Bibliografie tematiche / Schizophrenia Spectrum Disorders (SSDs)

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Letteratura scientifica selezionata sul tema "Schizophrenia Spectrum Disorders (SSDs)"

Autore: Grafiati

Pubblicato: 2 novembre 2024

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Articoli di riviste sul tema "Schizophrenia Spectrum Disorders (SSDs)"

Wu, Sally, Kristoffer J. Panganiban, Jiwon Lee, Dan Li, Emily C. C. Smith, Kateryna Maksyutynska, Bailey Humber et al. "Peripheral Lipid Signatures, Metabolic Dysfunction, and Pathophysiology in Schizophrenia Spectrum Disorders". Metabolites 14, n. 9 (28 agosto 2024): 475. http://dx.doi.org/10.3390/metabo14090475.

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Metabolic dysfunction is commonly observed in schizophrenia spectrum disorders (SSDs). The causes of metabolic comorbidity in SSDs are complex and include intrinsic or biological factors linked to the disorder, which are compounded by antipsychotic (AP) medications. The exact mechanisms underlying SSD pathophysiology and AP-induced metabolic dysfunction are unknown, but dysregulated lipid metabolism may play a role. Lipidomics, which detects lipid metabolites in a biological sample, represents an analytical tool to examine lipid metabolism. This systematic review aims to determine peripheral lipid signatures that are dysregulated among individuals with SSDs (1) with minimal exposure to APs and (2) during AP treatment. To accomplish this goal, we searched MEDLINE, Embase, and PsychINFO databases in February 2024 to identify all full-text articles written in English where the authors conducted lipidomics in SSDs. Lipid signatures reported to significantly differ in SSDs compared to controls or in relation to AP treatment and the direction of dysregulation were extracted as outcomes. We identified 46 studies that met our inclusion criteria. Most of the lipid metabolites that significantly differed in minimally AP-treated patients vs. controls comprised glycerophospholipids, which were mostly downregulated. In the AP-treated group vs. controls, the significantly different metabolites were primarily fatty acyls, which were dysregulated in conflicting directions between studies. In the pre-to-post AP-treated patients, the most impacted metabolites were glycerophospholipids and fatty acyls, which were found to be primarily upregulated and conflicting, respectively. These lipid metabolites may contribute to SSD pathophysiology and metabolic dysfunction through various mechanisms, including the modulation of inflammation, cellular membrane permeability, and metabolic signaling pathways.

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Ousley, O. Y., E. Smearman, S. Fernandez-Carriba, K. A. Rockers, K. Coleman, E. F. Walker e J. F. Cubells. "Axis I psychiatric diagnoses in adolescents and young adults with 22q11 deletion syndrome". European Psychiatry 28, n. 7 (settembre 2013): 417–22. http://dx.doi.org/10.1016/j.eurpsy.2013.06.002.

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AbstractBackground22q11.2 deletion syndrome (22q11DS) associates with schizophrenia spectrum disorders (SSDs), autism spectrum disorders (ASDs), and other psychiatric disorders, but co-occurrence of diagnoses are not well described.MethodsWe evaluated the co-occurrence of SSDs, ASDs and other axis I psychiatric diagnoses in 31 adolescents and adults with 22q11DS, assessing ASDs using either stringent Collaborative Program for Excellence in Autism (ASD-CPEA) criteria, or less stringent DSM-IV criteria alone (ASD-DSM-IV).ResultsTen (32%) individuals met criteria for an SSD, five (16%) for ASD-CPEA, and five others (16%) for ASD-DSM-IV. Of those with ASD-CPEA, one (20%) met SSD criteria. Of those with ASD-DSM-IV, four (80%) met SSD criteria. Depressive disorders (8 individuals; 26%) and anxiety disorders (7; 23%) sometimes co-occurred with SSDs and ASDs. SSDs, ASDs, and anxiety occurred predominantly among males and depression predominantly among females.ConclusionsIndividuals with 22q11DS can manifest SSDs in the presence or absence of ASDs and other axis I diagnoses. The results suggest that standard clinical care should include childhood screening for ASDs, and later periodic screening for all axis I diagnoses.

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Oliver, Lindsay, Iska Moxon-Emre, Aristotle Voineskos e Stephanie Ameis. "M49. BEHAVIOURAL SOCIAL COGNITION IN SCHIZOPHRENIA SPECTRUM DISORDERS IN COMPARISON TO AUTISM SPECTRUM DISORDER: A SYSTEMATIC REVIEW AND META-ANALYSIS". Schizophrenia Bulletin 46, Supplement_1 (aprile 2020): S152—S153. http://dx.doi.org/10.1093/schbul/sbaa030.361.

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Abstract Background Schizophrenia spectrum disorders (SSDs) and autism spectrum disorder (ASD) both feature social cognitive deficits, which are highly debilitating. These include lower-level processes (e.g. emotion recognition), thought to be subserved by a frontoparietal mirroring network, and higher-level mentalizing processes (e.g. theory of mind), involving cortical midline and lateral temporal brain regions. Across both disorders, impairments in social cognition persist over time, drive disability, and predict functional outcome. Overlapping symptoms in SSDs and ASD have long been recognized, particularly in the realm of social deficits. However, despite some studies including both individuals with SSDs and ASD showing similar levels of social cognitive impairment, including lower-level and higher-level deficits, results are mixed. Thus, our objective was to determine based on the extant literature how deficits in social cognition diverge or overlap between individuals with SSDs and ASD by conducting a systematic review and meta-analysis of studies directly comparing these groups on behavioural social cognitive measures. Methods Literature searches were conducted in MEDLINE, Embase, PsycINFO, and Web of Science to identify articles that utilized behavioural measures to assess social cognition in both SSD and ASD samples. Of 3682 articles identified, 28 met all inclusion criteria. Across the accepted articles, lower-level (e.g. facial and/or context-embedded emotion recognition) and higher-level (e.g. intention understanding, perspective taking) social cognitive measures were identified, and random-effects meta-analyses were conducted for each category. A separate meta-analysis was also conducted for the Reading the Mind in the Eyes test given that it was the most commonly used social cognitive metric. Effect sizes were estimated using Hedges’ g. Homogeneity of effects and publication bias were also assessed for each meta-analysis. Results A significant difference in lower-level social cognitive performance was found between individuals with SSDs and ASD, with the SSD group performing better than the ASD group (Hedges’ g = 0.30, 95% CI [0.05, 0.56], p = .018). In contrast, there was no significant difference in higher-level social cognitive performance between SSD and ASD groups (Hedges’ g = -0.14, 95% CI [-0.52, 0.24], p = .46). Similarly, the Reading the Mind in the Eyes test meta-analysis revealed no significant difference in effect sizes between disorders (Hedges’ g = 0.24, 95% CI [-0.07, 0.55], p = .14). Effect size distributions were significantly heterogeneous in all three cases (all p < .001). Discussion Based on meta-analyses of the extant literature, both shared and differential social cognitive deficits may be present between individuals with SSDs and ASD. Though no differences were detected between SSD and ASD groups on higher-level social cognitive tasks or the Reading the Mind in the Eyes test, lower-level social cognitive deficits were found to be more severe in individuals with ASD than SSDs. Notably, the majority of studies included in the meta-analyses had small sample sizes, and heterogeneity of effect sizes was apparent. Thus, studies including larger sample sizes and validated measures of social cognition in conjunction with other methodologies are needed to substantiate these results, and better understand the shared and unique behavioural underpinnings and associated neural circuit abnormalities underlying social cognitive deficits in SSDs and ASD.

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Agarwal, Sri Mahavir, Joel Dissanayake, Ofer Agid, Christopher Bowie, Noah Brierley, Araba Chintoh, Vincenzo De Luca et al. "Characterization and prediction of individual functional outcome trajectories in schizophrenia spectrum disorders (PREDICTS study): Study protocol". PLOS ONE 18, n. 9 (21 settembre 2023): e0288354. http://dx.doi.org/10.1371/journal.pone.0288354.

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Schizophrenia spectrum disorders (SSDs) are associated with significant functional impairments, disability, and low rates of personal recovery, along with tremendous economic costs linked primarily to lost productivity and premature mortality. Efforts to delineate the contributors to disability in SSDs have highlighted prominent roles for a diverse range of symptoms, physical health conditions, substance use disorders, neurobiological changes, and social factors. These findings have provided valuable advances in knowledge and helped define broad patterns of illness and outcomes across SSDs. Unsurprisingly, there have also been conflicting findings for many of these determinants that reflect the heterogeneous population of individuals with SSDs and the challenges of conceptualizing and treating SSDs as a unitary categorical construct. Presently it is not possible to identify the functional course on an individual level that would enable a personalized approach to treatment to alter the individual’s functional trajectory and mitigate the ensuing disability they would otherwise experience. To address this ongoing challenge, this study aims to conduct a longitudinal multimodal investigation of a large cohort of individuals with SSDs in order to establish discrete trajectories of personal recovery, disability, and community functioning, as well as the antecedents and predictors of these trajectories. This investigation will also provide the foundation for the co-design and testing of personalized interventions that alter these functional trajectories and improve outcomes for people with SSDs.

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Pushko, Ye. "PHENOMENOLOGICAL RESEARCH OF IMAGINATION IN SCHIZOPHRENIA SPECTRUM DISORDERS AS A CONCEPTUAL FRAMEWORK FOR UNDERSTANDING PSYCHOTHERAPEUTIC PROCESSES AND RECOVERY STRATEGIES". Psychology and Personality, n. 1 (13 marzo 2023): 178–97. http://dx.doi.org/10.33989/2226-4078.2023.1.274746.

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Although imagination abnormalities are frequent and handicapping in schizophrenia spectrum disorders (SSDs), psychopathology lacks a conceptual framework for modeling imagination disorders. Recently, in connection with the “imaginary turn” in phenomenology, translational approaches between philosophy and psychopathology have been sought. The purpose of the article is the presentation and analysis of modern foreign phenomenological studies of imagination in SSDs by a group of researchers headed by A. Rasmussen and J. Parnas, for the possible implementation of the results in domestic practice. The author first examines the features of anomalous fantasy and imagination in SSDs from the phenomenological point of view and then presents an overview of the EAFI instrument for a semistructured, phenomenological study of anomalous fantasy and imagination through interviews. Then the author analyzes the theoretical and practical implications of such research for understanding psychotherapeutic processes and recovery strategies. The studied disorders of imagination are characterized by three phenomenological dimensions: 1) perceptualization of imagery: the experience acquires certain quasi-perceptual qualities, such as spatialization, spatiotemporal constancy and explorabilty; 2) autonomization of imagery with a quasi-involuntary flow and a sense of empirical distance between the conscious image and the sense of agency; and 3) erosion of irreality: whereas the imagination is normally lived with an ever-present character of unreality, people with SSDs can experience vivid imagery without a clear separation with the real world. Rasmussen et al. not only describe clinical experience, they also offer a conceptual model of imagination disorders as expressions of minimal self-disorders (disorders of ipseity). The researchers hypothesize that impaired ipseity itself is the core generative disorder of schizophrenia, and positive/negative symptoms derive from this core phenotype. Thus, imagination is understood as a mental domain that affects the underlying disorder, meaning that imagination has the same status as all other modes of intentional consciousness (such as perception or memory). T. Gozé and I. Fazakas go further and suggest a phenomenological distinction between fantasy and imagination, which resembles the distinction between body schema and body image.

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Springfield, Cassi, Lillian Hammer, Amy Pinkham, Raeanne Moore, Robert Ackerman, Philip Harvey, Colin Depp e Kelsey Bonfils. "0692 Relationships Between Sleep and Social Cognitive Biases in Schizophrenia-Spectrum and Bipolar Disorders". SLEEP 46, Supplement_1 (1 maggio 2023): A304. http://dx.doi.org/10.1093/sleep/zsad077.0692.

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Abstract Introduction People with schizophrenia-spectrum disorders (SSDs) and bipolar disorders (BDs) experience difficulty with social cognition, or the mental processes that underlie social interactions, but determinants of social cognitive impairment are still under investigation. Research suggests that poor sleep quality is related to reduced social cognitive ability in BDs, but it is unclear if sleep quality is related to social cognition in SSDs and if sleep may be related to different types of social cognition (e.g., emotion recognition, biases) in different ways. This study aimed to examine relationships between sleep and different types of social cognition in SSDs and BDs. Given known relationships between blaming and untrustworthiness biases and paranoia in these populations, paranoia was also examined as potential mediator of these relationships. Methods Participants (SSDs n=91; BDs with psychotic features n=87) completed tasks of social cognitive ability (e.g., facial and multi-modal emotion recognition, attributional bias, untrustworthiness bias). Participants self-reported their sleep quality. Paranoia was assessed via clinical interview. Results In the BD group, poor sleep quality (r=-.23, p=.04) and shorter sleep duration (r=-.25, p=.02) were associated with a bias towards untrustworthiness. For those with SSDs, increased use of sleep medication was associated with poorer multi-modal emotion recognition (r=-.22, p=.04). Additionally, poor sleep quality and overall poor sleep were associated with increased blaming (r=.22, p=.03; r=.21, p=.04) and untrustworthiness biases (r=-.24, p=.03; r=-.24, p=.03) in this group. Higher daytime tiredness was also associated with untrustworthiness bias (r=-.23, p=.03) in SSDs. Regarding mediation results, paranoia did serve as a mediator in the relationships between sleep and blaming and untrustworthiness biases across the sample. Conclusion Results suggest that poor sleep quality is linked to increased attributional and untrustworthiness biases, and that these relationships may be at least partially explained by paranoia symptoms. Of note, however, is that indirect effect sizes in mediation models were small. Contrary to expectations, poor sleep quality was not consistently associated with reduced social cognitive ability in the current sample. Findings from the current study require further exploration and replication. Support (if any) This work was supported by the National Institute of Mental Health (grant number R01 MH116902-04 awarded to C.A.D).

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Snethen, PhD, LRT/CTRS, Gretchen, Bryan P. McCormick, PhD, CTRS e Marieke Van Puymbroeck, PhD, CTRS. "Independence through Community Access and Navigation in adults with schizophrenia spectrum disorders Part 1: Theoretical and practical foundations". American Journal of Recreation Therapy 10, n. 1 (1 gennaio 2011): 25–33. http://dx.doi.org/10.5055/ajrt.2011.0004.

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Negative symptoms and cognitive dysfunction are two symptomatic categories of schizophrenia spectrum disorders (SSDs) that significantly impair functioning. Treatment for adults with SSDs continues to focus primarily on medication adherence and positive symptom reduction, despite the fact that medication has little impact on negative and cognitive symptoms within this population and, thus, little impact on improving community functioning. This two-part series presents an intervention developed to increase community participation in adults with SSDs. This article presents a comprehensive description of the functional impairments experienced by this population, framed within the World Health Organization’s International Classification of Functioning, Disability, and Health. This article will also apply Self-Determination Theory to this population of adults with SSDs as a foundation to help this population increase community participation and successful integration.

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Bartoli, F., A. Calabrese, F. Moretti, M. Castiglioni, L. Prestifilippo, A. De Pietra, M. Gazzola, P. Camera, C. Crocamo e G. Carrà. "The relationship between depression and overall, general psychopathology, positive, and negative symptoms in people with schizophrenia spectrum disorders: a cross-sectional study". European Psychiatry 67, S1 (aprile 2024): S387—S388. http://dx.doi.org/10.1192/j.eurpsy.2024.797.

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IntroductionDepressive symptoms are a common occurrence in people suffering from schizophrenia spectrum disorders (SSDs), representing a separate domain that interacts in peculiar ways with positive and negative symptoms. Nonetheless, available evidence on the relationship between depression and key clinical dimensions of SSDs is limited.ObjectivesTo increase the knowledge regarding depression in SSDs, we performed a cross-sectional study aimed to investigate the association of depressive symptoms with overall, general psychopathology, positive, and negative symptoms in individuals with SSDs.MethodsAdult people with SSDs were recruited from two psychiatric inpatient units in the northern area of the Metropolitan City of Milan from May 2020 to March 2023. Study participants with a Calgary Depression Scale for Schizophrenia score >6 were rated as depressed. Symptom severity was assessed by using the Positive and Negative Syndrome Scale (PANSS). Variables associated with depression at the univariate level were included into two multiple logistic regression models to analyse the association between depression and PANSS overall score as well as General Psychopathology, Positive, and Negative sub-scores.ResultsA total of 231 subjects with SSDs were included. Among them, approximately one third (N=78; 33.8%) reported depressive symptoms. Multiple logistic regression models suggested that depression in individiuals with SSDs was associated with higher overall (p<0.001) and General Psychopathology (p<0.001) PANSS scores. Conversely, an inverse relationship between depression and positive symptoms was found (p=0.002). Negative symptoms were not associated with depression (p=0.210).ConclusionsOur findings suggest that people affected by comorbid SSDs and depression have more severe overall and General Psychopathology symptoms according to PANSS scores, as well as lower levels of positive symptoms. Further investigations are needed to evaluate the generalisability of these findings and to improve the clinical management of people with SSDs and depression.Disclosure of InterestNone Declared

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Gozé, Tudi, e Istvan Fazakas. "Imagination and Self Disorders in Schizophrenia: A Review". Psychopathology 53, n. 5-6 (2020): 264–73. http://dx.doi.org/10.1159/000509488.

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Anomalies of imagination are frequent and handicapping in schizophrenia spectrum disorders (SSDs) but neglected in psychopathology due to the lack of a conceptual framework to model disorders of imagination. Recently, the link between minimal self disorders and pathology of imagination has been emphasized. The aim of the present article is to discuss this initiative by stressing their paradigm drawing on the recent imaginary turn in phenomenological research. Although this field of research is currently very active in philosophy, there are very few translational approaches in psychopathology or cognitive sciences. In this paper, we examine how contemporary research concerning fantasy and imagination can lead to the elaboration of an epistemological and phenomenological framework for schizophrenia research. We first examine the psychopathological literature on anomalous fantasy and imagination in SSDs. Then we propose an exhaustive overview of the imaginary turn of philosophical phenomenology. Further, we examine the theoretical and practical implications of such a recasting of phenomenological research. We show how fantasy and imagination are involved in the embodiment process, and how identity and imagination are interlinked. Finally, we propose an overview of the possible implications for the understanding of psychotherapeutic processes and recovery strategies.

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Fantozzi, Pamela, Claudia Del Grande, Stefano Berloffa, Greta Tolomei, Carmen Salluce, Antonio Narzisi, Gianluca Salarpi, Barbara Capovani e Gabriele Masi. "Neurodevelopmental Disorders, Schizophrenia Spectrum Disorders and Catatonia: The “Iron Triangle” Rediscovered in a Case Report". Children 10, n. 1 (30 dicembre 2022): 77. http://dx.doi.org/10.3390/children10010077.

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Catatonia is a complex neuropsychiatric syndrome, occurring in the context of different psychiatric and neurodevelopmental disorders, in neurological and medical disorders, and after substance abuse or withdrawal. The relationship between Autism Spectrum Disorder (ASD), Schizophrenia Spectrum Disorders (SSDs) and catatonia has been previously discussed, with the three disorders interpreted as different manifestations of the same underlying brain disorder (the “Iron Triangle”). We discuss in this paper the diagnostic, clinical and therapeutic implications of this complex relationship in an adolescent with ASD, who presented an acute psychotic onset with catatonia, associated with mixed mood symptoms. Second-generation antipsychotics were used to manage psychotic, behavioral and affective symptoms, with worsening of the catatonic symptoms. In this clinical condition, antipsychotics may be useful at the lowest dosages, with increases only in the acute phases, especially when benzodiazepines are ineffective. Mood stabilizers with higher GABAergic effects (such as Valproate and Gabapentin) and Lithium salts may be more useful and well tolerated, given the frequent association of depressive and manic symptoms with mixed features.

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Più fonti

Tesi sul tema "Schizophrenia Spectrum Disorders (SSDs)"

Lee, Yuet-may May, e 李月媚. "Service disengagement in schizophrenia spectrum disorders". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hub.hku.hk/bib/B50434512.

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Disengagement from mental health services by patients with schizophrenia spectrum disorders is an important issue. Most research in this area has been focused on studying the patients’ demographic and clinical characteristics that may be related to disengagement. However, research on patients’ perspective in regard to their decision of disengagement has been limited. An assessment tool developed based on an in--‐‑depth understanding of patients’ subjective experiences may capture other crucial factors. This may widen our scope of understanding of this phenomenon. Therefore, a mixed research method was employed in this thesis and three independent studies with distinctive research aims were carried out. The first study was a qualitative study which aimed at exploring reasons and factors that patients perceived influential to their decision of disengagement. Six ever--disengaged male patients aged between 18 and 28 with schizophrenia spectrum disorder were interviewed as a purposive sample after a thorough subject identification procedure. A thematic analysis of the data yielded seven themes which grouped into three domains: service (patient--‐‑clinician communication, service orientation, clinic operation); patient (psychological response, perception of illness); and medication (side effects and uncertain efficacy). A 16--‐‑item self--‐‑administered questionnaire, the Patient’s Perception of Psychiatric Service (PPPS) questionnaire, was developed. The construction of PPPS was based entirely on the themes identified from the first qualitative study. This questionnaire measured the subjective perception of the patient about the service and patient--clinician communication. Validation of the PPPS questionnaire was conducted in the second study by recruiting 50 patients with a diagnosis of a schizophrenia spectrum disorder from a psychiatric outpatient clinic. Results demonstrated that the PPPS questionnaire has good internal consistency, test-retest reliability, and convergent validity. The Singh O'ʹBrien Level of Engagement Scale (SOLES), Client Satisfaction Questionnaire (CSQ), and an internalized stigma scale were also translated and validated in this study for use in the third study. The third study explored the relationship between disengagement and the patient’s perception of service, using PPPS, level of engagement (SOLE), satisfaction with service (CSQ), and other factors including clinical characteristics and service utilization. One hundred and fifty patients with schizophrenia spectrum disorder were recruited from two specialized outpatient clinics. In view of local clinical observation, patients who had more than one disengagement episode and each lasted more than two weeks were classified into the severe--‐‑disengagement group. In a forward stepwise regression model, results suggested that PPPS and length of service predict severe disengagement. In this thesis, the use of mixed study methods showed that it was pertinent to incorporate patients’ first person experience into an assessment tool. Measuring patients’ perception of service, by using PPPS, can effectively identify patients with severe disengagement history. PPPS as a patient--‐‑rated self--‐‑administered questionnaire can be used in clinical settings to enhance the understanding of a patient’s appraisal of the service and thus proactive measures can be taken to reduce service disengagement.
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Psychiatry
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Master of Philosophy

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Remy, Irving. "Les fonctions visuelles rétiniennes et corticales dans les troubles du spectre de la schizophrénie et les situations à risque de psychose". Electronic Thesis or Diss., Strasbourg, 2024. http://www.theses.fr/2024STRAJ030.

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Les troubles psychotiques sont caractérisés par d’importantes conséquences fonctionnelles avec des preuves émergentes concernant l’altération des fonctions visuelles de bas niveau. Le lien anatomique et fonctionnel entre la rétine et le cortex visuel a notamment permis d’émettre des hypothèses quant à l’association entre les altérations des deux étages visuels. Nous avons investigué les mesures électrophysiologiques visuelles rétiniennes et corticales dans les troubles du spectre de la schizophrénie et dans les situations à risque de psychose dont l’usage régulier de cannabis et les phases précoces de psychose font partie intégrante. Les résultats ont mentionné des altérations portant sur la plupart des cellules rétiniennes et des déficits au regard du cortex visuel primaire, avec un lien potentiel entre les deux types de mesures dans la schizophrénie. L’intérêt des biomarqueurs électrophysiologiques réside également dans le lien décrit avec les symptômes de la psychose, ce qui incite ainsi à les utiliser davantage en pratique clinique à des fins d’améliorations diagnostiques
Psychotic disorders are characterized by severe functional consequences, with emerging evidence of impairment in low-level visual functions. Most notably, the anatomical and functional link between the retina and the visual cortex led to hypotheses concerning the association between alterations in both visual stages. We investigated retinal and cortical visual electrophysiological measurements in schizophrenia spectrum disorders and situations at risk of psychosis, of which regular cannabis use and early phases of psychosis are an integral part. The results highlighted alterations in most retinal cells and deficits in the primary visual cortex, with a potential link between both measures in schizophrenia. The relevance of electrophysiological biomarkers also lies in the link described with psychotic symptoms, motivating them to be used more widely in clinical practice to improve diagnosis

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BARATTIERI, DI SAN PIETRO CHIARA. "Semantic and syntactic modifications in Schizophrenia Spectrum Disorders". Doctoral thesis, Università degli Studi di Milano-Bicocca, 2020. http://hdl.handle.net/10281/277375.

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Nonostante la comprovata presenza di alterazioni a carico del linguaggio nei disturbi dello spettro schizofrenico (DSS - American Psychiatric Association, 2013), la piena caratterizzazione del fenomeno non è ancora stata raggiunta. L’ipotesi della “schizofrenia come prezzo da pagare per il linguaggio" (Crow, 1997) apre nuove prospettive al problema sotto osservazione e suggerisce la necessità di un approccio volto a integrare gli strumenti attualmente utilizzati per la valutazione clinica delle abilità linguistiche nei DSS. L’obiettivo generale del presente lavoro è l'avanzamento nella comprensione dei disturbi del linguaggio in questa popolazione. A tal fine è stato adottato un approccio interdisciplinare a cavallo tra la neuropsicologia, la psicolinguistica e la linguistica computazione. In particolare, il presente lavoro si concentra: i) sullo studio dell’interazione tra il magazzino semantico e le funzioni esecutive ai compiti di fluenza verbale; ii) sulla produzione e la comprensione della struttura argomentale del verbo e della complessità sintattica; e iii) sulla sensibilità alle violazioni semantiche a carico di diversi ruoli tematici. Quarantatré persone con DSS sono state reclutate presso l’IRCCS Fatebenefratelli di Brescia. I processi di elaborazione linguistica dei partecipanti sono stati studiati attraverso: i) due fluenze verbali analizzate adottando sia punteggi tradizioni, sia algoritmi di Natural Language Processing (NLP); ii) la Northwestern Assessment of Verb Argument Structure (NAVS – Cho-Reyes & Thompson, 2012; Barbieri et al., 2019); iii) uno studio sui movimenti oculari durante un compito di lettura di frasi con violazioni semantiche. Come confronto, lo stesso protocollo sperimentale è stato somministrato a un campione di soggetti sani di controllo appaiati per sesso ed età. Nei compiti di fluenza verbale si sono osservate differenze significative tra i due gruppi relativamente alla dimensione media dei cluster semantici, al numero di switch tra cluster, nonché alle misure di coerenza semantica, mettendo in evidenza il contributo differenziale e non mutualmente esclusivo dell’integrità del magazzino semantico e delle funzioni esecutive alla fluenza verbale. Inoltre, gli algoritmi sperimentali NLP basati sulle misure adottate hanno dimostrato un’elevata prestazione nella classificazione dei soggetti con o senza DSS. Dai risultati della batteria NAVS è stato inoltre possibile identificare una difficoltà specifica dei pazienti rispetto a strutture argomentali complesse, nonché rispetto a frasi aventi un ordine delle parole non canonico, sia in produzione sia in comprensione, compatibili con la Argument Structure Complexiy Hypothesis (ASCH – Thompson, 2003) e con un deficit del movimento sintattico che soggiace alle frasi non canoniche (Chomsky, 1981). Infine, tramite lo studio dei movimenti oculari è stato possibile osservare una diminuita sensibilità alle violazioni sul ruolo tematico di “Agente”, compatibile con la presenza di un “disturbo del Sé” (Henriksen & Noordgard, 2014) nei DSS. In conclusione, i nostri risultati confermano la presenza di deficit specifici a carico delle abilità semantiche e sintattiche osservabili in produzione e in comprensione nei DSS. Inoltre, l’esito dello studio supporta l’applicazione di un approccio multi-disciplinare al problema in oggetto. Il presente studio dimostra come misure di fluenza verbale derivate da un approccio linguistico-computazionale associate a una dettagliata caratterizzazione del linguaggio recettivo e produttivo nei DSS grazie agli strumenti e alle cornici teoriche della psicolinguistica possono contribuire all'avanzamento nella caratterizzazione delle modificazioni del linguaggio nei DSS oltre allo stato dell’arte.
Although the presence of language disturbances in people with Schizophrenia Spectrum Disorders (SSD) is well established (American Psychiatric Association, 2013), a full characterization of the phenomenon is still missing. The hypothesis of “schizophrenia as the price we pay for language” (Crow, 1997) opens new perspectives on the problem at stake, and suggests the need for a combined approach aiming at integrating the clinical tools nowadays employed to assess language abilities in SSD. The overall objective of the present work is to advance the understanding of language disturbances in this population by adopting an interdisciplinary approach embracing neuropsychology, psycholinguistics, and computational linguistics. In particular, the present work is focused on: i) the differential contribution of semantic storage and executive functions to verbal fluency; ii) the production and comprehension of verbs argument structure and syntactic complexity, and; iii) the sensitivity to semantics violation on different Thematic Roles. Forty-three persons with SSD were recruited at the IRCCS Fatebenefratelli of Brescia. Participants’ linguistic processes were investigated by means of: i) two verbal fluency tasks for the evaluation of semantic store integrity and executive function performance, both computed manually and derived from Natural Language Processing (NLP) methodologies; ii) the Northwestern Assessment of Verb Argument Structure (NAVS – Cho-Reyes & Thompson, 2012; Barbieri, Brambilla, Thompson, & Luzzatti, 2019); iii) an eye-tracking study on semantic violations. For comparison, the same battery was administered to a sample of healthy control subjects matched by age and gender. In the fluency tasks significant differences in the mean size of semantic clusters, number of switches, as well as measure of coherence were observed between groups, highlighting the differential and non-mutually exclusive contribution of the semantic store integrity and the executive functions to verbal fluency. Moreover, NLP-derived algorithms shown a high-level performance in classifying subjects with and without SSD. A specific difficulty with complex verb argument structure, as well as with non-canonical word order of sentences, both in production and comprehension, was identified in the SSD population. These results are compatible with the Argument Structure Complexity Hypothesis (ASCH – Thompson, 2003) and the presence of an underlying syntactic movement in non-canonical sentences (Chomsky, 1981). Finally, an impaired sensitivity to semantic violations on the “Agent” was observed in the eye-tracking study, compatible with the presence of a “disorder of the self” (Henriksen & Noordgard, 2014) in this population. In summary, our results underline the presence of specific semantic and syntactic impairments in SSD as seen in language production and comprehension. Moreover, our result support the application of a multi-disciplinary approach to the issue at stake. Our study show how the added value of fluency measures derived by a computational linguistic approach paired with a fine-grained characterization of receptive and productive language in SSD by means of the tools and theoretical frameworks derived from psycholinguistics can contribute to further characterize language modifications in SSD beyond the current knowledge.

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Gregory, Benjamin Luke. "Questions of continuum and category in autism spectrum disorders and schizophrenia". Thesis, University of Cambridge, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708076.

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Darrell-Berry, Hannah. "Predictors and mediators of anger and aggression in schizophrenia spectrum disorders". Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/predictors-and-mediators-of-anger-and-aggression-in-schizophrenia-spectrum-disorders(ea8600bc-2498-4f6b-9ff2-6c0315c7db99).html.

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The aim of this thesis was to explore the relationship between anger and aggression, insecure attachment, paranoia and social cognition in psychosis. It is presented as three separate papers: 1) a systematic review examining the relationship between paranoia and aggression in schizophrenia spectrum disorders, 2) an empirical study investigating predictors and mediators of trait anger across the psychosis continuum: the role of insecure attachment, paranoia and social cognition and 3) a critical reflection of the research process. Paper one provides a systematic review of the relationship between paranoia and aggression in schizophrenia spectrum disorders. A comprehensive search of the published literature identified fifteen eligible studies. The quality of the included articles is critically appraised during the synthesis of the findings. Methodological limitations, clinical implications and recommendations for future research are considered. Paper two provides an examination of predictors and mediators of trait anger across the psychosis continuum, considering the role of insecure attachment, paranoia and social cognition. Tests of theory of mind and measures of attachment, hostile attribution bias, paranoia and anger were administered to 174 participants (14 ultra-high risk of psychosis, 20 first-episode psychosis, 20 established psychosis and 120 non-clinical). Multiple regression analysis found attachment avoidance, paranoia and hostile attribution bias were significantly related to trait anger. Mediation analysis revealed paranoia mediated the relationship between attachment avoidance and trait anger. The results are discussed with consideration to previous research and limitations of the study. Clinical implications and recommendations for future research are also offered. Paper three provides a critical reflection of papers one and two, with reference to their design, implementation and interpretation. Personal reflections of the research process as a whole are also provided.

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Burns, Amy Minh Nhat. "Theory of mind, social cognition, and neural functioning in schizophrenia spectrum disorders". Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/59475.

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Social cognitive functioning has been shown to be impaired in patients with schizophrenia (SZ), and these impairments are associated with functional outcomes. To better understand these deficits this dissertation investigated the neurocognitive processes associated with several social cognitive tasks. A novel irony comprehension paradigm was developed for use with electroencephalogram (EEG). The N400, a negative event related potential (ERP) that occurs 300-500 ms after the onset of a semantically incongruent word, and the P600, a positive ERP that occurs around 500-800 ms, were used to index irony comprehension. Study 1 revealed that SZ performed worse than healthy controls (HC) across three measures of social cognition – emotion perception, Theory of Mind (ToM), and irony comprehension. Furthermore, negative symptoms of SZ were associated with poor ToM performance. ERP findings showed that HC exhibited hemispheric differences in N400 amplitude in response to ironic sentences, with the left hemisphere showing smaller amplitudes to ironic compared to literal statements, whereas SZ did not show this differentiation. Although HC processed ironic statements differently compared to SZ, the direction of the effect was opposite of what was hypothesized. Study 2 examined the durability of this unanticipated finding in a larger group of HC. The N400 effect from Study 1was not replicated – there were no differences in N400 amplitude for ironic and literal statements. A difference in P600 was found whereby the P600 amplitude for literal was greater than for ironic. Self-reported schizotypal traits were associated with poor ToM performance. Study 3 examined whether computerized cognitive remediation (CCR), which has been shown to improve neurocognition, would generalize to social cognition, and whether these changes could be detected at a neural level using EEG. The CCR program implemented in this study produced no improvement in neurocognition or social cognition. Taken together, these results suggest that several aspects of social cognition are impaired in patients with schizophrenia, on a behavioural and possibly a neural level. Future studies are necessary to determine the most effective framework for CCR to minimize the deficits in interpersonal skills that are linked to both general cognitive abilities and social cognition in those with schizophrenia.
Arts, Faculty of
Psychology, Department of
Graduate

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Beulke, Joshua Thomas. "The Effectiveness of Psychotherapy for Schizophrenia Spectrum Disorders in Community Residential Settings". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2521.

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The purpose of this research was to analyze the effectiveness of psychotherapy for individuals diagnosed with schizophrenia spectrum disorders who reside in community residential settings. The present body of literature did not address the utility of psychotherapy treatment for this population. A key area of focus for this research was whether psychotherapy has an impact on psychiatric hospitalization rates for the target population. An additional research question was whether significant differences exist in psychiatric hospitalization rates between males and females for the target population. Data analyses were conducted using archival data from the Blossom Hill Corporation and Sunrise Farm Corporation in the State of Minnesota. Research questions were analyzed with a 2x2 factorial analysis of variance (ANOVA). Results indicated no significant differences in hospitalization rates for individuals in the target population who received psychotherapy (n = 60) compared to those who did not (n = 76). Hospitalization rates also did not differ between gender in psychotherapy treatment response for individuals diagnosed with schizophrenia spectrum disorders in community residential settings. This study has implications for social change because it informs community residential providers in Minnesota serving individuals in the target population about the impact of psychotherapy on reducing psychiatric hospitalizations. Social change is further affected by providing data about how psychotherapy and theory can be used to better treat and understand the target population's mental health stability.

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Faiola, Eliana [Verfasser]. "Psychometric, Cognitive, and Oculomotor Characteristics of Schizotypy and Schizophrenia Spectrum Disorders / Eliana Faiola". Bonn : Universitäts- und Landesbibliothek Bonn, 2020. http://d-nb.info/1224270495/34.

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Delfin, Carl. "The neural basis of aberrant salience attribution in unmedicated patients with schizophrenia spectrum disorders". Thesis, Högskolan Kristianstad, Sektionen för lärande och miljö, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-12152.

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Due to abnormal functioning of the brain’s reward and prediction system patients with schizophrenia spectrum disorders are thought to assign salience to non-relevant objects and events and to form context-inappropriate associations. The brain’s ventral striatum is critical in the formation of associations, and aberrant associations are believed to create delusional content during psychosis. The study wanted to examine the neural response, particularly in the ventral striatum, combined with subjective reports as patients learn associations in an aversive Pavlovian conditioning paradigm. The stimuli were randomized and involved circles of different colors. The conditioned stimuli (CS+) was followed by an unconditioned stimuli (US), consisting of an unpleasant sound, in 50% of events. The unconditioned (CS-) stimuli was followed by a low, not unpleasant sound in 50% of events. The degree of striatal activation was thought to be associated with the severity of patient’s illness. Functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) responses were examined in eleven unmedicated non-institutionalized patients with schizophrenia spectrum disorders and 15 matched healthy controls. No significant within group differences in neural or subjective response to the [CS+ > CS-] contrast were found. No significant associations between severity of illness and degree of striatal activation in response to CS+ or CS- were found. Significant differences in neural activation for the [CS+ > CS-] contrast were found in the ventral striatum, the right inferor frontal gyrus, and the right angular gyrus, with patients exhibiting stronger activation compared to controls. The results and implications are discussed along with suggestions for future research.

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Rouse, Jennifer Louise. "Evaluating the case for kamin blocking as a cognitive endophenotype of schizophrenia spectrum disorders". Thesis, University of Nottingham, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.537788.

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Libri sul tema "Schizophrenia Spectrum Disorders (SSDs)"

Ritsner, Michael, a cura di. Handbook of Schizophrenia Spectrum Disorders, Volume II. Dordrecht: Springer Netherlands, 2011. http://dx.doi.org/10.1007/978-94-007-0831-0.

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Ritsner, Michael S., a cura di. Handbook of Schizophrenia Spectrum Disorders, Volume III. Dordrecht: Springer Netherlands, 2011. http://dx.doi.org/10.1007/978-94-007-0834-1.

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Ritsner, Michael S., a cura di. Handbook of Schizophrenia Spectrum Disorders, Volume I. Dordrecht: Springer Netherlands, 2011. http://dx.doi.org/10.1007/978-94-007-0837-2.

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1950-, Gillberg Christopher, a cura di. The schizophrenias: A biological approach to the schizophrenia spectrum disorders. New York: Springer Pub. Co., 1996.

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service), SpringerLink (Online, a cura di. Handbook of Schizophrenia Spectrum Disorders, Volume I: Conceptual Issues and Neurobiological Advances. Dordrecht: Springer Science+Business Media B.V., 2011.

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Woodberry, Kristen A., Emily Kline e Anthony J. Giuliano. Schizophrenia Spectrum Disorders. A cura di Thomas H. Ollendick, Susan W. White e Bradley A. White. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780190634841.013.17.

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Schizophrenia spectrum disorders (SSDs) are among the most serious and complicated psychiatric disorders, particularly in children and adolescents. They have a major impact on all aspects of functioning, including family and social relationships, school, work, and self-care. While schizophrenia tends to develop in late adolescence and early adulthood, nonspecific abnormalities, prodromal symptoms, and a significant proportion of its incidence unfold before age 18. It behooves child and adolescent clinicians to be knowledgeable about and alert to the range of SSD clinical presentations. The chapter reviews the current state of the literature regarding the phenomenology, epidemiology, assessment, diagnosis, and treatment of SSD within a developmental and systems framework. Although both evidence-based and promising practices are presented, these are all too often drawn from the adult literature, underscoring the pressing need for progress in developmentally sensitive assessment and treatment research with this population. Practice implications and future directions are briefly discussed.

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Schulz, S. Charles, Michael F. Green e Katharine J. Nelson, a cura di. Schizophrenia and Psychotic Spectrum Disorders. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199378067.001.0001.

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Schizophrenia and Psychotic Spectrum Disorders. Oxford University Press, 2016.

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Handbook of Schizophrenia Spectrum Disorders Volume III. Springer, 2011.

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The Spectrum of Psychotic Disorders. Cambridge University Press, 2007.

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Capitoli di libri sul tema "Schizophrenia Spectrum Disorders (SSDs)"

Brown, Ronald T., David O. Antonuccio, George J. DuPaul, Mary A. Fristad, Cheryl A. King, Laurel K. Leslie, Gabriele S. McCormick, William E. Pelham, John C. Piacentini e Benedetto Vitiello. "Schizophrenia spectrum disorders." In Childhood mental health disorders: Evidence base and contextual factors for psychosocial, psychopharmacological, and combined interventions., 97–103. Washington: American Psychological Association, 2008. http://dx.doi.org/10.1037/11638-009.

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DeRight, Jonathan. "Schizophrenia Spectrum Disorders". In Essential Neuropsychology: A Concise Handbook for Adult Practitioners, 279–84. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-85372-3_39.

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Hemmings, Colin. "Schizophrenia Spectrum Disorders". In Autism and Child Psychopathology Series, 147–60. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-8250-5_10.

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Johnson, Hannah. "Schizophrenia Spectrum Disorders". In Psychosocial Elements of Physical Therapy, 149–60. New York: Routledge, 2024. http://dx.doi.org/10.4324/9781003526063-9.

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Chemerinski, Eran, e Larry J. Siever. "The Schizophrenia Spectrum Personality Disorders". In Schizophrenia, 62–90. Oxford, UK: Wiley-Blackwell, 2011. http://dx.doi.org/10.1002/9781444327298.ch5.

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Maier, Wolfgang, Peter Falkai e Michael Wagner. "Schizophrenia Spectrum Disorders: A Review". In Schizophrenia, 311–405. Chichester, UK: John Wiley & Sons, Ltd, 2001. http://dx.doi.org/10.1002/0470842334.ch5.

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Maier, Wolfgang, Peter Falkai e Michael Wagner. "Schizophrenia Spectrum Disorders: A Review". In Schizophrenia, 317–411. Chichester, UK: John Wiley & Sons, Ltd, 2003. http://dx.doi.org/10.1002/0470861649.ch5.

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Gogtay, Nitin. "Childhood Schizophrenia". In Encyclopedia of Autism Spectrum Disorders, 602–13. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4419-1698-3_1391.

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Gogtay, Nitin. "Childhood Schizophrenia". In Encyclopedia of Autism Spectrum Disorders, 899–910. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-319-91280-6_1391.

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Knorr, James. "Childhood-Onset Schizophrenia Spectrum Disorders". In Handbook of DSM-5 Disorders in Children and Adolescents, 107–22. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-57196-6_5.

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Atti di convegni sul tema "Schizophrenia Spectrum Disorders (SSDs)"

Polec, Jaroslav, Radoslav Vargic, Filip Csoka, Eva Smolejova, Anton Heretik, Mria Bielikova, Martin Svrcek e Robert Moro. "Detection of Schizophrenia Spectrum Disorders Using Saliency Maps". In 2017 IEEE 11th International Conference on Application of Information and Communication Technologies (AICT). IEEE, 2017. http://dx.doi.org/10.1109/icaict.2017.8687223.

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T.S., Lee, Jo S.N., Lim K.Ok., Jang So.Y., Cha S.M. e Han S.L. "Vibraimage Characteristics of Offenders with Schizophrenia Spectrum Disorder". In Современная психофизиология. Технология виброизображения. Modern Psychophysiology. The Vibraimage Technology., 338–46. Crossref, 2024. http://dx.doi.org/10.25696/elsys_mpvt_07_en08.

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The purpose of this study was to identify vibraimage parameters in schizophrenia spectrum and other psychotic disorders. This study retrospectively analyzed subjects who were referred to the National Forensic Hospital at Gongju city in Republic of Korea for psychiatric evaluation between April 2019 and October 2019. After divided into two groups; Schizophrenia Spectrum Disorders group and non-organic, non-psychotic disorders group, vibraimage parameters and MMPI-2 items were compared between the two groups. In addition, we investigated the relations between vibraimage parameters and MMPI-2 items characteristic of schizophrenia spectrum and other psychotic disorders by using correlation analysis. Compared to non-organic and non-psychotic disorders group, Schizophrenia Spectrum Disorders group scored low at Aggression (t = -2.752, p = 0.007), Tension (t = -2.106, p = 0.039), and Suspects (t = -2.617, p = 0.011); high at Neuroticism (t = 4,215, p<0.001) by vibraimage parameters, and the group scored comparatively high at Sc (Schizophrenia) (t = -2.099, p = 0.039) and low at Hy (Hysteria) (t = -2.228, p = 0.029) by MMPI-2 estimation. The Sc (Schizophrenia) item in the MMPI-2 showed a negative correlation with Suspect parameter (r = 0.242 p = 0.035) and positive correlation with Neuroticism parameter (r = 0.267, p = 0.02) in vibraimage. Our findings suggest that Suspect and Neuroticism parameters of vibraimage are correlated with schizophrenia spectrum and other psychotic disorders, and showed potential as diagnostic tools, especially in psychiatric evaluations.

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"Social Motivations of Schizophrenia Spectrum Disorders and Its Status in Psychiatric Rehabilitation". In Congress on mental health meeting the needs of the XXI century. Gorodets, 2016. http://dx.doi.org/10.22343/mental-health-congress-compendium335-338.

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Runge, K., L. Tebartz van Elst, H. Kuzior, BL Fiebich e D. Endres. "Elevated interleukin-8 levels in the cerebrospinal fluid of patients with Schizophrenia Spectrum Disorders". In Abstracts of the 2nd Symposium of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) and Deutsche Gesellschaft für Biologische Psychiatrie (DGBP). Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0039-3402996.

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Wroblewski, A., Y. He e B. Straube. "Dynamic causal modelling suggests impaired effective connectivity in schizophrenia spectrum disorders during gesture-speech integration". In Abstracts of the 2nd Symposium of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) and Deutsche Gesellschaft für Biologische Psychiatrie (DGBP). Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0039-3403024.

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Melinda, Christy, e Ainul Mardiah. "The Role of Coping Strategies on Quality of Life among People with Schizophrenia Spectrum Disorders in Jakarta". In Proceedings of the International Conference on Psychology and Communication 2018 (ICPC 2018). Paris, France: Atlantis Press, 2019. http://dx.doi.org/10.2991/icpc-18.2019.10.

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Chern, Jen-Suh, e Yu-Chih Mao. "Effects of Immersive Virtual Reality Puzzle Solving Video Games on Cognition, Motor Control, and Functional Behavior in People with Schizophrenia Spectrum Disorders". In 2023 IEEE 5th Eurasia Conference on Biomedical Engineering, Healthcare and Sustainability (ECBIOS). IEEE, 2023. http://dx.doi.org/10.1109/ecbios57802.2023.10218477.

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Guasp, Mar, Mireia Rosa-Justicia, Amaia Muñoz-Lopetegi, Eugenia Martinez-Hernandez, Thais Armangue, Gisela Sugranyes, Heike Stein et al. "Clinical characterisation of patients in the post-acute stage of anti-NMDA receptor encephalitis: a prospective cohort study and comparison with patients with schizophrenia spectrum disorders (S22.006)". In 2023 Annual Meeting Abstracts. Lippincott Williams & Wilkins, 2023. http://dx.doi.org/10.1212/wnl.0000000000202506.

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Rapporti di organizzazioni sul tema "Schizophrenia Spectrum Disorders (SSDs)"

Di Francesco, Antonio, Pierfelice Cutrufelli, Cecilia Chiarenza, Luca Zambuto, Carmen Concerto, Ludovico Mineo, Antonino Petralia, Alessandro Rodolico e Maria Salvina Signorelli. CBD for the treatment of positive and negative symptoms in schizophrenia spectrum disorders - A systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, giugno 2024. http://dx.doi.org/10.37766/inplasy2024.6.0019.

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