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First-episode schizophrenia: A follow-up study on neurological soft signs
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2. Phenomenology DO FAMILY ENVIRONMENT AND SOCIAL SUPPORT PREDICT PSYCHOPATHOLOGY IN PUTATIVE SCHIZOTYPES? K. A. A d a m s , * L. Collins, W. L e u n g , K. Tervo, M. Aghevli, J. J. B l a n c h a r d
Psychology, University of Maryland, College Park, College Park, MD, USA Social anhedonia has been identified by previous psychometric highrisk studies as a potential indicator of schizotypy. However, the mechanism by which family environment an d other forms of social support might interact with social anhedonia in the development of schizophrenia has not been delineated. This has potential implications in determining who may be at higher risk for schizophrenia. Evidence suggests that the level of emotional expressivity in a household may predict the course of psychotic disorder in certain individuals. In the proposed poster, we will report on findings from an ongoing longitudinal study of socially anhedonic and control subjects recruited from a heterogeneous community sample. These 18-yearold subjects completed a measure of family enviromnent and reported on the quantity and quality of social supports they received. In addition, all participants underwent two semi-structured diagnostic interviews. It is hypothesized that, compared to control subjects, socially anhedonic subjects will live in households characterized by higher incidences of negative interactions among family members and will report less social support. Within socially anhedonic subjects, we will also examine the hypothesis that a more supportive family environment and greater social support may serve as protective factors such that these characteristics will be associated with less psychopathology. This study is funded by a grant from the National Institute of Mental Health.
THE PSYCHOPATHOLOG OF TREATMENT RESISTANCE SCHIZOPHRENIA: A FACTOR ANALYSIS USING THE BPRS-A T. M. A l v e s , * H. Elkis
Psychiatly, Projesq- lnstituto de Psiquiatria-Hospital das Clinicas, Sdo Paulo, SP,,Brazil Background: There are many factor analyses which have shown that the standard version of the BPRS has at least 4 factors namely: thought disorder, withdrawal/retardation, hostility/suspiciousness and anxiety/depression. The anchored version of BPRS (BPRS-A) is considered a more reliable version of the instrument but only one factor analysis was performed based on data from very heterogeneous population in terms of psychiatric diagnosis. There are also only one factor analysis of the BPRS in patients with Treatment Resistant Schizophrenia (TRS) but it was base on the standard version: The aim of the present study is to factor analyze psychopathological baseline data obtained from an homogeneous sample of strictly defined TRS which was entering in a trial with clozapine and which was evaluated by the BPRS-A. Methods: 96 TRS patients as defined by Kane's et al criteria(1988) were evaluated by the BPRSA at baseline before initiating treatment with clozapine. Reliability of the scale was high and was reported previously elsewhere. 69 were men and 27 were women. Mean (sd) age was 33.6 (9) y.o., mean (sd) age of onset y,o. was 19.3 (4.9) and they have been ill for 14 (7.3) years. A factor analysis with varimax rotation was performed and
the Kayser-Meyer-Olkin (KMO) measure of sampling adequacy calculated and the Bartlett test of sphericity (BTS) was obtained. Results: A initial factor solution revealed 5 factors with loadings higher than 0.5: excitement, disorganized/negative, psychotic, depressive and anxiety with a KMO of 0.70 and the BTS was 773 (p=0.001). Based on the dendogram of a cluster analyses of the same 18 baseline symptoms we could very that the items somatic concern and anxiety fitted not so well among the other factors and we tested the hypothesis if we could obtain a better fit eliminating these two items. The factor analyses showed 4 items which were : negative/ disorganization, excitement, depression and psychotic. The KMO was 0.714 and the BTS was 701 (p=0.001). Conclusions: As defined by the BPRS-A the main psychopathological symptoms of patients with TRS are: psychotic, negative/disorganization, depression and excitement.
FIRST-EPISODE SCHIZOPHRENIA: A FOLLOWUP STUDY ON NEUROLOGICAL SOFT SIGNS S. B a c h m a n n , * C. Bottmer, D. Weimer, J. S c h r 6 d e r
Dept. of Psychiatry, University of Heidelberg, Heidelberg, Germany The presence of neurological soft signs (NSS) has been shown in treated as well as in untreated schizophrenia. Levels of NSS expression differ according to symptomatology and subsyndromes. However, it is unclear whether the character of NSS is state- or trait-like and whether or not they can be used as a predictor of outcome. We studied 39 patients (21 female, 18 male, age 27.0 years +/- 7.7) during their first treatment for schizophrenia, schizoaffective or schizophreniform disorder. A follow-up examination was performed after 14.2 months +/- 1.6, NSS were rated with the Heidelberg scale on remission and on follow-up. Handedness was assessed by the Edinburgh inventory, diagnoses by SCID for DSM-IV, psychopathology by PANSS, predictors of early course by SCS, and side-effects of medication by AIMS, the Simpson/Angus and the Barnes scales. The overall initial treatment response was good, and 85% of patients were compliant with outpatient treatment, On follow-up period 30 patients were recoverd on a syndromal level. Relapses had occured in 13 cases, 5 patients had been continuously ill. Between remission and follow-up NSS scores decreased significantly (remission: 15.7 +/- 7.1; follow-up: 10.1 +/- 7.9; p < .001), although the level of psychopathology remained unchanged. Correlations were detected between NSS and the SCS as well as negative symptoms. According to our results it seems likely that NSS are a state variable and might be used as a predictor of outcome in first-episode schizophrenia.
THE PROFILE OF SCHIZOTYPY IN A NORMAL (STUDENT) POPULATION E. J. Barkus,* J. StMing, S. Lewis, R. H o p k i n s
Dept. of Psychology and Speech Pathology, Manchester Metropolitan University, Manchestez United Kingdom Schizotypy traits in non-clinical populations provide comparative models for schizotypy features in clinical illness. Using the Oxford Liverpool Inventory of Feelings and Experiences (O-LIFE) and the Launay-Slade Hallucinations Scale (LSHS) schizotypy traits in 978 students were recorded. The mean age of the sample was 22.7 years and there were 326 males and 645 females. This is the first large scale study using both the O-LIFE and the LSHS. 9.2% of the sample reported having been troubled by hearing voices, 8.8% had heard the voice of God, and 4.4% had heard the voice of the Devil, Items con-
International Congress on Schizophrenia Research 2003
2. Phenomenology DO FAMILY ENVIRONMENT AND SOCIAL SUPPORT PREDICT PSYCHOPATHOLOGY IN PUTATIVE SCHIZOTYPES? K. A. A d a m s , * L. Collins, W. L e u n g , K. Tervo, M. Aghevli, J. J. B l a n c h a r d
Psychology, University of Maryland, College Park, College Park, MD, USA Social anhedonia has been identified by previous psychometric highrisk studies as a potential indicator of schizotypy. However, the mechanism by which family environment an d other forms of social support might interact with social anhedonia in the development of schizophrenia has not been delineated. This has potential implications in determining who may be at higher risk for schizophrenia. Evidence suggests that the level of emotional expressivity in a household may predict the course of psychotic disorder in certain individuals. In the proposed poster, we will report on findings from an ongoing longitudinal study of socially anhedonic and control subjects recruited from a heterogeneous community sample. These 18-yearold subjects completed a measure of family enviromnent and reported on the quantity and quality of social supports they received. In addition, all participants underwent two semi-structured diagnostic interviews. It is hypothesized that, compared to control subjects, socially anhedonic subjects will live in households characterized by higher incidences of negative interactions among family members and will report less social support. Within socially anhedonic subjects, we will also examine the hypothesis that a more supportive family environment and greater social support may serve as protective factors such that these characteristics will be associated with less psychopathology. This study is funded by a grant from the National Institute of Mental Health.
THE PSYCHOPATHOLOG OF TREATMENT RESISTANCE SCHIZOPHRENIA: A FACTOR ANALYSIS USING THE BPRS-A T. M. A l v e s , * H. Elkis
Psychiatly, Projesq- lnstituto de Psiquiatria-Hospital das Clinicas, Sdo Paulo, SP,,Brazil Background: There are many factor analyses which have shown that the standard version of the BPRS has at least 4 factors namely: thought disorder, withdrawal/retardation, hostility/suspiciousness and anxiety/depression. The anchored version of BPRS (BPRS-A) is considered a more reliable version of the instrument but only one factor analysis was performed based on data from very heterogeneous population in terms of psychiatric diagnosis. There are also only one factor analysis of the BPRS in patients with Treatment Resistant Schizophrenia (TRS) but it was base on the standard version: The aim of the present study is to factor analyze psychopathological baseline data obtained from an homogeneous sample of strictly defined TRS which was entering in a trial with clozapine and which was evaluated by the BPRS-A. Methods: 96 TRS patients as defined by Kane's et al criteria(1988) were evaluated by the BPRSA at baseline before initiating treatment with clozapine. Reliability of the scale was high and was reported previously elsewhere. 69 were men and 27 were women. Mean (sd) age was 33.6 (9) y.o., mean (sd) age of onset y,o. was 19.3 (4.9) and they have been ill for 14 (7.3) years. A factor analysis with varimax rotation was performed and
the Kayser-Meyer-Olkin (KMO) measure of sampling adequacy calculated and the Bartlett test of sphericity (BTS) was obtained. Results: A initial factor solution revealed 5 factors with loadings higher than 0.5: excitement, disorganized/negative, psychotic, depressive and anxiety with a KMO of 0.70 and the BTS was 773 (p=0.001). Based on the dendogram of a cluster analyses of the same 18 baseline symptoms we could very that the items somatic concern and anxiety fitted not so well among the other factors and we tested the hypothesis if we could obtain a better fit eliminating these two items. The factor analyses showed 4 items which were : negative/ disorganization, excitement, depression and psychotic. The KMO was 0.714 and the BTS was 701 (p=0.001). Conclusions: As defined by the BPRS-A the main psychopathological symptoms of patients with TRS are: psychotic, negative/disorganization, depression and excitement.
FIRST-EPISODE SCHIZOPHRENIA: A FOLLOWUP STUDY ON NEUROLOGICAL SOFT SIGNS S. B a c h m a n n , * C. Bottmer, D. Weimer, J. S c h r 6 d e r
Dept. of Psychiatry, University of Heidelberg, Heidelberg, Germany The presence of neurological soft signs (NSS) has been shown in treated as well as in untreated schizophrenia. Levels of NSS expression differ according to symptomatology and subsyndromes. However, it is unclear whether the character of NSS is state- or trait-like and whether or not they can be used as a predictor of outcome. We studied 39 patients (21 female, 18 male, age 27.0 years +/- 7.7) during their first treatment for schizophrenia, schizoaffective or schizophreniform disorder. A follow-up examination was performed after 14.2 months +/- 1.6, NSS were rated with the Heidelberg scale on remission and on follow-up. Handedness was assessed by the Edinburgh inventory, diagnoses by SCID for DSM-IV, psychopathology by PANSS, predictors of early course by SCS, and side-effects of medication by AIMS, the Simpson/Angus and the Barnes scales. The overall initial treatment response was good, and 85% of patients were compliant with outpatient treatment, On follow-up period 30 patients were recoverd on a syndromal level. Relapses had occured in 13 cases, 5 patients had been continuously ill. Between remission and follow-up NSS scores decreased significantly (remission: 15.7 +/- 7.1; follow-up: 10.1 +/- 7.9; p < .001), although the level of psychopathology remained unchanged. Correlations were detected between NSS and the SCS as well as negative symptoms. According to our results it seems likely that NSS are a state variable and might be used as a predictor of outcome in first-episode schizophrenia.
THE PROFILE OF SCHIZOTYPY IN A NORMAL (STUDENT) POPULATION E. J. Barkus,* J. StMing, S. Lewis, R. H o p k i n s
Dept. of Psychology and Speech Pathology, Manchester Metropolitan University, Manchestez United Kingdom Schizotypy traits in non-clinical populations provide comparative models for schizotypy features in clinical illness. Using the Oxford Liverpool Inventory of Feelings and Experiences (O-LIFE) and the Launay-Slade Hallucinations Scale (LSHS) schizotypy traits in 978 students were recorded. The mean age of the sample was 22.7 years and there were 326 males and 645 females. This is the first large scale study using both the O-LIFE and the LSHS. 9.2% of the sample reported having been troubled by hearing voices, 8.8% had heard the voice of God, and 4.4% had heard the voice of the Devil, Items con-
International Congress on Schizophrenia Research 2003