In patients with schizophrenia, symptoms improvement can be uncorrelated with quality of life improvement

Wilson-d’Almeida, K.; Karrow, A.; Bralet, Marie-Cécile; Bazin, Nadine; Hardy-Baylé, Marie-Christine; Falissard, Bruno

doi:10.1016/j.eurpsy.2011.10.002

Cited by 13 publications

(9 citation statements)

References 21 publications

(28 reference statements)

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“…In our study, one possible explanation for the lack of improvement in QOL outcomes, despite improvement in symptoms, is that QOL is a complex construct, for which symptomology only comprises one of the components. It was found in one study that psychotic symptom severity in schizophrenia was only weakly correlated with QOL scores, and in another study, completely uncorrelated . This relationship is further attenuated when QOL outcomes are measured in the inpatient setting, as ward environments are designed to meet patients’ needs .…”

Section: Discussionmentioning

confidence: 99%

Clinical effectiveness and speed of response of electroconvulsive therapy in treatment‐resistant schizophrenia

Chan

Abdin

Seow

et al. 2019

Psychiatry Clin Neurosci

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Aim Although electroconvulsive therapy (ECT) has been shown to be efficacious for patients with treatment‐resistant schizophrenia, there has been limited evidence on the rate of response, cognition, and quality‐of‐life outcomes. The primary aims of the present study were thus to examine the effectiveness and speed of response to ECT in a naturalistic retrospective cohort in patients with treatment‐resistant schizophrenia. Methods We performed a retrospective database analysis. The primary effectiveness outcome was defined as an improvement of ≥40% from pretreatment scores based on the Brief Psychiatric Rating Scale (BPRS) Psychotic Symptom subscale. Data were included for analysis for all patients with a primary DSM‐5 diagnosis of schizophrenia that was treatment‐resistant and who had had an acute course of ECT initiated for the treatment of schizophrenia between 1 July 2016 and 1 December 2016. Results A total of 50 inpatients were included for analysis. The present study revealed that 50% of patients showed at least a 40% reduction in BPRS Psychotic Symptom subscale scores after completion of ECT and that 16.7% of patients responded after the first three sessions, 39.3% after six sessions, 46.4% after nine sessions, and 50% after 12 sessions. The greatest improvement in BPRS scores was between the third and sixth ECT sessions. BPRS scores, Clinical Global Impression, Montreal Cognitive Assessment, and Global Assessment of Functioning showed significant improvement. There was no significant difference in quality‐of‐life outcomes. Conclusion Utilizing modern techniques in treatment‐resistant schizophrenia, this study demonstrates the real‐world effectiveness and rate of response of patients receiving ECT.

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Section: Discussionmentioning

confidence: 99%

Clinical effectiveness and speed of response of electroconvulsive therapy in treatment‐resistant schizophrenia

Chan

Abdin

Seow

et al. 2019

Psychiatry Clin Neurosci

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“…People with a diagnosis of chronic schizophrenia who live in institutionalized settings have very low levels of social functioning and social activity ( Kovács et al, 2004 ). Individual or combined measures of symptomatology, quality of life and adherence to treatment are commonly used to assess the efficacy of a psychosocial rehabilitation process for patients with schizophrenia ( Wilson-d’Almeida et al, 2013 ), but not together in the same study. By including these measures and adding an assessment of salivary cortisol and alpha-amylase, our study provides an interesting insight into the use of combined measures.…”

Section: Discussionmentioning

confidence: 99%

Animal Assisted Therapy (AAT) Program As a Useful Adjunct to Conventional Psychosocial Rehabilitation for Patients with Schizophrenia: Results of a Small-scale Randomized Controlled Trial

et al. 2016

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Currently, one of the main objectives of human–animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6–month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre–program with post–program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre–session with post–session salivary cortisol and alpha–amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty–two institutionalized patients with chronic schizophrenia completed the 6–month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT–treatment group (n = 14) participated in twice–weekly 1–h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT–treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT–treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT-treatment was significantly higher than overall adherence to the control group’s functional rehabilitation activities. Cortisol level was significantly reduced after participating in an AAT session, which could indicate that interaction with the therapy dogs reduced stress. In conclusion, the results of this small-scale RCT suggest that AAT could be considered a useful adjunct to conventional psychosocial rehabilitation for people with schizophrenia.

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“…Falissard et al (2006) remarked that QoL self-evaluation may be influenced by defensive reactions. With a different measure, it was demonstrated that QoL remained stable, despite a decrease in symptoms (Wilson-d’Almeida et al, 2013). This stability might be due to the fact that improvement is associated with better judgment about one’s position in life and higher expectations.…”

Section: Discussionmentioning

confidence: 99%

Correlations of Theory of Mind Deficits with Clinical Patterns and Quality of Life in Schizophrenia

et al. 2013

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Background: Numerous studies have demonstrated the existence of theory of mind (ToM) impairments in patients with schizophrenia. The clinical consequences of these impairments are currently under debate. Accumulated evidence suggests that ToM deficits are linked to negative and disorganization symptoms, but direct correlations are lacking. Moreover, it is unclear whether ToM deficits are related to reduced quality of life (QoL).Methods: To extend the understanding of objective (i.e., clinical symptoms) and subjective (QoL) correlates of impaired ToM, we assessed 206 patients with schizophrenia based on performance of an ecological task (Versailles-Situational Intention Reading, V-SIR), a Communication Disorders Scale (SCD), the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression rating, and a QoL questionnaire (S-QoL). Statistical inferences were drawn from correlations analyses considering both factors/subscales aggregates and single items.Results: ToM performance was negatively correlated to disorganization and negative PANSS factors. Poor V-SIR performance was correlated with “conceptual disorganization,” “difficulties in abstract thinking,” and “apathy/social withdrawal.” The SCD was correlated with “negative,” “disorganization,” and “anxiety/depression” PANSS factors. The S-QoL total score was not significantly correlated with ToM performance. Only the item “difficulties in expressing feelings” was significantly correlated with poorer V-SIR performance.Conclusion: We discuss the intriguing paucity of the results and what they reveal about the difficulties faced by psychiatrists with patients not expressing complaints about lack of social skills.

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In patients with schizophrenia, symptoms improvement can be uncorrelated with quality of life improvement

Cited by 13 publications

References 21 publications

Clinical effectiveness and speed of response of electroconvulsive therapy in treatment‐resistant schizophrenia

Clinical effectiveness and speed of response of electroconvulsive therapy in treatment‐resistant schizophrenia

Animal Assisted Therapy (AAT) Program As a Useful Adjunct to Conventional Psychosocial Rehabilitation for Patients with Schizophrenia: Results of a Small-scale Randomized Controlled Trial

Correlations of Theory of Mind Deficits with Clinical Patterns and Quality of Life in Schizophrenia

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