66 research outputs found
Inverse relationship between serum high density lipoprotein and negative syndrome in antipsychotic-naive schizophrenia
Background: Recent literature suggests a role for apolipoprotein L (apoL) aberrations in the pathogenesis of schizophrenia. ApoL is almost exclusively associated with apolipoprotein A-I in high-density lipoproteins (HDLs). The objective of this study was to examine the correlation between symptom scores and serum HDL in antipsychotic-naive schizophrenia patients. Methods: In this cross-sectional study, 60 antipsychotic-naive schizophrenia patients were systematically examined for their symptom scores, with good inter-rater reliability. Concurrently, an overnight fasting serum lipid profile from these patients was assessed. Results: Serum HDL had a significant inverse correlation with a total negative syndrome score (Ď=â0.43; p=0.001). Conclusions: The study observation supports the potential role for HDL abnormalities in the genesis of negative symptoms in schizophrenia. Clin Chem Lab Med 2010;48:95â8.Peer Reviewe
Schedule of Factors Influencing Adherence (SOFIA) to Psychiatric Treatment in Persons with Schizophrenia: Validity and Pilot Testing
Qualitative research has highlighted the complexinterplay of multiple factors that preclude persons withschizophrenia in rural Indian settings for discontinuedpsychiatric treatment. In this context, this paper aims toestablish the face and content validities of an interviewschedule titled âSchedule of Factors InfluencingAdherence (SOFIA) to Psychiatric Treatment in Personswith Schizophreniaâ which comprehensively assessesfactors for discontinued psychiatric treatment and  thefeasibility of its administration of the schedule. SOFIAcontains 16 factors. This schedule involves three phases of interviewing patients and family members. This wasgiven to twelve experts who used likert scales to rate eachitems wells as the dimensions of the schedule. Later on,fifteen persons with schizophrenia were interviewed withSOFIA to test the feasibility of administration. The resultsshowed that Fourteen items were rated as eithersatisfactory (score=4) or very much satisfactory (score=5)by all twelve experts; remaining two were rated as 4 or 5by 11 experts. Regarding comprehensiveness of thefactors, scoring methods and general instructions given tothe interviewers, all provided scores > 4; regardingmethod of interviewing, 11 provided score of > 4; withregard to overall interview schedule, all experts providedscores > 4. Pilot testing revealed that it took 60 minutes to administer SOFIA
Yoga for schizophrenia: PatientsⲠperspective
Context: Yoga-based intervention is emerging as an effective add-on therapy in the management of schizophrenia. However, many barriers make it difficult for patients to avail yoga therapy programs. One of them is motivation for yoga therapy. Ways to address the barriers are critical to employ yoga as a treatment in this population.
Aim: This study aims at exploring patientsⲠwillingness to participate in add-on yoga therapy programs on out-patient basis.
Settings and Design: The study was conducted on 100 schizophrenia patients attending psychiatry out-patient services of a tertiary care hospital.
Materials and Methods: A total of 100 schizophrenia patients (male: female = 57:43; age: 35.8 Î 9.2 years) attending the psychiatry out-patient services of a tertiary neuropsychiatry hospital were administered a survey questionnaire.
Statistical Analysis Used: Chi-square test was used for testing the significance of proportions. P < 0.05 was taken to be significant.
Results: About 46% were aware that yoga is also one of the complementary therapies useful in schizophrenia. 32% had tried yoga in the past for some reasons, but only 31% of them were continuing yoga; commonest reasons for not continuing being lack of motivation (31%) and inability to spare time (27.6%). However, the majority (88.5%) of them were willing to take up add-on yoga therapy on out-patient basis along with their regular medical follow-up.
Conclusions: In spite of the lack of motivation to practice yoga, the majority of patients were willing to participate in add-on yoga therapy programs if given on out-patient basis along with their regular conventional medical follow-up
Early intervention in psychotic disorders: Challenges and relevance in the Indian context
Over the last two decades, there has been an increasing interest in the concept of early intervention (EI) in psychotic disorders, notably schizophrenia. Several lines of research underlie this emerging paradigm shift: (a) an increasingly well-established association between the duration of prolonged untreated illness and poor outcome; (b) evidence of progressive neurobiological changes in the early course of schizophrenia both in the pre-psychotic and psychotic phases, as evidenced by brain imaging studies in schizophrenia; and (c) emerging data, albeit preliminary, suggesting the efficacy and effectiveness of EI programs in improving the outcome in these patients. Mental health service systems across the globe, including Asian countries, have been incorporating specialized early intervention programs. However, literature on EI in the Indian setting is relatively sparse. In this article, we will review the rationale and approaches to EI and the application of these approaches to the Indian context, in light of the available literature. We also examine the constraints in the implementation of EI. Controlled data are needed to evaluate EI and the roadblocks to them, in order to implement EI in the resource-strapped mental health service settings in India
Proton magnetic resonance spectroscopy in depression
Magnetic Resonance Spectroscopy (MRS) is a unique technique that can directly assess the concentration of various biochemical metabolites in the brain. Thus, it is used in the study of molecular pathophysiology of different neuropsychiatric disorders, such as, the major depressive disorder and has been an area of active research. We conducted a computer-based literature search using the Pubmed database with âmagnetic resonance spectroscopyâ, âMRSâ, âdepressionâ, and âmajor depressive disorderâ as the key words, supplemented by a manual search of bibliographic cross-referencing. Studies in depression report abnormalities in the frontal cortex, basal ganglia, hippocampus, anterior cingulate cortex, and the occipital cortex. These abnormalities improve after treatment with selective serotonin reuptake inhibitor, electroconvulsive therapy, and yoga, and thus, are possibly state-dependent. The findings are consistent with other morphometric and clinical studies and support the proposed pathophysiological theory of dysfunction in the neuronal circuits involving the frontal cortex, limbic cortex, and basal ganglia. Spectroscopy also has potential implications in predicting the response to treatment and formulating individualized pharmacotherapy
Mirror neuron dysfunction and ego-boundary disturbances in schizophrenia: A transcranial magnetic stimulation study
Background: Ego-boundary disturbance (EBD) is a unique symptom cluster characterized by passivity experiences (involving thoughts, actions, emotions and sensations) attributed by patients to some external agency. The neurobiology of these "first rank" symptoms is poorly understood. Aberrant mirror neuron activation may explain impaired self-monitoring and agency attribution underlying these symptoms. We aim to study mirror neuron activity (MNA) in schizophrenia patients with and without EBD using transcranial magnetic stimulation (TMS). Materials and Methods: 50 right-handed schizophrenia patients (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) were evaluated using the Mini-International Neuropsychiatric Interview and the Positive and Negative Syndrome Scale. They completed a TMS experiment to assess putative premotor MNA. Motor evoked potential (MEP) was recorded in the right first dorsal interosseous muscle (FDI) with (a) 120% of resting motor threshold (RMT), (b) stimulus intensity set to evoke MEP of motor threshold 1 mV amplitude (MT1), (c) two paired pulse paradigms (short- and long interval intra-cortical inhibition). These were done in three states: Actual observation of an action using the FDI, virtual-observation (video) of this action and resting state. The percent change of MEP from resting to action-observation states formed the measure of putative MNA. Results: MNA measured using MT1 and 120% RMT paradigms was significantly lower in the 18 patients with EBD (thought-broadcast/withdrawal/insertion, made-act/impulse/affect and somatic passivity) than the 32 patients without EBD (t = 2.431, P = 0.020; t = 2.051, P = 0.04 respectively for the two paradigms). The two groups did not differ on age, gender, education and total symptom scores. Conclusion: Schizophrenia patients with EBD have lower premotor MNA. This highlights the role of MNA dysfunction in the pathophysiology of this unique and intriguing symptom cluster in schizophrenia
Yoga as an add-on treatment in the management of schizophrenia: a randomized controlled trial
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