Revolving Door Syndrome usually corresponds to what might be called "hospital multiple readmissions phenomenon". Beyond consequences to the patients and their families, frequent re-readmissions also heavily increase healthcare cost and cause burn out among medical and paramedical staff. The objective of this study was to find the characteristics of Tunisian patients with "revolving door" syndrome. The purpose of this study was to identify factors associated to short-term readmissions in a sample of Tunisian patients with schizophrenia.
The prodromal phase of schizophrenia is the time interval preceding a first psychotic episode. It begins with the appearance of nonspecific symptoms. It ends with the outbreak of an episode meeting the diagnostic criteria for schizophrenia. This phase is considered a key period in the prognosis of the disease because it provides access to early diagnosis. Objectives: Identify the symptoms of the prodromal phase of schizophrenia and point out the duration of their development in a sample of Tunisian patients. Aims: Detect the specifities of prodromal phase in Tunisia. Methods: 15 schizophrenia patients with illness duration of less than 3 years were included. All patients were in clinical remission from at least 3 months (PANNS and BPRS). Exclusion criteria were any history of other psychiatric or neurological disorders and alcohol or drug abuse. Prodromal symptoms were assessed with the scale of prodromal symptoms (SOPS) developed by Mc Glashan. It is a heteroquestionnaire for patients and their parents. Results: The mean duration of prodromal phase was about 2 years with extremes ranging from 6 months to 4 years. The most severe prodromal symptoms were suspiciousness/ persecutory ideas, social isolation, dysphoric mood and impaired tolerance to normal stress The most frequent prodromal symptoms were impaired tolerance to normal stress, dysphoric mood, sleep disturbance, social isolation and suspiciousness/ persecutory ideas. We have not found any difference between male and female. Conclusion: The prodromal symptoms of schizophrenia found in the Tunisian socio cultural context are similar to those found in other countries.
IntroductionResearch has suggested that schizophrenia involves significant deficits in executive functioning. Yet, the literature has little studied patients with a recent onset of first episode of schizophrenia. Besides, only few studies have focused on symptom-free intervals. Furthermore, previous studies have included patients under polymedication of antipsychotics without any restriction on other psychotropes.ObjectivesTo investigate executive functions in remitted patients with recent onset of first episode of schizophrenia receiving only a monotherapy of antipsychotics.AimsExecutive dysfunction in schizophrenia is not a consequence of the long term course of the disease, of the relapses, of the symptoms or of the polymedication.Methods25 schizophrenic outpatients with less than 3 years of illness duration and only one psychotic episode were included. All patients received a monotherapy of antipsychotics and none had an antidepressant, mood stabilizer, hypnotics or benzodiazepines. 25 healthy participants were matched according to age and educational level.Patients were assessed by the Positive and Negative Syndrome Scale. Executive functions were assessed by the Davidson et al. computerized battery designed to manipulate inhibition and cognitive flexibility vary demands on these abilities.ResultsCompared to healthy controls, remitted schizophrenia patients have shown significant differences in the percentage of correct responses and in the reaction time. This indicates a disorder in inhibition and in cognitive flexibility.ConclusionsOur results reinforce the findings that the executive dysfunction in schizophrenia stands for itself and that it cannot be explained by relapses, duration of the disease and impact of medication or symptoms.
IntroductionLiterature suggests that schizophrenia (SCZ) could, early in the evolution, involve significant deficits in executive functioning. However, little is known about patients with recent onset first episode. Besides, only few studies focused on symptom-free intervals. Furthermore, most of them included patients on polymedication of antipsychotics including also add on psychotropics.ObjectivesWe aimed to investigate executive dysfunction in first-episode schizophrenia remitted patients with recent onset of the disease, receiving a strict monotherapy of antipsychotics.AimsEnhance the existence of executive dysfunction early in SCZ limiting the impact of relapses, medication and symptoms.Methods25 first episode outpatients with schizophrenia, having less than 3 years illness duration were included. All patients received a monotherapy of antipsychotic with no antidepressant, mood stabilizer, hypnotics or benzodiazepines. 25 healthy participants were matched one by one, according to age and educational level. For clinical evaluation, PANSS was applied. Executive functions were assessed with the Davidson et al. (2006) computerized battery designed to manipulate both inhibition and cognitive flexibility. It encompasses interrelated tasks that enabled us to independently vary demands on these abilities.ResultsCompared to controls, patients showed significant differences in the percentage of correct responses and in reaction time attesting difficulties in inhibition and in cognitive flexibility.ConclusionsOur results emphasize the notion that executive dysfunction in schizophrenia stands for itself early in the disease, cannot be only explained by relapses, duration of the disease, impact of medication nor symptoms.
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