7 results
Gender, age at onset, and duration of being ill as predictors for the long-term course and outcome of schizophrenia: an international multicenter study
- Konstantinos N. Fountoulakis, Elena Dragioti, Antonis T. Theofilidis, Tobias Wiklund, Xenofon Atmatzidis, Ioannis Nimatoudis, Erik Thys, Martien Wampers, Luchezar Hranov, Trayana Hristova, Daniil Aptalidis, Roumen Milev, Felicia Iftene, Filip Spaniel, Pavel Knytl, Petra Furstova, Tiina From, Henry Karlsson, Maija Walta, Raimo K. R. Salokangas, Jean-Michel Azorin, Justine Bouniard, Julie Montant, Georg Juckel, Ida S. Haussleiter, Athanasios Douzenis, Ioannis Michopoulos, Panagiotis Ferentinos, Nikolaos Smyrnis, Leonidas Mantonakis, Zsófia Nemes, Xenia Gonda, Dora Vajda, Anita Juhasz, Amresh Shrivastava, John Waddington, Maurizio Pompili, Anna Comparelli, Valentina Corigliano, Elmars Rancans, Alvydas Navickas, Jan Hilbig, Laurynas Bukelskis, Lidija I. Stevovic, Sanja Vodopic, Oluyomi Esan, Oluremi Oladele, Christopher Osunbote, Janusz K. Rybakowski, Pawel Wojciak, Klaudia Domowicz, Maria L. Figueira, Ludgero Linhares, Joana Crawford, Anca-Livia Panfil, Daria Smirnova, Olga Izmailova, Dusica Lecic-Tosevski, Henk Temmingh, Fleur Howells, Julio Bobes, Maria P. Garcia-Portilla, Leticia García-Alvarez, Gamze Erzin, Hasan Karadağ, Avinash De Sousa, Anuja Bendre, Cyril Hoschl, Cristina Bredicean, Ion Papava, Olivera Vukovic, Bojana Pejuskovic, Vincent Russell, Loukas Athanasiadis, Anastasia Konsta, Nikolaos K. Fountoulakis, Dan Stein, Michael Berk, Olivia Dean, Rajiv Tandon, Siegfried Kasper, Marc De Hert
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- Journal:
- CNS Spectrums / Volume 27 / Issue 6 / December 2022
- Published online by Cambridge University Press:
- 09 August 2021, pp. 716-723
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Background
The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia.
MethodsTwenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 ± 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects.
ResultsThere was a 3-year later age at onset for females (P < .001) and lower rates of negative symptoms (P < .01) and higher depression/anxiety measures (P < .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages (P = .001). No significant effects were found concerning duration of illness.
DiscussionOur results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples.
Short-term functional outcome and premorbid adjustment in clinical high-risk patients. Results of the EPOS project
- R.K.R. Salokangas, M. Heinimaa, T. From, E. Löyttyniemi, T. Ilonen, S. Luutonen, J. Hietala, T. Svirskis, H.G. von Reventlow, G. Juckel, D. Linszen, P. Dingemans, M. Birchwood, P. Patterson, F. Schultze-Lutter, S. Ruhrmann, J. Klosterkötter
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- Journal:
- European Psychiatry / Volume 29 / Issue 6 / August 2014
- Published online by Cambridge University Press:
- 15 April 2020, pp. 371-380
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Purpose
In patients with schizophrenia, premorbid psychosocial adjustment is an important predictor of functional outcome. We studied functional outcome in young clinical high-risk (CHR) patients and how this was predicted by their childhood to adolescence premorbid adjustment.
MethodsIn all, 245 young help-seeking CHR patients were assessed with the Premorbid Adjustment Scale, the Structured Interview for Prodromal Syndromes (SIPS) and the Schizophrenia Proneness Instrument (SPI-A). The SIPS assesses positive, negative, disorganised, general symptoms, and the Global Assessment of Functioning (GAF), the SPI-A self-experienced basic symptoms; they were carried out at baseline, at 9-month and 18-month follow-up. Transitions to psychosis were identified. In the hierarchical linear model, associations between premorbid adjustment, background data, symptoms, transitions to psychosis and GAF scores were analysed.
ResultsDuring the 18-month follow-up, GAF scores improved significantly, and the proportion of patients with poor functioning decreased from 74% to 37%. Poor premorbid adjustment, single marital status, poor work status, and symptoms were associated with low baseline GAF scores. Low GAF scores were predicted by poor premorbid adjustment, negative, positive and basic symptoms, and poor baseline work status. The association between premorbid adjustment and follow-up GAF scores remained significant, even when baseline GAF and transition to psychosis were included in the model.
ConclusionA great majority of help-seeking CHR patients suffer from deficits in their functioning. In CHR patients, premorbid psychosocial adjustment, baseline positive, negative, basic symptoms and poor working/schooling situation predict poor short-term functional outcome. These aspects should be taken into account when acute intervention and long-term rehabilitation for improving outcome in CHR patients are carried out.
Perceived negative attitude of others predicts transition to psychosis in patients at risk of psychosis
- R.K.R. Salokangas, P. Patterson, M. Heinimaa, T. Svirskis, T. From, L. Vaskelainen, J. Klosterkötter, S. Ruhrmann, H.G. von Reventlow, G. Juckel, D. Linszen, P. Dingemans, M. Birchwood, the EPOS Group
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- Journal:
- European Psychiatry / Volume 27 / Issue 4 / May 2012
- Published online by Cambridge University Press:
- 15 April 2020, pp. 264-266
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Aim
Our previous study (Salokangas et al., 2009) suggested that the subjective experience of negative attitude of others (NAO) towards oneself is an early indicator of psychotic development. The aim of this prospective follow-up study was to test this hypothesis.
MethodsA total of 55 young psychiatric outpatients assessed as being at current risk of psychosis (CROP) were followed for up to 60 months and rates of transition to psychosis (TTP) identified. CROP was assessed employing the Bonn Scale for assessment of basic symptoms (Schultze-Lutter and Klosterkötter, 2002) and the Structured Interview for prodromal symptoms (Miller et al., 2002). TTP was defined by a psychotic episode lasting for more than one week. Associations between NAO at baseline and TTP were analyzed by a Cox regression survival analysis.
ResultsEight (14.5%) TTP were identified: four (57.1%) within seven NAO patients and four (8.7%) within forty-six non-NAO patients. In the multivariate Cox regression analysis, NAO at baseline significantly (P = 0.007) predicted TTP.
ConclusionThe prospective follow-up results support our hypothesis that subjective experience of NAO is an early indicator of psychotic in development.
Modeling psychological function in patients with schizophrenia with the PANSS: an international multi-center study
- Konstantinos N. Fountoulakis, Elena Dragioti, Antonis T. Theofilidis, Tobias Wiklund, Xenofon Atmatzidis, Ioannis Nimatoudis, Erik Thys, Martien Wampers, Luchezar Hranov, Trayana Hristova, Daniil Aptalidis, Roumen Milev, Felicia Iftene, Filip Spaniel, Pavel Knytl, Petra Furstova, Tiina From, Henry Karlsson, Maija Walta, Raimo K.R. Salokangas, Jean-Michel Azorin, Justine Bouniard, Julie Montant, Georg Juckel, Ida S. Haussleiter, Athanasios Douzenis, Ioannis Michopoulos, Panagiotis Ferentinos, Nikolaos Smyrnis, Leonidas Mantonakis, Zsófia Nemes, Xenia Gonda, Dora Vajda, Anita Juhasz, Amresh Shrivastava, John Waddington, Maurizio Pompili, Anna Comparelli, Valentina Corigliano, Elmars Rancans, Alvydas Navickas, Jan Hilbig, Laurynas Bukelskis, Lidija I. Stevovic, Sanja Vodopic, Oluyomi Esan, Oluremi Oladele, Christopher Osunbote, Janusz K. Rybakowski, Pawel Wojciak, Klaudia Domowicz, Maria L. Figueira, Ludgero Linhares, Joana Crawford, Anca-Livia Panfil, Daria Smirnova, Olga Izmailova, Dusica Lecic-Tosevski, Henk Temmingh, Fleur Howells, Julio Bobes, Maria P. Garcia-Portilla, Leticia García-Alvarez, Gamze Erzin, Hasan Karadağ, Avinash De Sousa, Anuja Bendre, Cyril Hoschl, Cristina Bredicean, Ion Papava, Olivera Vukovic, Bojana Pejuskovic, Vincent Russell, Loukas Athanasiadis, Anastasia Konsta, Dan Stein, Michael Berk, Olivia Dean, Rajiv Tandon, Siegfried Kasper, Marc De Hert
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- Journal:
- CNS Spectrums / Volume 26 / Issue 3 / June 2021
- Published online by Cambridge University Press:
- 15 April 2020, pp. 290-298
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Background
The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model.
MethodsTwenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed.
ResultsThe results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage.
ConclusionsThe current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.
Causal Connection Between Depression and Paranoia
- R.K.R. Salokangas, J. Hietala, M. Heinimaa, T. From, H. Graf von Reventlow, D. Linszen, P. Dingemans, M. Birchwood, P. Patterson, F. Schultze-Lutter, J. Klosterkötter, S. Ruhrmann
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- Journal:
- European Psychiatry / Volume 30 / Issue S1 / March 2015
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
The link between depression and paranoia has long been discussed in the psychiatric literature. Because this association is difficult to study in patients with full-blown psychosis, we investigated clinical high-risk (CHR) patients.
ObjectiveTo clarify the causal connection between depression and paranoia.
AimsTo investigate how clinical depression relates to presence and new occurrence of paranoid symptoms in CHR patients.
MethodsAltogether, 245 young help-seeking CHR patients were assessed for suspiciousness/paranoid symptoms with the Structured Interview for Prodromal Syndromes at baseline, 9-month and 18-month follow-up. At baseline, clinical diagnoses were assessed by the Structured Clinical Interview for DSM-IV, childhood stressful experiences by the Trauma and Distress Scale, trait of suspiciousness by the Schizotypal Personality Questionnaire, and anxiety and depressive symptoms by the Positive and Negative Syndrome Scale.
ResultsAt baseline, 54.3 % of CHR patients reported at least moderate paranoid symptoms. At 9- and 18-month follow-ups, the corresponding figures were 28.3 % and 24.4 %. Depressive disorder, sexual abuse and anxiety symptoms associated with paranoid symptoms. Depressive, obsessive-compulsive and somatoform disorders, sexual abuse, and anxiety predicted occurrence of paranoid symptoms.
ConclusionDepressive disorder is one of the major clinical factors associating with and predicting paranoid symptoms in CHR patients; also childhood sexual abuse and anxiety symptoms associate with paranoia. In addition, obsessive-compulsive and somatoform disorders seem to predict paranoid symptoms. Low self-esteem may be a common mediator between affective disorders and paranoia. Effective treatment of these disorders may alleviate paranoid symptoms and improve interpersonal functioning in CHR patients.
EPA-0665 – Premorbid Adjustment Predicts Functional Outcome in Clinical High-Risk Patients. Results of the Epos Project.
- R.K.R. Salokangas, M. Heinimaa, T. From, E. Löyttyniemi, J. Hietala, H. Graf von Reventlow, D. Linszen, M. Birchwood, S. Ruhrmann, J. Klosterkötter
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- Journal:
- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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- Article
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- You have access Access
- Export citation
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Introduction:
In patients with schizophrenia, premorbid psychosocial adjustment is an important predictor of functional outcome. We studied functional outcome in young clinical high-risk (CHR) patients and how this was predicted by their premorbid adjustment.
Methods:In all, 245 young help-seeking CHR patients were assessed with the Premorbid Adjustment Scale, the Structured Interview for Prodromal Syndromes (SIPS) and the Schizophrenia Proneness Instrument (SPI-A). The SIPS assesses positive, negative, disorganized, general symptoms, and the Global Assessment of Functioning (GAF), the SPI-A self-experienced basic symptoms; they were carried out at baseline, at 9- month and 18-month follow-up. Transitions to psychosis were identified. In the hierarchical linear model, associations between premorbid adjustment, background data, symptoms, transitions to psychosis and GAF scores were analyzed.
Results:During the 18-month follow-up, GAF scores improved significantly, and the proportion of patients with poor functioning decreased from 45% to 25%. Low GAF scores were predicted by poor premorbid adjustment, negative, positive and basic symptoms, and poor baseline work status. The association between premorbid adjustment and follow-up GAF scores remained significant, even when baseline GAF and transition to psychosis were included in the model.
Conclusion:A great majority of help-seeking CHR patients suffer from deficits in their functioning. In CHR patients, premorbid psychosocial adjustment, baseline positive, negative, basic symptoms and poor working/schooling situation predict poor short-term functional outcome. These aspects should be taken into account when acute intervention and long-term rehabilitation for improving outcome in CHR patients are executed.
Perception of livestock ecosystem services in grazing areas
- G. Leroy, I. Hoffmann, T. From, S. J. Hiemstra, G. Gandini
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This study investigates how the ecosystem services (ES) linked to livestock grazing are perceived across countries. A total of 82 case studies collected from 42 countries via survey (53.7% cases from Europe and 46.3% from outside of Europe) have been analysed through a multivariate approach. In all, 18 non-provisioning ES were considered. Overall, the reported impacts of livestock grazing on the different ES were much more positive than negative. Notably, a large proportion of respondents reported either positive or very positive impacts for some cultural ES, namely cultural, historic and natural heritage (84%), knowledge systems and educational values (77%), landscape values (74%), and for some supporting and regulating ES, namely habitat provision (66%), nutrient cycling (65%), and bush encroachment/fire control (66%). Based on multiple regression analysis, geographic origin, stakeholder type and species category, as well as protection status of the grazing area, had significant effects on the perception of the impacts. Respondents reported those impacts as more positive in Europe, in protected areas and where several species were present in the grazing area. A significantly larger proportion of respondents reported recognition of ES provided by the grazing livestock population in European countries (40.9%) compared with non-European countries (23.7%). Based on the survey responses it appears that in non-European countries absence of formal recognition, especially by policy makers, is a major challenge for the continued provision of ES in grazing systems. In Europe, where such recognition is already often included in legislation, the long-term sustainability of related policies and incentives to provide such services is viewed as a major issue by the respondents.