Long-And Short-Term Inpatients With Schizophrenia in China: Implications For Community-Based Service Development

the short-term inpatients scored significantly
higher than their long-term counterparts on the Positive Syndrome

sub-scale and the SSRS and lower on the Negative Syndrome sub-scale.
there were positive

correlations between LOS and the Negative Syndrome
score (r = 0.289, P 0.001), age (r = 0.545,
P 0.001) and duration of illness (r = 0.609,
P 0.001) (Table 4).
Long- and short-term inpatients with schizophrenia

in China:
Implications for community-based service
development
Guowei Wu1 MD, Xuan Ouyang1 PhD MD, Bo Yang1 PhD MD, Li Li1 MD, Zheng Wang1 PhD
MD,
Wenying Yi1 PhD, Chang Liu1 PhD, Peng Wang1 PhD, Helen F.K. Chiu2 MD, Edwin Lee2 MD,
Zhimin Xue1 PhD MD, Robert Rosenheck3 MD & Zhening Liu1 PhD MD
Asia-Pacific Psychiatry 5 (2013) E39E46
DOI:10.1111/j.1758-5872.2012.00229.x
Menurut penelitian yang dilakukan oleh Patel et al (2015) terhadap

7678 pasien skizofrenia yang menjalani rawat inap di inggris
didapatkan hasil bahwa pasien skizofrenia yang mengalami 2 atau
lebih gejala negatif rata-rata menjalani rawat inap 21 hari lebih lama.
Patel R, Jayatilleke N,
Broadbent M, et al. Negative

symptoms in schizophrenia:
a study in a large clinical
sample of patients using a
novel automated method.
BMJ Open 2015;5:e007619.
doi:10.1136/bmjopen-2015-
007619
The aetiology and

pathophysiology of negative symptoms are
unknown, and there are no effective
treatments
Fusar-Poli P, Papanastasiou E, Stahl D, et al. Treatments of

negative symptoms in schizophrenia: meta-analysis of 168
randomized placebo-controlled trials. Schizophr Bull 2014;41:
8929.
In addition, it was reported that LOS may be related to deficiencies

of vitamins B6 and B12, as well as to poorer nutritional
status, in 52 elderly rehabilitation patients [5], OLeary et al. study
[5] of Australia, which evaluated B vitamin status, dietary intake,
and length of stay in 52 elderly rehabilitation patients. They
pointed out the high risk of vitamin B deficiencies in the elderly
and suggested that deficiencies of B12 are associated with length
of stay.
OLeary F, Flood VM, Petocz P, Allman-Farinelli M, Samman SB. Vitamin

status, dietary intake and length of stay in a sample of elderly rehabilitation
patients. J Nutr Health Aging 2011;15:4859.
LOS in our population did not relate to vitamin B12 and folic
acid levels.
Pnar Soysal M.D. a, Ahmet Turan Isik M.D., Prof. b,*, Aycan U_gur M.D. a,
Rumeyza Kazancioglu M.D., Prof. c, Fatih Ergun M.D. a, Gulsen Babacan Yildiz M.D. d
Vitamin B12 and folic acid levels are not related to length of stay
in elderly inpatients
www.nutritionjrnl.com http://dx.doi.org/10.1016/j.nut.2012.10.003
Additionally, negative symptoms

(e.g. anhedonia and amotivation) are largely unresponsive
to antipsychotic treatment but have a strong infuence
on functional outcomes (Kirkpatrick et al. 2006;
Alvarez-Jimenez et al. 2012).
Alvarez-Jimenez M, Gleeson J, Henry L, Harrigan S, Harris

M, Killackey E, Bendall S, Amminger G, Yung A,
Herrman H (2012). Road to full recovery: longitudinal
relationship between symptomatic remission and
psychosocial recovery in first-episode psychosis over 7.5
years. Psychological Medicine 42, 595606.
Kirkpatrick B, Fenton WS, Carpenter WT, Marder SR (2006).

The NIMH-MATRICS consensus statement on negative
symptoms. Schizophrenia Bulletin 32, 214219.
Serum indicators
of reduced D and B vitamins have been found to hold
significant associations with illness severity, particularly
with regards to negative symptoms (Kale et al.
2010; Graham et al. 2015).
Furthermore, these vitamin

deficiencies are associated with neurological abnormalities
observed in schizophrenia; such as hippocampal
deterioration and cognitive impairments (Graham et al.
2015; Shivakumar et al. 2015), perhaps due to the essential
role these vitamins play in the biosynthesis of proteins
which promote neuronal growth and repair.
Shivakumar V, Kalmady SV, Amaresha AC, Jose D,

Narayanaswamy JC, Agarwal SM, Joseph B,
Venkatasubramanian G, Ravi V, Keshavan MS,
Gangadhar BN (2015). Serum vitamin D and hippocampal
gray matter volume in schizophrenia. Psychiatry Research:
Neuroimaging 233, 175179.
Subjects with longer length

of stay ( 21 days) were marginally older (83 vs 78 years
p=0.054), had lower vitamin B6 (median 14.5 vs 21.5 nmol/L,
Mann Whitney Test p=0.025), lower serum folate
concentrations (14 vs 18 nmol/L, p=0.035) and had more B
vitamin deficiencies (Phi coefficient 0.38, p=0.026).
Length of
stay was found to increase with increasing age and MMA
levels; and was related to poorer nutritional status, lower serum
folate, vitamin B6 and albumin levels. Length of stay was
longer in subjects with two or more B vitamin deficiencies and
these subjects had lower dietary intakes of calcium, ribofavin
and vitamin B12. deficiencies of vitamins B6 and B12 are associated with length of stay
B VITAMIN STATUS, DIETARY INTAKE AND LENGTH OF
STAY IN A SAMPLE
OF ELDERLY REHABILITATION PATIENTS
F. OLEARY1, V.M. FLOOD1,2, P. PETOCZ3, M. ALLMAN-FARINELLI1, S.
SAMMAN1
The Journal of Nutrition, Health & Aging
Volume 15, Number 6, 2011
Cognitive dysfunction
and negative symptoms, both of which are often
enduring and resistant to conventional treatments, are
present in most persons with schizophrenia.
Relationship of Cognitive
Functioning, Adaptive Life
Skills, and Negative Symptom
Severity in Poor-Outcome
Geriatric Schizophrenia
Patients
Susan R. McGurk, Ph.D.
Patrick J. Moriarty, M.A.
Philip D. Harvey, Ph.D.
Michael Parrella, Ph.D.
Leonard White, Ph.D.
Joseph Friedman, M.D.
Kenneth L. Davis, M.D
J Neuropsychiatry Clin Neurosci 12:2, Spring 2000
Prior cross-sectional studies of chronically hospitalized

patients with poor outcome have demonstrated significant
correlations between both negative and cognitive
symptoms and impaired adaptive life skills,13
Harvey PD, Howanitz E, Parrella M, et al: Cognitive, adaptive,

and clinical symptoms in geriatric patients with lifelong schizophrenia:
a comparative study across treatment sites. Am J Psychiatry
1998; 155:10801086
Studies applying
factor analysis and regression analysis of BPRS-E symptoms
in hospitalized psychiatric patients with persistent mental
illness found that the severity of negative symptoms was
the best predictor of the inpatient length of stay [18].
Biancospino B, Barbui C, Grassi L. The BPRS-E as predictor of

length of stay in a residential facility. Psychiatric Serv 2004; 55(1):
77-9.
The most important predictor of duration of hospitalization

was the POSITIVE SYMPTOMS factor (= 0.22;
p<0.005). The NEGATIVE SYMPTOMS factor was also a
significant predictor but the strength of correlation was relatively
weak (= 0.16; p<0.05)
Symptom Dimensions as Predictors of Clinical Outcome,

Duration of
Hospitalization, and Aggressive Behaviours in Acutely
Hospitalized
Patients with Psychotic Exacerbation
Alessandro Colasanti1,2, Silvia Paletta1, Donatella Moliterno1, Alessandra Mazzocchi1,
Massimo
Carlo Mauri1,* and Alfredo Carlo Altamura1
Clinical Practice & Epidemiology in Mental Health, 2010, 6, 72-78
Anderson et al. [17], however, showed

that negative symptoms factors were the best predictor of the
length of stay. The discrepancies between these studies
might be due to the fact that the sample of Anderson was
constituted by patients affected by severe and persistent illness
in a medium-term care setting (mean stay more than
100 days). Since in such sample negative symptoms tend to
be more treatment resistant than other symptoms, it is conceivable
that in Andersons study negative symptoms may be
the best correlate of the length of hospitalization.

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the short-term inpatients scored significantly

higher than their long-term counterparts on the Positive Syndrome

there were positive

Long- and short-term inpatients with schizophrenia

Asia-Pacific Psychiatry 5 (2013) E39E46

Menurut penelitian yang dilakukan oleh Patel et al (2015) terhadap

Broadbent M, et al. Negative

The aetiology and

Fusar-Poli P, Papanastasiou E, Stahl D, et al. Treatments of

In addition, it was reported that LOS may be related to deficiencies

OLeary F, Flood VM, Petocz P, Allman-Farinelli M, Samman SB. Vitamin

Additionally, negative symptoms

Alvarez-Jimenez M, Gleeson J, Henry L, Harrigan S, Harris

Kirkpatrick B, Fenton WS, Carpenter WT, Marder SR (2006).

Furthermore, these vitamin

Shivakumar V, Kalmady SV, Amaresha AC, Jose D,

Subjects with longer length

Prior cross-sectional studies of chronically hospitalized

Harvey PD, Howanitz E, Parrella M, et al: Cognitive, adaptive,

Biancospino B, Barbui C, Grassi L. The BPRS-E as predictor of

The most important predictor of duration of hospitalization

Symptom Dimensions as Predictors of Clinical Outcome,

Anderson et al. [17], however, showed

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