2.Effectiveness of family-focused intervention in patients with schizophrenia in family and community practice – A meta-analysis study
Cherry Louise M. Orfanel, MD ; Marinol B. Villafuerte, MD
The Filipino Family Physician 2023;61(1):108-116
Background:
Schizophrenia is a pervasive, chronic mental disorder that negatively impacts the biological, socioeconomic and family well being of the patient. Active involvement of family members and other significant individuals appears to benefit overall management.
Objective:
To determine the effectiveness of family-focused intervention in improving symptoms of schizophrenia.
Methods:
The authors searched for eligible clinical trials in the PubMed, Cochrane Central Register of Controlled Trials, Research Gate, Google Scholar and grey literature databases. Participants should be patients diagnosed to have schizophrenia and interventions should involve the family or be labeled as ‘family therapy.’ The primary outcome considered was symptom improvement based on the Positive and Negative Symptom Scale (PANSS). Secondary outcomes included quality of life, family functioning and subjective experience of the treatment process. The authors used the RevMan 5.4 software for data analysis. Bias, subgroup and sensitivity analyses were performed. Strength of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.
Results:
A total of 1,794 trials were initially identified, of which three publications were included in the review. Two studies used psychosocial approaches whereas one used cognitive behavioral therapy in conjunction with family intervention. Meta-analysis revealed the studies to be heterogeneous based on p values <0.10 and I2 >50%. Subgroup analysis by type of intervention showed no difference between the intervention and control groups, although there was a positive trend in favor of psychosocial intervention for improvement in PANSS score. Family-based intervention had a significant positive effect on quality of life.
Conclusion
Family-based interventions are effective in the management of schizophrenia, helping to improve quality of life, potentially reducing symptom burden and serving as an adjunct to health institution-based management.
schizophrenia
;
meta-analysis
3.Aripiprazole in the treatment of acute episode of schizophrenia: a real-world study in China.
Qian LI ; Yun'ai SU ; Xuemei LIAO ; Maosheng FANG ; Jianliang GAO ; Jia XU ; Mingjun DUAN ; Haiying YU ; Yang YANG ; Zhiyu CHEN ; Jintong LIU ; Shaoxiao YAN ; Peifen YAO ; Shuying LI ; Changhong WANG ; Bin WU ; Congpei ZHANG ; Tianmei SI
Chinese Medical Journal 2023;136(9):1126-1128
6.Impact of social support for schizophrenia patients on their quality of life and family life satisfaction.
Hong Mei DU ; Jian Jian LI ; Feng DOU ; Yi Ni ZHAO ; Zhi Bin MA ; Chao YANG ; Xiao Bin HU
Chinese Journal of Epidemiology 2023;44(5):786-790
Objective: To explore the relationship of social support to patients with schizophrenia, family burden with patients' quality of life and family life satisfaction. Methods: Multi-stage stratified cluster random sampling was used to select 358 patients with schizophrenia and 358 patients' family members in Gansu Province who met the inclusion criteria were included. The Social Support Rating Scale, Family Burden Scale, Satisfaction with Life Scale and Quality of Life Scale were used in the survey. AMOS 24.0 was used to explore the pathway of influence of family burden on social support to patients with schizophrenia, patients' quality of life and patients' family life satisfaction. Results: There was a two-by-two significant correlation between patients' access to social support, family burden, patients' life quality and family life satisfaction (P<0.05), and the total score of the social support scale negatively predicted the total score of the life quality scale (β=-0.28, P<0.05) and positively predicted the total score of the life satisfaction scale (β=0.52, P<0.05). Family burden was a full mediator between the social support to the patient and the patient's quality of life, and as a partial mediator between the social support to the patient and the family's life satisfaction. Conclusions: Social support to people with schizophrenia is a significant predictor of their quality of life and family life satisfaction. Family burden mediates the relationship of social support to patients with their quality of life and family life satisfaction. Interventions can focus on increasing social support for the patient and reducing the burden on the patient's family to improve the patient's quality of life and increase the satisfaction of the patient's family.
Humans
;
Patient Satisfaction
;
Quality of Life
;
Schizophrenia
;
Family Relations
;
Social Support
7.Psychiatric morbidities after stroke in Asia: A systematic review
Meliza Angelica J. De Leon ; Alejandro C. Baroque II
Journal of Medicine University of Santo Tomas 2023;7(2):1222-1228
Background:
Stroke is currently the second leading cause of death worldwide and is one of the leading causes of long-term disability . Mood disorders are prevalent after a stroke and may hinder physical, functional, and cognitive recovery; hence, it is undeniably necessary to recognize them early. Stroke mortality is generally higher in Asia as most of the countries therein are in economic transition . Socioeconomic status is a major contributor to stroke burden as greater odds of disability are found in patients with lower educational status and income.
Objectives:
The primary objective of this study is to identify the psychiatric morbidities commonly seen after a stroke in Asia.
Search Methods:
The following databases were utilized for extensive literature search: PubMed (January 2002 to June 2022), Cochrane Library (January 2002 to June 2022), and EBSCO (January 2002 to June 2022). The search made use of keyword combinations, Boolean operators "AND" and "OR," truncations, and field tags last October 2022.
Selection Criteria:
Articles on the prevalence and cross-sectional studies were included if they involved stroke survivors who developed post-stroke psychiatric morbidities in Asia. Additional inclusion criteria consisted of studies that have to be written in the English language and having free full texts available.
Data Collection and Analysis:
This systematic review made use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and guidelines. The JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data was used in the assessment for the quality of articles to be included in this systematic review.
Results and Conclusion
Affective disorders and generalized anxiety disorder were the common psychiatric morbidities identified post-stroke. The Hospital Anxiety and Depression Scale (HADS) may be used to diagnose post-stroke depression and anxiety. Males in their middle to late adulthood with higher National Institutes of Health Stroke Scale (NIHSS) scores and poor stroke outcomes (higher scores in the Modified Rankin Scale) were associated with a higher likelihood of developing the aforementioned psychiatric morbidities.
Depression
;
Anxiety
;
Mania
;
Psychotic Disorders
;
Asia
8.Clinical experience with paliperidone palmitate in a specialty hospital in the Philippines: A short report
Amadeo A. Alinea, Jr. ; Carl Abelardo T. Antonio ; Amiel Nazer C. Bermudez ; Kim L. Cochon ; Maria Fatima V. Martinez ; Jonathan P. Guevarra
The Philippine Journal of Psychiatry 2023;4(1-2):47-
Objectives:
This study aimed to describe the clinical outcomes related to theintroduction of Paliperidone Palmitate in a specialty hospital in the Philippines.
Methodology:
Cross-sectional study among patients with Schizophrenia seen at thepsychiatry service of a specialty hospital catering to war veterans who were initiated onPaliperidone Palmitate. We reviewed and abstracted baseline patient data from themedical record of eligible patients. Outcome of treatment was collected through a one-time objective assessment of the patient by a third-party psychiatrist using theStructured Clinical Interview for Symptoms of Remission (SCI-SR) tool.
Results:
A total of 30 patients were recruited for the study from August 2020 and June2021, the majority of whom were males (80%), residents of the National Capital Region(50%) and single (20%). The median duration from schizophrenia diagnosis to initiation of Paliperidone treatment was 19.50 years (IQR: 16.60 – 33.50). In eight patients (22.67%),other antipsychotic drugs were discontinued following initiation of Paliperidonetreatment; in the remaining 22 participants (73.33%), Paliperidone was taken concurrentlywith other antipsychotic drugs. The median duration from the initiation of Paliperidonetreatment to follow-up assessment was 27.20 months (IQR: 24.73 – 30.50), with allparticipants having at least 6 months of treatment. At follow-up assessment, allparticipants were classified to be in remission.
Conclusion
In this study among patients with schizophrenia seen in a specialtyhospital in the Philippines, we found evidence that clinical outcomes with PaliperidonePalmitate were comparable to those given a combination of oral and long- actingantipsychotics.
Paliperidone Palmitate
;
Schizophrenia
10.Shared and distinct abnormalities of brain magnetization transfer ratio in schizophrenia and major depressive disorder: a comparative voxel-based meta-analysis.
Huan LAN ; Xueling SUO ; Chao ZUO ; Weishi NI ; Song WANG ; Graham J KEMP ; Qiyong GONG
Chinese Medical Journal 2023;136(23):2824-2833
BACKGROUND:
Patients with schizophrenia (SCZ) and major depressive disorder (MDD) share significant clinical overlap, although it remains unknown to what extent this overlap reflects shared neural profiles. To identify the shared and specific abnormalities in SCZ and MDD, we performed a whole-brain voxel-based meta-analysis using magnetization transfer imaging, a technique that characterizes the macromolecular structural integrity of brain tissue in terms of the magnetization transfer ratio (MTR).
METHODS:
A systematic search based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in PubMed, EMBASE, International Scientific Index (ISI) Web of Science, and MEDLINE for relevant studies up to March 2022. Two researchers independently screened the articles. Rigorous scrutiny and data extraction were performed for the studies that met the inclusion criteria. Voxel-wise meta-analyses were conducted using anisotropic effect size-signed differential mapping with a unified template. Meta-regression was used to explore the potential effects of demographic and clinical characteristics.
RESULTS:
A total of 15 studies with 17 datasets describing 365 SCZ patients, 224 MDD patients, and 550 healthy controls (HCs) were identified. The conjunction analysis showed that both disorders shared higher MTR than HC in the left cerebellum ( P =0.0006) and left fusiform gyrus ( P =0.0004). Additionally, SCZ patients showed disorder-specific lower MTR in the anterior cingulate/paracingulate gyrus, right superior temporal gyrus, and right superior frontal gyrus, and higher MTR in the left thalamus, precuneus/cuneus, posterior cingulate gyrus, and paracentral lobule; and MDD patients showed higher MTR in the left middle occipital region. Meta-regression showed no statistical significance in either group.
CONCLUSIONS
The results revealed a structural neural basis shared between SCZ and MDD patients, emphasizing the importance of shared neural substrates across psychopathology. Meanwhile, distinct disease-specific characteristics could have implications for future differential diagnosis and targeted treatment.
Humans
;
Depressive Disorder, Major/drug therapy*
;
Schizophrenia/pathology*
;
Brain/pathology*
;
Prefrontal Cortex
;
Frontal Lobe
;
Magnetic Resonance Imaging/methods*


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