Antenatal risk factors for postnatal depression: a prospective study of chinese women at maternal and child health centres

Background: Risk factors for postnatal depression (PND) are under-explored in the Chinese populations. There is increasing recognition of the importance of identifying predictive factors during the antenatal period for PND. The present study aimed to identify the risk factors for postnatal depression in a community cohort of Chinese women with special focus on the antenatal risk factors.Methods: Eight hundred and five Chinese women were interviewed during their third trimester of pregnancy and at around 2 months postnatally. Putative risk factors for PND were collected and the diagnosis of PND was confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders. The 2-month postnatal depression status was used as the dependent variable for univariate and multivariate analyses against putative risk factors.Results: Marital dissatisfaction (Relative Risk = 8.27), dissatisfied relationship with mother-in-law (Relative Risk = 3.93), antenatal depressive symptomatology (Relative Risk = 3.90), and anxiety-prone personality (Relative Risk = 2.14) predicted PND in Chinese women independently.Conclusions: Chinese women tend to keep their own feelings and emotions and it is important to monitor Chinese pregnant women with these predictive risk factors so that PND can be identified early. © 2012 Siu et al; licensee BioMed Central Ltd.published_or_final_versio

What would help? Factors associated with the mood disturbance of mothers at their postpartum period

Poster Presentation - Maternal and Child Health: no. PS76Theme: Innovation to Advance Practice Nursin

Normalization of semantic categorization deficit in first-episode schizophrenia patients following symptomatic recovery: a three-year prospective longitudinal study

Poster no. 259BACKGROUND: Semantic memory dysfunction has been suggested in schizophrenia using the categorization task. However, data were largely inconsistent and the longitudinal trajectory of the deficit was unknown. Current study aimed to explore the 3-year longitudinal course of semantic memory deficits in first-episode schizophrenia patients. METHODS: First-episode schizophrenia patients (DSM-IV) were assessed prospectively at the point of first contact (A1), after clinical stabilization (A2), and each year for the following 3 years (Y1, Y2, Y3) using the categorization task. Patients are required to make decision (yes or no) on whether a 'word' belonged to a 'category'. 40 pairs of words were divided into 4 categories: fruits, furniture, drinks and clothing. Each category (e.g., furniture) was subdivided into five degrees of semantic relatedness: (1) typical word of the category (e.g., table), (2) atypical of the category (e.g., bookcase), (3) borderline word (e.g., clock), (4) related but outside the category (e.g., painting) and (5) unrelated and outside the category (e.g., sun). Data on both reaction time and proportion of yes response were analyzed. Normal participants were assessed once. RESULTS: 37 first-episode schizophrenia patients and 37 normal were recruited (matched for gender, age and education). Five ANOVAs were carried out to detect the difference in the five semantic relatedness conditions between patients and control at each of the 5 timepoints. In the first ANOVA which compared patients at A1 and control, reaction times in all conditions were slower in patients compared with control (F(1, 72)=7.83, p=.007). Significant main effect of semantic relatedness condition (F(4, 288)=12.30, p<.001) and interaction effect were also found (F(4, 288)=4.88, p=.001). Post-hoc pairwise comparisons found the two groups were different with regard to typical (p=.006), related (p=.036), and unrelated condition (p<.001). Interestingly, the remaining ANOVAs produced the same results. Significant main effect of condition (p=.015, p<.001, p<.001, p<.001, respectively) was observed in patients at A2, Y1, Y2 and Y3 as compared with control. Besides, pairwise comparisons had suggested significant difference in all conditions (all with p<.001). Likewise, ANOVA was carried out in the yes response data and similar results were identified. Main effect of group was found at A1 only (F(1, 72)=7.10, P=.009) but not the other timepoints. DISCUSSION: The data clearly show semantic memory abnormalities (slower reaction time and more error, i.e., more yes response in the outside the category condition) in first-episode schizophrenia as compared with normal. Intriguingly, they largely normalized following symptomatic recovery and remained stable for up to the first three years of the disorder, suggesting a state effect rather than a trait effect.The 2nd Biennial Schizophrenia International Research Conference, Florence, Italy, 10-14 April 2010. In Schizophrenia Research, 2010, v. 117 n. 2-3, p. 292-29

The association between semantic categorization deficit and symptoms in first-episode schizophrenia

Poster no. 255BACKGROUND: Semantic memory was defined as a store of culturally shared general knowledge about the meaning of the world, including words and objects, as well as their categorization. Previous studies had found that the deficits are related to some variables (such as age of onset) and symptomatology (such as delusion and formal thought disorder) in chronic patients. However, the relationship might have undermined by other factors such as medication effect in chronic/mixed samples. Importantly, further exploration is essential as clinical and cognitive correlates of the deficit could help elucidate the underlying mechanisms of the disorder. We therefore aim to explore the clinical and cognitive correlates of semantic memory deficit in first-episode schizophrenia patients. METHODS: Semantic memory was assessed using the categorization task in 37 first-episode schizophrenia patients. They were requested to make a category decision (yes/no) as to whether an exemplar word belonged to a category. Exemplars consisted of five semantic relatedness conditions, namely 'typical', 'atypical', 'borderline', 'related' and 'unrelated'. Categorization performance was further operationalized using the reaction time data as typicality effect, false-relatedness effect, borderline peak, borderline shift and overall speed. Data on proportion of yes response in each semantic relatedness condition was also measured. Other than that, positive and negative symptoms, as well as cognitive deficits (executive function, verbal fluency, and sustained attention, verbal and visual memory) were assessed during first episode, after clinical stabilization, and each year for the following three years. RESULTS: Correlation analysis demonstrated that different dimensions of categorization performance are related to different symptoms and cognitive dimensions. At presentation, negative symptoms was significantly correlated with typicality effect (r=-.43, P=.008), borderline peak (r=-.44, P=.007), overall speed (r=.38, P=.02), and over inclusiveness (% of yes response in the unrelated condition) (r=.37, P=.03). Visual memory was related to borderline shift (r=-.48, P=.002) and verbal fluency with overall speed (r=-.32, P=.05). At stabilization, positive symptoms was significantly associated with over-inclusiveness (r=.44, P=.006). At year 3, while there was a strong correlation between positive symptoms and borderline shift (r=-.52, P<.001), negative symptoms was related to borderline peak (r=.33, P=.04). DISCUSSION: Interestingly, positive symptoms were unrelated to semantic memory deficit in first-episode. However, it was strongly related to borderline shift at year 3. The current study had suggested a potential relationship between symptom formation and impairments in semantic memory. Future studies could look at specific symptomatology by separate clinical measure such as formal thought disorder in patients with schizophrenia.The 2nd Biennial Schizophrenia International Research Conference, Florence, Italy, 10-14 April 2010. In Schizophrenia Research, 2010, v. 117 n. 2-3, p. 409-41

A prospective 3-year longitudinal study of cognitive predictors of relapse in first-episode schizophrenic patients

Background: Cognitive predictors of relapse have been extensively explored only in few long term longitudinal studies of first-episode schizophrenia. Method: This study prospectively followed 93 patients with first-episode schizophrenia, schizophreniform disorder, and schizoaffective disorder for 3 years after their first-episode illness. Cognitive domains including verbal intelligence, verbal and visual memory, verbal fluency, and Wisconsin Card Sorting Test performance were investigated as potential predictors of relapse. Results: We found that by the first year 21% patients had relapsed, by the second year 33% had relapsed, and by the third year 40% had relapsed. There was a significant difference in the relapse rate between patients with good adherence and patients with poor adherence to medication regimes. A multiple logistic regression analysis revealed that after controlling for medication adherence, perseverative error in the Wisconsin Card Sorting Test was the only cognitive function that significantly predict relapse with an odds ratio of 2.4. Conclusions: Cognitive flexibility in set shifting is related to tendency towards relapse in first-episode schizophrenic patients. Other cognitive factors appear not to be related to relapse. Possible mechanisms included the link between prefrontal dysfunction and sub-cortical dopamine system stability, as well as the effects of executive dysfunction on insight impairment and adherence behavior. © 2005 Elsevier B.V. All rights reserved.link_to_subscribed_fulltex

The impact of family experience on the duration of untreated psychosis (DUP) in Hong Kong

Background: Previous family experience of psychotic illness may play an important role in whether and when a patient seeks help in first-episode psychosis. This study investigated the relationship between family experience of psychosis and the duration of untreated psychosis in a prospective sample of first-episode psychosis patients in Hong Kong. We also studied the effects of pre-morbid adjustment, educational level, living alone, and mode of onset as potential determinants of the duration of untreated psychosis (DUP). Methods: A total of 131 first-ep isode psychosis patients in Hong Kong were recruited in a study of the DUP and related factors. The Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS) was used to measure the DUP and to provide a structured assessment of family history, educational level, household arrangement, and mode of onset. Results: Previous family experience of psychiatric illness (the presence of another family member who has been receiving psychiatric treatment) and an acute mode of onset were significant predictors of a shorter DUP. Educational level had a modest effect on its own, but was not significant in the binary logistic regression model. Living alone had a moderate effect size, but was non-significant, possibly because of the small proportion of single-person households in the sample. The symptom profile, pre-morbid adjustment, and other demographic factors were not significantly related to the DUP. Conclusion: In addition to the mode of onset, previous family experience plays an important role in the presentation of early psychosis. Educational efforts that target the family should be an important part of any strategy for the early detection of psychosis. © Steinkopff Verlag 2005.link_to_subscribed_fulltex

A 3-year prospective study of neurological soft signs in first-episode schizophrenia

Neurological soft signs are biological traits that underlie schizophrenia and are found to occur at higher levels in at-risk individuals. The expression of neurological soft signs may be modifiable during the onset of the first psychotic episode and the subsequent evolution of the illness and its treatment. This study investigates neurological soft signs in 138 patients with first-episode schizophrenia and tracks the expression of motor soft signs in the following 3 years. For the 93 patients who have completed the 3-year follow-up, we find that neurological soft signs are stable in the 3 years that follow the first psychotic episode, and that neurological soft signs are already elevated at the presentation of first-episode psychosis in medication-naïve subjects. The level of neurological soft signs at clinical stabilization is lower for patients with a shorter duration of untreated psychosis. Although the quantity of neurological soft signs does not significantly change in the 3 years that follow the first episode, the relationship between neurological soft signs and negative symptoms does not become apparent until 1 year after the initial episode. A higher level of neurological soft signs is related to a lower educational level and an older age at onset, but the level of neurological soft signs does not predict the outcome in terms of relapse or occupational functioning. © 2004 Elsevier B.V. All rights reserved.link_to_subscribed_fulltex

Longitudinal changes in semantic categorization performance after symptomatic remission from first-episode psychosis: A 3-year follow-up study

Semantic categorization abnormalities have been observed in schizophrenia, but studies have rarely focused on the longitudinal trajectory. In this study, we consider semantic performance and the relationship with symptomatic changes during recovery from a first-episode of schizophrenia over a period of 3. years. Thirty-seven first-episode patients with schizophrenia were compared to thirty-seven matched controls in a categorization task. Patients were assessed at first episode, after clinical stabilization, and annually for the subsequent 3. years. In the task, participants indicated whether a word belonged to a given category. Each category contained words of varying degrees of semantic relatedness: typical, atypical, borderline, related-but-outside, and unrelated. Reaction times and proportion of 'yes' responses were analyzed. At first assessment, semantic categorization abnormalities were observed in first-episode patients. Patients assigned more semantically-dissimilar words to the categories than controls. As patients stabilized from acute states, their semantic categorization performance improved and then remained stable throughout the entire follow up period of 3. years. Interestingly, semantic performance deficits, particularly a diminished typicality effect, correlated with negative symptoms in the initial episode, but not at stabilization when symptoms subsided. No significant associations between positive and negative symptoms, or pre-defined categorization measures were identified. The data demonstrated semantic memory abnormalities in first-episode schizophrenia. However, an improvement of semantic categorization performance was observed in stabilized schizophrenia patients. Overall, the data are suggestive of a state effect in semantic abnormalities rather than a trait effect. The correlation between degree of impairment and symptoms may explain previous inconsistent findings. © 2012 Elsevier B.V.link_to_subscribed_fulltex