSS total score had significant negative correlations with the standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal sinus intervals (RMSSD). With respect to the PANSS factors, the score of the PANSS cognitive/disorganisation factor had significant negative correlations with SDNN and RMSSD.Conclusion: These results provide some evidence that the severity of psychotic symptoms, especially cognitive/disorganisation symptom dimensions, may be associated with reduced HRV, suggesting a potential involvement of neuroautonomic dysfunction in the pathophysiology of specific symptoms of schizophrenia.

Obstetrical Complications, Social Class and Type of Schizophrenia

The emerging neurodevelopmental model posits that prenatal and perinatal factors can play an etiological role in schizophrenia. Consistently, the research on obstetrical complications (OCs) reports an association with the development of more severe schizophrenic symptoms. Low socioeconomic status (SES) has also been linked to both limited prenatal healthcare and to worse prognosis of schizophrenic symptoms. A large sample (n=437) of patients from a state hospital population in the U. S. was screened for study variables. A sequential analysis was conducted, first applying cross tabulations using the chi-square test, and then building separate logit models for poor and nonpoor patients. The cross tabulations indicated an association between OCs and negative symptoms for poor schizophrenic patients, but not for nonpoor patients. Multivariate logit models further supported this result. This is the first study to examine the interaction of OCs, schizophrenic symptomatology and SES of origin.

Obsessive-compulsive disorder and obsessive-compulsive symptoms in Japanese inpatients with chronic schizophrenia – A possible schizophrenic subtype

To investigate the prevalence of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) and their association with demographic and clinical factors, 92 inpatients with chronic schizophrenia participated in this study. Demographic factors, severity of psychiatric symptoms as determined by Brief Psychiatric Rating Scale and OCS by Yale–Brown Obsessive Compulsive Scale, general functioning, extrapyramidal symptoms, and dose of antipsychotics were compared between patients with and without OCD or OCS. The Mini-International Neuropsychiatric Interview was employed for diagnosis of OCD and OCS. OCD and OCS were observed in 14.1% and 51.1% of inpatients with schizophrenia, respectively. Schizophrenic patients with OCS exhibited significantly earlier onset of schizophrenia, lower socioeconomic status, and more severe psychiatric symptoms than those without OCS. Earlier hospitalization of schizophrenia, family history of psychosis, and more severe schizophrenic symptoms were associated with comorbidity of OCS, as determined by logistic regression analysis, and younger age was associated with more severe OCS. However, negative symptoms were associated with comorbidity of OCD in chronic schizophrenia. Our findings suggest there is a subtype of schizophrenia with OCS, which is related to earlier onset and more severe psychotic symptoms.

Plasma alanine levels increase in patients with schizophrenia as their clinical symptoms improve—Results from the Juntendo University Schizophrenia Projects (JUSP)

Since oral administration of d-alanine, an agonist that binds to the glycine site of N-methyl- d-aspartate (NMDA) receptors, improves the positive and cognitive symptoms of patients with schizophrenia, measurement of endogenous plasma alanine levels could serve as a clinical marker for schizophrenia severity and improvement. Mean plasma alanine levels were compared in healthy controls and patients with schizophrenia during the clinical course of the disease. Methods: eighty-one Japanese patients with schizophrenia and 50 age- and gender-matched healthy controls were studied. Plasma alanine levels were measured twice, during the acute stage and during the remission stage, using high-performance liquid chromatography. On admission, lower plasma alanine levels in patients with schizophrenia were accompanied by more severe schizophrenic symptoms, especially positive symptoms. The plasma alanine levels in patients with schizophrenia increased significantly from the time of admission to discharge, when they were significantly higher than control levels. An increase in plasma alanine levels from the acute stage to the remission stage of schizophrenia was correlated with improvement in symptoms. Drug-naïve patients did not show a significant difference in plasma alanine levels when compared with healthy controls. The measurement of plasma alanine levels may be a therapeutic marker for schizophrenia.

Short Communication

A previous epidemiological study found an association between high sugar consumption and two year outcome of schizophrenia. The primary aim of the present pilot study was to assess the possible relationship between dietary sugar intake and the severity of schizophrenic symptoms in a group of 20 patients. A significant negative correlation ( r =−0.54 , p =0.02 ) between dietary sugar and severity of schizophrenic symptoms, appears to be confounded by the effect of medication. Patients taking the antipsychotic drug clozapine consumed almost twice as much sugar as those taking other antipsychotic agents, (235.4±92.6 g/day versus 143±59, p =0.02 ) and had less severe symptoms. Consumption of other nutrients showed no association with clozapine treatment. In a secondary analysis, severity of schizophrenic symptoms correlated with dietary intake of polyunsaturated fatty acids ( r =−0.54 , p =0.02 ) and this was independent of the effect of medication. This finding is consistent with earlier studies.

Association between severity of schizophrenic symptoms and urinary retention

A case is presented in which severe urinary retention (UR) occurred during an acute psychotic exacerbation of paranoid schizophrenia. The voiding dysfunction was apparent during continuous treatment with unchanged doses of haloperidol, and it completely resolved with the remission of the psychotic symptoms. A clear temporal correlation was evident between the patient’s mental status, the Brief Psychiatric Rating Scale (BPRS) score and the degree of the UR as assessed by quantitatively measuring the total daily postvoiding urine residues. We could not relate the UR to any apparent general medical condition or to the haloperidol treatment. The presented data suggests that UR in schizophrenic patients might be the end-result of various psychosis-related mechanisms.

Skin conductance and schizophrenic symptomatology.

Skin conductance is a psychophysiological parameter that reflects fundamental processes such as attention and arousal. The present study explored whether deviations in skin conductance activity are associated with severity of schizophrenic symptoms. For this purpose, Skin Conductance Responses (SCRs) to discrete stimuli (80 dB noises) and Skin Conductance Levels (SCLs) of 37 schizophrenic patients and 31 healthy volunteers were recorded. In accordance with previous studies, schizophrenic patients were found to be hyporesponsive compared to healthy controls. More specifically, almost half of the patients (46%) did not react with any SCR to the first 3 stimuli, whereas only 10% of the control group exhibited such a non-responding. Accordingly, the mean amplitude of the first 3 SCRs - as measured in u Siemens - was found to be significantly lower in patients compared to controls. As well, mean SCL was found to be (marginally) elevated in the patient group. This was especially the case for patients who did exhibit SCRs. In the patient group, a negative correlation was found between amplitude of SCRs and symptom severity. This association was mainly carried by a significant correlation between positive symptoms and reduced SCRs. The clinical relevance of these findings is discussed in detail.

Clinical symptoms of schizophrenia affect reference-independent measures of task-induced EEG alpha asymmetry

Differential patterns of EEG alpha asymmetry during verbal and spatial cognitive activity are commonly described and are thought to reflect predominance of left- vs. right-sided cortical activation. Although these patterns have been difficult to elicit reliably in schizophrenics, the authors have previously suggested that clinical status may have confounded results. Therefore, EEG data from 17 additional schizophrenic patients, 16 mood disorder patient controls, and 17 normal controls were used to examine the relationship between severity of schizophrenic symptoms and task induced alpha asymmetry. Subjects performed verbal and spatial tasks during recording of 16-channel EEG. After transformation to the average reference, log alpha power from central and temporal leads was analyzed by MANOVA and MANCOVA. The expected task-side interaction ( P < 0.02) was present for the total sample and for each control group when analyzed alone. However, it was only present in schizophrenics when the BPRS score was entered as a covariable. Patterns of correlations between BPRS scores, left temporal alpha power, right/left temporal alpha ratios, and task differences in ratios suggested that higher symptom levels were associated with excessive left-sided activation during spatial activity. This is consistent with other evidence of left hemisphere overactivity in schizophrenics.

A conceptual model of quality of life in schizophrenia: description and preliminary clinical validation.

The utility of quality of life (QOL) as an evaluative tool in clinical psychiatric research and drug trials could be enhanced by developing appropriate conceptual models of QOL, specific for psychiatric disorders. In our proposed model, QOL of individuals maintained on antipsychotic drug therapy for schizophrenia, is viewed as the subject's perception of the outcome of an interaction between severity of psychotic symptoms, side-effects including subjective responses to antipsychotic drugs, and the level of psychosocial performance. In order to test the validity of the model in clinical setting, we selected a sample of 62 schizophrenic patients clinically stabilized on antipsychotic drug therapy, and measured their subjective QOL and other potentially relevant clinical and psychosocial factors. Standardized scales including the positive and negative syndromes scale (PANSS), abnormal involuntary movements scale (AIMS), Hillside Akathisia scale (HAI), and the social performance schedule (SPS) were used for this purpose. Results of a multiple regression analysis using subjective quality of life as the outcome variable, indicated that severity of schizophrenic symptoms (partial R2 = 0.32, p < 0.0001) and subjective distress caused by akathisia (partial R2 = 0.11, p < 0.01) and neuroleptic dysphoria (partial R2 = 0.06, p < 0.05), accounted for nearly half of the variance, while the contribution from the psychosocial indicators was negligible. These results broadly endorse key aspects of the proposed model, and suggest further studies in this direction. These results experiences during antipsychotic therapy can enhance patients' QOL. This conceptual model has been developed with particular focus on the impact of antipsychotic medications on the QOL of persons with schizophrenia. As such, it is more applicable to clinical trials of new antipsychotic medications but may not be broad enough to be applicable for other social or vocational interventions.

Correlation between reduced in vivo benzodiazepine receptor binding and severity of psychotic symptoms in schizophrenia.

Although there is evidence from postmortem studies suggestive of deficient inhibitory neurotransmission of gamma-aminobutyric acid (GABA) in schizophrenia, no direct in vivo evidence has been obtained to date. The authors used single photon emission computed tomography (SPECT) with iodine-123-labeled iomazenil ([123I]iomazenil), a radioligand that selectively binds with high affinity to the benzodiazepine subunit of the GABAA receptor complex in the human brain, to investigate the presence of benzodiazepine receptor abnormalities in the cerebral cortex of living subjects with schizophrenia. Dynamic [123I]iomazenil SPECT was performed in 15 patients (14 patients with DSM-III-R schizophrenia and one with schizophreniform disorder) and 12 healthy subjects over a period of 2 hours. The time-integral method was used to generate ratios of "specific" to "nonspecific" [123I]iomazenil binding at equilibrium for several cortical regions. No overall between-group differences in benzodiazepine receptor binding were found, but significant correlations emerged between the severity of schizophrenic symptoms and [123I]iomazenil binding in limbic cortical regions: positive symptom scores were negatively correlated with benzodiazepine receptor binding in the left medial temporal region, and negative symptoms were inversely related to receptor binding in the medial frontal region. These correlations were not significant when a Bonferroni correction for multiple comparisons was applied. These preliminary results are consistent with previous research implicating limbic cortical regions in the pathophysiology of schizophrenia, suggesting that reduced inhibitory GABAergic tone in these areas may contribute to the appearance of schizophrenic symptoms.

Relationships between symptoms of schizophrenia and substance abuse.

Previous work posits that severity of substance abuse and severity of schizophrenic symptoms should be linked by either or both of two mechanisms: self-regulation of symptoms and drug-induced exacerbation of symptoms. Research on these relationships has yielded mixed results. We examined the interrelationships of schizophrenic symptoms and substance abuse in 172 patients with co-occurring disorders. Relationships were weak or nonexistent, without any consistent pattern. Our findings do not support the view that substances are used to self-regulate symptoms. In addition, our results suggest that substance abuse may lead to higher rates of institutionalization through mechanisms other than by exacerbating symptoms.