scholarly journals Atypical Antipsychotics in the Treatment of Depressive and Psychotic Symptoms in Patients with Chronic Schizophrenia: A Naturalistic Study

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Marco Innamorati ◽  
Stefano Baratta ◽  
Cristina Di Vittorio ◽  
David Lester ◽  
Paolo Girardi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Mental Disorder ◽  
Atypical Antipsychotics ◽  
Depression Scale ◽  
Chronic Schizophrenia ◽  
Psychotic Symptoms ◽  
Naturalistic Study ◽  
Syndrome Scale ◽  
Negative Syndrome

Objectives. The aim of this naturalistic study was to investigate whether treatment with clozapine and other atypical antipsychotics for at least 2 years was associated with a reduction in psychotic and depressive symptoms and an improvement in chronic schizophrenia patients’ awareness of their illness.Methods. Twenty-three adult outpatients (15 men and 8 women) treated with clozapine and 23 patients (16 men and 7 women) treated with other atypical antipsychotics were included in the study. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms were assessed with the Calgary Depression Scale for Schizophrenia (CDSS), and insight was assessed with the Scale to Assess Unawareness of Mental Disorder (SUMD).Results. The sample as a whole had a significant reduction in positive, negative, and general symptoms, whereas the reduction in depression was significant only for patients with CDSS scores of 5 and higher at the baseline. At the follow-up, patients treated with other atypical antipsychotics reported a greater reduction in depression than patients treated with clozapine, but not when limiting the analyses to those with clinically relevant depression.Conclusions. Atypical antipsychotics may be effective in reducing psychotic and depressive symptoms and in improving insight in patients with chronic schizophrenia, with no differences in the profiles of efficacy between compounds.

scholarly journals Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ravi Philip Rajkumar
Keyword(s):  
Depressive Symptoms ◽  
Suicidal Behaviour ◽  
Depression Scale ◽  
Psychotic Symptoms ◽  
Symptom Dimensions ◽  
Syndrome Scale ◽  
Episode Frequency ◽  
Clinically Significant ◽  
Negative Syndrome

Introduction. Depressive symptoms are common in schizophrenia and are associated with poorer functioning, lower quality of life, and an elevated risk of suicidal behaviour. There are few studies on the occurrence and correlates of these symptoms in acutely ill patients with schizophrenia.Method.72 acutely ill patients with schizophrenia were assessed for depression using the Calgary Depression Scale for Schizophrenia (CDSS). A cut-off score of ≥6 on the CDSS was used to identify clinically significant depressive symptoms. The relationship between depression and illness variables, including psychotic symptom dimensions as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), was examined.Results. Eleven (15.3%) patients had clinically significant depressive symptoms. These patients scored higher on the positive and general psychopathology scales of the PANSS and had higher rates of suicidal behavior and poorer functioning. The severity of depressive symptoms was positively correlated with the PANSS positive subscale and negatively correlated with the PANSS negative subscale.Discussion. These findings confirm previous reports that depressive symptoms in active schizophrenia is related to the severity of positive psychotic symptoms and is a risk factor for suicidal behaviour in these patients.

Tolerability and treatment response in patients with recently diagnosed vs. chronic schizophrenia treated with paliperidone ER

2011 ◽  
Vol 26 (S2) ◽  
pp. 1502-1502
Author(s):  
A. Schreiner ◽  
D. Hoeben ◽  
C. Tessier ◽  
M. Lahaye ◽  
J. Turczynski ◽  
...  
Keyword(s):  
Treatment Response ◽  
Chronic Schizophrenia ◽  
Psychotic Symptoms ◽  
Chronic Patients ◽  
Open Label ◽  
Patient Functioning ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
Mean Time ◽  
Time Since Diagnosis

ObjectiveTo explore tolerability and treatment response in adult patients with recently diagnosed (<5 years) and chronic (>5 years) schizophrenia treated with flexible doses of paliperidone ER.MethodsInternational prospective open-label 6-month study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), patient functioning and treatment-emergent adverse events (TEAEs).ResultsOf 713 recently diagnosed patients, most were male (60.9%), mean age was 33.6 ± 11.2 years and mean time since diagnosis was 2.3 ± 1.7 years. Chronic patients (n = 1003) were predominantly male (59.2%) with a mean age of 43.8 ± 11.4 and mean time since diagnosis of 15.6 ± 9.2 years. 70.4% and 71.7% of patients completed the study, respectively. Mean mode doses of paliperidone ER were similar between recently diagnosed and chronic patients (7.0 ± 2.9 mg/day and 7.2 ± 2.9 mg/day). 63.1% of recently diagnosed and 60.8% of chronic patients switching due to lack of efficacy with their previous antipsychotic had a >20% improvement in PANSS total score at endpoint, and improvement with other switching reasons was consistently numerically higher in recently diagnosed patients. The rate of patients with mild or no functional impairment increased from 17.7% to 39.8% in recently diagnosed and from 14.4% to 32.9% in chronic patients. TEAEs reported in >5% were insomnia (10.7% and 8.1%), anxiety (8.6% and 6.0%) and somnolence (5.8% and 3.4%), respectively.ConclusionThese data suggest that both recently diagnosed and chronic patients previously unsuccessfully treated with other oral antipsychotics may benefit from paliperidone ER, with a tendency for recently diagnosed patients showing some higher treatment response in psychotic symptoms and patient functioning.

scholarly journals Tratamento em regime compulsivo ambulatório: estudo de follow-up após um ano em Portugal

2017 ◽  
pp. 21-9
Author(s):  
Sofia Brissos ◽  
Sofia Brissos ◽  
Gonçalo Sobreira ◽  
João Miguel Oliveira ◽  
Zita Gameiro ◽  
...  
Keyword(s):  
Mental Disorder ◽  
Word Association ◽  
Social Performance ◽  
Digit Span ◽  
Association Test ◽  
Word Association Test ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
Performance Scale

Enquadramento: Não existem evidências suficientes relativamente ao impacto do tratamento em regime compulsivo ambulatório (TCA). Objetivos: Avaliámos o impacto do TCA ao longo de um ano em sintomas, funcionamento pessoal e social, insight e cognição. Métodos: Análise naturalística, longitudinal, no início e no follow-up após um ano, de 15 pacientes seguidos numa consulta especializada de TCA. Os pacientes foram submetidos a avaliação estandardizada com o Positive and Negative Syndrome Scale (PANSS) (Escala Positiva e Negativa do Síndroma), Personal and Social Performance Scale (PSP) (Escala de Desempenho Pessoal e Social), Berrios-Markova Scale to Assess Unawareness in Mental Disorder (SUMD) (Escala de Avaliação da Falta de Consciência no Distúrbio Mental), Trails A e B, Digit Span, e o Controlled Oral Word Association Test (COWA) (Teste de Associação Verbal Controlada). Resultados: No follow-up houve melhorias significativas no funcionamento pessoal e social (PSP inicial total: média=46,9; follow-up: média=59,3), e nomeadamente nas atividades socialmente úteis incluindo trabalho e estudos (p=0,012) e relações pessoais e sociais (p=0,033). Três pacientes (20%) pontuaram =>69 no PSP, um bom nível de funcionamento. Porém, não verificámos melhorias significativas nos sintomas (PANSS=56,8), insight subjetivo ou objetivo (Berrios-Markova=10,0 e SUMD=11,0), ou desempenho cognitivo. Conclusões: No follow-up após um ano, os pacientes em TCA revelaram melhorias significativas no funcionamento pessoal e social, especificamente nas atividades socialmente úteis incluindo trabalho e estudos e nas relações pessoais e sociais, mas não registaram melhorias nos sintomas, insight e funcionamento cognitivo.

The practitioner cope with adverse events on atypical antipsychotics: About 63 patients with schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S537-S537
Author(s):  
I. Berrahal ◽  
R. Triki ◽  
R. Chebbi ◽  
B. Ghanjati ◽  
R. Ghachem
Keyword(s):  
Atypical Antipsychotics ◽  
Adverse Drug Events ◽  
Psychotic Symptoms ◽  
Appropriate Treatment ◽  
Syndrome Scale ◽  
Tunisian Patients ◽  
Insulin Dependent ◽  
Adult Outpatient ◽  
Competing Interest ◽  
Negative Syndrome

IntroductionThe propensity of atypical antipsychotics (AAP) for having a therapeutic effect with fewer side effects and the balancing of these supposed benefits with tolerance are the subject of many studies.Aims and objectivesWe focused on adverse drug events (ADEs), occurred under AAP, in a population of patients with schizophrenia to assess the prevalences and describe how the practitioner deal with these ADEs.MethodsWe have used a retrospective and descriptive study of 63 Tunisian patients with schizophrenia, consulting in the adult outpatient of Razi hospital and treated by one type of AAP. The study period was 6 months from the 1st January 2015. We used the Birchwood Insight Scale (BIS), Positive and Negative Syndrome Scale (PANSS) and Udvalg for Kliniske Undersogelser (UKU) to assess the insight, psychotic symptoms and ADEs.ResultsTwenty-four patients were on risperidone, 22 on olanzapine, 8 on amisulpride and 9 on clozapine. Antiparkinsonism drug (15.9%) was associated because of neurological ADEs mainly Parkinsonism. Asthenia had a prevalence of 20.6%. Hypersalivation and palpitation were estimated at 7.9% both. Weight gain's prevalence was 25.4%, including 1 case associated with hypercholesterolemia and 1 case of unbalanced non-insulin-dependent diabetes. The erectile dysfunction's prevalence was 36.3% and decreased libido 27%. There were 2 cases of neutropenia and thrombocytopenia. The management of these ADEs was observed when they moderately began to influence the patient's daily activity.ConclusionADEs must be subject to an appropriate treatment and if necessary resort to a specialist consultation to confirm or deny imputability to AAP.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Insomnia Symptoms in Chinese Patients with Chronic Schizophrenia: Prevalence, Clinical Correlates and Relationship with Inflammation

2020 ◽  
Author(s):  
Lei Xia ◽  
Yi Zhong ◽  
Zhiwei Liu ◽  
Yulong Zhang ◽  
Wenzheng Li ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Inflammatory Markers ◽  
Sleep Disturbances ◽  
Depression Scale ◽  
Chronic Schizophrenia ◽  
Older Age ◽  
Chinese Patients ◽  
Psychotic Symptoms ◽  
Clinical Correlates ◽  
Insomnia Symptoms

Abstract Background: Sleep disturbances are common in patients with schizophrenia, with serious consequences. The purpose of this study was to investigate the prevalence and clinical correlates of insomnia symptoms, and to explore the relationship between insomnia and inflammatory markers in Chinese patients with chronic schizophrenia. Methods: A total of 328 inpatients with chronic schizophrenia were recruited. Insomnia Severity Index (ISI), Calgary Depression Scale for Schizophrenia (CDSS), and Positive and Negative Syndrome Scale (PANSS) were used to assess the severity of insomnia, depression, and psychotic symptoms. The plasma levels of several inflammatory markers (CRP, IL-6, and TNF-α) were measured.Results: The prevalence of insomnia symptoms in patients with schizophrenia was 38.4%. Depressive symptoms were significantly associated with insomnia symptoms (OR = 1.23, 95%CI: 1.13-1.33, P < 0.001). Higher CDSS score (beta = 0.55, t = 8.21, P < 0.001) and older age (beta = 0.06, t = 3.59, P < 0.001) were significantly associated with higher ISI score, while taking a single SGA (beta = -0.85, t = -1.99, P < 0.05) was independently associated with lower ISI score. There was no significant association between any inflammatory markers and insomnia or ISI score.Conclusions: Our results demonstrate that the prevalence of insomnia symptoms is high in Chinese inpatients with chronic schizophrenia. Some demographic and clinical variables, such as depressive symptoms and older age, are risk factors, while others are beneficial factor, such as taking atypical antipsychotic drug for insomnia in schizophrenia patients. No association has been found between insomnia symptoms and inflammation.

Tolerability and treatment response in patients with recently diagnosed vs. chronic schizophrenia treated with paliperidone ER

2011 ◽  
Vol 26 (S2) ◽  
pp. 1503-1503
Author(s):  
A. Schreiner ◽  
D. Hoeben ◽  
C. Tessier ◽  
M. Lahaye ◽  
J. Turczynski ◽  
...  
Keyword(s):  
Treatment Response ◽  
Chronic Schizophrenia ◽  
Psychotic Symptoms ◽  
Chronic Patients ◽  
Open Label ◽  
Patient Functioning ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
Mean Time ◽  
Time Since Diagnosis

ObjectiveTo explore tolerability and treatment response in adult patients with recently diagnosed (≤5 years) and chronic (>5 years) schizophrenia treated with flexible doses of paliperidone ER.MethodsInternational prospective open-label 6-month study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), patient functioning and treatment-emergent adverse events (TEAEs).ResultsOf 713 recently diagnosed patients, most were male (60.9%), mean age was 33.6 ± 11.2 years and mean time since diagnosis was 2.3 ± 1.7 years. Chronic patients (n = 1003) were predominantly male (59.2%) with a mean age of 43.8 ± 11.4 and mean time since diagnosis of 15.6 ± 9.2 years. 70.4% and 71.7% of patients completed the study, respectively. Mean mode doses of paliperidone ER were similar between recently diagnosed and chronic patients (7.0 ± 2.9 mg/day and 7.2 ± 2.9 mg/day). 63.1% of recently diagnosed and 60.8% of chronic patients switching due to lack of efficacy with their previous antipsychotic had a ≥20% improvement in PANSS total score at endpoint, and improvement with other switching reasons was consistently numerically higher in recently diagnosed patients. The rate of patients with mild or no functional impairment increased from 17.7% to 39.8% in recently diagnosed and from 14.4% to 32.9% in chronic patients. TEAEs reported in ≥5% were insomnia (10.7% and 8.1%), anxiety (8.6% and 6.0%) and somnolence (5.8% and 3.4%), respectively.ConclusionThese data suggest that both recently diagnosed and chronic patients previously unsuccessfully treated with other oral antipsychotics may benefit from paliperidone ER, with a tendency for recently diagnosed patients showing some higher treatment response in psychotic symptoms and patient functioning.

Prevalence and clinical correlates of depression in the acute phase of first episode schizophrenia

2010 ◽  
Vol 27 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Eric Roche ◽  
Mary Clarke ◽  
Stephen Browne ◽  
Niall Turner ◽  
Orflaith McTuige ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Depression Scale ◽  
First Episode ◽  
Syndrome Scale ◽  
Prevalence Of Depression ◽  
History Of ◽  
First Episode Schizophrenia ◽  
Negative Syndrome ◽  
First Episode Of Schizophrenia

AbstractBackground: Reported rates of depression in schizophrenia vary considerably.Objective: To measure the prevalence of depression in a first episode sample of people with schizophrenia.Methods: All referrals with a first episode of schizophrenia diagnosed using SCID interviews were assessed pre-discharge and again six months later. We used the Calgary Depression Scale for Schizophrenia (CDSS) and Positive and Negative Syndrome Scale (PANSS) to assess the severity of symptoms.Results: Pre-discharge, 10.4% of the sample met CDSS criteria for depression. According to the PANSS depression (PANSS -D) subscale, 3% of patients were depressed, with a mean score of 7.48 (SD = 2.97). Only 3% of patients pre-discharge were found to be depressed on both the CDSS and the PANSS-D. Six months later 6.5% were depressed according to the CDSS. However none reached depression criteria according to the PANSS-D. The CDSS correlated with PANSS-D both pre-discharge and at follow-up. Feelings of depression and self-deprecation were the most common symptoms at baseline and follow-up. The CDSS was unrelated to negative symptoms at both stages. A lifetime history of alcohol abuse increased the risk for depression.Conclusion: Rates of depression in this sample were low. The CDSS appears to discriminate between depression and negative symptoms. Like the general population, alcohol misuse is a risk factor for depression in first episode schizophrenia.

scholarly journals Increased plasma leptin as a novel predictor for psychopathological depressive symptoms in chronic schizophrenia

2018 ◽  
Vol 31 (3) ◽  
pp. e100018 ◽  
Author(s):  
Jinjie Xu ◽  
Yumei Jiao ◽  
Mengjuan Xing ◽  
Yezhe Lin ◽  
Yousong Su ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Negative Symptoms ◽  
Influencing Factor ◽  
Chronic Schizophrenia ◽  
Stepwise Multiple Regression ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Syndrome Scale ◽  
Plasma Leptin ◽  
Negative Syndrome

BackgroundDepressive symptoms are often seen in schizophrenia. The overlap in presentation makes it difficult to distinguish depressive symptoms from the negative symptoms of schizophrenia. The adipokine leptin was found to be altered in both depression and schizophrenia. There are few studies focusing on the prediction of leptin in diagnosis and evaluation of depressive symptoms in schizophrenia.ObjectiveAimsTo assess the plasma leptin level in patients with schizophrenia and its relationships with depressive symptoms.MethodsCross-sectional studies were applied to (1) compare the levels of plasma leptin between schizophrenia (n=74) and healthy controls (n=50); and (2) investigate the relationship between plasma leptin levels and depressive subscores.Results(1) Plasma leptin levels were significantly higher in patients with schizophrenia than in healthy controls. (2) Correlation analysis revealed a significant negative association between leptin levels and the depressed factor scores on the Positive and Negative Syndrome Scale (PANSS). (3) Stepwise multiple regression analyses identified leptin as an influencing factor for depressed factor score on PANSS.ConclusionLeptin may serve as a predictor for the depressive symptoms of chronic schizophrenia.

scholarly journals Association of FKBP5 genotype with depressive symptoms in patients with coronary heart disease: a prospective study

2020 ◽  
Vol 127 (12) ◽  
pp. 1651-1662
Author(s):  
Julia Brandt ◽  
Katharina Warnke ◽  
Silke Jörgens ◽  
Volker Arolt ◽  
Katja Beer ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Depressive Symptoms ◽  
Coronary Revascularization ◽  
Central Element ◽  
Depression Scale ◽  
Stress System ◽  
Linear Regression Models ◽  
A Prospective Study

AbstractDepression and coronary heart disease (CHD) are prevalent and often co-occurring disorders. Both have been associated with a dysregulated stress system. As a central element of the stress system, the FKBP5 gene has been shown to be associated with depression. In a prospective design, this study aims to investigate the association of FKBP5 with depressive symptoms in CHD patients. N = 268 hospitalized CHD patients were included. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS-D) at four time points (baseline, and after 1 month, 6 months, and 12 months). The functional FKBP5 single-nucleotide polymorphism (SNP) rs1360780 was selected for genotyping. Linear regression models showed that a higher number of FKBP5 C alleles was associated with more depressive symptoms in CHD patients both at baseline (p = 0.015) and at 12-months follow-up (p = 0.025) after adjustment for confounders. Further analyses revealed that this effect was driven by an interaction of FKBP5 genotype with patients’ prior CHD course. Specifically, only in patients with a prior myocardial infarction or coronary revascularization, more depressive symptoms were associated with a higher number of C alleles (baseline: p = 0.046; 1-month: p = 0.026; 6-months: p = 0.028). Moreover, a higher number of C alleles was significantly related to a greater risk for dyslipidemia (p = .016). Our results point to a relevance of FKBP5 in the association of the two stress-related diseases depression and CHD.

Significance of Positive and Negative Syndromes in Chronic Schizophrenia

1986 ◽  
Vol 149 (4) ◽  
pp. 439-448 ◽  
Author(s):  
S. R. Kay ◽  
L. A. Opler ◽  
A. Fiszbein
Keyword(s):  
Hospital Admissions ◽  
Chronic Schizophrenia ◽  
Strongly Correlated ◽  
General Psychopathology ◽  
Developmental Impairment ◽  
Schizophrenic Patients ◽  
History Of ◽  
Patient Stay ◽  
Negative Syndrome

Positive and negative syndromes were studied in relation to demographic, historical, genealogical, clinical, psychometric, extrapyramidal, and follow-up measures of 101 chronic schizophrenic patients. The criterion scales proved to be reliable, normally distributed, and strongly correlated with general psychopathology, but otherwise inversely related to one another. Multiple regression analysis identified sets of 4–6 independent variables that explained 74%-81 % of the scales' variance. A positive syndrome was associated chiefly with productive features, family history of sociopathy, more previous hospital admissions, and longer in-patient stay during the 30-month follow-up period. A negative syndrome correlated with deficits in cognitive, affective, social, and motor spheres, higher incidence of major psychiatric illness but less affective disorder among relatives, lower education, and greater cognitive developmental impairment. The results underscore the importance of genetic and biodevelopmental variables for understanding schizophrenic syndromes.

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