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The risk factors of criminal behavior in patients with schizophrenia are not well explored. This study is to explore the risk factors for criminal behavior in patients with schizophrenia in rural China.
We used data from a 14-year prospective follow-up study (1994-2008) of criminal behavior among a cohort (n=510) of patients with schizophrenia in Xinjin County, Chengdu, China.
There were 489 patients (95.9%) who were followed up from 1994 to 2008. The rate of criminal behavior was 13.5% among these patients with schizophrenia during the follow-up period. Compared with female subjects (6 cases, 20.0%), male patients had significantly higher rate of violent criminal behavior (e.g., arson, sexual assault, physical assault, and murder) (24 cases, 80.0%) (p< 0.001). Bivariate analyses showed that the risk of criminal behavior was significantly associated with being unmarried, of younger age, previous violent behavior, homelessness, lower family economic status, no family caregivers, and higher scores on measures (PANSS) of positive, negative, and total symptoms of illness. In multiple logistic regression analyses being unmarried and previous violent behavior were identified as independent predictors of increased criminal behavior in persons with schizophrenia.
The risk factors for criminal behavior among patients with schizophrenia should be understood within a particular social context. Criminal behavior may be predicted by specific characteristics of patients with schizophrenia in rural community. The findings of risk factors for criminal behavior should be considered in planning community mental health care and interventions for high-risk patients and their families.
Impairments of attention and memory are evident in early psychosis, and often lead to severe, longstanding functional disability. Effective non-pharmacological interventions are needed due to the unsuccessful results of pharmacological interventions.
To determine whether yoga is effective for cognitive impairments, and the neural mechanism underlying these effects.
It was a randomized controlled study of 12-week of yoga and aerobic exercise (walking and cycling) intervention vs wait-list control for female early psychotic patients. Memory was measured with Hong Kong List Learning Test and Digit Span test, and attention was measured with Letter Cancellation test. Cognitive data analysis was based on the Intention-to-Treat method using a mixed-model analysis. Seed based functional connectivity was applied using posterior cingulate cortex (PCC) as seed with AFNI. Cortical thickness analyses were performed using FreeSurfer. Results from yoga and control groups were presented.
A total of 140 women were recruited and randomized into three groups. 95 completed the study, and 115 were included for cognitive data analysis. For imaging data, 42 participants were used for cortical thickness analyses; and 60 were included for neural connectivity analyses. Yoga group demonstrated significant improvements in working memory, verbal acquisition and attention (P=.01). Cortical thickness increased in the postcentral gyrus (P<.01); connectivity between PCC and bilateral inferior parietal gyrus increased after yoga intervention (P<.005).
Yoga has been found to be effective for memory and attention in early psychotic patients. The increases of thickness and neural connectivity indicate the possible neural mechanisms underlying the improvements of cognition.
Amotivation is prevalent in first-episode psychosis (FEP) patients and is a major determinant of functional outcome. Prediction of amotivation in the early stage of psychosis, however, is under-studied. We aimed to prospectively examine predictors of amotivation in FEP patients in a randomized-controlled trial comparing a 1-year extension of early intervention (Extended EI, 3-year EI) with step-down psychiatric care (SC, 2-year EI).
One hundred sixty Chinese patents were recruited from a specialized EI program for FEP in Hong Kong after they have completed this 2-year EI service, randomly allocated to Extended EI or SC, and followed up for 12 months. Assessments on premorbid adjustment, onset profiles, baseline symptom severity and treatment characteristics were conducted. Data analysis was based on 156 subjects who completed follow-up assessments.
Amotivation at 12-month follow-up was associated with premorbid adjustment, allocated treatment condition, and levels of positive symptoms, disorganization, amotivation, diminished expression (DE) and depression at study intake. Hierarchical multiple regression analysis revealed that Extended EI and lower levels of DE independently predicted better outcome on 12-month amotivation.
Our findings indicate a potentially critical therapeutic role of an extended specialized EI on alleviating motivational impairment in FEP patients. The longer-term effect of Extended EI on amotivation merits further investigation.
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