Comparison of Cardiovascular Risks following Smoking Cessation Treatments Using Varenicline vs. NRT among Schizophrenic Smokers
Published on: 19th October, 2017
OCLC Number/Unique Identifier: 7586872815
Background: Schizophrenic patients have a lot higher smoking rates when compared to people in the general population. A variety of pharmaceutical cessation aids are available, which include nicotine replacement therapy (NRT), Bupropion SR, and Varenicline. Our objective was to assess which cessation medication would have lower risks in developing risk factors of cardiovascular diseases.
Methods: A population-based retrospective cohort study was conducted using the General Electric (GE) electronic medical record database (1995-2011). The cohort consisted of patients with a diagnosis of schizophrenia or schizoaffective disorder (ICD-9 code 295.00-295.99) and who had newly initiated use of any smoking cessation medication. We excluded our cohort who (1) were not prescribed atypical antipsychotics and (2) already had diagnosis of diabetes, hyperlipidemia or hypertension prior to index date. Follow up period was from 12 weeks onwards index date up to one year. The hazard ratio of developing cardiovascular risks was assessed using Cox proportional hazards regression model after controlling for other covariates.
Results: A total of 580 patients were included in our cohort. Among those, nearly half (n=276, 47.59%) developed one or more criteria of the metabolic syndromes. We found that smokers who were prescribed NRT were less likely to develop metabolic syndromes as compared to those who were prescribed Varenicline.
Conclusions: Physicians are advised to carefully weigh the risks against the benefits before prescribing cessation medications since risks for metabolic syndromes were found to be very high. Healthcare providers should monitor patients’ lab data regularly as this minority population is under higher risks.
Burnout and Related Factors in Caregivers of outpatients with Schizophrenia
Published on: 9th March, 2017
OCLC Number/Unique Identifier: 7317652087
Objectives: Care of a person with schizophrenia involves multiple problems, possibly leading to burnout which is a culturally influenced phenomenon. The aim of this study was to investigate burnout and related factors in caregivers of outpatients with schizophrenia.
Methods: Subjects included in the study were 40 primary caregivers of outpatients with schizophrenia (15 males, 25 females) whom were assessed with the Maslach Burnout Inventory (MBI), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). Patients were also administered the Calgary Depression Scale (CDS). Also, sociodemographic information about patients and their caregivers were taken. The significance of differences between two groups was determined by Mann-Whitney U-test. The relationships between the variables were evaluated by Pearson correlation analysis.
Results: No significant difference was found in the MBI subscale scores in terms of caregivers gender, marital status, and education, being a family member, having enough information about the illness and taking support during caregiving. Emotional Exhaustion and Personal Accomplishment subscale scores of the caregivers were significantly different in terms of patients’ adaptation to treatment or not (respectively; p=0.010, p=0.030). The MBI-Emotional Exhaustion scores revealed significant positive correlations with the BDI and BAI total scores. Also, the MBI- Depersonalization scores and the BAI scores were positively correlated.
Conclusions: Burnout levels in caregivers of patients with schizophrenia were lower when compared with other cultures. Only treatment compliance predicted burnout, while other factors were excluded. Therefore, professionals have to help to patients primarily adapt to their treatment.
Discrepancy in Microglia and Peripheral Monocytic Cells - A scope in the Pathophysiology of Psychiatric maladies
Published on: 29th June, 2018
Broad medleys of research have recognized the microglial activation in perilous psychiatric maladies such as schizophrenia, bipolar disorder, and major depressive disorder. There is a scenario of enlivening of peripheral monocytic cells along with the microglial interactions within the body while considering the Pathogenesis of psychiatric disorders. this review, epitomize and discuss the activation of microglia and monocytic cells in psychiatric disorders, thereby showcasing the potential association between these cell types and the Pathogenisis of the ailment , and proffer perspectives for future research on these processes.
Cytokine intoxication as a model of cell apoptosis and predict of schizophrenia - like affective disorders
Published on: 20th December, 2021
OCLC Number/Unique Identifier: 9396214740
For a long time there was no explanation of a study which had revealed that people with schizoaffective disorders and in particular suicidal attempts rarely get cancer. But now, we can assume that there are diseases that are “mirrored” because they occur with reverse/feedback pathophysiological mechanisms so that they are, in fact, antagonists.
Fregoli syndrome in schizophrenia: about a case report
Published on: 31st May, 2022
A Fregoli syndrome, just like Capgras Syndrome, Double Subjective Syndrome, and Inter metamorphosis Syndrome, belongs to the group of delusion misidentification syndromes. It is a rare neuropsychiatric pathology that could affect the brain with repercussions on behavior. It is the belief that a familiar person is disguised as a strange person by taking a different physical appearance but remains the same person psychologically. This entity has heterogonous etiologies, occurring mainly in the setting of organic diseases, affective disorders, or schizophrenia. In this article, we proposed to expose a case of a schizophrenic patient who developed Fregoli syndrome.
Nutritional interventions for the prevention and treatment of neurological disorders such as anxiety, bipolar disorder, depression, epilepsy, multiple sclerosis, and schizophrenia
Published on: 11th November, 2022
Neurological disorders are a significant cause of mortality and disability across the world. The current aging population and population expansion have seen an increase in the prevalence of neurological and psychiatric disorders such as anxiety, bipolar disorder, depression, epilepsy, multiple sclerosis and schizophrenia. These pose a significant societal burden, especially in low - and middle-income countries. Many neurological disorders have complex mechanisms and lack definitive cures; thus, improving our understanding of them is essential. The pathophysiology of neurological disorders often includes inflammation, mitochondrial dysfunction and oxidative stress. Oxidative stress processes, especially the generation of reactive oxygen species, are key mechanisms in the development of neurological disorders. Oxidative stress refers to an imbalance between the production of reactive oxygen species and antioxidants that can counteract them. Through their impacts on the pathophysiology of neurological disorders, nutrients with anti-inflammatory, neuroprotective and antioxidative properties have been suggested to prevent or mitigate these disorders. Certain vitamins, minerals, polyphenols and flavonoids may have therapeutic effects as adjuvant treatments for neurological disorders. Diet quality is also a risk factor for some neurological and psychiatric disorders and addressing nutritional deficiencies may alleviate symptoms. Therefore, optimizing nutritional intake may represent a potential treatment or prevention strategy. This review summarizes a selection of promising nutrients for the prevention and amelioration of neurological disorders to provide a summary for scientists, clinicians and patients, which may improve understanding of the potential benefits of nutrients in the treatment of neurological disorders.
Clinical and immunological characteristics of depressive patients with a clinical high risk of schizophrenia
Published on: 3rd March, 2023
Objective: To study clinical and immunological characteristics of depressive patients with high clinical risk of schizophrenia.Materials and methods: We examined 30 depressive patients with attenuated positive symptoms (APS), which indicates a clinically high risk of schizophrenia, 20 depressive patients without APS and 27 healthy volunteers with no mental disorders. APS identified according to the presence of three or more scores on at least one of the following items on the Scale of Prodromal Symptoms (SOPS) positive symptoms subscale: P1 (Unusual thought content/Delusional ideas), P2 (Suspiciousness/Persecutory ideas) and P4 (Perceptual abnormalities/Hallucinations). The psychometric assessment was carried out on the Hamilton Depression Rating Scale (HDRS), SOPS, and the Scale for Assessment of Negative Symptoms (SANS). The activity of leukocyte elastase (LE) and α1-proteinase inhibitor (α1-PI), the autoantibodies to neoantigens S100B and myelin basic protein, and the ratio of LE and α1-PI activity or Leukocyte Inhibitory Index (LII) were determined. Results: The activity of inflammatory markers LE and α1-PI was increased in patients in both clinical groups compared with controls. In the total group of patients, the associations between LII and the score on the positive subscale SOPS, and between LII and the score on the negative subscale SOPS and SANS scale with the most pronounced association with the SANS subscales «Affective Flattening or Blunting» and «Alogia» were established. Conclusion: The identified correlations between immune response features and positive and negative symptoms in depressive patients may have prognostic value for establishing a high risk of schizophrenia.
The Role of Buspirone in the Treatment of Patients with Paranoid Schizophrenia with Non-Suicidal Auto Aggression Who Have Had a Coronavirus Infection
Published on: 21st June, 2023
The relevance of this work is due to the insufficient number of modern studies on the treatment of patients with paranoid schizophrenia with non-suicidal autoaggressive actions or in short: “NSAA”, who have had a coronavirus infection. The aim of the study was to study the role of buspirone in the complex therapy of patients with paranoid schizophrenia with NSAA who had a coronavirus infection. Materials and research methods: 99 patients with paranoid schizophrenia meeting ICD-10 criteria were examined by a continuous, non-randomized clinical method. Fisher’s test was used for statistical evaluation. Results: It was established that the consequence of the coronavirus infection was an increase in the proportion of residual organic changes in the form of manifestations of the dysphoric syndrome, specific changes in the cognitive sphere, and the autonomic nervous system. The manifestations of dysphoria included an increase in the frequency of openly manifested aggression, anxiety, impulsivity, and the implementation of NSAA by the type of affective discharge. The structure of acquired cognitive impairments consisted of changes in thinking by the type of thoroughness, and rigidity of perseveration. Changes in the autonomic nervous system are presented in the form of diencephalic crises. Also, psychotic states not characteristic of the previously examined patients were noted, such as twilight stupefaction, delusional symptoms of Cappgras, Fregoli, and tactile hallucinosis. It has been established that the use of buspirone as part of complex therapy with neuroleptics, compared with monotherapy with neuroleptics, increases the effectiveness of therapy in relation to these clinical manifestations in the studied individuals. Conclusion: The use of buspirone in combination with neuroleptic drugs increases the effectiveness of therapy in relation to the leading psychopathological manifestations in patients with paranoid schizophrenia with NSAA who have undergone coronavirus infection.
Most Comparative Study of Cerebral Volumetric Variations in Patients with Schizophrenia with their Unaffected First-degree Relatives, using Magnetic Resonance Imaging Technique, a Case-control Study
Published on: 3rd January, 2024
Background and purpose: Schizophrenia (SZH) is a chronic mental disorder affecting the individuals` thoughts, perceptions, emotions, and behaviors. People with SZH may experience a wide range of positive, negative, and cognitive symptoms. Since there are no laboratory assays for definite SZH diagnosis, the authors aimed to identify the cerebral volumetric variations in SZH patients with the most prevalent positive symptoms as a diagnostic tool. This study selected 15 SZH patients displaying the most prevalent positive symptoms based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Assessment tools included the Mini-Mental State Examination (MMSE) for cognitive impairment, the Positive and Negative Syndrome Scale (PANSS) for symptom evaluation, and the Wechsler Intelligence Scale (WIS) for intelligence assessment. Additionally, 15 Healthy Controls (HC) without cerebral pathologies were recruited. T1w MRI images underwent analysis using Freesurfer software. Data analysis employed Mann-Whitney U and χ² tests, considering p < 0.05 as significant.Results: SZH and HC groups showed no significant differences in age and gender. However, significant (p < 0.05) alterations in Gray Matter (GM) volume were observed in SZH patients compared to HC. In the right hemisphere, several regions exhibited volume reduction, including the Fusiform sulcus, Rostral middle frontal gyrus, isthmus cingulate, Frontal pole, Middle temporal gyrus, Lateral occipital gyrus, and Inferior Parietal gyrus. Notably, the Precentral sulcus and Postcentral gyrus demonstrated volume acceleration. Similarly, in the left hemisphere, various regions showed volume reduction while the Paracentral gyrus indicated volume acceleration, all significant (p < 0.05).Conclusion: SZH patients display significant volumetric brain changes, indicating potential for future diagnostic procedures in SZH.
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