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Lee, Heeyoung. "Protective and risk factors in adolescents with schizophrenia /". Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/7263.
Pełny tekst źródłaEriksson, Åsa. "Risk factors for criminal offending among men with schizophrenia". Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-666-2/.
Pełny tekst źródłaSuvisaari, Jaana. "Incidence and risk factors of schizophrenia in Finland". Helsinki : University of Helsinki, 1999. http://ethesis.helsinki.fi/julkaisut/laa/kansa/vk/suvisaari/.
Pełny tekst źródłaRoberts, Seth. "Season of Birth and Risk for Schizophrenia". VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/1633.
Pełny tekst źródłaSpencer, Michelle Kerry. "Examining the use of dynamic risk factors to predict high risk behaviours in people with schizophrenia". Thesis, University of Warwick, 2009. http://wrap.warwick.ac.uk/3261/.
Pełny tekst źródłaMorgan, Vera Anne. "Intellectual disability co-occurring with schizophrenia and other psychiatric illness : epidemiology, risk factors and outcome". University of Western Australia. School of Psychiatry and Clinical Neurosciences, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0209.
Pełny tekst źródłaPukall, Monica G. "Postnatal risk factors in the etiology of schizophrenia : association with good premorbid adjustment". Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=30728.
Pełny tekst źródłaDavie, Brenda J. "Suicidality among individuals with schizophrenia, the interaction of personality and known risk factors". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ30938.pdf.
Pełny tekst źródłaPukall, Monica G. "Postnatal risk factors in the etiology of schizophrenia, association with good premorbid adjustment". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ64433.pdf.
Pełny tekst źródłaThompson, Rhiannon. "Genetic and functional investigation of FXYD6 and MAP2K7 as risk factors in schizophrenia". Thesis, University of Glasgow, 2013. http://theses.gla.ac.uk/4157/.
Pełny tekst źródłaHubbard, Leon. "Common and rare genetic risk factors for schizophrenia and their associations with cognition". Thesis, Cardiff University, 2014. http://orca.cf.ac.uk/73174/.
Pełny tekst źródłaFilatova, S. (Svetlana). "Incidence of schizophrenia and associations of schizophrenia and schizotypy with early motor developmental milestones". Doctoral thesis, Oulun yliopisto, 2017. http://urn.fi/urn:isbn:9789526217178.
Pełny tekst źródłaTiivistelmä Skitsofrenia on monimuotoinen mielenterveyden häiriö, jonka etiologiaa voidaan tutkia erilaisissa teoreettisissa viitekehyksissä. Tämä väitöskirja tutkii skitsofreniaa neurologisen kehityksen ja psykoosin jatkumon näkökulmista. Skitsofrenian neurokehitykselliset teoriat pitävät kehittyvän keskushermoston poikkeavuuksia varhaisina skitsofrenian alttiuden ennustajina. Skitsofreniaa voidaan pitää myös progressiivisena sairautena ja oireiden jatkumona persoonallisuuden piirteistä (skitsotypaalisuudesta) täysimittaiseen skitsofreniaan. Tämän väitöskirjatutkimuksen tavoitteena on tutkia skitsofrenian ilmaantuvuutta, skitsotypaalisten piirteiden yleisyyttä ja skitsofrenian ja skitsotypaalisten piirteiden yhteyttä varhaiseen motoriseen kehitykseen. Tutkimusasetelmina ovat prospektiiviset syntymäkohortit, systemaattinen katsaus ja meta-analyysi. Kahdessa peräkkäisessä 20 vuoden välein kerätyssä Pohjois-Suomen syntymäkohortissa (1966 ja 1986) skitsofrenian ilmaantuvuus pysyi samana, mutta muiden psykoosien ja siten kaikkien psykoosien ilmaantuvuudet olivat korkeampia vuoden 1986 syntymäkohortissa. Vuoden 1966 syntymäkohortissa negatiivisen skitsotypaalisuuden piirteet olivat korkeita ja positiivisen skitsotypaalisuuden piirteet alhaisia verrattuna 24 muuhun väestöaineistoon. Varhaisen motorisen kehityksen ja aikuisiän skitsofrenian välistä yhteyttä tutkittiin meta-analyysin (3–5 tutkimusta) avulla. Tilastollisesti merkitsevä pieni negatiivinen yhteys löytyi aikuisiän skitsofrenian ja kävelemään, istumaan ja seisomaan oppimisen välillä. Pohjois-Suomen vuoden 1966 syntymäkohortissa skitsotypaaliset piirteet liittyivät hitaampaan vatsalleen kääntymisen, peukalo-etusormi otteen, seisomisen, tuetta istumisen ja tuen kanssa kävelemisen oppimiseen. Näissä yhteyksissä oli vaihtelua tutkittavan sukupuolen mukaan. Yhteenvetona voidaan todeta, että psykoosien ilmaantuvuus on kasvanut Pohjois-Suomen syntymäkohorteissa, mutta skitsofrenian ei. Tämä on linjassa aikaisempien tutkimusten kanssa. On kuitenkin huomioitava myös diagnostisten järjestelmien ja käytäntöjen merkitys näiden muutosten arvioimisessa. Varhainen motorinen kehitys ennusti sekä skitsofreniaa että skitsotypaalisia piirteitä. Havainto tukee sekä neurokehityksellistä että psykoosin jatkumoon liittyvää lähestymistapaa skitsofrenian etiologiassa
Keskinen, E. (Emmi). "Parental psychosis, risk factors and protective factors for schizophrenia and other psychosis:the Northern Finland Birth Cohort 1966". Doctoral thesis, Oulun yliopisto, 2015. http://urn.fi/urn:isbn:9789526210483.
Pełny tekst źródłaTiivistelmä Tämän tutkimuksen tavoitteena oli selvittää, eroavatko psykoosien riskitekijät henkilöillä, joiden vanhemmalla oli psykoosi verrattuna niihin joiden vanhemmalla ei ollut psykoosia sekä tutkia vanhemman psykoosin ja riskitekijöiden yhdysvaikutusta. Myös psykoosilta suojaavia tekijöitä tutkittiin. Tutkimusaineistona oli Pohjois-Suomen vuoden 1966 syntymäkohortti (N = 10458). Erityisesti biologiset tekijät lisäsivät skitsofrenian ja muiden psykoosien riskiä henkilöillä, joiden vanhemmalla oli psykoosi. Viivästynyt pään kannattelun ja pinsettiotteen oppiminen lisäsivät skitsofreniariskiä henkilöillä joiden vanhemmalla oli psykoosi. Vastasyntyneen suurella koolla, äidin korkealla iällä ja raskaudenaikaisella masentuneella mielialalla oli yhdysvaikutus vanhemman psykoosin kanssa skitsofreniariskin osalta ja äidin raskaudenaikaisella tupakoinnilla muiden psykoosien riskin osalta. Vanhemman psykoosilla ja viivästyneellä pinsettiotteen oppimisella oli yhdysvaikutus sekä skitsofrenian että muiden psykoosien riskin osalta. Koko aineistossa useat tekijät liittyivät alentuneeseen psykoosiriskiin. Vain äidin ei-masentunut mieliala ja työskentely kodin ulkopuolella tai opiskelu suojasivat psykoosilta henkilöitä, joiden vanhemmalla oli psykoosi. Tämä on yksi harvoista tutkimuksista, jossa on tutkittu psykoosien riskitekijöitä erikseen henkilöillä, joiden vanhemmalla oli tai ei ollut psykoosia sekä vanhempien psykoosin ja riskitekijöiden yhdysvaikutusta. Useat riskitekijät lisäsivät skitsofreniariskiä ainoastaan henkilöillä, joiden vanhemmalla oli psykoosi, joten vanhemman psykoosi voisi selittää osan psykoosien riskitekijöistä. Psykoosilta suojaavia tekijöitä löydettiin yllättävän vähän niillä, joiden vanhemmalla oli psykoosi. Suojaavien tekijöiden tutkiminen on tärkeää, jotta suuressa psykoosiriskissä olevien sairastumista voidaan ennaltaehkäistä
Zammit, Stanley. "An investigation into the use of cannabis and tobacco as risk factors for schizophrenia". Thesis, Cardiff University, 2004. http://orca.cf.ac.uk/48919/.
Pełny tekst źródłaMasse, Marjolaine. "Risk factors for premorbid cannabis use and the relationship between cannabis use and schizophrenia symptoms". Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=95187.
Pełny tekst źródłaL'usage de cannabis accroit proportionnellement le risque de développer la psychose. Ce risque est particulièrement élevé chez les moins de 15 ans. Les facteurs prédisposant à l'usage prémorbide, et expliquant le montant utilisé par les patients sont inexplorés, conséquemment, on ignore si ces groupes ont des prédispositions différentes. La variation dans les symptômes expliquée par ces facteurs d'usage et la contribution unique du cannabis, lorsque les facteurs de risques pour la psychose sont contrôlés, sont également inconnus. Les résultats démontrent que certains facteurs de risque s'appliquent aux deux populations et d'autres pas. Le montant, l'intensité et la durée de l'usage sont associés avec les symptômes positifs chez les patients. Aucun effet de médiation de l'usage de marijuana sur les facteurs de prédisposition à la schizophrénie n'a été observé. Les résultats sont examinés dans le contexte d'une hypothèse de réseaux neuronaux communs à la schizophrénie et l'usage de cannabis.
Stålberg, Gabriella. "Vulnerability and Social Functioning in Schizophrenia". Doctoral thesis, Uppsala universitet, Psykiatri, Akademiska sjukhuset, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-209626.
Pełny tekst źródłaNilsson, Emma. "Genetic epidemiological studies of adverse pregnancy outcomes and the role of schizophrenia /". Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-590-9/.
Pełny tekst źródłaStokes, Paul Robert Alexander. "Investigating the effects of gnetic and environmental risk factors for schizophrenia on the human dopaminergic system". Thesis, Imperial College London, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.530447.
Pełny tekst źródłaDickson, Marguerite Mulryan. "Genetic and psychiatric treatment related risk factors for type 2 diabetes in schizophrenia and schizoaffective disorder patients". Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2009r/dickson.pdf.
Pełny tekst źródłaAlaräisänen, A. (Antti). "Risk factors and pathways leading to suicide with special focus in schizophrenia:the Northern Finland 1966 Birth Cohort Study". Doctoral thesis, University of Oulu, 2010. http://urn.fi/urn:isbn:9789514262630.
Pełny tekst źródłaTiivistelmä Tämän tutkimuksen tarkoitus oli tutkia itsemurhien esiintyvyyttä, riskitekijöitä, siihen johtavia kehityspolkuja yleisväestöön perustuvassa prospektiivisessa pitkittäistutkimuksessa. Pohjois-Suomen vuoden 1966 syntymäkohorttiin kuului alun perin 12,068 raskaana olevaa naista joiden laskettu aika oli vuonna 1966, ja heidän 12,058 elävänä syntynyttä lastaan, kohortin jäsenet. Tässä tutkimuksessa käytetty aineisto on kerätty 11,017 kohortin jäsenestä, jotka olivat elossa ja asuivat Suomessa 16-vuotiaana. Käytetty aineisto on kerätty äitiysneuvoloissa, 14-vuotiaana tehdyssä postikyselyssä ja kansallisista rekistereistä. Kaikkiaan 121 itsemurhayritystä (joista 57 miehillä) ja 69 itsemurhaa (56 miehillä) tapahtui vuoden 2005 loppuun mennessä. Yhden vanhemman perhe syntymän aikaan oli riski myöhemmälle itsemurhayritykselle ja syntyminen monilapsiseen perheeseen (yli viisi lasta) oli riski itsemurhalle. Tupakointi 14-vuotiaana ennusti itsemurhayrityksiä kummallakin sukupuolella sekä itsemurhia miehillä. Hyvä koulumenestys 16-vuotiaana liittyi kohonneeseen itsemurhavaaraan niillä jotka myöhemmin sairastuivat psykoosiin, kun muilla se liittyi alentuneeseen vaaraan. Skitsofreniaan sairastuneista 7 % teki itsemurhan ja yli kaksi kolmannesta skitsofreniaan sairastuneiden itsemurhista tapahtui kolmen vuoden kuluessa sairastumisesta. Tämä tutkimus vahvisti aikaisempia havaintoja varhaisista riskitekijöistä itsemurhayrityksiin ja itsemurhiin. Tässä tutkimuksessa tutkittiin myös kokonaan uusia varhaisia riskitekijöitä, joita ei ole ennen tutkittu suhteessa itsemurhaan tai itsemurhayrityksiin, kuten äidin raskaudenaikainen masennus ja tupakointi sekä ei-toivottu raskaus. Tämän tutkimuksen avulla saatiin myös uutta tietoa teini-iässä aloitetun tupakoinnin suhteesta itsemurhiin ja -yrityksiin. Tutkimus paljasti hyvän koulumenestyksen lisäävän riskiä itsemurhaan henkilöillä jotka sairastuvat myöhemmin psykoosiin. Tämä oli ensimmäinen tutkimus, jossa skitsofreniaa sairastavien henkilöiden itsemurhakuolleisuutta selvitettiin yleisväestöön pohjautuvassa syntymäkohortissa. Vaikka tutkimuksessa tuli ilmi sekä syntymän, että nuoruuden aikaisia varhaisia riskitekijöitä, myöhempi psykiatrinen sairaus on merkittävin itsemurhan ja -yritysten riskitekijä. Siitä huolimatta itsemurha on aina monitekijäinen prosessi, joka voi alkaa jo ennen syntymää ja johon myöhemmät elämänvaiheet vaikuttavat
Stenson, Gillian. "Impact of environmental risk factors for schizophrenia on the developing brain : characterisation of the effects of polyIC and THC on functional neural systems and behaviour". Thesis, University of Strathclyde, 2012. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=19517.
Pełny tekst źródłaMungly, Shazia. "The Prevalence Of Metabolic Disorders And Their Associated Risk Factors In Forensic Patients With Schizophrenia Spectrum Disorders On Clozapine Compared To Haloperidol At Valkenberg Hospital". Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/31076.
Pełny tekst źródłaPrats, Balado Claudia. "Genetic risk factors in Schizophrenia and Neurodevelopmental disorders: Association and epistatic analyses of Neuritin-1 gene and white matter related genes = Factores genéticos en esquizofrenia y enfermedades del neurodesarrollo: análisis de asociación y epistáticos en el gen Neuritina-1 y en genes relacionados con la materia blanca". Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/456897.
Pełny tekst źródłaActualmente, se estima que alrededor de 450 millones de personas en el mundo sufren de un trastorno mental o de la conducta. Según la Organización Mundial de la Salud (OMS), el 33% de los años vividos con discapacidad (YLD) se asocian a trastornos psiquiátricos. En este sentido, los trastornos psicóticos, incluyendo la esquizofrenia (EQ), siguen siendo uno de los trastornos mentales más desconocidos y costosos en términos de sufrimiento humano y gasto social. En los últimos años, el campo de la genética molecular ha estado descubriendo evidencias acerca de la compleja arquitectura poligénica de la EQ y de otros trastornos relacionados. Además, los estudios GWAS han identificado varios genes asociados con EQ, los cuales se ha demostrado que convergen en vías moleculares complejas e identificables relacionados con la plasticidad sináptica, la neurotransmisión y los procesos de conectividad. Además, estos estudios han informado de un importante solapamiento genético a través de varios trastornos psiquiátricos como la esquizofrenia (EQ), el trastorno bipolar (TB), el trastorno depresivo mayor (TDM) o los trastornos del espectro autista (TEA), lo que se suma a la consideración de mecanismos fisiopatológicos comunes en estos trastornos. En este sentido, el creciente cuerpo de evidencias ha establecido que la conectividad y la plasticidad sináptica modulada por la actividad neuronal, es una característica inherente de la función cerebral durante el desarrollo y la edad adulta. La presente tesis plantea la hipótesis de que la variabilidad genética en genes implicados en la plasticidad sináptica (NRN1, BDNF y DTNBP1) y/o en las vías relacionadas con la materia blanca (y sus interacciones) se asociarán con Trastornos del Espectro de la Esquizofrenia (TEE). Además, debido al solapamiento clínico, cognitivo, de neuroimagen y genético observado a través de los diferentes trastornos psiquiátricos, también hipotetizamos que la variabilidad genética estudiada se asocia con otros trastornos psiquiátricos del neurodesarrollo, como el TEE y TEA. En este sentido, se han llevado a cabo cuatro estudios. Los tres primeros estudios analizan la variabilidad genética del gen Neuritin-1 (NRN1) y su relación con el riesgo de desarrollar TEE y TB, así como algunos fenotipos clínicos y cognitivos tanto en pacientes como en sujetos sanos de la población general. Además, en estos estudios también analizamos si la acción de NRN1 es modulada por otros genes como BDNF y DTNBP1. El cuarto estudio analiza los efectos integradores de un conjunto de genes relacionados con la materia blanca (genes relacionados con Oligodendrocitos/mielinización - OMR) y su contribución a TEE y TEA. Nuestros resultados centrados en la variabilidad genética del gen NRN1, sugieren que su variabilidad genética tendría un impacto en el riesgo de desarrollar TEE / TB y también en la presencia de síntomas depresivos en la población general. Este efecto pleiotrópico también se ve respaldado por sus efectos sobre otros fenotipos: como el rendimiento cognitivo y la edad de inicio. Además, nuestros resultados de interacción genéticas (gxg) sugieren que la acción de NRN1 es modulada por los genes BDNF y DTNBP1. Por otro lado, los resultados del cuarto estudio sugieren que algunas de las variantes de riesgo genético de los genes OMR parecen ser compartidas a través de del continuum TEE-TEA. El hecho de que algunos genes OMR estén ligeramente asociados con ambos trastornos, así como también, debido a su participación en los efectos epistáticos detectados, parece apoyar la noción de que la desregulación en los procesos de mielinización podría ser subyacente a la susceptibilidad para desarrollar TEE o TEA. Para concluir, se necesitan más estudios genéticos que ayuden a descifrar el trasfondo biológico subyacente a los trastornos mentales, lo que en última instancia puede conducir a un mejor tratamiento con el fin de mejorar la calidad de vida de los pacientes.
Mitjans, Niubó Marina. "Genetic Risk Factors for the Lack of Response to Clinical Treatment in Mental Disorders: an Approach from Pharmacogenetics". Doctoral thesis, Universitat de Barcelona, 2014. http://hdl.handle.net/10803/289981.
Pełny tekst źródłaLos trastornos mentales graves, como son la depresión mayor (DM), el trastorno bipolar (TB) y la esquizofrenia (SCZ), se han convertido en los últimos años en un importante problema de salud en los países desarrollados. Aunque el avance alcanzado en el desarrollo de tratamientos farmacológicos ha constituido uno de los grandes logros de la psiquiatría moderna, no debemos olvidar que hay un porcentaje muy alto de pacientes que no reciben el tratamiento adecuado para su enfermedad. En este sentido, la farmacogenética tiene como objetivo identificar y caracterizar los factores genéticos que se encuentran en la base de las diferencias existentes entre individuos en la respuesta clínica al tratamiento farmacológico. La presente tesis pretende estudiar variación genética basada en genes que codifican para moléculas implicadas directamente o indirectamente en los mecanismos de acción del tratamiento con citalopram (DM), carbonato de litio (TB) y clozapina (SCZ) que nos explicará parte del riesgo para la no respuesta clínica y la no remisión del episodio tratado farmacológicamente. Los resultados nos permitieron identificar variación genética asociada a la respuesta al tratamiento. Concretamente, nuestros resultados indicaron que variabilidad genética relacionada con el sistema endocannabinoide se asociaba con la respuesta a citalopram en DM. Por otro lado, genes involucrados con el sistema de fosfoinositoles podrían explican parte de la variación en la respuesta al litio en el TB. En referencia al estudio de la respuesta a clozapina en pacientes con SCZ, los resultados sugieren que variantes genéticas en los genes FKBP5 y NTRK2 pueden jugar un papel en la respuesta. En este sentido, nuestro estudio proporciona evidencia de la implicación del eje hipotálamo-pituitario-adrenal (HPA) y de factores neurotróficos en la modulación de la respuesta a clozapina. La detección de diferencias genéticas individuales en la respuesta a los fármacos psicotrópicos puede proporcionar nuevas estrategias para el tratamiento de trastornos mentales, así como, nuevos conocimientos sobre la etiología de estos trastornos.
Rothärmel, Maud. "La résistance pharmacologique dans les pathologies psychiatriques : Exemple de la dépression, la schizophrénie et l'autisme. Identification of potential genetic risk factors for bipolar disorder by whole-exome sequencing Les traitements pharmacologiques dans les troubles du spectre de l’autisme Troubles de l’humeur ? Quand recourir à la stimulation magnétique transcrânienne ? Repeated transcranial magnetic stimulation (rTMS) to improve electroconvulsive therapy (ECT) in TReatment-Resistant Depression : a report of two cases". Thesis, Normandie, 2019. http://www.theses.fr/2019NORMR125.
Pełny tekst źródłaDrug resistance is a common problem in medicine, that also concerns psychiatry. As there are resistant epilepsies, there are resistant depression or schizophrenia. Autism is in a slightly different situation as there is no reference treatment for neurodevelopmental disorders. These three disorders constitue major public health issues from both the economic and social perspective with important functional impact of the disease. After focusing on the definition of drug resistance in depression, schizophrenia and autism and on the hypothetical underlying pathophysiological processes, we investigated what could be common to these disorders. This allowed us to understand how to optimize their treatments. Several augmentation methods are possible, such as the potentiation of drugs between them or the potentiation of drugs by neurostimulation (electroconvulsive therapy, ECT, repetitive transcranial magnetic stimulation, rTMS, transcranial direct current stimulation, tDCS). In the second part of this work, we studied the effects of different ways to optimizing treatments : the use of clozapine on aggressive behaviors for patients with autism spectrum disorders (ASD) ; the use of tDCS on executive functions in patients with ASD ; the clozapine augmentation strategie by ECT in ultra-resistant schizophrenia and the ECT augmentation strategie by rTMS in treatment-resistant depression. Our encouraging results led us to focus on the mechanisms of these potentiation strategies, including ECT and on the development of new protocols to confirm our results
Roisko, R. (Riikka). "Parental Communication Deviance as a risk factor for thought disorders and schizophrenia spectrum disorders in offspring:The Finnish Adoptive Family Study". Doctoral thesis, Oulun yliopisto, 2014. http://urn.fi/urn:isbn:9789526206066.
Pełny tekst źródłaTiivistelmä Skitsofreniaspektrin sairauksien varsinaisia syytekijöitä ei tunneta, mutta niillä on lukuisia sekä perimään että biologiseen ja psykososiaaliseen ympäristöön liittyviä riskitekijöitä. Nykytietämyksen mukaan riskitekijät eivät vaikuta sairauden syntyyn itsenäisesti, vaan perimän ja ympäristön vuorovaikutuksella on merkittävä osuus. Paljon tutkittuja ympäristöön liittyviä riskitekijöitä ovat lapsen talvi- tai kevätsyntymä ja vanhempien hajanainen kommunikaatio. Tässä väitöskirjassa tutkitaan vanhempien hajanaista kommunikaatiota adoptiolapsen ajatushäiriöiden ja skitsofreniaspektrin sairauksien riskitekijänä. Vanhempien hajanaisen kommunikaation ja lapsen skitsofreniaspektrin sairauksien ja ajatushäiriöiden yhteydestä laadittiin systemaattinen katsaus. Meta-analyysi voitiin tehdä vain skitsofreniaspektrin sairauksiin liittyen. Vanhempien hajanaisen kommunikaation ja lapsen skitsofreniaspektrin sairauksien välisellä yhteydellä havaittiin olevan suuri efektikoko (0,79, 95 % luottamusväli 0,21–1,37). Katsaukseen sisällytetyt tutkimukset viittaavat siihen, että vanhempien hajanaisella kommunikaatiolla ja lapsen ajatushäiriöillä on myös yhteys. Väitöskirjan alkuperäistutkimukset perustuvat Suomalaisen adoptiolapsiperhetutkimuksen aineistoon (n= 382). Aluksi tutkittiin vanhempien yksilö- ja perhe-Rorschach-tilanteissa mitatun hajanaisen kommunikaation määrän ja lapsen ja vanhempien ominaisuuksien välistä yhteyttä. Hajanaisen kommunikaation määrän vaihtelu selittyi pääosin vanhempien ominaisuuksilla. Seuraavaksi tutkittiin adoptiolapsen ajatushäiriöiden ja skitsofreniaspektrin sairauksien yhteyttä lapsen skitsofreniaspektrin sairauksille altistavan perimän, talvi- tai kevätsyntymän ja vanhempien hajanaisen kommunikaation kanssa. Huomioon otettiin myös riskitekijöiden yhteisvaikutukset. Mikään riskitekijä tai niiden yhteisvaikutus ei ollut yhteydessä lapsen skitsofreniaspektrin sairauteen. Lapsen ajatushäiriöt olivat yhteydessä ainoastaan vanhempien hajanaiseen kommunikaatioon. Tutkimuksen tulokset osoittavat, että vanhempien hajanainen kommunikaatio on kohtalaisen muuttumaton piirre, joka on lapsen skitsofreniaspektrin sairauksien riskitekijä. Tulokset viittaavat myös siihen, että vanhempien hajanainen kommunikaatio voi olla lapsen ajatushäiriöiden riskitekijä
Badowska, Dorota [Verfasser], Moritz [Akademischer Betreuer] Rossner, Hannelore [Akademischer Betreuer] Ehrenreich, André [Akademischer Betreuer] Fischer, Michael [Akademischer Betreuer] Hoerner i Mikael [Akademischer Betreuer] Simons. "Schizophrenia risk factor Tcf4 and gene-environment interaction in mice / Dorota Badowska. Gutachter: Hannelore Ehrenreich ; André Fischer ; Michael Hoerner ; Mikael Simons. Betreuer: Moritz Rossner". Göttingen : Niedersächsische Staats- und Universitätsbibliothek Göttingen, 2015. http://d-nb.info/1067626573/34.
Pełny tekst źródłaBurt, Melissa. "Investigating the effect of prenatal immune activation, a risk factor for Schizophrenia, on hippocampal n-methyl-d- aspartate receptor function in a rodent model". Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=119491.
Pełny tekst źródłaL'hypofonctionnement des récepteurs au N-methyl-D-aspartate (NMDA) est une des principales hypothèses pour expliquer les symptômes de la schizophrénie, en particulier les déficits cognitifs. Bien que les causes de la schizophrénie soient méconnues, une infection durant la grossesse est un des facteurs de risque qui a été identifié. Alors que la maladie ne se manifeste qu'à l'âge adulte, les déficits cognitifs peuvent apparaitre avant. Des études suggèrent que le stress affecte les capacités cognitives via les récepteurs NMDA et la plasticité synaptique dans l'hippocampe. Par conséquent, l'infection prénatale pourrait augmenter la vulnérabilité à la schizophrénie par une modulation des récepteurs NMDA dans l'hippocampe, dont les conséquences seraient observables à l'adolescence et à l'âge adulte. Afin d'étudier cette hypothèse nous avons évalué la fonction des récepteurs NMDA dans l'hippocampe de rats adultes et adolescents suite à une infection prénatale. Nous avons utilisé un modèle d'activation du système immunitaire chez la rate gestant : une dose de lipopolysaccharide (LPS) est injectée à des rates à 15 et 16 jours de gestation et les effets sur la progéniture ont été étudiés. Les effets de cette exposition au LPS sur les fonctions cognitives sont présentés dans le chapitre 2. Les rats adolescents exposés au LPS ont montré des déficits de mémoire spatiale à long terme et une augmentation de la réversion de l'apprentissage spatial. Les rats adultes n'ont présenté aucun déficit. Ces deux tâches étant associées à la fonction des récepteurs NMDA dans la plasticité synaptique et à la dépression synaptique à long terme (LTD) dans l'hippocampe, nous avons dans le troisième chapitre étudié l'effet de l'exposition au LPS sur la transmission synaptique liée aux récepteurs NMDA et sur la LTD dans l'hippocampe des rats adolescents. De plus, nous avons étudié la relation entre le stress et l'exposition au LPS. Nous avons montré que l'exposition au LPS abolit la LTD. Cet effet est associé à une diminution de la fonction des récepteurs NMDA puisque les potentiels de champ dépendant des récepteurs NMDA ainsi que les courants NMDA furent diminués. Un stress de contention permet de rétablir les déficits de LTD observés dans le groupe exposé au LPS alors qu'un traitement à la corticostérone augmente la LTD seulement chez les animaux du groupe LPS. Aucune altération de la fonction des récepteurs NMDA et de la plasticité synaptique n'a été observée chez l'animal adulte (chapitre 4). Par conséquent une exposition au LPS affecte les fonctions des récepteurs NMDA hippocampiques de façon transitoire pendant l'adolescence.Dans le chapitre 5, nous avons étudié l'effet de l'exposition au LPS sur l'expression de la reelin et de la GAD 67 chez le rat juvénile et adolescent. L'expression de ces deux protéines est réduite chez les schizophrènes et des études suggèrent que cela affecte la plasticité synaptique en modulant les récepteurs NMDA. Nous avons observé une diminution du nombre de cellules exprimant la reelin et la GAD67 dans l'hippocampe à 14 et 28 jours chez les rats du groupe LPS. L'ensemble de nos résultats montrent que l'exposition prénatale au LPS cause des altérations de la fonction des récepteurs NMDA de l'hippocampe de façon transitoire durant l'adolescence. Elle induit un hypofonctionnement des récepteurs NMDA et augmente l'effet du stress sur leur fonction ainsi que sur la LTD pendant l'adolescence. De plus, la diminution de l'expression de la reelin et de la GAD67 observée dans l'hippocampe chez les rats juvéniles et adolescents exposés au LPS suggère que ces changements pourraient avoir un impact sur le développement des récepteurs NMDA. En conclusion, nos résultats soutiennent l'hypothèse que l'infection prénatale augmente la vulnérabilité à la schizophrénie à l'adolescence et élucident une partie des mécanismes par lesquels l'infection prénatale augmente les risques de développer la schizophrénie.
Chaumette, Boris. "Identification de facteurs biologiques de la transition psychotique". Thesis, Sorbonne Paris Cité, 2016. http://www.theses.fr/2016USPCB046/document.
Pełny tekst źródłaPsychosis is a progressive mental disorder which normally occurs during adolescence in at-risk subjects following a dynamic process termed “psychotic transition”. These at-risk subjects are clinically identifiable but biological data are still insufficient in explaining the onset of psychosis. Throughout this thesis, we aim to identify biological factors implicated in this pathophysiological process. Current hypotheses explaining the psychotic transition favor the interaction between genes and the environment mediated by epigenetic mechanisms. We conducted studies examining methylomic and transcriptomic changes during psychotic transition using molecular biology and bioinformatics techniques at a whole genome scale. Our results suggest that psychotic transition may be linked to methylomic and transcriptomic changes in genes implicated in axon guidance or oxidative stress. These longitudinal changes could be related to environmental factors. Some of these factors could deregulate the hormonal stress response at the earliest phases of psychosis. Indeed, our results show that secretion of basal cortisol is increased in prodromal individuals. Moreover, it is likely that genes and processes regulating epigenetic modifications are also implicated in the individual response to the environment. We have shown the importance of the one-carbon metabolism for at least one sub-group of patients affected by psychosis. Our results should be replicated using other paradigms in order to definitively validate the implication of these various actors in the psychotic transition. If confirmed, knowledge of these biological mechanisms could lead to the development of targeted therapeutics to prevent psychosis in at-risk individuals
Yerabham, Antony Sravan Kumar [Verfasser], Carsten [Gutachter] Korth i Georg [Gutachter] Groth. "Investigations of the structural organization of the Disrupted-in-Schizophrenia 1 (DISC1) protein, a major risk factor for mental illness / Antony Sravan Kumar Yerabham ; Gutachter: Carsten Korth, Georg Groth". Düsseldorf : Universitäts- und Landesbibliothek der Heinrich-Heine-Universität Düsseldorf, 2017. http://d-nb.info/1138114480/34.
Pełny tekst źródłaTang, Chao-Jung, i 湯昭容. "The Related Factors of High Risk Behavior for Patient with Schizophrenia". Thesis, 2002. http://ndltd.ncl.edu.tw/handle/64978899018658917707.
Pełny tekst źródła國立臺灣大學
護理學研究所
90
ABSTRACT The purpose of this study was to explore the related factors of high-risk sexual behaviors of patients with schizophrenia. A descriptive correlation study design was used. Structured questionnaires were filled by the investigator through interviews. A purposive sample of 208 patients of schizophrenia came from outpatient psychiatric departments of a medical center and a psychiatric hospital in central Taiwan. Descriptive and inferential statistics were used for data analysis. Major findings of this study included: 1. Patients practiced as much as 7 high-risk sexual behaviors. 55.8% of patients had practiced high-risk sexual behaviors. Causal sex happened with 46.2% of patients. Substance related high-risk sexual behavior sex happened with 25.5% of patients. 2. The characteristics of patients practiced high-risk sexual behaviors were male, had history of substance use, were frequently hospitalized, perceived the impact of psychotropic medications on their sexual feelings, experienced more severe positive symptoms, experienced less severe negative symptoms, had first sexual experience in their early age, had multiple sexual partners, had history of HIV-infection or other sexual transmitted diseases. 3. The characteristics of patients practiced causal sex were male, married, had history of substance abuse, were frequently hospitalized, were diagnosed with schizophrenia in their early age, had more severe positive symptoms, had first sexual experience in their early age, had multiple partners, had history of HIV-infection or other sexual transmitted diseases. 4. The characteristics of patients practice substance related high-risk sexual behaviors were had history of substance use, perceived the impact of psychotropic medications on their sexual feelings, had less severe negative symptoms, had first sexual experience in their early age, had multiple sexual partners, infrequently used condoms, had history of HIV infection or other sexual transmitted diseases. 5. The HIV/AIDS related knowledge was positively correlated with attitudes towards HIV/AIDS. Patients with more positive attitudes towards HIV/AIDS practiced less high-risk sexual behaviors and less casual sex. 6. Statistically significant correlates of a higher high-risk sexual practice included frequent hospitalization, more sexual partners, more positive symptoms, and less negative symptoms. 7. Statistically significant correlates of a higher casual sex included male, not married, and more sexual partners. 8. Statistically significant correlates of a higher substance-related sexual practice included more sexual partners, less negative symptoms, and had history of HIV infection and other sexual transmitted diseases. The implications of this study were threefold. First, the results can be used to increase the assessment and understanding of mental health professionals of high-risk sexual behaviors of patients with schizophrenia. Secondly, the results provide a guideline for psychiatric nurses in designing and implementing nursing care related to sexual behaviors. Lastly, patients can be educated to increase their knowledge and practice of safe sex. Future educational and administrative efforts should focus on improving quality of nursing care related to sexual health of patients with schizophrenia.
KUO, HUI-WEN, i 郭惠雯. "A Study of Schizophrenia Risk Factors for Rehospitalization in One Year". Thesis, 2013. http://ndltd.ncl.edu.tw/handle/78221492500538148557.
Pełny tekst źródła國立臺北護理健康大學
健康事業管理研究所
101
Background: The prevalence rate of psychiatric disorders was 53‰ in Taiwan. Both in the acute psychiatric ward or chronic psychiatric ward, most patients were schizophrenia. In acute psychiatric ward, 58% patients were schizophrenia. In chronic psychiatric ward, 80% patients were schizophrenia. Schizophrenia was a chronic and lifelong mental illness. As patients with schizophrenia often relapse, it consumed a lot of social and medical resources. Objectives: The purpose of this study was to investigate the risk factors affecting the rehospitalization in patients with schizophrenia within one year after discharged. In the present study, it was hoped to be a reference for caregivers making better care plans in order to prevent relapse and rehospitalization for patients with schizophrenia. Methods: The study cohort was retrieved from the National Health Insurance Research Database published by the National Health Research Institutes, and it was composed by 5,284 schizophrenic patients who admitted and discharged in 2007. Patients who was younger than 18 years old were excluded from the study. Rehospitalization was considered as the primary outcome variable in this study. In the present study, it used the Kaplan-Meier method to estimate the Survival curve and the multivariate Cox proportional hazards regression model to identify risk factors. Data was analyzed with SAS version 9.2 for Windows. Results: The one-year rehospitalization rate was estimated at 57.49%, and the mean time to rehospitalization was 218.39 days (SE= 2.028 ). The present study found the risk of rehospitalization reduced with age (HR=0.994, 95% CI=0.990-0.997). Compared to employees of public or private enterprises or institutions, there were significantly higher risks of rehospitalization, which included farmer or fishermen(HR=1.290, 95% CI=1.034-1.609), low income households(HR=1.545, 95% CI=1.261-1.893) and who were unemployed and qualify as dependents(HR=1.335, 95% CI=1.090-1.634) or insured by administrative office in the village, township, city or area(HR=1.385, 95% CI=1.146-1.674). Compared to patients lived in highly urbanized town, those lived in ordinary town (HR=1.147, 95% CI=1.003-1.313) or in aging town (HR=1.446, 95% CI=1.144-1.828) had higher risk of rehospitalization. Additionally, there were significantly higher risks of rehospitalization, if the number of previous hospitalizations for psychiatric was over 2 times (HR=1.563, 95% CI=1.426-1.714). Furthermore, the risk of rehospitalization also increased with the cumulative days of previous hospitalizations for psychiatric. Conclusions: The present study found risk factors of affecting the rehospitalization in patients with schizophrenia included type of identity, urbanization stratification, the number of previous hospitalizations for psychiatric, and the cumulative days of previous hospitalizations for psychiatric. The present study suggested that caregivers should enhance the patients’ social skill training and the support from families. The present study also suggested that the health policy makers should make people acquainted with psychiatric.
Cheng, Chin-Chi, i 鄭沁綺. "The Survey of the Risk Factors for Metabolic Syndrome in Schizophrenia". Thesis, 2007. http://ndltd.ncl.edu.tw/handle/12422917004010335251.
Pełny tekst źródła高雄醫學大學
行為科學研究所碩士班
95
Objective: The metabolic syndrome has been recognized as a side effect of antipsychotic treatment. ApoE polymorphism was associated with lipid metabolism in the metabolic syndrome. The study explored the relationship of schizophrenia and metabolic syndrome and predicted the prevalence about the risk of metabolic syndrome in the atypical antipsychotic treatment. Further, we explored the relationship between the ApoE genotypes and metabolic syndrome in schizophrenic patients. Method: This is a retrospective and chart review study. Total of 111 Taiwanese patients met the DSM III-R criteria for schizophrenia and schizoaffective disorder. All individuals were collected the data of age, onset age, gender, height, weight, blood pressure, fasting glucose, triglyceride, cholesterol level, ApoE genotype and the type of antipsychotics. Logistic regression and structural equation modeling were used to identify the relationship of cause and effect. Results: The logistic regression and structural equation modeling revealed that atypical antipsychotics negative directly influenced hypertension (β=-.18, p =0.049), triglyceride (β=-.31, p<0.001) and cholesterol (β=-.21, p =0.026) of plasma. The atypical antipsychotics compared with conventional antipsychotics individuals less hypertension and hyperlipidemia. In the study, the atypical antipsychotics showed indirect influence with the variable of body mass index. Conclusion: Our findings showed atypical antipsychotics compared with conventional antipsychotics individuals decreases risk of hypertension and hyperlipidemia, especially predominant on triglyceride plasma level. The atypical antipsychotic did not directly influenced body mass index (BMI), but indirectly influenced BMI by the variables of hypertension and triglyceride.
Cheng, Liang-Chih, i 鄭良志. "An Investigation of the Risk Factors for Prediction Pneumonia among Schizophrenia Inpatients". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/9kx6u9.
Pełny tekst źródła義守大學
醫務管理學系
106
Backgroubd and purpose: Schizophrenia regards as severe mental disorder diseases. Ever increaing patients are treated with medications mainly, though 2nd generation antipsychotic Clozapine has less extrapyramidal symptoms still left serious adverse effect, including pneumonia. This thesis focus on study of Clozapine Induced Pneumonia and other risk factors. Materials and Methods: This thesis investigate on how Schizophrenia patients after taking Clozapine and other factors might lead to pneumonia. The research main focus includes variable factors of population, medications, blood tests and physical assesments. Use study of Chart review method was used to collect inpatients from southern Taiwan mental hospital. Results and Conclusions: 217 hospitalized patients data retracted from central of disease control (CDC) archives during period of 1-9-2013 till 2-28- 2018. Logistic Regression analysis shown 80 Schizophrenia patient taken Clozapine developed penumonia (β = 2.71,p < .05), 15 times more than those without; male (β = 2.02,p < .05) and blood sugar (β = -0.13,p < .05) also positive related which considerd as risk factors, furthermore, male pneumonia complications is 7.55 times more than female; one degree of blood sugar increment, pneumonia complications increase 1.33 times. Besides, Chi-square test results show that drug interactions are associated with pneumonia (χ2 = 5.20,p < .05); Two sample t test indicated that Clozapine cause low WBC count (t = -3.70,p < .001) , low neutrophil (t = -5.40,p < .001). This research concluded that special attention should be given to male inpatients with schizophrenia, taking Clozapine drugs, generating drug interactions, and closely monitoring blood glucose, white blood cell count, and neutrophil numbers to prevent the development of pneumonia.
Tseng, Chiu-Yu, i 曾秋玉. "Exploration of Risk Factors of Glycemic Control in Patients with Schizophrenia and Diabetes". Thesis, 2017. http://ndltd.ncl.edu.tw/handle/63382940854827245168.
Pełny tekst źródła高雄醫學大學
藥學系碩士在職專班
105
Background: In recent years, many studies have found that sleep quality and glycemic control are highly correlated, but few studies have extensively investigated the relations of glycemic control, sleep quality and drugs. Especially in many patients with schizophrenia are not only using a single anti- psychotropic drugs but also using mood stabilizers. Objective: This study was aimed to investigate the relations of glycemic control efficacy, quality of sleep, drugs and physiological diseases in hospitalized patients with schizophrenia and Diabetes. Also analysis the result to predict the risk factors mainly affects glycemic control. Methods: This study is a retrospective case-control study and conducted schizophrenia inpatients with diabetes in a hospital in the central region of Taiwan during the period from 2013 to 2014. The patients were divided into the good glycemic control group (glycated hemoglobin, HbA1c<7%) and the poor glycemic control group (HbA1c≧7 %). The information including the use of drugs (antipsychotics, antidiabetic drug, hypnotics and mood stabilizers), biochemical tests, disease status and other related factors that affect blood glucose control were collected from their medical records. Data was analyzed using logistic regression and tested with Chi-Square test. Results: A total of 183 schizophrenia patients with diabetes were enrolled in this study. Among them, 89 patients were poor glycemic control group and 94 patients were good glycemic control group with an average age of 52.9±11.8 years old. Patients in poor glycemic control group with diabetes mellitus was longer than those in good glycemic control (8.79±3.31 vs 6.21±2.58) and had a significant difference (p<0.001). In terms of disease, it had the higher percentage of poor glycemic control group with high blood pressure (38.2% vs 23.4%) and hyperlipidemia (33.7% vs 13.8%), and significant differences were observed. In the case of drug use, the poor glycemic control group resulted in a higher proportion of clozapine (46.1% vs 27.7%) and mood stabilizer (33.7% vs 14.9%) use, and significant differences were observed. In the treatment of diabetes with metformin, the poor glycemic control group had a lower proportion of it’s use (23.6% vs 69.1%), and significant differences were observed. After adjusting for other factors, the multiple logistic regression analysis results showed that the risk of poor glycemic control increased by 1.29-fold for each additional year with diabetes year (95% CI=1.12~1.51, p=0.001). The body mass index (BMI) for every additional unit increased the risk of poor glycemic control increased by 1.38 -fold (95% CI =1.18-1.63, p<0.001). Sleep less than 5 hours compared to sleep more than 7 hours , the risk of poor glycemic control increased by 4.31-fold (95% CI=1.49-12.53, p=0.007). Co-administration of clozapine and mood stabilizer compared to non-users , the risk of poor glycemic control increased by 8.22-fold (95% CI=2.01-33.54, p=0.003). With the use of metformin compared to non-users, the risk of poor glycemic control was increased by 0.16-fold (95% CI=0.06-0.38, p<0.001). Conclusion: This study revealed that BMI (>27.7), sleep time (<5 hours), diabetes extended disease duration, and combined use of clozapine and emotional stabilizers are main risk factors of poor glycemic control. And the use of metformin can reduce the chance of 84% of poor glycemic control. These findings provide medical care information for hospitalized schizophrenia patients with diabetic, so as to provide pharmaceutical care to control blood glucose level.
Liang, Yu-Min, i 梁鈺敏. "Risk Factors Associated with the Relapse of Schizophrenia-Application of the Survival analysis of Cox ProportionalHazards Model". Thesis, 2006. http://ndltd.ncl.edu.tw/handle/11714947329028966912.
Pełny tekst źródła高雄醫學大學
行為科學研究所碩士班
94
Objective:The aim of this study was to use the method of the survival analysis of cox proportional hazards models to explore the risk factors of relapse in schizophrenia, according to several articles about this issues , the risk factors associated with the relapse in schizophrenia were investigated from the anamnesis. Methods:Cases consisted of 94 patients who were diagnosed as schizophrenia (295.0-295.9)by psychiatrists from one of the teaching hospital in southern Taiwan. All of these patients were required to have the condition of first hospitalization after the onset. During the five years of observation (2001-2005), 52(55.32%)patients who were hospitalized once more due to the illness relapse belonged to the group of relapse;the remainders of 42 patients(44.68%)belonged to the group of not being relapsed. According to the literatures, patient's anamnesis of prognosis, nursing records, assessment of social workers and the measurements of COTE were turned into variables. Then, the survival analysis of COX proportional risk model was used to find out the hazard factors in predicting relapse in schizophrenia. Moreover, hazard ratio(HR)and 95 % Cl for HR would indicate the degree of relapse. Results:The results showed that if the first child or usually conflicts with the family was 4.8 times higher than the patients who never involves in a conflict(p=0.004);95% Cl for HR would be 0.071-0.613;if the patient who is the first child of the family was 2.95 times higher to be illness relapse than other siblings(p=0.049). The relapse rate of patient who conflicted with family members was 4.8 times higher than whom didn't(p=0.004). 95% Cl for HR was 0.071-0.613; the first child was 2.95 times higher than the other ranking children (p=0.049), and the 95% Cl for HR would be 0.116-0.995.The social work assessment showed that the worse relationship with the father would result higher illness relapse (p=0.027). Conclusion:If the patient who is the first child and usually conflicts with family or if the patient has worse relationship with the father are the hazardous factors to cause illnss relapse in schizophrenia. The results can be a helpful reference for planning intervention and prevention programs for the prevention of relapse in schizophrenia.
Cheng-Chen i 張正辰. "Variability of waist circumference measurements at three sites and its relationship with cardiovascular risk factors in patients with schizophrenia". Thesis, 2010. http://ndltd.ncl.edu.tw/handle/11267723539853484015.
Pełny tekst źródła中山醫學大學
醫學研究所
98
Objective:1. To compare the magnitude of waist circumference (WC) measured at 3 sites (immediately above the iliac crest, midpoint between the lowest rib and the iliac crest, umbilical level) in males and females. 2. To examine the correlation of WC with lipid profiles, glucose and metabolic syndrome. Methods and Materials: Patients with the DSM-IV diagnosis of schizophrenia, regular follow-up at an outpatient clinic were recruited. After explaining the purpose of the study and obtaining patient’s agreement, the following data are collected: age, gender, education level, marital status, height, weight, and smoking. WC was measured using an inelastic plastic tape at each site. Fasting venous blood samples were collected for lipid and glucose analyses. Differences in WC across sites were tested using repeated measures ANOVA, adjusted for multiple comparisons. Linear regression methods were used to model the relation between fat values measured and WC, with separate calculations performed for each of the 3 sites, adjusting of age and smoking. Results:Our sample consisted of 45 men and 35 women (29-52 years).Both in men and women, the mean WC for all sites were significantly different from each other, with the exception of the iliac crest and umbilical site. WC values at 3 sites were significantly correlated with triglyceride, high-density lipoprotein in men. Midline WC had higher correlation with fasting glucose, diastolic blood pressure, cholesterol/high-density lipoprotein ratio, and metabolic syndrome in men. In women, only iliac crest WC had higher correlation with systolic blood pressure and cholesterol/high-density lipoprotein ratio. Conclusion and Suggestion: The magnitude of WC is influenced by measurement site in both genders. Adopting a standard measurement protocol in schizophrenic patients will facilitate the interpretation and clinical utility of WC for evaluation of cardiovascular risk.
Shumar, Erik. "Associations between Homelessness and Psychiatric Symptom Severity and How Homelessness Interacts with Risk Factors among First-Admission Psychiatric Patients". Thesis, 2014. https://doi.org/10.7916/D8FJ2DZV.
Pełny tekst źródłaMotta, Carolina Dall'Antónia da. "Uncovering the endophenotypic factors on the impact of functional outcomes in schizophrenia: studies on different genetic risk samples from the Portuguese Population". Doctoral thesis, 2020. http://hdl.handle.net/10316/92414.
Pełny tekst źródłaThe administration of neurophysiological, neurocognitive and behavioral measures as endophenotypes in studies about schizophrenia is in vogue, particularly the inquiry on their interrelationships and their impact on patient’s functional outcome. To this date, increasingly large Portuguese samples with genetic risk to schizophrenia (patients and families) have been integrated into studies about candidate genes to schizophrenia or linkage studies relating schizophrenia to other severe mental illnesses. The inclusion of Portuguese samples gained significant interest for being genetically homogenous in comparison to other western populations. However, despite cognitive abilities being also largely inheritable and relevant to the understanding of schizophrenia, the profile of cognitive deficits in schizophrenia has not been sufficiently explored in our national samples. The use of neurocognitive assessment in schizophrenia has the potential to yield innovations in the multidisciplinary treatment and intervention for affected patients and families, and future research that heighten our understanding about what stands between the genotype and the phenotype regarding this complex and impairing disease. The work hereby presented provides an empirical contribute to the understanding of the endophenotypic aspects involved in schizophrenia, and to the discussion of the implications to research, new intervention targets and psychosocial approaches for families and patients. We studied several putative neurocognitive endophenotypes of that illness by developing an in-depth investigation of the neurocognitive and social cognition in schizophrenia in Portuguese samples of patients affected with schizophrenia, first-degree relatives, and controls. We dove below the cloudy waters of clinical heterogeneity of symptoms to attempt to provide a characterization of schizophrenia – both on an endophenotypic and functional level – in an objective and comprehensive approach. By empirically tracing a latent neurocognitive profile and characterizing the underlying processes of the clinical and biological underpinnings of schizophrenia, we expected to contribute to a more coherent systematization of schizophrenia and treatment/rehabilitation. As a by-product of this research, we also aimed to provide specific and psychometrically sound tools for neurocognitive assessment and performance-based skills assessment relevant to practitioners and researchers working in several disciplinary fields with Portuguese-speaking populations.
A administração de medidas neurofisiológicas, neurocognitivas e comportamentais para a avaliação de variáveis endofenotípicas nos estudos sobre a esquizofrenia é uma área que tem adquirido um progressivo destaque, particularmente no que toca o questionamento sobre as inter-relações entre estas variáveis e o seu impacto na capacidade funcional dos doentes. Até a data, diversos estudos sobre genes candidatos à esquizofrenia ou estudos de ligação relacionando a esquizofrenia a outras doenças mentais graves integraram grandes amostras portuguesas de sujeitos em risco genético para esquizofrenia (pacientes e famílias). A inclusão destas amostras relaciona-se com o facto da população portuguesa ser geneticamente mais homogénea em comparação com outras populações ocidentais. No entanto, e apesar das capacidades cognitivas serem, em grande parte, também hereditárias e relevantes para a compreensão da esquizofrenia, o perfil dos défices cognitivos na esquizofrenia não tem sido suficientemente explorado em amostras nacionais. O uso da avaliação neurocognitiva na esquizofrenia tem o potencial de introduzir inovação no tratamento e potenciar intervenções multidisciplinares direcionadas para pacientes e famílias afetadas, bem como o potencial de fomentar futuras investigações orientadas para o aumento da nossa compreensão sobre o que existe entre o genótipo e o fenótipo desta doença tão complexa e invalidante. O trabalho aqui apresentado é um contributo para a compreensão dos aspetos endofenotípicos subjacentes à esquizofrenia, bem como para a discussão das suas implicações para a investigação, para o estabelecimento de alvos específicos de intervenção e para o desenvolvimento abordagens psicossociais específicas para famílias e pacientes que sofrem de esquizofrenia. Estudámos diversos endofenótipos neurocognitivos putativos da doença, encontrados na literatura, desenvolvendo uma investigação aprofundada da neurocognição e da cognição social na esquizofrenia, em amostras portuguesas de pacientes diagnosticados com esquizofrenia, parentes em primeiro grau e controlos. Mergulhámos para além das águas conturbadas pela heterogeneidade clínica dos sintomas para tentar proporcionar uma caracterização da esquizofrenia – tanto ao nível endofenotípico quanto funcional – recorrendo a abordagens objetivas e metodologicamente abrangentes. Ao traçar empiricamente um perfil neurocognitivo latente e ao caracterizar os processos clínicos e biológicos subjacentes da esquizofrenia, esperámos poder contribuir para uma futura sistematização mais coerente da esquizofrenia, bem como para o seu tratamento e reabilitação. Como um subproduto deste trabalho, procurámos, ainda, fornecer ferramentas específicas e psicometricamente robustas para a avaliação neurocognitiva e para a avaliação de habilidades baseadas no desempenho, que se mostrassem relevantes para profissionais e investigadores atuantes em diversas áreas disciplinares junto de populações falantes da língua portuguesa.
"Environmental Stimuli Activates Early Growth Response 3 (EGR3), an Immediate Early Gene Residing at the Center of a Biological Pathway Associated with Risk for Schizophrenia". Doctoral diss., 2020. http://hdl.handle.net/2286/R.I.63032.
Pełny tekst źródłaDissertation/Thesis
Doctoral Dissertation Neuroscience 2020
Σταθοπούλου, Αναστασία. "Ενδομήτρια έκθεση στον καπνό του τσιγάρου, κίνδυνος εκδήλωσης σχιζοφρένειας και βαρύτητα θετικών/αρνητικών αποτελεσμάτων". Thesis, 2014. http://hdl.handle.net/10889/7994.
Pełny tekst źródłaPrenatal exposure to cigarette smoke causes chronic fetal hypoxia, dysregulation of endocrine equilibrium, and disruption of fetal neurodevelopment associated with brain malfunction, all of which potentially could induce vulnerability to schizophrenia. A total of 212 schizophrenia patients aged 14-30 years, and 212 matched controls were studied. Prenatal tobacco smoke exposure of the schizophrenia patients was compared to that of the normal controls by applying logistic regression analysis and controlling for several confounding factors The outcomes of interest were comparison of the frequency of maternal and paternal smoking between patients and controls as well as the severity of positive and negative symptoms between the offspring of smoking and nonsmoking parents. Furthermore, we investigated the relative frequency of subtypes of schizophrenia among offspring of smoking and non-smoking parent. Among the mothers of schizophrenia patients and controls, 92 (43.4%) and 46 (21.7%) smoked, respectively. Maternal smoking during pregnancy had a significant unique contribution on increasing the risk for development of schizophrenia (p=0.001), and a greater severity of negative symptoms (p=0.023). Simultaneously, logistic regression analysis showed that maternal smoking during pregnancy had significantly unique contribution to increased risk for the development of schizophrenia with possible ratio = 2.32, 95% CI = 1.41-3.81, p = 0.001 and frequency of non-paranoid subtypes as potential ratio = 2.94,95% CI = 1.50-5.76, p = 0.002. Paternal smoking did not have a significant effect on the risk of schizophrenia, or severity of negative symptoms. The findings suggest that maternal smoking during pregnancy puts offspring at an increased risk for later schizophrenia, with increased severity of negative symptoms. Given the wide practice of smoking during pregnancy, fetal exposure to tobacco smoke could be a major preventable neurodevelopmental factor that increases vulnerability to schizophrenia.
Auerbach, Isabelle. "Kindliche Traumatisierung, elterliche Erziehungsstile, familiäre Vorbelastung und Geburtsrisikofaktoren bei Patienten mit Schizophrenie". Doctoral thesis, 2012. http://hdl.handle.net/11858/00-1735-0000-0006-B2F6-0.
Pełny tekst źródłaShing-Chia, Chen. "Heterogeneity and Risk factors of Aggressive Acts among Schizophrenic Inpatients". 2005. http://www.cetd.com.tw/ec/thesisdetail.aspx?etdun=U0001-0108200519064200.
Pełny tekst źródłaChen, Shing-Chia, i 陳杏佳. "Heterogeneity and Risk factors of Aggressive Acts among Schizophrenic Inpatients". Thesis, 2005. http://ndltd.ncl.edu.tw/handle/38296465019485419625.
Pełny tekst źródła國立臺灣大學
護理學研究所
93
Background: Psychiatric inpatients’ aggressive acts can occur frequently and are recognized as a significant problem in psychiatric settings. Understanding of aggressive acts in clinical settings is still incomplete and the clinical care of aggressive acts remains unsatisfactory. It is therefore crucial to establish objective measures and to develop insights into the heterogeneity and related risk factors of aggressive acts, for improvement in the management and prevention of aggressive acts. Objective: The purpose of this study has a many-fold intention depicted as follows: to describe and characterize schizophrenic inpatients’ aggressive acts, to identify and specify heterogeneity in their structure, and to look for and set up risk factors for prevention. This study investigates four major issues: (1) Establishing an objective behavior rating scale for measuring aggressive acts; (2) Understanding the characteristics and incidence of aggressive acts by inpatients with schizophrenia; (3) Exploration of the heterogeneous structure of aggressive acts by inpatients with schizophrenia; and (4) Identifying the risk factors of aggressive acts of inpatients with schizophrenia. Method: The “Two-Stage Model of suicide and violence” coined by Plutchik, van Praag, and Conte and MacArthur’s “Violence Risk Assessment Model” have been incorporated in developing the conceptual framework of this study. At first, by back translation, an English version of the violence scale (VS) was translated into Chinese (VS-C) with counts scaling, including three categories of aggressive acts: (1) towards property (AggP), (2) towards others (AggO), and (3) towards self (AggS). The content validity, construct validity, and internal consistency of VS-C were examined. Prospective panel design was used for data collection. Patients fulfilling the DSM-IV criteria of schizophrenia in the acute psychiatric ward of a university teaching hospital were recruited over a one-year period (April 2001 to March 2002) as study subjects, after signing informed consent. The sample size was 107. Aggressive acts were rated daily using the VS-C by participant observation during the hospitalization period. The raw counts of aggressive acts were summed weekly as a data unit. The risk factors of schizophrenic inpatients’ aggressive acts were measured using “Past Month History of Aggressive Acts”, “State-Trait Anger Expression Inventory”, “Patients’ Basic Demographic and Clinical Data”, “Ward Restriction Scale”, and “Psychiatric Symptoms Checklist”. The heterogeneous structure of aggressive acts was assessed by three indicators: (1) the concurrence of specific categories and types of aggressive acts in the initial week after hospitalization, (2) the correlation of the severity of aggressiveness among specific categories and types between past-month and initial-week aggressive acts, and (3) the concordance of specific categories between past-month and initial-week aggressive acts in sensitivity, specificity, and positive and negative predictive value. The software applications SPSS12.0, S-PLUS6.0, and LISREL8.43 were used for statistical analysis. The statistical methods included descriptive statistics, Chi-square test, Pearson’s correlation, Confirmatory Factor Analysis (CFA), Receiver Operating Characteristic (ROC) curves analysis, multiple regression model and interaction analysis. Results: There was a Poisson distribution and over-dispersion on aggressive acts found in this study. The VS-C with 16 items showed an acceptable quality, but lacked a high internal consistency value (Cronbach’s α = .67). A shorter version of the VS-C could be drawn with one latent variable of 6 items sharing a core meaning labeled as “common outward aggressive acts.” In this study, participating subjects had a mean age of 33.4 (SD = 11.9). The majority of them was single (68.2%), female (69.2%), unemployed (73.8%), and had an Eastern religious affiliation (57.9%). The average duration of their hospitalization was 4 weeks (SD = 2.4, range = 2 to 13). About one quarter of them were involuntarily admitted (26.2%). The mean age of the onset of initial nonspecific symptoms was 24.1 years old. Ninety-one out of 107 patients (85.0%) had a history of past-month aggressive acts, and 63 patients (58.9%) exhibited aggressive acts (mean = 10, SD = 9.8, range = 1 to 46) in the initial week after admission. The past-month incidence rate of aggressive acts was in the order of AggO (70.1%), AggP (44.9%), and AggS (32.7%). The initial-week incidence rate of aggressive acts was in the order of AggO (47.7%), AggP (27.1%), and AggS (14.0%). The category AggO occurred more frequently than the other two categories. All aggressive acts decreased during the treatment course of patients’ hospitalization. The incidence rate of aggressive acts that decreased the most, over weeks, were “loud verbal arguments with another person”, “low grade hostility”, and “used property in a threatening manner without damage”. The incidence rate of aggressive acts decreased to 33.3%, 26.8%, and 16.9% in the following second, third, and forth week respectively during hospitalization. Most patients’ aggressive acts were quickly decreased in two weeks. The study subjects’ aggressive acts were heterogeneous as evidenced by: (1) a high concurrent rate of AggO with AggP (r = .52), especially with physical AggP (r = .51), whereas only physical AggO was concurrent with AggS (r = .24) in the initial week after hospitalization, (2) a high significant correlation of the severity of aggressive acts between corresponding categories of past-month and initial-week aggressive acts (toward property, r= .46 ; toward others, r = .50; toward self, r = .41; and Past-month AggP with AggO, r = .34, and Past-month AggO with AggP, r = .43), whereas the correlation between aggressive acts toward self and the other two categories were all low, and (3) a high concordance rate of corresponding categories of past-month and initial-week aggressive acts (toward property, 72.0%; toward person, 72.6%; toward self, 70.7%). The concordance between past-month AggP and initial-week AggO (64.7%), past-month AggO and initial-week AggP (64.6%) were also high, whereas the concordance between aggressive acts towards the self and other two categories were low. The risk factors of weekly averages of AggP during hospitalization were weekly averages of past-month AggP, and positive and negative psychiatric symptoms. The risk factors of weekly averages of AggO during hospitalization were weekly averages of past-month AggO, affective psychiatric symptom, and the interaction of weekly averages of past-month AggO and gender factor. The risk factors of weekly averages of AggS during hospitalization were only the weekly averages of past-month AggS. Apparently, the risk factors of these three categories of aggressive acts were different. Globally, the risk factors that significantly predict the single latent factors of “common outward aggressive acts.” were the corresponding category of past-month aggressive acts, psychiatric symptoms, and gender factor. Discussion: The strength of this study on aggressive acts of inpatients with schizophrenia was a prospective observation study design using an objective measure. Previous studies of patients’ aggressive acts mainly used retrospective reports, which might underestimate the occurrence of patients’ aggressive acts, and which provided a cross-sectional data only. This study revealed information on aggressive acts occurring weekly after admission into the psychiatric ward. In addition, to identify the risk factors of aggressive acts and consider their developmental directions to predict the formation of aggressive acts. This brings insight into the dynamic nature of aggressive acts of schizophrenia inpatients. Further, the incidence rate of aggressive acts decreased of 83.1% after 4 weeks of admission. This information is useful for emphasizing prevention and management of aggressive acts of inpatients with schizophrenia after admission. The specific category of initial-week aggressive acts was accurately predicted around seventy percent of the time by the corresponding category occurring in the past month prior to admission. This evidence is crucial for clinical psychiatric service in the prevention of aggressive acts. AggP was also predicted by high level of the positive and low level of the negative psychiatric symptoms; the AggO was also predicted by high level of the affective psychiatric symptoms. Male patients with a past-month history of AggO predict AggO more accurately than the same for female patients. Gender has no effect on the prediction of the other two categories of AggP and AggS. The risk factors of aggressive acts among schizophrenic inpatients occurring during hospitalization did not include the personality variable of an anger trait. This might be due to the fact that the acute phase of illness might reduce the effect of the anger trait on aggressive acts. The anger trait may play a role on aggressive acts that occur in the stabilized state of illness. This needs to be studied further.
Badowska, Dorota. "Schizophrenia risk factor Tcf4 and gene-environment interaction in mice". Doctoral thesis, 2014. http://hdl.handle.net/11858/00-1735-0000-0022-5DCD-B.
Pełny tekst źródłaTseng, Pei-Hsin, i 曾姵馨. "Risk and determined factars of developing Dementia in patients with Schizophrenia". Thesis, 2015. http://ndltd.ncl.edu.tw/handle/90548900711352052784.
Pełny tekst źródła中山醫學大學
醫療產業科技管理學系碩士班
103
Background:As the global population aging, advances in medical technology, the elderly population is growing ensue a rapid increase in dementia and schizophrenia patients. World Health Organization in April 2012 report released by the Global dementia, estimated in 2010 of 35.6 million worldwide with dementia, with 7.7 million annual increase rate of growth, that is, about every four seconds on a new diseased person. According to the study,schizophrenia patients may got hypertension, diabetes,cerebrovascular disease , metabolic syndrome related comorbidities .And reduce healthy management ability.Schizophrenia patients will significantly increase the risk of dementia,In this study, we use"National Health Insurance Research Database" to analyzethat if schizophrenia patient will developdementia or not.Schizophrenia patients will significantly increase the risk of dementia, Objective: Schizophrenia and dementia are important diseases in the medical field. The study was designed to investigate the risk factors of schizophrenia , related factors of dementia and whether the elderly patients with schizophrenia will increase the risks of dementia or not. Methods:The study used 2005 from the National Health Insurance data and randomly selected one million representative samples of the large-scale data .The database is from 2000 to 2010 , all the medical data of this study conducted a case-control study. By age, gender and comorbidity to pair up. After pairing , experimental group are 8497 people ,and there are 33,988 in control groupe. Conducting descriptive statistics and logistic regression with SPSS 18.0 to analyze patients with schizophrenia increasing the risks of dementia. Results:The studies showed that patients who have gender, schizophrenia, cerebrovascular disease , chronic liver disease, diabetes, hypertension, hyperlipidemia, alcoholic diseases are significant differences. Statistics showed that patients with comorbid disease and schizophrenia increases the risk of dementia.Cerebrovascular disease, chronic liver disease, diabetes, hypertension, hyperlipidemia, and alcoholic diseases, included as control variables,. Schizophrenia patients will significantly increase the risk of dementia, the risk (RR=3.84). We can find that patients who are under 65 years old will significantly increase the risk of dementia, and the risk is higher than the population over 65 years old. In ages among 50-59 ,with the highest risk. Men’s schizophrenia patients will significantly increase the risk of dementia, and the risk is higher than the female population. Conclusion:The study found that patients with schizophrenia may increase the risk of dementia, patients with chronic diseases particularly increase the risk of dementia, hyper-aged society in Taiwan, people with schizophrenia and dementia increasing. It should be early detection , giving diagnosis and treatment.
Dragomir, Elena Alice. "Évaluation de l'impact clinique et économique du développement d'un traitement pour la schizophrénie". Thèse, 2010. http://hdl.handle.net/1866/4818.
Pełny tekst źródłaAim: Pharmacological strategies for schizophrenia have received increasing attention due to the development of new therapies more effective, better tolerated but more expensive. Schizophrenia is a chronic illness with various states of illness. Objectives: This research program aimed: 1) to evaluate the factors associated with the risk of being in a specific state of schizophrenia in order to construct the risk functions of the course of schizophrenia modeling; 2) to develop and validate a Markov model with Monte-Carlo micro-simulations in order to simulate the natural course of patients who have been newly diagnosed with schizophrenic based upon the individual risk factors profile; and 3) to estimate the direct healthcare and non-healthcare cost of schizophrenia and to simulate clinical and economic impact of developing a new treatment, in a cohort of patients newly diagnosed with schizophrenia, over the first 5 years following their diagnosis. Methods: For the first objective of this research program, a total of 14,320 newly diagnosed patients with schizophrenia were identified based on data from the RAMQ and Med-Echo databases. Six disorder states of schizophrenia were defined: first episode (FE), low dependency state (LDS), high dependency state (HDS), Stable state (Stable), Well state (Well) and Death state (Death). To evaluate factors associated to the risk of being in each disease state, we constructed 4 risk functions based on the Cox proportional hazard analysis for competing risks. For the second objective, a Markov model with Monte-Carlo microsimulations with the six specific states of schizophrenia was developed and validated. In the model, each subject had his own probabilities of transition between specific states, which were estimated based on the cumulative incidence function. For the third objected, we used the Markov model we previously developed. The model includes direct healthcare costs estimated from the Régie de l’assurance maladie du Québec and Med-Echo databases and direct non-healthcare costs estimated from the surveys and publications of Statistics Canada. Results: A total of 14,320 individuals were identified in the study cohort as newly diagnosed patients with schizophrenia. The mean follow-up of the subjects was of 4.4 (± 2.6) years. The age, the sex, the schizophrenia treatment, and having comorbidities are factors that are associated with the schizophrenia course. After a five-year period, our results show that 41% of patients will be considered as having recovered, 13% will be in stable condition and 3.4% of patients will have died. The mean direct healthcare and non-healthcare cost of schizophrenia over the first 5 years following diagnosis was estimated $36,701 Canadian (CAN) (95% CI: 36,264 to 37,138). The direct healthcare cost accounted for 56.2% of the total cost, welfare assistance for 34.6% and long term care facilities for 9.2%. On the direct healthcare cost, hospitalisation cost accounted for 64.6%, medical cost for 11.4% and drug-related cost for 24%. In the case where a new treatment with 20% increase of effectiveness will be available, the direct healthcare and non-healthcare costs can be reduced up to 14.2%. Conclusion: We have identified factors associated with the schizophrenia’s specific states, The Markov model we have developed is the first Canadian model incorporating transition probabilities adjusted for individual risk factor profiles using real-life data. The model shows a good internal and external validity. Based on the cost estimates, our results indicate that a new treatment could possibly reduce hospitalization and long-term care facility costs while potentially enabling patients to return to active employment that would in turn contribute to the reduction of the welfare assistance cost.
Lin, Chia-Jung, i 林嘉容. "Explore the Moderation and Mediation Effects among those Risk Factors of the Treatment of Schizophrenia:A Longitudinal Study". Thesis, 2010. http://ndltd.ncl.edu.tw/handle/57607287032319739600.
Pełny tekst źródła淡江大學
數學學系碩士班
98
Schizophrenia is a complex and heterogeneous psychosis. The durations of antipsychotic trial for drug treatment of schizophrenia recommend to at least 42 days. Efficacy and drug safety were assessed on days 0, 14, 28, and 42. Therefore, the data structure is a longitudinal dependent data. We have published 20 papers to explore the relationship between the treatment effects of schizophrenia and some potential prognostic/risk factors. Those factors can be classified into three major areas: genes, disease related factors and patients’ personal characteristics. Efficacy was measured by the PANSS and/or other clinical evaluation forms like Clinical Global Impression (CGI), named dependent variables. We used GEE method’s generalized linear models/other non-parametric methods to explore the possible moderation effects and/ the mediation effects among those aforementioned risk factors. One of the primary study purposes of evaluating the treatment effects of schizophrenia is to figure out the changes of each response variable with respect to time. Therefore, to explore the moderation effect, we focus on the moderation effect on the treatment time to each response variable. Accordingly, to explore the mediation effect, we used the GEE method’s generalized linear model to adjust the time effect. Some other nonparametric methods, such as Chi-Square Test, Kruskal-Wallis Test, Kolmogorov-Smirnov Test, or Kendall’s bivariates correlations, were used to explore the mediation effect of those risk factors to each response variable according to the characteristics of risk factors. In conclusion, the relationships between treatment week and those nine response variables were influenced by the genetic factors; the disease related factors influence the relationships between treatment week and the response variables (except CGI); the patients’ characteristic factors were influence on the relationships between treatment week and four indicators ( CGI, PANSS negative score, PANSS total score, and response ). Further analyses on the partial/complete mediator, we found that some genetic and disease related factors were partial mediators. And, body weight was the only complete mediator of sex to PANSS negative score.
Mei-Kuei i 吳梅桂. "The risk factors of cardiovascular disease and the effect of diet and physical activity program in clozapine-treated schizophrenic obesity". Thesis, 2008. http://ndltd.ncl.edu.tw/handle/81974959043939493828.
Pełny tekst źródła中山醫學大學
營養學研究所
96
Schizophrenia has a prevalence of 1 percent in all cultures and is equally common in men and women. It is a devastating mental illness that impairs mental and social functioning. Clozapine is effective in treating not only the positive symptoms of schizophrenia, but also in reducing negative symptoms and cognitive deficits. Several studies have reported significant weight gain with clozapine and the largest weight gains seen with antipsychotic drug and had a significantly higher mean BMI value and rate of obesity than patients treated with other SGAs. Obese patients with schizophrenia being treated with clozapine (OSC) and non-psychiatric obese (OB) are often assumed to share the same physiological changes in obesity. In fact, the obese patients with schizophrenia being treated with clozapine was different from non-psychiatric obese in physiological change. Although the anthropometric parameters in the OB and OSC groups were similar, in the OSC group the waist-to-hip ratio (WHR), insulin levels and HOMA index were significantly higher, while insulin sensitivity, cholesterol, low-density lipoprotein (LDL) cholesterol, TC/HDL-C, LDL-C/HDL-C, IGF-1 and IGF-1/IGFBP-3 molar ratio were lower, than those of the OB group. Significant weight gain can lead to health complications such as cardiovascular disease, hypertension, dyslipidemia, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, certain cancers, and type 2 diabetes. Compliance with prescribed antipsychotic medication is low and weight gain contributes to psychotropic non-compliance. The intervention program of dietary control and regular physical activity in obese patients with schizophrenia being treated with clozapine can showed a significant decrease in body weight, BMI, body fat percentage, and waist and hip girths. In addition, participating patients showed improved metabolic profiles of triglyceride, insulin, IGFBP-3 levels, and the IGF-1 to IGFBP3 molar ratio. In conclusion, the obese patients with schizophrenia being treated with clozapine was different from non-psychiatric obese in physiological 3 change. The obese patients with schizophrenia being treated with clozapine group was characterized by impaired glucose–insulin homeostasis, abnormal lipid profiles and hormonal changes in the GH-IGF-IGFBP axis and in leptin. By way of the program of dietary control and regular physical activity can significantly reduce body weight and improve metabolic profiles of insulin, triglyceride, and IGFBP-3 among obese inpatients taking clozapine for the treatment of schizophrenia.
Chen, Po-Yu, i 陳柏妤. "Family history of obesity related metabolic diseases as the risk factor of metabolic disturbances in schizophrenic patients receiving antipsychotics". Thesis, 2008. http://ndltd.ncl.edu.tw/handle/61122088915656095016.
Pełny tekst źródła國立臺灣大學
臨床醫學研究所
96
Objective: Obesity and diabetes mellitus are common side effects during antipsychotics treatment. These side effects may predispose cardiovascular diseases and decrease antipsychotics compliance in schizophrenic patients. Higher prevalence of metabolic diseases in schizophrenic patients was frequently reported in many countries. However, there are not many studies of the prevalence of metabolic diseases in community patients in Taiwan. Different effects on metabolic disease among various antipsychotics have been broadly discussed. However, clinical risk factors focusing on patient aspects still need to be further clarified. Family history was demonstrated as an important risk factor for metabolic diseases in general population. However, whether family history us also important for antipsychotics related metabolic disease is still an unresolved question. Our study aimed to provide reference for prevalence of metabolic disease in community schizophrenic patient in our country. Furthermore, this study examined the influence of family history on the metabolic outcomes related to antipsychotics treatments Methods: Volunteer schizophrenic patients were recruited during a disease screening activity, sponsored by Taipei Public Health Bureau. Schizophrenic who live in community and half-way houses were invited. Personal interview for clinical information were performed. All patients receive anthropometric measurements and fasting blood sampling to evaluate metabolic disease status. Prevalence of metabolic diseases among our patients was described. Multiple logistic regression model was use to define the metabolic family histories risk on various metabolic outcomes. Results: Totally 307 patients were included in this study. Our analysis revealed prevalence in these patients were 60% for overweight, 30% for obese, 33.01% for metabolic syndrome, 33.66% for hypertension, 10.46% for diabetes mellitus and 9.48% in hypercholesterolemia. Most of these prevalence rates were higher than general population. Males tend to have hypertension. Females were found to have more diabetes and central obesity. Antipsychotics effects on metabolic diseases were not significant distinct in our study. Family history of DM elevated the risk to 2.35 in overweight, 2.01 in obesity, 2.07 in central obesity and 3.31 in DM. In addition, family history of DM increases 4.95 kg of mean body weight and 2.11 of body mass index. Family history of DM could be a predictor for overweight, obesity, central obesity and DM when patient receiving antipsychotics and as a reference for medical decision. Also, our study found interaction between antipsychotics and family history of DM , comparing to those without family history of DM, typical and second-generation antipsychotics generated more prominent risks for central obesity. Other metabolic disease family histories didn’t showed significant correlation with the metabolic outcomes in schizophrenic patients receiving antipsychotics. There are several limitations of this study. First of all, only current drug information was available. Second, there are many kinds of drugs in this study and the sample size for single drug is too small to clarify the specific drug effect. Also, information about family history was self-reported .It may be under estimated due to impaired cognitive function of schizophrenic patients. Conclusion: The prevalence of metabolic diseases for schizophrenic patients in community was higher than the general population. Specific gender differences were found. Family history of DM predicts overweight, obesity, central obesity and DM in schizophrenic patient with antipsychotics treatments.