Methods: 40 schizophrenia outpatients who wante
d to stop smoking participate
d. Four separate groups with 10 subjects were hel
d for 7 sessions. A
dherence to the mo
difie
d program was monitore
d. Assessments inclu
de
d the Positive an
d Negative Syn
drome Scale, the Simpson-Angus Scale, nicotine
depen
dence, an
d urine cotinine were a
dministere
d pre-group, post-group an
d at 3 months.
Results: Sixteen (40 % ) had stopped smoking post-group and seven (18 % ) remained abstinent at three months. These changes were significant (p < 0.001) and are comparable to quit rates for non-psychiatric populations. There was significant improvement of nicotine dependence (p < 0.001) and no changes in symptoms. Most of those who quit used transdermal nicotine. These results suggest that stopping smoking is possible for individuals with schizophrenia especially if the treatment is specifically designed for this population.div>div>
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Schizophrenia Research, Volume 68, Issues 2-3, 1 June 2004, Pages 331-337
Jean-Pierre Lindenmayer, Eileen Brown, Robert W. Baker, Leslie M. Schuh, Lixin Shao, Mauricio Tohen, Saeeduddin Ahmed, Virginia L. Stauffer
Abstract
<div class=""mlktScroll""><div style=""line-height:150 % "">Background: We sought to develop and validate an excitement subscale from the Positive and Negative Syndrome Scale (PANSS) to allow the investigation of mania-like excitement symptoms in clinical trials of patients with schizophrenia using the PANSS and to provide clinicians with a short assessment tool for these states. Methods: Baseline PANSS data from six double-blind, randomized registration trials of olanzapine, three in schizophrenia and three in acute bipolar mania, were used in these post-hoc analyses. Schizophrenia study data were pooled and randomly split in half. Exploratory principal component factor analysis was performed on half of the data. Factors were extracted based on minimum eigenvalue criteria (eigenvalue≥1); loadings were determined using an equamax rotation. Confirmatory principal component factor analysis was performed on the other half of the data, retaining the original number of factors. Principal component factor analysis was also done for the pooled bipolar studies. Change in the new mania-like factor scores was then correlated with Young Mania Rating Scale (Y-MRS) scores in each bipolar study. Results: Exploratory principal components analysis on the pooled schizophrenia data extracted five factors: negative, positive, excitement, cognitive, and depressive factors. The mania-like excitement factor was represented by four items (uncooperativeness, poor impulse control, excitement, and hostility), with only moderate loadings by tension and suspiciousness/persecution. Results were similar in the confirmatory analysis and the pooled bipolar studies. Change from baseline to endpoint for the mania-like factor correlated reasonably well (0.64–0.78) with change in Y-MRS scores in the bipolar studies. At baseline, bipolar patients scored higher than patients with schizophrenia on three of four PANSS mania-like factor items: poor impulse control, excitement, and hostility; the converse was true for most other PANSS items. Conclusion: Factor analyses of the PANSS consistently uncovered an excitement factor including uncooperativeness, poor impulse control, excitement, and hostility items. This factor may be useful in examining manic symptoms in studies where the addition of a scale specific to mania would be burdensome and where symptoms of excitement are part of the clinical presentation.div>div>
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Biological Psychiatry, Volume 57, Issue 6, 15 March 2005, Pages 594-608
Deepak Cyril D’Souza, Walid Michel Abi-Saab, Steven Madonick, Kimberlee Forselius-Bielen, Anne Doersch, Gabriel Braley, Ralitza Gueorguieva, Thomas B. Cooper, John Harrison Krystal
Abstract
<div class=""mlktScroll""><div style=""line-height:150 % "">Background
Recent advances in the neurobiology of cannabinoids have renewed interest in the association between cannabis and psychotic disorders.Methods
In a 3-day, double-blind, randomized, placebo-controlled study, the behavioral, cognitive, motor, and endocrine effects of 0 mg, 2.5 mg, and 5 mg intravenous Δ-9-tetrahydrocannabinol (Δ-9-THC) were characterized in 13 stable, antipsychotic-treated schizophrenia patients. These data were compared with effects in healthy subjects reported elsewhere.
Results
Delta-9-tetrahydrocannabinol transiently increased 1) learning and recall deficits; 2) positive, negative, and general schizophrenia symptoms; 3) perceptual alterations; 4) akathisia, rigidity, and dyskinesia; 5) deficits in vigilance; and 6) plasma prolactin and cortisol. Schizophrenia patients were more vulnerable to Δ-9-THC effects on recall relative to control subjects. There were no serious short- or long-term adverse events associated with study participation.
Conclusions
Delta-9-tetrahydrocannabinol is associated with transient exacerbation in core psychotic and cognitive deficits in schizophrenia. These data do not provide a reason to explain why schizophrenia patients use or misuse cannabis. Furthermore, Δ-9-THC might differentially affect schizophrenia patients relative to control subjects. Finally, the enhanced sensitivity to the cognitive effects of Δ-9-THC warrants further study into whether brain cannabinoid receptor dysfunction contributes to the pathophysiology of the cognitive deficits associated with schizophrenia.div>div>
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In vivo occipital–frontal temperature-gradient in schizophrenia patients and its possible association with psychopathology: A magnetic resonance spectroscopy study