The Initial Onset of Schizophrenia and Family Expressed Emotion

1989 ◽  
Vol 154 (2) ◽  
pp. 212-217 ◽  
Author(s):  
Lois Imber Mintz ◽  
Keith H. Nuechterlein ◽  
Michael J. Goldstein ◽  
Jim Mintz ◽  
Karen S. Snyder
Keyword(s):  
Hospital Admission ◽  
Expressed Emotion ◽  
Patient Treatment ◽  
First Episode ◽  
Parental Report ◽  
Illness Onset ◽  
Best Estimate ◽  
Duration Of Illness ◽  
Initial Onset ◽  
Schizophrenic Patients

The relationships between duration of schizophrenic illness before first hospital admission, expressed emotion in key relatives, and illness course have yielded conflicting reports. This study examined the issue from a methodological perspective in a sample of first-episode schizophrenic patients. A ‘best estimate’ of illness onset, based on a compilation of all sources, was compared with an estimate based on parental report. Parental estimates suggested that the children of high-EE parents had been ill for significantly longer, but this difference was not confirmed by the best estimate. In most cases, the ill children of high-EE parents were living at home before hospital admission and their parents' estimates of duration were quite accurate. In the few cases in which the child was living away from home, high-EE parents strikingly overestimated duration. Children of low-EE families were more likely to be living away from home, but this factor did not explain the consistent underestimates of duration made by their parents. Although duration of illness did not relate to EE, successful engagement in out-patient before in-patient treatment was more common among children from low-EE families.

The Study of the Antisaccade Performance and Contingent Negative Variation Characteristics in First-Episode and Chronic Schizophrenia Patients

2017 ◽  
Vol 20 ◽  
Author(s):  
Anna V. Kirenskaya ◽  
Andrej A. Tkachenco ◽  
Vladimir Yu. Novototsky-Vlasov
Keyword(s):  
Effect Size ◽  
Contingent Negative Variation ◽  
Chronic Schizophrenia ◽  
First Episode ◽  
Chronic Patients ◽  
Duration Of Illness ◽  
Latency Variability ◽  
Variation Characteristics ◽  
Schizophrenic Patients ◽  
Functional Deterioration

AbstractThe study tested whether the antisaccade (AS) performance and Contingent Negative Variation (CNV) measures differed between the first-episode and chronic patients to provide the evidence of PFC progressive functional deterioration. Subjects included 15 first-episode and 20 chronic schizophrenic patients (with the duration of illness more than 5 years), and 21 control subjects. The first-episode and chronic patients had significantly elevated error percent (p < .05, effect size 1.10 and p < .001, effect size 1.25), increased AS latencies (p < .01, effect size 1.18 and p < .001, effect size 1.69), and increased latencies variability (p < .01, effect size 1.52 and p < .001, effect size 1.37) compared to controls. Chronic patients had marginally significant increase of the response latency (p = .086, effect size .78) and latency variability (p < .099, effect size .63) compared to first-episode ones. Results of CNV analysis revealed that chronic patients only exhibited robustly declined frontal CNV amplitude at Fz (p < .05, effect size .70), F3 (p < .05, effect size .88), and F4 (p < .05, effect size .71) sites compared to controls. The obtained results might be related to specific changes in prefrontal cortex function over the course of schizophrenia.

Stress-Indicative Patterns of Non-Verbal Behaviour Their Role in Family Interaction

1992 ◽  
Vol 161 (S18) ◽  
pp. 103-113 ◽  
Author(s):  
Andreas Altorfer ◽  
Michael J. Goldstein ◽  
David J. Miklowitz ◽  
Keith H. Nuechterlein
Keyword(s):  
Mental Illness ◽  
Social Interaction ◽  
Hospital Admission ◽  
Expressed Emotion ◽  
Family Interaction ◽  
Short Term ◽  
Interpersonal Behaviour ◽  
Affective Attitudes ◽  
Verbal Behaviour ◽  
Schizophrenic Patients

Research in the field of interpersonal behaviour is widely recognised as an important key to understanding the nature of mental illness. In schizophrenic patients especially, deviant social interaction has been proved to be associated with pathological behaviour (see Bellack et al, 1989). Numerous studies have revealed that affective attitudes expressed towards the patient by a relative during hospital admission for an episode of schizophrenia (high expressed emotion (EE)) are predictive of the short-term course of the disorder (Leff & Vaughn, 1985; Jenkins et al, 1986; Nuechterlein et al, 1986; Mintz et al, 1987).

Changes in the Positive and Negative Symptoms of Schizophrenic In-patients in China

1991 ◽  
Vol 159 (2) ◽  
pp. 226-231 ◽  
Author(s):  
Michael R. Phillips ◽  
Zuan Zhao ◽  
Xianzhang Xiong ◽  
Xiufang Cheng ◽  
Guirong Sun ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Psychiatric Hospitals ◽  
Chronic Schizophrenia ◽  
First Episode ◽  
Positive Symptoms ◽  
Positive Type ◽  
Duration Of Illness ◽  
Assessment And Treatment ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

Positive and negative symptoms at admission and discharge of 401 unselected schizophrenic patients from four psychiatric hospitals around China were studied. On admission, 58% of patients had prominent negative symptoms and the overall severity of negative symptoms was similar to that of positive symptoms; at discharge, negative symptoms were more prevalent and more severe. The severity of negative symptoms was not significantly correlated with duration of illness or with dosage of medication; 48% of first-episode, drug-naive patients had prominent negative symptoms on admission. Negative symptoms responded to standard neuroleptic treatment, but the improvement was less marked than that in positive symptoms (47% v. 80%). The proportion of patients classified as positive type, negative type, and mixed type schizophrenia altered dramatically with treatment. These findings highlight the importance of negative symptoms in the assessment and treatment of both acute and chronic schizophrenia.

352. Thalamic volumes in first episode schizophrenic patients

2000 ◽  
Vol 47 (8) ◽  
pp. S106
Author(s):  
A. Gilbert ◽  
S. Spencer ◽  
I. Mankowski ◽  
M.R. Zeigler ◽  
D.M. Montrose ◽  
...  
Keyword(s):  
First Episode ◽  
Schizophrenic Patients

Appraisal, psychological adjustment and expressed emotion in relatives of patients suffering from schizophrenia

1997 ◽  
Vol 171 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Christine Barrowclough ◽  
Michael Parle
Keyword(s):  
Expressed Emotion ◽  
Symptom Control ◽  
Well Being ◽  
Primary Appraisal ◽  
Coping Theory ◽  
Secondary Appraisal ◽  
Multivariate Relationships ◽  
Schizophrenic Patients ◽  
A Prospective Study ◽  
Appraisal Processes

BackgroundIt is argued that coping theory may be useful in attempting to understand how relatives adapt to the demands of living with a schizophrenia sufferer.MethodIn a prospective study, univariate and multivariate relationships were explored between appraisal variables (appraisal of symptom threat (primary appraisal) and perceived symptom control (secondary appraisal)) and (a) expressed emotion, and (b) psychological distress in relatives of schizophrenic patients. The profile of relatives who showed sustained distress over time was also examined.ResultsThe appraisal variables were found to be related to both the concurrent distress (GHQ scores), EE ratings of relatives at the time of the patients relapse and hospitalisation, as well as the subsequent GHQ scores of relatives when the patient was discharged back home. Relatives who showed sustained distress were likely to show high EE and have a longer caring history.ConclusionsThe study gives some support to the theory that appraisal processes underlie how relatives react to having a family member with schizophrenia, and may have implications both for identifying those at risk of poor adaptation, and for understanding strategies that improve well-being.

The SIEP-DIRECT's Project on the discrepancy between routine practice and evidence. An outline of main findings and practical implications for the future of community based mental health services

2008 ◽  
Vol 17 (4) ◽  
pp. 358-368 ◽  
Author(s):  
Mirella Ruggeri ◽  
Antonio Lora ◽  
Domenico Semisa
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Guideline Implementation ◽  
Specific Treatment ◽  
Care Process ◽  
First Episode ◽  
Routine Practice ◽  
Nice Guidelines ◽  
Illness Onset

SUMMARYAims– To highlight the major discrepancies that emerged between evidence and routine practice in the framework of the SIEP-DIRECT's Project (DIscrepancy betweenRoutine practice andEvidence in psychiatricCommunityTreatments onSchizophrenia). The Project was conducted in 19 Italian mental health services (MHS), with the aims of: a) evaluating the appropriateness of the NICE Guidelines for Schizophrenia in the Italian context, b) developing and testing a set of 103 indicators that operationalised preferred clinical practice requirements according to the NICE Guidelines, and c) evaluating their actual application in Italian MHSs.Methods– The indicators investigated five different areas: common elements in all phases of schizophrenia; first episode treatment; crisis treatment; promoting recovery; the aggressive behaviour management.Results– The NICE recommendations examined were judged in most instances to be appropriate to the Italian MHS context, and the indicators fairly easy to use. The more severe and frequently encountered evidence-practice discrepancies were: lack of written material, guidelines, and information to be systematically provided to users; lack of intervention monitoring and evaluation; difficulty in implementingspecific and structured forms of intervention; difficulty in considering patients' family members as figures requiring targeted support themselves and who should also be regularly involved in the patient care process.Conclusions– The key actions to be undertaken to favour implementation of evidence-based routine practices are: focussing on mental illness onset and family support/involvement in care; planning training activities aimed at achieving specific treatment goals; encouraging MHS participation in evaluation activities; identifying thresholds for guideline application and promoting specific guideline implementation actions; and activating decision making and resource allocationprocesses that rely more strictly on evidence and epidemiological assessment. These considerations are of value for rethinking the model of community psychiatry in Italy as well as in other countries.Declaration of Interest: None.

Expressed emotion and relapse rates in schizophrenic patients

1992 ◽  
Vol 6 (2) ◽  
pp. 172-173
Author(s):  
R. Cohen ◽  
T. Niedermeier ◽  
H. Watzl
Keyword(s):  
Expressed Emotion ◽  
Schizophrenic Patients ◽  
Relapse Rates
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