Online ISSN: 2515-8260

Keywords : schizophrenia

A Cross-Sectional Study of Association between Treatment Adherence & Medication in Pateints with Schizophrenia

Aliya Farheen, Suresh Reddy K., G. Surekha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 4020-4029

Background: Schizophrenia is the most incapacitating mental disorder, with a lifetime prevalence of 1% and symptoms often appearing in late adolescence or early adulthood. It is characterised by delusions, hallucinations, disorganised speech, grossly disorganised behaviour or catatonic behaviour, negative symptoms. Antipsychotic (neuroleptic) medications are an essential part of schizophrenia treatment. To keep symptoms under control and prevent relapse, effective care necessitates long-term treatment. Medication adherence can be defined as the extent to which the patient’s medication taking matches that agreed with the prescriber. The current study focusses on medication adherence & various illness related factors. To study relationship between medication adherence & severity of schizophrenia, antipsychotic medication & its adherence, antipsychotic medication & its side effects in patients with schizophrenia.
Materials and Methods: It is a cross sectional study conducted in 60 subjects aged 18 – 55 yrs fulfilling the criteria for schizophrenia as per ICD-10 classification. Information collected was intake proforma, Positive and Negative Syndrome Scale (PANSS) scale to assess symptoms severity, Drug Attitude Inventory (DAI-30) to assess positive or negative attitude towards treatment adherence, Udvalg for Kliniske Undersogelser (UKU) side effect scale to assess the side effects of antipsychotics. To assess overall severity of schizophrenia PANSS was compared with CGI scale (clinical global impression scale). A score of (58-74) was considered minimally ill, (75-94) as mildly ill, (95-115) as moderately ill & (=/> 116) as severely ill. The antipsychotics used by the patients in our study are Olanzapine (n=23), Risperidone (n=18), Amisulpride (n=15), clozapine (n=2), Cariprazine (n=1), Trifluoperazine (n=1).


Dr. A. Kowsalya Dr. Mathivanan Dr KN Lavanya

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 247-253

Various Studies have shown that the early- and late-onset schizophrenia patients differ and accompanied by impairments in several domains of cognitive function. Hence studying Cognitive impairment will be helpful to understand pathology and phenomenology of schizophrenia and giving cognitive remediation therapy in a better way.
To evaluate the neurocognitive impairment in Early-onset Schizophrenia and Late-onset Schizophrenia. To find out difference in severity of neurocognitive impairment between two groups.
Materials and methods
This study was approved by Institutional Ethical Committee, Madras Medical College, Tamil Nadu, India. The study subjects were taken from the Institute of mental health hospital.  For each group, 150 samples were taken. Administration of NIMHANS neuropsychological battery to both groups testing domains of, Working memory, Verbal learning & memory,  Auditory verbal learning test, Visual learning & memory and Mental speed. The results were statistically evaluated with IBM SPSS 20.
Verbal N Back test hits were comparatively higher in late onset schizophrenia patients than early onset. Similarly the error was more in early onset schizophrenia patients. Visual N Back test hits were comparatively higher in late onset schizophrenia patients than early onset. Similarly the error was more in early onset schizophrenia patients. The time taken was similar in both the groups. The error due to digital vigilance test was more in early onset schizophrenia patients. The time taken for color trail test was significantly higher in early onset schizophrenia patients. The time taken for complex figure test was significantly higher in late onset schizophrenia patients. The time taken for Digital symbol substitution test was significantly higher in early onset schizophrenia patients.
In this study, early onset schizophrenia patients had more cognitive impairment than late onset schizophrenia patients in most of the measured cognitive domains.

Association of caregiver burden with cognition in persons suffering from Schizophrenia

Dr. SVR Naga Pavan Kumar Kampalli, Dr. Prasanna Kumar Neredumilli, Dr. Phaniram Vavila

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 39-45

Introduction: Schizophrenia is a chronic psychiatric illness which ahas enormous impact on the persons suffering from the illness as well as the persons taking care of them. Cognitive deficits are common in the persons suffering from Schizophrenia, which further lead to impairment in the daily living of the individual. Caregiving of persons with Schizophrenia places a significant burden on the caretakers and this study tries to study the association between the caregiver burden and the cognitive deficits in persons suffering from Schizophrenia.
1)      To measure the cognitive deficits in persons suffering from Schizophrenia.
2)      To find the caregiver burden in the caregivers of persons suffering from Schizophrenia.
3)      To find the relationship between the caregiver burden with cognition of persons suffering from Schizophrenia.
Materials and Methods: This is an cross-sectional study and the study sample consisted of 60 persons suffering from Schizophrenia and their respective caregivers attending the Government Hospital for Mental Care, Visakhapatnam. Persons suffering from Schizophrenia’ cognitive status was assessed using the Cognitive Assessment Interview (CAI). Caregivers’ sociodemographic data was taken and the caregivers’ burden was assessed using the Burden Assessment Schedule (BAS). Statistical analysis of the data was carried out using SPSS software version 23.
Results: The mean Global Cognitive assessment score was 2.73 with a S.D. of 0.74. The mean score of caregiver burden according to the BAS was 76.9 with a S.D. of 6.7. There was a statistically significant correlation between the global cognitive score and the caregiver burden (r=0.783, p<0.01).
Conclusions: This study concludes that there is cognitive impairment seen in persons suffering from Schizophrenia. Caregivers of persons suffering from Schizophrenia have significant burden. There is a significant correlation between the cognitive impairment and the caregiver burden.

Therapeutic outcome and monitoring of patients coming to psychiatry OPD with schizophrenia in tertiary care hospital of northern India: A prospective observational study

Mithlesh Kumar, Suyog Sindhu, Narendra Kumar, Arpita Singh, Vivek Aggrawal, Rajendra Nath, Rakesh K Dixit, Amod K Sachan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10888-10889

Introduction- Schizophrenia is a chronic, multifaceted mental health illness marked
by a variety of symptoms, including delusions, hallucinations, disorganized speech
or behaviours, and cognitive impairment. The purpose of this study is to track and
evaluate the effects and results of schizophrenia disorder treatment.
Method- This prospective observational research was performed from December
2019 to December 2021. The study participants were patients suffering from
schizophrenia (according to DSM-5 criteria) who were treated at the tertiary care
centre, Overall, 62 patients were included in the study as cases according to
inclusion/exclusion criteria. Further, the demographic and clinical variables of
patients were collected with a personal information form.
Results- The mean age of the total enrolled cases was 49.62±5.87, with male
dominance was observed. Furthermore, in the case of FROGS SCALE, maximum
mean was reported for the category of the frogs general, i.e. 48.02±15.21and
minimum was observed for the category of Occupational functioning, i.e. 5.23±2.02.
In the case of WHOQOL-BREF SCALE maximum mean was reported for the
category of the Environment domain, i.e. 13.81±2.99 and the minimum was
observed for the category of Social domain, i.e. 10.76±3.80. Also, as per the MARS
Score, the mean with the range of 0-10 was 4.05±2.99, the median was 5 and the
interquartile range was 2-6. Lastly, the maximum mean was reported for the
category of the Environment domain, i.e. 26.23±4.87 and the minimum was observed
for the category of Social domain, i.e. 10.37±2.02, in the case of quality of life (QOL).
Conclusion- Our research reveals the strong association between QOL perception
and functional recovery in a group of schizophrenia patients with low levels of
functional recovery.

Study of Soft Neurological Signs in Schizophrenia Patients

Pruthvi Reddy Muddasani, Charan Teja Koganti, Janagam Sheetal Reddy

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 6085-6093

Background:Soft neurological symptoms have been observed in patients with
schizophrenia. Several studies have shown neurological abnormalities in schizophrenia
patients, but their presence has been complicated by a number of potentially
confounding variables such as the duration of the illness, drug doses, and the use of
diverse assessment methodologies. Soft neurological symptoms appear to be a
characteristic component of schizophrenia as well as a probable biological indication of
prognosis. As a result, early detection and action may result in a better prognosis. The
assessment of soft neurological symptoms is a straightforward, simple, and low-cost
method of determining the severity of brain dysfunction in schizophrenia. The
relationship between the presence of schizophrenia and soft neurological symptoms in a
patient has not been widely examined in the context of the Indian population. As a
result, the purpose of this study is to assess the presence of mild neurological symptoms
in individuals with schizophrenia.
Materials and Methods: 80 subjects, 40 patients with schizophrenia and 40 healthy
matched controls were evaluated. Tools used were PANSS for evaluation of
symptomatology in schizophrenia patients, NES for evaluation of neurological soft
signs, MMSE for evaluation of cognitive functions and SESS for evaluation of socioeconomic
Results: When compared to controls, patients with schizophrenia had significantly
higher NES scores. Age, gender, educational position, and disease duration show no link
with the existence of soft neurological symptoms in individuals with schizophrenia,
according to socio-demographic and clinical characteristics. There are statistically
significantpositive associations between the PANSS negative symptom subscale, the
Total PANSS score, and the NES scores in patients with schizophrenia. In
schizophrenia patients, there is a substantial negative connection between the Total
NES score and the Total MMSE score.
Conclusion: Wound infection following previous surgery was the most important risk
factor associated with incisional hernia. The other risk factors were obesity and COPD.
Polypropylene mesh repair is superior to anatomical repair as it has less recurrence.

Assessment of thyroid dysfunction among different psychiatric disorders

Dileep Singh Verma, Bhagyashree Garasia, Amrit Ku Gausai, Suresh Gocher, Sushil Kherada

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2301-2308

Thyroid hormone abnormality is mutual in foremost psychiatric disorders. Thyroid hormones play critical function in the method of Neurogenesis and Neurodevelopment i.e., Myelination, dendrite proliferation and formation of synapses. There is link among thyroid axis and several experienced psychiatric disorders. Noteworthy results on cerebral thyroid characteristic are observed while there are even small variations in thyroid hormone levels, within the normal range. Alterations in mood, behaviour and cognition are resulting from this. Depression, psychosis and cognitive disorder are observed in the patients of hypothyroidism. Meanwhile, people with hyperthyroidism had been observed to have psychosis, aggression, anxiety as well as cognitive impairment. Memory impairment is related with Subclinical hypothyroidism.
The objective of this study was to analyse the socio-demographic profile with assessment and comparison the type of thyroid dysfunction among patients with major psychiatric disorders. This was a cross-Sectional Observational study on 166 patient samples. Assess serum thyroid stimulating hormone (TSH), T3 (triiodothyroxine), T4 (L-thyroxine), free unbound fractions of T3 and T4 (FT3 and FT4) with the COBAS e 411 ANALYSER at Kalpana path lab, R.M.R.S.M.B. govt. hospital, Udaipur for all recruited patients.
Result of our study is that thyroid dysfunction occurs significantly in patients with psychiatric disorders. Subclinical hypothyroidism was the most common abnormality observed in the study population. Thyroid dysfunctions were predominant in females. Most of the cases with thyroid dysfunction were from rural area and age group 41-50 years. In present study, 25% of total cases drug naïve for ≥ 6 months and 10.6% of total new cases had thyroid dysfunction. Most of the cases with thyroid dysfunction were related to F20-F29 block. Isolated increased FT4 level found in significant proportion of population. This is a useful finding as this calls for frequent monitoring of Thyroid function tests in all psychiatric patients on treatment, to enable proper management.

Features of the Metabolic Syndrome and Type 2 Diabetes Mellitus in Schizotypal Disorder

Oleg V. Ermilov; Andrey Yu. Tretyakov; Lyubov V. Romasenko; Nina I. Zhernakova; Elizaveta S. Rudycheva; Inna V. Tikhonova; Irina A. Misan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 122-127

Objective: To describe the features and mechanisms of development of metabolic
syndrome (MS), type 2 diabetes melitus (DM2) and intermediate states of glycemia in
psychosis the occurrence of these disorders, the values of total cholesterol (TC),
fractions of high density lipoproteins (HDL), very low density lipoproteins (VLDL),
triglycerides (TG), values of atherogenic coefficient (AC), insulinemia, С-peptidemia,
insulin resistance (IR) the level of glycated hemoglobin (HbA1c) in a sample of patients
with schizophrenia and in mentally healthy individuals.
Materials and methods: The frequency of carbohydrate metabolism disorders (CMD) was
studied. Fasting glycemia was determined, and in the presence of its violation, a glucose
tolerance test was performed. MS components were studied in patients with DM2,
plasma concentrations of TC, HDL, VLDL, TG, C-peptide (CP), insulin and HbA1c were
determined in patients with DM2, AC values and IR indices were calculated using
HOMA-IR and CARO criteria.
Results: CMD in schizophrenia are more common than among mentally healthy subjects,
amounting to 13.1% (p=0.02), and the main condition here is a significant number of
individuals with impaired fasting glycemia (IFG) and impaired glucose tolerance (IGT)
among women (CMD p=0.01; IGT p<0.001; IFG p=0.03). A feature of psychiatric
sampling is a decrease in HDL by 16.4% (p=0.03) and an increase in AC by 52%
(p=0.02). Mentally ill men with MS are characterized by a significantly large value of AC
(p=0.019), insulinemia (p=0.02), CP level (p=0.02), HOMA-IR (p=0.01) and CARO
(p=0.04) values than in mentally ill patients with DM2 without MS. In comparison with
the control, regardless of gender, the schizophrenic patients with DM2 have significantly
lower values of insulin (p=0.03), C-peptidemia (p=0.04) and IR, according to the criteria of
HOMA-IR (p=0.01) and CARO (p=0.03).


Rashmi Shukla; Dr. Ajinkya Ghogare; Dr. Pradeep Patil

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 2113-2121

Background: Schizophrenia is characterized by disordered thoughts, emotions, perceptions, language, sense of self and behavior. Primary caregivers of individuals with Schizophrenia encounter comprehensive care giving challenges that causes physical as well as mental stress and can deteriorate the family functioning. However, if primary caregivers are resilient enough with strong and positive mindset, they can overcome burden associated with patient care and preserve own health and health of family as well.
Aim: To assess the relationship between depression, anxiety, stress and resilience perceived by primary caregivers of persons with Schizophrenia 
Materials and Methods: Primary caregivers of person diagnosed with Schizophrenia disease reporting to OPD and IPD of Department of Psychiatry of Medical College as per DSM-5 diagnostic criteria will be assessed for depression, anxiety, stress and resilience after taking informed consent for the study by applying inclusion and exclusion criteria. Then psychological scales will be applied on these primary caregivers. The Depression Anxiety and Stress (DASS-21) and Brief Resilience Scale (BRS) scales will be applied and accordingly the points will be given.
Conclusion: We expect to find significant relationship between depression, anxiety, stress and resilience perceived by caregivers of persons with Schizophrenia.

Determinant Factors Related to Relapse of Schizoprenic Patients at the Islamic Mental Hospital

MahyarSuara .; Sandeep Poddar; Roy Rillera Marzo

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 129-139

Background: During the last century, there has been a high increase in health problems in the world, including Indonesia, one of it is mental health. The actual prevalence of mental health disorders worldwide remains poorly understood. Mental health is very much underreported, and under-diagnosed.
The purpose of this study was to identify factors associated with schizophrenia relapse of patients at the Islamic Mental Hospital in Jakarta, Indonesia.
Settings and Design
The research method with a quantitative approach was performed with a total sample comprisedof 150 respondents using primary data.
Material and Methods
The data collection method used was library research, field research (observation), and questionnaire research design through a cross-sectional approach.
Statistical Analysis
Univariate analysis process (frequency distribution) and Bivariate analysis with the Chi-square test and multi-variate with path analysis was used in this study
Based on the results of the validity of the instrument, the variable of compliance for taking medication (X1), Stress variable (X2), Drug Abuse variable (X3), the Psychology variable (X4), the variable of Emotional Expression (X5), Relapse among schizophrenic patients (Y) was considered. The results revealed that the correlation of the adherence to the antipsychotic drugs consumption (X1), stress level (X2), and psychological response (X4) to the relapse in schizophrenia patients (Z) is acceptable, whereas the strongest or dominant correlation is the stress factor (X2).
The results of this study can provide a plan for schizophrenic patients in the country. Since schizophrenic patients need medication and treatment for a long time, the researchers recommend for the government to provide medical assistance.