Factors Associated With Real-Life Functioning in Persons With Schizophrenia in a 4-Year Follow-up Study of the Italian Network for Research on Psychoses

Mucci, Armida; Galderisi, Silvana; Gibertoni, Dino; Rossi, Alessandro; Rocca, Paola; Bertolino, Alessandro; Aguglia, Eugenio; Amore, Mario; Bellomo, Antonello; Biondi, Massimo; Blasi, Giuseppe; Brasso, Claudio; Bucci, Paola; Carpiniello, Bernardo; Cuomo, Alessandro; Dell’Osso, Liliana; Giordano, Giulia; Marchesi, Carlo; Monteleone, Palmiero; Niolu, Cinzia; Oldani, Lucio; Pettorruso, Mauro; Pompili, Maurizio; Roncone, Rita; Tenconi, Elena; Vita, Antonio; Zeppegno, Patrizia; Maj, Mario

doi:10.1001/jamapsychiatry.2020.4614

Cited by 95 publications

(79 citation statements)

References 60 publications

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“…Under the above active inference account, these patients are in a state where the precision of their observations is reduced–that is, the confidence in, and therefore the attention afforded to, observations that may oppose their hallucination- and delusion- inducing priors is reduced. This is concordant with evidence that deficits in attention and other cognitive domains is a feature of schizophrenia that can impair social and occupational functioning ( 4 , 61 , 62 ). Two solutions to this situation seem plausible.…”

Section: Proposed Theoretical Frameworksupporting

confidence: 87%

Computational Mechanism for the Effect of Psychosis Community Treatment: A Conceptual Review From Neurobiology to Social Interaction

et al. 2021

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The computational underpinnings of positive psychotic symptoms have recently received significant attention. Candidate mechanisms include some combination of maladaptive priors and reduced updating of these priors during perception. A potential benefit of models with such mechanisms is their ability to link multiple levels of explanation, from the neurobiological to the social, allowing us to provide an information processing-based account of how specific alterations in self-self and self-environment interactions result in the experience of positive symptoms. This is key to improving how we understand the experience of psychosis. Moreover, it points us toward more comprehensive avenues for therapeutic research by providing a putative mechanism that could allow for the generation of new treatments from first principles. In order to demonstrate this, our conceptual paper will discuss the application of the insights from previous computational models to an important and complex set of evidence-based clinical interventions with strong social elements, such as coordinated specialty care clinics (CSC) in early psychosis and assertive community treatment (ACT). These interventions may include but also go beyond psychopharmacology, providing, we argue, structure and predictability for patients experiencing psychosis. We develop the argument that this structure and predictability directly counteract the relatively low precision afforded to sensory information in psychosis, while also providing the patient more access to external cognitive resources in the form of providers and the structure of the programs themselves. We discuss how computational models explain the resulting reduction in symptoms, as well as the predictions these models make about potential responses of patients to modifications or to different variations of these interventions. We also link, via the framework of computational models, the patient's experiences and response to interventions to putative neurobiology.

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Section: Proposed Theoretical Frameworksupporting

confidence: 87%

Computational Mechanism for the Effect of Psychosis Community Treatment: A Conceptual Review From Neurobiology to Social Interaction

et al. 2021

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“…Despite significant advances in the available pharmacological and psychosocial interventions, the impairment in real-life functioning, represents, to date, an unmet need in the care of people suffering from this disorder, with a huge burden on patients, their families, and health-care systems ( 4 – 10 ). Different factors, some related to the illness, others to personal resources, and others to the context, have been demonstrated to contribute to the impairment in functioning ( 6 – 8 , 10 , 11 ). Among these factors, prolonged periods of untreated psychosis have a role in determining a chronic course of symptoms and a poor functional outcome ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

EEG-Based Measures in At-Risk Mental State and Early Stages of Schizophrenia: A Systematic Review

et al. 2021

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Introduction: Electrophysiological (EEG) abnormalities in subjects with schizophrenia have been largely reported. In the last decades, research has shifted to the identification of electrophysiological alterations in the prodromal and early phases of the disorder, focusing on the prediction of clinical and functional outcome. The identification of neuronal aberrations in subjects with a first episode of psychosis (FEP) and in those at ultra high-risk (UHR) or clinical high-risk (CHR) to develop a psychosis is crucial to implement adequate interventions, reduce the rate of transition to psychosis, as well as the risk of irreversible functioning impairment. The aim of the review is to provide an up-to-date synthesis of the electrophysiological findings in the at-risk mental state and early stages of schizophrenia.Methods: A systematic review of English articles using Pubmed, Scopus, and PsychINFO was undertaken in July 2020. Additional studies were identified by hand-search. Electrophysiological studies that included at least one group of FEP or subjects at risk to develop psychosis, compared to healthy controls (HCs), were considered. The heterogeneity of the studies prevented a quantitative synthesis.Results: Out of 319 records screened, 133 studies were included in a final qualitative synthesis. Included studies were mainly carried out using frequency analysis, microstates and event-related potentials. The most common findings included an increase in delta and gamma power, an impairment in sensory gating assessed through P50 and N100 and a reduction of Mismatch Negativity and P300 amplitude in at-risk mental state and early stages of schizophrenia. Progressive changes in some of these electrophysiological measures were associated with transition to psychosis and disease course. Heterogeneous data have been reported for indices evaluating synchrony, connectivity, and evoked-responses in different frequency bands.Conclusions: Multiple EEG-indices were altered during at-risk mental state and early stages of schizophrenia, supporting the hypothesis that cerebral network dysfunctions appear already before the onset of the disorder. Some of these alterations demonstrated association with transition to psychosis or poor functional outcome. However, heterogeneity in subjects' inclusion criteria, clinical measures and electrophysiological methods prevents drawing solid conclusions. Large prospective studies are needed to consolidate findings concerning electrophysiological markers of clinical and functional outcome.

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“…Social function has always been an important standard to measure the rehabilitation of patients with schizophrenia [ 38 ]. Because of the influence of antipsychotic drugs, long-term hospitalization and the evolution of the disease itself, the negative symptoms and social function of patients decreased, which accelerated mental decline [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Medication Adherence and Its Influencing Factors in Patients with Schizophrenia in the Chinese Institutional Environment

Wei

Tong

Sun

et al. 2021

IJERPH

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Background: Factors related to medication adherence in patients with schizophrenia have always been key to the treatment and rehabilitation of these patients. However, the treatment modes in different countries are not the same, and there is no research on the factors influencing medication adherence under different mental health service modes. Objectives: The purpose of this study was to explore medication adherence and its influencing factors in patients with schizophrenia in the Chinese institutional environment. Methods: We conducted a cross-sectional study of hospitalized persons living with schizophrenia from November 2018 to January 2019. A systematic sampling method was used to select 217 hospitalized persons living with schizophrenia. The Medication Adherence Rating Scale (MARS), Positive and Negative Syndrome Scale (PANSS), General Self-Efficacy Scale (GSES), Schizophrenia Quality of Life Scale (SQLS), and Scale of Social Skills for Psychiatric Inpatients (SSPI) were used to explore medication compliance and its influencing factors in the Chinese institutional environment. Results: The descriptive analysis and ANOVA showed that there were no significant differences in medication adherence when assessed by demographic characteristics such as sex, marital status, and education level (p > 0.05). A correlation analysis showed that there was no significant correlation between medication adherence and mental symptoms (p > 0.05) but that there was a positive correlation with self-efficacy, quality of life, and activities of daily living (p < 0.01). The linear regression analysis showed that self-efficacy, psychosocial factors, symptoms/side effects, and activities of daily living had significant effects on medication adherence (F = 30.210, p < 0.001). Conclusions: Our findings show that the self-efficacy, quality of life, and social function of patients with schizophrenia are important self-factors influencing medication adherence in the Chinese institutional environment.

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Factors Associated With Real-Life Functioning in Persons With Schizophrenia in a 4-Year Follow-up Study of the Italian Network for Research on Psychoses

Cited by 95 publications

References 60 publications

Computational Mechanism for the Effect of Psychosis Community Treatment: A Conceptual Review From Neurobiology to Social Interaction

Computational Mechanism for the Effect of Psychosis Community Treatment: A Conceptual Review From Neurobiology to Social Interaction

EEG-Based Measures in At-Risk Mental State and Early Stages of Schizophrenia: A Systematic Review

Analysis of Medication Adherence and Its Influencing Factors in Patients with Schizophrenia in the Chinese Institutional Environment

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