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González-Blanch C, Medrano LA, Bendall S, D'Alfonso S, Cagliarini D, McEnery C, O'Sullivan S, Valentine L, Gleeson JF, Alvarez-Jimenez M. The role of social relatedness and self-beliefs in social functioning in first-episode psychosis: Are we overestimating the contribution of illness-related factors? Eur Psychiatry 2020; 63:e92. [PMID: 33032679 PMCID: PMC7681152 DOI: 10.1192/j.eurpsy.2020.90] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective Numerous research studies have demonstrated an association between higher symptom severity and cognitive impairment with poorer social functioning in first-episode psychosis (FEP). By contrast, the influence of subjective experiences, such as social relatedness and self-beliefs, has received less attention. Consequently, a cohesive understanding of how these variables interact to influence social functioning is lacking. Method We used structural equation modeling to examine the direct and indirect relationships among neurocognition (processing speed) and social cognition, symptoms, and social relatedness (perceived social support and loneliness) and self-beliefs (self-efficacy and self-esteem) in 170 individuals with FEP. Results The final model yielded an acceptable model fit (χ2 = 45.48, comparative fit index = 0.96; goodness of fit index = 0.94; Tucker–Lewis index = 0.94; root mean square error of approximation = 0.06) and explained 45% of social functioning. Negative symptoms, social relatedness, and self-beliefs exerted a direct effect on social functioning. Social relatedness partially mediated the impact of social cognition and negative symptoms on social functioning. Self-beliefs also mediated the relationship between social relatedness and social functioning. Conclusions The observed associations highlight the potential value of targeting social relatedness and self-beliefs to improve functional outcomes in FEP. Explanatory models of social functioning in FEP not accounting for social relatedness and self-beliefs might be overestimating the effect of the illness-related factors.
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Affiliation(s)
- César González-Blanch
- Mental Health Centre, University Hospital Marqués de Valdecilla - IDIVAL, Santander, Spain
| | - Leonardo A Medrano
- Faculty of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Sarah Bendall
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simon D'Alfonso
- Orygen, Melbourne, Victoria, Australia.,School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
| | - Daniela Cagliarini
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Carla McEnery
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Shaunagh O'Sullivan
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lee Valentine
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John F Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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302
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Bland AR, .Roiser JP, Mehta MA, Sahakian BJ, Robbins TW, Elliott R. COVID-19 induced social isolation; implications for understanding social cognition in mental health. Psychol Med 2020; 52:1-2. [PMID: 33028434 PMCID: PMC7591753 DOI: 10.1017/s0033291720004006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 11/22/2022]
Affiliation(s)
- A. R. Bland
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - J. P .Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - M. A. Mehta
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - B. J. Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - T. W. Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - R. Elliott
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
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303
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Poddar I, Callahan PM, Hernandez CM, Pillai A, Yang X, Bartlett MG, Terry AV. Oral quetiapine treatment results in time-dependent alterations of recognition memory and brain-derived neurotrophic factor-related signaling molecules in the hippocampus of rats. Pharmacol Biochem Behav 2020; 197:172999. [PMID: 32702397 DOI: 10.1016/j.pbb.2020.172999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022]
Abstract
Antipsychotic drugs (APDs) have a variety of important therapeutic applications for neuropsychiatric disorders. However, they are routinely prescribed off-label across all age categories, a controversial practice given their potential for producing metabolic and extrapyramidal side effects. Evidence also suggests that chronic treatment with some APDs may lead to impairments in cognition and decreases in brain volume, although these findings are controversial. The purpose of the studies described here was to evaluate one of the most commonly prescribed APDs, quetiapine, for chronic effects on recognition memory, brain-derived neurotrophic factor (BDNF), its precursor proBDNF, as well as relevant downstream signaling molecules that are known to influence neuronal plasticity and cognition. Multiple cohorts of adult rats were treated with quetiapine (25.0 mg/kg/day) for 30 or 90 days in their drinking water then evaluated for drug effects on motor function in a catalepsy assessment, recognition memory in a spontaneous novel object recognition (NOR) task, and BDNF-related signaling molecules in the post mortem hippocampus via Western Blot. The results indicated that oral quetiapine at a dose that did not induce catalepsy, led to time-dependent impairments in NOR performance, increases in the proBDNF/BDNF ratio, and decreases in Akt and CREB phosphorylation in the hippocampus. These results indicate that chronic treatment with quetiapine has the potential to adversely affect recognition memory and neurotrophin-related signaling molecules that support synaptic plasticity and cognitive function. Given the widespread use this APD across multiple conditions and patient populations, such long-term effects observed in animals should be considered.
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Affiliation(s)
- Indrani Poddar
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Patrick M Callahan
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America; Small Animal Behavior Core, Augusta University, Augusta, GA 30912, United States of America
| | - Caterina M Hernandez
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Anilkumar Pillai
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Xiangkun Yang
- Department of Pharmaceutical and Biomedical Sciences, University of Georgia College of Pharmacy, Athens, GA 30602, United States of America
| | - Michael G Bartlett
- Department of Pharmaceutical and Biomedical Sciences, University of Georgia College of Pharmacy, Athens, GA 30602, United States of America
| | - Alvin V Terry
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America; Small Animal Behavior Core, Augusta University, Augusta, GA 30912, United States of America.
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304
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Cognitive Heterogeneity across Schizophrenia and Bipolar Disorder: A Cluster Analysis of Intellectual Trajectories. J Int Neuropsychol Soc 2020; 26:860-872. [PMID: 32423506 DOI: 10.1017/s1355617720000442] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Cognitive dysfunction cut across diagnostic categories and is present in both schizophrenia and bipolar disorder, although with considerable heterogeneity in both disorders. This study examined if distinct cognitive subgroups could be identified across schizophrenia and bipolar disorder based on the intellectual trajectory from the premorbid phase to after illness onset. METHOD Three hundred and ninety-eight individuals with schizophrenia (n = 223) or bipolar I disorder (n = 175) underwent clinical and neuropsychological assessment. Hierarchical and k-means cluster analyses using premorbid (National Adult Reading Test) and current IQ (Wechsler Abbreviated Scale of Intelligence) estimates were performed for each diagnostic category, and the whole sample collapsed. Resulting clusters were compared on neuropsychological, functional, and clinical variables. Healthy controls (n = 476) were included for analyses of neuropsychological performance. RESULTS Cluster analyses consistently yielded three clusters: a relatively intact group (36% of whole sample), an intermediate group with mild cognitive impairment (44%), and an impaired group with global deficits (20%). The clusters were validated by multinomial logistic regression and differed significantly for neuropsychological, functional, and clinical measures. The relatively intact group (32% of the schizophrenia sample and 42% of the bipolar sample) performed below healthy controls for speeded neuropsychological tests. CONCLUSIONS Three cognitive clusters were identified across schizophrenia and bipolar disorder using premorbid and current IQ estimates. Groups differed for clinical, functional, and neuropsychological variables, implying their meaningfulness. One-third of the schizophrenia sample belonged to the relatively intact group, highlighting that neuropsychological assessment is needed for the precise characterization of the individual.
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305
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Resting-state hyperconnectivity within the default mode network impedes the ability to initiate cognitive performance in first-episode schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry 2020; 102:109959. [PMID: 32376341 DOI: 10.1016/j.pnpbp.2020.109959] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/15/2020] [Accepted: 04/30/2020] [Indexed: 02/07/2023]
Abstract
Among multiple cognitive impairments present in schizophrenia, a decline in fast information processing is one of the most severe neuropsychological deficit. Reduced ability to efficiently launch a coherent cognitive activity might be a significant factor contributing to poor results in time-limited tasks obtained by schizophrenia patients. The aim of this study was to identify neurophysiological predictors of expected cognitive initiation failures in a group of first-episode schizophrenia individuals (SZ). To evaluate the effectiveness of initiation, a dynamic analysis of design fluency test was applied, assessing to what extent the productivity was focused within the first interval of the performance, what is a typical way healthy subjects execute this task. Resting-state EEG recordings were obtained from SZ patients (n = 34) and controls (n = 30) to examine functional connectivity between 84 intra-cortical current sources determined by eLORETA (exact low-resolution brain electromagnetic tomography) for six conventionally analyzed frequencies. The nonparametric randomization approach was used to identify hypo- and hyper-connections, i.e. synchronizations significantly differentiating the studied samples in terms of connectivity strength. Generally, SZ patients obtained poor outcomes in fluency test and dynamic analysis of performance confirmed the presence of initiation deficit in clinical sample, which was a single factor explaining the intergroup difference regarding the entire task. In the majority of frequencies, the arrangement of synchronizations in SZ group was dominated by hypo-connections, except for the theta band, in which the strength of synchronizations between posterior cingulate cortex, cuneus and precuneus was significantly higher for SZ group. These theta-band hyper-connections turned out to be significant predictors of cognitive initiation failure in the clinical sample. Additionally, theta hyper-connections correlated negatively with the total number of unique designs generated by patients, however, the strength of this correlation was weaker than regarding initiation index. The results of this study suggest that baseline hyperconnectivity within the posterior hub of the Default Mode Network, containing posterior cingulate gyrus and precuneus, might disturb effective cognitive outcome, not only by interfering with task-positive functional networks but also by delaying the starting phase of performance, which might be specifically deleterious for the execution of time-limited tests.
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306
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Barlati S, Minelli A, Ceraso A, Nibbio G, Carvalho Silva R, Deste G, Turrina C, Vita A. Social Cognition in a Research Domain Criteria Perspective: A Bridge Between Schizophrenia and Autism Spectra Disorders. Front Psychiatry 2020; 11:806. [PMID: 33005149 PMCID: PMC7485015 DOI: 10.3389/fpsyt.2020.00806] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/27/2020] [Indexed: 12/27/2022] Open
Abstract
Schizophrenia and autism spectra disorders are currently conceptualized as distinct clinical categories. However, the relationship between these two nosological entities has been revisited in recent years due to the evidence that they share some important clinical and neurobiological features, putting into question the nature and the extent of their commonalities and differences. In this respect, some core symptoms that are present in both disorders, such as social cognitive deficits, could be a primary target of investigation. This review briefly summarizes the commonalities and overlapping features between schizophrenia and autism spectra disorders in social cognitive functions, considering this construct in a Research Domain Criteria perspective. The clinical manifestation of deficits in social cognition are similar in schizophrenia spectrum disorders and autism spectrum disorders, and brain areas that appear to be altered in relation to these impairments are largely shared; however, the results of various studies suggest that, in some cases, the qualitative nature of these alterations may be different in the two spectra. Moreover, relevant differences could be present at the level of brain networks and connections. More research is required in this field, regarding molecular and genetic aspects of both spectra, to better define the neurobiological mechanisms involved in social cognition deficits, with the objective of developing specific and targeted treatments.
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Affiliation(s)
- Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, and Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alessandra Minelli
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Anna Ceraso
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Gabriele Nibbio
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Rosana Carvalho Silva
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Giacomo Deste
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Cesare Turrina
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
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307
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Rokita KI, Dauvermann MR, Mothersill D, Holleran L, Holland J, Costello L, Cullen C, Kane R, McKernan D, Morris DW, Kelly J, Gill M, Corvin A, Hallahan B, McDonald C, Donohoe G. Childhood trauma, parental bonding, and social cognition in patients with schizophrenia and healthy adults. J Clin Psychol 2020; 77:241-253. [DOI: 10.1002/jclp.23023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/18/2020] [Accepted: 06/04/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Karolina I. Rokita
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Maria R. Dauvermann
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - David Mothersill
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Laurena Holleran
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Jessica Holland
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Laura Costello
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Caroline Cullen
- Wellcome—HRB Clinical Research Facility St. James's Hospital Dublin Ireland
- Department of Psychiatry, Trinity Centre for Health Sciences St. James's Hospital Dublin Ireland
| | - Ruán Kane
- School of Psychology National University of Ireland Galway Galway Ireland
- Department of Psychiatry, Trinity Centre for Health Sciences St. James's Hospital Dublin Ireland
| | - Declan McKernan
- Department of Pharmacology and Therapeutics, School of Medicine National University of Ireland Galway Galway Ireland
| | - Derek W. Morris
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - John Kelly
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Michael Gill
- Department of Psychiatry, Trinity Centre for Health Sciences St. James's Hospital Dublin Ireland
| | - Aiden Corvin
- Department of Psychiatry, Trinity Centre for Health Sciences St. James's Hospital Dublin Ireland
| | - Brian Hallahan
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
- Department of Psychiatry, Clinical Science Institute National University of Ireland Galway Galway Ireland
| | - Colm McDonald
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
- Department of Psychiatry, Clinical Science Institute National University of Ireland Galway Galway Ireland
| | - Gary Donohoe
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
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308
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Sjølie C, Meyn EK, Raudeberg R, Andreassen OA, Vaskinn A. Nonsocial cognitive underpinnings of theory of mind in schizophrenia. Psychiatry Res 2020; 289:113055. [PMID: 32446008 DOI: 10.1016/j.psychres.2020.113055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 04/30/2020] [Indexed: 12/30/2022]
Abstract
Social cognition is a mediator between nonsocial cognition and functional outcome in schizophrenia. However, the relationship between specific nonsocial cognitive and social cognitive domains is less clear. The aim of this study was to investigate which specific nonsocial cognitive domains best predict theory of mind (ToM) performance in schizophrenia. We indexed ToM by a composite score of the video-based Movie for the Assessment of Social Cognition test (MASCtot) in a sample of 91 individuals with schizophrenia. Nonsocial cognition was measured with the nonsocial cognitive subtests of the MATRICS Consensus Cognitive Battery (MCCB) and the Wechsler Abbreviated Scale of Intelligence (WASI IQ). Bivariate and multiple regression analyses were applied. We found statistically significant bivariate associations between MASCtot and five nonsocial cognitive tests, measuring intelligence, speed of processing, verbal or visual memory, and non-verbal working memory. Together, they accounted for 17% of the variation in MASCtot, but none of the five tests made significant unique contributions to MASCtot in the regression analysis. Our results confirm that nonsocial cognition and ToM are associated, albeit distinct, constructs. The findings suggest that cognitive remediation must include social cognitive targets in order to achieve improved ToM and better functioning.
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Affiliation(s)
- Charlotte Sjølie
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Emilie K Meyn
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Rune Raudeberg
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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309
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Rathnaiah M, Liddle EB, Gascoyne L, Kumar J, Zia Ul Haq Katshu M, Faruqi C, Kelly C, Gill M, Robson S, Brookes M, Palaniyappan L, Morris P, Liddle PF. Quantifying the Core Deficit in Classical Schizophrenia. ACTA ACUST UNITED AC 2020; 1:sgaa031. [PMID: 32803162 PMCID: PMC7418866 DOI: 10.1093/schizbullopen/sgaa031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In the classical descriptions of schizophrenia, Kraepelin and Bleuler recognized disorganization and impoverishment of mental activity as fundamental symptoms. Their classical descriptions also included a tendency to persisting disability. The psychopathological processes underlying persisting disability in schizophrenia remain poorly understood. The delineation of a core deficit underlying persisting disability would be of value in predicting outcome and enhancing treatment. We tested the hypothesis that mental disorganization and impoverishment are associated with persisting impairments of cognition and role function, and together reflect a latent core deficit that is discernible in cases diagnosed by modern criteria. We used Confirmatory Factor Analysis to determine whether measures of disorganization, mental impoverishment, impaired cognition, and role functioning in 40 patients with schizophrenia represent a single latent variable. Disorganization scores were computed from the variance shared between disorganization measures from 3 commonly used symptom scales. Mental impoverishment scores were computed similarly. A single factor model exhibited a good fit, supporting the hypothesis that these measures reflect a core deficit. Persisting brain disorders are associated with a reduction in post-movement beta rebound (PMBR), the characteristic increase in electrophysiological beta amplitude that follows a motor response. Patients had significantly reduced PMBR compared with healthy controls. PMBR was negatively correlated with core deficit score. While the symptoms constituting impoverished and disorganized mental activity are dissociable in schizophrenia, nonetheless, the variance that these 2 symptom domains share with impaired cognition and role function, appears to reflect a pathophysiological process that might be described as the core deficit of classical schizophrenia.
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Affiliation(s)
- Mohanbabu Rathnaiah
- Institute of Mental Health, University of Nottingham, Nottingham, UK.,Nottinghamshire Healthcare NHS Foundation Trust, Duncan McMillan House, Nottingham, UK
| | | | - Lauren Gascoyne
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Jyothika Kumar
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Mohammad Zia Ul Haq Katshu
- Institute of Mental Health, University of Nottingham, Nottingham, UK.,Nottinghamshire Healthcare NHS Foundation Trust, Duncan McMillan House, Nottingham, UK
| | - Catherine Faruqi
- Nottinghamshire Healthcare NHS Foundation Trust, Duncan McMillan House, Nottingham, UK
| | - Christina Kelly
- Nottinghamshire Healthcare NHS Foundation Trust, Duncan McMillan House, Nottingham, UK
| | - Malkeet Gill
- Nottinghamshire Healthcare NHS Foundation Trust, Duncan McMillan House, Nottingham, UK
| | - Sian Robson
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Matt Brookes
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Lena Palaniyappan
- Department of Psychiatry and Robarts Research Institute, Western University, London, ON, Canada.,Lawson Imaging, Lawson Health Research Institute, London, ON, Canada
| | - Peter Morris
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Peter F Liddle
- Institute of Mental Health, University of Nottingham, Nottingham, UK
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310
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Silverstein SM, Demmin DL, Schallek JB, Fradkin SI. Measures of Retinal Structure and Function as Biomarkers in Neurology and Psychiatry. Biomark Neuropsychiatry 2020. [DOI: 10.1016/j.bionps.2020.100018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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311
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Green MF, Lee J, Wynn JK. Experimental approaches to social disconnection in the general community: can we learn from schizophrenia research? World Psychiatry 2020; 19:177-178. [PMID: 32394575 PMCID: PMC7215060 DOI: 10.1002/wps.20734] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Michael F. Green
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of CaliforniaLos AngelesCAUSA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education and Clinical CenterLos AngelesCAUSA,Veterans Affairs Program on Enhancing Community Integration for Homeless VeteransLos AngelesCAUSA
| | - Junghee Lee
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of CaliforniaLos AngelesCAUSA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education and Clinical CenterLos AngelesCAUSA,Veterans Affairs Program on Enhancing Community Integration for Homeless VeteransLos AngelesCAUSA
| | - Jonathan K. Wynn
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of CaliforniaLos AngelesCAUSA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education and Clinical CenterLos AngelesCAUSA,Veterans Affairs Program on Enhancing Community Integration for Homeless VeteransLos AngelesCAUSA
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312
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Kotov R, Jonas KG, Carpenter WT, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Hobbs K, Reininghaus U, Slade T, South SC, Sunderland M, Waszczuk MA, Widiger TA, Wright AGC, Zald DH, Krueger RF, Watson D. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): I. Psychosis superspectrum. World Psychiatry 2020; 19:151-172. [PMID: 32394571 PMCID: PMC7214958 DOI: 10.1002/wps.20730] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a scientific effort to address shortcomings of traditional mental disorder diagnoses, which suffer from arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. This paper synthesizes evidence on the validity and utility of the thought disorder and detachment spectra of HiTOP. These spectra are composed of symptoms and maladaptive traits currently subsumed within schizophrenia, other psychotic disorders, and schizotypal, paranoid and schizoid personality disorders. Thought disorder ranges from normal reality testing, to maladaptive trait psychoticism, to hallucinations and delusions. Detachment ranges from introversion, to maladaptive detachment, to blunted affect and avolition. Extensive evidence supports the validity of thought disorder and detachment spectra, as each spectrum reflects common genetics, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, biomarkers, and treatment response. Some of these characteristics are specific to one spectrum and others are shared, suggesting the existence of an overarching psychosis superspectrum. Further research is needed to extend this model, such as clarifying whether mania and dissociation belong to thought disorder, and explicating processes that drive development of the spectra and their subdimensions. Compared to traditional diagnoses, the thought disorder and detachment spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and higher acceptability to clinicians. Validated measures are available to implement the system in practice. The more informative, reliable and valid characterization of psychosis-related psychopathology offered by HiTOP can make diagnosis more useful for research and clinical care.
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Affiliation(s)
- Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Katherine G Jonas
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | | | - Michael N Dretsch
- Walter Reed Army Institute of Research, US Army Medical Research Directorate - West, Silver Spring, MD, USA
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Miriam K Forbes
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Kelsey Hobbs
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
- ESRC Centre for Society and Mental Health, King's College London, London, UK
- Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Abuse, University of Sydney, Sydney, NSW, Australia
| | - Susan C South
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Abuse, University of Sydney, Sydney, NSW, Australia
| | - Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Thomas A Widiger
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - David Watson
- Department of Psychology, University of Notre Dame, South Bend, IN, USA
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313
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Gainsford K, Fitzgibbon B, Fitzgerald PB, Hoy KE. Transforming treatments for schizophrenia: Virtual reality, brain stimulation and social cognition. Psychiatry Res 2020; 288:112974. [PMID: 32353694 DOI: 10.1016/j.psychres.2020.112974] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/16/2020] [Accepted: 03/29/2020] [Indexed: 12/13/2022]
Abstract
Schizophrenia is characterised by delusions, hallucinations, anhedonia and apathy; while impairments in social cognition are often less recognised. Poor social cognition can lead to difficulties in obtaining and maintaining employment, academic progression, interpersonal relationships, and community functioning. Current interventions are highly intensive, require significant resources and have only modest effects on functional outcomes. Virtual reality (VR) and non-invasive brain stimulation (NIBS) may have a role in addressing these limitations. VR allows treatments that are potentially more accessible, less delivery intensive, and have higher ecological validity. While NIBS is able to directly modulate activity in social brain areas in order to promote neuroplasticity, strengthen neural connections and enhance brain function related to social cognitive behaviours. Therefore, the combination of VR and NIBS may allow for more efficient and transferrable interventions than those currently available. This review will explore the potential role of these technologies in the treatment of social cognitive impairment.
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Affiliation(s)
- Kirsten Gainsford
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
| | - Bernadette Fitzgibbon
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
| | - Paul B Fitzgerald
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
| | - Kate E Hoy
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
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314
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Dubreucq J, Gabayet F, Ycart B, Faraldo M, Melis F, Lucas T, Arnaud B, Bacconnier M, Bakri M, Cambier G, Carmona F, Chereau I, Challe T, Morel S, Pires S, Roussel C, Lamy P, Legrand G, Pages E, Pommier R, Rey R, Souchet Y, Llorca PM, Massoubre C. Improving social function with real-world social-cognitive remediation in schizophrenia: Results from the RemedRugby quasi-experimental trial. Eur Psychiatry 2020; 63:e41. [PMID: 32349835 PMCID: PMC7355162 DOI: 10.1192/j.eurpsy.2020.42] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background. Functional capacity (FC) has been identified as a key outcome to improve real-world functioning in schizophrenia. FC is influenced by cognitive impairments, negative symptoms, self-stigma and reduced physical activity (PA). Psychosocial interventions targeting FC are still under-developed. Methods. we conducted a quasi-experimental study evaluating the effects of an exercise-enriched integrated social cognitive remediation (SCR) intervention (RemedRugby [RR]) compared with an active control group practicing Touch Rugby (TR). To our knowledge, this is the first trial to date evaluating the effectiveness of such a program provided in a real-life environment. Results. Eighty-seven people with schizophrenia were included and allocated to either the RR group (n = 57) or the TR group (n = 30) according to the routine clinical practice of the recruiting center. Outcomes were evaluated at baseline and post-treatment in both groups and after 6 months of follow-up in the RR group using standardized scales for symptom severity, social functioning, self-stigma, and a large cognitive battery. After treatment we observed moderate to large improvements in social function (Personal and Social Performance Scale [PSP], p < 0.001, d = 1.255), symptom severity (Positive and Negative Syndrome Scale [PANSS] negative, p < 0.001, d = 0.827; PANSS GP, p < 0.001, d = 0.991; PANSS positive, p = 0.009, d = 0.594), verbal abstraction (p = 0.008, d = 0.554), aggression bias (p = 0.008, d = 0.627), and self-stigma (stereotype endorsement, p = 0.019, d = 0.495; discrimination experiences, p = 0.047; d = 0.389) that were specific to the RR group and were not observed in participants playing only TR. Effects were persistent over time and even larger between post-treatment and follow-up. Conclusions. Exercise-enriched integrated SCR appears promising to improve real-life functioning in schizophrenia. Future research should investigate the potential effects of this intervention on neuroplasticity and physical fitness.
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Affiliation(s)
- Julien Dubreucq
- Centre de Neurosciences Cognitive, UMR 5229, CNRS and Université Lyon 1, Lyon, France.,Centre Référent de Réhabilitation Psychosociale et de Remédiation cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France.,Réseau Handicap Psychique, Grenoble, France
| | - Franck Gabayet
- Centre Référent de Réhabilitation Psychosociale et de Remédiation cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France
| | - Bernard Ycart
- Laboratoire Jean Kuntzmann, CNRS UMR 5224, Université Grenoble-Alpes, Grenoble, France
| | - Megane Faraldo
- Centre Référent de Réhabilitation Psychosociale et de Remédiation cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France
| | - Fanny Melis
- Centre Référent de Réhabilitation Psychosociale et de Remédiation cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France
| | - Thierry Lucas
- Centre Référent de Réhabilitation Psychosociale et de Remédiation cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France
| | - Benjamin Arnaud
- Centre Hospitalier Sainte Marie de Clermont Ferrand, 33 rue Gabriel Péri, CS 9912, Clermont-Ferrand Cedex 1 63037, France
| | - Mickael Bacconnier
- Centre Médical La Teppe, 25 Avenue de la Bouterne, CS 9721, Tain-l'Hermitage Cedex 26602, France.,Centre de Réhabilitation Psychosociale et de Remédiation Cognitive (C2R), CH Drôme Vivarais, Montéléger, France
| | - Motassem Bakri
- Centre de Réhabilitation Psychosociale et de Remédiation Cognitive (C2R), CH Drôme Vivarais, Montéléger, France
| | - Gentiane Cambier
- Centre Hospitalier de la Savoie, 89 avenue de Bassens, Bassens73000, France
| | | | - Isabelle Chereau
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, Clermont-Ferrand Cedex 1 63003, France
| | - Titaua Challe
- Centre Départemental de Réhabilitation Psychosociale des Glières, 219 Chemin des Bois des Fornets, La Roche sur Foron 74800, France
| | - Sophie Morel
- Centre de Réhabilitation Psychosociale et de Remédiation Cognitive (C2R), CH Drôme Vivarais, Montéléger, France
| | - Sylvie Pires
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, Clermont-Ferrand Cedex 1 63003, France
| | - Celine Roussel
- Centre Départemental de Réhabilitation Psychosociale des Glières, 219 Chemin des Bois des Fornets, La Roche sur Foron 74800, France
| | - Philippe Lamy
- REHALise, CHU de Saint-Etienne, Saint-Etienne, France
| | - Guillaume Legrand
- Centre Hospitalier Sainte Marie de Clermont Ferrand, 33 rue Gabriel Péri, CS 9912, Clermont-Ferrand Cedex 1 63037, France
| | - Emmanuelle Pages
- Centre Hospitalier de la Savoie, 89 avenue de Bassens, Bassens73000, France
| | | | - Romain Rey
- Fondation FondaMental, Créteil, France.,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39, 95 bd Pinel, Bron Cedex69678, France
| | - Yohan Souchet
- Fondation FondaMental, Créteil, France.,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39, 95 bd Pinel, Bron Cedex69678, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, Clermont-Ferrand Cedex 1 63003, France
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315
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Wang W, Zhou Y, Wang J, Xu H, Wei S, Wang D, Wang L, Zhang XY. Prevalence, clinical correlates of suicide attempt and its relationship with empathy in patients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109863. [PMID: 31931089 DOI: 10.1016/j.pnpbp.2020.109863] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Previous studies have shown that cognitive impairment plays a key role in suicide, an important factor leading to premature death in schizophrenia (SCZ) patients. Empathy has received extensive attention recently; however, the relationship of empathy with suicide in schizophrenia is still unknown. The main aim of this study was to investigate the prevalence of suicide attempts and its association with empathy and other characteristics in Chinese chronic SCZ patients. METHODS The suicide attempt data, together with demographic characteristics and clinical variables were collected from 627 chronic inpatients with schizophrenia. We utilized the Positive and Negative Syndrome Scale (PANSS) for the psychopathological symptoms, and the Interpersonal Reactivity Index (IRI) for affective and cognitive empathy in this study. RESULTS We found a suicide attempt rate of 11.3% in chronic SCZ patients. Compared to non-attempters, suicide attempters were more likely to be women, had younger age and higher education levels, as well as higher positive symptoms and depressive factor score, but lower negative symptoms of PANSS (all p < .05). Moreover, after controlling the confounding factors, suicide attempters scored higher in Personal Distress subscale of IRI (F1, 455 = 5.446, p = .020) than non-attempters. CONCLUSIONS The prevalence of suicide attempt is high in chronic SCZ patients. Its risk factors include some demographic and clinical variables. Moreover, suicide attempters experienced stronger personal distress, suggesting that stronger empathy may be a risk factor of suicide.
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Affiliation(s)
- Wenjia Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yongjie Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Jiesi Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hang Xu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Shuochi Wei
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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316
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Crouse JJ, Chitty KM, Iorfino F, Carpenter JS, White D, Nichles A, Zmicerevska N, Tickell AM, Lee RS, Naismith SL, Scott EM, Scott J, Hermens DF, Hickie IB. Transdiagnostic neurocognitive subgroups and functional course in young people with emerging mental disorders: a cohort study. BJPsych Open 2020; 6:e31. [PMID: 32191172 PMCID: PMC7176869 DOI: 10.1192/bjo.2020.12] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Neurocognitive impairments robustly predict functional outcome. However, heterogeneity in neurocognition is common within diagnostic groups, and data-driven analyses reveal homogeneous neurocognitive subgroups cutting across diagnostic boundaries. AIMS To determine whether data-driven neurocognitive subgroups of young people with emerging mental disorders are associated with 3-year functional course. METHOD Model-based cluster analysis was applied to neurocognitive test scores across nine domains from 629 young people accessing mental health clinics. Cluster groups were compared on demographic, clinical and substance-use measures. Mixed-effects models explored associations between cluster-group membership and socio-occupational functioning (using the Social and Occupational Functioning Assessment Scale) over 3 years, adjusted for gender, premorbid IQ, level of education, depressive, positive, negative and manic symptoms, and diagnosis of a primary psychotic disorder. RESULTS Cluster analysis of neurocognitive test scores derived three subgroups described as 'normal range' (n = 243, 38.6%), 'intermediate impairment' (n = 252, 40.1%), and 'global impairment' (n = 134, 21.3%). The major mental disorder categories (depressive, anxiety, bipolar, psychotic and other) were represented in each neurocognitive subgroup. The global impairment subgroup had lower functioning for 3 years of follow-up; however, neither the global impairment (B = 0.26, 95% CI -0.67 to 1.20; P = 0.581) or intermediate impairment (B = 0.46, 95% CI -0.26 to 1.19; P = 0.211) subgroups differed from the normal range subgroup in their rate of change in functioning over time. CONCLUSIONS Neurocognitive impairment may follow a continuum of severity across the major syndrome-based mental disorders, with data-driven neurocognitive subgroups predictive of functional course. Of note, the global impairment subgroup had longstanding functional impairment despite continuing engagement with clinical services.
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Affiliation(s)
| | - Kate M. Chitty
- Translational Australian Clinical Toxicology (TACT) Research Group, University of Sydney, NSW, Australia
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Australia; and InnoWell, Pty Ltd, Australia
| | | | - Django White
- The Black Dog Institute, University of New South Wales, Australia
| | | | | | | | - Rico S.C. Lee
- Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Sharon L. Naismith
- Charles Perkins Centre, University of Sydney; and Brain and Mind Centre, University of Sydney, Australia
| | | | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, UK
| | - Daniel F. Hermens
- Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Australia
| | - Ian B. Hickie
- Brain and Mind Centre, University of Sydney, Australia
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317
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Halverson TF, Hajdúk M, Pinkham AE, Harvey PD, Jarskog LF, Nye L, Penn DL. Psychometric properties of the Observable Social Cognition Rating Scale (OSCARS): Self-report and informant-rated social cognitive abilities in schizophrenia. Psychiatry Res 2020; 286:112891. [PMID: 32145477 PMCID: PMC7483899 DOI: 10.1016/j.psychres.2020.112891] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 02/07/2023]
Abstract
Individuals with schizophrenia spectrum disorders (SSD) consistently show deficits in social cognition (SC) which is associated with real world outcomes. Psychosocial treatments have demonstrated reliable improvements in SC abilities, highlighting the need for accurate identification of SC deficits for efficient and individualized treatment planning. To this end, the Observable Social Cognition Rating Scale (OSCARS) is an 8-item scale with both self and informant versions. This study investigated psychometric properties of the OSCARS as both a self and informant-reported scale in a large sample of SSD (n = 382) and individuals without a psychiatric diagnosis (n = 289). A two-factor structure (Social Cognitive Bias and Social Cognitive Ability) of the OSCARS demonstrated acceptable model fit with good internal consistency for both self- and informant-report. The OSCARS had adequate convergent, external, and predictive validity. Area Under the Curve (AUC) values suggest the OSCARS has some value in identifying individuals with impaired SC and social competence, although stronger AUC values were demonstrated when identifying individuals with impaired real-world functioning. Overall, psychometric properties indicate the OSCARS may be a useful first-step tool for clinicians to detect functioning deficits in SSD and efficiently identify individuals in need of additional assessment or psychosocial interventions.
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Affiliation(s)
- Tate F Halverson
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC, United States.
| | - Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia; Clinic of Psychiatry, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Center for Psychiatric Disorders Research - UK, Science Park, Comenius University in Bratislava, Slovakia
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX; Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL; Research Service, Miami VA Healthcare System, Miami, FL
| | - L Fredrik Jarskog
- University of North Carolina at Chapel Hill, North Carolina Psychiatric Research Center, Raleigh, NC, United States
| | - Lana Nye
- College of Social Work, The University of Utah, Salt Lake City, UT
| | - David L Penn
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC, United States; Australian Catholic University, School of Behavioural and Health Sciences, Melbourne, VIC, Australia
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318
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Bröcker AL, Bayer S, Stuke F, Just S, Bertram G, Funcke J, Grimm I, Lempa G, von Haebler D, Montag C. Levels of Structural Integration Mediate the Impact of Metacognition on Functioning in Non-affective Psychosis: Adding a Psychodynamic Perspective to the Metacognitive Approach. Front Psychol 2020; 11:269. [PMID: 32153475 PMCID: PMC7047329 DOI: 10.3389/fpsyg.2020.00269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/04/2020] [Indexed: 12/12/2022] Open
Abstract
Synthetic metacognition is defined by integrative and contextualizing processes of discrete reflexive moments. These processes are supposed to be needed to meet intrapsychic as well as interpersonal challenges and to meaningfully include psychotic experience in a personal life narrative. A substantial body of evidence has linked this phenomenon to psychosocial functioning and treatment options were developed. The concept of synthetic metacognition, measured with the Metacognition Assessment Scale-Abbreviated (MAS-A), rises hope to bridge gaps between therapeutic orientations and shares valuable parallels to modern psychodynamic constructs, especially the 'levels of structural integration' of the Operationalized Psychodynamic Diagnosis (OPD-2). As theoretical distinctions remain, aim of this study was to compare the predictive value of both constructs with regard to psychosocial functioning of patients with non-affective psychoses, measured with the International Classification of Functioning, Disability and Health (MINI-ICF-APP). It was further explored if levels of structural integration (OPD-LSIA) would mediate the impact of metacognition (MAS-A) on function (MINI-ICF-APP). Expert ratings of synthetic metacognition (MAS-A), the OPD-2 'levels of structural integration' axis (OPD-LSIA), psychosocial functioning (MINI-ICF-APP) and assessments of general cognition and symptoms were applied to 100 individuals with non-affective psychoses. Whereas both, MAS-A and OPD-LSIA, significantly predicted MINI-ICF-APP beyond cognition and symptoms, OPD-LSIA explained a higher share of variance and mediated the impact of MAS-A on MINI-ICF-APP. Levels of structural integration, including the quality of internalized object representations and unconscious interpersonal schemas, might therefore be considered as valuable predictors of social functioning and as one therapeutic focus in patients with non-affective psychoses. Structural integration might go beyond and form the base of a person's actual reflexive and metacognitive capabilities. Psychotherapeutic procedures specific for psychoses may promote and challenge a patient's metacognitive capacities, but should equally take the need for maturing structural skills into account. Modern psychodynamic approaches to psychosis are shortly presented, providing concepts and techniques for the implicit regulation of interpersonal experience and aiming at structural integration in this patient group.
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Affiliation(s)
- Anna-Lena Bröcker
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Samuel Bayer
- International Psychoanalytic University Berlin, Berlin, Germany
| | - Frauke Stuke
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sandra Just
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gianna Bertram
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jakob Funcke
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Imke Grimm
- International Psychoanalytic University Berlin, Berlin, Germany
| | | | - Dorothea von Haebler
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- International Psychoanalytic University Berlin, Berlin, Germany
| | - Christiane Montag
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
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319
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Dubreucq J, Plasse J, Gabayet F, Faraldo M, Blanc O, Chereau I, Cervello S, Couhet G, Demily C, Guillard-Bouhet N, Gouache B, Jaafari N, Legrand G, Legros-Lafarge E, Pommier R, Quilès C, Straub D, Verdoux H, Vignaga F, Massoubre C, Franck N. Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort. Eur Psychiatry 2020; 63:e13. [PMID: 32093806 PMCID: PMC7315867 DOI: 10.1192/j.eurpsy.2019.12] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background. Self-stigma
is a major issue in serious mental illness (SMI) and is negatively associated with patient outcomes. Most studies have been conducted in schizophrenia (SZ). Less is known about self-stigma in other SMI and autism spectrum disorder (ASD). The objectives of this study are: (i) to assess the frequency of self-stigma in a multicentric nonselected psychiatric rehabilitation SMI and ASD sample; and (ii) to investigate the correlates of elevated self-stigma in different SMI conditions and in ASD. Methods. A total of 738 SMI or ASD outpatients were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluations included sociodemographic data, illness characteristics, and standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, personal recovery, a large cognitive battery, and daily functioning assessment. Results.
31.2% of the total sample had elevated self-stigma. The highest prevalence (43.8%) was found in borderline personality disorder and the lowest (22.2%) in ASD. In the multivariate analysis, elevated self-stigma was best predicted by early stages of personal recovery (moratorium, p = 0.001, OR = 4.0 [1.78–8.98]; awareness, p = 0.011, OR = 2.87 [1.28–6.44]), history of suicide attempt (p = 0.001, OR = 2.27 [1.37–3.76]), insight (p = 0.002, OR = 1.22 [1.08–1.38]), wellbeing (p = 0.037, OR = 0.77 [0.60–0.98]), and satisfaction with interpersonal relationships (p < 0.001, OR = 0.85 [0.78–0.93]). Conclusions. The present study has confirmed the importance of addressing self-stigma in SMI and ASD patients enrolled in psychiatric rehabilitation. The effectiveness of psychiatric rehabilitation on self-stigma and the potential mediating effects of changes in self-stigma on treatment outcomes should be further investigated.
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Affiliation(s)
- J Dubreucq
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France.,Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France.,Réseau Handicap Psychique, Grenoble, France
| | - J Plasse
- Centre Référent Lyonnais de Réhabilitation Psychosociale CL3R, Centre Hospitalier Le Vinatier, Lyon, France.,Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Hôpital Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France
| | - F Gabayet
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France
| | - M Faraldo
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France
| | - O Blanc
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - I Chereau
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - S Cervello
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France.,Centre Référent Lyonnais de Réhabilitation Psychosociale CL3R, Centre Hospitalier Le Vinatier, Lyon, France.,Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Hôpital Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France
| | - G Couhet
- Centre Référent de Réhabilitation Psychosociale C2RP Nouvelle-Aquitaine Sud, Pôle de Réhabilitation Psychosociale, Centre de la Tour de Gassies, Bruges, France
| | - C Demily
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France.,Centre de Référence Maladies Rares Génopsy, Centre Hospitalier Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France
| | | | - B Gouache
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France
| | - N Jaafari
- CREATIV & URC Pierre Deniker, CH Laborit, Poitiers, France
| | - G Legrand
- Centre Hospitalier Sainte Marie de Clermont Ferrand, 63037Clermont-Ferrand Cedex 1, France
| | - E Legros-Lafarge
- Centre Référent de Réhabilitation Psychosociale de Limoges C2RL, CH Esquirol, Limoges, France
| | - R Pommier
- REHALise, CHU de Saint-Etienne, Saint-Priest-en-Jarez, France
| | - C Quilès
- Centre Référent de Réhabilitation Psychosociale C2RP Nouvelle Aquitaine Sud, Pôle Universitaire de Psychiatrie Adulte, Centre Hospitalier Charles Perrens, Bordeaux & Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, 33000Bordeaux, France
| | - D Straub
- Centre de Réhabilitation Psychosociale, Centre Hospitalier de Roanne, Roanne, France
| | - H Verdoux
- Centre Référent de Réhabilitation Psychosociale C2RP Nouvelle Aquitaine Sud, Pôle Universitaire de Psychiatrie Adulte, Centre Hospitalier Charles Perrens, Bordeaux & Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, 33000Bordeaux, France
| | - F Vignaga
- Dispositif de Soins de Réhabilitation Psychosociale, Centre Psychothérapeutique de l'Ain, Bourg-en-Bresse, France
| | - C Massoubre
- REHALise, CHU de Saint-Etienne, Saint-Priest-en-Jarez, France
| | | | - N Franck
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France.,Centre Référent Lyonnais de Réhabilitation Psychosociale CL3R, Centre Hospitalier Le Vinatier, Lyon, France.,Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Hôpital Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France
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320
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Shimada T, Ito S, Makabe A, Yamanushi A, Takenaka A, Kawano K, Kobayashi M. Aerobic exercise and cognitive functioning in schizophrenia: Results of a 1-year follow-up from a randomized controlled trial. Psychiatry Res 2020; 286:112854. [PMID: 32078891 DOI: 10.1016/j.psychres.2020.112854] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 11/20/2022]
Abstract
We previously reported that adding combined, individual, and group aerobic exercise (AE) interventions to the treatment as usual (TAU) for schizophrenia showed significant improvements in cognition and other outcomes compared to those with TAU alone in a randomized controlled trial. Following the promising results of our previous study, this 1-year follow-up study evaluated the improvements in cognition and other outcomes with TAU + AE compared to those with TAU alone. Of 41 randomized patients, 40 were included in the intent-to-treat population-20 in the TAU + AE and 20 in the TAU alone; all patients completed the 1-year follow-up. Mixed models were applied to assess changes in outcome measures over time from baseline to 1-year follow-up. At 1-year follow-up, the TAU + AE demonstrated significant group by time interaction effects in several cognitive domains, intrinsic motivation, negative symptom, interpersonal relations, and functional outcome compared with the TAU alone. Our results demonstrate that the improvements in cognition and other outcomes with TAU + AE were maintained and that functional outcome improved over 1-year follow-up. These findings show that the improvements sustained for each outcome over 1 year have the potential to offer opportunities for greater transitions to improvement of functional outcome.
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Affiliation(s)
- Takeshi Shimada
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, Nagano, Japan.
| | - Shoko Ito
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, Nagano, Japan
| | - Aya Makabe
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, Nagano, Japan
| | - Ayumi Yamanushi
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, Nagano, Japan
| | - Ami Takenaka
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, Nagano, Japan
| | - Kojiro Kawano
- Medical Corparation Yuaikai Tikumaso Mental Hospital, Nagano, Japan
| | - Masayoshi Kobayashi
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
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321
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Galderisi S, Rucci P, Mucci A, Rossi A, Rocca P, Bertolino A, Aguglia E, Amore M, Bellomo A, Bozzatello P, Bucci P, Carpiniello B, Collantoni E, Cuomo A, Dell'Osso L, Di Fabio F, di Giannantonio M, Gibertoni D, Giordano GM, Marchesi C, Monteleone P, Oldani L, Pompili M, Roncone R, Rossi R, Siracusano A, Vita A, Zeppegno P, Maj M. The interplay among psychopathology, personal resources, context-related factors and real-life functioning in schizophrenia: stability in relationships after 4 years and differences in network structure between recovered and non-recovered patients. World Psychiatry 2020; 19:81-91. [PMID: 31922687 PMCID: PMC6953544 DOI: 10.1002/wps.20700] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Improving real-life functioning is the main goal of the most advanced integrated treatment programs in people with schizophrenia. The Italian Network for Research on Psychoses previously explored, by using network analysis, the interplay among illness-related variables, personal resources, context-related factors and real-life functioning in a large sample of patients with schizophrenia. The same research network has now completed a 4-year follow-up of the original sample. In the present study, we used network analysis to test whether the pattern of relationships among all variables investigated at baseline was similar at follow-up. In addition, we compared the network structure of patients who were classified as recovered at follow-up versus those who did not recover. Six hundred eighteen subjects recruited at baseline could be assessed in the follow-up study. The network structure did not change significantly from baseline to follow-up, and the overall strength of the connections among variables increased slightly, but not significantly. Functional capacity and everyday life skills had a high betweenness and closeness in the network at follow-up, as they had at baseline, while psychopathological variables remained more peripheral. The network structure and connectivity of non-recovered patients were similar to those observed in the whole sample, but very different from those in recovered subjects, in which we found few connections only. These data strongly suggest that tightly coupled symptoms/dysfunctions tend to maintain each other's activation, contributing to poor outcome in schizophrenia. Early and integrated treatment plans, targeting variables with high centrality, might prevent the emergence of self-reinforcing networks of symptoms and dysfunctions in people with schizophrenia.
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Affiliation(s)
- Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Rocca
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - Alessandro Bertolino
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Antonello Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Paola Bozzatello
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - Paola Bucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Enrico Collantoni
- Psychiatric Clinic, Department of Neurosciences, University of Padua, Padua, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
| | - Liliana Dell'Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Fabio Di Fabio
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | | | - Dino Gibertoni
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Carlo Marchesi
- Psychiatry Unit, Department of Neuroscience, University of Parma, Parma, Italy
| | - Palmiero Monteleone
- Section of Neuroscience, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Lucio Oldani
- Department of Psychiatry, University of Milan, Milan, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Rita Roncone
- Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alberto Siracusano
- Psychiatry and Clinical Psychology Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Antonio Vita
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy
- Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Patrizia Zeppegno
- Psychiatric Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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322
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McCutcheon RA, Krystal JH, Howes OD. Dopamine and glutamate in schizophrenia: biology, symptoms and treatment. World Psychiatry 2020; 19:15-33. [PMID: 31922684 PMCID: PMC6953551 DOI: 10.1002/wps.20693] [Citation(s) in RCA: 283] [Impact Index Per Article: 70.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Glutamate and dopamine systems play distinct roles in terms of neuronal signalling, yet both have been proposed to contribute significantly to the pathophysiology of schizophrenia. In this paper we assess research that has implicated both systems in the aetiology of this disorder. We examine evidence from post-mortem, preclinical, pharmacological and in vivo neuroimaging studies. Pharmacological and preclinical studies implicate both systems, and in vivo imaging of the dopamine system has consistently identified elevated striatal dopamine synthesis and release capacity in schizophrenia. Imaging of the glutamate system and other aspects of research on the dopamine system have produced less consistent findings, potentially due to methodological limitations and the heterogeneity of the disorder. Converging evidence indicates that genetic and environmental risk factors for schizophrenia underlie disruption of glutamatergic and dopaminergic function. However, while genetic influences may directly underlie glutamatergic dysfunction, few genetic risk variants directly implicate the dopamine system, indicating that aberrant dopamine signalling is likely to be predominantly due to other factors. We discuss the neural circuits through which the two systems interact, and how their disruption may cause psychotic symptoms. We also discuss mechanisms through which existing treatments operate, and how recent research has highlighted opportunities for the development of novel pharmacological therapies. Finally, we consider outstanding questions for the field, including what remains unknown regarding the nature of glutamate and dopamine function in schizophrenia, and what needs to be achieved to make progress in developing new treatments.
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Affiliation(s)
- Robert A McCutcheon
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- MRC London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital, London, UK
- South London and Maudsley Foundation NHS Trust, Maudsley Hospital, London, UK
| | - John H Krystal
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Oliver D Howes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- MRC London Institute of Medical Sciences, Imperial College London, Hammersmith Hospital, London, UK
- South London and Maudsley Foundation NHS Trust, Maudsley Hospital, London, UK
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323
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Waddington JL, Zhen X, O'Tuathaigh CMP. Developmental Genes and Regulatory Proteins, Domains of Cognitive Impairment in Schizophrenia Spectrum Psychosis and Implications for Antipsychotic Drug Discovery: The Example of Dysbindin-1 Isoforms and Beyond. Front Pharmacol 2020; 10:1638. [PMID: 32063853 PMCID: PMC7000454 DOI: 10.3389/fphar.2019.01638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
Alongside positive and negative symptomatology, deficits in working memory, attention, selective learning processes, and executive function have been widely documented in schizophrenia spectrum psychosis. These cognitive abnormalities are strongly associated with impairment across multiple function domains and are generally treatment-resistant. The DTNBP1 (dystrobrevin-binding protein-1) gene, encoding dysbindin, is considered a risk factor for schizophrenia and is associated with variation in cognitive function in both clinical and nonclinical samples. Downregulation of DTNBP1 expression in dorsolateral prefrontal cortex and hippocampal formation of patients with schizophrenia has been suggested to serve as a primary pathophysiological process. Described as a "hub," dysbindin is an important regulatory protein that is linked with multiple complexes in the brain and is involved in a wide variety of functions implicated in neurodevelopment and neuroplasticity. The expression pattern of the various dysbindin isoforms (-1A, -1B, -1C) changes depending upon stage of brain development, tissue areas and subcellular localizations, and can involve interaction with different protein partners. We review evidence describing how sequence variation in DTNBP1 isoforms has been differentially associated with schizophrenia-associated symptoms. We discuss results linking these isoform proteins, and their interacting molecular partners, with cognitive dysfunction in schizophrenia, including evidence from drosophila through to genetic mouse models of dysbindin function. Finally, we discuss preclinical evidence investigating the antipsychotic potential of molecules that influence dysbindin expression and functionality. These studies, and other recent work that has extended this approach to other developmental regulators, may facilitate identification of novel molecular pathways leading to improved antipsychotic treatments.
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Affiliation(s)
- John L Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Xuechu Zhen
- Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Colm M P O'Tuathaigh
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,Medical Education Unit, School of Medicine, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
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324
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Mentalization and Psychosis: A Rationale for the Use of Mentalization Theory to Understand and Treat Non-affective Psychotic Disorder. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2020. [DOI: 10.1007/s10879-019-09449-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractSocial functioning can be severely impaired in non-affective psychotic disorder (NAPD). Current models of psychosis pathogenesis do not tend to focus on social dysfunction and pharmacological treatment fails to ameliorate it. In this article, we propose that mentalization theory provides a valuable contribution to the understanding and treatment of NAPD. Impaired mentalizing may contribute to both positive and negatives symptoms as well as social dysfunction observed in NAPD. Furthermore, impaired mentalizing may help explain the relation between childhood abuse, insecure attachment and psychosis. Mentalization based treatment may contribute to the functional recovery of NAPD patients as it targets the social cognitive processes underlying social interaction. The article includes a description of the principles of MBT in general, specific characteristics of using MBT with patients with NAPD and a clinical vignette to illustrate these principles.
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325
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Seo E, Park HY, Park K, Koo SJ, Lee SY, Min JE, Lee E, An SK. Impaired Facial Emotion Recognition in Individuals at Ultra-High Risk for Psychosis and Associations With Schizotypy and Paranoia Level. Front Psychiatry 2020; 11:577. [PMID: 32676040 PMCID: PMC7333645 DOI: 10.3389/fpsyt.2020.00577] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/05/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patients with schizophrenia and individuals at ultra-high risk for psychosis (UHR) have been reported to exhibit impaired recognition of facial emotion expressions. This impairment has involved both inaccuracy and negative bias of facial emotion recognition. The present study aimed to investigate whether UHR individuals display both types of impaired facial emotion recognition and to explore correlations between these impairments and schizotypy, as well as paranoia levels, in these individuals. METHODS A total of 43 UHR individuals and 57 healthy controls (HC) completed a facial emotion recognition task consisting of 60 standardized facial photographs. To explore correlations, we assessed schizotypy using the Revised Physical Anhedonia Scale and Magical Ideation Scale and paranoia level using the Paranoia Scale and persecution/suspicious item of the Positive and Negative Syndrome Scale in UHR individuals. RESULTS Compared with HC, UHR individuals exhibited less accuracy for facial emotion recognition (70.6% vs. 75.6%, p=0.010) and a higher rate of "fear" responses for neutral faces (14.5% vs. 6.0%, p=0.003). In UHR individuals, inaccuracy was significantly correlated with schizotypy scores, but not with paranoia level. Conversely, "disgust" response for neutral faces was the only fear response correlated with paranoia level, and no threat-related emotion response correlated with schizotypy scores. DISCUSSION UHR individuals exhibited inaccuracy and negative bias of facial emotion recognition. Furthermore, schizotypy scores were associated with inaccuracy but not with negative bias of facial emotion recognition. Paranoia level was correlated with "disgust" responses for neutral faces but not with inaccuracy. These findings suggest that inaccuracy and negative bias of facial emotion recognition reflect different underlying processes, and that inaccuracy may be a vulnerability marker for schizophrenia.
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Affiliation(s)
- Eunchong Seo
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Hye Yoon Park
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Kyungmee Park
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Department of Hospital Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, Gyeonggi-do, South Korea
| | - Se Jun Koo
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Su Young Lee
- Department of Psychiatry, Myongji Hospital, Gyeonggi-do, South Korea
| | - Jee Eun Min
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Lee
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Suk Kyoon An
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Graduate Program in Cognitive Science, Yonsei University, Seoul, South Korea
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326
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Fernández-Modamio M, Gil-Sanz D, Arrieta-Rodríguez M, Santacoloma-Cabero I, Bengochea-Seco R, González-Fraile E, Muñiz J. Neurocognition functioning as a prerequisite to intact social cognition in schizophrenia. Cogn Neuropsychiatry 2020; 25:14-27. [PMID: 31621495 DOI: 10.1080/13546805.2019.1680355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: There are mixed findings regarding the relationships between neurocognition and social cognition in schizophrenia. This study aims to provide new empirical evidence to help determine the relationships between these constructs in schizophrenia.Methods: 299 stabilised patients with schizophrenia aged 18-65 years old were recruited. After having into account exclusion criteria, final sample was contained 284 patients. The Emotion Recognition Assessment Test (ERAT) was used to assess six basic emotions. To assess the theory of mind (ToM), the Hinting Task and the Faux-Pas Test were used, and the Screen for Cognitive Impairment in Psychiatry (SCIP) was administered to assess cognitive functioning. Bivariate and multivariate analyses (partial correlations, canonical correlation, regression analysis, and confirmatory and exploratory factor analysis) were conducted.Results: Statistically significant relationships were found between the subtests of the SCIP and social cognitive measures. The redundancy coefficient in the canonical analysis was 0.13. The CFA analysis showed that the best model has a two-factor structure, in which neurocognition and social cognition are correlated factors. Less than 10% of patients with impaired cognitive functioning have a performance within normal range on social cognition tests.Conclusions: The findings show that neurocognition and social cognition are independent but related constructs.
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Affiliation(s)
| | - David Gil-Sanz
- Centro Hospitalario Padre Menni, Santander, Spain.,Universidad Europea del Atlántico, Santander, Spain
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- Centro Hospitalario Padre Menni, Santander, Spain
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327
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Fekete J, Pótó Z, Varga E, Csulak T, Zsélyi O, Tényi T, Herold R. Persons With Schizophrenia Misread Hemingway: A New Approach to Study Theory of Mind in Schizophrenia. Front Psychiatry 2020; 11:396. [PMID: 32457668 PMCID: PMC7224255 DOI: 10.3389/fpsyt.2020.00396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/17/2020] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Theory of Mind (ToM) is a key component of social cognition. Recently the Short Story Task (SST) was developed as a new measurement of ToM. SST uses a short story of Ernest Hemingway to assess ToM skills. SST proved to be a suitable tool, and sensitive to individual differences among healthy subjects. Our aim was to test SST to evaluate the ToM skills of persons with schizophrenia. MATERIALS AND METHODS SST was used to assess ToM skills. After reading the short story "The End of Something" a structured interview was done with 14 questions. Spontaneous mental state reasoning, explicit mental state inference and comprehension of nonmental aspects of the story were evaluated. 47 persons with schizophrenia in remission and 48 healthy controls were assessed and compared. RESULTS Persons with schizophrenia performed significantly more poorly in the explicit mental state inference questions. Ceiling effect was not detectable in explicit ToM scores. Patients made less spontaneous mental state references as well, although the occurrence of spontaneous mental state terms was infrequent in both groups. Patients were also less accurate in answering comprehension questions, but the difference was not significant after Bonferroni correction. DISCUSSION Our results lined up with the original findings and we found SST to be a sensitive tool to explore the individual differences in ToM performance, not only among healthy subjects, but also among persons with schizophrenia especially in explicit mental state inferences without observing the ceiling effect. We found, however, SST to be less sensitive to measure spontaneous mental state reasoning and also the lack of the use of another ToM test to assess convergent validity of SST for indicating ToM deficits in schizophrenia stands as a limitation of current study.
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Affiliation(s)
- Judit Fekete
- Doctoral School of Clinical Neurosciences, Medical School, University of Pécs, Pécs, Hungary
| | - Zsuzsanna Pótó
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Eszter Varga
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Tímea Csulak
- Doctoral School of Clinical Neurosciences, Medical School, University of Pécs, Pécs, Hungary
| | - Orsolya Zsélyi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
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328
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Fekete K, Török E, Makkos Z, Kelemen O, Csigó K, Kéri S. Mentalization across the psychosis spectrum. Schizophr Res 2020; 215:471-472. [PMID: 31471247 DOI: 10.1016/j.schres.2019.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/26/2019] [Accepted: 08/19/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Kata Fekete
- Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Edina Török
- Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
| | - Zoltán Makkos
- Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Oguz Kelemen
- Department of Behavioral Science, University of Szeged, Szeged, Hungary
| | - Katalin Csigó
- Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Szabolcs Kéri
- Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary; Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary; Department of Physiology, University of Szeged, Szeged, Hungary.
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329
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Abstract
In psychiatry, the information conveyed by diagnosis (i.e., the "type" to which the individual patient is reconducted) is in itself insufficient for therapeutic and prognostic purposes. Hence the need for a more detailed characterization of the individual case, with a special focus on the assessment of low-order and high-order psychopathological dimensions, the evaluation of the severity of the clinical picture, the assessment of the stage of development of the disorder, and the exploration of a series of antecedent and concomitant variables. We should start to promote the construction and validation of tools guiding the clinician systematically in this characterization, trying to incorporate in this effort elements of the approaches that are currently presented as "alternative" to the ICD and DSM.
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Affiliation(s)
- Mario Maj
- Department of Psychiatry, University of Campania L. Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy
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330
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Improving Cognition via Exercise (ICE): Study Protocol for a Multi-Site, Parallel-Group, Single-Blind, Randomized Clinical Trial Examining the Efficacy of Aerobic Exercise to Improve Neurocognition, Daily Functioning, and Biomarkers of Cognitive Change in Individuals with Schizophrenia. ACTA ACUST UNITED AC 2019; 4. [PMID: 31938726 DOI: 10.20900/jpbs.20190020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Individuals with schizophrenia (SZ) display cognitive deficits that have been identified as major determinants of poor functioning and disability, representing a serious public health concern and an important target for interventions. At present, available treatments offer only minimal to moderate benefits to ameliorate cognitive deficits. Thus, there remains an urgent need to identify novel interventions to improve cognition in people with SZ. Emerging evidence from animal and basic human research suggests aerobic exercise training (AE) has beneficial effects on cognition. Preliminary findings suggest that AE is efficacious in improving cognitive functioning in SZ, however the extant studies have been limited by small samples, a dearth of information on biologically-relevant covariates, and limited information on impact on daily functioning. Additionally, while AE-related cognitive benefits have been linked to Brain-Derived Neurotrophic Factor (BDNF) upregulation, this putative mechanism needs confirmation. The present report describes a study protocol designed to address these limitations-we review and summarize the current literature on treatment of cognitive deficits in SZ, state the rationale for employing AE to target these deficits, and describe the current protocol-a multi-site, single-blind, randomized clinical trial aiming to recruit 200 community-dwelling individuals with SZ. Participants are randomized to one of two 12-week interventions: AE using active-play video games (i.e., Xbox Kinect) and traditional cardiovascular exercise equipment or a stretching-and-toning (ST) control intervention. Participants undergo assessments of aerobic fitness, cognition, and daily functioning, as well as BDNF and other biomarkers of cognitive change, at baseline and after 6-and 12-weeks.
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331
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Shimada T, Ito S, Makabe A, Yamanushi A, Takenaka A, Kobayashi M. Aerobic exercise and cognitive functioning in schizophrenia: A pilot randomized controlled trial. Psychiatry Res 2019; 282:112638. [PMID: 31685285 DOI: 10.1016/j.psychres.2019.112638] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
Abstract
This pilot randomized controlled trial evaluated the combined effect of individual and group aerobic exercises (AEs) on cognition in schizophrenia. Among 32 randomized patients, 31 were included in the intent-to-treat population: 16 in treatment as usual (TAU) + AE and 15 in TAU groups. Over 12 weeks, patients were given a dose of 2 exercise sessions per week, including 1 individual session and 1 group session. TAU + AE patients showed significant improvements in cognition, intrinsic motivation, psychiatric symptoms, and interpersonal relations. These encouraging findings support the promise of integrated individual and group AEs to improve cognition and other outcomes in schizophrenia.
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Affiliation(s)
- Takeshi Shimada
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, 3057-1, Shiogawa, Ueda, Nagano, Japan.
| | - Shoko Ito
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, 3057-1, Shiogawa, Ueda, Nagano, Japan
| | - Aya Makabe
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, 3057-1, Shiogawa, Ueda, Nagano, Japan
| | - Ayumi Yamanushi
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, 3057-1, Shiogawa, Ueda, Nagano, Japan
| | - Ami Takenaka
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, 3057-1, Shiogawa, Ueda, Nagano, Japan
| | - Masayoshi Kobayashi
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
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332
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Raabe FJ, Slapakova L, Rossner MJ, Cantuti-Castelvetri L, Simons M, Falkai PG, Schmitt A. Oligodendrocytes as A New Therapeutic Target in Schizophrenia: From Histopathological Findings to Neuron-Oligodendrocyte Interaction. Cells 2019; 8:cells8121496. [PMID: 31771166 PMCID: PMC6952785 DOI: 10.3390/cells8121496] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022] Open
Abstract
Imaging and postmortem studies have revealed disturbed oligodendroglia-related processes in patients with schizophrenia and provided much evidence for disturbed myelination, irregular gene expression, and altered numbers of oligodendrocytes in the brains of schizophrenia patients. Oligodendrocyte deficits in schizophrenia might be a result of failed maturation and disturbed regeneration and may underlie the cognitive deficits of the disease, which are strongly associated with impaired long-term outcome. Cognition depends on the coordinated activity of neurons and interneurons and intact connectivity. Oligodendrocyte precursors form a synaptic network with parvalbuminergic interneurons, and disturbed crosstalk between these cells may be a cellular basis of pathology in schizophrenia. However, very little is known about the exact axon-glial cellular and molecular processes that may be disturbed in schizophrenia. Until now, investigations were restricted to peripheral tissues, such as blood, correlative imaging studies, genetics, and molecular and histological analyses of postmortem brain samples. The advent of human-induced pluripotent stem cells (hiPSCs) will enable functional analysis in patient-derived living cells and holds great potential for understanding the molecular mechanisms of disturbed oligodendroglial function in schizophrenia. Targeting such mechanisms may contribute to new treatment strategies for previously treatment-resistant cognitive symptoms.
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Affiliation(s)
- Florian J. Raabe
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany; (F.J.R.); (L.S.); (P.G.F.)
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Kraepelinstr, 2-10, 80804 Munich, Germany
- Molecular and Behavioural Neurobiology, Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, 80336 Munich, Germany;
| | - Lenka Slapakova
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany; (F.J.R.); (L.S.); (P.G.F.)
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Kraepelinstr, 2-10, 80804 Munich, Germany
| | - Moritz J. Rossner
- Molecular and Behavioural Neurobiology, Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, 80336 Munich, Germany;
| | - Ludovico Cantuti-Castelvetri
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen Str. 17, 81377 Munich, Germany; (L.C.-C.); (M.S.)
| | - Mikael Simons
- German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen Str. 17, 81377 Munich, Germany; (L.C.-C.); (M.S.)
- Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany
- Institute of Neuronal Cell Biology, Technical University Munich, 80805 Munich, Germany
| | - Peter G. Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany; (F.J.R.); (L.S.); (P.G.F.)
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany; (F.J.R.); (L.S.); (P.G.F.)
- Molecular and Behavioural Neurobiology, Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, 80336 Munich, Germany;
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, 05453-010 São Paulo, Brazil
- Correspondence: ; Tel.: +49-(0)89-4400-52761; Fax: +49-(0)89-4400-55530
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333
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Pathways to functional outcomes in schizophrenia spectrum disorders: Meta-analysis of social cognitive and neurocognitive predictors. Neurosci Biobehav Rev 2019; 105:212-219. [DOI: 10.1016/j.neubiorev.2019.07.020] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/26/2019] [Accepted: 07/28/2019] [Indexed: 01/27/2023]
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334
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Gonzalez-Blanco L, Garcia-Portilla MP, Dal Santo F, Garcia-Alvarez L, de la Fuente-Tomas L, Menendez-Miranda I, Bobes-Bascaran T, Saiz PA, Bobes J. Predicting real-world functioning in outpatients with schizophrenia: Role of inflammation and psychopathology. Psychiatry Res 2019; 280:112509. [PMID: 31446217 DOI: 10.1016/j.psychres.2019.112509] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/04/2019] [Accepted: 08/04/2019] [Indexed: 10/26/2022]
Abstract
Several studies indicate that negative and cognitive symptoms are determining factors of functioning in patients with schizophrenia. However, they do not usually include biological aspects, such as inflammatory markers. The current prospective study aims to identify clinical and biological factors predicting real-world functioning, at baseline and at one-year follow-up, of outpatients in an early stage of schizophrenia. Sample consist of 73 clinically stable patients with schizophrenia, of which 57 completed the one-year follow-up. Accurate psychopathology, functioning, and cognitive assessments were performed at baseline and follow-up (Positive and Negative Syndrome, Brief Negative Symptom, Calgary Depression, Personal and Social Performance Scales, and MATRICS Cognitive Consensus Battery). Biological biomarkers including anthropometric data and blood parameters were collected. Pearson correlation and multiple regression analyses including potential confounding factors were performed. Negative symptoms (especially asociality and avolition), along with the inflammatory biomarker interleukin-2, are the most important determining factors of poor real-world functioning in early-stage schizophrenia. The previous functioning, along with baseline cognitive performance in attention and vigilance, predicts functioning at one-year follow-up in these patients. Strategies aimed at improving negative and cognitive symptoms, as well as modifying certain inflammatory pathways, should be the targets to achieve functional recovery in the first years of schizophrenia.
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Affiliation(s)
- Leticia Gonzalez-Blanco
- Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Department of Psychiatry, University of Oviedo, Spain
| | - Maria Paz Garcia-Portilla
- Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Department of Psychiatry, University of Oviedo, Spain
| | - Francesco Dal Santo
- Servicio de Salud del Principado de Asturias, Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.
| | - Leticia Garcia-Alvarez
- Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Department of Psychiatry, University of Oviedo, Spain
| | - Lorena de la Fuente-Tomas
- Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Department of Psychiatry, University of Oviedo, Spain
| | - Isabel Menendez-Miranda
- Servicio de Salud del Principado de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Teresa Bobes-Bascaran
- Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Department of Psychology, University of Oviedo, Spain
| | - Pilar A Saiz
- Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Department of Psychiatry, University of Oviedo, Spain
| | - Julio Bobes
- Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Department of Psychiatry, University of Oviedo, Spain
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335
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Jimenez AM, Riedel P, Lee J, Reavis EA, Green MF. Linking resting-state networks and social cognition in schizophrenia and bipolar disorder. Hum Brain Mapp 2019; 40:4703-4715. [PMID: 31322784 DOI: 10.1002/hbm.24731] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/21/2019] [Accepted: 07/07/2019] [Indexed: 12/25/2022] Open
Abstract
Individuals with schizophrenia and bipolar disorder show alterations in functional neural connectivity during rest. However, resting-state network (RSN) disruptions have not been systematically compared between the two disorders. Further, the impact of RSN disruptions on social cognition, a key determinant of functional outcome, has not been studied. Forty-eight individuals with schizophrenia, 46 with bipolar disorder, and 48 healthy controls completed resting-state functional magnetic resonance imaging. An atlas-based approach was used to examine functional connectivity within nine RSNs across the cortex. RSN connectivity was assessed via nonparametric permutation testing, and associations with performance on emotion perception, mentalizing, and emotion management tasks were examined. Group differences were observed in the medial and lateral visual networks and the sensorimotor network. Individuals with schizophrenia demonstrated reduced connectivity relative to healthy controls in all three networks. Individuals with bipolar disorder demonstrated reduced connectivity relative to controls in the medial visual network and connectivity within this network was significantly positively correlated with emotion management. In healthy controls, connectivity within the medial and lateral visual networks positively correlated with mentalizing. No significant correlations were found for either visual network in schizophrenia. Results highlight the role of altered early visual processing in social cognitive deficits in both schizophrenia and bipolar disorder. However, individuals with bipolar disorder appear to compensate for disrupted visual network connectivity on social cognitive tasks, whereas those with schizophrenia do not. The current study adds clarity on the neurophysiology underlying social cognitive deficits that result in impaired functioning in serious mental illness.
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Affiliation(s)
- Amy M Jimenez
- Desert Pacific MIRECC, VA Greater Los Angeles Healthcare System, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Philipp Riedel
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California.,Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Junghee Lee
- Desert Pacific MIRECC, VA Greater Los Angeles Healthcare System, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Eric A Reavis
- Desert Pacific MIRECC, VA Greater Los Angeles Healthcare System, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Michael F Green
- Desert Pacific MIRECC, VA Greater Los Angeles Healthcare System, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
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336
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Melle I. Cognition in schizophrenia: a marker of underlying neurodevelopmental problems? World Psychiatry 2019; 18:164-165. [PMID: 31059634 PMCID: PMC6502404 DOI: 10.1002/wps.20646] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Ingrid Melle
- NORMENT Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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337
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Keefe RSE. Why are there no approved treatments for cognitive impairment in schizophrenia? World Psychiatry 2019; 18:167-168. [PMID: 31059617 PMCID: PMC6502426 DOI: 10.1002/wps.20648] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Richard S E Keefe
- Department of Psychiatry, Duke University Medical Center, Durham, NC, USA
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338
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Davidson M. Cognitive impairment as a diagnostic criterion and treatment target in schizophrenia. World Psychiatry 2019; 18:171-172. [PMID: 31059612 PMCID: PMC6502436 DOI: 10.1002/wps.20651] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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339
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Falkai P, Schmitt A. The need to develop personalized interventions to improve cognition in schizophrenia. World Psychiatry 2019; 18:170. [PMID: 31059619 PMCID: PMC6502408 DOI: 10.1002/wps.20650] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany,2Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
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340
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Grant PM, Best M W, Beck AT. The meaning of group differences in cognitive test performance. World Psychiatry 2019; 18:163-164. [PMID: 31059607 PMCID: PMC6502459 DOI: 10.1002/wps.20645] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Paul M. Grant
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael W. Best
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aaron T. Beck
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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341
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Reichenberg A, Velthorst E, Davidson M. Cognitive impairment and psychosis in schizophrenia: independent or linked conditions? World Psychiatry 2019; 18:162-163. [PMID: 31059615 PMCID: PMC6502409 DOI: 10.1002/wps.20644] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount SinaiNew YorkNYUSA
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342
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Harvey PD, Strassnig MT. Cognition and disability in schizophrenia: cognition-related skills deficits and decision-making challenges add to morbidity. World Psychiatry 2019; 18:165-167. [PMID: 31059625 PMCID: PMC6502430 DOI: 10.1002/wps.20647] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Philip D. Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA,Research Service, Miami VA Healthcare System, Miami, FL, USA
| | - Martin T. Strassnig
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA,Palm Beach County Mental Health Services, Delray Beach, FL, USA
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343
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Barch DM. Nonsocial and social cognitive function in psychosis: interrelationships, specificity and innovative approaches. World Psychiatry 2019; 18:117-118. [PMID: 31059631 PMCID: PMC6502400 DOI: 10.1002/wps.20653] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Deanna M. Barch
- Departments of Psychological and Brain Sciences, Psychiatry and RadiologyWashing‐ton University in St. LouisSt. LouisMOUSA
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344
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Sahakian BJ, Savulich G. Innovative methods for improving cognition, motivation and wellbeing in schizophrenia. World Psychiatry 2019; 18:168-170. [PMID: 31059610 PMCID: PMC6502422 DOI: 10.1002/wps.20649] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Barbara J. Sahakian
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - George Savulich
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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