Overview of Nutritional Status in Schizophrenic Patients at Dr. Soeharto Heerdjan Grogol Hospital in 2019

Nutritional status is a state of health due to interactions between food, the human body and the human environment. If lack of nutrients, the body will be more easily infected. Nevertheless, more nutrition can also be detrimental because it can lead to degenerative diseases. Therefore, it is crucial to maintain a balanced intake of nutrients following the body's needs. This study discusses the description of the nutritional status of schizophrenic patients at the Mental Hospital dr. Soeharto Heerdjan Grogol in 2019. This study used a descriptive observational research method to see the nutritional status and food intake of inpatient schizophrenia patients. One hundred fifty-five schizophrenia patients were hospitalized. The results showed more male patients than female patients. Changes in weight in schizophrenia patients increase more than is reduced. The most nutritional status of schizophrenia patients is good. Patients with malnutrition are 12.9%. Many patients leave <25% food. Patients with good nutrition are primarily found in the Peacock Room, which is an independent patient room. Key words: Schizophrenia, Nutritional Status, Malnutrition, Food Intake.

A Comparison of Thioredoxin 1 Gene Expression in Schizophrenia Patients before and after Treatment with Risperidone

Background: Schizophrenia is a mental disorder characterized by distortions in thinking, perception, emotions, language, self-sense, and behavior. Recent research suggests that Reactive Oxygen Species (ROS) are involved in the pathophysiology of schizophrenia. Studies have also shown the increased plasma and serum levels of the Trx1 molecule in schizophrenia patients. In the present study, the researchers compared the expression levels of Trx1 mRNA in peripheral blood leukocytes of Iranian schizophrenia patients compared to healthy controls. Methods: First-episode patients (n=35) who met DSM-IV criteria for schizophrenia were recruited from patients referred to psychiatrists in the city of Ilam and Farabi Hospital in Kermanshah. Healthy people were also selected by recruiting people who, according to a psychiatrist, did not have any mental illness. Diagnoses were made for each patient by two independent experienced psychiatrists and confirmed by the Structured Clinical Interview for DSM-IV (SCID). Patients were treated with risperidone for three months and then compared with thirty- five healthy volunteers. Patients were sampled before and after treatment and then by RNA Extraction and DNA synthesis, Trx1 gene expression was performed by real-time PCR method. Results: Comparison of Trx1 gene expression in PBMCs of schizophrenic patients before and after treatment with the control group showed that the expression of Trx1 gene of the “before” treatment group was significantly increased compared with that of the control group (P= 0.0007). Also, Trx1 gene expression in PBMCs of “before” and “after “groups showed that Trx1 gene expression of “after” group was significantly decreased compared to the “before” group (P= 0.014). These results showed that the mean of positive, negative, and general psychopathology was reduced significantly in schizophrenic patients before and after treatment in all three cases (P <0.001). Conclusion: the expression of TRX in PBMCs of schizophrenic patients decreased after risperidone treatment. This reduction of expression was statistically significant and indicates the possible effect of risperidone on the expression of the TRX gene in PBMCs of these patients and decreased gene expression is associated with reduced symptoms. Confirmation of the achievement of this study requires further research. Key words: Schizophrenia, Thioredoxin, Risperidone

Structure and types of response to disease and indexes of adaptability/maladaptation in endogenous psychoses with episodic course in the context of pathopersonalogical transformations in post-manifestation period

The study examined the structure and types of attitude toward the disease (ATD) and adaptability/maladaptation indices in 312 patients with endogenous episodic episodes (schizophrenia, schizoaff ective disorder (SAD) and aff ective disorders (AD)) in remission/ intermittent states and compared them. Characteristics of ATD and indicators of adaptability/disadaptation in endogenous psychosis with episodic course in the remission/intermission period are a sign of stable post-manifestation of pathopersonalogical transformations and have nosospecifi c diff erences. Patients suffering from endogenous episodic psychosis have a reserve of personal adaptive capacity. This is confirmed by the fact that among patients with maladaptive types of ATD, a signifi cant percentage is of the types with an interpsychic orientation (74.0 % of the contingent in AD, 55.9 % of those surveyed with SAD and 57.6 % with schizophrenia), which is a sign of the use of personal reserves in confronting the negative eff ects of the disease. The above-mentioned reserve of personal adaptation possibilities in AD is the largest, as shown by the larger (χ2 = 6.065, p < 0.05) percentages of types with an interpsychic orientation in the structure of maladaptive types of ATD. The obtained data can be implemented into the system of diff erential diagnosis and counteraction to social maladaptation, which is formed as a result of the disease. Key words: schizophrenia, schizoaff ective disorder, aff ective disorders, clinic, adaptation, pathopersonalogical features

Genetic Basis of Positive and Negative Symptom Domains in Schizophrenia

Schizophrenia is a highly heritable disorder, the genetic etiology of which has been well established. Yet despite significant advances in genetics research, the pathophysiological mechanisms of this disorder largely remain unknown. This gap has been attributed to the complexity of the polygenic disorder, which has a heterogeneous clinical profile. Examining the genetic basis of schizophrenia subphenotypes, such as those based on particular symptoms, is thus a useful strategy for decoding the underlying mechanisms. This review of literature examines the recent advances (from 2011) in genetic exploration of positive and negative symptoms in schizophrenia. We searched electronic databases PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature using key words schizophrenia, symptoms, positive symptoms, negative symptoms, cognition, genetics, genes, genetic predisposition, and genotype in various combinations. We identified 115 articles, which are included in the review. Evidence from these studies, most of which are genetic association studies, identifies shared and unique gene associations for the symptom domains. Genes associated with neurotransmitter systems and neuronal development/maintenance primarily constitute the shared associations. Needed are studies that examine the genetic basis of specific symptoms within the broader domains in addition to functional mechanisms. Such investigations are critical to developing precision treatment and care for individuals afflicted with schizophrenia.

Review paper. Gluten-related disorders and schizophrenia - potential linking mechanisms, diagnostic and therapeutic challenge

More and more evidence confirms the theory that the intake of cereal products containing gluten may play an important role in the pathogenesis of many diseases. There are also premises indicating the relationship between the so-called gluten-related diseases and the development and course of mental disorders, including schizophrenia. The aim of this article is to review the literature on the potential relationship between the consumption of gluten and schizophrenia, considering the etiopathogenesis and the role of gluten-free diet in the treatment of schizophrenia. Methods: There were analysed available research papers in PubMed and Google Scholar with the key words: schizophrenia, gluten- related disorders, allergy to grain products, celiac disease, microbiota, immune system, exorphins and time span: 1960-2016 . Conclusions: Existing research results indicate a possible relationship between diet rich in grain products with high gluten content and the occurrence or exacerbation of schizophrenia symptoms. However, further studies are necessary to: 1) identify groups of patients for whom the consumption of cereal products (gluten) is associated with a particular risk of schizophrenia exacerbation, 2) determine the mechanisms relating the consumption of gluten with the mental state of schizophrenic patients, 3) get the possible benefits of implementing gluten-free diet in patients with schizophrenia.

STUDI RETROSPEKTIF PENGGUNAAN TRIHEXYFENIDIL PADA PASIEN SKIZOFRENIA RAWAT INAP YANG MENDAPAT TERAPI ANTIPSKOTIK DI RUMAH SAKIT JIWA SAMBANG LIHUM

Trihexyphenidyl (THP) is used to treat symptoms of Parkinson's disease or involuntary movements due to the side effects of certain psychiatric drugs. It can also decrease other side effects such as muscle stiffness/rigidity (extrapyramidal syndrome or EPS). EPS were an unavoidable consequence of effective antipsychotic therapy. EPS reduce beneficial effects of antipsychotic treatment on the negative, cognitive, and mood symptom domains, while increasing the risk of tardive dyskinesia and reducing compliance. The purpose of this research was to analyze the percentage use of THP and the pattern of THP usage on schizophrenia patient which treated at Sambang Lihum Hospital. This retrospective observational study was conducted at an inpatient Sambang Lihum Hospital. This research were conducted to 264 medical records of patients period January 2013 to December 2013 which receive antipsychotics medication. Data were analyzed by univariate analysis. The result showed 94.32% (n=264) received THP. This research has shown the pattern of THP usage in Sambang Lihum Hospital which was to give THP directly to patients without EPS examination is 96.79% (n=249) and there are 15.66% (n=249) patients evaluated after 14 days after THP administered. Key Words: Schizophrenia, Trihexyphenidyl, EPS

Aggression in Psychoses

Most individuals diagnosed with a mental illness are not violent, but some mentally ill patients commit violent acts. PubMed database was searched for articles published between 1980 and November 2013 using the combination of key words “schizophrenia” or “bipolar disorder” with “aggression” or “violence.” In comparison with the general population, there is approximately a twofold increase of risk of violence in schizophrenia without substance abuse comorbidity and ninefold with such comorbidity. The risk in bipolar disorder is at least as high as in schizophrenia. Most of the violence in bipolar disorder occurs during the manic phase. Violence among adults with schizophrenia may follow two distinct pathways: one associated with antisocial conduct and another associated with the acute psychopathology, particularly anger and delusions. Clozapine is the most effective treatment of aggressive behavior in schizophrenia. Emerging evidence suggests that olanzapine may be the second most effective treatment. Treatment nonadherence greatly increases the risk of violent behavior, and poor insight as well as hostility is associated with nonadherence. Nonpharmacological methods of treatment of aggression in schizophrenia and bipolar disorder are increasingly important. Cognitive behavioral approaches appear to be effective in cases where pharmacotherapy alone is not sufficient.

SOCIAL SKILL TRAINING PADA PENYANDANG SKIZOFRENIA

Besides psychotic symptoms, schizophrenic patients also show alterations in cognitive function, verbal information, and emotional response, due to disturbances of interpersonal interaction. The impact of all of these is the disturbance in social function. Treatment of schizophrenic patients with psychopharmacotherapy can only suppress the symptoms, but it can not overcome the functional deficit. For this reason, combination of psychopharmacotherapy, psychotherapy, and social rehabilitationin is introduced to obtain a better result in schizophrenic management. Social skill training is a part of the social rehabilitation that is very useful in improving the patients’ quality of life in preparing them to be functional in their society. Key words: schizophrenia, social rehabilitation, social skill training. Abstrak: Pada penyandang skizofrenia selain gejala-gejala psikotik juga terdapat perubahan dalam fungsi kognisi, informasi verbal dan respon emosi akibat terganggunya interaksi interpersonal, yang berdampak gangguan dalam fungsi sosial. Pengobatan skizofrenia dengan menggunakan psikofarmaka hanya dapat menekan gejala-gejala penyakit ini tetapi tidak dapat mengatasi defisit fungsional. Untuk hal ini, pada pengobatan skizofrenia terkini digunakan kombinasi psikofarmaka, psikoterapi dan rehabilitasi sosial. Social skill training merupakan salah satu bagian dari rehabilitasi sosial yang bermanfaat meningkatkan kwalitas hidup dalam mempersiapkan penyandang skizofrenia untuk dapat berfungsi kembali dalam masyarakat. Kata kunci: skizofrenia, rehabilitasi sosial, social skill training.

Assessing Social Functioning in Schizophrenia

Aims:Social functioning has increasingly become recognised as an important outcome in schizophrenia. While measures of symptom status are highly developed and widely used there has been only limited work on developing instruments for measuring social functioning in a reliable and consistent manner. We aimed to review the schizophrenia literature to identify the structured social functioning measures that have been used with any frequency and compare their features (1).Method:A detailed electronic literature search (1990 - 2006) using the key words schizophrenia and social function was carried out and those papers containing details of any structured assessment of social function were used. The most frequently used instruments were identified. A search was also conducted for the use of social function measures in trials of antipsychotics in schizophrenia.Results:301 articles employed 87 potential social function measures and of these only 20 were used 3 or more times. Only 14 RCTs of antipsychotics employed them.Conclusions:There is limited consensus on the definition and measurement of social functioning but two or three scales show promise for regular usage.

Effectiveness of an Attention- and Memory-Training Program on Neuropsychological Deficits in Schizophrenia

The effect of two cognitive remediation procedures developed for closed head injury, Attention Process Training (APT) and Prospective Memory Training (PROMT), on neuropsychological deficits in schizophrenia was investigated. Six pa tients with schizophrenia, varying in baseline intellectual function and symptoms, were studied; three in a remediation condition and three in a nonremediated control con dition. Results were evaluated individually for each of the three treated patients. Two of three remediation-treated subjects showed marked improvement on tests of sus tained and divided attention. Untreated patients showed little evidence of change in neuropsychological test performance across a similar time interval, when tested on a subset of the measures administered to remediation-treated patients. The results of this study are discussed with a view toward future studies using larger sample sizes with homogeneous subject populations. Key Words: Schizophrenia—Cognitive—Reha bilitation—Symptoms—Outcome.