Retinal vascular tortuosity in schizophrenia and bipolar disorder

\u3cp\u3eThe micro-vasculature of retina and brain share common morphological, physiological, and pathological properties. Retina being easily accessible, retinal vascular examination provides an indirect assessment of cerebral vasculature. Considering the high prevalence of vascular morbidity in SCZ and BD a few studies have examined retinal vascular caliber and have reported increased retinal venular caliber in schizophrenia (SCZ). Retinal vascular tortuosity could serve as a better structural measure than caliber as it is static and less susceptible to pulse period variations. However, to date, no study has examined retinal vascular tortuosity in SCZ and bipolar disorder (BD). Hence, we examined retinal vascular tortuosity in comparison with healthy volunteers (HV). We included 255 subjects (78 HV, 79 SCZ, and 86 BD) in the age range of 18 to 50 years. Trained personnel acquired images using a non-mydriatic fundus camera. To measure the average retinal arteriolar tortuosity index (RATI) and retinal venular tortuosity index (RVTI), we used a previously validated, semi-automatic algorithm. The results showed significant differences across the three groups in RATI but not in RVTI; both BD and SCZ had significantly increased RATI compared to HV. There was also a significant difference between SCZ and BD, with BD having higher RATI. If shown to be of predictive utility in future longitudinal studies, it has the potential to identify patients at risk of development of adverse vascular events. As retinal vascular imaging is non-invasive and inexpensive, it could serve as a proxy marker and window to cerebral vasculature.\u3c/p\u3

Yoga therapy for Schizophrenia

Schizophrenia is one of the most severe mental disorders. Despite significant advances in pharmacotherapy, treatment remains sub-optimal, with many patients having persisting deficits, especially in cognitive and social functioning. Yoga as a therapy has proven to be effective as a sole or additional intervention in psychiatric disorders such as depression and anxiety. Recently, there has been significant interest in the application of yoga therapy in psychosis and schizophrenia. To review a) the evidence for the use of yoga therapy in patients with schizophrenia b) studies which have been done in this area, c) the barriers for reaching yoga to patients, and d) future directions, an English language literature search of PubMed/MEDLINE, Google Scholar, and EBSCO as well as grey literature was done. Research reports have demonstrated the feasibility and efficacy of yoga as an add-on therapy in schizophrenia, particularly in improving negative symptomatology and social cognition. However, the biological underpinnings of this effect remain unclear, although there are some indications that hormones like oxytocin may contribute to the changes in social cognition

Neurobiological Markers of Schizophrenia: Findings from Indian Studies of Early Psychoses

Neurobiological Markers of Schizophrenia: Findings from Indian Studies of Early Psychoses. Amresh Srivastava, Megan Johnston, John John, Harsha Halahalli,Shivarama Varambally 1The University of Western Ontario, London, Ontario, Canada/3NIMHANS, Banglore , Karnataka , India OVERALL PANEL PROPOSAL: Advancement in technology together with early intervention studies have revealed a great deal about changes in neurobiological profile of brain in schizophrenia. In last fifteen years , there has been a trend all over the world to study early psychosis from the perspective of not only risk factors and causes of psychosis but also about brain vulnerability to understand what exactly happens that emotional reactivity becomes pathological. Appearance of psychosis is hugely dependent upon possibility of gene-environment interaction in a given substrate. The vulnerability of genetic nature almost always gets transformed into a real risk because of potential stress factors causing unfolding of protective factors. Research has shown several clinical markers as well as predictive factors from short and long-term clinical-phenomenological studies. So far there are no definite biological makers however a reliable body of research shows that cognitive factors reflect abnormality of prefrontal cortex in schizophrenia. The present symposium addresses the issues of several neurobiological markers of schizophrenia in Indian cultures. SPEAKER 1 ABSTRACT: Cognitive factors in long term outcome of first episode psychosis Amresh Shrivastava, Megan Johnston, Nilesh Shah , Meghana Thakar , and Larry Stitt One negative outcome associated with schizophrenia is a deterioration of cognitive functioning. The existing research on cognitive functioning in first-episode schizophrenia suggests that cognitive deficits may be present quite early on in the illness. Less is known about what happens to cognitive abilities in the years following a diagnosis of first-episode schizophrenia. The present study examined the cognitive function of individuals first diagnosed with schizophrenia and then again ten years later to examine changes in cognitive functioning across this time period. Individuals diagnosed with first-episode schizophrenia, who ten years later were classified as recovered, had their cognitive functioning assessed both at the time of diagnosis and at the ten year follow-up. Our results indicate deterioration in some abilities at baseline and a decline of cognitive abilities in the group of clinically recovered patients. Visuo-spatial memory, working memory and executive functioning were shown to decrease in the ten years of treatment following diagnosis and many individuals classified as recovered still demonstrate abnormal cognitive functioning. These findings suggest that cognitive functions should be focused on to a much greater degree in current treatment methods

Yoga for schizophrenia: Patients′ perspective

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 patients′ willingness 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 ΁ 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

Effectiveness of mindfulness-based cognitive therapy in patients with bipolar affective disorder: A case series

The present investigation was undertaken to examine the effects of mindfulness-based cognitive therapy (MBCT) on interepisodic symptoms, emotional regulation, and quality of life in patients with bipolar affective disorder (BPAD) in remission. The sample for the study comprised a total of five patients with the diagnosis of BPAD in partial or complete remission. Each patient was screened to fit the inclusion and exclusion criteria and later assessed on the Beck Depressive Inventory I, Beck Anxiety Inventory, Difficulties in Emotion Regulation Scale, Acceptance and Action Questionnaire-II, and The World Health Organization Quality of Life Assessment-BREF. Following preassessments, patients underwent 8–10 weeks of MBCT. A single case design with pre- and post-intervention assessment was adopted to evaluate the changes. Improvement was observed in all five cases on the outcome variables. The details of the results are discussed in the context of the available literature. Implications, limitations, and ideas for future investigations are also discussed