Background The impairment of social function is widespread in the patients with chronic schizophrenia, which seriously affects family, life and work conditions.Aims The main purpose of this study was to investigate th...Background The impairment of social function is widespread in the patients with chronic schizophrenia, which seriously affects family, life and work conditions.Aims The main purpose of this study was to investigate the efficacy of paliperidone in the treatment of social function in chronic schizophrenia.Methods A total of 81 patients who met the standard criteria for schizophrenia and long-term hospitalised inpatients were randomly divided into the treatment group and normal control group following a 1-year prospective follow-up study. The reatment group(41 cases) used paliperidone extended-release tablets for reducing dosage, as appropriate, based on the original treatment strategy; and the control group(40 cases) used the former drugs. All patients were assessed using the Positive and Negative Symptom Scales(PANSS), and the Treatment Emergent Symptom Scale(TESS) was used to assess adverse drug reactions. The Hospitalised Psychiatric Patients' Social Functions Rating Scale(SSPI) was used to assess social function of participants before and after 8 weeks, 6 months and 1 year of treatment.Results At baseline there were no significant differences between the two groups in age, duration of illness, educational background and dosage of antipsychotic drugs(converted into chlorpromazine equivalency). There was statistically significant difference in PANSS positive symptoms by interaction effect(Fgroup×time=18.24, df=3237, p<0.001) and time effect(Ftime=21.66, df=3, p<0.01) and the difference in PANSS positive symptoms by grouping effect(Fgroup=0.68, df=1, p=0.41) was not statistically significant. The difference of grouping effect of PANSS negative symptoms(Fgroup=9.93, df=1, p=0.002), time effect(Ftime=279.15, df=3, p<0.001) and interaction effect(Fgroup×time=279.15, df=3237, p<0.001) were statistically significant. There were statistically significant differences in the grouping effect(Fgroup=6.59, df=1, p=0.012), time effect(Ftime=152.97, df=3, p<0.001) and interaction effect(Fgroup×time=148.82, df=3237, p<0.001) of PANSS general pathological symptoms, the same as the total score of the PANSS, which showed large differences in grouping effect(Fgroup=7.04, df=1, p=0.001), time effect(Ftime=210.78, df=3, p<0.001) and interaction effect(Fgroup×time=205.20, df=3237, p<0.01). We found in the total SSPI score, grouping effect(Fgroup=31.70, df=1, p<0.001), time effect(Ftime=161.84, df=3, p<0.001) and interaction effect(Fgroup×time=132.74, df=3237, p<0.001) were demonstrated to be significantly different. Even though adverse reactionsoccurred 7 times in the treatment group and 44 times in the control group based on the Treatment Emergent Symptom Scale(TESS), incidence rate was significantly lower than that of the control group(χ2=18.854, p<0.001).Conclusion Paliperidone can safely and effectively improve negative symptoms and social function in patients with chronic schizophrenia.展开更多
The risk of dementia increases in patients with cognitive impairment.However,it is not clear what factors contribute to the onset of dementia in those with cognitive impairment.In this prospective cohort study,we will...The risk of dementia increases in patients with cognitive impairment.However,it is not clear what factors contribute to the onset of dementia in those with cognitive impairment.In this prospective cohort study,we will investigate the every-five-year incidence of cognitive impairment and prognostic factors for cognitive impairment.The Jidong cognitive impairment cohort was established from April 2012 to August 2015,during which we recruited 5854 healthy participants(55.1%male)older than 45 years(mean,57 years).Participants received a health examination in the Staff Hospital,Jidong Oilfield Branch,China National Petroleum Corporation.Baseline data and blood samples were collected.Cognitive impairment was evaluated using the Mini-Mental State Examination,and was defined as a Mini-Mental State Examination score of less than 24.Dementia was assessed using the criteria of Diagnostic and Statistical Manual of Mental Disorders(Fourth edition),the International Working Group criteria,and the Mini-Mental State Examination score.The follow-up will continue until December 2024,during which a prognostic model will be constructed.The primary outcome is the presence/absence of dementia and the secondary outcome is quality of life.Baseline screening results showed the following:(1)Cognitive impairment was apparent in 320 participants(5.5%).These participants will be excluded from the Jidong cohort study,and the remaining participants will be followed up.(2)Of the 320 participants with cognitive impairment,there was a significantly higher prevalence of illiteracy than other education levels(35.9%,P<0.05).Age,arterial hypertension,alcohol consumption,and passive smoking differed significantly between the cognitive impairment and healthy groups(P<0.05).Multivariate logistic regression models showed that age(odds ratio[OR]=1.059,95%confidence interval[CI]:1.044-1.074)and arterial hypertension(OR=1.665,95%CI:1.143-2.427)were risk factors for mild cognitive impairment.With the increase of educational level(illiteracy,primary school,junior high school,high school,university,and above),cognitive impairment gradually decreased(OR<1,P<0.05).(3)This cohort study has initially screened for several risk factors for cognitive impairment at baseline,and subsequent prospective data will further describe,validate,and evaluate the effects of these risk factors on cognitive impairment and dementia.These results can provide clinical evidence for the early prevention of cognitive impairment and dementia.The study was approved by the Ethics Committee of Kailuan General Hospital of Tangshan City and the Medical Ethics Committee,Staff Hospital,Jidong Oilfield Branch,China National Petroleum Corporation on July 12,2013(approval No.2013 YILUNZI 1).展开更多
基金supported in part by the National Science Fund of China(81771450,81471358)Shanghai Health Bureau scientific research grant(201540029)Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant(20152530)
文摘Background The impairment of social function is widespread in the patients with chronic schizophrenia, which seriously affects family, life and work conditions.Aims The main purpose of this study was to investigate the efficacy of paliperidone in the treatment of social function in chronic schizophrenia.Methods A total of 81 patients who met the standard criteria for schizophrenia and long-term hospitalised inpatients were randomly divided into the treatment group and normal control group following a 1-year prospective follow-up study. The reatment group(41 cases) used paliperidone extended-release tablets for reducing dosage, as appropriate, based on the original treatment strategy; and the control group(40 cases) used the former drugs. All patients were assessed using the Positive and Negative Symptom Scales(PANSS), and the Treatment Emergent Symptom Scale(TESS) was used to assess adverse drug reactions. The Hospitalised Psychiatric Patients' Social Functions Rating Scale(SSPI) was used to assess social function of participants before and after 8 weeks, 6 months and 1 year of treatment.Results At baseline there were no significant differences between the two groups in age, duration of illness, educational background and dosage of antipsychotic drugs(converted into chlorpromazine equivalency). There was statistically significant difference in PANSS positive symptoms by interaction effect(Fgroup×time=18.24, df=3237, p<0.001) and time effect(Ftime=21.66, df=3, p<0.01) and the difference in PANSS positive symptoms by grouping effect(Fgroup=0.68, df=1, p=0.41) was not statistically significant. The difference of grouping effect of PANSS negative symptoms(Fgroup=9.93, df=1, p=0.002), time effect(Ftime=279.15, df=3, p<0.001) and interaction effect(Fgroup×time=279.15, df=3237, p<0.001) were statistically significant. There were statistically significant differences in the grouping effect(Fgroup=6.59, df=1, p=0.012), time effect(Ftime=152.97, df=3, p<0.001) and interaction effect(Fgroup×time=148.82, df=3237, p<0.001) of PANSS general pathological symptoms, the same as the total score of the PANSS, which showed large differences in grouping effect(Fgroup=7.04, df=1, p=0.001), time effect(Ftime=210.78, df=3, p<0.001) and interaction effect(Fgroup×time=205.20, df=3237, p<0.01). We found in the total SSPI score, grouping effect(Fgroup=31.70, df=1, p<0.001), time effect(Ftime=161.84, df=3, p<0.001) and interaction effect(Fgroup×time=132.74, df=3237, p<0.001) were demonstrated to be significantly different. Even though adverse reactionsoccurred 7 times in the treatment group and 44 times in the control group based on the Treatment Emergent Symptom Scale(TESS), incidence rate was significantly lower than that of the control group(χ2=18.854, p<0.001).Conclusion Paliperidone can safely and effectively improve negative symptoms and social function in patients with chronic schizophrenia.
基金supported by the National Natural Science Foundation of China,No.91749205(to YZ),81973112(to YZ),81973138(to DL),81903401(to WJX)the Young Taishan Scholars Program of Shandong Province of China,No.tsqn20161046(to WJX)
文摘The risk of dementia increases in patients with cognitive impairment.However,it is not clear what factors contribute to the onset of dementia in those with cognitive impairment.In this prospective cohort study,we will investigate the every-five-year incidence of cognitive impairment and prognostic factors for cognitive impairment.The Jidong cognitive impairment cohort was established from April 2012 to August 2015,during which we recruited 5854 healthy participants(55.1%male)older than 45 years(mean,57 years).Participants received a health examination in the Staff Hospital,Jidong Oilfield Branch,China National Petroleum Corporation.Baseline data and blood samples were collected.Cognitive impairment was evaluated using the Mini-Mental State Examination,and was defined as a Mini-Mental State Examination score of less than 24.Dementia was assessed using the criteria of Diagnostic and Statistical Manual of Mental Disorders(Fourth edition),the International Working Group criteria,and the Mini-Mental State Examination score.The follow-up will continue until December 2024,during which a prognostic model will be constructed.The primary outcome is the presence/absence of dementia and the secondary outcome is quality of life.Baseline screening results showed the following:(1)Cognitive impairment was apparent in 320 participants(5.5%).These participants will be excluded from the Jidong cohort study,and the remaining participants will be followed up.(2)Of the 320 participants with cognitive impairment,there was a significantly higher prevalence of illiteracy than other education levels(35.9%,P<0.05).Age,arterial hypertension,alcohol consumption,and passive smoking differed significantly between the cognitive impairment and healthy groups(P<0.05).Multivariate logistic regression models showed that age(odds ratio[OR]=1.059,95%confidence interval[CI]:1.044-1.074)and arterial hypertension(OR=1.665,95%CI:1.143-2.427)were risk factors for mild cognitive impairment.With the increase of educational level(illiteracy,primary school,junior high school,high school,university,and above),cognitive impairment gradually decreased(OR<1,P<0.05).(3)This cohort study has initially screened for several risk factors for cognitive impairment at baseline,and subsequent prospective data will further describe,validate,and evaluate the effects of these risk factors on cognitive impairment and dementia.These results can provide clinical evidence for the early prevention of cognitive impairment and dementia.The study was approved by the Ethics Committee of Kailuan General Hospital of Tangshan City and the Medical Ethics Committee,Staff Hospital,Jidong Oilfield Branch,China National Petroleum Corporation on July 12,2013(approval No.2013 YILUNZI 1).
