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.
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.
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.
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 explor the influence of the hospital-community-family mental rehabilitation mode on the quality of life of patients with schizophrenia. Methods We selected 101 patients diagnosed as schizophrenia according to ICD-10, who were hospitalized in mental health center of the West China Hospital and took part in rehabilitation voluntarily after discharge. Those patients were randomly assigned to two groups. Hospital-community-family mental rehabilitation mode intervention was applied to the patients based on inpatient rehabilitation in the trial group (n=52), while inpatient rehabilitation alone was applied in the control group (n=49). The total score of quality of life, psycho-social dimension, motivation and energy dimension, score of mental disability and social function, and family social care index were recorded. Then, statistical analysis was performed using SPSS 17.0 software. Results After 3 months and 6 months, the trial group had lower scores of the total score of quality of life, psycho-social domain, and motive and energy dimension than those of the control group (Plt;0.05). After 6 months, the trial group had lower scores of mental disability and social function (Plt;0.05) but a higher score of family social care index (Plt;0.05). The scores of WHO-DSA II and SQLS were positively correlated, while the scores of APGAR and SQLS were negatively correlated. Conclusion The integral mode of hospital-community-family mental rehabilitation effectively improves the quality of life of patients with schizophrenia, which also positively improves patients’ rehabilitation.
Objective To explore the relationship between depression and quality of life in schizophrenic patients, and the mediating role of sleep quality and weakness. Methods We selected inpatients with schizophrenia from 4 secondary and above psychiatric hospitals in Chengdu for questionnaire survey by convenient sampling method between March and July 2022. The questionnaires included general demographic data, disease-related questionnaire, Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Fried Frailty Phenotype (FFP) and Schizophrenia Quality of Life Scale (SQLS). Results A total of 594 patients were included, including 373 males (62.8%) and 221 females (37.2%). The univariate analysis of the factors affecting the quality of life of the patients showed that there was no significant difference in the age, sex, only child or not, education level, course of schizophrenia, and combined medication (P>0.05), except for the family history of mental disorders (P<0.05). SQLS score was positively correlated with SDS score (r=0.635, P<0.001), PSQI score (r=0.402, P<0.001) and FFP score (r=0.327, P<0.001). The mediation of sleep quality and weakness on depression and quality of life are significant, and chain-mediated effect of depression and quality of life was significant. Conclusion The depression level of schizophrenia patients can not only directly affect their quality of life, but also indirectly affect their quality of life through the mediation of sleep quality, weakness and chain mediation of sleep quality and weakness.
Objective
To investigate the difference in first onset age, family history and medication compliance between male and female patients with schizophrenia in communities.
Methods
We used self-designed questionnaire to survey and analyze 372 cases of schizophrenia between June to August 2014.
Results
There were no significant differences between male and female schizophrenic patients in the family history, personality before the disease, education level, age, and the onset type and disease course (P > 0.05). The first onset age of male patients [(24.92±8.22) years] was significantly earlier than female patients [(27.02±11.28) years] and the difference was statistically significant (P < 0.05). The number of unmarried male patients (115, 58.97%) was significantly more than unmarried females (81, 45.76%) and the difference was statistically significant (P < 0.05). The full medication compliance rate of female patients (127, 71.75%) was significantly better than that of male patients (115, 58.97%) (P < 0.05).
Conclusion
The first onset age, marital status and medication compliance are significantly different between the two genders of patients with schizophrenia, which indicates that prevention, treatment and recovery measures for male and female patients should be differentiated.
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.
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 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.
