OBJECTIVE: Garcinia mangostana Linn., commonly known as mangosteen, is a tropical fruit with a thick pericarp rind containing bioactive compounds that may be beneficial as an adjunctive treatment for schizophrenia. The biological underpinnings of schizophrenia are believed to involve altered neurotransmission, inflammation, redox systems, mitochondrial dysfunction, and neurogenesis. Mangosteen pericarp contains xanthones which may target these biological pathways and improve symptoms; this is supported by preclinical evidence. Here we outline the protocol for a double-blind randomized placebo-controlled trial evaluating the efficacy of adjunctive mangosteen pericarp (1,000 mg/day), compared to placebo, in the treatment of schizophrenia. METHODS: We aim to recruit 150 participants across two sites (Geelong and Brisbane). Participants diagnosed with schizophrenia or schizoaffective disorder will be randomized to receive 24 weeks of either adjunctive 1,000 mg/day of mangosteen pericarp or matched placebo, in addition to their usual treatment. The primary outcome measure is mean change in the Positive and Negative Symptom Scale (total score) over the 24 weeks. Secondary outcomes include positive and negative symptoms, general psychopathology, clinical global severity and improvement, depressive symptoms, life satisfaction, functioning, participants reported overall improvement, substance use, cognition, safety and biological data. A 4-week post treatment interview at week 28 will explore post-discontinuations effects. RESULTS: Ethical and governance approvals were gained and the trial commenced. CONCLUSION: A positive finding in this study has the potential to provide a new adjunctive treatment option for people with schizophrenia and schizoaffective disorder. It may also lead to a greater understanding of the pathophysiology of the disorder.
Cognition ; Depression ; Fruit ; Garcinia mangostana ; Garcinia ; Inflammation ; Neurogenesis ; Outcome Assessment (Health Care) ; Oxidation-Reduction ; Oxidative Stress ; Psychopathology ; Psychotic Disorders ; Schizophrenia ; Synaptic Transmission ; Xanthones

OBJECTIVE: Dopamine plays a significant role in working memory by acting as a key neuromodulator between brain networks. Additionally, treatment of patients with schizophrenia using amisulpride, a pure dopamine class 2/3 receptor antagonist, improves their clinical symptoms with fewer side effects. We hypothesized that patients with schizophrenia treated with amisulpride and aripiprazole show increased working memory and glucose metabolism compared with those treated with cognitive behavioral therapy (CBT) and aripiprazole instead. METHODS: Sixteen patients with schizophrenia (eight in the amisulpride group [aripiprazole+amisulpride] and eight in the CBT group [aripiprazole+CBT]) and 15 age- and sex-matched healthy control subjects were recruited for a 12-week-long prospective trial. An [18F]-fluorodeoxyglucose-positron emission tomography/computerized tomography scanner was used to acquire the images. RESULTS: After 12 weeks of treatment, the amisulpride group showed greater improvement in the Letter-Number Span scores than the CBT group. Additionally, although brain metabolism in the left middle frontal gyrus, left occipital lingual gyrus, and right inferior parietal lobe was increased in all patients with schizophrenia, the amisulpride group exhibited a greater increase in metabolism in both the right superior frontal gyrus and right frontal precentral gyrus than the CBT group. CONCLUSION: This study suggests that a small dose of amisulpride improves the general psychopathology, working memory performance, and brain glucose metabolism of patients with schizophrenia treated with aripiprazole.
Aripiprazole ; Brain ; Cognition ; Cognitive Therapy ; Dopamine ; Electrons ; Frontal Lobe ; Glucose ; Humans ; Memory, Short-Term ; Metabolism ; Neurotransmitter Agents ; Occipital Lobe ; Parietal Lobe ; Positron-Emission Tomography ; Prefrontal Cortex ; Prospective Studies ; Psychopathology ; Schizophrenia ; Sulpiride

Corollary discharge mechanism refers to the suppression of sensory consequences of self-generated actions; a process that serves to distinguish between self and non-self based on discrimination of origination of action. It explains, say for example, why we cannot tickle ourselves. This review discusses how corollary discharge model is an essential neural integration mechanism central to the motor functioning of animal kingdom. In this article, research conducted in the field of corollary discharge has been reviewed to understand the neuroanatomical and neurophysiological basis of corollary discharge and gain insight into the biochemical basis of its dysfunction. This review article also explores the role of corollary discharge and its dysfunction in the presentation of symptoms of schizophrenia, discussing the findings from corollary discharge studies on schizophrenia population. Lastly, the link between schizophrenia psychopathology and corollary discharge dysfunction has been highlighted, and an attempt has been made to establish a case for correction of corollary discharge deficit in schizophrenia through neuromodulation.
Animals ; Discrimination (Psychology) ; Hallucinations ; Motor Activity ; Psychopathology ; Schizophrenia ; Transcranial Direct Current Stimulation

OBJECTIVES: In the treatment of schizophrenia, treatment compliance is an important prognostic factor. As insight has a significant impact on treatment compliance, an appropriate assessment of insight is essential in the treatment of schizophrenia. This study examined the reliability and validity of the Korean version of Birchwood Insight Scale (BIS). METHODS: Fifty seven adult patients diagnosed with schizophrenia according to DSM-5 were recruited from a university hospital. They were evaluated using the Positive and Negative Syndrome Scale (PANSS), The Scale to Assessment Unawareness of Mental Disorder (SUMD) and BIS. Explorative factor analysis was performed to examine the construct validity of the Korean version of BIS. Concurrent validity was evaluated by a comparison with the PANSS G12 item and SUMD. The test-retest correlation was evaluated to examine the test-retest reliability. Multiple regression analysis was performed to examine the variables affecting insight. RESULTS: Explorative factor analysis showed that the Korean version of BIS was composed of 2 factors, which are ‘Awareness of symptoms’ and ‘Awareness of illness and need for treatment.’ The Korean version of BIS was reliable in terms of the internal consistency. Concurrent validity with the PANSS G 12 item and SUMD was statistically significant. The test-retest reliability was also statistically significant. Multiple regression analysis showed that the PANSS negative factor affects the BIS score, indicating that negative symptoms of schizophrenia may impair insight of the illness. CONCLUSION: This study suggests that the Korean version of BIS is a valid and reliable tool for assessing the insight of patients with schizophrenia.
Adult ; Compliance ; Humans ; Mental Disorders ; Psychopathology ; Reproducibility of Results ; Schizophrenia

OBJECTIVES: This study examined the functional disabilities of patients with chronic schizophrenia using WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and its related factors. METHODS: The subjects consisted of 86 patients with schizophrenia with more than 10 years' duration of illness and 40 healthy volunteers. The functional disabilities and psychopathology were evaluated using the WHODAS 2.0 and 18-items Brief Psychiatric Rating Scale (BPRS-18), respectively. This study analyzed the six sub-domains ('cognition', 'mobility', 'self-care', 'getting along', 'life activities', and 'participation') of WHODAS 2.0 and the four sub-scales ('positive symptoms', 'negative symptoms', 'affect', and 'resistance') of BPRS-18. RESULTS: Patients with chronic schizophrenia experienced severe functional disabilities across all six sub-domains of WHODAS 2.0 compared to healthy people. Hierarchical regression showed that 'negative symptoms' explained the disabilities in the WHODAS 2.0 sub-domains of 'cognition' (p<0.05), 'self-care' (p<0.05), 'getting along' (p<0.01), and 'life activities' (p<0.05). 'Positive symptoms' and 'affect' explained the disabilities in 'cognition' (p<0.01 and p<0.05, respectively) and 'participation' (p<0.05 and p<0.01, respectively). 'Resistance' was found to be a predictor of 'getting along' disabilities (p<0.01). CONCLUSION: Negative symptoms mainly accounted for the multiple domains of functional disabilities in the WHODAS 2.0 but residual positive and affective symptoms could also deteriorate the cognition and social participation of patients with chronic schizophrenia.
Affective Symptoms ; Appointments and Schedules ; Brief Psychiatric Rating Scale ; Cognition ; Disability Evaluation ; Global Health ; Healthy Volunteers ; Humans ; Psychopathology ; Schizophrenia ; Social Participation ; World Health Organization

Many event-related potentials (ERPs) studies have been performed in major depressive disorder. ERPs include P50, N170, loudness dependence of auditory evoked potentials (LDAEP), P300, and mismatch negativity (MMN). These ERPs have good time-resolution as noninvasive methods, so they can be used easily in clinical practice and research. For example, ERPs can be used to differentiate patients from healthy people, as well as for assessing the subtype and severity, investigating the psychopathology, and predicting the treatment response in mental disorders. This review focuses on P50, N170, LDAEP, P300, and MMN in major depressive disorders.
Depressive Disorder, Major ; Evoked Potentials ; Evoked Potentials, Auditory ; Humans ; Mental Disorders ; Psychopathology

OBJECTIVES: This study examined the admission type and its related factors among patients with psychotic disorders defined based on the revised mental health welfare law. METHODS: This study was conducted on a total of 100 patients diagnosed on the schizophrenia spectrum and other psychotic disorders. The admission type and sociodemographic characteristics were examined. Social support, psychopathology, excitement, insight, and social functioning were evaluated using the Social Support Scale, Positive and Negative Syndrome Scale (PANSS), PANSS excitement component, Brief Psychiatric Rating Scale, Global Assessment Functioning Scale, Strauss-Carpenter scale, Korean version of the Scale to Assess Unawareness of Mental Disorder, and Korean version of Beck Cognitive Insight Scale. RESULTS: The severity of psychotic symptoms, excitement, social functioning, and insight were significantly different between involuntary and voluntary admissions (p<0.05). Excitement and insight were found to be factors affecting the admission type (p<0.05). CONCLUSION: Excitement and insight were factors mainly accounting for the admission type in patients with psychotic disorder. This study could be helpful in improving clinical decision-making and community mental health care.
Brief Psychiatric Rating Scale ; Clinical Decision-Making ; Humans ; Jurisprudence ; Mental Disorders ; Mental Health ; Patient Admission ; Psychopathology ; Psychotic Disorders ; Schizophrenia Spectrum and Other Psychotic Disorders ; Schizophrenia

OBJECTIVES: We aimed to compare the differences in parenting stress, parenting attitudes, and parents' mental health between different adult attachment styles. METHODS: Forty-four parents who completed a parental education program were enrolled in our study. They completed the Korean version of the Experience of Close Relationship Revised, Korean-Parenting Stress Index-Short Form, Maternal Behavior Research Instrument, and Symptom Checklist-90-Revised. RESULTS: The avoidant attachment score positively correlated with parenting stress. The anxious attachment score showed a positive relationship with parenting stress, hostile parenting attitude, and psychopathology, but a negative association with an affectionate parenting attitude. The secure attachment group exhibited a more autonomous, affectionate parenting style and a less hostile parenting attitude and less parenting stress than the insecure attachment group. Dismissing-avoidant attachment parents reported significantly higher parenting stress scores than secure attachment parents. Preoccupied and fearful-avoidant attachment parents displayed a more hostile parenting style than secure attachment parents. Dismissing-avoidant and preoccupied parents reported a less affectionate parenting attitude than secure attachment parents. CONCLUSION: There were differences in parenting stress, parenting attitudes, and parents' mental health depending on the adult attachment style. More specific education and interventions based on parental attachment type are necessary for parents.
Adult ; Education ; Humans ; Maternal Behavior ; Mental Health ; Parenting ; Parents ; Psychopathology

INTRODUCTION: Family history of psychopathology is a risk factor for mood and anxiety disorders in children, but little is known about rates of parental psychopathology among treatment-seeking youth with affective disorders in the Asia Pacific region. This study examined patterns of emotional and behavioural problems in parents of clinically-referred youth in Singapore. We hypothesised that parents would have higher rates of affective disorders compared to the Singapore national prevalence rate of 12%. MATERIALS AND METHODS: In this cross-sectional study, 47 families were recruited from affective disorders and community-based psychiatry programmes run by a tertiary child psychiatry clinic. All children had a confirmed primary clinical diagnosis of depression or an anxiety disorder. Parents completed the Mini International Neuropsychiatric Interview (MINI) to assess for lifetime mood and anxiety disorders. They also completed the Adult Self Report (ASR) and Adult Behavior Checklist (ABCL) to assess current internalising and externalising symptoms. RESULTS: Consistent with our hypothesis, 38.5% of mothers and 10.5% of fathers reported a lifetime mood and anxiety disorder. Nearly 1/3 of mothers had clinical/subclinical scores on current internalising and externalising problems. A similar pattern was found for internalising problems among fathers, with a slightly lower rate of clinical/subclinical externalising problems. CONCLUSION Our findings are consistent with previous overseas studies showing elevated rates of affective disorders among parents - particularly mothers - of children seeking outpatient psychiatric care. Routine screening in this population may help to close the current treatment gap for adults with mood and anxiety disorders.
Adult ; Anxiety Disorders ; diagnosis ; epidemiology ; psychology ; Child ; Cross-Sectional Studies ; Family Health ; statistics & numerical data ; Female ; Humans ; Male ; Mood Disorders ; diagnosis ; epidemiology ; psychology ; Parent-Child Relations ; Parenting ; psychology ; Parents ; psychology ; Psychiatric Status Rating Scales ; Psychopathology ; Singapore ; epidemiology

The behavioural patterns of individuals in the same species are very diverse. The phenomenon in which different behavioural phenotypes are maintained in the same species for long time can be explained by niche specialization or frequency dependent selection, but it has not been proven yet. Especially, the high prevalence of mental illnesses as extreme behaviour patterns is one of the challenges of evolutionary psychology. From an evolutionary point of view, several frameworks for studying various patterns of behaviours or psychopathologies may be proposed. In this paper, I briefly explain animal models, personality factor models, DSM-IV multiaxial models, FSD models, and RDoC models, and discuss their advantages and disadvantages, focusing on the evolutionary approach to behavioural variation among individuals.
Diagnostic and Statistical Manual of Mental Disorders ; Models, Animal ; Phenotype ; Prevalence ; Psychology ; Psychopathology