Durk Wiersma - Academia.edu (original) (raw)
Papers by Durk Wiersma
![Research paper thumbnail of [Routine Outcome Monitoring for patients with severe mental illness: a consensus document]](https://attachments.academia-assets.com/45006969/thumbnails/1.jpg)
](Tijdschrift voor psychiatrie, 2010
Routine outcome monitoring (ROM) means the assessment of the patient's condition on a routine... more Routine outcome monitoring (ROM) means the assessment of the patient's condition on a routine basis using instruments. So far there is no consensus about which instruments should be used for ROM with severely mentally ill patients (ROM-SMI). To reach a consensus about instruments for ROM-SMI in the Netherlands and Belgium and to create possibilities for comparison of ROM data. This article discusses the consensus document of the National Remission Working Group for ROM in patients with smi and covers the following topics: reasons for ROM-SMI, domains for ROM-SMI and appropriate instruments, logistics and analyses of the data. Patients with SMI have problems in several domains. These can be assessed by collecting information about psychiatric symptoms, addiction, somatic problems, general functioning, needs, quality of life and care satisfaction. Potential instruments for ROM-SMI are short, valid, reliable and assess several domains, taking the patient's perspective into acco...
Schizophrenia Bulletin, 2007
Schizophrenia Research, 2012
BMC psychiatry, 2015
In outpatient forensic psychiatry, assessment of re-offending risk and treatment needs by case ma... more In outpatient forensic psychiatry, assessment of re-offending risk and treatment needs by case managers may be hampered by an incomplete view of client functioning. The client's appreciation of his own problem behaviour is not systematically used for these purposes. The current study tests whether using a new client self-appraisal risk assessment instrument, based on the Short Term Assessment of Risk and Treatability (START), improves the assessment of re-offending risk and can support shared decision making in care planning. In a sample of 201 outpatient forensic psychiatric clients, feasibility of client risk assessment, concordance with clinician assessment, and predictive validity of both assessments for violent or criminal behaviour were studied. Almost all clients (98 %) were able to fill in the instrument. Agreement between client and case manager on the key risk and protective factors of the client was poor (mean kappa for selection as key factor was 0.15 and 0.09, respe...
European Psychiatry, 2011
European Psychiatry, 2011
Schizophrenia Research, 2010
schizotypy. However, studies thus far have not clarified the differential association of neurotic... more schizotypy. However, studies thus far have not clarified the differential association of neuroticism with individual schizotypy dimensions and the role it plays in the expression of schizophreniaspectrum phenomena. Methods: 204 nonclinically ascertained participants completed selfreport questionnaires assessing neuroticism and the positive and negative schizotypy dimensions, and underwent structured interviews assessing schizophrenia-spectrum psychopathology (psychotic-like experiences, negative symptoms, cluster A personality disorders), mood episodes, substance abuse, and global functioning. Results: Results indicated that neuroticism predicted positive symptoms of schizophrenia and depression, over and above the effects of both schizotypy dimensions. Also, neuroticism moderated the association of positive schizotypy with interview measures of psychopathology and functioning. Discussion: The results of this study support other research indicating that neuroticism is etiologically relevant for spectrum psychopathology and that it cannot be considered solely a 'secondary effect' of spectrum disorders. Current psychological models of psychosis can accomodate the finding of neuroticism being a shared vulnerability factor for affective and psychotic disorders.
British Journal of Psychiatry, 2010
Hearing voices occurs in middle childhood, but little is known about prevalence, aetiology and im... more Hearing voices occurs in middle childhood, but little is known about prevalence, aetiology and immediate consequences. To investigate prevalence, developmental risk factors and behavioural correlates of auditory vocal hallucinations in 7- and 8-year-olds. Auditory vocal hallucinations were assessed with the Auditory Vocal Hallucination Rating Scale in 3870 children. Prospectively recorded data on pre- and perinatal complications, early development and current problem behaviour were analysed in children with auditory vocal hallucinations and matched controls. The 1-year prevalence of auditory vocal hallucinations was 9%, with substantial suffering and problem behaviour reported in 15% of those affected. Prevalence was higher in rural areas but auditory vocal hallucinations were more severe and had greater functional impact in the urban environment. There was little evidence for associations with developmental variables. Auditory vocal hallucinations in 7- and 8-year-olds are prevalent but mostly of limited functional impact. Nevertheless, there may be continuity with more severe psychotic outcomes given the serious suffering in a subgroup of children and there is evidence for a poorer prognosis in an urban environment.
PloS one, 2015
Alexithymia is a personality construct denoting emotion processing problems. It has been suggeste... more Alexithymia is a personality construct denoting emotion processing problems. It has been suggested to encompass two dimensions: a cognitive and affective dimension. The cognitive dimension is characterized by difficulties in identifying, verbalizing and analyzing emotions, while the affective dimension reflects the level of emotional arousal and imagination. Alexithymia has been previously proposed as a risk factor for developing psychosis. More specifically, the two alexithymia dimensions might be differentially related to the vulnerability for psychosis. Therefore, we examined the two dimensions of alexithymia, measured with the BVAQ in 94 siblings of patients with schizophrenia, 52 subjects at ultra-high risk (UHR) for developing psychosis, 38 patients with schizophrenia and 109 healthy controls. The results revealed that siblings and patients had higher levels of cognitive alexithymia compared to controls. In addition, subjects at UHR for psychosis had even higher levels of cogn...
Objective: This study aimed to investigate the outcome of an 18-month randomized controlled trial... more Objective: This study aimed to investigate the outcome of an 18-month randomized controlled trial (RCT) on subjective burden and psychopathology of patients suffering from schizophrenia.
Journal of psychiatry & neuroscience : JPN, Jan 17, 2015
Grey matter, both volume and concentration, has been proposed as an endophenotype for schizophren... more Grey matter, both volume and concentration, has been proposed as an endophenotype for schizophrenia given a number of reports of grey matter abnormalities in relatives of patients with schizophrenia. However, previous studies on grey matter abnormalities in relatives have produced inconsistent results. The aim of the present study was to examine grey matter differences between controls and siblings of patients with schizophrenia and to examine whether the age, genetic loading or subclinical psychotic symptoms of selected individuals could explain the previously reported inconsistencies. We compared the grey matter volume and grey matter concentration of healthy siblings of patients with schizophrenia and healthy controls matched for age, sex and education using voxel-based morphometry (VBM). Furthermore, we selected subsamples based on age (< 30 yr), genetic loading and subclinical psychotic symptoms to examine whether this would lead to different results. We included 89 siblings...
NeuroImage, 2011
Genetic variation in the catechol-O-methyltransferase (COMT) Val158Met polymorphism has been show... more Genetic variation in the catechol-O-methyltransferase (COMT) Val158Met polymorphism has been shown to influence performance on cognitive and emotional tasks. Specifically, it has been suggested that the Met allele might be less advantageous than the Val allele with respect to emotional processing. This study addresses the question whether the presence of the Met allele is directly related to both lower emotional verbalizing proficiency and differences in brain activation during emotional processing. Specifically, we investigated whether COMT genotype would be associated with differences in activation in cortical midline structures during valence evaluation of words. Forty participants ranging from low to high on the verbalizing subscale of the Bermond-Vorst Alexithymia Questionnaire (BVAQ) were genotyped for the COMT Val158Met polymorphism. During fMRI, they evaluated the valence of emotional words. Met homozygotes reported more difficulties in verbalizing their feelings. In additio...
Comprehensive Psychiatry, 2000
Schizophrenia Bulletin, 2000
The purpose of the study was to examine (1) to which negative symptoms schizophrenia patients att... more The purpose of the study was to examine (1) to which negative symptoms schizophrenia patients attribute distress and (2) whether clinical variables can predict the levels of reported distress. With the help of a research assistant, 86 hospitalized patients completed a self-rating scale for negative symptoms. The 21 items of the self-rating scale were taken from the Scale for the
International Clinical Psychopharmacology, 2006
The present study reports on the development of a new self-administered instrument to assess pati... more The present study reports on the development of a new self-administered instrument to assess patients' responses to antipsychotic medication. The Subjects' Response to Antipsychotics (SRA) Questionnaire is a 74-item instrument with eight scales (Recovery, Weight Gain, Sexual Anhedonia, Sedation, Affective Flattening, Extrapyramidal Symptoms, Diminished Sociability and Increased Sleep), and a total adverse responses score including additional items. Psychometric aspects were examined in a study of 320 inpatients and outpatients showing good internal consistency, reproducibility and external validity.
Schizophrenia Research, 1999
The cognitive correlates of five symptom dimensions based on PANSS ratings were examined in a gro... more The cognitive correlates of five symptom dimensions based on PANSS ratings were examined in a group of 50 recent onset psychotic patients, using both objective and subjective cognitive measures. We were particularly interested in the depression dimension, since it has not been studied extensively thus far. The depression dimension showed a high number of correlations with both objective and subjective
Schizophrenia Research, 2010
Background: Intelligence scales supply a global measure of cognitive abilities, in the same way t... more Background: Intelligence scales supply a global measure of cognitive abilities, in the same way they can predict the performance of other neuropsychological measures. Therefore, as well as in clinical practice as in investigation the IQ results are used as a descriptive measure of the general intellectual capacity and as an interpretative context of other neuropsychological test's results. The most used intelligence scale is Wechsler Adult Intelligence Scale (WAIS-III), it is compounded of 14 subscales and its application takes about 60 to 110 minutes. It is usually used as a neuropsychological battery. For this reason, different authors have been trying to find a briefer way of applying WAIS, reducing the application time using a reduced number of subscales, without compromising the estimate of the Full-Scale IQ (FSIQ). Most of these investigations have focused on WAIS-R for different schizophrenic and Spanish speaker's populations. Our main objective was to find a brief way of application, composed by 4 subscales, one for each WAIS-III indicator, in Spanish persons with schizophrenia. Methods: Regression analysis was used for the data obtained in the WAIS-III application for 46 out-patients, who fulfill DSM-IV diagnostic criteria for schizophrenia. Each of these patients was sent by his/her psychiatrist, and they all fulfill the requirement of being in a stable clinical period of the disease. During the evaluation process all the participants were receiving antipsychotic medication, without any changes in the preceding 3 months. Apart from the application time and the punctuation, the Verbal Comprehension (VCI), Perceptual Organization (POI), Working Memory (WMI) and the Processing Speed (PSI) WAIS-III indicators were regarded. All the possible combinations were studied, and the one which offered the best reliability to estimate the FSIQ was selected, without underestimating the predictive capacity of other indicators. In order to estimate the correlation between the short form punctuations and the different indicators of the full WAIS-III, R 2 was corrected. Results: The 4-factors version that explained the biggest variations in the FSIQ punctuations, for this group of persons, is compounded by the Vocabulary (V), the Digit Symbol (DSym), the Block Design (BD) and the Digit Span (DS) subscales. The results for the R 2 and R 2 -corrected was respectively 0,954 and 0,95 for the FSIQ; 0,929 and 0,922 for the VCI; 0,855 and 0,841 for the POI; 0,889 and 0,878 for the WMI; 0,927 and 0,920 for the PSI. The derived formula for the regression analysis was FSIQ = 32,88 + 2,474 V + 1,064 DSym + 1,213 BD + 1,553 DS. The beta coefficients indicate the relative importance of each subscale in this brief form: 0,448 for V, 0,172 for DSym, 0,217 for BD, y 0,257 for DS. Discussion: Although the sample should be amplified, we recommend the WAIS-III short form compounded of V-DSym-BD-DS for future investigations and clinical practice, for stable patients with schizophrenia diagnostic, when the aim is to obtain a fast IQ estimation. In future investigations, it should be interesting to see if the application of this short form really works by itself, since its integration in the complete WAIS-III battery can affect the results.
Schizophrenia Bulletin, 2015
A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Mos... more A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Most patients show an interest in sex that differs little from the general population. By contrast, psychiatric symptoms, institutionalization, and psychotropic medication contribute to frequently occurring impairments in sexual functioning. Women with schizophrenia have a better social outcome, longer lasting (sexual) relationships, and more offspring than men with schizophrenia. Still, in both sexes social and interpersonal impairments limit the development of stable sexual relationships. Although patients consider sexual problems to be highly relevant, patients and clinicians not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment. Studies using structured interviews or questionnaires result in many more patients reporting sexual dysfunctions. Although sexual functioning can be impaired by different factors, the use of antipsychotic medication seems to be an important factor. A comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole. Postsynaptic dopamine antagonism, prolactin elevation, and α 1 -receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction. Psychosocial strategies to treat antipsychotic-induced sexual dysfunction include psychoeducation and relationship counseling. Pharmacological strategies include lowering the dose or switching to a prolactin sparing antipsychotic. Also, the addition of a dopamine agonist, aripiprazole, or a phosphodiesterase-5 inhibitor has shown some promising results, but evidence is currently scarce.
PLoS ONE, 2014
Background: Patients with schizophrenia often experience problems regulating their emotions. Non-... more Background: Patients with schizophrenia often experience problems regulating their emotions. Non-affected relatives show similar difficulties, although to a lesser extent, and the neural basis of such difficulties remains to be elucidated. In the current paper we investigated whether schizophrenia patients, non-affected siblings and healthy controls (HC) exhibit differences in brain activation during emotion regulation.
Tijdschrift voor psychiatrie, 2010
Routine outcome monitoring (ROM) means the assessment of the patient's condition on a routine... more Routine outcome monitoring (ROM) means the assessment of the patient's condition on a routine basis using instruments. So far there is no consensus about which instruments should be used for ROM with severely mentally ill patients (ROM-SMI). To reach a consensus about instruments for ROM-SMI in the Netherlands and Belgium and to create possibilities for comparison of ROM data. This article discusses the consensus document of the National Remission Working Group for ROM in patients with smi and covers the following topics: reasons for ROM-SMI, domains for ROM-SMI and appropriate instruments, logistics and analyses of the data. Patients with SMI have problems in several domains. These can be assessed by collecting information about psychiatric symptoms, addiction, somatic problems, general functioning, needs, quality of life and care satisfaction. Potential instruments for ROM-SMI are short, valid, reliable and assess several domains, taking the patient's perspective into acco...
Schizophrenia Bulletin, 2007
Schizophrenia Research, 2012
BMC psychiatry, 2015
In outpatient forensic psychiatry, assessment of re-offending risk and treatment needs by case ma... more In outpatient forensic psychiatry, assessment of re-offending risk and treatment needs by case managers may be hampered by an incomplete view of client functioning. The client's appreciation of his own problem behaviour is not systematically used for these purposes. The current study tests whether using a new client self-appraisal risk assessment instrument, based on the Short Term Assessment of Risk and Treatability (START), improves the assessment of re-offending risk and can support shared decision making in care planning. In a sample of 201 outpatient forensic psychiatric clients, feasibility of client risk assessment, concordance with clinician assessment, and predictive validity of both assessments for violent or criminal behaviour were studied. Almost all clients (98 %) were able to fill in the instrument. Agreement between client and case manager on the key risk and protective factors of the client was poor (mean kappa for selection as key factor was 0.15 and 0.09, respe...
European Psychiatry, 2011
European Psychiatry, 2011
Schizophrenia Research, 2010
schizotypy. However, studies thus far have not clarified the differential association of neurotic... more schizotypy. However, studies thus far have not clarified the differential association of neuroticism with individual schizotypy dimensions and the role it plays in the expression of schizophreniaspectrum phenomena. Methods: 204 nonclinically ascertained participants completed selfreport questionnaires assessing neuroticism and the positive and negative schizotypy dimensions, and underwent structured interviews assessing schizophrenia-spectrum psychopathology (psychotic-like experiences, negative symptoms, cluster A personality disorders), mood episodes, substance abuse, and global functioning. Results: Results indicated that neuroticism predicted positive symptoms of schizophrenia and depression, over and above the effects of both schizotypy dimensions. Also, neuroticism moderated the association of positive schizotypy with interview measures of psychopathology and functioning. Discussion: The results of this study support other research indicating that neuroticism is etiologically relevant for spectrum psychopathology and that it cannot be considered solely a 'secondary effect' of spectrum disorders. Current psychological models of psychosis can accomodate the finding of neuroticism being a shared vulnerability factor for affective and psychotic disorders.
British Journal of Psychiatry, 2010
Hearing voices occurs in middle childhood, but little is known about prevalence, aetiology and im... more Hearing voices occurs in middle childhood, but little is known about prevalence, aetiology and immediate consequences. To investigate prevalence, developmental risk factors and behavioural correlates of auditory vocal hallucinations in 7- and 8-year-olds. Auditory vocal hallucinations were assessed with the Auditory Vocal Hallucination Rating Scale in 3870 children. Prospectively recorded data on pre- and perinatal complications, early development and current problem behaviour were analysed in children with auditory vocal hallucinations and matched controls. The 1-year prevalence of auditory vocal hallucinations was 9%, with substantial suffering and problem behaviour reported in 15% of those affected. Prevalence was higher in rural areas but auditory vocal hallucinations were more severe and had greater functional impact in the urban environment. There was little evidence for associations with developmental variables. Auditory vocal hallucinations in 7- and 8-year-olds are prevalent but mostly of limited functional impact. Nevertheless, there may be continuity with more severe psychotic outcomes given the serious suffering in a subgroup of children and there is evidence for a poorer prognosis in an urban environment.
PloS one, 2015
Alexithymia is a personality construct denoting emotion processing problems. It has been suggeste... more Alexithymia is a personality construct denoting emotion processing problems. It has been suggested to encompass two dimensions: a cognitive and affective dimension. The cognitive dimension is characterized by difficulties in identifying, verbalizing and analyzing emotions, while the affective dimension reflects the level of emotional arousal and imagination. Alexithymia has been previously proposed as a risk factor for developing psychosis. More specifically, the two alexithymia dimensions might be differentially related to the vulnerability for psychosis. Therefore, we examined the two dimensions of alexithymia, measured with the BVAQ in 94 siblings of patients with schizophrenia, 52 subjects at ultra-high risk (UHR) for developing psychosis, 38 patients with schizophrenia and 109 healthy controls. The results revealed that siblings and patients had higher levels of cognitive alexithymia compared to controls. In addition, subjects at UHR for psychosis had even higher levels of cogn...
Objective: This study aimed to investigate the outcome of an 18-month randomized controlled trial... more Objective: This study aimed to investigate the outcome of an 18-month randomized controlled trial (RCT) on subjective burden and psychopathology of patients suffering from schizophrenia.
Journal of psychiatry & neuroscience : JPN, Jan 17, 2015
Grey matter, both volume and concentration, has been proposed as an endophenotype for schizophren... more Grey matter, both volume and concentration, has been proposed as an endophenotype for schizophrenia given a number of reports of grey matter abnormalities in relatives of patients with schizophrenia. However, previous studies on grey matter abnormalities in relatives have produced inconsistent results. The aim of the present study was to examine grey matter differences between controls and siblings of patients with schizophrenia and to examine whether the age, genetic loading or subclinical psychotic symptoms of selected individuals could explain the previously reported inconsistencies. We compared the grey matter volume and grey matter concentration of healthy siblings of patients with schizophrenia and healthy controls matched for age, sex and education using voxel-based morphometry (VBM). Furthermore, we selected subsamples based on age (< 30 yr), genetic loading and subclinical psychotic symptoms to examine whether this would lead to different results. We included 89 siblings...
NeuroImage, 2011
Genetic variation in the catechol-O-methyltransferase (COMT) Val158Met polymorphism has been show... more Genetic variation in the catechol-O-methyltransferase (COMT) Val158Met polymorphism has been shown to influence performance on cognitive and emotional tasks. Specifically, it has been suggested that the Met allele might be less advantageous than the Val allele with respect to emotional processing. This study addresses the question whether the presence of the Met allele is directly related to both lower emotional verbalizing proficiency and differences in brain activation during emotional processing. Specifically, we investigated whether COMT genotype would be associated with differences in activation in cortical midline structures during valence evaluation of words. Forty participants ranging from low to high on the verbalizing subscale of the Bermond-Vorst Alexithymia Questionnaire (BVAQ) were genotyped for the COMT Val158Met polymorphism. During fMRI, they evaluated the valence of emotional words. Met homozygotes reported more difficulties in verbalizing their feelings. In additio...
Comprehensive Psychiatry, 2000
Schizophrenia Bulletin, 2000
The purpose of the study was to examine (1) to which negative symptoms schizophrenia patients att... more The purpose of the study was to examine (1) to which negative symptoms schizophrenia patients attribute distress and (2) whether clinical variables can predict the levels of reported distress. With the help of a research assistant, 86 hospitalized patients completed a self-rating scale for negative symptoms. The 21 items of the self-rating scale were taken from the Scale for the
International Clinical Psychopharmacology, 2006
The present study reports on the development of a new self-administered instrument to assess pati... more The present study reports on the development of a new self-administered instrument to assess patients' responses to antipsychotic medication. The Subjects' Response to Antipsychotics (SRA) Questionnaire is a 74-item instrument with eight scales (Recovery, Weight Gain, Sexual Anhedonia, Sedation, Affective Flattening, Extrapyramidal Symptoms, Diminished Sociability and Increased Sleep), and a total adverse responses score including additional items. Psychometric aspects were examined in a study of 320 inpatients and outpatients showing good internal consistency, reproducibility and external validity.
Schizophrenia Research, 1999
The cognitive correlates of five symptom dimensions based on PANSS ratings were examined in a gro... more The cognitive correlates of five symptom dimensions based on PANSS ratings were examined in a group of 50 recent onset psychotic patients, using both objective and subjective cognitive measures. We were particularly interested in the depression dimension, since it has not been studied extensively thus far. The depression dimension showed a high number of correlations with both objective and subjective
Schizophrenia Research, 2010
Background: Intelligence scales supply a global measure of cognitive abilities, in the same way t... more Background: Intelligence scales supply a global measure of cognitive abilities, in the same way they can predict the performance of other neuropsychological measures. Therefore, as well as in clinical practice as in investigation the IQ results are used as a descriptive measure of the general intellectual capacity and as an interpretative context of other neuropsychological test's results. The most used intelligence scale is Wechsler Adult Intelligence Scale (WAIS-III), it is compounded of 14 subscales and its application takes about 60 to 110 minutes. It is usually used as a neuropsychological battery. For this reason, different authors have been trying to find a briefer way of applying WAIS, reducing the application time using a reduced number of subscales, without compromising the estimate of the Full-Scale IQ (FSIQ). Most of these investigations have focused on WAIS-R for different schizophrenic and Spanish speaker's populations. Our main objective was to find a brief way of application, composed by 4 subscales, one for each WAIS-III indicator, in Spanish persons with schizophrenia. Methods: Regression analysis was used for the data obtained in the WAIS-III application for 46 out-patients, who fulfill DSM-IV diagnostic criteria for schizophrenia. Each of these patients was sent by his/her psychiatrist, and they all fulfill the requirement of being in a stable clinical period of the disease. During the evaluation process all the participants were receiving antipsychotic medication, without any changes in the preceding 3 months. Apart from the application time and the punctuation, the Verbal Comprehension (VCI), Perceptual Organization (POI), Working Memory (WMI) and the Processing Speed (PSI) WAIS-III indicators were regarded. All the possible combinations were studied, and the one which offered the best reliability to estimate the FSIQ was selected, without underestimating the predictive capacity of other indicators. In order to estimate the correlation between the short form punctuations and the different indicators of the full WAIS-III, R 2 was corrected. Results: The 4-factors version that explained the biggest variations in the FSIQ punctuations, for this group of persons, is compounded by the Vocabulary (V), the Digit Symbol (DSym), the Block Design (BD) and the Digit Span (DS) subscales. The results for the R 2 and R 2 -corrected was respectively 0,954 and 0,95 for the FSIQ; 0,929 and 0,922 for the VCI; 0,855 and 0,841 for the POI; 0,889 and 0,878 for the WMI; 0,927 and 0,920 for the PSI. The derived formula for the regression analysis was FSIQ = 32,88 + 2,474 V + 1,064 DSym + 1,213 BD + 1,553 DS. The beta coefficients indicate the relative importance of each subscale in this brief form: 0,448 for V, 0,172 for DSym, 0,217 for BD, y 0,257 for DS. Discussion: Although the sample should be amplified, we recommend the WAIS-III short form compounded of V-DSym-BD-DS for future investigations and clinical practice, for stable patients with schizophrenia diagnostic, when the aim is to obtain a fast IQ estimation. In future investigations, it should be interesting to see if the application of this short form really works by itself, since its integration in the complete WAIS-III battery can affect the results.
Schizophrenia Bulletin, 2015
A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Mos... more A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Most patients show an interest in sex that differs little from the general population. By contrast, psychiatric symptoms, institutionalization, and psychotropic medication contribute to frequently occurring impairments in sexual functioning. Women with schizophrenia have a better social outcome, longer lasting (sexual) relationships, and more offspring than men with schizophrenia. Still, in both sexes social and interpersonal impairments limit the development of stable sexual relationships. Although patients consider sexual problems to be highly relevant, patients and clinicians not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment. Studies using structured interviews or questionnaires result in many more patients reporting sexual dysfunctions. Although sexual functioning can be impaired by different factors, the use of antipsychotic medication seems to be an important factor. A comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole. Postsynaptic dopamine antagonism, prolactin elevation, and α 1 -receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction. Psychosocial strategies to treat antipsychotic-induced sexual dysfunction include psychoeducation and relationship counseling. Pharmacological strategies include lowering the dose or switching to a prolactin sparing antipsychotic. Also, the addition of a dopamine agonist, aripiprazole, or a phosphodiesterase-5 inhibitor has shown some promising results, but evidence is currently scarce.
PLoS ONE, 2014
Background: Patients with schizophrenia often experience problems regulating their emotions. Non-... more Background: Patients with schizophrenia often experience problems regulating their emotions. Non-affected relatives show similar difficulties, although to a lesser extent, and the neural basis of such difficulties remains to be elucidated. In the current paper we investigated whether schizophrenia patients, non-affected siblings and healthy controls (HC) exhibit differences in brain activation during emotion regulation.