ObjectAimed to describe the clinical characteristics of the patients with interictal schizophrenia-like psychoses of epilepsy (SLPE), so as to improve the identification, diagnosis and treatment.MethodsWe collected the cases from January 2017 to December 2019 that diagnosed as "epileptic psychosis/organic mental disorders/brain damage and functional disorders and somatic diseases caused by other mental disorders/organic delusions (schizophrenia-like) disorders" in the medical record system of the Sixth Hospital of Changchun. The discharge records were re-diagnosed by two experienced epilepsy specialists and psychiatrists respectively. Retrospective statistical analysis was performed on the cases identified as SLPE.ResultsA total of 45 patients were diagnosed as SLPE (male: female=1:1.4). The onset age of epilepsy and mental symptoms was (16.4±12.5) years and (35.3±13.4) years respectively. The duration of mental symptoms after first seizure was (18.9±13.4) years. 7 patients (15.6%) were not treated with AEDs, and 26 patients (57.8%) were treated with first generation AEDs. 8 patients (17.8%) had no seizures within 1 year before the onset of mental symptoms, and 28 patients (62.2%) had frequent seizures, even status epilepticus or clustered seizures. 2 patients (4.4%) had generalized tonic-clonic seizure, only 4 patients (8.9%) showed focal impaired awareness seizure, and 39 patients (86.7%) had focal to bilateral tonic-clonic seizure.The PANSS positive symptom score, PANSS negative symptom score and BPRS score were (15.1±4.4), (17.7±4.6) and (44.7±8.4) respectively.ConclusionThere were some features of epilepsy in SLPE, such as early onset age, frequent seizure (some patients were seizure-free), focal epilepsy, and poor AEDs treatment compliance. The onset age of mental symptoms in SLPE was later than Schizophrenia and long duration after first seizure. The PANSS scale showed that the mental symptoms of patients with SLPE were similar to those of patients with schizophrenia, and both positive and negative symptoms existed.
ObjectiveTo systematically review the effectiveness of Tai Chi for improving negative symptoms and activity participation in patients with schizophrenia. MethodsDatabases including PubMed, The Cochrane Library (Issue 3, 2016), EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched to collect the randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCT) about Tai Chi for improving negative symptoms and activity participation in patients with schizophrenia from inception to Apirl 1st 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of three RCTs and two quasi-RCTs were included. The result of meta-analyses showed that no significant difference was found in negative symptom scores (MD=–0.95, 95% CI –3.78 to –1.89, P=0.51) and positive symptoms scores of PANSS (MD=–0.02, 95% CI –0.50 to 0.46, P=0.94) between two groups. However, the Tai Chi group was superior to the control group in items including attention, avolition, anhedonia-asociality, alogia and affective flattening/blunting of SANS (all P values<0.05). ConclusionTai Chi may have positively influence on various negative symptoms in patients with schizophrenia, but no evidence to support the Tai Chi's effects for activities participation. Larger and higher quality studies are needed.
Objective To explore the difference of white matter changes between bipolar affective disorder and schizophrenia using diffusion tensor imaging (DTI). Methods Patients with bipolar affective disorder and schizophrenia were selected from the Mental Health Center of West China Hospital of Sichuan University between October 2014 and January 2017. Volunteers were recruited from October 2014 to January 2017. The included patients were divided into bipolar affective disorder group and schizophrenia group according to their diagnosis. Volunteers were divided into normal control group. The bipolar affective disorder group was divided into two subgroups: manic episode and depressive episode. DTI was performed on the included patients and volunteers. Tract based spatial statistics (TBSS) was used to study the differences in fractional anisotropy (FA) of white matter between patients and normal controls, and FA values of two subgroups of bipolar affective disorder and schizophrenia were compared. Results A total of 99 patients and 40 normal controls were included in this study. Among them, there were 40 cases in schizophrenia group and 59 cases in bipolar affective disorder group (31 cases of manic episode and 28 cases of depressive episode). Compared with the normal control group, FA values decreased in corpus callosum, fornix, occipital forceps and left inferior longitudinal fasciculus with bipolar affective disorder group and schizophrenia group (P<0.05). There was no significant difference in FA values between bipolar affective disorder group and schizophrenia group (P>0.05), but the FA value in left posterior thalamic radiation decreased in depressive episode of bipolar affective disorder group compared with schizophrenia group (P=0.001). Conclusions There are similarities between white matter changes in bipolar affective disorder and schizophrenia. However, the white matter change in posterior thalamic radiation may be the characteristic change in depressive episode of bipolar affective disorder.
Objective To investigate the status and influencing factors of psychosis-related post-traumatic stress disorder (PR-PTSD) in hospitalized patients with schizophrenia. Methods A questionnaire survey was conducted among the hospitalized patients with schizophrenia in three grade Ⅱ or above psychiatric hospitals in Chengdu between March and July, 2022, using the convenient sampling method. Questionnaires included the General Information Questionnaire, Impact of Event Scale-revised (IES-R), Self-rating Depression Scales, Simplified Coping Style Questionnaire, and Intolerance of Uncertainty Scale. If the score showed skewed distribution, it was expressed by the median (lower quartile, upper quartile). According to IES-R score, the patients included were divided into 2 groups. The patients whose score ≥33 were divided into PR-PTSD group, and <33 were divided into non-PR-PTSD group. The general information of the two groups of patients were compared. The correlation between PR-PTSD and depression, coping style and intolerance of uncertainty of the included patients were analyzed. The factors affecting the PR-PTSD of hospitalized patients with schizophrenia were analyzed by multivariate binary logistic regression analysis. Results A total of 388 patients were included. Among them, there were 282 cases in the non-PR-PTSD group and 106 cases in the PR-PTSD group. The IES-R score was 23.00 (15.00, 33.00), the depression score was 45.00 (38.00, 53.00), the negative coping style score was 11.00 (8.00, 14.75), the positive coping style score was 20.00 (16.00, 25.00), and the intolerance of uncertainty score was 28.00 (22.25, 33.00). IES-R was positively correlated with depression (r=0.370, P<0.001), negative coping style (r=0.396, P<0.001), positive coping style (r=0.111, P=0.029) and intolerance of uncertainty (r=0.467, P<0.001). Regression analysis showed that depression [(odds ratio, OR)=1.073, 95% confidence interval (CI) (1.043, 1.105), P<0.001)], negative coping style [OR=1.121, 95%CI (1.040, 1.208), P=0.003], intolerance of uncertainty [OR=1.081, 95%CI (1.045, 1.118), P<0.001] were the influencing factors of PR-PTSD in hospitalized patients with schizophrenia. Conclusions The prevalence of PR-PTSD in hospitalized patients with schizophrenia is high. Depression, negative coping style and intolerance of uncertainty are the risk factors for PR-PTSD in hospitalized schizophrenia patients.
ObjectiveTo investigate the incidence of nosocomial infection in acute and serious schizophrenic inpatients and its risk factors. MethodsBetween January 1st and December 31st, 2012, we investigated 1 621 schizophrenic patients on the status of nosocomial infections according to the hospital standard of nosocomial infection diagnosis. They were divided into infected group and uninfected group according to the survey results. The risk factors were analyzed by logistic regression method. ResultsTwenty-nine infected patients were found among the 1 621 patients, and the incidence rate was 1.79%. Among the nosocomial infections, the most common one was respiratory infection (79.31%), followed by gastrointestinal infection and urinary infection (6.90%). There were significant differences between the two groups of patients in age, hospital stay, positive and negative syndrome scale (PASS), combined somatopathy, the time of protective constraint, modified electraconvulsive therapy (MECT), using two or more antipsychotics drugs, using antibiotics and side effects of drugs (P<0.05). However, there were no statistical differences in gender, age classes, the course of disease, frequency of hospitalization and seasonal incidence of hospital infection (P>0.05). The results of multivariate analysis showed that hospital stay, positive symptom score, negative symptom score, the time of protective constraint, MECT, using two or more antipsychotics drugs and side effects of drugs were the main risk factors for nosocomial infection of inpatients with psychopathy (P<0.05). ConclusionBased on the different traits and treatments of acute and serious schizophrenia, a screening table of infections should be set. For the high risk group of nosocomial infection, effective measures should be taken to prevent and control the nosocomial infection of patients with schizophrenia.
ObjectiveTo compare social function of schizophrenic patients of different marriage status and breeding status. MethodsA total of 218 people diagnosed to have schizophrenia between June and December 2013 were investigated. The research instruments included General Status Questionnaire and Social Disability Screening Scale. ResultsMen had no significant difference in social deficit from women (P>0.05). At the onset of the disease, married male patients were better than single male ones in terms of social function retreating and family function (P<0.05); married female patients were better in all aspects of social function than single female ones (P<0.05); male patients with children were better in family function than those without children (P<0.05); female patients without children had much worse social dysfunction than those with children except in the area of activity outside the family (P<0.05); male patients without children had more obvious social dysfunction than those with children except in such areas as little activity within the family, personal care, external interests and concern (P<0.05); single female patients had worse social dysfunction than married ones at present (P<0.05). ConclusionMarried schizophrenic patients with children have better social function.
Objective To explore the relationship of self-efficacy and coping styles with parenting styles in patients with schizophrenia, and provide the theory and practical basis for family-interventions of rehabilitation of patients with schizophrenia. Methods From January to June 2015, General Self- Efficacy Scale, Simplified Coping Style Questionnaire and Egma Minnen av Bardndosnauppforstran were used to evaluate 60 inpatients with schizophrenia and in good rehabilitation in a grade A tertiary general hospital. Results The scores of self-efficacy, parental emotional warmth and father’s over protection were lower in patients with schizophrenia than the norms (P<0.01). The scores of parental punishment and rejection and father’s over intervention were higher in patients with schizophrenia than the norms (P<0.01). In patients with schizophrenia, the active coping domain was positively correlated to parental emotion warmth (P<0.05); the negative coping domain was positively correlated to parental rejection, father’s over protection and mother’s over intervention (P<0.05); self-efficacy was positively correlated to father’s emotion warmth and preference of parents (P<0.05). Conclusions Active family-interventions is important in the rehabilitation of patients with schizophrenia. The parents should be instructed to correctly educate the children, to improve the patients’ general self-efficacy, and help the patients successfully solve the problem with good coping style.
ObjectiveTo explore the influence factors of therapeutic compliance and emotional expression of first-degree relatives in acute schizophrenic patients with psychotic symptoms. MethodsThe Brief Psychiatric Rating Scale (BPRS) was used to measure the severity of psychotic symptoms in sixty schizophrenic patients from June to September 2014 in West China Hospital and the Toronto Alexithymia Scale (TAS) was used to survey the emotional expression in their family members. The homemade treatment adherence scale was used to survey the treatment adherence in patients for one week. ResultsThere was a poor therapeutic compliance in nineteen patients with acute schizophrenia (32%) and the other 41(68%) had good therapeutic compliance; the relatives of schizophrenic patients had high TAS scores (male: 67.61±10.03; female: 69.68±11.46) than the normal models did (P ＜ 0.05) . The differences between the patients with different therapeutic compliance in BPRS total score, reactivator, hostile and suspicion factor (P ＜ 0.05) . The therapeutic compliance was related to the severity of the psychotic symptoms (P ＜ 0.05) . Conclusions There is a bad emotional expression in the relatives of acute schizophrenic patients. The psychotic symptoms can influence the therapeutic compliance. The milder the psychotic symptoms, the better the therapeutic dependence.
Objective To detect the contingent negative variation (CNV) in first episode deficit and non-deficit schizophrenia and the relationship between CNV and clinical symptoms. Methods Nihon Kohden evoked brain potentials machine were used to measure CNV in 60 patients with non-deficit schizophrenia (NDS), including 50 patients with deficit schizophrenia (DS) and 60 unrelated healthy controls (HC). Click-flashing paradigm was used to record the CNV and the differences among three groups were compared. The clinical status of patients with schizophrenia was determined using the Positive and Negative Syndrome Scale (PANSS). The overall functioning status was assessed using the Global Assessment of Functioning Scale (GAF). Partial correlations were computed to explore associations among the CNV in DS and the clinical data, controlling the sex, age, and education level. Results Compared to HC, both DS and NDS groups showed significantly reduced amplitude of B (F=27.38, P=0.00), significantly delayed reaction time (F=50.30, P=0.00). Compared to HC, the course of PINV in the DS group significantly shortened, while it was significantly delayed in the NDS group (F=15.32, P=0.00). Only in DS, when compared with that in HC, the latency of point A in CNV was delayed (F=61.01, P=0.00). There was no significant difference among three groups in both area of A-S2’ (F=2.34, P=0.10) and area of PINV (F=1.07, P=0.35). Amplitude of B and the course of PINV in the DS group correlated negatively with PANSS subscale of negative symptoms (r= –0.94, –0.89, respectively, Plt;0.05), whereas in the NDS group amplitude of B correlated negatively with PANSS subscale of positive symptoms (r= –0.87, Plt;0.05), but the course of PINV correlated positively with PANSS subscale of positive symptoms (r=0.88, Plt;0.05). Latency of point A in CNV, which was delayed in the DS group, correlated negatively with GAF (r= –0.48, Plt;0.05). Conclusion Generalized abnormalities of CNV existed in DS and NDS, while DS may cause more impairments in CNV than in NDS. The latency of point A in CNV may predict the social function outcomes of DS.
Objective To probe into the influence of hospital-community seamless recovery mode on quality of life in schizophrenia patients. Methods Fifty-six patients with stable condition discharged from hospital in 2011 were recruited. All the patients accepted hospital-community seamless recovery mode based on rehabilitation inside the hospital. Personal and social performance scale (PSP) and family APGAR (adaptability, partnership, growth, affection, resolve) index were used to evaluate the change of social function and family APGAR index at the beginning of the study, 3 months and 6 months after this research. All the data were analyzed by SPSS 16.0 software. Results Scores of APGAR scale and PSP scale of patients 3 months and 6 months after rehabilitation training were significantly higher than those before the training (P<0.05). APGAR scale and PSP scale had positive correlation. As APGAR score increased, PSP score also increased (P<0.05). Conclusion Hospital-community seamless recovery mode can improve the quality of life and promote rehabilitation positively in patients with schizophrenia.