Automatic Thoughts, Self-Stigma, and Resilience Among Schizophrenia Patients with Metabolic Syndrome: A Cross-Sectional Study

Purpose The study aims to clarify the negative psychological state and resilience impairments of schizophrenia (SCZ) with metabolic syndrome (MetS) while evaluating their potential as risk factors. Patients and Methods We recruited 143 individuals and divided them into three groups. Participants were evaluated using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD)-24, Hamilton Anxiety Rating Scale (HAMA)-14, Automatic Thoughts Questionnaire (ATQ), Stigma of Mental Illness scale and Connor–Davidson Resilience Scale (CD-RISC). Serum biochemical parameters were measured by automatic biochemistry analyzer. Results The score of ATQ was highest in the MetS group (F = 14.5, p < 0.001), and the total score of CD-RISC, subscale tenacity score and subscale strength score of CD-RISC were lowest in the MetS group (F = 8.54, p < 0.001; F = 5.79, p = 0.004; F = 10.9, p < 0.001). A stepwise regression analysis demonstrated that a negative correlation was observed among the ATQ with employment status, high-density lipoprotein (HDL-C), and CD-RISC (β=−0.190, t=−2.297, p = 0.023; β=−0.278, t=−3.437, p = 0.001; β=−0.238, t=−2.904, p = 0.004). A positive correlation was observed among the ATQ with waist, TG, WBC, and stigma (β=0.271, t = 3.340, p = 0.001; β=0.283, t = 3.509, p = 0.001; β=0.231, t = 2.815, p = 0.006; β=0.251, t=−2.504, p = 0.014). The area under the receiver-operating characteristic curve analysis showed that among all independent predictors of ATQ, the TG, waist, HDL-C, CD-RISC, and stigma presented excellent specificity at 0.918, 0.852, 0.759, 0.633, and 0.605, respectively. Conclusion Results suggested that the non-MetS and MetS groups had grievous sense of stigma, particularly, high degree of ATQ and resilience impairment was shown by the MetS group. The TG, waist, HDL-C of metabolic parameters, CD-RISC, and stigma presented excellent specificity to predict ATQ, and the waist showed excellent specificity to predict low resilience level.

[1]  Jichao Liu,et al.  Metabolic syndrome in patients with schizophrenia: Why should we care , 2022, Medicine.

[2]  Yongyong Shi,et al.  Decoding psychosis: from national genome project to national brain project , 2022, General Psychiatry.

[3]  Peijun Ju,et al.  The Predictive Role of Aberrant Metabolic Parameters and Negative Automatic Thinking on the Cognitive Impairments Among Schizophrenia Patients with Metabolic Syndrome , 2022, Neuropsychiatric disease and treatment.

[4]  K. Dong,et al.  Consensus on potential biomarkers developed for use in clinical tests for schizophrenia , 2022, General Psychiatry.

[5]  C. Bredicean,et al.  The Relation between Negative Automatic Thoughts and Psychological Inflexibility in Schizophrenia , 2022, Journal of clinical medicine.

[6]  Ö. Şahin Altun,et al.  Investigation of the relationship between the negative automatic thoughts of patients with schizophrenia and their levels of social functionality. , 2021, Perspectives in psychiatric care.

[7]  Janice M. Fullerton,et al.  A schizophrenia subgroup with elevated inflammation displays reduced microglia, increased peripheral immune cell and altered neurogenesis marker gene expression in the subependymal zone , 2021, Translational Psychiatry.

[8]  H. Komatsu,et al.  Mediating effects of self-stigma and depression on the association between autistic symptoms and recovery in patients with schizophrenia-spectrum disorders: a cross-sectional study , 2021, BMC Psychiatry.

[9]  M. A. Karaman,et al.  Elevated Monocyte to High-density Lipoprotein Ratios as an Inflammation Markers for Schizophrenia Patients , 2021, Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology.

[10]  S. Sullivan,et al.  Antipsychotic Polypharmacy and Metabolic Syndrome in Schizophrenia: A Review of Systematic Reviews. , 2020, Focus.

[11]  M. Şahpolat,et al.  Higher prevalence of metabolic syndrome and related factors in patients with first-episode psychosis and schizophrenia: a cross-sectional study in Turkey , 2020, Nordic journal of psychiatry.

[12]  M. Jang,et al.  Risk Factors of Metabolic Syndrome in Community-Dwelling People with Schizophrenia , 2020, International journal of environmental research and public health.

[13]  Roger L. Brown,et al.  Properties of the Early Symptom Measurement of Post-Stroke Depression: Concurrent Criterion Validity and Cutoff Scores , 2020, The journal of nursing research : JNR.

[14]  A. Prouteau,et al.  Schizophrenia stigma in mental health professionals and associated factors: A systematic review , 2020, Psychiatry Research.

[15]  M. Şahpolat,et al.  Plasma Apelin, Visfatin and Resistin Levels in Patients with First Episode Psychosis and Chronic Schizophrenia , 2020, Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology.

[16]  F. Korkusuz,et al.  What happens to bone mineral density, strength and body composition of ex-elite female volleyball players: A cross sectional study , 2019, Science & Sports.

[17]  N. Küçükkubaş,et al.  Relationship Between Body Composition, Vertical Jump, 30 M Sprint, Static Strength and Anaerobic Power for Athletes , 2019, International Journal of Sport, Exercise & Training Sciences.

[18]  A. Demir,et al.  Comparison of Dynamic Balance Properties of Hypermobility in Boys , 2019, International Journal of Sport, Exercise & Training Sciences.

[19]  Sayo Hamatani,et al.  Negative and positive self-thoughts predict subjective quality of life in people with schizophrenia , 2019, Neuropsychiatric disease and treatment.

[20]  M. Mimura,et al.  Religiosity and psychological resilience in patients with schizophrenia and bipolar disorder: an international cross‐sectional study , 2018, Acta psychiatrica Scandinavica.

[21]  B. Penninx,et al.  Metabolic syndrome in psychiatric patients: overview, mechanisms, and implications , 2018, Dialogues in clinical neuroscience.

[22]  A. Othman,et al.  Efficacy and Safety of the α7-Nicotinic Acetylcholine Receptor Agonist ABT-126 in the Treatment of Cognitive Impairment Associated With Schizophrenia: Results From a Phase 2b Randomized Controlled Study in Smokers. , 2017, The Journal of clinical psychiatry.

[23]  J. Soares,et al.  Prevalence, demographic and clinical features of comorbid depressive symptoms in drug naïve patients with schizophrenia presenting with first episode psychosis , 2017, Schizophrenia Research.

[24]  S. Ivezić,et al.  Effects of a Group Psychoeducation Program on Self-Stigma, Empowerment and Perceived Discrimination of Persons with Schizophrenia. , 2017, Psychiatria Danubina.

[25]  G. Garyfallos,et al.  Resilience in Patients With Recent Diagnosis of a Schizophrenia Spectrum Disorder , 2016, The Journal of nervous and mental disease.

[26]  G. Kemmler,et al.  Resilience, internalized stigma, self-esteem, and hopelessness among people with schizophrenia: Cultural comparison in Austria and Japan , 2016, Schizophrenia Research.

[27]  Norio Sugawara,et al.  Attitudes toward metabolic adverse events among patients with schizophrenia in Japan , 2016, Neuropsychiatric disease and treatment.

[28]  A. Yung,et al.  Cardiometabolic risk factors in young people at ultra-high risk for psychosis: A systematic review and meta-analysis , 2016, Schizophrenia Research.

[29]  R. Emsley,et al.  A systematic review of genetic variants associated with metabolic syndrome in patients with schizophrenia , 2016, Schizophrenia Research.

[30]  D. Vancampfort,et al.  A narrative synthesis investigating the use and value of social support to promote physical activity among individuals with schizophrenia , 2016, Disability and rehabilitation.

[31]  T. Lan,et al.  Validation of a five-factor model of a Chinese Mandarin version of the Positive and Negative Syndrome Scale (CMV-PANSS) in a sample of 813 schizophrenia patients , 2015, Schizophrenia Research.

[32]  M. Emul,et al.  Etiology of cardiovascular disease in patients with schizophrenia: current perspectives , 2015, Neuropsychiatric disease and treatment.

[33]  O. Andreassen,et al.  Increased Mortality in Schizophrenia Due to Cardiovascular Disease – A Non-Systematic Review of Epidemiology, Possible Causes, and Interventions , 2014, Front. Psychiatry.

[34]  P. Corrigan,et al.  Mental health stigma and primary health care decisions , 2014, Psychiatry Research.

[35]  A. Adelufosi,et al.  Self-stigma, quality of life and schizophrenia: An outpatient clinic survey in Nigeria , 2014, The International journal of social psychiatry.

[36]  Michael B First,et al.  Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility. , 2013, The Journal of nervous and mental disease.

[37]  Sandeep Grover,et al.  Metabolic syndrome in schizophrenia , 2013, Indian journal of psychological medicine.

[38]  Oya Mortan Sevi,et al.  OTOMATİK DÜŞÜNCELER ÖLÇEĞİ’NİN ŞİZOFRENİ HASTALARININ OLUMSUZ OTOMATİK DÜŞÜNCELERİNİ DEĞERLENDİRMEDE GEÇERLİK VE GÜVENİRLİĞİNE DAİR BİR ÖN ÇALIŞMA , 2013 .

[39]  D. Vancampfort,et al.  Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders--a systematic review and meta-analysis. , 2013, Schizophrenia bulletin.

[40]  Mogens Vestergaard,et al.  Life expectancy and cardiovascular mortality in persons with schizophrenia , 2012, Current opinion in psychiatry.

[41]  M. Hasnain,et al.  Metabolic Syndrome Associated with Schizophrenia and Atypical Antipsychotics , 2010, Current diabetes reports.

[42]  G. Thornicroft,et al.  Experiences of mental illness stigma, prejudice and discrimination: a review of measures , 2010, BMC health services research.

[43]  Paul L. Huang.  A comprehensive definition for metabolic syndrome , 2009, Disease Models & Mechanisms.

[44]  D. Wong,et al.  Cognitive–Behavioral Treatment Groups for People with Chronic Physical Illness in Hong Kong: Reflections on a Culturally Attuned Model , 2007, International journal of group psychotherapy.

[45]  J. Davidson,et al.  Development of a new resilience scale: The Connor‐Davidson Resilience Scale (CD‐RISC) , 2003, Depression and anxiety.

[46]  Ömer Şenormancı,et al.  Resilience and Associated Factors in Schizophrenia. , 2022, Turk psikiyatri dergisi = Turkish journal of psychiatry.

[47]  J. Boyd,et al.  Internalized Stigma of Mental Illness (ISMI) scale: a multinational review. , 2014, Comprehensive psychiatry.

[48]  Si Tian.  Evaluation of the Reliability and Validity of Chinese Version of the Mini-International Neuropsychiatric Interview in Patients with Mental Disorders , 2009 .

[49]  [Chinese guidelines on prevention and treatment of dyslipidemia in adults]. , 2007, Zhonghua xin xue guan bing za zhi.

[50]  R. Reznek,et al.  Increased visceral fat distribution in drug-naive and drug-free patients with schizophrenia , 2002, International Journal of Obesity.