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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We sought to explore the relationships of three temperament factors with domain-specific subjective quality of life (QOL) of patients with schizophrenia. Ninety patients with schizophrenia were evaluated using the Quality of Life Enjoyment and Life Satisfaction Questionnaire, the Tridimensional Personality Questionnaire, the Positive and Negative Syndromes Scale, the Distress Scale for Adverse Symptoms, the Insight and Treatment Attitudes Questionnaire, the Insight Self-Report Scale, and standardized questionnaires for self-reported emotional distress and stress process-related variables. Predictors of domain-specific QOL were identified using multiple regression techniques. Temperament factors explain 6% to 16% of variability in QOL domain scores among patients with schizophrenia after controlling for the remaining variables (emotional distress, social support, self-esteem, avoidance coping, age, side effects, and depression). We found that higher levels of novelty seeking are associated with better general QOL, physical health, and more positive subjective feelings, whereas higher levels of reward dependence are related to better satisfaction from social relationships. Higher levels of harm avoidance are associated with poorer satisfaction with general activities, and medication. Thus, temperament factors, as assessed by the Tridimensional Personality Questionnaire, substantially influence satisfaction with life quality in schizophrenia. Novelty seeking, reward dependence, and harm avoidance are associated with different domains of QOL.
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PMID:Satisfaction with quality of life varies with temperament types of patients with schizophrenia. 1455 69

The successful integration of former psychiatric inpatients into the community requires innovative programs of psychosocial rehabilitation, including supported education. This article examines psychological distress as an outcome variable, and social support and coping strategies as mediating variables among 70 service-user students (SUS) with schizophrenia and a comparison group of 55 adult students (AS) with no psychiatric diagnosis. Both groups were participants in a supported education program. The study variables were assessed by standardized research instruments: the Talbieh Brief Distress Inventory (TBDI), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Coping Inventory for Stressful Situations (CISS). Univariate and multivariate analyses were used. Compared with the control subjects, SUS reported higher emotional distress and the utilization of emotion-oriented coping strategies, and a lesser availability of social support from family and friends. These variables explained 46.3%, 24.5%, and 22.5%, respectively, of the total variance in psychological distress scores. The findings provide the basis for interventions geared to reduce distress and, as a result, to enable students with severe mental illness to fully utilize the supported education program.
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PMID:Stress in adult students with schizophrenia in a supported education program. 1533 4

Ego functioning of 222 outpatients with a diagnosis of schizophrenia or schizoaffective disorder was evaluated using the Bell Object Relations and Reality Testing Inventory (BORRTI). Sixty-one of these had BORRTI profiles identified as sealed-over recovery style, and 36 had profiles interpreted as integrated recovery style. Groups were compared on demographic characteristics, symptom profiles, and the Wisconsin Card Sorting Test, a performance measure of executive function. Groups had comparably low levels of positive symptoms, but the integrated recovery group had higher scores on the BORRTI uncertainty of perception scale. The integrated recovery group had significantly fewer minority patients, higher IQ, and higher levels of emotional discomfort. The sealed-over recovery group had higher levels of cognitive disorganization. When differences in ethnicity and IQ were controlled for, the integrated recovery group had better executive functioning. Wisconsin Card Sorting Test categories completed emerged as the significant predictor in a logistic regression, explaining 19% of the variance. These findings support the discriminant validity of these two recovery styles and reveal the importance of executive function in a recovery style that allows for investment in relationships, affect tolerance, and acknowledgment of symptoms.
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PMID:Integrated versus sealed-over recovery in schizophrenia: BORRTI and executive function. 1567 28

Schizophrenia spectrum disorders often involve a profound diminishment in people's ability to coherently narrate their lives. Unknown is whether narrative difficulties of persons with schizophrenia differ from those with other disabilities, and how they relate to clinical or neurocognitive aspects of schizophrenia. To address both issues, personal narratives were obtained for 25 participants with schizophrenia spectrum disorders and a comparison group of eight legally blind participants and four with major depressive disorders. Flexibility of abstract thought and positive, negative, and emotional discomfort symptoms were assessed among the schizophrenia group. ANCOVA comparing scores on our scale to assess narrative development, controlling for age, found the schizophrenia group narratives significantly more impoverished than the comparison group on multiple dimensions, including self-worth and agency. Neurocognitive impairment and negative symptoms were significant predictors of impoverishment in the schizophrenia group. Results may highlight deficits that could be addressed in psychotherapy or rehabilitation to promote recovery.
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PMID:Narrative qualities in schizophrenia: associations with impairments in neurocognition and negative symptoms. 1580 20

The Quality of Life Scale (QLS(21)) is widely used in clinical trials involving schizophrenia patients. This study aimed to identify a core subset of QLS(21) items that maintains the validity and psychometric properties of the complete version. A parsimonious subset of items from the QLS(21) that can accurately predict the total scale score was sought and evaluated in 133 schizophrenia patients, using the heuristic algorithm for a regression model. Two additional data sets were used for model validation: a subset of 124 patients who participated in the model construction and who completed the QLS(21) 1 year later as well as a new sample of 40 inpatients. Patients were examined with the Positive and Negative Syndrome Scale (PANSS), the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Talbieh Brief Distress Inventory (TBDI), the Extrapyramidal Symptom Rating Scale (ESRS) and the Global Assessment of Functioning Scale (GAF). Using only five QLS items (social initiatives, adequacy, acquaintances, motivation, and time utilization; QLS(5)) as predictors, the correlation was 0.9805 between the predicted and true QLS totals. Two validation samples confirmed this finding. Additional analyses indicate that the QLS(5) exhibited similar performance to the QLS(21) regarding construct validity, test-retest reliability and responsiveness to changes over time. Thus, the five-item condensed Quality of Life Scale for schizophrenia maintains the validity of the full QLS, and has the advantage of shorter administration time. Utilization of the revised QLS(5) in routine care and clinical trials may potentially facilitate evaluation of treatment outcomes in schizophrenia.
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PMID:Condensed version of the Quality of Life Scale for schizophrenia for use in outcome studies. 1589 Apr 13

Cross-section research suggests reported childhood abuse in schizophrenia spectrum disorders is linked with graver symptom levels and social dysfunction. To examine this prospectively, we compared biweekly ratings of positive and emotional discomfort symptoms and weekly accounts of hours worked over 4 months of rehabilitation of 12 participants with schizophrenia or schizoaffective disorder and childhood sexual abuse history and 31 with schizophrenia or schizoaffective disorder and no childhood sexual abuse history. Repeated-measures ANOVA revealed the abuse group had consistently higher levels of both symptom components and poorer participation in vocational rehabilitation. A time by group effect was observed for hours of work, with the abuse group working increasingly fewer hours over time. Participants reporting abuse also were more likely to perform poorly on a test of executive function and to have particularly higher levels of hallucinations and anxiety over time. Clinical and theoretical implications are discussed.
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PMID:Reported history of child sexual abuse in schizophrenia: associations with heightened symptom levels and poorer participation over four months in vocational rehabilitation. 1631

This study aimed to investigate the relationship between measures of clinical symptom severity and sleep EEG parameters in a relatively diagnostically homogeneous group of patients with schizophrenia. We obtained sleep EEG data in 15 drug-free inpatients who met DSM-IV-R criteria for schizophrenia, undifferentiated type, with 15 age- and sex-matched normal controls over two consecutive night polysomnographic recordings. Clinical symptoms were assessed by the Positive and Negative Symptom Scale (PANSS) and Hamilton Rating Scale for Depression. Characteristic features of sleep disturbance were seen in patients with schizophrenia: profound difficulties in sleep initiation and maintenance, poor sleep efficiency, a slow wave sleep (SWS) deficit, and an increased REM density. SWS was inversely correlated with cognitive symptoms. REM density was inversely correlated with positive, cognitive, and emotional discomfort symptoms as well as PANSS total score. Our data demonstrate that drug-free patients with chronic undifferentiated type schizophrenia suffer from profound disturbances in sleep continuity and sleep architecture. Both the SWS deficit and cognitive impairment found in schizophrenics in this study may relate to similar underlying structural brain abnormalities.
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PMID:Clinical significance of sleep EEG abnormalities in chronic schizophrenia. 1637 58

Weight gain is associated with the use of many psychotropic medications, including antidepressants, mood stabilizers, antipsychotic drugs, and may have serious long term consequences: it can increase health risks, specifically from overweight (BMI = 25-29.9 kg/m2) to obesity (BMI > or =30 kg/m2), according to Body Mass Index (BMI), and the morbidity associated therewith in a substantial part of patients (hypertension, coronary heart desease, ischemic stroke, impaired glucose tolerance, diabetes mellitus, dyslipidemia, respiratory problems, osteoarthritis, cancer); according to patients, psychosocial consequences such as a sense of demoralization, physical discomfort and being the target of substantial social stigma are so intolerable that they may discontinue the treatment even if it is effective. The paper reviews actual epidemiological data concerning drug induced weight gain and associated health problems in psychiatric patients : there is a high risk of overweight, obesity, impaired glucose tolerance, diabetes mellitus, premature death, in patients with schizophrenia or bipolar disorder; and the effects of specific drugs on body weight: Tricyclic Antidepressants (TCA) induced weight gain correlated positively with dosage and duration of treatment, more pronounced with amitriptyline ; Selective Serotonin Reuptake Inhibitors (SSRI) decrease transiently bodyweight during the first few weeks of treatment and may then increase bodyweight; weight gain appears to be most prominent with some mood stabilizers (lithium, valproate); atypical antipsychotics tend to cause more weight gain than conventional ones and weight gain, diabetes, dyslipidemia, seem to be most severe with clozapine and olanzapine. Conceming the underlying mechanisms of drug induced weight gain, medications might interfere with central nervous functions regulating energy balance; patients report about: increase of appetite for sweet and fatty foods or "food craving" (antidepressants, mood stabilizers, antipsychotic drugs) and weight gain despite reduced appetite which can be explained by an altered resting metabolic rate (TCA, SSRI, Monoaminoxidase Inhibitors MAO I). According to current concepts, appetite and feeding are regulated by a complex of neurotransmitters, neuromodulators, cytokines and hormones interacting with the hypothalamus, including the leptin and the tumor necrosis factor system. The pharmacologic mechanisms underlying weight gain are presently poorly understood: maybe the different activities at some receptor systems may induce it, but also genetic predisposition. Understanding of the metabolic consequences of psychotropic drugs (weight gain, diabetes, dyslipidemia) is essential: the insulin-like effect of lithium is known; treatment with antipsychotic medications increases the risk of impaired glucose tolerance and diabetes mellitus. Several management options of weight gain are available from choosing or switching to another drug, dietary advices, increasing physical activities, behavioural treatment, but the best approach seems to attempt to prevent the weight gain : patients beginning maintenance therapy should be informed of that risk, and nutritional assessment and counselling should be a routine part of treatment management, associated with monitoring of weight, BMI, blood pressure, biological parameters (baseline and three months monitoring of fasting glucose level, fasting cholesterol and triglyceride levels, glycosylated haemoglobin). Psychiatrics must pay attention to concomitant medications and individual factors underlying overweight and obesity. Weight gain has been described since the discovery and the use of the firstpsychotropic drugs, but seems to intensify with especially some of the second generation antipsychotic medications ; understanding of the side effects of psychotropic drugs, including their metabolic consequences (weight gain, diabetes, dyslipidemia) is essential for the psychiatrics to avoid on the one hand a risk of lack of compliance, a discontinuation of the pharmacological medication and also a risk of relapse and rehospitalization, and on the other hand to avoid acute life threatening events (diabetic ketoacidocetosis and non ketotic hyperosmolar coma, long term risk complications of diabetes and overweight).
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PMID:[Psychotropic drugs induced weight gain: a review of the literature concerning epidemiological data, mechanisms and management]. 1638 18

Recovery from schizophrenia may involve persons developing a renewed sense of their illness, identity, agency, and worth within their life stories. To explore the requirements and challenges of psychotherapy that could facilitate this, we present a case study of a person with schizophrenia enrolled in treatment for over 19 months. Observed challenges to this process include the therapist's inclinations to "fix" the client, the client's own deficits and symptoms, and discomfort within the therapeutic relationship. Techniques to address these difficulties are presented, along with an objective means of assessing the treatment outcomes in terms of changes in narrative processes.
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PMID:Narrative enrichment in the psychotherapy for persons with schizophrenia: a single case study. 1648 68

This study aimed to identify factors that influence changes in satisfaction with quality of life (QOL) of schizophrenia patients. Baseline and follow up data for 148 schizophrenia patients were obtained at hospital admission and 16 months later. Relationships between changes over time in the general QOL index, and various factors were investigated using factor, multiple regression, and partial correlation analyses. Findings indicate that baseline levels of activation symptoms, emotional distress, task oriented coping, self-esteem and friend support together explain 41% of the variability in the general QOL index 16 months later. Changes in the general QOL of schizophrenia patients over time is associated with anergia, and paranoid symptoms, emotional distress, side effects, self-esteem, emotion and avoidance related coping styles, expressed emotion, and other social support. Determinants of change in QOL of patients were different being in hospital or out of hospital in the real world. No significant association of age, education, and follow up duration, with general QOL. Based on obtained data three types of overlapping factors were defined: (1) distressing, and protective; (2) primary and secondary; and (3) factors that remained constant or changed over time. Presented data are discussed within the framework of the Distress/Protection model of QOL. The conceptualization of three types of factors influencing QOL outcomes in this model demonstrates their predictive value, and may assist investigators and mental health workers in the interpretation of QOL data that may be used to improve patients' QOL outcomes.
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PMID:Determinants of changes in perceived quality of life in the course of schizophrenia. 1654 90


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