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Biomedical subjects

J Addington

Publications and source records attributed to J Addington.

At least 37 records · Page 2Linked to original sources
PubMed1999

Methodological and clinical challenges in evaluating treatment outcome of substance-related disorders and comorbidity.

OBJECTIVE: To review the steps required to develop an outcome evaluation package and to report on the 12-month outcome of an integrated day program. METHOD: Based on the identification of salient outcome predictors, standardized instruments were selected. A cohort of 78 patients was assessed at the time of admission to the program, at discharge, and 3, 6, and 12 months afterward. RESULTS: Improvements were sustained over 1 year in all areas including treatment needs, quality of life, and readiness to change. CONCLUSIONS: The gap between the "cultures" of treatment and research must be narrowed. Following evidence of a program's general effectiveness through outcome monitoring, a randomized control design is optimal for specific interventions. The optimal length of follow-up depends on the perceived confounds.

Adult↗
PubMed1999

Attributional style and depression in schizophrenia.

OBJECTIVES: The literature implies that negative attributional style is a psychological correlate of depression. Recent evidence suggests that negative attributional style may be specific to depression. This study examines the association between level of depression and negative attributional style in a sample of individuals with schizophrenia. METHOD: One hundred and thirteen inpatients with schizophrenia were assessed with the Calgary Depression Scale for Schizophrenia and the Attributional Style Questionnaire. RESULTS: Attributions of negative events to internal and to global causes were significantly associated with depressive symptoms. Only the global dimension was significantly associated with positive symptoms. No attributional dimensions were significantly associated with negative symptoms. CONCLUSIONS: These results are consistent with the idea that negative attributional style may be specific to depression and not a general characteristic of psychopathology.

Adult↗
PubMed1998

Visual attention and symptoms in schizophrenia: a 1-year follow-up.

Visual attention and positive and negative symptoms were assessed in a sample of inpatients with a relapse of schizophrenia and 3 months later during a period of relative remission. Visual attention was measured with the Continuous Performance Task (CPT) and the Span of Apprehension Task (SPAN). A previous report showed that in 59 schizophrenia subjects, poor visual attention was significantly associated with high levels of negative, but not positive, symptoms at the 3-month follow-up. Although symptoms improved significantly, the schizophrenia subjects' performance on the CPT and SPAN was relatively stable over time. In this follow-up study, symptoms were re-assessed 12 months (n = 40) after the acute relapse. There were no associations between attention at 3 months and negative or positive symptoms assessed at 12 months. These results appear contradictory to the hypothesis that deficits in visual attention are negative symptom-linked indicators.

Adult↗
PubMed1998

Relationship between cognitive and social dysfunction in schizophrenia.

This cross-sectional study examined the relationships between cognitive functioning, social functioning, and social problem solving in a sample of 30 outpatients with schizophrenia. The cognitive battery included measures of verbal ability, memory, executive functioning, visual-spatial ability, and attention. Social functioning was assessed with the Social Dysfunction Index (SDI) and the Social Adjustment Scale-II (SAS-II). Social problem solving was assessed with a video-based test, the Assessment of Interpersonal Problem-solving Skills (AIPSS). No significant association was found between social functioning as assessed by the SDI and the SAS-II and cognitive functioning. In multiple regression analyses, a measure of attention, the auditory Continuous Performance Test was a significant predictor of processing and sending skills, as assessed by the AIPSS. (F = 16.37, 9.23, p < 0.001).

Adult↗
PubMed1998

Facial affect recognition and information processing in schizophrenia and bipolar disorder.

This study assessed facial affect recognition and visual attention in a sample of 40 individuals with schizophrenia, at hospitalization and 3 months later during an out-patient phase of relative remission. Secondly, at the out-patient phase the performance of the individuals with schizophrenia on tasks of visual attention, facial affect recognition and facial recognition was compared to the performances of a non-psychiatric control group and a bipolar group on these tasks. Attention was measured with the Continuous Performance Test and the Span of Apprehension task. Facial affect recognition was measured with a discrimination task and an identification task. A measure of facial recognition was also used. The schizophrenia patients performed more poorly on measures of facial affect recognition and facial recognition than both control groups. Despite a significant improvement in symptoms over time, there was no change in facial affect recognition for the schizophrenia subjects. For the schizophrenia subjects there were significant associations between attention tasks and the facial tasks. These results suggest that for individuals with schizophrenia, deficits in facial affect recognition are stable deficits that are related to other impairments in neurocognition. This has implications for psychosocial treatments.

Adult↗
PubMed1998

Smoking cessation treatment for patients with schizophrenia.

OBJECTIVE: This study was an uncontrolled trial to assess the efficacy of a smoking cessation group program modified for individuals with schizophrenia. METHOD: Fifty outpatients with schizophrenia were divided into five groups who met separately for seven weekly sessions of a smoking cessation program. The subjects' schizophrenic and extrapyramidal symptoms were assessed before the group sessions began and after they had been completed. Assessments of smoking were made at those times and at 3-month and 6-month follow-ups. RESULTS: Forty-two percent of the subjects had stopped smoking at the end of the group sessions; 16% remained abstinent at 3 months, and 12% at 6 months. These changes were statistically significant. There was no change in the positive or negative symptoms of schizophrenia. CONCLUSIONS: The results suggest that it is possible for individuals with schizophrenia to stop smoking.

Adult↗
PubMed1998

Group treatment for smoking cessation among persons with schizophrenia.

People with schizophrenia smoke more than the general population and more than other psychiatric diagnostic groups. The rate of smoking in the general population is 30 percent, and reported rates for people with schizophrenia range between 62 percent and 81 percent. The author briefly reviews evidence that nicotine's augmentation of dopamine release may account for the high prevalence of smoking in this group. The affective, cognitive, and social difficulties and the symptoms experienced by many patients with schizophrenia indicate that existing smoking cessation programs may not be appropriate for them. The author describes three programs developed for use with this population and reviews evidence of their effectiveness. Preliminary evidence suggests that transdermal nicotine patches are effective and that patients do not misuse them. The author concludes that stopping smoking is possible for individuals with schizophrenia, especially if the treatment is specifically designed for them.

Behavior Therapy↗
PubMed1998

Group treatment for substance abuse in schizophrenia.

OBJECTIVES: A review of the relevant research suggests a need to develop an appropriate, effective, and replicable treatment to help individuals with schizophrenia and substance abuse problems. This pilot study describes a biweekly group specifically designed to help the individual with both schizophrenia and substance abuse. The components of the group were support, psychoeducation, and skills training. Attention was also paid to the stage of recovery. METHOD: Eighteen subjects attended the group and were assessed pregroup. Thirteen subjects completed a 1-year follow-up, and 5 subjects were assessed between 3 and 6 months. RESULTS: At the follow-up assessment, 8 subjects (44%) were abstinent. CONCLUSIONS: This type of treatment appears to be effective for reducing substance abuse in this population.

Adult↗
PubMed1998

Depression in people with first-episode schizophrenia.

BACKGROUND: Depression has been described in people presenting with first-episode schizophrenia, a group at high relative risk of suicide. METHOD: This was a longitudinal cohort study of 113 people during an acute relapse and 13 having a first episode. Follow-up occurred at three months and at one year. This report compares level of depression in the first episode and in the relapsing group. Levels of depression were assessed using the Calgary Depression Scale for Schizophrenia (CDSS). RESULTS: The median CDSS score was statistically significantly higher in the first-episode group both during the acute phase and at three month follow-up. At one year the first-episode group continued to have higher levels of depression than the multiple episode group. CONCLUSIONS: For people with a first episode of schizophrenia, depression is a major problem during the initial acute phase and during the first year of illness. In light of the high risk of suicide in this population, recognition and treatment of depression requires greater attention.

Cohort Studies↗
PubMed1998

Effect of substance misuse in early psychosis.

BACKGROUND: Studies examining the temporal relationship between substance use and the onset of psychotic symptoms in schizophrenia are inconclusive. METHOD: Three groups of out-patients with schizophrenia were compared on onset of illness, symptoms and quality of life. Fifty-one subjects had no past or present history of substance misuse, 29 subjects had a history of past substance misuse occurring around the onset of their illness, and 33 subjects were currently misusing substances. RESULTS: Current substance misusers had poorer quality of life scores and less negative symptoms than the non-users. Those who had a past history of substance misuse had a significantly earlier age of onset than those with no substance use. CONCLUSIONS: Attention should be paid to substance misuse present at the first episode. Treatment for schizophrenia should begin even though a diagnosis of drug-induced psychosis cannot be ruled out.

Adult↗
PubMed1997

Attentional vulnerability indicators in schizophrenia and bipolar disorder.

Visual attention and positive and negative symptoms were assessed in 59 inpatients with a relapse of schizophrenia and 3 months later during a period of relative remission. Visual attention was measured with the Continuous Performance Task (CPT) and the Span of Apprehension Task (SPAN). At follow-up schizophrenia subjects were compared on visual attention to 40 outpatients with bipolar disorder and 40 normal controls. Although symptoms improved significantly, the schizophrenia subjects' performance on the CPT and SPAN was relatively stable over time. Poor visual attention was significantly associated with high levels of negative, but not positive symptoms at the 3-month follow-up. The schizophrenia subjects had poorer visual attention than the normal controls. There were no differences between the schizophrenia and the bipolar subjects. These results offer partial support to the hypothesis that deficits in visual attention may be negative symptom-linked vulnerability indicators.

Adult↗
PubMed1997

Reasons for substance use in schizophrenia.

Abuse of and dependence on drugs, alcohol and other substances in schizophrenia are being increasingly recognized and well documented in the literature. It has been suggested that up to 60% of patients with schizophrenia use illicit drugs. A total of 41 subjects who fulfilled DSM-III-R criteria for schizophrenia and substance abuse or dependence were asked to describe their reasons for using such substances, the reasons why they might stop and the subjective effects of the substances. Drugs were reportedly used to increase pleasure, to 'get high' and to reduce depression. However, subjective effects of increased depression and positive symptoms were also reported. These results are considered in the context of potential treatment strategies.

Adult↗
PubMed1997

Readiness to stop smoking in schizophrenia.

OBJECTIVE: To assess the motivation and readiness to change of individuals with schizophrenia prior to developing a smoking cessation program. METHOD: Smoking history, nicotine dependence, readiness to stop smoking, and interest in a smoking cessation group were assessed in 60 schizophrenia outpatients who smoked. RESULTS: The majority were interested in attending a smoking cessation group and appeared to be appropriately motivated. CONCLUSIONS: Smoking cessation groups for a schizophrenia population may be a worthwhile endeavour. Current measures of motivation and readiness to change may be useful to identify those who are most likely to succeed.

Adult↗
PubMed1997

Substance abuse and cognitive functioning in schizophrenia.

Individuals with schizophrenia have an increased vulnerability to abuse drugs or alcohol. This vulnerability can interfere with the course and treatment of the disorder and may also have a detrimental effect on already compromised cognitive functioning. This study has a matched, cross-sectional design and compares the social and cognitive functioning and the symptoms of 33 schizophrenia subjects who abuse substances with 33 nonabusing schizophrenia subjects. Subjects were matched on sex, age, and education variables and were all outpatients. Measures of social functioning and quality of life were used. Assessment of cognitive functioning included measures of verbal ability, attention, executive functioning, and verbal and visual memory. Substance-abusing subjects had significantly lower quality of life. There were no other differences between the 2 groups. Several explanations are offered for the lack of observed differences in cognitive functioning.

Adult↗
PubMed1997

Distractibility and symptoms in schizophrenia.

Distractibility was assessed in 59 inpatients with a relapse of schizophrenia and 3 mo later during a period of relative remission. Distractibility was measured with a digit span task and symptoms with the Positive and Negative Syndrome Scale (PANSS). Although positive and negative symptoms improved significantly, the schizophrenia subjects' performance on the digit span task remained stable over time. There was no relationship between attention and symptoms. The possibility of distractibility being a vulnerability indicator for schizophrenia is discussed.

Adult↗
PubMed1997

Treatment of substance abusers: single or mixed gender programs?

Single-gender groups are advocated for women because substance abuse treatment programs tend to be male dominated both in numbers and in style. Although there is a paucity of empirical work that directly addresses this assumption, a body of literature that indirectly supports it is reviewed. Male and female substance abusers report different histories and courses for their disorders and display different needs and characteristics in treatment settings. Men and women may benefit from different treatment approaches with less structure required for women, particularly problem drinkers. Moreover, specific characteristics such as victimization, sexual orientation, sex-role conflict and degree of antisocial traits may be important mediating factors in whether single-gender groups are optimal. Social psychological research illustrates the effect of gender composition of groups for men and women. In general, mixed groups are associated with more variation in interpersonal style for men but are restrictive for women who show more variation in style in single-gender groups. These findings are suggestive of testable hypotheses concerning the effects of single and mixed gender programming. Such investigations have the potential of enhancing treatment efficacy.

Female↗
PubMed1996

A psychometric comparison of the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale.

This study compared two measures of depression in a population with schizophrenia. Inpatients (n = 112) with schizophrenia, were assessed on the Hamilton (HDRS), and Calgary (CDSS) depression scales and the Positive and Negative Syndrome Scale (PANSS). Eighty-nine were reassessed 3 months later. A principal components factor analysis was applied to each depression scale. The relationship between measures of depression and positive and negative symptoms was explored using correlation, factor and regression analyses. There were no significant correlations between the total CDSS and positive or negative symptoms at either time. In contrast, the HDRS total score was correlated with both positive and negative syndromes at time 2. Moreover, a number of HDRS factors correlated significantly with the PANSS positive scale at both times and with the negative subscale score at time 2. Multiple regression analysis showed that the HDRS accounted for more of the variance in positive and negative symptoms scores than did the CDSS. The CDSS has fewer factors and less overlap with positive and negative symptoms than the HDRS. This suggests that it is a more specific measure of level of depression than the HDRS for individuals with schizophrenia.

Adult↗