Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cogni...Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population. Aim To provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES. Methods An independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size. Results 56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as 'high quality' according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=-1.60,95% Cl -1.82 to -1.38,厂=67%) and all seven cognitive domains, with the SMD ranging from -0.87 to -1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=-1.90), Trail Making Test (TMT)(SMD=-1.36), Continuous Performance Test-Identical Pairs (SMD=-1.33), Hopkins Verbal Learning Test (SMD=-1.24), Brief Visuospatial Memory Test (SMD=-1.18), Mazes (SMD=-1.16), Category Fluency (SMD=-1.01), Spatial Span (SMD=-0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=-0.38). Conclusions Our meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.展开更多
Objective:Published studies have found prepulse inhibition(PPI)in schizophrenia is impaired,suggesting PPI may be a biomarker of schizophrenia.We aim to examine whether PPI deficits exist in antipsychotic-na-ve,first-...Objective:Published studies have found prepulse inhibition(PPI)in schizophrenia is impaired,suggesting PPI may be a biomarker of schizophrenia.We aim to examine whether PPI deficits exist in antipsychotic-na-ve,first-episode schizophrenia,and evaluate the effect size of PPI deficits between patients and healthy controls.Methods:The effect size of PPI deficits was evaluated for PPI%by calculating standard mean differences(SMDs)between patients with antipsychotic-na-ve,first-episode schizophrenia and healthy controls.Results:Twelve studies met the inclusion criteria,consisting390antipsychotic-na-ve,first-episode schizophrenia and406healthy controls.The effect sizes of76dB PPI in60ms and120ms interstimulus interval(ISI)were-0.19and-0.41respectively,and the76dB PPI overall effect size was-0.30.The effect sizes of85/86dB PPI in30ms,60ms and120ms ISI were-0.25,-0.42and-0.59respectively,and the85/86dB PPI overall effect size was-0.46.One study were excluded due to heterogeneity in the85/86dB,120ms ISI group,the pooled effect size of the PPI differences between patient group and health control dropped to-0.42,and the overall effect size changed to-0.39.There were no statistical differences in startle magnitude(overall effect size=-0.18)and habituation%(overall effect size=-0.17)between patients and healthy controls.Conclusions:Antipsychotic-na-ve,first-episode schizophrenia patients exhibit robust and reliable deficits in PPI,85/86dB PPI deficit was more severe than76dB PPI,and85/86dB,60-ms ISI PPI was more likely to be a biomarker for schizophrenia,it suggested that the parameters of PPI are particularly significant to affect the effect size so that should be interpreted with cautions in the future studies.展开更多
[Objectives]The research aimed to explore the effect of narrative therapy on the negative emotion,quality of life,care burden and nursing satisfaction of family caregivers of adolescents with first-episode depression....[Objectives]The research aimed to explore the effect of narrative therapy on the negative emotion,quality of life,care burden and nursing satisfaction of family caregivers of adolescents with first-episode depression.[Methods]Using convenient sampling method,the family caregivers of the adolescents with first-episode depression hospitalized in the Children and Adolescents Psychology Department of a GradeⅢLevel A hospital in Shiyan City,Hubei Province from July 2021 to April 2022 were selected as the research objects.The coin toss method was used to determine the test group and the control group,with 60 cases in each group.The control group received routine nursing care,and the experimental group implemented narrative therapy on this basis.Self-rating anxiety scale,self-rating depression scale,health status questionnaire(SF-36),and caregiver burden inventory were used to evaluate the anxiety and depression level,quality of life,and care burden level of the caregivers before and after the intervention.The nursing satisfaction questionnaire was used to evaluate the nursing satisfaction to the caregivers after the intervention.[Results]After 8 weeks of intervention,4 cases fell off in the control group and 3 cases fell off in the intervention group.The scores of anxiety and depression in the two groups were lower than those before intervention,and the scores in the test group were significantly lower than those in the control group(P<0.05).The life quality scores of life vitality,emotional function and mental health dimensions were higher than before the intervention,and the scores in the test group were significantly higher than those in the control group(P<0.05).The total score of care burden and the scores in time dependence,development limitation and physiological dimension of the two groups were lower than those before intervention,but the difference was not statistically significant(P>0.05).[Conclusions]Narrative therapy can effectively alleviate the negative emotions of family caregivers of adolescents with first-episode depression,and improve their quality of life and nursing satisfaction,but not their care burden.展开更多
Aims: Life expectancy is reduced by 10 - 20 years in psychotic disorders compared with the general population, largely due to high incidence of physical health disorders: heart attack, stroke, obesity, cardiovascular ...Aims: Life expectancy is reduced by 10 - 20 years in psychotic disorders compared with the general population, largely due to high incidence of physical health disorders: heart attack, stroke, obesity, cardiovascular disease (CVD), and type 2 diabetes. Early or first-episode psychosis patients can be especially vulnerable to physical health, psychological and social consequences of antipsychotic medication weight gain. The aim of this paper is to review diet and exercise lifestyle interventions employed to address these issues. Method: A review of research evidence on lifestyle interventions (diet and exercise) for individuals with early or first-episode psychosis (2000 to 2020) was undertaken. An internet-based literature search employed Medline, PsycINFO, Embase, PubMed and Web of Science. Results: Nine studies meeting the criteria were identified: comprising of three exercise intervention studies, one diet intervention study, and five combined diet and exercise intervention studies. Only one study used a RCT design with prior power analysis to determine participant numbers, two had a RCT design, two had a comparison group and four had no control group. Overall, these studies show that exercise and diet focused interventions may provide beneficial physical and mental health outcomes, but participant engagement and behaviour change may be difficult to achieve in early or first-episode psychosis due to individual factors associated with the experience of psychosis and medication prescribed, and health service related factors. Conclusion: There is a need for evidence-based lifestyle programmes in early or first-episode psychosis that includes individually targeted evidence based exercise and diet interventions. Further appropriately powered RCTs are required to strengthen the evidence base.展开更多
The present study investigated relationships between clozapine dose, clozapine and norclozapine plasma concentrations, and clinical responses to clozapine treatment in Tunisian schizophrenics. Fourteen schizophrenia-t...The present study investigated relationships between clozapine dose, clozapine and norclozapine plasma concentrations, and clinical responses to clozapine treatment in Tunisian schizophrenics. Fourteen schizophrenia-treatment resistant patients, recruited for this study, were treated with clozapine for 45 days. Patient health improvement was assessed before and after each cycle of two weeks of clozapine therapy, using the Brief Psychiatric Rating Scale (BPRS). Plasma clozapine and norclozapine concentrations were determined by high-performance liquid chromatography (HPLC). No significant correlations between plasma clozapine and norclozapine concentrations and clinical health improvement among our schizophrenic patients were found. However, a significant correlation was observed between clinical health improvement given by BPRS scores and norclozapine plasma concentration to daily clozapine dose ratio (NCZ/D). Despite the small sample size of our study, our findings suggest that the clozapine therapy response variations observed in our patients may be, in part, explained by the interindividual differences in plasma norclozapine concentration to clozapine dose ratio (NCZ/D). So the NCZ/D parameter could be used as a good indicator for adjusting the clozapine dose-adaptation strategy and consequently for improving the clinical psychopathological state of schizophrenia-treatment resistant patients.展开更多
After the description of a brain model based on glial-neuronal interactions, a computer system for simulation of human perception, called clocked perception system, is proposed. The computer system includes a receptor...After the description of a brain model based on glial-neuronal interactions, a computer system for simulation of human perception, called clocked perception system, is proposed. The computer system includes a receptor field with sensors, each of which receives data with specific characteristics. These data are passed to processors, whereby only those connections between sensors and processors are released that are suited for an evaluation of the data according to a combination of specific data dictated by a phase program circuit. The computer system also includes a selector circuit that discards those dictated program commands that lead to a “senseless” computation result. A motor program circuit for the control of effectors may be connected to the computer system which at least contributes to the movement of the receptor field in order to bring the receptor field closer to suitable data with specific characteristics for better execution of the program. From disorders of the computer system implications are deduced for the pathophysiology of the schizophrenic syndrome. Finally, a novel treatment approach to this syndrome is proposed.展开更多
The novel I Love Dick,written by Chris Kraus,discusses the“least described”social problem.The novel starts with describing Chris’s love affair.Her love affair is narrated with her illustrations of some social probl...The novel I Love Dick,written by Chris Kraus,discusses the“least described”social problem.The novel starts with describing Chris’s love affair.Her love affair is narrated with her illustrations of some social problems that are shrunk into personal problems.This article aims to examine how she uses the schizophrenic utterances to illustrate the failure of her love affair differently.展开更多
文摘Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population. Aim To provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES. Methods An independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size. Results 56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as 'high quality' according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=-1.60,95% Cl -1.82 to -1.38,厂=67%) and all seven cognitive domains, with the SMD ranging from -0.87 to -1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=-1.90), Trail Making Test (TMT)(SMD=-1.36), Continuous Performance Test-Identical Pairs (SMD=-1.33), Hopkins Verbal Learning Test (SMD=-1.24), Brief Visuospatial Memory Test (SMD=-1.18), Mazes (SMD=-1.16), Category Fluency (SMD=-1.01), Spatial Span (SMD=-0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=-0.38). Conclusions Our meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.
基金supported by researchgrants from the National Natural Science foundationof China (81471365, 81601169) Major Brain Program of Beijing Science and Technology Plan (Z161100002616017)Beijing Municipal Administration of Hospitals ClinicalMedicine Development of Special Funding Support(ZYLX201807).
文摘Objective:Published studies have found prepulse inhibition(PPI)in schizophrenia is impaired,suggesting PPI may be a biomarker of schizophrenia.We aim to examine whether PPI deficits exist in antipsychotic-na-ve,first-episode schizophrenia,and evaluate the effect size of PPI deficits between patients and healthy controls.Methods:The effect size of PPI deficits was evaluated for PPI%by calculating standard mean differences(SMDs)between patients with antipsychotic-na-ve,first-episode schizophrenia and healthy controls.Results:Twelve studies met the inclusion criteria,consisting390antipsychotic-na-ve,first-episode schizophrenia and406healthy controls.The effect sizes of76dB PPI in60ms and120ms interstimulus interval(ISI)were-0.19and-0.41respectively,and the76dB PPI overall effect size was-0.30.The effect sizes of85/86dB PPI in30ms,60ms and120ms ISI were-0.25,-0.42and-0.59respectively,and the85/86dB PPI overall effect size was-0.46.One study were excluded due to heterogeneity in the85/86dB,120ms ISI group,the pooled effect size of the PPI differences between patient group and health control dropped to-0.42,and the overall effect size changed to-0.39.There were no statistical differences in startle magnitude(overall effect size=-0.18)and habituation%(overall effect size=-0.17)between patients and healthy controls.Conclusions:Antipsychotic-na-ve,first-episode schizophrenia patients exhibit robust and reliable deficits in PPI,85/86dB PPI deficit was more severe than76dB PPI,and85/86dB,60-ms ISI PPI was more likely to be a biomarker for schizophrenia,it suggested that the parameters of PPI are particularly significant to affect the effect size so that should be interpreted with cautions in the future studies.
基金2019 Philosophy and Social Science Research Project of Hubei Provincial Department of Education(19D072)。
文摘[Objectives]The research aimed to explore the effect of narrative therapy on the negative emotion,quality of life,care burden and nursing satisfaction of family caregivers of adolescents with first-episode depression.[Methods]Using convenient sampling method,the family caregivers of the adolescents with first-episode depression hospitalized in the Children and Adolescents Psychology Department of a GradeⅢLevel A hospital in Shiyan City,Hubei Province from July 2021 to April 2022 were selected as the research objects.The coin toss method was used to determine the test group and the control group,with 60 cases in each group.The control group received routine nursing care,and the experimental group implemented narrative therapy on this basis.Self-rating anxiety scale,self-rating depression scale,health status questionnaire(SF-36),and caregiver burden inventory were used to evaluate the anxiety and depression level,quality of life,and care burden level of the caregivers before and after the intervention.The nursing satisfaction questionnaire was used to evaluate the nursing satisfaction to the caregivers after the intervention.[Results]After 8 weeks of intervention,4 cases fell off in the control group and 3 cases fell off in the intervention group.The scores of anxiety and depression in the two groups were lower than those before intervention,and the scores in the test group were significantly lower than those in the control group(P<0.05).The life quality scores of life vitality,emotional function and mental health dimensions were higher than before the intervention,and the scores in the test group were significantly higher than those in the control group(P<0.05).The total score of care burden and the scores in time dependence,development limitation and physiological dimension of the two groups were lower than those before intervention,but the difference was not statistically significant(P>0.05).[Conclusions]Narrative therapy can effectively alleviate the negative emotions of family caregivers of adolescents with first-episode depression,and improve their quality of life and nursing satisfaction,but not their care burden.
文摘Aims: Life expectancy is reduced by 10 - 20 years in psychotic disorders compared with the general population, largely due to high incidence of physical health disorders: heart attack, stroke, obesity, cardiovascular disease (CVD), and type 2 diabetes. Early or first-episode psychosis patients can be especially vulnerable to physical health, psychological and social consequences of antipsychotic medication weight gain. The aim of this paper is to review diet and exercise lifestyle interventions employed to address these issues. Method: A review of research evidence on lifestyle interventions (diet and exercise) for individuals with early or first-episode psychosis (2000 to 2020) was undertaken. An internet-based literature search employed Medline, PsycINFO, Embase, PubMed and Web of Science. Results: Nine studies meeting the criteria were identified: comprising of three exercise intervention studies, one diet intervention study, and five combined diet and exercise intervention studies. Only one study used a RCT design with prior power analysis to determine participant numbers, two had a RCT design, two had a comparison group and four had no control group. Overall, these studies show that exercise and diet focused interventions may provide beneficial physical and mental health outcomes, but participant engagement and behaviour change may be difficult to achieve in early or first-episode psychosis due to individual factors associated with the experience of psychosis and medication prescribed, and health service related factors. Conclusion: There is a need for evidence-based lifestyle programmes in early or first-episode psychosis that includes individually targeted evidence based exercise and diet interventions. Further appropriately powered RCTs are required to strengthen the evidence base.
文摘The present study investigated relationships between clozapine dose, clozapine and norclozapine plasma concentrations, and clinical responses to clozapine treatment in Tunisian schizophrenics. Fourteen schizophrenia-treatment resistant patients, recruited for this study, were treated with clozapine for 45 days. Patient health improvement was assessed before and after each cycle of two weeks of clozapine therapy, using the Brief Psychiatric Rating Scale (BPRS). Plasma clozapine and norclozapine concentrations were determined by high-performance liquid chromatography (HPLC). No significant correlations between plasma clozapine and norclozapine concentrations and clinical health improvement among our schizophrenic patients were found. However, a significant correlation was observed between clinical health improvement given by BPRS scores and norclozapine plasma concentration to daily clozapine dose ratio (NCZ/D). Despite the small sample size of our study, our findings suggest that the clozapine therapy response variations observed in our patients may be, in part, explained by the interindividual differences in plasma norclozapine concentration to clozapine dose ratio (NCZ/D). So the NCZ/D parameter could be used as a good indicator for adjusting the clozapine dose-adaptation strategy and consequently for improving the clinical psychopathological state of schizophrenia-treatment resistant patients.
文摘After the description of a brain model based on glial-neuronal interactions, a computer system for simulation of human perception, called clocked perception system, is proposed. The computer system includes a receptor field with sensors, each of which receives data with specific characteristics. These data are passed to processors, whereby only those connections between sensors and processors are released that are suited for an evaluation of the data according to a combination of specific data dictated by a phase program circuit. The computer system also includes a selector circuit that discards those dictated program commands that lead to a “senseless” computation result. A motor program circuit for the control of effectors may be connected to the computer system which at least contributes to the movement of the receptor field in order to bring the receptor field closer to suitable data with specific characteristics for better execution of the program. From disorders of the computer system implications are deduced for the pathophysiology of the schizophrenic syndrome. Finally, a novel treatment approach to this syndrome is proposed.
文摘The novel I Love Dick,written by Chris Kraus,discusses the“least described”social problem.The novel starts with describing Chris’s love affair.Her love affair is narrated with her illustrations of some social problems that are shrunk into personal problems.This article aims to examine how she uses the schizophrenic utterances to illustrate the failure of her love affair differently.
