1
|
The effects of guided discontinuation of antipsychotics on neurocognition in first onset psychosis. Eur Psychiatry 2020; 27:275-80. [DOI: 10.1016/j.eurpsy.2011.02.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 01/16/2011] [Accepted: 02/06/2011] [Indexed: 12/13/2022] Open
Abstract
AbstractObjectiveTo assess the effects of second generation antipsychotics on neurocognitive function in patients with stable remission of first episode psychosis.MethodsFifty-three patients with first onset psychosis in the schizophrenia spectrum entered a randomised controlled trial of guided discontinuation (GD) versus maintenance treatment (MT) with second generation antipsychotics. A comprehensive neurocognitive test battery was administered at the time of remission and shortly after dose reduction or discontinuation (GD-group) or at the same time in the MT-group.ResultsWith the exception of negative symptoms, PANSS scores decreased over time and neurocognition improved significantly on most tests in both groups. The GD-group, however, improved significantly more than the MT-group on three neurocognitive measures in the domain of speed of processing.ConclusionThese data suggest that, in first episode patients, dose reduction or discontinuation of second generation antipsychotics after stable remission is achieved, might improve neurocognitive function more than continuing second generation antipsychotics, suggesting a negative role for second generation antipsychotics, specifically in the domain of speed of processing.
Collapse
|
2
|
Obeid S, Hallit S, Sacre H, Kazour GR. Effectiveness of integrated psychological therapy on cognitive function among Lebanese patients with schizophrenia: a pilot study. Int J Psychiatry Clin Pract 2020; 24:43-52. [PMID: 31661346 DOI: 10.1080/13651501.2019.1682615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: The integrated term emphasises the need for cognitive therapy to always be embedded into an extended treatment concept adapted to cognitive resources and deficits and to patient rehabilitation. One of the first approaches is integrated psychological therapy (IPT).Aim: To assess the effect of the IPT Programme compared to the Treatment as Usual (TaU) in terms of cognitive performance and social skills among a group of schizophrenic patients.Methods: This randomised controlled study enrolled 20 patients in each group. Patients attended 60-min sessions, 3 days/week.Results: When considering the TaU group, the bivariate results showed that significantly higher means of attention scores, lower means in social dysfunction and aggression, social adaptation scores were found after IPT compared to before. The effect size for all tests was found to be weak. When considering the IPT group, significantly higher means attention score, lower means cognitive disorders, social dysfunction, aggression and social adaptation scores were found after IPT compared to before. The effect size for all tests was found to be high.Conclusion: The therapeutic combination of the IPT programme with medical treatment has shown additional beneficial effects on the schizophrenic patients' treatment, enabling them, as far as possible, to reintegrate into the community.KEY POINTSIn cases, a significantly higher GZ-F and KL scores and a lower SDAS-9 and SDAS-6 scores were found post-IPT respectively.In controls, a significant increase in the GZ-F and KL subscales and a decrease in all other scales was found post-IPT respectively.This therapeutic combination of the integrative programme with medical treatment has shown additive beneficial effects in patients with schizophreniaThe treatment approach would allow them, as far as possible, to reintegrate within the community.
Collapse
Affiliation(s)
- Sahar Obeid
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Arts and Science, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Hala Sacre
- INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Gisèle Rouphaël Kazour
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Arts and Human Sciences, Lebanese University, Beirut, Lebanon
| |
Collapse
|
3
|
Campos D, Modrego-Alarcón M, López-del-Hoyo Y, González-Panzano M, Van Gordon W, Shonin E, Navarro-Gil M, García-Campayo J. Exploring the Role of Meditation and Dispositional Mindfulness on Social Cognition Domains: A Controlled Study. Front Psychol 2019; 10:809. [PMID: 31031678 PMCID: PMC6470267 DOI: 10.3389/fpsyg.2019.00809] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 03/26/2019] [Indexed: 01/27/2023] Open
Abstract
Research suggests that mindfulness can induce changes in the social domain, such as enhancing emotional connection to others, prosocial behavior, and empathy. However, despite growing interest in mindfulness in social psychology, very little is known about the effects of mindfulness on social cognition. Consequently, the aim of this study was to explore the relationship between mindfulness and social cognition by comparing meditators with non-meditators on several social cognition measures. A total of 60 participants (meditators, n = 30; non-meditators, n = 30) were matched on sex, age, and ethnic group, and then asked to complete the following assessment measures: Mindful Awareness Attention Scale (MAAS), Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF), Interpersonal Reactivity Index (IRI), Revised Eyes Test, Hinting Task, Ambiguous Intentions and Hostility Questionnaire (AIHQ), Hospital Anxiety and Depression Scale (HADS), and Screening for Cognitive Impairment in Psychiatry (SCIP). The results showed that meditators reported higher empathy (except for the personal distress subscale), higher emotional recognition, higher theory of mind (ToM), and lower hostile attributional style/bias. The findings also demonstrated that dispositional mindfulness (both total score assessed with MAAS and mindfulness facets using the FFMQ) was associated with social cognition, although it was not equally correlated with all social cognition outcomes, and correlation patterns differ when analyses were conducted separately for meditators and non-meditators. In addition, results showed potential predictors for each social cognition variable, highlighting non-reactivity to inner experience as a key component of mindfulness in order to explain social cognition performance. In summary, the findings indicated that the meditator sample performed better on certain qualities (i.e., empathy, emotional recognition, ToM, hostile attributional style/bias) in comparison to non-meditators and, furthermore, support the notion that mindfulness is related to social cognition, which may have implications for the design of mindfulness-based approaches for use in clinical and non-clinical settings.
Collapse
Affiliation(s)
- Daniel Campos
- Laboratorio de Psicología y Tecnología, Department of Basic Psychology, Universitat Jaume I, Castelló de La Plana, Spain
- Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain
| | - Marta Modrego-Alarcón
- Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
| | - Yolanda López-del-Hoyo
- Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
| | | | - William Van Gordon
- Human Sciences Research Centre, University of Derby, Derby, United Kingdom
| | - Edo Shonin
- Awake to Wisdom Centre for Meditation and Mindfulness Research, Ragusa, Italy
| | - Mayte Navarro-Gil
- Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Javier García-Campayo
- Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
- University Hospital Miguel Servet, Zaragoza, Spain
| |
Collapse
|
4
|
Shaqiri A, Roinishvili M, Kaliuzhna M, Favrod O, Chkonia E, Herzog MH, Blanke O, Salomon R. Rethinking Body Ownership in Schizophrenia: Experimental and Meta-analytical Approaches Show no Evidence for Deficits. Schizophr Bull 2018; 44:643-652. [PMID: 29036731 PMCID: PMC5890460 DOI: 10.1093/schbul/sbx098] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Schizophrenia is a severe psychiatric disorder, in which patients experience an abnormal sense of self. While deficits in sensorimotor self-representation (agency) are well documented in schizophrenia, less is known about other aspects of bodily self-representation (body ownership). Here, we tested a large cohort (N = 59) of chronic schizophrenia patients and matched controls (N = 30) on a well-established body illusion paradigm, the Full Body Illusion (FBI). In this paradigm, changes in body ownership are induced through prolonged multisensory stimulation, in which participants are stroked on their back while seeing the stroking on the back of a virtual body. When the felt and seen stroking are synchronous, participants typically feel higher identification with the seen body as well as a drift in self-location towards it. However, when the stroking is asynchronous, no such changes occur. Our results show no evidence for abnormal body ownership in schizophrenia patients. A meta-analysis of previous work corroborates this result. Thus, while schizophrenia patients may be impaired in the sense of agency, their multisensory bodily self-representation, as tested here, seems to be unaffected by the illness.
Collapse
Affiliation(s)
- Albulena Shaqiri
- Laboratory of Psychophysics, Brain Mind Institute, EPFL, Lausanne, Switzerland
| | - Maya Roinishvili
- Vision Research Laboratory, Beritashvili Centre of Experimental Biomedicine, Tbilisi, Georgia
- Institute of Cognitive Neurosciences, Agricultural University of Georgia, Tbilisi, Georgia
| | - Mariia Kaliuzhna
- Laboratory of Cognitive Neuroscience, Brain Mind Institute, EPFL, Lausanne, Switzerland
- Chair in Cognitive Neuroprosthetics, Center for Neuroprosthetics, School of Life Science, EPFL, Geneva, Switzerland
- Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Ophélie Favrod
- Laboratory of Psychophysics, Brain Mind Institute, EPFL, Lausanne, Switzerland
| | - Eka Chkonia
- Institute of Cognitive Neurosciences, Agricultural University of Georgia, Tbilisi, Georgia
- Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
| | - Michael H Herzog
- Laboratory of Psychophysics, Brain Mind Institute, EPFL, Lausanne, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Brain Mind Institute, EPFL, Lausanne, Switzerland
- Chair in Cognitive Neuroprosthetics, Center for Neuroprosthetics, School of Life Science, EPFL, Geneva, Switzerland
| | - Roy Salomon
- Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
5
|
Ludwig KA, Pinkham AE, Harvey PD, Kelsven S, Penn DL. Social cognition psychometric evaluation (SCOPE) in people with early psychosis: A preliminary study. Schizophr Res 2017; 190:136-143. [PMID: 28302395 PMCID: PMC5735418 DOI: 10.1016/j.schres.2017.03.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 02/26/2017] [Accepted: 03/01/2017] [Indexed: 10/20/2022]
Abstract
Social cognition is an important outcome in schizophrenia research. Unfortunately, there has been a lack of consensus regarding which measures of social cognition best capture this domain of functioning. The Social Cognition Psychometric Evaluation (SCOPE) study was developed to address the need for a battery of measures that have sound psychometric properties and can be implemented in clinical trials for individuals with chronic schizophrenia. The current study expands upon the SCOPE study by examining the psychometric properties of the eight candidate measures administered to individuals early in the course of psychosis. Thirty-eight stable outpatients with first episode psychosis and thirty-nine healthy controls completed the battery at baseline and one-month follow-up assessments. The SCOPE battery was evaluated on a collection of psychometric properties, including: (1) Reliability - including test-retest and internal consistency, (2) Between group differences, (3) Utility as a repeated measure, (4) Relationship to social and occupational functioning, (5) Incremental validity - variance in functioning beyond neurocognition, and (6) Feasibility - including practicality of administration and tolerability. Social cognition accounted for substantially more variance in functional outcome than neurocognition. Only one measure, the Hinting task, displayed adequate psychometric properties to be recommended for use in clinical research with first episode psychosis. The remaining candidate measures would require modifications before implementation or cannot be recommended for use in clinical research with first episode psychosis.
Collapse
Affiliation(s)
- Kelsey A. Ludwig
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC
| | - 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
| | - Skylar Kelsven
- Department of Psychology, San Diego State University and The University of California at San Diego, San Diego, CA
| | - David L. Penn
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC,School of Psychology, Australian Catholic University, Melbourne, VIC
| |
Collapse
|
6
|
Herold CJ, Schmid LA, Lässer MM, Seidl U, Schröder J. Cognitive Performance in Patients with Chronic Schizophrenia Across the Lifespan. GEROPSYCH-THE JOURNAL OF GERONTOPSYCHOLOGY AND GERIATRIC PSYCHIATRY 2017. [DOI: 10.1024/1662-9647/a000164] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. Chronic schizophrenia involves neuropsychological deficits that primarily strike executive functions and episodic memory. Our study investigated these deficits throughout the lifespan in patients with chronic schizophrenia and in healthy controls. Important neuropsychological functions were tested in 94 patients and 66 healthy controls, who were assigned to three age groups. Compared with the healthy controls, patients performed significantly poorer on all tests applied. Significant age effects occurred on all tests except the digit span forward, with older subjects scoring well below the younger ones. With respect to cognitive flexibility, age effects were more pronounced in the patients. These findings underline the importance of cognitive deficits in chronic schizophrenia and indicate that diminished cognitive flexibility shows age-associated differences.
Collapse
Affiliation(s)
- Christina Josefa Herold
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Lena Anna Schmid
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Marc Montgomery Lässer
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Ulrich Seidl
- Center for Mental Health, Klinikum Stuttgart, Stuttgart, Germany
| | - Johannes Schröder
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
- Institute of Gerontology, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
7
|
Strauss ME, McLouth CJ, Barch DM, Carter CS, Gold JM, Luck SJ, MacDonald AW, Ragland JD, Ranganath C, Keane BP, Silverstein SM. Temporal stability and moderating effects of age and sex on CNTRaCS task performance. Schizophr Bull 2014; 40:835-44. [PMID: 23817024 PMCID: PMC4059430 DOI: 10.1093/schbul/sbt089] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Research in schizophrenia has increasingly focused on incorporating measures from cognitive neuroscience, but little is known about their psychometric characteristics. Here, we extend prior research by reporting on temporal stability, as well as age and sex effects, for cognitive neuroscience paradigms optimized as part of the Cognitive Neuroscience Test Reliability and Clinical applications for Schizophrenia consortium. Ninety-nine outpatients with schizophrenia and 131 healthy controls performed 5 tasks assessing 4 constructs at 3 sessions. The constructs were (1) Goal maintenance (Dot Probe Expectancy [DPX] and AX continuous performance tasks [AX-CPT]); (2) Episodic memory (Relational and Item-Specific Encoding and Retrieval task [RiSE]); (3) Visual integration (Jittered Orientation Visual Integration task [JOVI]); and (4) Perceptual gain control (Contrast-Contrast Effect Task [CCE]). Patients performed worse than controls on all but the CCE, and the magnitude of these group differences was stable across sessions, with no sex differences observed. Improvements over sessions were seen for the AX-CPT, the DPX, and the JOVI though practice effects for the AX-CPT and the DPX were primarily present in older participants. For the AX-CPT and the JOVI, practice effects were larger for T1 to T2 than for T2 to T3. Age was associated with poor associative recognition on the RiSE and accuracy on the JOVI. Test-rest reliability ranged from poor for the JOVI threshold score to adequate to good for the DPX, AX-CPT, and JOVI accuracy measures, with RiSE and CCE measures in the moderate range. These results suggest that group differences in DPX, AX-CPT, RiSE, and JOVI are robust and consistent across repeated testing.
Collapse
Affiliation(s)
- Milton E Strauss
- Department of Psychology, University of New Mexico, Albuquerque, NM;
| | | | - Deanna M Barch
- Department of Psychology, Washington University, St Louis, MO
| | | | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, Baltimore, MD
| | - Steven J Luck
- Department of Psychology, University of California, Davis, CA
| | | | | | | | - Brian P Keane
- Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, NJ; Center for Cognitive Science, Rutgers University, New Brunswick, NJ
| | - Steven M Silverstein
- Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, NJ
| |
Collapse
|
8
|
Calamia M, Markon K, Tranel D. The robust reliability of neuropsychological measures: meta-analyses of test-retest correlations. Clin Neuropsychol 2013; 27:1077-105. [PMID: 24016131 DOI: 10.1080/13854046.2013.809795] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Test-retest reliability is an important psychometric property relevant to assessment instruments typically used in neuropsychological assessment. This review presents a quantitative summary of test-retest reliability coefficients for a variety of widely used neuropsychological measures. In general, the meta-analytic test-retest reliabilities of the test scores ranged from adequate to high (i.e., r=.7 and higher). Furthermore, the reliability values were largely robust across factors such as age, clinical diagnosis, and the use of alternate forms. The values for some of the memory and executive functioning scores were lower (i.e., less than r=.7). Some of the possible reasons for these lower values include ceiling effects, practice effects, and across time variability in cognitive abilities measured by those tests. In general, neuropsychologists who use these measures in their assessments can be encouraged by the magnitude of the majority of the meta-analytic test-retest correlations obtained.
Collapse
Affiliation(s)
- Matthew Calamia
- a Department of Psychology , University of Iowa , Iowa City , IA , USA
| | | | | |
Collapse
|
9
|
Sacks S, Fisher M, Garrett C, Alexander P, Holland C, Rose D, Hooker C, Vinogradov S. Combining computerized social cognitive training with neuroplasticity-based auditory training in schizophrenia. CLINICAL SCHIZOPHRENIA & RELATED PSYCHOSES 2013; 7:78-86A. [PMID: 23367504 PMCID: PMC6939987 DOI: 10.3371/csrp.safi.012513] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Social cognitive deficits are an important treatment target in schizophrenia, but it is unclear to what degree they require specialized interventions and which specific components of behavioral interventions are effective. In this pilot study, we explored the effects of a novel computerized neuroplasticity-based auditory training delivered in conjunction with computerized social cognition training (SCT) in patients with schizophrenia. METHODS Nineteen clinically stable schizophrenia subjects performed 50 hours of computerized exercises that place implicit, increasing demands on auditory perception, plus 12 hours of computerized training in emotion identification, social perception, and theory of mind tasks. All subjects were assessed with MATRICS-recommended measures of neurocognition and social cognition, plus a measure of self-referential source memory before and after the computerized training. RESULTS Subjects showed significant improvements on multiple measures of neurocognition. Additionally, subjects showed significant gains on measures of social cognition, including the MSCEIT Perceiving Emotions, MSCEIT Managing Emotions, and self-referential source memory, plus a significant decrease in positive symptoms. CONCLUSIONS Computerized training of auditory processing/verbal learning in schizophrenia results in significant basic neurocognitive gains. Further, addition of computerized social cognition training results in significant gains in several social cognitive outcome measures. Computerized cognitive training that directly targets social cognitive processes can drive improvements in these crucial functions.
Collapse
Affiliation(s)
- Stephanie Sacks
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA; and Department of Psychiatry, University of California, San Francisco
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Melissa Fisher
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA; and Department of Psychiatry, University of California, San Francisco
| | - Coleman Garrett
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA; and Department of Psychiatry, University of California, San Francisco
| | - Phillip Alexander
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA; and Department of Psychiatry, University of California, San Francisco
| | - Christine Holland
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA; and Department of Psychiatry, University of California, San Francisco
| | - Demien Rose
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA; and Department of Psychiatry, University of California, San Francisco
| | | | - Sophia Vinogradov
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA; and Department of Psychiatry, University of California, San Francisco
| |
Collapse
|
10
|
|
11
|
Urben S, Baumann P, Barcellona S, Hafil M, Preuss U, Peter-Favre C, Clarke S, Halfon O, Holzer L. Cognitive efficacy of quetiapine in early-onset first-episode psychosis: a 12-week open label trial. Psychiatr Q 2012; 83:311-24. [PMID: 22101738 DOI: 10.1007/s11126-011-9201-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Twenty-three adolescents with psychotic disorders, aged from 13 to 18 years, participated in a 12-week open label trial (17 adolescents completed the study) in order to examine the impact of quetiapine on clinical status and cognitive functions (encompassing processing speed, attention, short-term memory, long-term memory and executive function). An improvement in Clinical Global Impression and Positive and Negative Symptom Scale (P's ≤ 0.001) was observed. In addition, after controlling for amelioration of symptoms, a significant improvement was observed on one executive function (P = 0.044; Trail Making Part B). The remaining cognitive abilities showed stability. In addition, we observed an interaction between quetiapine doses (>300 mg/day or <300 mg/day) and time, where lower doses showed more improvement in verbal short-term memory (P = 0.048), inhibition abilities (P = 0.038) and positive symptoms (P = 0.020). The neuropsychological functioning of adolescents with psychotic disorders remained mainly stable after 12 weeks of treatment with quetiapine. However, lower doses seemed to have a better impact on two components of cognition (inhibition abilities and verbal short-term memory) and on positive symptoms.
Collapse
Affiliation(s)
- Sébastien Urben
- Unité de Recherche, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (SUPEA), Centre Hospitalier Universitaire Vaudois (CHUV), Route du Bugnon 25A, 1011, Lausanne, Switzerland.
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Adaptación al español de la prueba de teoría de la mente Hinting Task. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2012; 5:79-88. [DOI: 10.1016/j.rpsm.2011.11.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 11/25/2011] [Accepted: 11/30/2011] [Indexed: 11/24/2022]
|
13
|
Gil D, Fernández-Modamio M, Bengochea R, Arrieta M. Adaptation of the Hinting Task theory of the mind test to Spanish. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.rpsmen.2011.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
14
|
Barnett JH, Robbins TW, Leeson VC, Sahakian BJ, Joyce EM, Blackwell AD. Assessing cognitive function in clinical trials of schizophrenia. Neurosci Biobehav Rev 2010; 34:1161-77. [DOI: 10.1016/j.neubiorev.2010.01.012] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Revised: 01/12/2010] [Accepted: 01/20/2010] [Indexed: 11/28/2022]
|
15
|
Bell MD, Johannesen JK, Greig TC, Wexler BE. Memory profiles in schizophrenia: categorization validity and stability. Schizophr Res 2010; 118:26-33. [PMID: 20085855 PMCID: PMC3699867 DOI: 10.1016/j.schres.2009.12.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 12/24/2009] [Accepted: 12/29/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND Memory profiles corresponding to nearly normal (NN), Subcortical impairment (Sub) and Cortical impairment (Cort) have been identified in schizophrenia by several investigators using cluster analytic techniques. Specific aims of the current study were to (1) perform a K means cluster analysis using Hopkins Verbal Learning Test-R scores (2) create classification rules based upon cluster distributions and expected memory profiles and to determine their concordance with cluster analysis; (3) explore differences among classified groups on demographic, neurocognitive and social cognitive domains; and (4) determine the stability of the classifications 12 months later. METHODS Clinical and neuropsychological assessments were obtained at intake and 12 months from 151 outpatients with schizophrenia or schizoaffective disorder from an urban community mental health center. RESULTS Clusters corresponded to those of the three expected subgroups. Using simple decision rules, rationally-derived groups were created and had 90% classification agreement with cluster groups. Groups did not differ on illness characteristics. Groups differed significantly in neurocognitive and social cognitive domains with NN>Cort and NN>Sub in all domains except visual/motor speed. Sub>Cort in verbal working memory. NN>Cort in social cognition. Rationally derived groupings showed fair stability at 12 month follow-up with 65% classification agreement. Specificity was good for NN (82.4%). DISCUSSION Results support validity of memory profiles and offer some support for their stability at 12 months. The simple rules for classification can be used by other investigators for neuroimaging and other studies. Findings support the hypothesis that verbal memory may be an important source of heterogeneity in schizophrenia.
Collapse
Affiliation(s)
- Morris D Bell
- VA Connecticut Healthcare System, Psychology Service, West Haven CT 06516, United States.
| | | | | | | |
Collapse
|
16
|
Fiszdon JM, Bell MD. Effects of presentation modality and valence on affect recognition performance in schizophrenia and healthy controls. Psychiatry Res 2009; 170:114-8. [PMID: 19900721 DOI: 10.1016/j.psychres.2008.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 11/13/2008] [Accepted: 11/19/2008] [Indexed: 10/20/2022]
Abstract
The majority of affect recognition research has used visual stimuli, with only a minority of studies examining auditory affect recognition, and fewer still comparing affect recognition across presentation modalities. In the current study, we evaluated affect recognition between 45 outpatients with schizophrenia or schizoaffective disorder and 56 healthy community controls on an auditory-only affect recognition task, as compared to a multichannel (videotape) version of the same task. We further examined between-group performance differences on auditory versus multichannel presentation modalities for a subset of positive and negative valence items. Results indicated that: 1) in general, healthy controls performed better than schizophrenia patients on affect recognition; 2) schizophrenia patients benefited less from a multichannel task presentation than did healthy controls, and 3) schizophrenia patients did not significantly differ from healthy controls on positive-valenced items presented in the auditory modality. These findings suggest the importance of carefully considering presentation modality and affective valence when assessing affect recognition in schizophrenia.
Collapse
|
17
|
Pietrzak RH, Snyder PJ, Jackson CE, Olver J, Norman T, Piskulic D, Maruff P. Stability of cognitive impairment in chronic schizophrenia over brief and intermediate re-test intervals. Hum Psychopharmacol 2009; 24:113-21. [PMID: 19090506 DOI: 10.1002/hup.998] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study examined between- and within-subject stability of cognitive performance in individuals with chronic schizophrenia. METHODS Thirty individuals with schizophrenia and 20 healthy controls matched by age, sex, education, and estimated IQ underwent repeated cognitive assessments at baseline and 30 days using computerized tests of psychomotor function, visual attention/information processing, non-verbal learning, and executive function. RESULTS Compared to healthy controls, individuals with schizophrenia scored lower on all cognitive measures and demonstrated greater variability in cognitive performance. Within-subject variability in cognitive performance in both the schizophrenia and healthy control groups remained stable at brief (i.e., hours) and intermediate (i.e., one month) assessments. CONCLUSIONS These results demonstrate the stability of between- and within-subject variability in cognitive performance in schizophrenia, and suggest that variability in cognitive performance may reflect an inherent characteristic of the disorder, rather than differences in test-retest reliability/error of cognitive measures.
Collapse
Affiliation(s)
- Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | | | | | | | | | | |
Collapse
|
18
|
Turner-Brown LM, Perry TD, Dichter GS, Bodfish JW, Penn DL. Brief report: feasibility of social cognition and interaction training for adults with high functioning autism. J Autism Dev Disord 2008; 38:1777-84. [PMID: 18246419 DOI: 10.1007/s10803-008-0545-y] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Accepted: 01/11/2008] [Indexed: 11/29/2022]
Abstract
The goal of this study was to evaluate the feasibility and utility of a group-based cognitive behavioral intervention to improve social-cognitive functioning in adults with high-functioning autism (HFA). We modified the treatment manual of a previously validated intervention, Social Cognition and Interaction Training (SCIT), for optimal use with HFA adults (SCIT-A). We then conducted a pilot study to compare SCIT-A (n = 6) to treatment as usual (TAU) (n = 5) for adults with HFA. Feasibility was supported; attendance was high (92%) and satisfaction reports were primarily positive. Participants in SCIT-A showed significant improvement in theory-of-mind skills and trend level improvements in social communication skills; TAU participants did not show these improvements. Findings indicate SCIT-A shows promise as an intervention for adults with HFA.
Collapse
Affiliation(s)
- Lauren M Turner-Brown
- Neurodevelopmental Disorders Research Center, University of North Carolina at Chapel Hill School of Medicine, CB #3367, UNC-Chapel Hill, Chapel Hill, NC 27599-3367, USA.
| | | | | | | | | |
Collapse
|
19
|
Greig TC, Zito W, Wexler BE, Fiszdon J, Bell MD. Improved cognitive function in schizophrenia after one year of cognitive training and vocational services. Schizophr Res 2007; 96:156-61. [PMID: 17669629 PMCID: PMC2080620 DOI: 10.1016/j.schres.2007.07.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 06/29/2007] [Accepted: 07/03/2007] [Indexed: 11/26/2022]
Abstract
A year-long program of Neurocognitive Enhancement Therapy (NET) was used to remediate cognitive deficits in people with schizophrenia who were participating in a vocational program. Seventy-two stable outpatients with schizophrenia or schizoaffective disorder, recruited from an urban community mental health center were randomly assigned to a twelve-month vocational program (VOC) or NET+VOC. The vocational program had characteristics of individual placement and support (IPS) programs but also included transitional funding. NET included computer-based cognitive training exercises, a social information processing group and a work feedback group. Sixty-two participants completed a neuropsychological test battery before and after treatment. After one year of treatment, participants receiving NET+VOC had significantly greater improvements on measures of executive function and working memory than did participants in the VOC only condition. Augmenting vocational services with a multifaceted cognitive remediation program may improve cognition in participants with schizophrenia or schizoaffective disorder.
Collapse
Affiliation(s)
- Tamasine C Greig
- Yale University School of Medicine, Department of Psychiatry, Connecticut, USA.
| | | | | | | | | |
Collapse
|
20
|
Wykes T, Reeder C, Landau S, Everitt B, Knapp M, Patel A, Romeo R. Cognitive remediation therapy in schizophrenia: randomised controlled trial. Br J Psychiatry 2007; 190:421-7. [PMID: 17470957 DOI: 10.1192/bjp.bp.106.026575] [Citation(s) in RCA: 173] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cognitive difficulties are prevalent in people with a diagnosis of schizophrenia and are associated with poor long-term functioning. AIMS To evaluate the effectiveness of cognitive remediation therapy on cognitive difficulties experienced by people with schizophrenia. METHOD Participants with a diagnosis of schizophrenia, a social behaviour problem and a cognitive difficulty (n=85) were randomised to 40 sessions of cognitive remediation or treatment as usual in a single-blind randomised controlled trial. Working memory, cognitive flexibility and planning, were measured at weeks 0,14 and 40. RESULTS There were durable improvements in working memory (advantage 1.33 points, 95% CI 0.43-2.16, standardised effect size 0.34) as well as an indication of improvement in cognitive flexibility. Memory improvement predicted improvement in social functioning. Costs were lower in the cognitive remediation group following therapy but rose at follow-up. However, cost-effectiveness analyses showed that improvements in memory were achieved at little additional cost. CONCLUSIONS Cognitive remediation therapy is associated with durable improvements in memory, which in turn are associated with social functioning improvements in people with severe mental illness.
Collapse
Affiliation(s)
- Til Wykes
- Department of Psychology, Kings College London, Institute of Psychiatry, London, UK.
| | | | | | | | | | | | | |
Collapse
|
21
|
Roder V, Müller DR, Zorn P. Therapieverfahren zu sozialen Fertigkeiten bei schizophren Erkrankten in der Arbeitsrehabilitation. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2006. [DOI: 10.1026/1616-3443.35.4.256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Die Arbeitsrehabilitation zählt heute zu den zentralen Ansätzen in der Behandlung und Rehabilitation schizophren Erkrankter. Fragestellung: Evaluation eines neu entwickelten manualisierten kognitiven Therapieverfahrens zu sozialen Fertigkeiten für den Arbeitsbereich (Experimentalgruppe, EG). Methode: Ziel der Studie war die EG mit einem herkömmlichen, unspezifischen Sozialen Fertigkeitstraining (Kontrollgruppe, KG) in einem bedingt randomisierten Studiendesign zu vergleichen. Insgesamt nahmen 41 ambulante oder teilstationäre schizophren Erkrankte an der Studie teil. Ergebnisse: Die EG-Patienten erzielten signifikant größere Effekte in Variablen zu Psychopathologie und Therapiemotivation verglichen mit den KG-Patienten. EG und KG unterschieden sich in der kognitiven und sozialen Funktionsfähigkeit nicht signifikant. Eine höhere Therapiemotivation erwies sich als Prädiktor für eine Reduktion negativer Symptome und ein verbessertes soziales Funktionsniveau in der Katamneseerhebung. Zusätzlich nahmen EG-Patienten vermehrt eine kompetitive Arbeit auf als KG-Patienten. Schlussfolgerungen: Der neu entwickelte Therapieansatz (EG) könnte eine effektive zusätzliche Behandlungsmöglichkeit innerhalb einer multimodalen Arbeitsrehabilitation darstellen.
Collapse
Affiliation(s)
| | | | - Peter Zorn
- Universitäre Psychiatrische Dienste Bern, Externe Psychiatrische Dienste Liestal
| |
Collapse
|