Background:
Schizophrenia is a chronic mental illness that strongly affects not only the patients with schizophrenia, but also their families and close relatives. So far, family research on patients ...with schizophrenia has mainly focused on parents, but has neglected siblings.
Aim:
This study aims to evaluate the well-being of 103 siblings of patients with schizophrenia within the Lazarus and Folkman’s Transactional Coping and Stress Model.
Materials:
A Sociodemographic Information Form, Subjective Well-being Scale, Zarit Caregiver Burden Scale, Multidimensional Perceived Social Support Scale, Ways of Coping Scale and Shortened Perceived Parental Rearing Styles Form were administered to the siblings of patients with schizophrenia.
Results:
The results of this study revealed that well-being was associated with perceived mother overprotection, perceived social support, problem-focused coping and indirect coping. Social support moderated the relationship between burden and well-being as a buffering factor.
Conclusion:
Therefore, siblings of patients with schizophrenia should be given access to social support and their problem-focused coping strategies should be strengthened. Besides, parents should be supported to provide suitable care for the siblings of patients with schizophrenia.
Suffering comes in many ways for patients confronting cancer. One of these is an unspecifiable fear about death, which is an existential issue. The aim of this study was to investigate the ...relationship between death anxiety and its correlates in cancer patients. Seventy cancer patients were assessed using SCID-I, Templer's Death Anxiety Scale, the Hospital Anxiety (A) and Depression (D) Scale, the Distress Thermometer, the Visual Analogue Scale for pain (VAS), the Global Assessment of Functioning, and Glock and Stark's Dimensions of Religious Commitment scales, and these assessments were compared between cancer patients with and without death anxiety. Multiple regression analysis was conducted after correlation analysis between death anxiety and sociodemographic and clinical variables. Axis I psychiatric diagnosis, pain scores, and negative believes about what will happen after death were found to be higher in patients having death anxiety than patients not having death anxiety. Also life expectancy was perceived as shortened in patients with death anxiety. Death anxiety was associated with anxiety, depressive symptoms, and beliefs about what will happen after death. In conclusion, death anxiety could not be regarded as a natural consequence of having cancer; it is associated with the unresolved psychological and physical distress.
Studies investigating the recovery from schizophrenia revealed two concepts of recovery; one is clinical recovery, and the other is personal or subjective recovery. Both states of recovery require ...specific assessment tools and therapeutic approaches. While current measures of clinical recovery can be used upon consensus all over the world, measures of subjective recovery which are based on cultural and individual values are yet to be investigated. The aim of this study was to develop and validate the Subjective Recovery Assessment Scale (SubRAS) for patients with schizophrenia.
The SubRAS consisting of 17-item was prepared using related literature with focus group interviews. Internal consistency reliability was assessed by Cronbach's alpha coefficients, and test-retest reliability was assessed. Exploratory factor analyses and correlations with Global Assessment of Functioning (GAF), The Heinrichs-Carpenter Quality of Life Scale (QLS), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression - Severity (CGI-S) were used to examine the factor-based validity and construct validity of the SubRAS.
The participants consisted of 127 patients with schizophrenia (n = 110) and schizoaffective disorder (n = 17), with 63.6% being male and a mean age of 41.2 years. Cronbach's alpha coefficient of the scale was calculated as 0.98 while item-total score correlation coefficients were measured between 0.83 and 0.94. Test-retest reliability (r = .98) was very satisfactory. As for construct validity, a one-factor solution was obtained that could explain 83.0% of the variance. The scale showed a high correlation with the GAF (r = .82), the QLS (r = .76), PANSS (r = −.74), and CGI-S (r = −.74).
SubRAS is a valid and reliable instrument that can be utilized for patients with schizophrenia to assess their subjective recovery states. It is a culture-sensitive self-assessment instrument and easy to use for Turkish patients with schizophrenia.
Schizophrenia is a heritable complex phenotype associated with a background risk involving multiple common genetic variants of small effect and a multitude of environmental exposures. Early twin and ...family studies using proxy‐genetic liability measures suggest gene‐environment interaction in the etiology of schizophrenia spectrum disorders, but the molecular evidence is scarce. Here, by analyzing the main and joint associations of polygenic risk score for schizophrenia (PRS‐SCZ) and environmental exposures in 1,699 patients with a diagnosis of schizophrenia spectrum disorders and 1,542 unrelated controls with no lifetime history of a diagnosis of those disorders, we provide further evidence for gene‐environment interaction in schizophrenia. Evidence was found for additive interaction of molecular genetic risk state for schizophrenia (binary mode of PRS‐SCZ above 75% of the control distribution) with the presence of lifetime regular cannabis use and exposure to early‐life adversities (sexual abuse, emotional abuse, emotional neglect, and bullying), but not with the presence of hearing impairment, season of birth (winter birth), and exposure to physical abuse or physical neglect in childhood. The sensitivity analyses replacing the a priori PRS‐SCZ at 75% with alternative cut‐points (50% and 25%) confirmed the additive interaction. Our results suggest that the etiopathogenesis of schizophrenia involves genetic underpinnings that act by making individuals more sensitive to the effects of some environmental exposures.
A cumulative environmental exposure score for schizophrenia (exposome score for schizophrenia ES-SCZ) may provide potential utility for risk stratification and outcome prediction. Here, we ...investigated whether ES-SCZ was associated with functioning in patients with schizophrenia spectrum disorder, unaffected siblings, and healthy controls.
This cross-sectional sample consisted of 1,261 patients, 1,282 unaffected siblings, and 1,525 healthy controls. The Global Assessment of Functioning (GAF) scale was used to assess functioning. ES-SCZ was calculated based on our previously validated method. The association between ES-SCZ and the GAF dimensions (symptom and disability) was analyzed by applying regression models in each group (patients, siblings, and controls). Additional models included polygenic risk score for schizophrenia (PRS-SCZ) as a covariate.
ES-SCZ was associated with the GAF dimensions in patients (symptom: B = -1.53, p-value = 0.001; disability: B = -1.44, p-value = 0.001), siblings (symptom: B = -3.07, p-value < 0.001; disability: B = -2.52, p-value < 0.001), and healthy controls (symptom: B = -1.50, p-value < 0.001; disability: B = -1.31, p-value < 0.001). The results remained the same after adjusting for PRS-SCZ. The degree of associations of ES-SCZ with both symptom and disability dimensions were higher in unaffected siblings than in patients and controls. By analyzing an independent dataset (the Genetic Risk and Outcome of Psychosis study), we replicated the results observed in the patient group.
Our findings suggest that ES-SCZ shows promise for enhancing risk prediction and stratification in research practice. From a clinical perspective, ES-SCZ may aid in efforts of clinical characterization, operationalizing transdiagnostic clinical staging models, and personalizing clinical management.
Exposures constitute a dense network of the environment: exposome. Here, we argue for embracing the exposome paradigm to investigate the sum of nongenetic "risk" and show how predictive modeling ...approaches can be used to construct an exposome score (ES; an aggregated score of exposures) for schizophrenia. The training dataset consisted of patients with schizophrenia and controls, whereas the independent validation dataset consisted of patients, their unaffected siblings, and controls. Binary exposures were cannabis use, hearing impairment, winter birth, bullying, and emotional, physical, and sexual abuse along with physical and emotional neglect. We applied logistic regression (LR), Gaussian Naive Bayes (GNB), the least absolute shrinkage and selection operator (LASSO), and Ridge penalized classification models to the training dataset. ESs, the sum of weighted exposures based on coefficients from each model, were calculated in the validation dataset. In addition, we estimated ES based on meta-analyses and a simple sum score of exposures. Accuracy, sensitivity, specificity, area under the receiver operating characteristic, and Nagelkerke's R2 were compared. The ESMeta-analyses performed the worst, whereas the sum score and the ESGNB were worse than the ESLR that performed similar to the ESLASSO and ESRIDGE. The ESLR distinguished patients from controls (odds ratio OR = 1.94, P < .001), patients from siblings (OR = 1.58, P < .001), and siblings from controls (OR = 1.21, P = .001). An increase in ESLR was associated with a gradient increase of schizophrenia risk. In reference to the remaining fractions, the ESLR at top 30%, 20%, and 10% of the control distribution yielded ORs of 3.72, 3.74, and 4.77, respectively. Our findings demonstrate that predictive modeling approaches can be harnessed to evaluate the exposome.
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