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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.
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.
Experience and Cultural–Repertoire Based Avenues of Trust: An Analysis of Public Trust in Statistical Agencies and their Data
- Michelle Smirnova, Paul Scanlon
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- Journal:
- Social Policy and Society / Volume 16 / Issue 2 / April 2017
- Published online by Cambridge University Press:
- 03 March 2016, pp. 219-236
- Print publication:
- April 2017
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Declining trust in statistical agencies has recently complicated the endeavour to collect high-quality, timely data that are used to inform US policy and practice. Given this context, understanding how respondents choose to trust particular statistical agencies and their products is incredibly important. This article details a series of cognitive interviews (85) and focus groups (3) used to measure how the US public develops trust for statistical agencies, their statistical products and their use of administrative records. Results show that respondents use two models of trust in their rationale: experience based and cultural‒repertoire based. When respondents did not have experience with a particular institution and/or its product, cultural values including personal liberty, cost-savings and the promotion of social goods (for example, government-sponsored schools and hospitals) were found to influence their motivations to trust or distrust. As a result, appeals to cultural values may have the potential to increase trust among respondents. Familiarity with statistical agencies and their products may also increase respondents’ levels of trust.