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A pilot study: comparative research of social functioning, circadian rhythm parameters, and cognitive function among institutional inpatients, and outpatients with chronic schizophrenia and healthy elderly people

Published online by Cambridge University Press:  05 August 2014

Yu Kume ,
Takio Sugita ,
Kenya Oga ,
Kai Kagami  and
Hitomi Igarashi
Yu Kume*
Affiliation:
Department of Occupational Therapy, Graduate School of Health Sciences, Akita University, Hondo, Akita, Japan
Takio Sugita
Affiliation:
Yokote Kohsei Hospital, Negishicho, Yokote, Japan
Kenya Oga
Affiliation:
Yokote Kohsei Hospital, Negishicho, Yokote, Japan
Kai Kagami
Affiliation:
Akita Higashi Hospital, Yamauchiazamarukibashi, Akita, Japan
Hitomi Igarashi
Affiliation:
Kasamatsu Hospital, Hamadaazaainohara, Akita, Japan
*
Correspondence should be addressed to: Yu Kume, Department of Occupational Therapy, Graduate School of Health Sciences, Akita University, 1-1-1 Hondo, Akita 010-8543, Japan. Phone & Fax: +81-18-884-6556. Email: [email protected].
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Abstract

Background:

Irregular circadian rhythm and cognitive impairment are frequently observed in patients with chronic schizophrenia. However, their effects in different living environments or with aging remain unclear. The aim of this study was to clarify the characteristics of circadian rhythm and cognition function in the patients with chronic schizophrenia.

Methods:

This report described data collected using continuous wrist-active monitoring in real-life settings for seven days and the Brief Assessment of Cognition in Schizophrenia Japanese Version (BACS-J) from 10 inpatients with chronic schizophrenia, 10 outpatients with chronic schizophrenia, and 15 healthy elderly people. The Global Assessment of Functioning (GAF) Scale was used to measure the social functioning in the patients with chronic schizophrenia.

Results:

The outpatients with chronic schizophrenia exhibited highly interrupted circadian patterns in terms of stability and the fragmentation of activity (p < 0.05) as indexed according to Interdaily Stability (IS) and Intradaily Variability (IV). The inpatients with chronic schizophrenia indicated the most stable rhythm (p < 0.05) and inactive state (p = 0.001) among the groups. Also, the inpatients with chronic schizophrenia showed poorer cognitive functioning with Z-scores of subtests except digit sequencing (p < 0.01). According to stepwise linear regression analysis, the motor speed of BACS-J and IS of circadian parameters were the most powerful variables to predict the GAF in patients with chronic schizophrenia.

Conclusions:

The characteristics of circadian rhythm and cognition function in the inpatients with chronic schizophrenia appear distinct from those in the outpatients and the healthy elderly people. Circadian rhythm and cognition function in the patients with chronic schizophrenia may, in part, be affected by different living environments.

Keywords

social functioncircadian rhythmcognitive impairmentchronic schizophreniaActiwatch 2
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 1 , January 2015 , pp. 135 - 143
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Bio, D. S. and Gattaz, W. F. (2011). Vocational rehabilitation improves cognition and negative symptoms in schizophrenia. Schizophrenia Research, 126, 265–269.Google Scholar
Bromundt, V. et al. (2011). Sleep-wake cycle and cognitive functioning in schizophrenia. British Journal of Psychiatry, 198, 269–276.CrossRefGoogle ScholarPubMed
Davidson, M. et al. (1995). Severity of symptoms in chronically institutionalized geriatric schizophrenic patients. American Journal of Psychiatry, 152, 197–207.Google ScholarPubMed
Gibson, R. W., D’Amico, M., Jaffe, L. and Arbesman, M. (2011). Occupational therapy interventions for recovery in the areas of community integration and normative life roles for adults with serious mental illness: a systematic review. American Journal Occupational Therapy, 65, 247–256.CrossRefGoogle ScholarPubMed
Grandin, L. D., Alloy, L. B. and Abramson, L. Y. (2006). The social zeitgeber theory, circadian rhythms, and mood disorders: review and evaluation. Clinical Psychology Review, 26, 679–694.Google Scholar
Gur, R. E. et al. (1998). A follow-up magnetic resonance imaging study of schizophrenia. Relationship of neuroanatomical changes to clinical and neurobehavioral measures. Archives of General Psychiatry, 55, 145–152.Google Scholar
Harvey, P. D. et al. (2000). Practice-related improvement in information processing with novel antipsychotic treatment. Schizophrenia Research, 46, 139–148.CrossRefGoogle ScholarPubMed
Kaneda, Y. et al. (2007). Brief assessment of cognition in schizophrenia: validation of the Japanese version. Psychiatry and Clinical Neurosciences, 61, 602–609.CrossRefGoogle ScholarPubMed
Keefe, R. S. et al. (2008). Norms and standardization of the brief assessment of cognition in schizophrenia (BACS). Schizophrenia Research, 102, 108–115.CrossRefGoogle ScholarPubMed
Krupa, T., Fossey, E., Anthony, W. A., Brown, C. and Pitts, D. B. (2009). Doing daily life: how occupational therapy can inform psychiatric rehabilitation practice. Psychiatric Rehabilitation Journal, 32, 155–161.Google Scholar
Loewenstein, D. A., Czaja, S. J., Bowie, C. R. and Harvey, P. D. (2012). Age-associated differences in cognitive performance in older patients with schizophrenia: a comparison with healthy older adults. American Journal of Geriatric Psychiatry, 20, 29–40.CrossRefGoogle ScholarPubMed
Luik, A. I., Zuurbier, L. A., Hofman, A., Van Someren, E. J. and Tiemeier, H. (2013). Stability and fragmentation of the activity rhythm across the sleep-wake cycle: the importance of age, lifestyle, and mental health. Chronobiology International, 30, 1223–1230.CrossRefGoogle ScholarPubMed
Martin, J. et al. (2001). Actigraphic estimates of circadian rhythms and sleep/wake in older schizophrenia patients. Schizophrenia Research, 47, 77–86.Google Scholar
Monti, J. M. et al. (2013). Sleep and circadian rhythm dysregulation in schizophrenia. Progress in Neuropsychopharmacology and Biological Psychiatry, 43, 209–216.Google Scholar
Moraes, W. et al. (2014). Effects of aging on sleep structure throughout adulthood: a population-based study. Sleep Medicine, 15, 401–409.Google Scholar
Morimoto, T., Matsuyama, K., Ichihara-Takeda, S., Murakami, R. and Ikeda, N. (2012). Influence of self-efficacy on the interpersonal behavior of schizophrenia patients undergoing rehabilitation in psychiatric day-care services. Psychiatry and Clinical Neuroscience, 66, 203–209.Google Scholar
Mueser, K. T. (2000). Cognitive functioning, social adjustment, and long-term outcome in schizophrenia. In Sharma, T. and Harvey, P. D. (eds.), Cognition in Schizophrenia (pp. 157–177). Oxford: Oxford University Press.CrossRefGoogle Scholar
Pizzi, M. A. (2013). Obesity, health and quality of life: a conversation to further the vision in occupational therapy. Occupational Therapy in Health Care, 27, 78–83.Google Scholar
Pritchett, D. et al. (2012). Evaluating the links between schizophrenia and sleep and circadian rhythm disruption. Journal of Neural Transmission, 119, 1061–1075.Google Scholar
Prouteau, A. et al. (2005). Cognitive predictors of psychosocial functioning outcome in schizophrenia: a follow-up study of subjects participating in a rehabilitation program. Schizophrenia Research, 77, 343–353.CrossRefGoogle Scholar
Staedt, J., Dewes, D., Danos, P. and Stoppe, G. (2000). Can chronic neuroleptic treatment promote sleep disturbances in elderly schizophrenic patients? International Journal of Geriatric Psychiatry, 15, 170–176.Google Scholar
Tombaugh, T. N., Kozak, J. and Rees, L. (1999). Normative data stratified by age and education for two measures of verbal fluency: FAS and animal naming. Archives of Clinical Neuropsychology, 14, 167–177.Google Scholar
Van Haren, N. E. et al. (2007). Focal gray matter changes in schizophrenia across the course of the illness: a 5-year follow-up study. Neuropsychopharmacology, 32, 2057–2066.Google Scholar
Van Someren, E. J. et al. (1999). Bright light therapy, improved sensitivity to its effects on rest-activity rhythms in Alzheimer patients by application of nonparametric methods. Chronobiology International, 16, 505–518.CrossRefGoogle ScholarPubMed
Wirz-Justice, A., Haug, H. J. and Cajochen, C. (2001). Disturbed circadian rest-activity cycles in schizophrenia patients: an effect of drugs? Schizophrenia Bulletin, 27, 497–502.CrossRefGoogle ScholarPubMed
Witting, W., Kwa, I. H., Eikelenboom, P., Mirmiran, M. and Swaab, D. F. (1990). Alterations in the circadian rest-activity rhythm in aging and Alzheimer's disease. Biological Psychiatry, 27, 563–572.CrossRefGoogle ScholarPubMed
Wulff, K., Dijk, D. J., Middleton, B., Foster, R. G. and Joyce, E. M. (2012). Sleep and circadian rhythm disruption in schizophrenia. British Journal of Psychiatry, 200, 308–316.CrossRefGoogle ScholarPubMed
Wyke, T. (2000). Cognitive rehabilitation and remediation. In Sharma, T. and Harvey, P. D. (eds.), Cognition in Schizophrenia (pp. 332–351). Oxford: Oxford University Press.CrossRefGoogle Scholar