Predictors of symptomatic remission in patients with first-episode schizophrenia: A 16 years follow-up study

Objective Recent views on schizophrenia outcome and treatment suggest that symptomatic remission is possible, and a definition of remission has been proposed by the Remission in Schizophrenia Working Group (RSWG). This study evaluated whether patients who achieved remission after several years of illness (R) showed psychopathological differences at the onset of their disorder compared to non-remitted (NR) patients. Method Forty-eight patients with first-episode schizophrenia were evaluated with the Positive and Negative Symptoms Scale (PANSS) both at the onset of illness and after a mean period of 16 years. Patients were defined as R or NR according to the RSWG criteria. Results Eighteen patients (37.5%) were classified as R at follow-up. At onset, R patients showed a lower illness severity, less severe negative and general psychopathology symptoms compared to NR. Furthermore, they underwent fewer psychotic episodes than NR over the course of follow-up. Remission was predicted by lower severity of negative and general psychopathology symptoms at onset and by lesser number of psychotic episodes during follow-up. Conclusions The symptomatic remission may be a viable outcome in schizophrenia, particularly for patients with a mild illness and less severe negative symptoms at onset and with few psychotic episodes over time. \ua9 2014 Elsevier Inc

Obsessive-compulsive symptoms in schizophrenia and in obsessive-compulsive disorder: Differences and similarities

Introduction: A growing literature suggests that obsessive-compulsive (OC) phenomena represent a distinct dimension in schizophrenia, independent of nuclear psychotic symptoms. Nevertheless, the OC psychopathologic profile in schizophrenia, compared with "pure" obsessive-compulsive disorder (OCD), has not yet been investigated extensively. This study investigated the clinical features of the OC dimension in patients with schizophrenia compared with patients with pure OCD. Methods: The main psychopathologic features of obsessions and compulsions were rated in 35 patients with schizophrenia and 31 patients with OCD, using the Structured Clinical Interview for DSM-IV Axis I Disorders, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale, and the Leyton Obsessional Inventory. Results: OC phenomena were indistinguishable in terms of their severity, resistance, interference, and control in both groups. However, patients with OCD showed higher rates of aggressive, contamination-related, sexual, and somatic themes; moreover, in the group with schizophrenia, a positive relationship was found between washing compulsions and delusions and between hoarding obsessions and delusions. Conclusions: These results indicate that patients with schizophrenia exhibit a narrower range of obsessive content compared with patients with OCD; in addition, OC and delusional themes tend to be related in schizophrenia as a unique symptomatic phenomenon

The impact of obsessive dimension on symptoms and functioning in schizophrenia

Obsessive Compulsive Symptoms (OCS) and Disorder (OCD) occur frequently in patients with schizophrenia. Nevertheless the impact of OCS/OCD on clinical characteristics and outcome of schizophrenia remains controversial. The aim of the present study is to examine the effect of obsessive-compulsive dimension on symptom expression and functioning in schizophrenia. Sixty patients affected by schizophrenia completed the SCID-IV, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale, the Social and Occupational Functioning Assessment Scale and the Strauss and Carpenter Level of Functioning Rating Scale. Obsessive-compulsive dimension was associated neither with positive or disorganization symptoms nor with negative symptoms. By contrast, it adversely affected levels of functioning, with a major impact exerted by compulsions rather than obsessions. Obsessive-compulsive dimension appears to be independent from negative and positive symptoms of schizophrenia and independently decreases social functioning

Type D personality in never-depressed patients and the development of major and minor depression after acute coronary syndrome

Background Type D personality (TDP) has been proposed as a risk factor for the development of depressive symptoms after an acute coronary syndrome (ACS). However, contrasting findings emerged about its predicting power on the onset of depression, since an overlap between TDP and depressive symptoms has been proposed. The present study was aimed to verify whether TDP predicts the development of a depressive disorder in the 6 months after the discharge from hospital. Methods Two hundred fifty consecutive patients were recruited, at the Coronary Intensive Care Unit at the University Hospital of Parma, who were both presenting their first ACS and had no history of depression. The presence and the severity of major (MD) and minor (md) depression were evaluated with the Primary Care Evaluation of Mental Disorders (PRIME-MD) and the Hospital Anxiety and Depression Scale (HADS) respectively. Type D Personality was assessed with the DS14, both at baseline and at 1, 2, 4 and 6 month follow ups. Results Out of 250 subjects (81.2% males), MD was diagnosed in 12 patients (4.8%) and md in 18 patients (7.2%). At baseline risk factors for a post-ACS depressive disorder were HADS depression scores, whereas TDP, or its subscales, did not showed any effect. Limitation The small amount of patients with incidence of depression, due to highly selective inclusion criteria, tempers the reliability of our results. Conclusion Our data suggests that TDP does not predict the development of depressive disorders in never-depressed patients at their first ACS, when the baseline depression severity was controlled. © 2013 Elsevier B.V

Type D personality in never depressed patients at their first acute coronary syndrome

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Decrease of functioning in remitted and non-remitted patients 16 years after a first-episode schizophrenia

In schizophrenia, a better level of functioning has been generally associated with symptomatic remission. However, this association has been supported by cross-sectional studies or by studies with a short follow-up period. Forty-eight patients with schizophrenia were evaluated by the Positive and Negative Symptoms Scale and the Social and Occupational Functioning Assessment Scale (SOFAS) at the first episode and after a mean period of 16 years. At follow-up, patients were defined as remitters (R) or non-remitters (NR) according to the Remission Schizophrenia Working Group criteria. R (n = 18; 37.5%) compared to NR showed at the first episode a lower illness severity and a better level of functioning. A functional decline was found in both groups at follow-up, even though NR showed a more than twofold reduction than R. Better SOFAS scores at follow-up were predicted by baseline SOFAS score and less severe negative symptoms at follow-up. Schizophrenia implies a functional decline over time, regardless of the symptomatic remission status with negative symptoms playing a major role

An investigation of the static damage mechanisms of pultruded glass fiber reinforced polymers with artificial neural networks.

Pultrusion is a promising technique for manufacturing composite materials in the form of constant-section profiles, which allows to obtain these products in a highly automated way and with an overall good fiber alignment and cohesion. This material is used in civil and structural applications, but its development is being slowed down due to the fact that different types of damage can suddenly develop during the loading of the structure, leading to unexpected failure. The objective of the study is to identify the damage modes evolving in pultruded glass-fiber reinforced polymers during static tensile tests. The experimental campaign consists of 34static tensile specimens with two different layups. During each test, Acoustic Emission data is recorded to assess the different characteristics of the signals and their location. A Self Organizing Map, clustered with the k-means algorithm, was used for retrieving classes of similar signals in the dataset. The evolution of damage and energy content of each class was followed during the test; this allowed identifying and separating different damage modes. Moreover, the possibility to apply unsupervised neural network clustering techniques to the AE data is investigated; this is used to filter out the signals which aren’t linkable to a material degradation

Damage assessment in pultruded GFRP with AE

Pultrusion is a process for manufacturing uniform section composite profiles, which allows to obtain structural elements of virtually any length. The use of E-glass fiber allows to obtain a material with a good rigidity-to-weight and strength-to-weight ratio; these features allowed to use these materials in civil structures, such as poles for anti-noise panels and public lighting, also thanks to their insulating properties. However, the knowledge on the damage development of these materials is still uncertain, and this is slowing down their development

Development of an artificial neural network processing technique for the analysis of damage evolution in pultruded composites with acoustic emission

Acoustic Emission (AE) is a promising technique for the damage detection and the real-time structural monitoring of composite lightweight structures; however data interpretation and discrimination among failure modes from AE data is difficult to be carried out without proper data processing techniques. In this paper, a neural-network based classification of AE signals from tensile tests of pultruded glass-fiber specimens is proposed. A self-organizing map is trained with AE data from one specimen; then the map is clustered with the k-means algorithm. The optimal number of clusters is chosen by a voting procedure that takes into account a number of quality indexes; then the clustered neural network is used to classify AE data from other specimen. Results have shown that the classifier built from a smooth specimen was able to correctly classify other specimens with the same and with a different material layup, and is capable of recognizing signals from notched specimens, thus providing interesting and encouraging indications in view of the application on real structures