Treatment Of Schizophrenia Patients Research Articles

Comparative study about the therapeutic effect of cTBS and rTMS in the treatment of auditory verbal hallucinations in schizophrenia.

This study aims to compare the therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) and continuous theta-burst stimulation (cTBS) treatment in schizophrenia patients with auditory verbal hallucinations (AVHs). We enrolled 64 schizophrenia patients with AVHs who were treated with either rTMS (n = 32) or cTBS (n = 32), and we compared the clinical outcomes by evaluating parameters from motor evoked potentials, Positive and Negative Syndrome Scale (PANSS), Auditory Hallucination Rating Scale (AHRS), and MATRICS Consensus Cognitive Battery (MCCB), as well as the changes of serum neurotrophic factors before and after the treatment. After the treatment, both treatments resulted in reduced PANSS scores, with the cTBS group showing more substantial symptom improvement across positive, negative, and general symptoms, highlighting the enhanced efficacy of cTBS. Cognitive functions assessed by MCCB also improved in both groups, with cTBS showing a generally higher therapeutic effect. Serum levels of brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) increased following treatment in both groups, with a more notable increase after cTBS, while GABA and glutamate levels remained unchanged. Cardiovascular indices were unaffected by either treatment, suggesting no significant impact on cardiovascular health. Our study found that both rTMS and cTBS treatment can exhibit therapeutic effects in the management of AVHs in patients with schizophrenia. However, cTBS treatment generally shows a higher therapeutic effect than rTMS treatment.

Gambaran Ketangguhan Keluarga dalam Merawat Pasien Skizofrenia

The prevalence of Schizophrenia in adults is about 1 in 222 people (0.45%). Families caring for members suffering from schizophrenia need to build resilience to cope with the stress and pressure they face. Resilience is the process of staying firm and able to overcome existing sufferings, difficulties, and challenges. The purpose of this study is to find out the picture of family resilience in treating Schizophrenia patients. This type of research is quantitative observational with a descriptive approach. The population consists of all families caring for 100 schizophrenia patients. The number of samples in this study was 80 people with an accidental sampling technique. The family resilience measurement tool uses the Connor-Davidson Resillience Scale (CD-RISC) questionnaire containing 25 statements with aspects of emotional regulation, impulse control, optimism, analysis of the cause of problems, empathy, self-efficacy, and reaching out. Univariate analysis in this study includes frequency distribution. The results of the study showed that family resilience was in the high category as many as 49 people (61.3%), medium category as many as 30 people (37.5%) and low category as many as 1 person (1.2%). It is expected that families will increase family resilience by participating in self-efficacy training, learning skills in relieving existing emotions, focusing on optimism so that they can reduce the stress experienced in caring for their family members who suffer from schizophrenia.

Olanzapine-induced Metabolic Syndrome and its Association with -759C>T Polymorphism of the HTR2C Gene in Iraqi Schizophrenic Patients

The hazardous metabolic effects of treating schizophrenia patients with olanzapine comprise serotonin 2C receptor (5-HT2C) antagonists. Metabolic side effects of antipsychotic drugs, including lipid abnormalities, disturbed glucose metabolism, and weight gain, can have a major impact on treating psychiatric patients. The intent of this study was to investigate whether there is an associated link between the genetic polymorphism at -759C>T in the promoter region of the 5-hydroxytryptamine 2C receptor (HTR2C) gene and the metabolic syndrome driven by olanzapine in schizophrenia patients. A cross-sectional study that involved fifty hospitalized patients with schizophrenia. The patients were split into two groups (metabolic and non-metabolic) according to the classification criteria of the metabolic syndrome. The HTR2C promoter region polymorphism was identified through sequencing using the Sanger method after polymerase chain reaction amplification of the extracted deoxyribonucleic acid. Even though none of the genotypes of the -759C>T variant are associated with the propensity to develop metabolic syndrome, there is a significant difference in the -759C>T variant's T allele (p-value = 0.001). The presence of the T allele in the -759 C/T variant was significantly associated with developing metabolic syndrome. Keywords: Schizophrenic patients, Olanzapine, Genetic polymorphism, 5-hydroxytryptamine 2C receptor (HTR2C) gene, -759C>T.

Influence of physical activity on the health and treatment of schizophrenia patients

influence of physical activity on the health and treatment of schizophrenia patients

Antipsychotic medications and sleep problems in patients with schizophrenia

BackgroundSleep problems are common and related to a worse quality of life in patients with schizophrenia. Almost all patients with schizophrenia use antipsychotic medications, which usually increase sleep. Still, the differences in subjective sleep outcomes between different antipsychotic medications are not entirely clear. MethodsThis study assessed 5466 patients with schizophrenia and is part of the nationwide Finnish SUPER study. We examined how the five most common antipsychotic medications (clozapine, olanzapine, quetiapine, aripiprazole, and risperidone) associate with questionnaire-based sleep problems in logistic regression analyses, including head-to-head analyses between different antipsychotic medications. The sleep problems were difficulties initiating sleep, early morning awakenings, fatigue, poor sleep quality, short (≤6 h) and long sleep duration (≥10 h). ResultsThe average number of antipsychotic medications was 1.59 per patient. Clozapine was associated with long sleep duration (49.0 % of clozapine users vs 30.2 % of other patients, OR = 2.05, 95 % CI 1.83–2.30, p < .001). Olanzapine and risperidone were in head-to-head analyses associated with less sleep problems than patients using aripiprazole, quetiapine, or no antipsychotic medication. Aripiprazole and quetiapine were associated with more insomnia symptoms and poorer sleep quality. Patients without antipsychotic medications (N = 159) had poorer sleep quality than patients with antipsychotic use, and short sleep duration was common (21.5 % of patients not using antipsychotics vs 7.8 % of patients using antipsychotics, OR = 2.97, 95 % CI 1.98–4.44, p < .001). ConclusionsPrevalence of sleep problems is markedly related to the antipsychotic medication the patient uses. These findings underline the importance of considering and assessing sleep problems when treating schizophrenia patients with antipsychotics.

Retrospective evaluation of sociodemographic and clinical characteristics of patients with schizophrenia receiving clozapine monotherapy and clozapine combined with different antipsychotics

IntroductionSchizophrenia is a chronic mental disorder and clozapine is an atypical antipsychotic that can be used in treatment-resistant schizophrenia patients. However, treatment-resistant schizophrenia may also include patients with an inadequate response to clozapine.ObjectivesIn our study, we retrospectively analysed the sociodemographic and clinical characteristics of patients receiving clozapine monotherapy and patients receiving clozapine in combination with different antipsychotics. In this way, we aimed to evaluate the factors that influence the response to clozapine.MethodsClozapine monotherapy and clozapine in combination with different antipsychotics were identified by retrospective chart review of patients followed up at the Schizophrenia and Other Psychotic Disorders Outpatient Clinic, Department of Psychiatry, Faculty of Medicine, Selçuk University. Sociodemographic and clinical characteristics were recorded and subjected to statistical analysis. The study was approved by the Ethics Committee of Selçuk University.Results Of the 143 patients whose data were analysed, 60 (42%) were female. The mean age of the patients was 40.2±12.0 years and the mean duration of training was 10.4±4.3 years. 62 patients (43.4%) used long-acting antipsychotics. 90 patients (62.9%) were using clozapine, 52 (36.4%) were using clozapine as monotherapy, 5 (3.5%) were using clozapine together with another oral antipsychotics drug, and 33 (23.1%) were using clozapine together with a long-acting antipsychotic. No statistically significant difference was found when comparing mean age, age at first antipsychotic initiation, age at clozapine initiation and mean clozapine dose between patients using clozapine monotherapy (n=52) and patients using different antipsychotics in combination with clozapine (n=38). When the two groups were compared, a significant difference was found in the mean number of antipsychotics used before starting clozapine and the mean number of hospitalisations, with a lower number in the monotherapy group (3.1±1.4 vs 4.1±2.0, p=0.01 and 2.8±2.2 vs 4.5±3.2, p=0.006, respectively).ConclusionsIt is important to assess the concept of treatment resistance appropriately in the treatment of schizophrenia patients. The results of our study suggest that starting clozapine treatment promptly in treatment-resistant patients may increase the likelihood that patients will benefit from clozapine and reduce the need for additional treatments. Although our data and criteria for evaluating response to treatment are limited, it is important to draw attention to the clinical results of proceeding in accordance with the guidelines in the treatment of schizophrenia. Evaluating the response to clozapine treatment needs studies with stronger data and larger sample sizes.Disclosure of InterestNone Declared

Effects of Aripiprazole on Olanzapine Population Pharmacokinetics and Initial Dosage Optimization in Schizophrenia Patients.

Olanzapine has already been used to treat schizophrenia patients; however, the initial dosage recommendation when multiple drugs are used in combination, remains unclear. The purpose of this study was to explore the drug-drug interaction (DDI) of multiple drugs combined with olanzapine and to recommend the optimal administration of olanzapine in schizophrenia patients. In this study, we obtained olanzapine concentrations from therapeutic drug monitoring (TDM) database. In addition, related medical information, such as physiological, biochemical indexes, and concomitant drugs was acquired using medical log. Sixty-five schizophrenia patients were enrollmented for analysis using population pharmacokinetic model by means of nonlinear mixed effect (NONMEM). Weight and combined use of aripiprazole significantly affected olanzapine clearance. Without aripiprazole, for once-daily olanzapine administration dosages, 0.6, 0.5 mg/kg/day were recommended for 40-70, and 70-100 kg schizophrenia patients, respectively; for twice-daily olanzapine administration dosages, 0.6, 0.5 mg/kg/day were recommended for 40-60, and 60-100 kg schizophrenia patients, respectively. With aripiprazole, for once-daily olanzapine administration dosages, 0.4, 0.3 mg/kg/day were recommended for 40-53, and 53-100 kg schizophrenia patients, respectively; for twice-daily olanzapine administration dosages, 0.4 mg/kg/day was recommended for 40-100 kg schizophrenia patients, respectively. Aripiprazole significantly affected olanzapine clearance, and when schizophrenia patients use aripiprazole, the olanzapine dosages need adjust. Meanwhile, we firstly recommended the optimal initial dosages of olanzapine in schizophrenia patients.

Genetic prediction of the causal relationship between schizophrenia and tumors: a Mendelian randomized study.

Patients with schizophrenia are at a higher risk of developing cancer. However, the causal relationship between schizophrenia and different tumor types remains unclear. Using a two-sample, two-way Mendelian randomization method, we used publicly available genome-wide association analysis (GWAS) aggregate data to study the causal relationship between schizophrenia and different cancer risk factors. These tumors included lung adenocarcinoma, lung squamous cell carcinoma, small-cell lung cancer, gastric cancer, alcohol-related hepatocellular cancer, tumors involving the lungs, breast, thyroid gland, pancreas, prostate, ovaries and cervix, endometrium, colon and colorectum, and bladder. We used the inverse variance weighting (IVW) method to determine the causal relationship between schizophrenia and different tumor risk factors. In addition, we conducted a sensitivity test to evaluate the effectiveness of the causality. After adjusting for heterogeneity, evidence of a causal relationship between schizophrenia and lung cancer risk was observed (odds ratio [OR]=1.001, 95% confidence interval [CI], 1.000-1.001; P=0.0155). In the sensitivity analysis, the causal effect of schizophrenia on the risk of lung cancer was consistent in both direction and degree. However, no evidence of causality or reverse causality between schizophrenia and other tumors was found. This study elucidated a causal relationship between the genetic predictors of schizophrenia and the risk of lung cancer, thereby providing a basis for the prevention, pathogenesis, and treatment of schizophrenia in patients with lung cancer.

Long-acting antipsychotic treatments: focus on women with schizophrenia.

Effective management of schizophrenia (SZ) requires long-term treatment with antipsychotics (APs) to prevent clinical relapse, attain remission and improve patients' personal and social functioning, and quality of life. Although APs remain the cornerstone treatment for patients with SZ, despite their potential benefits, long-acting injectable APs (LAI-APs) remain underused, most notably in women with SZ. The efficacy and tolerability of APs differ significantly between men and women, and some of these differences are more noticeable depending on the patient's age and the stage of the disorder. Although sex differences may influence treatment outcomes in SZ, their pertinence has been insufficiently addressed, especially regarding the use of LAI-APs. Some biological and social experiences, such as pregnancy, lactation, contraception and menopause, are specific to women, but these remain under-researched issues. Implications of this disorder in parenting are also of special pertinence regarding women; therefore, taking sex differences into account when treating SZ patients is now recommended, and improving personalized approaches has been proposed as a priority in the management of psychosis. In this narrative, critical review, we address some aspects specific to sex and their implications for the clinical management of women with SZ, with a special focus on the potential role of LAI-AP treatments.

Effect of psycho-religious group therapy on hallucination in schizophrenia patient

Background: Psycho-religious therapy can be used to treat schizophrenia patients. Group therapy is also effective at reducing the signs and symptoms of hallucinations. Combining these two methods for the intervention of schizophrenic patients who experience hallucinations still needs scientific evidence.Objective: This study aims to determine the influence of dhikr psycho-religious group therapy on changes in signs of hallucination symptoms in patients with a psychotic disorder.Methods: This is a pre-experiment study with a pre-post-test design. The sample number was 33 participants in schizophrenia patients with hallucinations. Sampling techniques use purposive sampling that meets inclusion criteria. The research instrument uses a hallucination signs and symptoms evaluation questionnaire. Dhikr psycho-religious group therapy is carried out in 4 times meetings with two stages—data analysis using frequency distribution and statistically paired t-test test.Results: The hallucination symptom score before the intervention was 22.36; after the intervention, it decreased to 11.03. The statistical analysis showed significant differences in hallucination symptoms before and after the intervention of psycho-religious group therapy (p&lt;0.05). Psycho-religious group therapy provides a medium effect in reducing hallucination symptoms (Cohen's d: 3.09).Conclusion: Psycho-religious group therapy can significantly reduce hallucination symptoms.

Response rate and factors associated with response in patients with schizophrenia undergoing bilateral electroconvulsive therapy

Schizophrenia is a severe mental illness and a common indication for electroconvulsive therapy (ECT). Research is lacking on the factors that influence response to acute ECT treatment in schizophrenia patients. This study examined the response rate and associated factors in patients with schizophrenia undergoing bilateral ECT. Demographic data, clinical characteristics, ECT data and treatment response were respectively reviewed in patients with schizophrenia undergoing bilateral ECT from January 2013 to June 2022. Forty-six patients were included. Nine responded after the first three sessions, 17 after six sessions, 20 after nine sessions, 25 after 12 sessions and 28 after the last ECT session, cumulatively. The mean of the baseline Brief Psychiatric Rating Scale psychotic symptom subscale score was significantly higher in responders (17.0) than non-responders (10.9) (P < 0.05). The mean of duration of electroencephalogram seizure was significantly longer in responders (53.9) than in non-responders (42.7). There was no association between demographic and ECT data and treatment response. Among 28 responders, 20 responded to ECT after nine sessions (faster responders) and eight responded later (slower responders). The number of failed antipsychotics prior to ECT was 2.8 for faster responders and 4.4 for slower responders (P = 0.02). Nominal logistic regression showed that the number of failed antipsychotics prior to ECT was associated with speed of response to ECT (P = 0.037, odds ratio = 1.77). ECT is an effective treatment for schizophrenia and may be influenced by the number of failed antipsychotics prior to ECT.

Tolerability and Safety of 219 Transcranial Direct Current Stimulation (TDCS) 2.0 mA Sessions in Adult Patients with Schizophrenia.

The objective of the study was to evaluate safety and tolerability of tDCS treatment in schizophrenia patients. Our results confirm already established evidence that tDCS is a very safe and well tolerated method of non-invasive brain stimulation for patients with schizophrenia. Database of 219 tDCS sessions in patients with paranoid schizophrenia has been analyzed. During 219 tDCS sessions there were no serious adverse effects. All adverse effects were mild to moderate and transitory and the most frequent were: itching/tingling (81%), burning (53%) or heat sensation (48%) and skin reddening (35%). Itching/tingling and burning sensation were also frequently reported as at least moderately severe. All major adverse events (itching/tingling, burning/heat sensation) were more often localized by patients under the anodal pad. Men were more prone to experience some adverse events (itching/tingling, burning/heat sensation, skin reddening, metallic taste and tiredness). Most of the adverse events had their onset at the beginning of tDCS session, resolved by the end of tDCS session (with the exception of skin reddening, which recovered within 30 minutes after stimulation) and were associated with mild or moderate distress. Our results confirm already established evidence that tDCS is a very safe and well tolerated method of non-invasive brain stimulation for patients with schizophrenia.

A clinical study on the effect of peperidone combined with cognitive behavioral therapy on symptoms of schizophrenia

BackgroundSchizophrenia is a common mental disease in clinic, which is a mental disorder with slow loss of function and decline. Schizophrenia is usually treated with drugs, such as risperidone. However, with the increase of schizophrenic patients and the enhancement of drug resistance, the effect of drug treatment alone has declined. Cognitive behavior therapy is a widely used psychotherapy method to treat mental disorders, which can be seen as a combination of cognitive therapy and behavior therapy. Cognitive behavior therapy can change individual behavior by adjusting individual cognition, and reconstruct individual irrational cognition through training. Therefore, the study will combine cognitive behavior therapy with risperidone to treat schizophrenia patients for clinical diagnosis and treatment.Subjects and MethodsIn this experiment, 98 schizophrenics in a hospital were selected as the research object. 45 of them were treated with risperidone alone, which was regarded as group A. The other 53 patients were treated with cognitive behavioral therapy on the basis of risperidone, and were regarded as group B. The basic data of the two groups were compared, such as age, sex, etc., to ensure the feasibility of this experiment. At the same time, the cognitive functions of the two groups were compared. Before and after treatment, a cognitive ability test consensus scale was used to quantify the cognitive abilities of patients. SPSS21.0 statistical software was used for statistical analysis. The results were shown in Figure 1.Figure 1.Scores of cognitive abilities before and after treatmentResultsCognitive dysfunction is an independent core symptom of schizophrenia. From the experimental results, the score of group B before treatment was 42±7.61, which was higher than 41.57±6.25 of group A, but lower than 50.47±7.65 of group A after treatment, which was 47.21±8.45. Among them, the scores of most indicators such as connectivity, visual learning, and social cognition in group B were higher than those in group A before treatment, but all indicators were lower than those in group A after treatment. To sum up, the method of risperidone combined with cognitive behavioral therapy selected in the study has certain effectiveness in alleviating the cognitive disorder of psychiatric patients, and can effectively alleviate the clinical symptoms of schizophrenia patients.ConclusionsThe cognitive impairment of schizophrenic patients has been paid more and more attention. In the actual work process, schizophrenics often show behaviors such as denying illness or refusing to take medicine, which will further aggravate their illness. Therefore, on the basis of the use of risperidone, combined with cognitive behavioral therapy, it can strengthen patients’ self-cognition, overcome their bad mentality, enhance patients’ attention to drug treatment, improve drug compliance, improve negative symptoms, and achieve treatment goals. It has high practicability in clinic.

Differential Treatment Responses in Pakistani Schizophrenia Samples: Correlation with Sociodemographic Parameters, Drug Addiction, Attitude to the Treatment and Antipsychotic Agents

Schizophrenia patients demonstrate variations in response to different therapies that are currently being used for the treatment of disorders, such as augmentation therapy (ECT or mood stabilizer) and combination therapy (with antipsychotics). These therapies are also used to treat schizophrenia patients in Pakistan; however, patients show poor overall response. Therefore, this study was conducted to investigate the association between the patients' response to treatment and the use of antipsychotic agents, with variability in overall response, within different groups of patients. Methods: We conducted a retrospective study that included schizophrenia subjects (N = 200) belonging to different age groups, ethnicities, and regions from different outpatient and inpatient departments in psychiatric institutes located in different cities of Pakistan. These patients were assessed for their response to treatment therapies and categorized into four groups (non-responders (N-R), slow response (S-R), patients with relapse, and completely recovered patients (C-R)) according to their responses. Results: The final analysis included 200 subjects, of which 73.5% were males. Mean age was 34 ± 10 years. Percentage of N-R was 5%, S-R was 42%, patients with relapse were 24%, and C-R was 1.5%. The generalized linear regression model shows a significant association between medication response and age (p = 0.0231), age of onset (p = 0.0086), gender (p = 0.005), and marital status (p = 0.00169). Variability within the medication responses was a result of the treatment regime followed. Antipsychotic agents were significantly associated with the treatment response (p = 0.00258, F = 4.981) of the patients. Significant variation was also observed in the treatment response (p = 0.00128) of the patients that were given augmentation therapy as well as combination therapy. Conclusion: The data suggests proper monitoring of patients' behavior in response to treatment therapies to implement tailored interventions. Despite several genetic studies supporting the heritability of schizophrenia, an insignificant association between characteristic features and family history might have been due to the limited sample size, suggesting collaborative work with massive sample sizes.

Comparative Analysis of the Pre- and Post-Medication Effects of Antipsychotic Agents on the Blood-Based Oxidative Stress Biomarkers in Patients with Schizophrenia: A Meta-Analysis.

Studies have shown that oxidative stress (OS) is related to the pathophysiology of schizophrenia (SCZ), but whether antipsychotics can induce OS has not been investigated well. Moreover, antipsychotics have differential effects on the OS level modulation, i.e., different types of antipsychotics have different effects on the cellular antioxidants or pro-oxidants. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and investigated the OS indicators including both enzymatic and nonenzymatic markers, such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), malondialdehyde (MDA), glutathione (GSH), vitamin C, etc., of SCZ patients at baseline and follow-up of mono-medication. Twenty studies met the inclusion criteria, with a total of 1162 patients enrolled at baseline, and 1105 patients completed the follow-up. OS markers were changed after a period of antipsychotic treatment in SCZ patients. The GPx activity and MDA level decreased in the whole blood (P<0.05), also the serum MDA level decreased (P<0.05). For the first-episode SCZ patients, the activity of GPx and the level of MDA decreased, while the level of vitamin C increased (all P<0.05). The levels of MDA in patients receiving atypical antipsychotics decreased (P<0.05), while the level of GSH in patients with typical antipsychotics decreased (P=0.05). Antipsychotic medication may cause changes in the levels of OS markers in different blood samples of SCZ patients. However, the available studies might not be sufficient to reveal the underlying facts accurately due to the poor quality of experimental designs in the published literature.

Treatment with aripiprazole once-monthly injectable formulation is effective in improving symptoms and global functioning in schizophrenia with and without comorbid substance use - a post hoc analysis of the ReLiAM study.

ReLiAM, Real-Life Assessment of Abilify Maintena, was the first reported long-term prospective non-interventional study for patients with schizophrenia treated with aripiprazole once-monthly injectable formulation (AOM) under real-life conditions. ReLiAM's primary aim was to evaluate the evolution of global functional status in patients treated with AOM for 12months in Canada. The objective of this post hoc analysis of the ReLiAM study is to investigate the treatment effects of real-life use of AOM over a 1-year period in the subgroup of patients with reported substance use compared with patients without substance use. The results of this post hoc analysis demonstrate that treatment with AOM for 12months in patients with schizophrenia was comparably effective in improving global functioning in subgroups of patients with and without concomitant substance use. These results support the use of AOM for the treatment of schizophrenia in patients with or without concomitant substance use. ClinicalTrials.gov NCT02131415, first posted on May 6, 2014. Overall trial status: Terminated.

Sevoflurane Ameliorates Schizophrenia in a Mouse Model and Patients: A Pre-Clinical and Clinical Feasibility Study.

GABAergic deficits have been considered to be associated with the pathophysiology of schizophrenia, and hence, GABA receptors subtype A (GABAARs) modulators, such as commonly used volatile anesthetic sevoflurane, may have therapeutic values for schizophrenia. The present study investigates the therapeutic effectiveness of low-concentration sevoflurane in MK801-induced schizophrenia-like mice and schizophrenia patients. Three weeks after MK801 administration (0.5 mg kg-1, i.p. twice a day for 5 days), mice were exposed to 1% sevoflurane 1hr/day for 5 days. Behavioral tests, immunohistochemical analysis, western blot assay, and electrophysiology assessments were performed 1-week post-exposure. Ten schizophrenia patients received 1% sevoflurane 5 hrs per day for 6 days and were assessed with the Positive and Negative Syndrome Scale (PANSS) and the 18-item Brief Psychiatric Rating Scale (BPRS-18) at week 1 and week 2. MK801 induced hypolocomotion and social deficits, downregulated expression of NMDARs subunits and postsynaptic density protein 95 (PSD95), reduced parvalbumin - and GAD67-positive neurons, altered amplitude and frequency of mEPSCs and mIPSCs, and increased the excitation/inhibition ratio. All these changes induced by MK-801 were attenuated by sevoflurane administration. Six and eight patients achieved a response defined as a reduction of at least 30% in the PANSS total score at 1st and 2nd week after treatments. The BPRS-18 total score was found to be significantly decreased by 38% at the 2nd week (p < 0.01). Low-concentration sevoflurane effectively reversed MK801-induced schizophrenialike disease in mice and alleviated schizophrenia patients' symptoms. Our work suggests sevoflurane to be a valuable therapeutic strategy for treating schizophrenia patients.

The relationship between difficulty in emotion regulation and metaworry and the tolerance of ambiguity in patients with schizophrenia

Introduction: Schizophrenia is a complex mental disorder, and one of the variables that are important in people with schizophrenia is emotional self-regulation. On the other hand, another study has shown that there is a relationship between emotion regulation disorder and ambiguity intolerance. Aim: The purpose of this study was to investigate the relationship between emotion regulation and meta-concern in the tolerance of ambiguity in patients with schizophrenia. Method: The present study was a correlational study and a cross-sectional study was conducted. The research population was schizophrenic patients referred to the Forghani-Nekoui Psychiatric Center in Qom in 2020. The sample of the study was 141 hospitalized patients or referred to a psychiatric center, which were selected using the convenience sampling method. In order to collect information, Questionnaires on Difficulty in Emotion Regulation Scale, Wells' Metacognitions Questionnaire and Ambiguity Tolerance Questionnaire were used. Research data were analyzed using pathway analysis with PLS software. Results: The average score of the difficulty in performing purposeful behaviors in times of helplessness was 54.1±21.63 and the average score of the difficulty in controlling impulsive behaviors in times of helplessness was 67.27±19.27. The average score of the ambiguity tolerance questions was 25.12±4.32. No significant relationship was found in the relationship between the variables, difficulty of emotion regulation and transcendence, difficulty of emotion regulation and tolerance of ambiguity. The only significant relationship was shown between the effect of meta-worry on the ambiguity tolerance (P=0.049). Conclusion: Therefore, it can be concluded that these patients, as mentioned, have less capacity to tolerate ambiguity and meta-worry. It is suggested to pay more attention to these aspects in the treatment of schizophrenia patients.

DESCRIPTION OF ANXIETY IN THE PATIENT'S FAMILY CAREGIVER SCHIZOPHRENIA IN THE COMMUNITY HEALTH CENTER OF MANYAR, GRESIK DISTRICT

Introduction: Schizophrenia is a disease process that affects perceptions, emotions, social behaviour and the ability to accept reality correctly. Caregivers with schizophrenia often feel anxious. This study aims to determine the description of anxiety in family caregivers of schizophrenia patients. Methods: This research is quantitative research with a descriptive approach. The number of respondents was 63 according to the inclusion and exclusion criteria. Using purposive sampling technique. This research was conducted at the Manyar District Health Center, Gresik Regency in March 2022. Processing and Data Analysis using Editing, coding, scoring, tabulating and percentages. In this study, the Hamilton Rating Scale for Anxiety ( HARS) questionnaire was used. Ethical Approval by the Faculty of Health, University Muhammadiyah of Gresik number 029/KET/II.3.UMG/KEP/A/2022, February 25, 2022. Results: The results of this study indicate the level of anxiety experienced by family caregivers of schizophrenic patients, that most of them experienced severe anxiety with many as 40 respondents (40.9%), a small proportion had no anxiety as many as 5 respondents (4.6%). Conclusions: Family caregivers who treat schizophrenia patients mostly experience mild anxiety. It is expected that the family caregiver can do distracted and deep breathing relaxation to reduce the level of anxiety experienced by the family caregiver.

Could psychedelic drugs have a role in the treatment of schizophrenia? Rationale and strategy for safe implementation.

Schizophrenia is a widespread psychiatric disorder that affects 0.5-1.0% of the world's population and induces significant, long-term disability that exacts high personal and societal cost. Negative symptoms, which respond poorly to available antipsychotic drugs, are the primary cause of this disability. Association of negative symptoms with cortical atrophy and cell loss is widely reported. Psychedelic drugs are undergoing a significant renaissance in psychiatric disorders with efficacy reported in several conditions including depression, in individuals facing terminal cancer, posttraumatic stress disorder, and addiction. There is considerable evidence from preclinical studies and some support from human studies that psychedelics enhance neuroplasticity. In this Perspective, we consider the possibility that psychedelic drugs could have a role in treating cortical atrophy and cell loss in schizophrenia, and ameliorating the negative symptoms associated with these pathological manifestations. The foremost concern in treating schizophrenia patients with psychedelic drugs is induction or exacerbation of psychosis. We consider several strategies that could be implemented to mitigate the danger of psychotogenic effects and allow treatment of schizophrenia patients with psychedelics to be implemented. These include use of non-hallucinogenic derivatives, which are currently the focus of intense study, implementation of sub-psychedelic or microdosing, harnessing of entourage effects in extracts of psychedelic mushrooms, and blocking 5-HT2A receptor-mediated hallucinogenic effects. Preclinical studies that employ appropriate animal models are a prerequisite and clinical studies will need to be carefully designed on the basis of preclinical and translational data. Careful research in this area could significantly impact the treatment of one of the most severe and socially debilitating psychiatric disorders and open an exciting new frontier in psychopharmacology.