| 1. |
- Sellgren, C., et al.
(author)
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The Association Between Schizophrenia and Rheumatoid Arthritis: A Nationwide Population-Based Swedish Study on Intraindividual and Familial Risks
- 2014
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In: Schizophrenia Bulletin. - Stockholm : Oxford University Press (OUP). - 0586-7614 .- 1745-1701. ; 40:6, s. 1552-1559
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Journal article (peer-reviewed)abstract
- Numerous studies have reported a reduced risk of rheumatoid arthritis (RA) in schizophrenia. The mechanisms are unknown, but recent genome-wide association studies of schizophrenia have shown strong associations with markers spanning the major histocompatibility complex region, indicating a possible role for adaptive immunity also in schizophrenia. In this population-based cohort study, we assess the associations between RA and schizophrenia and the extent to which any observed associations are specific to RA/schizophrenia. We then extend the assessments per RA subtype and to risks in first-degree relatives. The study population included every individual identified in the Swedish Population Register born in Sweden between 1932 and 1989. The risk for RA in schizophrenia was significantly decreased (hazard ratio [HR] = 0.69, 95% CI = 0.59-0.80), but similar reductions were noted for osteoarthritis (a noninflammatory joint disorder) and ankylosing spondylitis (a non-RA inflammatory disorder). Comparable associations were seen in schizoaffective subjects while no significant associations were observed in bipolar disorder. Overall, first-degree relatives of schizophrenia patients were not at reduced risk of RA, but the risk for seronegative RA was significantly decreased in children and siblings of schizophrenia probands (HR = 0.13, 95% CI = 0.02-0.95 and HR = 0.67, 95% CI = 049-0.92, respectively). In conclusion, our intraindividual analyses suggest that differential misclassification bias is an important factor for the observed inverse association and emphasize the need of optimized care-provision for nonpsychiatric symptoms in schizophrenia patients. Our familial analyses indicted the possibility of an inverse coinheritance of schizophrenia and seronegative RA.
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| 2. |
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| 4. |
- Alem, Atalay, et al.
(author)
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Clinical course and outcome of schizophrenia in a predominantly treatment-naive cohort in rural Ethiopia
- 2009
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In: Schizophrenia Bulletin. - : Oxford University Press (OUP). - 0586-7614 .- 1745-1701. ; 35:3, s. 646-654
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Journal article (peer-reviewed)abstract
- The established view that schizophrenia may have a favorable outcome in developing countries has been recently challenged; however, systematic studies are scarce. In this report, we describe the clinical outcome of schizophrenia among a predominantly treatment-naive cohort in a rural community setting in Ethiopia. The cohort was identified in a 2-stage sampling design using key informants and measurement-based assessment. Follow-up assessments were conducted monthly for a mean duration of 3.4 years (range 1-6 years). After screening 68 378 adults, ages 15-49 years, 321 cases with schizophrenia (82.7% men and 89.6% treatment naive) were identified. During follow-up, about a third (30.8%) of cases were continuously ill while most of the remaining cohort experienced an episodic course. Only 5.7% of the cases enjoyed a near-continuous complete remission. In the final year of follow-up, over half of the cases (54%) were in psychotic episode, while 17.6% were in partial remission and 27.4% were in complete remission for at least the month preceding the follow-up assessment. Living in a household with 3 or more adults, later age of onset, and taking antipsychotic medication for at least 50% of the follow-up period predicted complete remission. Although outcome in this setting appears better than in developed countries, the very low proportion of participants in complete remission supports the recent observation that the outcome of schizophrenia in developing countries may be heterogeneous rather than uniformly favorable. Improving access to treatment may be the logical next step to improve outcome of schizophrenia in this setting.
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| 5. |
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| 6. |
- Allerby, Katarina, 1980, et al.
(author)
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Person-Centered Psychosis Care (PCPC) In An Inpatient Setting : Ward Level Data And Staff Workload
- 2019
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In: Schizophrenia Bulletin. - : Oxford University Press. - 0586-7614 .- 1745-1701. ; 45:Supplement 2, s. S304-S304
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Journal article (peer-reviewed)abstract
- Background: The person-centered care approach has been little tested in inpatient settings for persons with schizophrenia. An intervention, PersonCentered Psychosis Care (PCPC), was created to increase person-centered care through an educational intervention for staff. The education had a participatory approach where participants were involved in shaping the education and creating projects aimed at care development. The PCPC intervention focused on the patient’s narrative, the creation of a partnership between the patient and staff, and on coming to an agreement between the patient and staff concerning the care. The present study aims to compare staff experienced workload and ward level data before and after implementation of the intervention.Methods: The study was carried out on 4 hospital wards (43 beds) at the Psychosis Clinic, Gothenburg, Sweden. Data was collected during a 6-month pre-intervention period, followed by an implementation period of 3 years, and finally a post intervention data collection period (9 months). During both data collection periods, one nurse per ward filled out a measure of daily subjective workload (a VAS scale with 0 indicating no burden at all and 10 indicating the highest imaginable burden). Additional ward level data (length of hospital stay, involuntary interventions, rehospitalization rates) were collected via the clinic’s electronic monitoring system.Results: The pre-intervention ratings (n=505) showed a mean subjective workload of 5.48 (SD=1.94). The post intervention workload (n=465) showed a mean of 4.51 (SD=2.08) which represents a significant reduction of experienced workload (t (968) = p <.0005). Analyses regarding length of hospital stay, involuntary interventions, and rehospitalization rates are underway and will be presented.Discussion: The findings indicate an improvement in the work environment for hospital staff and provide a quantitative result in line with staff experiences previously reported in our focus group study. The before and after design has its limitations, but the positive findings motivate further testing with a more rigorous design such as a cluster randomized study.
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| 7. |
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| 8. |
- Barth, C, et al.
(author)
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In Vivo Amygdala Nuclei Volumes in Schizophrenia and Bipolar Disorders
- 2021
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In: Schizophrenia bulletin. - : Oxford University Press (OUP). - 1745-1701 .- 0586-7614. ; 47:5, s. 1431-1441
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Journal article (peer-reviewed)abstract
- Abnormalities in amygdala volume are well-established in schizophrenia and commonly reported in bipolar disorders. However, the specificity of volumetric differences in individual amygdala nuclei is largely unknown. Patients with schizophrenia disorders (SCZ, N = 452, mean age 30.7 ± 9.2 [SD] years, females 44.4%), bipolar disorders (BP, N = 316, 33.7 ± 11.4, 58.5%), and healthy controls (N = 753, 34.1 ± 9.1, 40.9%) underwent T1-weighted magnetic resonance imaging. Total amygdala, nuclei, and intracranial volume (ICV) were estimated with Freesurfer (v6.0.0). Analysis of covariance and multiple linear regression models, adjusting for age, age2, ICV, and sex, were fitted to examine diagnostic group and subgroup differences in volume, respectively. Bilateral total amygdala and all nuclei volumes, except the medial and central nuclei, were significantly smaller in patients relative to controls. The largest effect sizes were found for the basal nucleus, accessory basal nucleus, and cortico-amygdaloid transition area (partial η2 > 0.02). The diagnostic subgroup analysis showed that reductions in amygdala nuclei volume were most widespread in schizophrenia, with the lateral, cortical, paralaminar, and central nuclei being solely reduced in this disorder. The right accessory basal nucleus was marginally smaller in SCZ relative to BP (t = 2.32, P = .05). Our study is the first to demonstrate distinct patterns of amygdala nuclei volume reductions in a well-powered sample of patients with schizophrenia and bipolar disorders. Volume differences in the basolateral complex (lateral, basal, and accessory basal nuclei), an integral part of the threat processing circuitry, were most prominent in schizophrenia.
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| 9. |
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| 10. |
- Bhavsar, V, et al.
(author)
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COULD CLOZAPINE REDUCE VIOLENT OFFENDING?
- 2018
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In: SCHIZOPHRENIA BULLETIN. - : Oxford University Press (OUP). - 0586-7614 .- 1745-1701. ; 44, s. S67-S67
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Conference paper (other academic/artistic)
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| 11. |
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| 12. |
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| 13. |
- Bolhuis, K, et al.
(author)
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Hospital Presentation for Self-Harm in Youth as a Risk Marker for Later Psychotic and Bipolar Disorders: A Cohort Study of 59 476 Finns
- 2021
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In: Schizophrenia bulletin. - : Oxford University Press (OUP). - 1745-1701 .- 0586-7614. ; 47:6, s. 1685-1694
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Journal article (peer-reviewed)abstract
- Expanding clinical strategies to identify high risk groups for psychotic and bipolar disorders is a research priority. Considering that individuals diagnosed with psychotic and bipolar disorder are at high risk of self-harm, we hypothesised the reverse order relationship would also be true (ie, self-harm would predict psychotic/bipolar disorder). Specifically, we hypothesised that hospital presentation for self-harm would be a marker of high risk for subsequent development of psychotic/bipolar disorder and sought to test this hypothesis in a large population sample. This prospective register-based study included everyone born in Finland in 1987, followed until age 28 years (N = 59 476). We identified all hospital records of self-harm presentations, as well as all ICD-10 healthcare registrations of first diagnoses of psychotic and bipolar disorders. Cox proportional hazards models were used to assess the relationship between self-harm and psychotic/bipolar disorders. Of all individuals who presented to hospital with self-harm (n = 481), 12.8% went on to receive a diagnosis of psychosis (hazard ratio [HR] = 6.03, 95% confidence interval [CI] 4.56–7.98) and 9.4% a diagnosis of bipolar disorder (HR = 7.85, 95% CI 5.73–10.76) by age 28 years. Younger age of first self-harm presentation was associated with higher risk—for individuals who presented before age 18 years, 29.1% developed a psychotic or bipolar disorder by age 28 years. Young people who present to hospital with self-harm are at high risk of future psychotic and bipolar disorders. They represent an important cohort for the prevention of serious mental illness.
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| 14. |
- Bolhuis, Koen, et al.
(author)
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Risk of Psychosis Among Individuals Who Have Presented to Hospital With Self-harm : A Prospective Nationwide Register Study in Sweden
- 2024
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In: Schizophrenia Bulletin. - : Oxford University Press. - 0586-7614 .- 1745-1701. ; 50:4, s. 881-890
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Journal article (peer-reviewed)abstract
- BACKGROUND AND HYPOTHESIS: Recent research showed that young people who presented to hospital with self-harm in Finland had a significantly elevated risk of later psychosis. We investigated the prospective relationship between hospital presentation for self-harm and risk of psychosis in an unprecedentedly large national Swedish cohort.STUDY DESIGN: We used inpatient and outpatient healthcare registers to identify all individuals born between 1981 and 1993 who were alive and living in Sweden on their 12th birthday and who presented to hospital one or more times with self-harm. We compared them with a matched cohort, followed up for up to 20 years, and compared the cumulative incidence of psychotic disorders. Furthermore, we examined whether the strength of the relationship between hospital presentation for self-harm and later psychosis changed over time by examining for cohort effects.STUDY RESULTS: In total, 28 908 (2.0%) individuals presented to hospital with self-harm without prior psychosis diagnosis during the follow-up. For individuals who presented to hospital with self-harm, the cumulative incidence of diagnosed psychosis was 20.7% at 20 years follow-up (hazard radio = 13.9, 95% CI 13.3-14.6, P-value <5 × 10-308). There was no evidence of a dilution of the effect over time: while the incidence of hospital self-harm presentation increased, this did not result in an attenuation over time of the strength of the relationship between hospital self-harm presentation and subsequent psychosis.CONCLUSIONS: Individuals who present to hospital with self-harm in their teens and 20s represent an important risk group for psychosis prediction and prevention.
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| 15. |
- Brandt, Christine Lycke, et al.
(author)
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Cognitive effort and schizophrenia modulate large-scale functional brain connectivity
- 2015
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In: Schizophrenia Bulletin. - 0586-7614 .- 1745-1701. ; 41:6, s. 1360-1369
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Journal article (peer-reviewed)abstract
- Schizophrenia (SZ) is characterized by cognitive dysfunction and disorganized thought, in addition to hallucinations and delusions, and is regarded a disorder of brain connectivity. Recent efforts have been made to characterize the underlying brain network organization and interactions. However, to which degree connectivity alterations in SZ vary across different levels of cognitive effort is unknown. Utilizing independent component analysis (ICA) and methods for delineating functional connectivity measures from functional magnetic resonance imaging (fMRI) data, we investigated the effects of cognitive effort, SZ and their interactions on between-network functional connectivity during 2 levels of cognitive load in a large and well-characterized sample of SZ patients (n = 99) and healthy individuals (n = 143). Cognitive load influenced a majority of the functional connections, including but not limited to fronto-parietal and default-mode networks, reflecting both decreases and increases in between-network synchronization. Reduced connectivity in SZ was identified in 2 large-scale functional connections across load conditions, with a particular involvement of an insular network. The results document an important role of interactions between insular, default-mode, and visual networks in SZ pathophysiology. The interplay between brain networks was robustly modulated by cognitive effort, but the reduced functional connectivity in SZ, primarily related to an insular network, was independent of cognitive load, indicating a relatively general brain network-level dysfunction.
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| 16. |
- Brandt, Christine Lycke, et al.
(author)
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Cognitive effort and schizophrenia modulate large-scale functional brain connectivity
- 2015
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In: Schizophrenia Bulletin. - : Oxford University Press. - 0586-7614 .- 1745-1701. ; 41:6, s. 1360-1369
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Journal article (peer-reviewed)abstract
- Schizophrenia (SZ) is characterized by cognitive dysfunction and disorganized thought, in addition to hallucinations and delusions, and is regarded a disorder of brain connectivity. Recent efforts have been made to characterize the underlying brain network organization and interactions. However, to which degree connectivity alterations in SZ vary across different levels of cognitive effort is unknown. Utilizing independent component analysis (ICA) and methods for delineating functional connectivity measures from functional magnetic resonance imaging (fMRI) data, we investigated the effects of cognitive effort, SZ and their interactions on between-network functional connectivity during 2 levels of cognitive load in a large and well-characterized sample of SZ patients (n = 99) and healthy individuals (n = 143). Cognitive load influenced a majority of the functional connections, including but not limited to fronto-parietal and default-mode networks, reflecting both decreases and increases in between-network synchronization. Reduced connectivity in SZ was identified in 2 large-scale functional connections across load conditions, with a particular involvement of an insular network. The results document an important role of interactions between insular, default-mode, and visual networks in SZ pathophysiology. The interplay between brain networks was robustly modulated by cognitive effort, but the reduced functional connectivity in SZ, primarily related to an insular network, was independent of cognitive load, indicating a relatively general brain network-level dysfunction.
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| 17. |
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| 18. |
- Byrne, EM, et al.
(author)
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Is Schizophrenia a Risk Factor for Breast Cancer?-Evidence From Genetic Data
- 2019
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In: Schizophrenia bulletin. - : Oxford University Press (OUP). - 1745-1701 .- 0586-7614. ; 45:6, s. 1251-1256
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Journal article (peer-reviewed)abstract
- Observational epidemiological studies have found an association between schizophrenia and breast cancer, but it is not known if the relationship is a causal one. We used summary statistics from very large genome-wide association studies of schizophrenia (n = 40675 cases and 64643 controls) and breast cancer (n = 122977 cases and 105974 controls) to investigate whether there is evidence that the association is partly due to shared genetic risk factors and whether there is evidence of a causal relationship. Using LD-score regression, we found that there is a small but significant genetic correlation (rG) between the 2 disorders (rG = 0.14, SE = 0.03, P = 4.75 × 10–8), indicating shared genetic risk factors. Using 142 genetic variants associated with schizophrenia as instrumental variables that are a proxy for having schizophrenia, we estimated a causal effect of schizophrenia on breast cancer on the observed scale as bxy = 0.032 (SE = 0.009, P = 2.3 × 10–4). A 1 SD increase in liability to schizophrenia increases risk of breast cancer 1.09-fold. In contrast, the estimated causal effect of breast cancer on schizophrenia from 191 instruments was not significantly different from zero (bxy = −0.005, SE = 0.012, P = .67). No evidence for pleiotropy was found and adjusting for the effects of smoking or parity did not alter the results. These results provide evidence that the previously observed association is due to schizophrenia causally increasing risk for breast cancer. Genetic variants may provide an avenue to elucidating the mechanism underpinning this relationship.
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| 19. |
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| 23. |
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| 25. |
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| 26. |
- DeVylder, Jordan E, et al.
(author)
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Stress Sensitivity and Psychotic Experiences in 39 Low- and Middle-Income Countries
- 2016
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In: Schizophrenia Bulletin. - : Oxford University Press (OUP). - 0586-7614 .- 1745-1701. ; 42:6, s. 1353-1362
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Journal article (peer-reviewed)abstract
- Stress has a central role in most theories of psychosis etiology, but the relation between stress and psychosis has rarely been examined in large population-level data sets, particularly in low- and middle-income countries. We used data from 39 countries in the World Health Survey (n = 176 934) to test the hypothesis that stress sensitivity would be associated with psychotic experiences, using logistic regression analyses. Respondents in low-income countries reported higher stress sensitivity (P < .001) and prevalence of psychotic experiences (P < .001), compared to individuals in middle-income countries. Greater stress sensitivity was associated with increased odds for psychotic experiences, even when adjusted for co-occurring anxiety and depressive symptoms: adjusted odds ratio (95% CI) = 1.17 (1.15-1.19) per unit increase in stress sensitivity (range 2-10). This association was consistent and significant across nearly every country studied, and translated into a difference in psychotic experience prevalence ranging from 6.4% among those with the lowest levels of stress sensitivity up to 22.2% among those with the highest levels. These findings highlight the generalizability of the association between psychosis and stress sensitivity in the largest and most globally representative community-level sample to date, and support the targeting of stress sensitivity as a potential component of individual- and population-level interventions for psychosis.
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| 27. |
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| 28. |
- Dupin, L, et al.
(author)
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Predictive Modulation of Corticospinal Excitability and Implicit Encoding of Movement Probability in Schizophrenia
- 2019
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In: Schizophrenia bulletin. - : Oxford University Press (OUP). - 1745-1701 .- 0586-7614. ; 45:6, s. 1358-1366
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Journal article (peer-reviewed)abstract
- The ability to infer from uncertain information is impaired in schizophrenia and is associated with hallucinations and false beliefs. The accumulation of information is a key process for generating a predictive internal model, which statistically estimates an outcome from a specific situation. This study examines if updating the predictive model by the accumulation of information in absence of feedback is impaired in schizophrenia. We explored the implicit adaptation to the probability of being instructed to perform a movement (33%-Go, 50%-Go, or 66%-Go) in a Go/NoGo task in terms of reaction times (RTs), electromyographic activity, and corticospinal excitability (CSE) of primary motor cortex (M1). CSE was assessed at two time points to evaluate prediction of the upcoming instruction based on previously accumulated information: at rest (preceding the warning signal) and at the Go/NoGo signal onset. Three groups were compared: patients with schizophrenia (n = 20), unaffected siblings (n = 16), and healthy controls (n = 20). Controls and siblings showed earlier movement onset and increased CSE with higher Go probability. CSE adaptation seemed long-lasting, because the two CSE measures, at least 1500 ms apart, strongly correlated. Patients with schizophrenia failed to show movement onset (RT) adaptation and modulation of CSE. In contrast, all groups decreased movement duration with increasing Go probability. Modulation of CSE in the anticipatory phase of the potential movement reflected the estimation of upcoming response probability in unaffected controls and siblings. Impaired modulation of CSE supports the hypothesis that implicit adaptation to probabilistic context is altered in schizophrenia.
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| 29. |
- Eisler, Anna, et al.
(author)
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Cognitive impairment and subjective time in schizophrenics
- 2011
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In: Schizophrenia Bulletin. - : Oxford University Press (OUP). - 0586-7614 .- 1745-1701. ; 37:Suppl. 1, s. 205-205
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Journal article (peer-reviewed)abstract
- Background: An experimental study was conducted to compare time perception of short durations, including intra- and interindividual variability of subjective duration judgments, in schizophrenic and in healthy males. Methods: The psychological methods of reproduction, and of verbal estimation in subjective seconds, were used. Results: It was found 1) that the means of the reproductions do not differ between the 2 groups, 2) the schizophrenics verbally estimated all durations longer and less veridical than the healthy subjects, 3) the variability of the estimates between, as well as within, subjects is much greater in schizophrenics than in the healthy group, 4) also the estimates by the schizophrenic group showed an approximately linear function of responses vs. the reference durations in log-log coordinates, in agreement with Stevens# power law. Conclusion: Schizophrenics are described in terms of distraction and of chaotic and disorganized behavior. This important aspect of schizophrenic symptomatology typically results in cognitive impairment. The impairment may be at the root of the deviant, though fairly consistent, estimations by the schizophrenic subjects. This vulnerability entails that the schizophrenics seem to be unable to translate perceived time into numbers (seconds), probably because of their general difficulty in being able to quantify. To be more specific, it appears that the better understanding of the cognitive processes and the vulnerability factors of experiencing time and of time-structuring behavior is important knowledge as to how the schizophrenics individuals orient themselves in time and space. The conclusion is that our result does not support the view of general time distortion as such in schizophrenia.
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| 30. |
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| 31. |
- Ekman, Carl Johan, et al.
(author)
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A History of Psychosis in Bipolar Disorder is Associated With Gray Matter Volume Reduction.
- 2017
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In: Schizophrenia bulletin. - : Oxford University Press (OUP). - 1745-1701 .- 0586-7614. ; 43:1, s. 99-107
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Journal article (peer-reviewed)abstract
- Psychotic symptoms are prevalent in schizophrenia, bipolar disorder, and other psychiatric and neurological disorders, yet the neurobiological underpinnings of psychosis remain obscure. In the last decade, a large number of magnetic resonance imaging studies have shown differences in local gray matter volume between patients with different psychiatric syndromes and healthy controls. Few studies have focused on the symptoms, which these syndromes are constituted of. Here, we test the association between psychosis and gray matter volume by using a sample of 167 subjects with bipolar disorder, with and without a history of psychosis, and 102 healthy controls. Magnetic resonance images were analyzed on group level using a voxel-wise mass univariate analysis (Voxel-Based Morphometry). We found that patients with a history of psychosis had smaller gray matter volume in left fusiform gyrus, the right rostral dorsolateral prefrontal cortex, and the left inferior frontal gyrus compared with patients without psychosis and with healthy controls. There was no volume difference in these areas between the no-psychosis group and healthy controls. These areas have previously been structurally and functionally coupled to delusions and hallucinations. Our finding adds further evidence to the probability of these regions as key areas in the development of psychotic symptoms.
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| 32. |
- Farrell, M, et al.
(author)
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Increased Prevalence of Rare Copy Number Variants in Treatment-Resistant Psychosis
- 2023
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In: Schizophrenia bulletin. - : Oxford University Press (OUP). - 1745-1701 .- 0586-7614. ; 49:4, s. 881-892
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Journal article (peer-reviewed)abstract
- BackgroundIt remains unknown why ~30% of patients with psychotic disorders fail to respond to treatment. Previous genomic investigations of treatment-resistant psychosis have been inconclusive, but some evidence suggests a possible link between rare disease-associated copy number variants (CNVs) and worse clinical outcomes in schizophrenia. Here, we identified schizophrenia-associated CNVs in patients with treatment-resistant psychotic symptoms and then compared the prevalence of these CNVs to previously published schizophrenia cases not selected for treatment resistance.MethodsCNVs were identified using chromosomal microarray (CMA) and whole exome sequencing (WES) in 509 patients with treatment-resistant psychosis (a lack of clinical response to ≥3 adequate antipsychotic medication trials over at least 5 years of psychiatric hospitalization). Prevalence of schizophrenia-associated CNVs in this sample was compared to that in a previously published large schizophrenia cohort study.ResultsIntegrating CMA and WES data, we identified 47 cases (9.2%) with at least one CNV of known or possible neuropsychiatric risk. 4.7% (n = 24) carried a known neurodevelopmental risk CNV. The prevalence of well-replicated schizophrenia-associated CNVs was 4.1%, with duplications of the 16p11.2 and 15q11.2-q13.1 regions, and deletions of the 22q11.2 chromosomal region as the most frequent CNVs. Pairwise loci-based analysis identified duplications of 15q11.2-q13.1 to be independently associated with treatment resistance.ConclusionsThese findings suggest that CNVs may uniquely impact clinical phenotypes beyond increasing risk for schizophrenia and may potentially serve as biological entry points for studying treatment resistance. Further investigation will be necessary to elucidate the spectrum of phenotypic characteristics observed in adult psychiatric patients with disease-associated CNVs.
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| 33. |
- Fazel, S, et al.
(author)
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STUCTURED RISK ASSESSMENT IN PSYCHIATRY
- 2018
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In: SCHIZOPHRENIA BULLETIN. - : Oxford University Press (OUP). - 0586-7614 .- 1745-1701. ; 44, s. S23-S24
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Conference paper (other academic/artistic)
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| 34. |
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| 35. |
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| 36. |
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| 37. |
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| 38. |
- Goulding, Anneli, 1966, et al.
(author)
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Person-centered psychosis care (PCPC) in an inpatient setting: Patient outcomes
- 2018
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In: Schizophrenia Bulletin. 44 (suppl 1), S426. - : Oxford University Press (OUP). - 0586-7614 .- 1745-1701.
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Conference paper (peer-reviewed)abstract
- Background The person-centered care approach has been little tested in inpatient settings for persons with schizophrenia and similar psychoses. We developed a staff educational intervention, Person-Centered Psychosis Care (PCPC) tailored to our care setting (4 hospital wards for persons with psychoses, 43 beds). The intervention was co-created by professionals, patients, and researchers using a participatory approach. There was a focus on the patient’s narrative, the creation of partnership between staff and patient, an agreement between staff and patient concerning care, and a bridging of inpatient and outpatient care and support. The present study aims to describe patient outcomes associated with PCPC. Methods The study had a before and after design. Before the PCPC intervention started, questionnaire data was collected from 50 inpatients shortly before discharge. Post intervention data are currently under collection (anticipated n=50). The primary outcome measure is self-reported empowerment (Empowerment Scale, Range 0–112) and the secondary measure is consumer satisfaction (UKU-ConSat Rating Scale, converted to range between 11 and 77). Participants also complete questionnaires related to possible confounding variables such as overall health (EQ-5D), symptom burden (PANSS), and functional ability (GAF). Results The participants (46% women) included in the pre-intervention sample had a mean age of 47.5 years (SD=14.5). The total mean empowerment score for the pre-intervention sample was 82.6 (SD=8.1) whereas the mean consumer satisfaction score was 51.5 (SD=12.9). There were no statistically significant gender differences regarding empowerment or consumer satisfaction. There were no significant correlations between age, any of the confounding variables, and empowerment and consumer satisfaction. We will present results from comparisons between the pre- and post-intervention groups regarding empowerment and consumer satisfaction. Discussion The before and after design has its limitations, but if the PCPC intervention proves beneficial, such a model could be tested with a cluster randomized study design.
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| 46. |
- Holmberg, Christopher, 1984
(author)
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Schizophrenia in print, digital, and audiovisual media: Trends, topics, and results from an anti-stigma intervention targeting media professionals.
- 2023
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In: Schizophrenia Bulletin. - 0586-7614 .- 1745-1701. ; 4:1
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Journal article (peer-reviewed)abstract
- Background: Negative portrayals of schizophrenia in media can prompt the condition’s stigmatization. However, because research on language stigmatizing schizophrenia has focused on paper-based media, its results have limited generalizability to contemporary media. Also, research on interventions to guide media professionals in accurately depicting schizophrenia has been scarce. The present study had two aims: (1) to assess how print, web, and radio/TV news media in Sweden portray schizophrenia and (2) to evaluate a campaign targeting media professionals’ responses to information about schizophrenia and the consequences of stigmatizing language. Study Design: Using data from Retriever's database, considering media types and topics, the terms “schizophrenia” and “schizophrenic” were examined in the past 20 years, whereas analyses of stigmatizing reporting of these terms used media from the past 10 years. Media professionals’ responses and actions in the anti-stigma information campaign StigmaWatch were also evaluated. Study Results: Between 2002 and 2022, “schizophrenia” was mentioned 34,141 times in the dataset and “schizophrenic” 10,058 times. However, no trends were statistically significant. All media topics and most types of media contained stigmatizing reporting. Of the 230 media professionals who received informative emails from StigmaWatch, 77 (33%) responded. Most responses were supportive, and 14% of the professionals reported taking corrective measures (e.g., revising erroneous descriptions of schizophrenia) following the email. Conclusions: No media topic was free of language stigmatizing schizophrenia. The anti-stigma information campaign seemed to have been effective, for most media professionals who responded were supportive, and a sizable proportion reported taking corrective measures.
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| 47. |
- Homman, Lina, et al.
(author)
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The Importance and Challenges of Longitudinal Studies Among Patients Diagnosed With Schizophrenia : Predicting Response to Antipsychotic Medication Using Strata
- 2017
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In: Schizophrenia Bulletin. - : Oxford University Press. - 0586-7614 .- 1745-1701. ; 43:suppl_1, s. S195-S195
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Journal article (other academic/artistic)abstract
- Background: Longitudinal studies are essential for understanding the trajectory and prognosis of patients diagnosed with schizophrenia, in particular those who are treatment resistant as this outcome is difficult to predict. However, follow-up is challenging within this patient population due to high relapse rates, difficulties recontacting participants due to regular change of address, and patients’ symptoms leading to their refusal to take part.Methods: We describe one of the work packages of STRATA (Schizophrenia: Treatment Resistance and Therapeutic Advances) as an example of the challenges facing follow-up studies in schizophrenia research. The main aim of STRATA is to identify differences between treatment-resistant and treatment-responsive patients with schizophrenia and create a method for early identification of treatment resistant patients; thereby allowing earlier transition to more suitable treatments such as clozapine. Cohorts of patients from pre-existing studies of first-episode psychosis are presently being recontacted. Three studies across the UK (“AESOP,” Nottingham and London samples; “RPGI” and “NIFEPS,” Belfast samples) were included in STRATA. In total, 484 participants were eligible for recontact; 157 participants from AESOP, 85 from the RPGI; and 242 from the NIFEPS study. Participants were contacted via their clinical team, letter, or phone. Participants were invited to take part in a 40-minute interview in which demographic, substance use, medication history, and symptomatology (PANSS) data was collected. Participants were also asked to provide a blood and urine sample. Ethical permission was obtained to contact participants using information collected at previous visits and to obtain up to date contact addresses.Results: Out of the 484 participants who were recontacted, 13 were deceased, 9 were excluded, 23 requested information after the first contact but then ceased to respond, 47 declined to participate, and addresses were not identified for 63 participants. Thirty-four consented and completed all the assessments. The remaining 295 participants have yet to respond. Clozapine had been prescribed to 8.82% of completed participants and 47.06% have been prescribed 3 or more antipsychotics.Conclusion: The present study confirms the difficulties in longitudinal studies of patients diagnosed with schizophrenia. More research is needed in order to identify the attitudes and practices, which keep patients from participating in research. Additionally, in the general population, it is estimated that about two-third of individuals diagnosed with schizophrenia are treatment resistant. We can therefore conclude that treatment resistance is somewhat over-represented in the present sample.
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- Ji, Jianguang, et al.
(author)
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Incidence of Cancer in Patients With Schizophrenia and Their First-Degree Relatives: A Population-Based Study in Sweden.
- 2013
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In: Schizophrenia Bulletin. - : Oxford University Press (OUP). - 1745-1701 .- 0586-7614. ; 39:3, s. 527-536
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Journal article (peer-reviewed)abstract
- Context: Previous studies of the association between schizophrenia and cancer have produced conflicting results, probably because of the failure to control for confounding factors. Objective: To test if the possible association between schizophrenia and cancer is genetic by investigating the incidence of cancer in patients with schizophrenia and their relatives. Design: Retrospective cohort study with follow-up between 1965 and 2008. Estimated smoking rates were used to adjust the incidence rates of smoking-related cancers. Participants: The entire Swedish population.Main outcome measures:Risk of overall cancer and 34 site-/type-specific cancers.Results:A total of 59 233 patients in Sweden with schizophrenia were identified, of whom 6137 developed cancer during the study period, giving a decreased standardized incidence ratio (SIR) of 0.79 (95% CI 0.77-0.81). The decrease was more pronounced (SIR 0.40, 95% CI 0.38-0.43) before the first diagnosis of schizophrenia. The overall risk was significantly reduced among their unaffected parents (SIR 0.96, 95% CI 0.94-0.98) and siblings (SIR 0.92, 95% CI 0.89-0.96). Sex-stratified analyses indicated different incidence rates between males and females, with female patients having higher cancer risks than the general population. Conclusions: The significantly decreased incidences of cancers in patients diagnosed with schizophrenia and their unaffected relatives suggest that familiar/genetic factors contributing to schizophrenia may protect against the development of cancer, especially for those cancer sites observed in both settings. The increased risk of breast, cervical, and endometrial cancers after the first diagnosis of schizophrenia could be attributed to nongenetic factors such as antipsychotics administration, which may justify preventive medical screening.
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