15 results on '"B Chiliza"'
Search Results
2. The trajectories and correlates of two negative symptom subdomains in first-episode schizophrenia.
- Author
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Phahladira L, Asmal L, Lückhoff HK, du Plessis S, Scheffler F, Smit R, Chiliza B, and Emsley R
- Subjects
- Humans, Longitudinal Studies, Psychiatric Status Rating Scales, Antipsychotic Agents therapeutic use, Schizophrenia complications, Schizophrenia diagnosis, Schizophrenia drug therapy
- Abstract
Background: Recent studies suggest a two-factor structure for negative symptoms as assessed by the Positive and Negative Syndrome Scale (PANSS) in schizophrenia, namely experiential and expressive subdomains. Little is known about their clinical correlates and treatment trajectories., Objectives: We sought to replicate the two factor-analysis derived subdomains for PANSS negative symptoms in schizophrenia and to assess their independent demographic, premorbid and treatment-related characteristics., Methods: This was a longitudinal study of 106 minimally treated participants with a first episode of a schizophrenia spectrum disorder who received treatment with flupenthixol decanoate 2-weekly injections over two years. Factor analysis was used to characterize the PANSS negative symptom subdomains and linear mixed-effect models for continuous repeated measures were constructed to assess the temporal relations between the negative symptom subdomains and premorbid and treatment related variables., Results: Factor analysis confirmed a two-factor solution for experiential and expressive subdomains of negative symptoms, although they were strongly correlated. The treatment response trajectories for the two subdomains did not differ significantly, and neither subdomain was significantly associated with our premorbid variables. We found significant main effects for disorganised symptoms and extrapyramidal symptoms on the expressive subdomain, and for disorganised symptoms and depressive symptoms on the experiential subdomain. Post-hoc testing indicated that reductions in HDL-cholesterol levels were associated with less improvement in both expressive and experiential subdomain scores., Conclusion: The two negative symptom subdomains are closely related, have similar premorbid correlates and respond similarly to antipsychotic treatment. Depression affects the experiential subdomain, whereas extrapyramidal symptoms affect the expressive subdomain., (Copyright © 2022 Elsevier B.V. All rights reserved.)
- Published
- 2022
- Full Text
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3. Sex and gender associations with indicators of neurodevelopmental compromise in schizophrenia spectrum disorders.
- Author
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Luckhoff HK, Asmal L, Scheffler F, du Plessis S, Chiliza B, Smit R, Phahladira L, and Emsley R
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- Female, Humans, Male, Pregnancy, Psychiatric Status Rating Scales, Sex Factors, Schizophrenia diagnosis
- Abstract
Background: It has been proposed that sex and gender differences described in schizophrenia can be explained from a neurodevelopmental perspective., Aim: In this study, we examined the associations of biological sex and gender role endorsement with putative indicators of neurodevelopmental compromise., Methods: We used the Bem Sex Role Inventory to calculate masculinity scores in 77 patients with a first episode of a schizophrenia spectrum disorder, and selected the following indicators of neurodevelopmental compromise: family history of schizophrenia, obstetric complications, premorbid functioning, neurological soft signs, and cognitive function. Secondary objectives included the moderating effects of age of onset of illness, substance use and negative symptoms on these associations., Results: There were no significant sex differences across any of the indicators of neurodevelopmental compromise. However, lower masculinity scores correlated significantly with poorer premorbid adjustment, sensory integration deficits and worse overall cognitive performance. Stepwise linear regression identified poorer premorbid adjustment in early adolescence and lower verbal learning scores as independent predictors of lower masculinity scores. In contrast to sex, gender showed several associations with indicators of neurodevelopmental compromise., Conclusions: Lower masculinity scores may represent part of a phenotype for a neurodevelopmental anomaly that places some individuals on a pathway to schizophrenia., (Copyright © 2022 Elsevier B.V. All rights reserved.)
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- 2022
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4. Sex versus gender as risk factors for the age of onset of schizophrenia spectrum disorders.
- Author
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Luckhoff H, Asmal L, Kilian S, Scheffler F, du Plessis S, Buckle C, Phahladira L, Smit R, Chiliza B, and Emsley R
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- Age Factors, Age of Onset, Humans, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, Psychotic Disorders epidemiology, Schizophrenia epidemiology
- Abstract
Competing Interests: Declaration of competing interest Bonginkosi Chiliza has received honoraria from Lundbeck, Mylan and Sandoz for speaking at educational meetings. Robin Emsley has participated in speakers/advisory boards and received honoraria from Janssen, Lundbeck, Servier and Otsuka. Hilmar Luckhoff, Lebogang Phahladira, Freda Scheffler, Stefan du Plessis, Laila Asmal, Chanelle Buckle, Retha Smit and Sanja Kilian declare that they have no conflicts of interest.
- Published
- 2020
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5. Weight gain and metabolic change as predictors of symptom improvement in first-episode schizophrenia spectrum disorder patients treated over 12 months.
- Author
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Luckhoff H, Phahladira L, Scheffler F, Asmal L, du Plessis S, Chiliza B, Kilian S, and Emsley R
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- Adult, Body Mass Index, Dopamine Antagonists administration & dosage, Dopamine Antagonists adverse effects, Female, Flupenthixol analogs & derivatives, Flupenthixol pharmacology, Humans, Longitudinal Studies, Male, Severity of Illness Index, Young Adult, Dopamine Antagonists pharmacology, Outcome Assessment, Health Care, Schizophrenia blood, Schizophrenia drug therapy, Schizophrenia physiopathology, Weight Gain drug effects
- Abstract
Background: Treatment-emergent weight gain is associated with antipsychotic efficacy in schizophrenia patients treated with clozapine and olanzapine. However, few studies have investigated this relationship in first-episode patients treated with other antipsychotics, in particular those with a lower obesogenic potential. Aim To investigate the relationships between weight gain and associated metabolic changes with psychopathology improvement in relation to age, sex, ethnicity, substance use, treatment duration and antipsychotic dose in first-episode schizophrenia spectrum disorder patients., Methods: This single site cohort study included 106 minimally treated or antipsychotic-naive patients treated with flupenthixol decanoate over 12 months. Psychopathology was evaluated using the Positive and Negative Syndrome Scale (PANSS) and BMI, fasting blood lipids and glucose were assessed at regular intervals. Linear regression models were constructed to determine the effects of socio-demographic, clinical and metabolic factors as predictors of change in total PANSS score and factor-derived domains., Results: BMI change scores were inversely correlated with change in PANSS total (R = -0.25; p = 0.011), positive (R = -0.23; p = 0.019), depressive anxiety (R = -0.21; p = 0.031) and disorganized symptoms (R = -0.32; p < 0.001). Linear regression analysis showed that increased BMI and treatment duration both predicted improvement in global psychopathology and disorganized symptoms independent of age, sex, ethnicity, substance use, co-medication with antidepressants and/or anticholinergics, as well as the dose and duration of antipsychotic exposure., Conclusions: Our findings suggest that the relationship between treatment-emergent weight gain and psychopathology improvement is not limited to patients treated with antipsychotics most associated with weight gain, and is not confounded by treatment duration and dose., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2019
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6. Changes in insight over the first 24 months of treatment in schizophrenia spectrum disorders.
- Author
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Phahladira L, Asmal L, Kilian S, Chiliza B, Scheffler F, Luckhoff HK, du Plessis S, and Emsley R
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- Adolescent, Adult, Female, Flupenthixol therapeutic use, Health Personnel psychology, Humans, Longitudinal Studies, Male, Psychiatric Status Rating Scales, Psychotic Disorders psychology, Quality of Life, Schizophrenic Psychology, Time Factors, Treatment Outcome, Young Adult, Antipsychotic Agents therapeutic use, Cognition, Flupenthixol analogs & derivatives, Psychotic Disorders drug therapy, Schizophrenia drug therapy
- Abstract
Background: While insight in schizophrenia improves with treatment, significant impairments often persist. The degree of persistence is not well characterised., Aims: We assessed patient and clinician-rated changes in insight in acutely ill, minimally treated first-episode schizophrenia spectrum disorder patients over 24 months of standardised treatment with a depot antipsychotic., Method: This single arm open label longitudinal cohort study included 105 participants with first-episode schizophrenia, schizophreniform or schizoaffective disorder. Insight was assessed at months 0, 6, 12 and 24 using the patient-rated Birchwood Insight Scale (BIS) and clinician-rated global insight item of the Positive and Negative Syndrome Scale (PANSS). Changes in insight over time were assessed using linear mixed-effect models for continuous repeated measures. Relationships between insight and psychopathology, functionality, cognition and quality of life were assessed with regression models., Results: There was significant improvement over time for the PANSS insight item (p < 0.0001). However, the only significant improvement for the BIS was with the Need for Treatment subscale (p = 0.01). There were no significant improvements noted for the Symptom Attribution (p = 0.7) and Illness Awareness (p = 0.2) subscales, as well as the BIS Total score (p = 0.6). Apart from depressive symptoms at baseline, there were no significant predictors of patient-rated insight., Conclusions: Clinicians should note that, even when treatment is assured and response is favourable, fundamental impairments in patient-rated insight persist., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2019
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7. Effects of cannabis use on body mass, fasting glucose and lipids during the first 12 months of treatment in schizophrenia spectrum disorders.
- Author
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Scheffler F, Kilian S, Chiliza B, Asmal L, Phahladira L, du Plessis S, Kidd M, Murray RM, Di Forti M, Seedat S, and Emsley R
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- Adult, Antipsychotic Agents adverse effects, Antipsychotic Agents therapeutic use, Cannabis, Fasting, Female, Humans, Longitudinal Studies, Male, Metabolic Syndrome blood, Metabolic Syndrome complications, Psychotic Disorders blood, Psychotic Disorders complications, Schizophrenia blood, Schizophrenia complications, Substance-Related Disorders blood, Waist Circumference drug effects, Weight Gain drug effects, Young Adult, Body Mass Index, Glucose metabolism, Lipids blood, Psychotic Disorders drug therapy, Schizophrenia drug therapy, Substance-Related Disorders complications
- Abstract
While acute cannabis use stimulates appetite, general population studies suggest that chronic use is associated with reduced risk of obesity and other cardiometabolic risk factors. In this study we investigated changes in body mass index (BMI), fasting blood glucose and lipids, and rates of metabolic syndrome risk factors in cannabis users vs. non-users in 109 minimally treated patients with first-episode schizophrenia, schizophreniform or schizo-affective disorder who were treated according to a standardized treatment regime with depot antipsychotic medication over 12 months. Participants underwent repeated urine toxicology tests for cannabis and those testing positive at any time during the study (n = 40), were compared with those who tested negative at all time points (n = 69). There was a significant group*time interaction effect (p = 0.002) with the cannabis negative group showing a greater increase in BMI than the cannabis positive group, after adjusting for age, sex, methamphetamine use and modal dose of antipsychotic. There were no group*time interaction effects for fasting blood glucose or lipids. Post hoc tests indicated significant increases in fasting blood glucose and triglycerides and a decrease in high-density lipoprotein cholesterol for the cannabis negative group, with no significant changes in the cannabis positive group. Rates of metabolic syndrome did not differ significantly between groups, although more cannabis negative patients had elevated waist-circumference at endpoint (p = 0.003). It may be that chronic cannabis use directly suppresses appetite, thereby preventing weight gain in users. However, other indirect effects such as dietary neglect and smoking may be contributory and could explain our findings., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
- Full Text
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8. Neurological soft signs in first-episode schizophrenia: State- and trait-related relationships to psychopathology, cognition and antipsychotic medication effects.
- Author
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Emsley R, Chiliza B, Asmal L, Kilian S, Riaan Olivier M, Phahladira L, Ojagbemi A, Scheffler F, Carr J, Kidd M, and Dazzan P
- Subjects
- Female, Flupenthixol administration & dosage, Flupenthixol analogs & derivatives, Humans, Interview, Psychological, Linear Models, Longitudinal Studies, Male, Memory, Short-Term drug effects, Motor Activity drug effects, Neurologic Examination, Psychiatric Status Rating Scales, Psychotic Disorders psychology, Schizophrenic Psychology, Severity of Illness Index, Treatment Outcome, Young Adult, Antipsychotic Agents administration & dosage, Cognition drug effects, Psychotic Disorders drug therapy, Psychotic Disorders physiopathology, Schizophrenia drug therapy, Schizophrenia physiopathology
- Abstract
Background: Neurological soft signs (NSS) are proposed to represent both state- and trait-related features of schizophrenia., Method: We assessed the course of NSS with the Neurological Evaluation Scale (NES) over 12months of standardised treatment in 126 patients with first-episode schizophrenia, schizophreniform or schizoaffective disorder, and evaluated their state- and trait-related associations with psychopathology, functionality, cognition and antipsychotic treatment. We considered change scores from baseline to be state-related and endpoint scores to be trait-related., Results: Significant effects for time were recorded for all NSS domains. For state-related change-scores greater improvements in sensory integration were predicted by more improvement in working memory (p=0.01); greater improvements in motor sequencing scores were predicted by more improvement in working memory (p=0.005) and functionality (p=0.005); and greater improvements in NES Total score were predicted by more improvement in disorganised symptoms (p=0.02). There were more substantial associations between trait-related endpoint scores than for state-related change scores. For endpoint scores lower composite cognitive score predicted poorer sensory integration (p=0.001); higher Parkinsonism score predicted poorer motor co-ordination (p=0.0001); lower composite cognitive score (p=0.001) and higher Parkinsonism score (p=0.005) predicted poorer motor sequencing; higher Parkinsonism score (p=0.0001) and disorganised symptoms (p=0.04), and lower composite cognitive score (p=0.0007) predicted higher NES total score., Conclusions: NSS improved with treatment, but were weakly associated with improvements in psychopathology. Studies investigating NSS as trait-markers should ensure that patients have been optimally treated at the time of testing, and should take possible effects of extrapyramidal symptoms into account., (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Published
- 2017
- Full Text
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9. Insight and white matter fractional anisotropy in first-episode schizophrenia.
- Author
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Asmal L, du Plessis S, Vink M, Fouche JP, Chiliza B, and Emsley R
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- Adolescent, Adult, Anisotropy, Depression diagnostic imaging, Depression etiology, Diffusion Tensor Imaging, Female, Humans, Image Processing, Computer-Assisted, Male, Psychiatric Status Rating Scales, Schizophrenia complications, Schizophrenic Psychology, Young Adult, Schizophrenia diagnostic imaging, White Matter diagnostic imaging
- Abstract
Impaired insight is a hallmark feature of schizophrenia. Structural studies implicate predominantly prefrontal, cingulate, cuneus/precuneus, and inferior temporal brain regions. The cortical midline structures (CMS) are also implicated in functional studies primarily through self-reflective processing tasks. However, few studies have explored the relationship between white matter tracts and insight in schizophrenia, and none in first-episode schizophrenia (FES). Here, we examined for fractional anisotropy (FA) differences in 89 minimally treated FES patients and 98 matched controls, and identified those FA differences associated with impaired clinical insight in patients. We found widespread FA reduction in FES patients compared to controls. Poorer insight in patients was predicted by lower FA values in a number of white matter tracts with a predilection for tracts associated with cortical midline structures (fronto-occipital, cingulate, cingulate hippocampus, uncinate, anterior corona radiata), and more severe depressive symptoms. The association between FA abnormalities and insight was most robust for the awareness of symptoms and illness awareness domains. Our study implicates a network of tracts involved in impaired insight in schizophrenia with a predilection for the CMS. This study is a first step in delineating the white matter tracts involved in insight impairment in schizophrenia prior to chronicity., (Copyright © 2016. Published by Elsevier B.V.)
- Published
- 2017
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10. Dorsal striatal volumes in never-treated patients with first-episode schizophrenia before and during acute treatment.
- Author
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Emsley R, Asmal L, du Plessis S, Chiliza B, Kidd M, Carr J, and Vink M
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- Adult, Antipsychotic Agents administration & dosage, Caudate Nucleus drug effects, Double-Blind Method, Female, Flupenthixol administration & dosage, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Organ Size, Psychiatric Status Rating Scales, Psychotic Disorders psychology, Putamen drug effects, Risperidone administration & dosage, Schizophrenic Psychology, Software, Treatment Outcome, Young Adult, Caudate Nucleus pathology, Psychotic Disorders drug therapy, Psychotic Disorders pathology, Putamen pathology, Schizophrenia drug therapy, Schizophrenia pathology
- Abstract
Background: Studies of pre-and post-treatment striatal volume in schizophrenia have reported conflicting results., Materials and Methods: We assessed dorsal striatal (caudate and putamen) volumes bilaterally in 22 never-treated, non-substance-abusing patients with first-episode schizophrenia or schizophreniform disorder and 23 healthy controls matched for age, sex and educational status. Patients received either risperidone or flupenthixol long acting injection and were compared by structural MRI with controls at weeks 0, 4 and 13. T1-weighted data on a 3T MRI scanner were obtained and images were reconstructed using FreeSurfer. Treatment outcome was assessed by changes in psychopathology, insight, functionality, cognitive performance and motor symptoms., Results: Caudate, but not putamen volumes was significantly larger in patients bilaterally at baseline (P=0.01). Linear mixed effects repeated measures found no significant group × time interactions for any of the regions. Caudate volume was not significantly associated with improvements in psychotic symptoms. Also, the findings of a regression model were inconsistent insofar as larger caudate volume was associated with less improvement in depression scores, greater improvement in functionality and greater improvement in verbal learning but less improvement in reasoning and problem solving (left caudate) and composite cognitive score (right caudate)., Conclusions: The increased caudate volumes prior to treatment are contrary to previous reports in never-treated patients with first-episode schizophrenia, and together with our failure to demonstrate volume changes related to acute treatment, call into question previous proposals that enlarged caudate volume is a consequence of antipsychotic treatment., (Copyright © 2015 Elsevier B.V. All rights reserved.)
- Published
- 2015
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11. Re: Less is more.
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Emsley R, Chiliza B, Asmal L, du Plessis S, Phahladira L, van Niekerk E, van Rensburg SJ, and Harvey BH
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- Female, Humans, Male, Antioxidants therapeutic use, Docosahexaenoic Acids therapeutic use, Eicosapentaenoic Acid therapeutic use, Psychotropic Drugs therapeutic use, Schizophrenia drug therapy, Thioctic Acid therapeutic use
- Published
- 2014
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12. A randomized, controlled trial of omega-3 fatty acids plus an antioxidant for relapse prevention after antipsychotic discontinuation in first-episode schizophrenia.
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Emsley R, Chiliza B, Asmal L, du Plessis S, Phahladira L, van Niekerk E, van Rensburg SJ, and Harvey BH
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- Adult, Antipsychotic Agents therapeutic use, Double-Blind Method, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Psychiatric Status Rating Scales, Secondary Prevention, Time Factors, Treatment Outcome, Antioxidants therapeutic use, Docosahexaenoic Acids therapeutic use, Eicosapentaenoic Acid therapeutic use, Psychotropic Drugs therapeutic use, Schizophrenia drug therapy, Thioctic Acid therapeutic use
- Abstract
Background: While antipsychotics are effective in the maintenance treatment of schizophrenia they have safety and tolerability risks. We investigated whether a combination of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) and a metabolic antioxidant, alpha-lipoic acid (α-LA), is effective in preventing relapse after antipsychotic discontinuation in subjects who were successfully treated for 2-3 years after a first-episode of schizophrenia, schizo-affective or schizophreniform disorder., Methods: In this randomized, double-blind, placebo controlled study antipsychotic treatment was tapered and discontinued and participants received either ω-3 PUFAs (eicosapentaenoic acid 2g/day and docosahexaenoic acid 1g/day)+α-LA 300 mg/day or placebo. Subjects were followed up for two years, or until relapse., Results: Recruitment was terminated prematurely due to the high relapse rates in both treatment groups as well as the severity of some of the relapse episodes. Of the 33 participants, 19/21(90%) randomized to ω-3 PUFAs+α-LA relapsed and one (5%) completed two years without relapse (p=0.6); and 9/12 (75%) randomized to placebo relapsed and none completed two years without relapse. Mean times to relapse were 39.8 ± 25.4 and 38.3 ± 26.6 weeks for the ω-3 PUFAs+α-LA and placebo groups, respectively (p=0.9). There were no significant differences between the groups in relapse symptom severity., Conclusions: We found no evidence that ω-3 PUFAs+α-LA could be a suitable alternative to maintenance antipsychotic treatment in relapse prevention, in this small study. Antipsychotic discontinuation after a single episode of schizophrenia carries a very high risk of relapse, and treatment guidelines endorsing this practice should be revised., (Copyright © 2014 Elsevier B.V. All rights reserved.)
- Published
- 2014
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13. The evidence for illness progression after relapse in schizophrenia.
- Author
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Emsley R, Chiliza B, and Asmal L
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- Disease Progression, Humans, Randomized Controlled Trials as Topic, Schizophrenia drug therapy, Secondary Prevention, Treatment Outcome, Schizophrenia diagnosis, Schizophrenia physiopathology
- Abstract
It has long been suspected that relapse in schizophrenia is associated with disease progression in so far as time to response is longer, negative and other symptoms persist, some patients become treatment refractory and neuroprogression in terms of structural brain changes may occur. This article examines the evidence for illness progression after relapse in patients with schizophrenia. It reports on indirect evidence obtained from retrospective, naturalistic and brain-imaging studies, as well as a few prospective studies examining pre- and post-relapse treatment response. Findings suggest that the treatment response after relapse is variable, with many patients responding rapidly, others exhibiting protracted impairment of response and a subgroup displaying emergent refractoriness. This subgroup comprises about 1 in 6 patients, irrespective of whether it is the first or a subsequent relapse, and even when the delay between onset of first symptoms of relapse and initiation of treatment is brief. While there is a lack of well-designed studies investigating the post-relapse treatment outcome, available evidence gives sufficient cause for concern that, in addition to the considerable psychosocial risks, an additional risk of biological harm may be associated with relapse., (Copyright © 2013 Elsevier B.V. All rights reserved.)
- Published
- 2013
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14. The 2nd Schizophrenia International Research Society Conference, 10-14 April 2010, Florence, Italy: summaries of oral sessions.
- Author
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Baharnoori M, Bartholomeusz C, Boucher AA, Buchy L, Chaddock C, Chiliza B, Föcking M, Fornito A, Gallego JA, Hori H, Huf G, Jabbar GA, Kang SH, El Kissi Y, Merchán-Naranjo J, Modinos G, Abdel-Fadeel NA, Neubeck AK, Ng HP, Novak G, Owolabi OO, Prata DP, Rao NP, Riecansky I, Smith DC, Souza RP, Thienel R, Trotman HD, Uchida H, Woodberry KA, O'Shea A, and DeLisi LE
- Subjects
- Animals, Disease Models, Animal, Humans, International Agencies, Societies, Scientific, Brain pathology, Cognition, Schizophrenia diagnosis, Schizophrenia genetics, Schizophrenia pathology, Schizophrenia therapy, Schizophrenic Psychology
- Abstract
The 2nd Schizophrenia International Research Society Conference, was held in Florence, Italy, April 10-15, 2010. Student travel awardees served as rapporteurs of each oral session and focused their summaries on the most significant findings that emerged from each session and the discussions that followed. The following report is a composite of these reviews. It is hoped that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research., (Copyright © 2010 Elsevier B.V. All rights reserved.)
- Published
- 2010
- Full Text
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15. Bilingualism and psychosis: a case report.
- Author
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Schoeman R, Chiliza B, Emsley R, and Southwood F
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- Adult, Cognition Disorders diagnosis, Cognition Disorders psychology, Humans, Interview, Psychological, Male, Psychiatric Status Rating Scales statistics & numerical data, Psychometrics, South Africa ethnology, Multilingualism, Schizophrenia diagnosis, Schizophrenic Language, Schizophrenic Psychology
- Published
- 2008
- Full Text
- View/download PDF
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