Objective To systematically review the health state utility values in patients with schizophrenia, and to provide references for subsequent studies on the health economics of schizophrenia. Methods The PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data, and VIP databases were searched from inception to December 1st, 2021 to collect studies on health state utility values in patients with schizophrenia. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by Stata 15.0 software. Results A total of 19 studies were included. Patients’ utility values were 0.68 (95%CI 0.59 to 0.77) for direct measures, and 0.77 (95%CI 0.75 to 0.80) and 0.66 (95%CI 0.61 to 0.70) for indirect measures with the EQ-5D-5L and EQ-5D-3L as the primary scales. Utility values varied with measures, tariffs, regions, and populations. Conclusion Studies on health state utility value in schizophrenia are diversified in measurement methods, showing high inter-study heterogeneity. Therefore, it is necessary to promote the study on utility value measurement in schizophrenia in China.
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.
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 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 family care and its influence on the life quality of schizophrenia patients. MethodsBetween September 2011 and March 2012, 101 schizophrenia patients were investigated with Questionnaire of Family Care and Quality of Life Inventory and were divided into two groups in order to compare their life quality. According to the scores of Questionnaire of Family Care, 56 subjects were in support group and 45 subjects were in control group. ResultsAmong the 101 patients, 55.45% had good family care and 44.55% had not. In the support group, there was no significant correlation between family care and life quality in the first month and the third month (r=0.023, P=0.894; r=-0.072, P=0.587), while there was a significant correlation between family care and life quality in the sixth month (r=-0.322, P=0.032). In the control group, there was no significant differences in the score of family care and life quality in the first, third and sixth month (r=0.021, P=0.893; r=0.114, P=0.482; r=1.863, P=0.226). ConclusionLong-term family care is significantly correlated with the life quality of schizophrenia patients. If schizophrenic patients get more poor family care, they will have lower life quality. It's important to create a good and comfortable environment for the patients.
ObjectiveTo explore the effects of drug management skill training on lightening the family burden of schizophrenic patients in their recovery period. MethodsBetween December 2011 and December 2013, 101 patients with schizophrenia were randomly divided into experimental group (n=56) and control group (n=45). The experimental group was given drug management skill training, while the control group only received routine follow-up. The course of the research was six months. Both groups were assessed by the positive and negative syndrome scale on patients' psychological symptoms, and family burden scale of diseases was used to assess the burden of the family. ResultsCompared with the controls, patients in the experimental group improved more in their positive symptoms (t=2.692, P=0.008), negative symptoms (t=2.729, P=0.008), general psychopathology symptoms (t=3.231, P=0.002) and the whole psychiatric symptoms (t=3.870, P<0.001). Moreover, the degree of patients' symptom improvement was positively correlated with the degree of family burden lightening (r=0.44, P<0.001). ConclusionFor patients with schizophrenia, reasonable drug management skill training can effectively improve patients' medication compliance, promote treatment effect and lighten family burden.
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 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 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.
In different stages of schizophrenia (SZ), alterations in gray matter volume (GMV) of patients are normally regulated by various pathological mechanisms. Instead of analyzing stage‐specific changes, this study employed a multivariate structural covariance model and sliding‐window approach to investigate the illness duration‐related developmental trajectory of GMV in SZ. The trajectory is defined as a sequence of brain regions activated by illness duration, represented as a sparsely directed matrix. By applying this approach to structural magnetic resonance imaging data from 145 patients with SZ, we observed a continuous developmental trajectory of GMV from cortical to subcortical regions, with an average change occurring every 0.208 years, covering a time window of 20.176 years. The starting points were widely distributed across all networks, except for the ventral attention network. These findings provide insights into the neuropathological mechanism of SZ with a neuroprogressive model and facilitate the development of process for aided diagnosis and intervention with the starting points.