1
|
Schjøtt-Pedersen O, Bull HC, Falkum E, Ueland T, Skancke Gjerdalen O, Øksendal Haaland V, Evensen S, Ullevoldsæter Lystad J. Measuring the concurrent validity of the norwegian versions of the psychotic symptom rating scales (PSYRATS) and the positive scale from the positive and negative syndrome scale (PANSS). Nord J Psychiatry 2024:1-4. [PMID: 38905132 DOI: 10.1080/08039488.2024.2367638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
PURPOSE The Positive and Negative Syndrome Scale (PANSS) is one of the most commonly used assessment tools for measuring psychotic symptoms. The Psychotic Symptom Rating Scales (PSYRATS) is another instrument created specifically to assess delusions and auditory hallucinations. However, research on the concurrent validity of PSYRATS with PANSS is limited. There are also inconsistent findings regarding the association between the PSYRATS scales and the PANSS positive scale. The present study aims to add to the understanding of the concurrent validity of these measures, while also incorporating a broader measure of psychiatric symptoms (the symptom scale from the Global Assessment of Functioning Scale - split version, GAF-S). MATERIALS AND METHODS Spearman's Rank Order Correlations (rho) were calculated for scores from the PANSS positive scale, PSYRATS and GAF-S in a sample of 148 participants with psychotic disorders at three time points. RESULTS The findings indicate concurrent validity between PSYRATS and PANSS, while the PSYRATS scales were not consistently correlated with GAF-S. CONCLUSIONS PSYRATS may be a valid assessment tool for evaluating psychotic symptoms. The utility of PSYRATS in research and clinical practice should be investigated further.
Collapse
Affiliation(s)
- Olivia Schjøtt-Pedersen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo Oslo, Norway
| | - Helen Christine Bull
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Erik Falkum
- Institute of Clinical Medicine, University of Oslo Oslo, Norway
| | - Torill Ueland
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Vegard Øksendal Haaland
- Department of Mental Health, Sørlandet Hospital, Kristiansand, Norway
- Clinical Neuroscience Research Group, Department of Psychology, , University of Oslo, Oslo, Norway
| | - Stig Evensen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Norwegian Labor and Welfare Administration, NAV, Nesodden, Norway
| | | |
Collapse
|
2
|
Tschöke S, Knauer Y, Flammer E, Usemann P, Uhlmann C. Psychotic Experiences and Daily Functioning in Borderline Personality Disorder and Schizophrenia. J Nerv Ment Dis 2024; 212:187-189. [PMID: 38412244 DOI: 10.1097/nmd.0000000000001755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
ABSTRACT Psychotic experiences have been shown to be comparable in borderline personality disorder (BPD) and schizophrenia. Preliminary evidence suggests differences in the impact of psychotic experiences on daily functioning. Therefore, in this study, we aimed to investigate the role of psychotic experiences in daily functioning in BPD compared with schizophrenia. We performed post hoc analyses on data from 23 inpatients with BPD and 21 inpatients with schizophrenia, for whom results from the Psychotic Symptom Rating Scales were available. No differences were found in frequency, intensity, and disruption of life in relation to auditory verbal hallucinations and the amount of preoccupation and conviction with regard to delusions. Significant differences were found in the disruption of life due to delusions. The results emphasize that the quality of psychotic experiences in BPD and schizophrenia is comparable, but the impact of delusions on daily life is different, which may improve differential diagnosis.
Collapse
|
3
|
Pratt DN, Bridgwater M, Schiffman J, Ellman LM, Mittal VA. Do the Components of Attenuated Positive Symptoms Truly Represent One Construct? Schizophr Bull 2023; 49:788-798. [PMID: 36454660 PMCID: PMC10154719 DOI: 10.1093/schbul/sbac182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND AND HYPOTHESES Psychosis-risk inventories, like the Structured Interview for Psychosis-Risk Syndromes (SIPS), utilize symptom components and coalesce the information into a single-severity rating. These components include frequency, duration, in-the-moment conviction, retrospective insight, distress, and effect on social/role functioning. While combining components distills a great deal of important information into one practical symptom rating, this approach may mask important details of the greater clinical picture. STUDY DESIGN Individuals at clinical high risk for psychosis (n = 115) were assessed with the SIPS Score Separable Components (SSSC) scale, created to accompany the SIPS positive items by dividing each item into the 7 components identified above. The latent structure of the SSSC was identified with an exploratory factor analysis (EFA). The factors were followed up with validation analyses including hypothesized cognitive, functioning, and symptom measures. Finally, clinical utility analyses were conducted to understand relationships between psychosis risk and common comorbidities. STUDY RESULTS EFA revealed that the SSSC had 3 interpretable factors with the appropriate fit (rmsr = 0.018, TLI = 0.921): Conviction (in-the-moment conviction, retrospective insight), Distress-Impairment (distress, social/role functioning), and Frequency/Duration (frequency, duration). Conviction was minimally valid, Distress-Impairment had excellent validity, and Frequency/Duration was not related to any of the candidate validators. Conviction significantly predicted elevated psychosis risk. Distress-Impairment was related to common comorbid symptoms. Notably, the factors associated more strongly with clinical features than the traditional SIPS scores. CONCLUSIONS The SSSC offers a supplemental approach to single-severity ratings, providing useful clinical insight, mechanistic understanding, and the potential for better capturing heterogeneity in this population.
Collapse
Affiliation(s)
- Danielle N Pratt
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Miranda Bridgwater
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
| |
Collapse
|
4
|
Cavelti M, Kaeser JM, Lerch S, Bauer S, Moessner M, Berger T, Hayward M, Kaess M. Smartphone-assisted guided self-help cognitive behavioral therapy for young people with distressing voices (SmartVoices): study protocol for a randomized controlled trial. Trials 2022; 23:902. [PMID: 36274185 PMCID: PMC9590132 DOI: 10.1186/s13063-022-06846-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background The long-standing view that auditory verbal hallucinations (AVH) or hearing voices is a sign of schizophrenia has been challenged by research demonstrating that they lie on a continuum ranging from normal to pathological experience related to distress and need for care. Hearing voices is more prevalent in adolescence than in later life, and hearing voices during adolescence indicates a risk for severe psychopathology, functional impairments, and suicide later in life. While there is increasing evidence for the efficacy of cognitive behavioral therapy for voices (CBTv) in adults with schizophrenia, research on psychological treatments for youth with distressing voices has been scarce. The aim of the current study is to examine the efficacy of CBTv, delivered using smartphone-based Ecological Momentary Assessment Intervention (EMI) in a transdiagnostic sample of youth. Methods This is a superiority randomized controlled trial comparing 8 weeks of CBTv-based EMI in addition to treatment as usual (TAU) versus TAU only. TAU covers both no treatment and any form of psychiatric/psychological treatment. In the EMI condition, participants will be prompted twice a day to complete an EMA survey, and receive one intervention proposal per assessment. One-hundred fifty-four youth aged 14–25 years with distressing voices will be recruited from psychiatric clinics, local private practices, internet forums, and advertisements in print and social media. Before and after the intervention phase, participants will undergo a 9-day EMA. Single-blinded assessments will be conducted at baseline (T0) and at 3-month (T1) and 6-month (T2) follow-up. The primary outcome is the distress dimension of the Auditory Hallucinations subscale of the Psychotic Symptom Rating Scales at T1. Secondary outcomes include perceived hostile intention, power, and dominance of voices, passive, aggressive, and assertive relating to voices, and negative core beliefs about the self. Discussion Adolescence provides a crucial window of opportunity for early intervention for hearing voices. However, youth are notoriously reluctant help-seekers. This study offers a low-intensity psychological intervention for youth with distressing voices beyond diagnostic boundaries that, using a mobile technology approach, may match the treatment preferences of the generation of “digital natives.” Trial registration German Clinical Trials Register DRKS00026243. Registered on 2 September 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06846-0.
Collapse
|
5
|
Opoka SM, Ludwig L, Mehl S, Lincoln TM. An experimental study on the effectiveness of emotion regulation in patients with acute delusions. Schizophr Res 2021; 228:206-217. [PMID: 33453692 DOI: 10.1016/j.schres.2020.11.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/28/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Patients with psychotic disorders report to apply more maladaptive and less adaptive emotion-regulation (ER) strategies compared to healthy controls. However, few studies have used experimental designs to investigate the success in ER and the results of those at hand are equivocal. AIM This study investigated whether patients with delusions show problems in downregulating negative affect via cognitive ER-strategies. METHOD Patients with schizophrenia spectrum disorders and acute delusions (n = 78) and healthy controls (n = 41) took part in an ER-experiment, in which they were instructed to downregulate anxiety and sadness via three ER-strategies (reappraisal, distraction, acceptance) or not to regulate their emotions (control-condition). ER-success was measured as the change in subjective emotion-intensity and physiological indicators (skin conductance and heart rate) from before to after regulation and was analyzed with mixed-repeated-measures ANOVAs. RESULTS We found a significant effect of the ER-strategy in the sense that the subjective emotion-intensity was significantly lower after applying the reappraisal- and distraction-strategies than after the just view-condition (p's < .001). This effect was not found for the acceptance strategy (p = .060). There was no ER-strategy ∗ time ∗ group interaction-effect F(4.918, 575.416) = 0.778, p = .564, ƞ2partial = 0.007. In all conditions, skin conductance decreased from pre- to post regulation (p < .001). CONCLUSION Our results indicate that patients with acute delusions can successfully apply cognitive ER-strategies. Before pursuing the relevant clinical implications of this finding, further research is needed to explore the role that the type of instruction has on ER-success and the extent to which the findings can be generalized to real life settings.
Collapse
Affiliation(s)
- Sandra M Opoka
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany.
| | - Lea Ludwig
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany
| | - Stephanie Mehl
- Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (CMBB), Faculty of Medicine, Philipps-University of Marburg, 35039 Marburg, Germany; Faculty of Health and Social Work, Frankfurt University of Applied Sciences, 60318 Frankfurt am Main, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany
| |
Collapse
|
6
|
A relationship of sorts: gender and auditory hallucinations in schizophrenia spectrum disorders. Arch Womens Ment Health 2021; 24:709-720. [PMID: 33743057 PMCID: PMC8492592 DOI: 10.1007/s00737-021-01109-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/25/2021] [Indexed: 10/27/2022]
Abstract
Voice hearing has been conceptualized as an interrelational framework, where the interaction between voice and voice hearer is reciprocal and resembles "real-life interpersonal interactions." Although gender influences social functioning in "real-life situations," little is known about respective effects of gender in the voice hearing experience. One hundred seventeen participants with a schizophrenia spectrum disorder took part in a semi-structured interview about the phenomenology of their voices and completed standardized self-rating questionnaires on their beliefs about their most dominant male and female voices and the power differentials in their respective voice-voice hearer interactions. Additionally, the voice hearers' individual masculine/feminine traits were recorded. Men heard significantly more male than female dominant voices, while the gender ratio of dominant voices was balanced in women. Although basic phenomenological characteristics of voices were similar in both genders, women showed greater amounts of distress caused by the voices and reported a persistence of voices for longer time periods. Command hallucinations that encouraged participants to harm others were predominantly male. Regarding voice appraisals, high levels of traits associated with masculinity (=instrumentality/agency) correlated with favorable voice appraisals and balanced power perceptions between voice and voice hearer. These positive effects seem to be more pronounced in women. The gender of both voice and voice hearer shapes the voice hearing experience in manifold ways. Due to possible favorable effects on clinical outcomes, therapeutic concepts that strengthen instrumental/agentic traits could be a feasible target for psychotherapeutic interventions in voice hearing, especially in women.
Collapse
|
7
|
Gmeiner A, Gaglia A, Habicher S, Rumpold T, Süßenbacher S, Schrank B, Amering M. Power to the voice hearer - The German version of the voice power differential scale. PLoS One 2020; 15:e0230778. [PMID: 32214352 PMCID: PMC7098598 DOI: 10.1371/journal.pone.0230778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 03/09/2020] [Indexed: 11/18/2022] Open
Abstract
Voice power is an important concept in daily life of voice hearers and in the support and therapy for voice hearers who seek help. Therefore, the ability to examine voice power differentials between a voice and a voice hearer is essential. The present study aimed to collect data on voice power differentials and to further validate the Voice Power Differential Scale (VPD). 105 participants aged ≥ 18 with an ICD10 F2-diagnosis that included hearing voices were included in this study. Internal consistency was good (alpha = 0.792), as well as test-retest-reliability (r = 0.855) and correlations with other constructs were generally as expected. The VPD questionnaire results correlated negatively with the Beliefs About Voices Questionnaire-Revised’s (BAVQ-R) items of Benevolence and Engagement-emotion. It correlated positively with Omnipotence and Resistance-emotion, as well as with Negative Content on the Psychotic Symptoms Rating-Scale (PSYRATS). Unexpectedly, no correlations were found with overall severity and command hallucinations. The Voice Power Differential Scale is an important tool for assessing and formulating a voice hearer’s experience when they seek treatment or support for their verbal auditory hallucinations. The results of this study enrich the on-going discussion about the importance of voice power for voice hearers.
Collapse
Affiliation(s)
- A. Gmeiner
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | - A. Gaglia
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Division of Psychology, Bangor University Wales, Bangor, United Kingdom
| | - S. Habicher
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - T. Rumpold
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - S. Süßenbacher
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - B. Schrank
- Department of Adult Psychiatry, Karl Landsteiner University for Health Sciences, University Clinic Tulln, Vienna, Austria
| | - M. Amering
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
8
|
A Feasibility Study of the Translation of Cognitive Behaviour Therapy for Psychosis into an Australian Adult Mental Health Clinical Setting. BEHAVIOUR CHANGE 2020. [DOI: 10.1017/bec.2020.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThere is evidence that Cognitive Behaviour Therapy for Psychosis (CBTp) is an effective intervention for reducing psychotic symptoms. The recently updated Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines (RANZCP CPG) recommend CBTp for the therapeutic management of schizophrenia and related disorders. Translational research is required to examine how well CBTp can be applied into public mental health services. This feasibility study aimed to provide preliminary evidence on how acceptable, implementable, and adaptable individual or group CBTp may be within a public mental health service in Australia. Twenty-seven participants initially agreed to participate in the study with 16 participants being randomised to either group or individual therapy, 11 starting therapy and 7 completing therapy. The intervention involved approximately 20 h of manualised CBTp. Attendance was higher in the individual therapy. Subjective reports indicated that the therapy was acceptable to all completers. Participants who engaged in individual or group CBTp experienced a similar level of reduction in the severity of hallucinations and delusions. Individual CBTp may be a feasible, acceptable, and effective intervention to include in Australian public mental health services. A pilot trial is now required to provide further evidence for and guidance of how best to translate CBTp protocols to Australian mental health services.
Collapse
|
9
|
Keeley JW, Gaebel W, First MB, Peterson DL, Rebello T, Sharan P, Reed GM. Psychotic disorder symptom rating scales: Are dichotomous or multi-point scales more clinically useful?-An ICD-11 field study. Schizophr Res 2018; 202:254-259. [PMID: 30017460 DOI: 10.1016/j.schres.2018.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 04/25/2018] [Accepted: 07/01/2018] [Indexed: 01/01/2023]
Abstract
Classifications of psychotic disorders are moving towards utilizing dimensional symptom domains as the preferred mechanism for describing psychotic symptomatology. The ICD-11 has proposed six symptom domains (Positive symptoms, Negative symptoms, Depressive symptoms, Manic symptoms, Psychomotor symptoms, and Cognitive symptoms) that would be rated in addition to providing a psychotic disorder diagnosis. This study investigated clinicians' use of dichotomous versus multi-point scales for rating these six domains. Global mental health professionals (n = 273) rated case vignettes using both a 2-point and 4-point version of a rating scale for the six domains. Clinicians were more accurate using the 2-point scale in absolute terms, but after correcting for chance guessing and disagreements, the two versions of the scale were equally accurate. Clinicians believed the 2-point scale would be easier to use, although they also indicated that the 4-point scale would provide richer clinical information. Participants were able to detect the presence of psychotic symptom domains in the vignettes with good reliability with no special training using either scale. We recommend that clinicians and researchers use the version of the scale that best matches their purpose (i.e., to maximize accuracy or enhance case description). Future work should develop the implementation characteristics of the scale to improve its potential for global application.
Collapse
Affiliation(s)
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University, Germany
| | - Michael B First
- Global Mental Health Program, Columbia University Medical Center, USA; New York State Psychiatric Institute, USA
| | | | - Tahilia Rebello
- Global Mental Health Program, Columbia University Medical Center, USA; New York State Psychiatric Institute, USA
| | | | - Geoffrey M Reed
- Global Mental Health Program, Columbia University Medical Center, USA; World Health Organization, Switzerland
| |
Collapse
|
10
|
Gmeiner A, Aslan J, Gaglia A, Rumpold T, Schrank B, Süßenbacher S, Amering M. [Beliefs and distress related to hearing voices: the German version of the Beliefs About Voices Questionnaire-Revised (BAVQ-R)]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2018; 32:214-221. [PMID: 30267381 DOI: 10.1007/s40211-018-0291-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 09/18/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Beliefs about voices are a determining factor with regards to distress, coping and therapeutic interventions in verbal auditory hallucinations. Aim of the present study was to use and validate the internationally well established Beliefs About Voices Questionnaire-Revised (BAVQ-R) in a German translation with people suffering from schizophrenic psychoses. METHODS 93 participants with a diagnosis of schizophrenia and current verbal auditory hallucinations completed the BAVQ-R autonomously for their dominant voice. Sociodemographic and clinical data as well as data concerning the severity of illness (CGI-Sch) and symptom specific dimensions of voice-hearing (PSYRATS-AH) were collected. Construct validity, reliability and test-retest-reliability were calculated. RESULTS Each of the subscales (malevolence, benevolence, resistance, engagement) with the exception of the subscale omnipotence showed satisfying internal consistency. Good test-retest-reliability was shown for the belief-subscales but not for emotion and behaviour in resistance and engagement. Significant correlations between the subscales showed the expected results, comparable to the results of the original BAVQ-R study. No correlations with severity of the illness, but with amount and intensity of distress through voices and their negative contents correlations were found. CONCLUSIONS FOR PRACTICE The BAVQ-R is a feasible instrument to collect data about beliefs about voices in a valid and reliable way in people with a diagnosis of schizophrenia. From a therapeutic as well as from a scientific point of view, the question about the conceptualization of the relationship between cognition, emotion and behaviour stays relevant.
Collapse
Affiliation(s)
- Andrea Gmeiner
- Klinische Abteilung für Sozialpsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
| | - Jessica Aslan
- Klinische Abteilung für Sozialpsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Amy Gaglia
- Abteilung für Psychologie, Bangor University, Bangor, Wales, Großbritannien
| | - Tamara Rumpold
- Klinische Abteilung für Sozialpsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Beate Schrank
- Universitätsklinik Tulln, Abteilung für Erwachsenenpsychiatrie, Karl Landsteiner Universität für Gesundheitswissenschaften, Tulln an der Donau, Österreich
| | - Stefanie Süßenbacher
- Klinische Abteilung für Sozialpsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Michaela Amering
- Klinische Abteilung für Sozialpsychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| |
Collapse
|
11
|
Cortical folding abnormalities in patients with schizophrenia who have persistent auditory verbal hallucinations. Eur Neuropsychopharmacol 2018; 28:297-306. [PMID: 29305294 DOI: 10.1016/j.euroneuro.2017.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/28/2017] [Accepted: 12/06/2017] [Indexed: 01/28/2023]
Abstract
In schizophrenia temporal cortical volume loss differs between patients presenting with persistent auditory verbal hallucinations (pAVH) in contrast to those without hallucinatory symptoms (nAVH). However, it is unknown whether this deficit reflects a neural signature of neurodevelopmental origin or if abnormal temporal cortical volume is reflective of factors which may be relevant at later stages of the disorder. Here, we tested the hypothesis that local gyrification index (LGI) in regions of the temporal cortex differs between patients with pAVH (n=10) and healthy controls (n=14), and that abnormal temporal LGI discriminates between pAVH and nAVH (n=10). Structural magnetic resonance imaging at 3T along with surface-based data analysis methods was used. Contrary to our expectations, patients with pAVH showed lower LGI in Broca´s region compared to both healthy persons and nAVH. Compared to nAVH, those individuals presenting with pAVH also showed lower LGI in right Broca's homologue and right superior middle frontal cortex, together with increased LGI in the precuneus and superior parietal cortex. Regions with abnormal LGI common to both patient samples were found in anterior cingulate and superior frontal areas. Inferior cortical regions exhibiting abnormal LGI in pAVH patients were associated with overall symptom load (BPRS), but not with measures of AVH symptom severity. The pattern of abnormal cortical folding in this sample suggests a neurodevelopmental signature in Broca's region, consistent with current AVH models emphasizing the pivotal role of language circuits and inner speech. Temporal cortical deficits may characterize patients with pAVH during later stages of the disorder.
Collapse
|
12
|
Abdul Wahab NA, Zakaria MN, Abdul Rahman AH, Sidek D, Wahab S. Listening to Sentences in Noise: Revealing Binaural Hearing Challenges in Patients with Schizophrenia. Psychiatry Investig 2017; 14:786-794. [PMID: 29209382 PMCID: PMC5714720 DOI: 10.4306/pi.2017.14.6.786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 12/23/2016] [Accepted: 03/19/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The present, case-control, study investigates binaural hearing performance in schizophrenia patients towards sentences presented in quiet and noise. METHODS Participants were twenty-one healthy controls and sixteen schizophrenia patients with normal peripheral auditory functions. The binaural hearing was examined in four listening conditions by using the Malay version of hearing in noise test. The syntactically and semantically correct sentences were presented via headphones to the randomly selected subjects. In each condition, the adaptively obtained reception thresholds for speech (RTS) were used to determine RTS noise composite and spatial release from masking. RESULTS Schizophrenia patients demonstrated significantly higher mean RTS value relative to healthy controls (p=0.018). The large effect size found in three listening conditions, i.e., in quiet (d=1.07), noise right (d=0.88) and noise composite (d=0.90) indicates statistically significant difference between the groups. However, noise front and noise left conditions show medium (d=0.61) and small (d=0.50) effect size respectively. No statistical difference between groups was noted in regards to spatial release from masking on right (p=0.305) and left (p=0.970) ear. CONCLUSION The present findings suggest an abnormal unilateral auditory processing in central auditory pathway in schizophrenia patients. Future studies to explore the role of binaural and spatial auditory processing were recommended.
Collapse
Affiliation(s)
- Noor Alaudin Abdul Wahab
- Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Audiology Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd. Normani Zakaria
- Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Abdul Hamid Abdul Rahman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Dinsuhaimi Sidek
- Department of Otorhinolaryngology, School of Medicine, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Suzaily Wahab
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
13
|
Cerebellar Contributions to Persistent Auditory Verbal Hallucinations in Patients with Schizophrenia. THE CEREBELLUM 2017; 16:964-972. [DOI: 10.1007/s12311-017-0874-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
14
|
Chien WT, Lee IYM, Wang LQ. A Chinese version of the Psychotic Symptom Rating Scales: psychometric properties in recent-onset and chronic psychosis. Neuropsychiatr Dis Treat 2017; 13:745-753. [PMID: 28331325 PMCID: PMC5352235 DOI: 10.2147/ndt.s131174] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The purpose of this study was to test the reliability, validity, and factor structure of a Chinese version of the Psychotic Symptom Rating Scale (PSYRATS) in 198 and 202 adult patients with recent-onset and chronic psychosis, respectively. The PSYRATS has been translated into different language versions and has been validated for clinical and research use mainly in chronic psychotic patients but not in recent-onset psychosis patients or in Chinese populations. The psychometric analysis of the translated Chinese version included assessment of its content validity, semantic equivalence, interrater and test-retest reliability, reproducibility, sensitivity to changes in psychotic symptoms, internal consistency, concurrent validity (compared to a valid psychotic symptom scale), and factor structure. The Chinese version demonstrated very satisfactory content validity as rated by an expert panel, good semantic equivalence with the original version, and high interrater and test-retest (at 2-week interval) reliability. It also indicated very good reproducibility of and sensitivity to changes in psychotic symptoms in line with the symptom severity measured with the Positive and Negative Syndrome Scale (PANSS). The scale consisted of four factors for the hallucination subscale and two factors for the delusion subscale, explaining about 80% of the total variance of the construct, indicating satisfactory correlations between the hallucination and delusion factors themselves, between items, factors, subscales, and overall scale, and between factors and relevant item and subscale scores of the PANSS. The Chinese version of the PSYRATS is a reliable and valid instrument to measure symptom severity in Chinese psychotic patients complementary to other existing measures mainly in English language.
Collapse
Affiliation(s)
- Wai-Tong Chien
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, People's Republic of China
| | - Isabella Yuet-Ming Lee
- Central Nursing Division, Ruttonjee Tang Shiu King Hospital, Wan Chai, Hong Kong, People's Republic of China
| | - Li-Qun Wang
- School of Nursing, Jilin Medical College, Jilin City, Jilin Province, People's Republic of China
| |
Collapse
|
15
|
Neural substrates underlying delusions in schizophrenia. Sci Rep 2016; 6:33857. [PMID: 27651212 PMCID: PMC5030611 DOI: 10.1038/srep33857] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 09/05/2016] [Indexed: 11/30/2022] Open
Abstract
Delusions are cardinal positive symptoms in schizophrenia; however, the neural substrates of delusions remain unknown. In the present study, we investigated the neural correlates of delusions in schizophrenia using multi-modal magnetic resonance imaging (MRI) techniques. Diffusion, structural and perfusion MRIs were performed in 19 schizophrenia patients with severe delusions, 30 patients without delusions and 30 healthy controls. Fractional anisotropy (FA), gray matter volume (GMV) and cerebral blood flow (CBF) were voxel-wisely compared among the three groups. Although patients without delusions exhibited decreased FA in white matter regions and decreased GMV in gray matter regions relative to controls, patients with severe delusions demonstrated comparable FA in all of these white matter regions and similar GMV in most of these gray matter regions. Both patient subgroups had less GMV in the amygdala and anterior cingulate cortex than controls. Although two patient subgroups showed consistent CBF changes relative to controls, only CBF in the anterior cingulate cortex was lower in patients with severe delusions than in patients without delusions. These findings suggest that schizophrenia patients with severe delusions have relatively normal structural integrity. Importantly, the excessively reduced perfusion in the anterior cingulate cortex may be associated with the development of delusions in schizophrenia.
Collapse
|
16
|
Eichner C, Berna F. Acceptance and Efficacy of Metacognitive Training (MCT) on Positive Symptoms and Delusions in Patients With Schizophrenia: A Meta-analysis Taking Into Account Important Moderators. Schizophr Bull 2016; 42:952-62. [PMID: 26748396 PMCID: PMC4903058 DOI: 10.1093/schbul/sbv225] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Metacognitive training (MCT) is a new, widely used intervention for psychosis. The present meta-analysis examines the efficacy of MCT in schizophrenia. Fifteen studies comparing effects of MCT on positive symptoms, delusions or acceptance of MCT with a control group were included in this meta-analysis. These studies comprised a total of 408 patients in the MCT condition and 399 in the control condition. The moderating effects of masking of outcome assessment, randomization, incomplete outcome data, use of an active control intervention, and individual vs group MCT were investigated. Possible effects of sensitivity analyses and publication bias were also examined. The results show a significant overall effect of MCT for positive symptoms (g = -0.34, 95% CI [-0.53, -0.15]), delusions (g = -0.41, 95% CI [-0.74, -0.07]) and acceptance of the intervention (g = -0.84, 95% CI [-1.37, -0.31]). Using only studies being at low risk for bias regarding randomization, masking and incomplete outcome data reduced effect sizes for positive symptoms and delusions (g = -0.28, 95% CI [-0.50, -0.06] and g = -0.18, 95% CI [-0.43, 0.06]), respectively. This meta-analysis demonstrates that MCT exerts a small to moderate effect on delusions and positive symptoms and a large effect on acceptance of the intervention. The effect on delusions is reduced, but remains significant when potential biases are considered.
Collapse
Affiliation(s)
- Carolin Eichner
- Faculty of Psychology, University of Hamburg, Hamburg, Germany
| | | |
Collapse
|
17
|
Simon JJ, Cordeiro SA, Weber MA, Friederich HC, Wolf RC, Weisbrod M, Kaiser S. Reward System Dysfunction as a Neural Substrate of Symptom Expression Across the General Population and Patients With Schizophrenia. Schizophr Bull 2015; 41:1370-8. [PMID: 26006262 PMCID: PMC4601714 DOI: 10.1093/schbul/sbv067] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Dysfunctional patterns of activation in brain reward networks have been suggested as a core element in the pathophysiology of schizophrenia. However, it remains unclear whether this dysfunction is specific to schizophrenia or can be continuously observed across persons with different levels of nonclinical and clinical symptom expression. Therefore, we sought to investigate whether the pattern of reward system dysfunction is consistent with a dimensional or categorical model of psychosis-like symptom expression. 23 patients with schizophrenia and 37 healthy control participants with varying levels of psychosis-like symptoms, separated into 3 groups of low, medium, and high symptom expression underwent event-related functional magnetic resonance imaging while performing a Cued Reinforcement Reaction Time task. We observed lower activation in the ventral striatum during the expectation of high vs no reward to be associated with higher symptom expression across all participants. No significant difference between patients with schizophrenia and healthy participants with high symptom expression was found. However, connectivity between the ventral striatum and the medial orbitofrontal cortex was specifically reduced in patients with schizophrenia. Dysfunctional local activation of the ventral striatum depends less on diagnostic category than on the degree of symptom expression, therefore showing a pattern consistent with a psychosis continuum. In contrast, aberrant connectivity in the reward system is specific to patients with schizophrenia, thereby supporting a categorical view. Thus, the results of the present study provide evidence for both continuous and discontinuous neural substrates of symptom expression across patients with schizophrenia and the general population.
Collapse
Affiliation(s)
- Joe J. Simon
- Section of Experimental Psychopathology and Neurophysiology, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg, Germany;,Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, Heidelberg, Germany;,*To whom correspondence should be addressed; Centre for Psychosocial Medicine, General Internal Medicine and Psychosomatics, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; tel: +49 (0)6221 56-38667, fax: +49 (0)6221 56-5988, e-mail:
| | - Sheila A. Cordeiro
- Department of General Adult Psychiatry, Centre for Psychosocial Medicine, Heidelberg, Germany
| | - Marc-André Weber
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, Heidelberg, Germany;,LVR-Klinikum Essen, Department of Psychosomatic Medicine and Psychotherapy, Essen, Germany
| | - Robert C. Wolf
- Department of General Adult Psychiatry, Centre for Psychosocial Medicine, Heidelberg, Germany;,Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University, Homburg, Germany
| | - Matthias Weisbrod
- Section of Experimental Psychopathology and Neurophysiology, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg, Germany;,Department of General Adult Psychiatry, Centre for Psychosocial Medicine, Heidelberg, Germany;,SRH Klinikum, Karlsbad-Langensteinbach, Germany
| | - Stefan Kaiser
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
18
|
Kubera KM, Barth A, Hirjak D, Thomann PA, Wolf RC. Noninvasive brain stimulation for the treatment of auditory verbal hallucinations in schizophrenia: methods, effects and challenges. Front Syst Neurosci 2015; 9:131. [PMID: 26528145 PMCID: PMC4601083 DOI: 10.3389/fnsys.2015.00131] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 09/07/2015] [Indexed: 12/12/2022] Open
Abstract
This mini-review focuses on noninvasive brain stimulation techniques as an augmentation method for the treatment of persistent auditory verbal hallucinations (AVH) in patients with schizophrenia. Paradigmatically, we place emphasis on transcranial magnetic stimulation (TMS). We specifically discuss rationales of stimulation and consider methodological questions together with issues of phenotypic diversity in individuals with drug-refractory and persistent AVH. Eventually, we provide a brief outlook for future investigations and treatment directions. Taken together, current evidence suggests TMS as a promising method in the treatment of AVH. Low-frequency stimulation of the superior temporal cortex (STC) may reduce symptom severity and frequency. Yet clinical effects are of relatively short duration and effect sizes appear to decrease over time along with publication of larger trials. Apart from considering other innovative stimulation techniques, such as transcranial Direct Current Stimulation (tDCS), and optimizing stimulation protocols, treatment of AVH using noninvasive brain stimulation will essentially rely on accurate identification of potential responders and non-responders for these treatment modalities. In this regard, future studies will need to consider distinct phenotypic presentations of AVH in patients with schizophrenia, together with the putative functional neurocircuitry underlying these phenotypes.
Collapse
Affiliation(s)
- Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Anja Barth
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Dusan Hirjak
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Philipp A Thomann
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany ; Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University Homburg, Germany
| |
Collapse
|
19
|
Wahab S, Zakaria MN, Sidek D, Abdul Rahman AH, Shah SA, Abdul Wahab NA. Evaluation of auditory hallucinations in patients with schizophrenia: A validation study of the Malay version of Psychotic Symptom Rating Scales (PSYRATS). Psychiatry Res 2015; 228:462-7. [PMID: 26142835 DOI: 10.1016/j.psychres.2015.06.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 06/24/2015] [Accepted: 06/25/2015] [Indexed: 02/07/2023]
Abstract
The Psychotic Symptom Rating Scales (PSYRATS) is the most widely used validated scale to measure the specific symptoms of auditory hallucination and delusion. The aim of this study was to validate and to examine the psychometric properties of the auditory hallucination component of the Malay PSYRATS (MyPSYRATS). The research was done in the Universiti Kebangsaan Malaysia Medical Center (UKMMC) among 51 schizophrenia inpatients and outpatients who had experienced or reported verbal auditory hallucination. The psychometric properties of MyPSYRATS (auditory hallucination) were studied and a comparison was made between the psychometric properties obtained and the Positive and Negative Syndrome Scale (PANSS). The internal consistency of MyPSYRATS was good as revealed by Cronbach's alpha value. Factor analysis replicated three components (emotional, cognitive, and physical) similar to the factorial structure of the original auditory hallucination scale. However, two items were regrouped under the emotional component. Spearman's rank-order correlation showed a significant positive relationship between the total score of auditory hallucinations and PANSS auditory hallucinations item (P3). In conclusion, the auditory hallucination domain of MyPSYRATS is a reliable and valid assessment tool for further clinical applications.
Collapse
Affiliation(s)
- Suzaily Wahab
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Malaysia
| | - Mohd Normani Zakaria
- Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Krian, Malaysia
| | - Dinsuhaimi Sidek
- Department of Otorhinolaryngology, Medical Faculty, Universiti Sains Malaysia, 16150 Kubang Krian, Malaysia
| | | | - Shamsul Azhar Shah
- Department of Public Health, Universiti Kebangsaan Malaysia Medical Center, 56000 Cheras, Malaysia
| | - Noor Alaudin Abdul Wahab
- Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Krian, Malaysia; Audiology Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, 53200 Kuala Lumpur, Malaysia.
| |
Collapse
|
20
|
Gao B, Wang Y, Liu W, Chen Z, Zhou H, Yang J, Cohen Z, Zhu Y, Zang Y. Spontaneous Activity Associated with Delusions of Schizophrenia in the Left Medial Superior Frontal Gyrus: A Resting-State fMRI Study. PLoS One 2015. [PMID: 26204264 PMCID: PMC4512714 DOI: 10.1371/journal.pone.0133766] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Delusions of schizophrenia have been found to be associated with alterations of some brain regions in structure and task-induced activation. However, the relationship between spontaneously occurring symptoms and spontaneous brain activity remains unclear. In the current study, 14 schizophrenic patients with delusions and 14 healthy controls underwent a resting-state functional magnetic resonance imaging (RS-fMRI) scan. Patients with delusions of schizophrenia patients were rated with Positive and Negative Syndrome Scale (PANSS) and Characteristics of Delusional Rating Scale (CDRS). Regional homogeneity (ReHo) was calculated to measure the local synchronization of the spontaneous activity in a voxel-wise way. A two-sample t-test showed that ReHo of the right anterior cingulate gyrus and left medial superior frontal gyrus were higher in patients, and ReHo of the left superior occipital gyrus was lower, compared to healthy controls. Further, among patients, correlation analysis showed a significant difference between delusion scores of CRDS and ReHo of brain regions. ReHo of the left medial superior frontal gyrus was negatively correlated with patients’ CDRS scores but not with delusional PANSS scores. These results suggested that altered local synchronization of spontaneous brain activity may be related to the pathophysiology of delusion in schizophrenia.
Collapse
Affiliation(s)
- Bin Gao
- Department of Psychiatry, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR China
| | - Yiquan Wang
- Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, PR China; Mental Health Center, School of Medicine, Zhe Jiang University, Hangzhou, Zhejiang, PR China
| | - Weibo Liu
- Department of Psychiatry, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR China
| | - Zhiyu Chen
- Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, PR China
| | - Heshan Zhou
- Hangzhou First People's Hospital, Hangzhou, Zhejiang, PR China
| | - Jinyu Yang
- Department of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR China
| | - Zachary Cohen
- Alpert Medical School of Brown University, Richmond St., Providence, RI, United States of America
| | - Yihong Zhu
- Department of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, PR China; Mental Health Education and Counseling Center, Zhejiang University, Hangzhou, Zhejiang, PR China
| | - Yufeng Zang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, Zhejiang, PR China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang, PR China
| |
Collapse
|
21
|
Woodward TS, Jung K, Hwang H, Yin J, Taylor L, Menon M, Peters E, Kuipers E, Waters F, Lecomte T, Sommer IE, Daalman K, van Lutterveld R, Hubl D, Kindler J, Homan P, Badcock JC, Chhabra S, Cella M, Keedy S, Allen P, Mechelli A, Preti A, Siddi S, Erickson D. Symptom dimensions of the psychotic symptom rating scales in psychosis: a multisite study. Schizophr Bull 2014; 40 Suppl 4:S265-74. [PMID: 24936086 PMCID: PMC4141314 DOI: 10.1093/schbul/sbu014] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 01/23/2014] [Accepted: 01/24/2014] [Indexed: 11/26/2022]
Abstract
The Psychotic Symptom Rating Scales (PSYRATS) is an instrument designed to quantify the severity of delusions and hallucinations and is typically used in research studies and clinical settings focusing on people with psychosis and schizophrenia. It is comprised of the auditory hallucinations (AHS) and delusions subscales (DS), but these subscales do not necessarily reflect the psychological constructs causing intercorrelation between clusters of scale items. Identification of these constructs is important in some clinical and research contexts because item clustering may be caused by underlying etiological processes of interest. Previous attempts to identify these constructs have produced conflicting results. In this study, we compiled PSYRATS data from 12 sites in 7 countries, comprising 711 participants for AHS and 520 for DS. We compared previously proposed and novel models of underlying constructs using structural equation modeling. For the AHS, a novel 4-dimensional model provided the best fit, with latent variables labeled Distress (negative content, distress, and control), Frequency (frequency, duration, and disruption), Attribution (location and origin of voices), and Loudness (loudness item only). For the DS, a 2-dimensional solution was confirmed, with latent variables labeled Distress (amount/intensity) and Frequency (preoccupation, conviction, and disruption). The within-AHS and within-DS dimension intercorrelations were higher than those between subscales, with the exception of the AHS and DS Distress dimensions, which produced a correlation that approached the range of the within-scale correlations. Recommendations are provided for integrating these underlying constructs into research and clinical applications of the PSYRATS.
Collapse
Affiliation(s)
- Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; BC Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada;
| | - Kwanghee Jung
- Department of Pediatrics, University of Texas Health Science Center, Houston, TX
| | - Heungsun Hwang
- Department of Psychology, McGill University, Montreal, Québec, Canada
| | - John Yin
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; BC Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada
| | - Laura Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; BC Mental Health and Addictions Research Institute, Vancouver, British Columbia, Canada
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emmanuelle Peters
- Department of Psychology, and the BRC of the South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, King's College London, London, UK
| | - Elizabeth Kuipers
- Department of Psychology, and the BRC of the South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, King's College London, London, UK
| | - Flavie Waters
- North Metro Health Service Mental Health, and School of Psychiatry and Clinical Neuroscience, University of Western Australia, Perth, Australia
| | - Tania Lecomte
- Department of Psychology, University of Montreal, Montreal, Québec, Canada
| | - Iris E Sommer
- Department of Psychiatry, Universitair Medisch Centrum, Utrecht, The Netherlands
| | - Kirstin Daalman
- Department of Psychiatry, Universitair Medisch Centrum, Utrecht, The Netherlands
| | - Remko van Lutterveld
- Department of Psychiatry, Universitair Medisch Centrum, Utrecht, The Netherlands
| | - Daniela Hubl
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Philipp Homan
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Johanna C Badcock
- School of Psychology, University of Western Australia, Crawley, Western Australia, Australia
| | - Saruchi Chhabra
- School of Psychology, University of Western Australia, Crawley, Western Australia, Australia
| | - Matteo Cella
- Department of Psychology, and the BRC of the South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, King's College London, London, UK
| | - Sarah Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Paul Allen
- Department of Psychosis Studies, King's College London, London, UK
| | - Andrea Mechelli
- Department of Psychosis Studies, King's College London, London, UK
| | - Antonio Preti
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Sara Siddi
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - David Erickson
- Fraser North Early Psychosis Program, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| |
Collapse
|
22
|
Source-based morphometry of gray matter volume in patients with schizophrenia who have persistent auditory verbal hallucinations. Prog Neuropsychopharmacol Biol Psychiatry 2014; 50:102-9. [PMID: 24321225 DOI: 10.1016/j.pnpbp.2013.11.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 11/14/2013] [Accepted: 11/27/2013] [Indexed: 12/11/2022]
Abstract
Abnormal structure of frontal and temporal brain regions has been suggested to occur in patients with schizophrenia who have frequent auditory verbal hallucinations (AVH). However, it is unknown whether this is specific to this patient subgroup. This study tested the hypothesis that frontotemporal gray matter volume changes would characterize patients with persistent AVH (pAVH) in contrast to healthy controls and patients without AVH. Using structural magnetic resonance imaging at 3T, we studied 20 patients with schizophrenia and 14 matched healthy controls. Ten patients were classified as having chronic and treatment resistant AVH, whereas the remaining 10 patients either never had AVH in the past or were in full remission with regard to AVH (nAVH). Using a multivariate statistical technique for structural data, i.e. "source-based morphometry" (SBM), we investigated naturally grouping patterns of gray matter volume variation among individuals, the magnitude of their expression between-groups and the relationship between gray matter volume and AVH-specific measures. SBM identified a reduction of medial and inferior frontal, insular and bilateral temporal gray matter volume between pAVH and nAVH. This pattern did not differ between nAVH patients and controls and was associated with "physical" AVH characteristics (such as symptom duration, location, frequency and intensity) in the pAVH patient group. These results suggest that a pattern of lower gray matter volume in medial frontal, insular and bilateral temporal cortical regions differentiates between patients with persistent AVH and non-hallucinating patients. Moreover, the data support a specific role of this neural pattern in AVH symptom expression.
Collapse
|
23
|
Bjartveit K, Helskog EH, Kryvi PD, Brauer H. Kvinne i 30-årene med kronisk utmattelse. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2014; 134:423-5. [DOI: 10.4045/tidsskr.13.0142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
|
24
|
Favrod J, Rexhaj S, Ferrari P, Bardy S, Hayoz C, Morandi S, Bonsack C, Giuliani F. French version validation of the psychotic symptom rating scales (PSYRATS) for outpatients with persistent psychotic symptoms. BMC Psychiatry 2012; 12:161. [PMID: 23020603 PMCID: PMC3514145 DOI: 10.1186/1471-244x-12-161] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 09/25/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Most scales that assess the presence and severity of psychotic symptoms often measure a broad range of experiences and behaviours, something that restricts the detailed measurement of specific symptoms such as delusions or hallucinations. The Psychotic Symptom Rating Scales (PSYRATS) is a clinical assessment tool that focuses on the detailed measurement of these core symptoms. The goal of this study was to examine the psychometric properties of the French version of the PSYRATS. METHODS A sample of 103 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms over the previous three months was assessed using the PSYRATS. Seventy-five sample participants were also assessed with the Positive And Negative Syndrome Scale (PANSS). RESULTS ICCs were superior to .90 for all items of the PSYRATS. Factor analysis replicated the factorial structure of the original version of the delusions scale. Similar to previous replications, the factor structure of the hallucinations scale was partially replicated. Convergent validity indicated that some specific PSYRATS items do not correlate with the PANSS delusions or hallucinations. The distress items of the PSYRATS are negatively correlated with the grandiosity scale of the PANSS. CONCLUSIONS The results of this study are limited by the relatively small sample size as well as the selection of participants with persistent symptoms. The French version of the PSYRATS partially replicates previously published results. Differences in factor structure of the hallucinations scale might be explained by greater variability of its elements. The future development of the scale should take into account the presence of grandiosity in order to better capture details of the psychotic experience.
Collapse
Affiliation(s)
- Jerome Favrod
- La Source, Health Campus of the University of Applied Sciences of Western Switzerland, Lausanne, Switzerland
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Shyhrete Rexhaj
- La Source, Health Campus of the University of Applied Sciences of Western Switzerland, Lausanne, Switzerland
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Pascale Ferrari
- La Source, Health Campus of the University of Applied Sciences of Western Switzerland, Lausanne, Switzerland
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Sabrina Bardy
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | | | - Stéphane Morandi
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Charles Bonsack
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Fabienne Giuliani
- Department of Psychiatry, Community Psychiatry Service, University Hospital Center of Lausanne, Lausanne, Switzerland
| |
Collapse
|
25
|
Rückl S, Büche L, Gentner NC, Heyne J, von Bock A, Barthel A, Vedder H, Bürgy M, Kronmüller KT. Heidelberg Coping Scales for Delusions: psychometric evaluation of an expert rating instrument. Psychopathology 2012; 45:244-51. [PMID: 22653293 DOI: 10.1159/000330583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 07/05/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Coping is of substantial relevance in the treatment and course of psychiatric disorders. Standardized instruments to assess coping with psychotic symptoms, particularly delusions, are rare. The aim of this study was to develop and evaluate the psychometric properties of a new instrument to assess coping strategies in the context of delusional experiences: the Heidelberg Coping Scales for Delusions (HCSD). METHODS Two hundred and twelve inpatients with schizophrenia spectrum disorders and affective disorders currently experiencing delusions were interviewed with the HCSD and other coping assessment instruments. Psychometric properties and factor structure were analyzed. RESULTS The HCSD showed good inter-rater reliability and convergent validity. Factor analysis yielded an interpretable structure with five factors: resource-oriented coping, medical care, distraction, cognitive coping, and depressive coping. Symptomatic behavior, due to its particular characteristics, was considered apart. CONCLUSION The HCSD is a reliable and valid instrument for the assessment of coping strategies in patients with delusions. Further research is needed to evaluate coping changes over time and their influence on treatment and clinical outcomes.
Collapse
Affiliation(s)
- Sarah Rückl
- Department of Psychiatry, University of Heidelberg, Heidelberg, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|