1
|
Clougher D, Forte MF, Mezquida G, Sánchez-Torres AM, Serra-Navarro M, Penadés R, Lobo A, Pinto AG, Panadero R, Roldán A, Vieta E, de la Serna E, Trabsa A, Martínez-Aran A, Torrent C, Tortorella A, Menculini G, Ramos-Quiroga JA, Cuesta MJ, Bernardo M, Amoretti S. Emotional intelligence and neurocognition profiles in first-episode psychosis: A two-year follow-up study. Eur Neuropsychopharmacol 2024; 85:66-77. [PMID: 39013243 DOI: 10.1016/j.euroneuro.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/10/2024] [Accepted: 05/12/2024] [Indexed: 07/18/2024]
Abstract
Emotional intelligence (EI) and neurocognition (NC) impairments are common in first-episode psychosis (FEP), yet their evolution over time remains unclear. This study identified patient profiles in EI and NC performance in FEP. 98 adult FEP patients and 128 healthy controls (HCs) were tested on clinical, functional, EI, and NC variables at baseline and two-year follow-up (FUP). A repeated-measures ANOVA compared the effects of group (patients and HCs) and time on EI. Significant EI improvements were observed in both groups. Four groups were created based on NC and EI performance at baseline and FUP in patients: impairment in NC and EI, impairment in NC only, impairment in EI only, and no impairment. At FUP, patients impaired in NC and EI showed less cognitive reserve (CR), greater negative and positive symptoms, and poorer functional outcomes. At FUP, three group trajectories were identified: (I) maintain dual impairment (II) maintain no impairment or improve, (III) maintain sole impairment or worsen. The maintain dual impairment group had the lowest levels of CR. EI and NC impairments progress differently in FEP. Greater CR may protect against comorbid EI/NC impairment. Identifying these patient characteristics could contribute to the development of personalised interventions.
Collapse
Affiliation(s)
- Derek Clougher
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain; BIOARABA, Department Psychiatry. Hospital Universitario de Alava. CIBERSAM. University of the Basque Country, Vitoria, Spain
| | - Maria Florencia Forte
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain; Serra-Hunter Fellow, Department of Basic Clinal Practice, Pharmacology Unit, University of Barcelona
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain Department of Health Sciences, Universidad Pública de Navarra, Pamplona, Spain; Departamento de Ciencias de la Salud, Universidad Pública de Navarra (UPNA), Campus de Arrosadia, 31006, Pamplona, España
| | - Maria Serra-Navarro
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | - Rafael Penadés
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Zaragoza University. Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERSAM, ISCIII, Zaragoza, Spain
| | - Ana González Pinto
- BIOARABA, Department Psychiatry. Hospital Universitario de Alava. CIBERSAM. University of the Basque Country, Vitoria, Spain
| | - Rocío Panadero
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Alexandra Roldán
- Psychiatry Department, Hospital de la Santa Creu i Sant Pau, IIB SANT PAU, CIBERSAM, Barcelona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain.
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute of Neurosciences, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Amira Trabsa
- Hospital del Mar Medical Research Institute; Universitat Pompeu Fabra, MELIS Department, CIBERSAM, ISCIII, Barcelona, Spain
| | - Anabel Martínez-Aran
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain.
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Josep Antoni Ramos-Quiroga
- Group of Psychiatry, Mental Health and Addictions, Valld'Hebron Research Institute (VHIR); Psychiatric Genetics Unit, Valld'Hebron Research Institute (VHIR); CIBERSAM, ISCIII, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain Department of Health Sciences, Universidad Pública de Navarra, Pamplona, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Valld'Hebron Research Institute (VHIR); Psychiatric Genetics Unit, Valld'Hebron Research Institute (VHIR); CIBERSAM, ISCIII, Barcelona, Spain
| |
Collapse
|
2
|
Uğurpala C, Tükel R, Ziylan EÇ, Ertekin E, Berberoğlu E. Social Cognition and Functioning in Patients With Social Anxiety Disorder and/or Attention-Deficit/Hyperactivity Disorder. J Nerv Ment Dis 2023; 211:828-834. [PMID: 37432028 DOI: 10.1097/nmd.0000000000001696] [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: 07/12/2023]
Abstract
ABSTRACT In recent years, social cognition and one of its dimensions, the theory of mind, have been more commonly investigated in patients with social anxiety disorder (SAD) and attention-deficit/hyperactivity disorder (ADHD). In this study, SAD, ADHD, comorbid SAD-ADHD, and healthy control (HC) groups, each consisting of 30 participants, were included and compared in terms of social cognition and functionality. Mean global functioning assessment scores were found to be significantly higher in the HC group compared with the other three groups and in the ADHD group compared with the SAD and SAD-ADHD groups. Mean Dokuz Eylül Theory of Mind Index total scores were found to be significantly higher in the HC group compared with the other three groups and in the SAD and SAD-ADHD groups compared with the ADHD group. These findings suggest that SAD patients with or without ADHD show better social cognition but worse functioning compared with pure ADHD patients.
Collapse
Affiliation(s)
- Can Uğurpala
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ege Çağın Ziylan
- Physiology and Pharmacology Laboratory, Beykent University Faculty of Medicine, Beykent University, Büyükçekmece, Istanbul, Turkey
| | - Erhan Ertekin
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ertuğ Berberoğlu
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| |
Collapse
|
3
|
Kakar G, Mehendale AM, Sadh K, Bakshi SS, Bodke H, Krishnani H. A Phenomenal Depiction of Paranoid Schizophrenia With Auditory Hallucinations: A Case Report. Cureus 2023; 15:e46092. [PMID: 37900418 PMCID: PMC10611902 DOI: 10.7759/cureus.46092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
This case report provides a vivid illustration of a schizophrenic case in a 59-year-old man with auditory hallucinations, illuminating the nature of his symptoms. Auditory hallucinations were prominent, and the patient received voices urging him to perform actions that clearly corresponded to his paranoid thoughts. Through comprehensive research and long-term follow-up, this report reveals the complexity of traumatic schizophrenia, highlighting the importance of early recognition and intervention. One must emphasize a multidisciplinary approach, including psychiatric assessment, pharmacotherapy, and psychotherapy. This case report aims to highlight the critical role of comprehensive individual care in improving the patient's condition and emphasizes the importance of compassionate healthcare practices.
Collapse
Affiliation(s)
- Gauri Kakar
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ashok M Mehendale
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kamaldeep Sadh
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sanket S Bakshi
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harsh Bodke
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harshil Krishnani
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
4
|
Lepage M, Bowie CR, Montreuil T, Baer L, Percie du Sert O, Lecomte T, Joober R, Abdel-Baki A, Jarvis GE, Margolese HC, De Benedictis L, Schmitz N, Malla AK. Manualized group cognitive behavioral therapy for social anxiety in first-episode psychosis: a randomized controlled trial. Psychol Med 2023; 53:3335-3344. [PMID: 35485835 PMCID: PMC10277720 DOI: 10.1017/s0033291721005328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/28/2021] [Accepted: 12/08/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Social anxiety (SA), a prevalent comorbid condition in psychotic disorders with a negative impact on functioning, requires adequate intervention relatively early. Using a randomized controlled trial, we tested the efficacy of a group cognitive-behavioral therapy intervention for SA (CBT-SA) that we developed for youth who experienced the first episode of psychosis (FEP). For our primary outcome, we hypothesized that compared to the active control of group cognitive remediation (CR), the CBT-SA group would show a reduction in SA that would be maintained at 3- and 6-month follow-ups. For secondary outcomes, it was hypothesized that the CBT-SA group would show a reduction of positive and negative symptoms and improvements in recovery and functioning. METHOD Ninety-six patients with an FEP and SA, recruited from five different FEP programs in the Montreal area, were randomized to 13 weekly group sessions of either CBT-SA or CR intervention. RESULTS Linear mixed models revealed that multiple measures of SA significantly reduced over time, but with no significant group differences. Positive and negative symptoms, as well as functioning improved over time, with negative symptoms and functioning exhibiting a greater reduction in the CBT-SA group. CONCLUSIONS While SA decreased over time with both interventions, a positive effect of the CBT-SA intervention on measures of negative symptoms, functioning, and self-reported recovery at follow-up suggests that our intervention had a positive effect that extended beyond symptoms specific to SA.ClinicalTrials.gov identifier: NCT02294409.
Collapse
Affiliation(s)
- Martin Lepage
- Prevention and Early Intervention Program for Psychoses, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Christopher R. Bowie
- Department of Psychology, Department of Psychiatry, Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Tina Montreuil
- Departments of Educational & Counselling Psychology and Psychiatry, McGill University, Montreal, Quebec, Canada
- Child Health and Human Development, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Larry Baer
- Prevention and Early Intervention Program for Psychoses, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Olivier Percie du Sert
- Prevention and Early Intervention Program for Psychoses, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Tania Lecomte
- Department of Psychology, University of Montréal, Montréal, Quebec, Canada
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychoses, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Amal Abdel-Baki
- Clinique JAP-Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal CRCHUM, Montréal, Québec, Canada
- Département de psychiatrie et d'addictologie, Université de Montréal, Montréal, Québec, Canada
| | - G. Eric Jarvis
- First Episode Psychosis Program, Jewish General Hospital, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Howard C. Margolese
- Prevention and Early Intervention Program for Psychoses, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Luigi De Benedictis
- Connec-T Clinic (First Psychotic Episode and Early Intervention Program), Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada
| | - Norbert Schmitz
- Department of Population-Based Medicine, Institute of Health Sciences, University Hospital Tuebingen, Tuebingen, Germany
| | - Ashok K. Malla
- Prevention and Early Intervention Program for Psychoses, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
5
|
Achim AM, Thibaudeau É, Huot A, Cellard C, Roy MA. What areas of everyday functioning are affected by theory of mind deficits in recent-onset schizophrenia spectrum disorders? Early Interv Psychiatry 2023; 17:57-64. [PMID: 35411646 DOI: 10.1111/eip.13291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/01/2022] [Accepted: 03/13/2022] [Indexed: 01/21/2023]
Abstract
AIM Functional recovery is now a recognized treatment goal for schizophrenia. It is therefore important to better understand the cognitive and psychological factors that influence functioning. Theory of mind (ToM) deficits are common in schizophrenia and have been linked to greater impairments in functioning. The current study aimed to identify which specific areas of functioning are linked to ToM in a group of 54 patients with a recent-onset of a schizophrenia spectrum disorder. METHODS ToM was assessed with the Combined Stories Test (COST). Several areas of functioning were rated based on an extensive semi-structured interviews. RESULTS Among the different areas of functioning that were examined, ToM showed a significant, positive relationship with ratings for productive activities (e.g. work or school) as well as with collaboration to psychiatric care. CONCLUSION These results suggest that ToM can impair functioning especially in situations in which patients need to collaborate with others, including the interactions with the clinical team.
Collapse
Affiliation(s)
- Amélie M Achim
- Département de psychiatrie et neurosciences, Université Laval, Québec, Québec, Canada.,CERVO Brain Research Centre, Québec, Québec, Canada
| | - Élisabeth Thibaudeau
- Département de psychiatrie, Université McGill, Montréal, Québec, Canada.,Institut universitaire en santé mentale Douglas, Montréal, Québec, Canada
| | - Andréanne Huot
- Département de psychiatrie et neurosciences, Université Laval, Québec, Québec, Canada.,CERVO Brain Research Centre, Québec, Québec, Canada
| | - Caroline Cellard
- CERVO Brain Research Centre, Québec, Québec, Canada.,École de Psychologie, Université Laval, Québec, Québec, Canada
| | - Marc-André Roy
- Département de psychiatrie et neurosciences, Université Laval, Québec, Québec, Canada.,CERVO Brain Research Centre, Québec, Québec, Canada.,CIUSSS Capitale-Nationale, Institut Universitaire en Santé Mentale de Québec, Québec, Québec, Canada
| |
Collapse
|
6
|
Validity and Reliability of the Staden Schizophrenia Anxiety Rating Scale. Diagnostics (Basel) 2022; 12:diagnostics12040831. [PMID: 35453879 PMCID: PMC9028449 DOI: 10.3390/diagnostics12040831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
In schizophrenia, none of the standard anxiety measures exhibit strong psychometric properties, and all performed poorly against quality assessment criteria. Developed for the schizophrenia population, this study examined the validity and reliability of the Staden Schizophrenia Anxiety Rating Scale (S-SARS) that measures both specified and undifferentiated anxiety. Among 353 schizophrenia patients, strong correlations with anxiety parameters supported the S-SARS's convergent validity. Criterion-related validity testing yielded accuracy, sensitivity, and specificity rates of around 95%. Its discriminant validity was observed for measures of depression, psychosis, akathisia, fatigue, vigour, procrastination, behavioural inhibition and activation, and personal growth and initiative. Structural validity was found in a single-factor unidimensional model with a 0.953 factor score. Excellent results were found for internal consistency (Cronbach's alpha = 0.931; Spearman-Brown coefficient = 0.937; Guttman split-half coefficient = 0.928) and inter-rater reliability (Krippendorff's alpha = 0.852). It incurred no more than a small error of measurement whereby the observed scores were within 1.54 to 3.58 of a true score on a zero to 50 scale. These strong psychometric properties suggest that the S-SARS is a valid and reliable instrument for measuring specified and undifferentiated anxiety in schizophrenia, providing the means for the accurate measurement of anxiolytic treatment effects.
Collapse
|
7
|
Bouchard M, Lecomte T, Cloutier B, Herrera-Roberge J, Potvin S. Dropout Rates in Psychosocial Interventions for People With Both Severe Mental Illness and Substance Misuse: A Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:842329. [PMID: 35633799 PMCID: PMC9133375 DOI: 10.3389/fpsyt.2022.842329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/07/2022] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Over the years, many psychosocial interventions for individual having both a psychotic spectrum disorder and a substance use disorder diagnoses have been developed and studied. However, there is a high dropout rate among this clinical population. OBJECTIVES This meta-analysis aims to replicate a previous meta-analysis on the effects of psychosocial treatment for dual disorders, while including and determining the dropout rates in those type of interventions. METHOD Based on a Cochrane systematic review conducted in 2019, we conducted a meta-analysis including 40 randomized clinical trials on psychosocial treatment among persons suffering from schizophrenia spectrum disorder and substance use disorder. RESULTS A dropout rate of 27,2% was obtained. Stimulants use significantly affected dropout rates. Age, gender, diagnosis, alcohol and cannabis abuse, and duration of treatment did not affect dropout rates. CONCLUSION The 27,2% rate of dropout from psychosocial treatment highlights the need to engage participants having a dual diagnosis from the start by focusing on therapeutic alliance and motivation for treatment.
Collapse
Affiliation(s)
- Marianne Bouchard
- Department of Psychology, University of Montreal, Montréal, QC, Canada
| | - Tania Lecomte
- Department of Psychology, University of Montreal, Montréal, QC, Canada.,Centre de recherche de l'Institut Universitaire en Santé mentale de Montréal, Montreal, QC, Canada
| | - Briana Cloutier
- Department of Psychology, University of Montreal, Montréal, QC, Canada
| | | | - Stéphane Potvin
- Centre de recherche de l'Institut Universitaire en Santé mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| |
Collapse
|
8
|
Aunjitsakul W, McGuire N, McLeod HJ, Gumley A. Candidate Factors Maintaining Social Anxiety in the Context of Psychotic Experiences: A Systematic Review. Schizophr Bull 2021; 47:1218-1242. [PMID: 33778868 PMCID: PMC8379542 DOI: 10.1093/schbul/sbab026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Social anxiety is common in psychosis and associated with impaired functioning, poorer quality of life, and higher symptom severity. This study systematically reviewed factors maintaining social anxiety in people with attenuated, transient, or persistent psychotic experiences. Other correlates of social anxiety were also examined. MEDLINE, Embase, CENTRAL, and PsycINFO were searched for relevant literature up to October 19, 2020. Forty-eight articles were eligible for narrative synthesis: 38 cross-sectional studies, 8 prospective studies, 1 uncontrolled trial, and 1 qualitative study. From 12060 participants, the majority was general population (n = 8771), followed by psychosis samples (n = 2532) and those at high risk of psychosis (n = 757). The methodological quality and risk of bias were assessed using the Mixed Methods Appraisal Tool. Ninety percent of studies were rated as high to very-high quality. Poorer quality studies typically failed to adequately control for confounds and provided insufficient information on the measurement validity and reliability. Prominent psychological factors maintaining social anxiety included self-perceptions of stigma and shame. Common correlates of social anxiety included poorer functioning and lower quality of life. In conclusion, stigma and shame could be targeted as a causal mechanism in future interventional studies. The integration of findings from this review lead us to propose a new theoretical model to guide future intervention research.
Collapse
Affiliation(s)
- Warut Aunjitsakul
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand,Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK,To whom correspondence should be addressed; Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Fleming Pavilion, West of Scotland Science Park (Todd Campus), Glasgow, G20 0XA, UK; tel: 0141-330-4852, e-mail:
| | - Nicola McGuire
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Hamish J McLeod
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Andrew Gumley
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
9
|
Thibaudeau É, Cellard C, Turcotte M, Achim AM. Functional Impairments and Theory of Mind Deficits in Schizophrenia: A Meta-analysis of the Associations. Schizophr Bull 2021; 47:695-711. [PMID: 33433606 PMCID: PMC8084438 DOI: 10.1093/schbul/sbaa182] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Schizophrenia is associated with major functioning difficulties. Theory of mind (ToM), the ability to infer the mental states of others, is an important determinant of functioning. However, the contribution of ToM to each specific domain of functioning remains to be better understood. The objectives of this meta-analysis were to document and compare the magnitude of the associations between ToM and (1) different domains of functioning (social functioning, productive activities, and instrumental activities of daily living), each assessed separately for functional performance and functional outcome and (2) different aspects of functioning (functional performance and functional outcome) in schizophrenia. Fifty-nine studies (N = 4369) published between 1980 and May 2019 targeting patients with schizophrenia or schizoaffective disorder aged between 18 and 65 years old were included. Studies were retrieved from seven databases. Correlations were extracted from the articles, transformed into effect sizes Zr and combined as weighted and unweighted means. The strength of the associations between the domains and aspects of functioning were compared using focused tests. A moderate association was observed between ToM and all domains of functioning, with a stronger association between ToM and productive activities compared with social functioning (only for functional outcome [χ2(2) = 6.43, P = 0.040]). Regarding the different aspects of functioning, a stronger association was observed between ToM and functional performance, compared with functional outcome, for overall functioning (χ2(1) = 13.77, P < 0.001) and social functioning (χ2(1) = 18.21, P < 0.001). The results highlight a stronger association of ToM with productive activities and with functional performance, which should be considered in future studies to improve functional recovery in schizophrenia.
Collapse
Affiliation(s)
- Élisabeth Thibaudeau
- École de psychologie, Université Laval, Québec, Québec, Canada,CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada,To whom correspondence should be addressed; Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, local 1528, Québec, QC G1V 0A6, Canada; tel: 418-656-2131, e-mail:
| | - Caroline Cellard
- École de psychologie, Université Laval, Québec, Québec, Canada,CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada
| | | | - Amélie M Achim
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada,Département de psychiatrie et neurosciences, Université Laval, Québec, Québec, Canada
| |
Collapse
|
10
|
Lin X, Zhang X, Liu Q, Zhao P, Zhong J, Pan P, Wang G, Yi Z. Empathy and Theory of Mind in Multiple Sclerosis: A Meta-Analysis. Front Psychiatry 2021; 12:628110. [PMID: 33897490 PMCID: PMC8062809 DOI: 10.3389/fpsyt.2021.628110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/18/2021] [Indexed: 12/25/2022] Open
Abstract
Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system. Studies have shown that MS disrupts several social cognitive abilities [including empathy and theory of mind (ToM)]. Overall ToM deficits in MS are well documented, but how the specific ToM subcomponents and empathic capacity are affected remains unclear. For this meta-analysis, we searched PubMed, Web of Science, and Embase from inception to July 2020. Effect sizes were calculated using Hedges g with a random-effects model. Thirty-three studies were included. Relative to healthy controls (HCs), patients with MS were moderately impaired in overall empathy (g = -0.67), overall ToM (g = -74), cognitive ToM (g = -0.72), and the overlapping domains of cognitive empathy/affective ToM (g = -0.79); no group differences were identified for affective empathy (g = -0.19). Compared with HCs, patients with relapsing-remitting MS (RRMS) and progressive MS were impaired in overall empathy, overall ToM, cognitive ToM, and cognitive empathy/affective ToM, without significant RRMS-progressive MS differences in impairment degree. We conducted the first meta-analytic review investigating the empathy and ToM functioning patterns in patients with MS and examined the overlapping and distinct subcomponents of these constructs. The findings suggest differential impairment of the core aspects of social cognitive processing in patients with MS, which may importantly inform the development of structured social cognitive MS interventions.
Collapse
Affiliation(s)
- XiaoGuang Lin
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - XueLing Zhang
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - QinQin Liu
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - PanWen Zhao
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - PingLei Pan
- Department of Neurology and Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - GenDi Wang
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| | - ZhongQuan Yi
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, China
| |
Collapse
|
11
|
Nemoto T, Uchino T, Aikawa S, Matsuo S, Mamiya N, Shibasaki Y, Wada Y, Yamaguchi T, Katagiri N, Tsujino N, Usami T, Mizuno M. Impact of changes in social anxiety on social functioning and quality of life in outpatients with schizophrenia: A naturalistic longitudinal study. J Psychiatr Res 2020; 131:15-21. [PMID: 32911206 DOI: 10.1016/j.jpsychires.2020.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/04/2020] [Accepted: 08/09/2020] [Indexed: 12/15/2022]
Abstract
The prevalence of comorbid social anxiety disorder among patients with schizophrenia is currently attracting attention, and symptoms of social anxiety are reportedly associated with various clinical features. However, the contribution of social anxiety to social functioning and quality of life (QOL) over time remains obscure. The aim of this study was to examine the impact of changes in social anxiety symptoms on social functioning and QOL among outpatients with schizophrenia. Of the 207 outpatients who were eligible at baseline, 118 patients agreed with and completed a follow-up investigation at least 1 year (695.8 days on average) after the baseline study. Stepwise multiple regressions examining the change in social functioning using demographic data and changes in clinical variables as explanatory variables demonstrated that the changes in social anxiety and general psychopathology contributed to the change in the Social Functioning Scale, while the changes in clinical severity and negative symptoms contributed to the change in the Global Assessment of Functioning scale. Stepwise multiple regressions for the change in QOL demonstrated that the changes in social anxiety and depression contributed to the change in the World Health Organization QOL scale, Brief version, and the changes in social anxiety and positive symptoms contributed to the Subjective Well-being Under Neuroleptic Drug Treatment, Short Form. The results revealed that the changes in social anxiety symptoms were significantly associated with the change in functional outcome among patients with schizophrenia. Treatments targeting social anxiety seem to be key to achieving a full recovery in patients with schizophrenia.
Collapse
Affiliation(s)
- Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan.
| | - Takashi Uchino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Sayaka Aikawa
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Matsuo
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Noriyuki Mamiya
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan
| | | | - Yo Wada
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Tomohiro Usami
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
12
|
Faghel-Soubeyrand S, Lecomte T, Bravo MA, Lepage M, Potvin S, Abdel-Baki A, Villeneuve M, Gosselin F. Abnormal visual representations associated with confusion of perceived facial expression in schizophrenia with social anxiety disorder. NPJ SCHIZOPHRENIA 2020; 6:28. [PMID: 33004809 PMCID: PMC7529755 DOI: 10.1038/s41537-020-00116-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/19/2020] [Indexed: 01/25/2023]
Abstract
Deficits in social functioning are especially severe amongst schizophrenia individuals with the prevalent comorbidity of social anxiety disorder (SZ&SAD). Yet, the mechanisms underlying the recognition of facial expression of emotions-a hallmark of social cognition-are practically unexplored in SZ&SAD. Here, we aim to reveal the visual representations SZ&SAD (n = 16) and controls (n = 14) rely on for facial expression recognition. We ran a total of 30,000 trials of a facial expression categorization task with Bubbles, a data-driven technique. Results showed that SZ&SAD's ability to categorize facial expression was impared compared to controls. More severe negative symptoms (flat affect, apathy, reduced social drive) was associated with more impaired emotion recognition ability, and with more biases in attributing neutral affect to faces. Higher social anxiety symptoms, on the other hand, was found to enhance the reaction speed to neutral and angry faces. Most importantly, Bubbles showed that these abnormalities could be explained by inefficient visual representations of emotions: compared to controls, SZ&SAD subjects relied less on fine facial cues (high spatial frequencies) and more on coarse facial cues (low spatial frequencies). SZ&SAD participants also never relied on the eye regions (only on the mouth) to categorize facial expressions. We discuss how possible interactions between early (low sensitivity to coarse information) and late stages of the visual system (overreliance on these coarse features) might disrupt SZ&SAD's recognition of facial expressions. Our findings offer perceptual mechanisms through which comorbid SZ&SAD impairs crucial aspects of social cognition, as well as functional psychopathology.
Collapse
Affiliation(s)
- Simon Faghel-Soubeyrand
- Département de Psychologie, Université de Montréal, Montréal, Canada. .,School of Psychology, University of Birmingham, Birmingham, United Kingdom.
| | - Tania Lecomte
- Département de Psychologie, Université de Montréal, Montréal, Canada
| | | | - Martin Lepage
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Stéphane Potvin
- Départment de Psychiatrie, Université de Montréal, Montréal, Canada
| | - Amal Abdel-Baki
- Centre hospitalier de l'Université de Montréal-Hôpital Notre-Dame, Montréal, Canada
| | - Marie Villeneuve
- Institut universitaire en santé mentale de Montréal, Montréal, Canada
| | - Frédéric Gosselin
- Département de Psychologie, Université de Montréal, Montréal, Canada
| |
Collapse
|
13
|
Wong GHY. Social anxiety within a network of mild delusional ideations, negative symptoms and insight in outpatients with early psychosis: A psychopathological path analysis. ANXIETY STRESS AND COPING 2020; 33:342-354. [DOI: 10.1080/10615806.2020.1723007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Gloria Hoi-Yan Wong
- Department of Social Work and Social Administration and Department of Psychiatry, The University of Hong Kong, Hong Kong
| |
Collapse
|
14
|
Thibaudeau É, Achim AM, Parent C, Turcotte M, Cellard C. A meta-analysis of the associations between theory of mind and neurocognition in schizophrenia. Schizophr Res 2020; 216:118-128. [PMID: 31899095 DOI: 10.1016/j.schres.2019.12.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 12/27/2022]
Abstract
Theory of mind (ToM) refers to the ability to infer the mental states of others. ToM is impaired in schizophrenia and these deficits seem to hinder functional recovery. ToM is thus an important, but complex treatment target, supported by several processes. A large number of studies report significant associations between ToM and neurocognition (e.g. memory, attention), but the neurocognitive domains that are most closely linked to ToM remain to be identified. A meta-analysis was conducted to estimate the magnitude of the associations between ToM and neurocognition in people with schizophrenia. Correlations were extracted from the relevant literature, transformed into effect sizes Zr and pooled as weighted means. Focused-tests were employed to test for differences between neurocognitive domains and for differences linked to the characteristics of ToM tasks. Ninety-one studies (N = 5462) were included. Moderate associations emerged between ToM and each neurocognitive domain (Zrs 0.27-0.43), with no significant difference between domains (χ2(8) = 11.89, p = 0.156). Within the domain of executive functions, abstraction showed a stronger association with ToM (χ2(4) = 18.93, p = 0.001). Several ToM tasks characteristics (e.g. modality of stimuli, type of mental state), were significantly related to the magnitude of the associations between ToM and executive functions, visuospatial/problem solving, attention and episodic memory. These results suggest that ToM is linked to a wide range of neurocognitive abilities in schizophrenia, and that ToM tasks are a significant moderator of these associations. The assessment and treatment of ToM should consider the neurocognitive profile of each patient to understand his difficulties and to tailor interventions.
Collapse
Affiliation(s)
- Élisabeth Thibaudeau
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), 2601 Chemin de la Canardière, G1J 2G3 Québec, Québec, Canada; École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Québec, Canada.
| | - Amélie M Achim
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), 2601 Chemin de la Canardière, G1J 2G3 Québec, Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050 avenue de la Médecine, local 4873, G1V 0A6 Québec, Québec, Canada.
| | - Carolane Parent
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), 2601 Chemin de la Canardière, G1J 2G3 Québec, Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050 avenue de la Médecine, local 4873, G1V 0A6 Québec, Québec, Canada.
| | - Mélissa Turcotte
- École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Québec, Canada.
| | - Caroline Cellard
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), 2601 Chemin de la Canardière, G1J 2G3 Québec, Québec, Canada; École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Québec, Canada.
| |
Collapse
|
15
|
Lu SM, Lin MF, Chang HJ. Progressive muscle relaxation for patients with chronic schizophrenia: A randomized controlled study. Perspect Psychiatr Care 2020; 56:86-94. [PMID: 31012119 DOI: 10.1111/ppc.12384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/08/2019] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To evaluate progressive muscle relaxation (PMR) as an intervention for anxiety, psychotic symptoms, and quality of life (QOL) in patients with chronic schizophrenia. DESIGN AND METHODS Eighty patients were recruited from a Taiwanese psychiatry ward. The intervention group received group PMR; control group received treatment-as-usual. RESULTS The results indicated that PMR might have a short-term effect on reducing anxiety, improving psychotic syndromes, and QOL among patients with chronic schizophrenia; however, the effectiveness at the 3-month follow-up was not evident. PRACTICE IMPLICATIONS Both the psychiatric patients and the health institutions may be able to list PMR as a clinical routine care, and then become a mental health practice strategy for mental patients to improve the quality of mental care. IMPLICATIONS FOR NURSING PRACTICE Our studies suggest that prevention of severe mental illness among patients with schizophrenia requires PMR interventions. PMR had an immediate effect, and it is possible that a shorter intervention period using this approach would also be successful.
Collapse
Affiliation(s)
- Shu-Min Lu
- School of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiu-Ju Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
16
|
Naidu K, van Staden W, Fletcher L. Discerning undifferentiated anxiety from syndromal anxiety in acute-phase schizophrenia. Ann Gen Psychiatry 2020; 19:26. [PMID: 32318113 PMCID: PMC7158120 DOI: 10.1186/s12991-020-00277-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/04/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Literature on anxiety in schizophrenia is confined to well-established diagnostic syndromes and the diagnostic category of unspecified anxiety disorder has not been quantitatively verified in this population. This study examined whether anxiety that is not differentiated into the well-established syndromes is empirically discernible from syndromal anxiety and no anxiety in acute-phase schizophrenia. METHODS After sampling 111 acute-phase schizophrenia patients, they were stratified into three groups: syndromal anxiety; undifferentiated anxiety; and without anxiety disorder. The groups were compared statistically in two data sets on measures for anxiety, psychotic severity, depressive features, akathisia and medication use. RESULTS On two measures of anxiety and for both data sets, the groups were significantly different without evidence of a confounding influence by akathisia, medication, or psychotic severity. The undifferentiated group was different from the syndromal group on the Staden Schizophrenia Anxiety Rating Scale (S-SARS) for both data sets (mean difference = 7.46, p < 0.001; mean difference = 7.69, p < 0.002) and on the Hamilton Anxiety Rating Scale for the one data set (mean difference = 14.68, p < 0.001) but not for the replicative data set (mean difference = 1.49, p = 0.494). The undifferentiated anxiety group was different from the no anxiety group for the respective data sets on both anxiety scales (S-SARS: mean difference = 8.67, p < 0.001; mean difference = 8.64, p < 0.001)(HAM-A: mean difference = 6.05, p < 0.001; mean difference = 8.67, p = 0.002). When depressive features had a confounding effect, it was small relative to the group differences. CONCLUSIONS The results suggest some patients in acute-phase schizophrenia present with undifferentiated anxiety that is discernible from both syndromal anxiety and those without an anxiety disorder. This finding may serve as empirical grounds for clinicians to recognise undifferentiated anxiety in acute-phase schizophrenia, and for further research into the clinical importance of undifferentiated anxiety in this population.
Collapse
Affiliation(s)
- Kalai Naidu
- 1Department of Psychiatry, University of Pretoria, Pretoria, South Africa
| | - Werdie van Staden
- 1Department of Psychiatry, University of Pretoria, Pretoria, South Africa.,2Centre for Ethics and Philosophy of Health Sciences, Faculty of Health Sciences, University of Pretoria, Arcadia, Private Bag X323, Pretoria, 0007 South Africa
| | - Lizelle Fletcher
- 3Department of Statistics, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
17
|
Deng WY, Grove T, Deldin P. Anxiety Mediates the Relationship between Psychotic-Like Experiences and Social Functioning in the General Population. Psychopathology 2020; 53:95-102. [PMID: 32623434 DOI: 10.1159/000507869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/13/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Within the psychosis continuum that includes schizophrenia (SZ) at the severe end and the general population at the mild end, anxiety may negatively impact social functioning more than psychosis or psychotic-like experiences (PLE). This claim is supported by previous reports that show anxiety mediates the relationship between psychosis and social functioning in SZ, suggesting anxiety is critical to social functioning in SZ. Yet no studies have examined a similar relationship in the general population, and this is important because people with PLE are at a significantly higher risk for developing full-blown psychosis. METHODS Similar to those with SZ, we predicted heightened anxiety would mediate the relationship between PLE, as measured by The -Oxford-Liverpool Inventory of Feelings and Experiences, and social functioning, as measured by Social Adjustment Scale - Self-Report, in the general population. RESULTS Indeed, the current study showed that the relationship between PLE and social functioning was mediated by anxiety (z = 7.81, p < 0.001) within an unselected crowdsourcing sample representative of the general population (Amazon M-Turk; n = 197, mean age 32.38 years). CONCLUSION Taken together with previous reports, the current findings suggest that anxiety is a functionally relevant dimension across the psychosis continuum and improving anxiety may improve social functioning across this continuum.
Collapse
Affiliation(s)
- Wisteria Y Deng
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA, .,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, USA,
| | - Tyler Grove
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Patricia Deldin
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
18
|
Pothier W, Cellard C, Corbière M, Villotti P, Achim AM, Lavoie A, Turcotte M, Vallières C, Roy MA. Determinants of occupational outcome in recent-onset psychosis: The role of cognition. SCHIZOPHRENIA RESEARCH-COGNITION 2019; 18:100158. [PMID: 31463205 PMCID: PMC6710235 DOI: 10.1016/j.scog.2019.100158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 01/18/2023]
Abstract
Working or studying is a common goal among people with recent-onset psychosis. Cognitive deficits have been reported to influence occupational outcome, but to date few studies have evaluated if cognitive deficits independently predict occupational outcome when taking into account other important determinants, such as self-esteem, motivation, length of time absent from employment/school, job/school search behaviours, subjective cognitive complaints and psychotic symptoms. Hence, this longitudinal study aimed to evaluate the role of cognition, as well as other key factors relevant to occupational outcome, to predict occupational status six months after baseline in people with recent-onset psychosis. A total of 27 participants receiving treatment in rehabilitation programs were included in the study. Neuropsychological, psychological, clinical and occupational measures were administered at baseline, and occupational status was collected six months later. Ordinal regression indicated that working memory and length of time absent from employment/school at baseline predicted 48.1% of the variance of occupational status at six months, with both variables showing a unique significant contribution to the model. These results suggest that working memory could be integrated in comprehensive models of occupational outcome in people with recent-onset psychosis. In addition, supported employment and education programs could target cognitive deficits and length of time absent from employment/school to help these individuals to acquire a job or return to school given their strong predictive value on occupational outcome.
Collapse
Affiliation(s)
- William Pothier
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Caroline Cellard
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Marc Corbière
- Université du Québec à Montréal (UQÀM), 405 Rue Sainte-Catherine Est, H2L 2C4, Montréal, Canada.,Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401 Rue Hochelaga, Pavillon Riel, Aile 228, H1N 3M5 Montréal, Canada
| | - Patrizia Villotti
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401 Rue Hochelaga, Pavillon Riel, Aile 228, H1N 3M5 Montréal, Canada
| | - Amélie M Achim
- Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Andréanne Lavoie
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Mélissa Turcotte
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Chantal Vallières
- Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Marc-André Roy
- Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada.,Département de psychiatrie et neurosciences de l'Université Laval, 1050 avenue de la Médecine, G1V 0A6 Québec, Canada
| |
Collapse
|
19
|
Takeuchi S, Hida H, Uchida M, Naruse R, Yoshimi A, Kitagaki S, Ozaki N, Noda Y. Blonanserin ameliorates social deficit through dopamine-D 3 receptor antagonism in mice administered phencyclidine as an animal model of schizophrenia. Neurochem Int 2019; 128:127-134. [PMID: 30998952 DOI: 10.1016/j.neuint.2019.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/02/2019] [Accepted: 04/15/2019] [Indexed: 01/02/2023]
Abstract
Blonanserin differs from other antipsychotic drugs, such as risperidone and olanzapine, and exhibits a higher affinity for dopamine-D2/3 receptors than for serotonin 5-HT2A receptors. We investigated the involvement of dopamine-D3 receptors in the effect of blonanserin on the social deficit observed in an animal model of schizophrenia and sought to elucidate the molecular mechanism underlying its action. Mice received phencyclidine (PCP: 10 mg/kg/day, s.c.), a non-competitive N-methyl-d-aspartate (NMDA) receptor antagonist, once a day for 14 consecutive days. We then evaluated the sociability, using a social interaction test, and the expression of GluN1 subunit, an essential subunit of the NMDA receptors, in these mice. Blonanserin significantly ameliorated the PCP-induced social deficit, whereas olanzapine and haloperidol did not. This effect of blonanserin was antagonized by 7-OH-DPAT, a dopamine-D3 receptor agonist, and SCH23390, a dopamine-D1 receptor antagonist. However, the ameliorating effect of blonanserin was not inhibited by DOI, a serotonin 5-HT2A receptor agonist. The PCP-induced social deficit was also ameliorated by U99194, a dopamine-D3 receptor antagonist and SKF38393, a dopamine-D1 receptor agonist, being effects antagonized by 7-OH-DPAT or SCH23390. Blonanserin significantly inhibited the decrease in the phosphorylation levels of GluN1 at Ser897 by protein kinase A (PKA) in the prefrontal cortex (PFC) in PCPadministered mice. These results suggest that activation of NMDA receptors due to Ser897-phosphorylation of GluN1 subunit, which is a step linked to dopamine-D1 receptor-PKA signaling through dopamine-D3 receptor antagonism in the PFC, is required for the ameliorating effect of blonanserin on the PCP-induced social deficit. These findings also provide in vivo evidence that blonanserin antagonism of the dopamine-D3 receptors may be useful as a novel treatment strategy and that the dopamine-D3 receptors can be a novel therapeutic target molecule for the social deficit observed in schizophrenia.
Collapse
Affiliation(s)
- Saori Takeuchi
- Division of Clinical Sciences and Neuropsychopharmacology, Faculty of Pharmacy, Meijo University, Nagoya, 468-8503, Japan
| | - Hirotake Hida
- Division of Clinical Sciences and Neuropsychopharmacology, Faculty of Pharmacy, Meijo University, Nagoya, 468-8503, Japan
| | - Mizuki Uchida
- Division of Clinical Sciences and Neuropsychopharmacology, Graduate School of Pharmacy, Meijo University, Nagoya, 468-8503, Japan
| | - Ryo Naruse
- Division of Clinical Sciences and Neuropsychopharmacology, Faculty of Pharmacy, Meijo University, Nagoya, 468-8503, Japan
| | - Akira Yoshimi
- Division of Clinical Sciences and Neuropsychopharmacology, Faculty of Pharmacy, Meijo University, Nagoya, 468-8503, Japan
| | - Shinji Kitagaki
- Department of Medical Chemistry, Graduate School of Pharmacy, Meijo University, Nagoya, 468-8503, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, 466-8560, Japan
| | - Yukihiro Noda
- Division of Clinical Sciences and Neuropsychopharmacology, Faculty of Pharmacy, Meijo University, Nagoya, 468-8503, Japan; Division of Clinical Sciences and Neuropsychopharmacology, Graduate School of Pharmacy, Meijo University, Nagoya, 468-8503, Japan; Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, 466-8560, Japan.
| |
Collapse
|
20
|
Abstract
Social anxiety is highly prevalent in individuals with schizophrenia, with studies suggesting rates of 30%. This study aimed at determining if social anxiety is linked to specific emotion recognition deficits and to specific social functioning deficits. A total of 47 participants with a diagnosis of schizophrenia and receiving outpatient services answered measures of facial recognition (Ekman; Facial Emotion Identification Test), facial discrimination (Facial Emotion Discrimination Test), role-play, social anxiety (Social Interaction Anxiety Scale and Brief Social Phobia Scale), psychiatric symptoms (Brief Psychiatric Rating Scale), self-esteem (Self-Esteem Rating Scale-Short Form), and social functioning (Social Functioning Scale). A total of 22 (47%) participants were rated as socially anxious. Those with social anxiety had worse social functioning in the domains of interpersonal communication (t[45] = 2.28, p = 0.025) and engagement (in conversations) (t[45] = 2.89, p = 0.000) and had lower self-esteem (t[45] = 4.05, p = 0.001). Participants with social anxiety also had more difficulties in recognizing neutral emotional faces (t[31] = 2.19, p = 0.036). More studies are warranted to better understand the link between neutral expression recognition and social anxiety in schizophrenia.
Collapse
|
21
|
Siu MW, Chong CSY, Lo WTL. Prevalence and clinicians' awareness of psychiatric comorbidities among first-episode schizophrenia. Early Interv Psychiatry 2018; 12:1128-1136. [PMID: 30456864 DOI: 10.1111/eip.12426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 10/21/2016] [Accepted: 11/22/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND To explore the prevalence and clinicians' awareness of psychiatric comorbidities, and to identify factors associated with current psychiatric comorbidities in first-episode schizophrenia (FES) patients. METHOD In this cross-sectional study, 128 patients with FES, who were in symptomatic remission, were consecutively recruited from a local early intervention clinic. All patients were interviewed using the Chinese bilingual version of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Axis I Disorders, Positive and Negative Syndrome Scales, Scale to Assess Unawareness of Mental Disorder, Social and Occupational Functioning Assessment Scale, Simpson-Angus Scale, Barnes Akathisia Rating Scale and Abnormal Involuntary Movement Scale. Bivariate and multivariate analyses were performed to investigate factors associated with psychiatric comorbidities in FES patients. RESULTS The lifetime and point prevalence of psychiatric comorbidities among FES patients were 47.7% and 27.3%, respectively. Current psychiatric comorbidities were documented on the medical records of 39.3% of the patients. The FES patients with current psychiatric comorbidities had a lower level of functioning. Depression in FES was also associated with akathisia. CONCLUSION Psychiatric comorbidities are prevalent among community FES patients. In addition to achieving symptomatic remission in schizophrenia, both treating psychiatric comorbidities and minimizing the side-effects of treatment, particularly akathisia, are fundamental for supporting FES patients in their journey to recovery.
Collapse
Affiliation(s)
- Man-Wah Siu
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong SAR, China
| | | | | |
Collapse
|
22
|
Kimoto S, Makinodan M, Kishimoto T. Neurobiology and treatment of social cognition in schizophrenia: Bridging the bed-bench gap. Neurobiol Dis 2018; 131:104315. [PMID: 30391541 DOI: 10.1016/j.nbd.2018.10.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 10/01/2018] [Accepted: 10/31/2018] [Indexed: 01/15/2023] Open
Abstract
Social cognition refers to the psychological processes involved in the perception, encoding, storage, retrieval, and regulation of information about others and ourselves. This process is essential for survival and reproduction in complex social environments. Recent evidence suggests that impairments in social cognition frequently occur in schizophrenia, mainly contributing to poor functional outcomes, including the inability to engage in meaningful work and maintain satisfying interpersonal relationships. With the ambiguous definition of social cognition, the neurobiology underlying impaired social cognition remains unknown, and the effectiveness of currently available intervention strategies in schizophrenia remain limited. Considering the advances and challenges of translational research for schizophrenia, social cognition has been considered a high-priority domain for treatment development. Here, we describe the current state of the framework, clinical concerns, and intervention approaches for social cognition in schizophrenia. Next, we introduce translatable rodent models associated with schizophrenia that allow the evaluation of different components of social behaviors, providing deeper insights into the neural substrates of social cognition in schizophrenia. Our review presents a valuable perspective that indicates the necessity of building bridges between basic and clinical science researchers for the development of novel therapeutic approaches in impaired social cognition in schizophrenia.
Collapse
Affiliation(s)
- Sohei Kimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan.
| | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toshifumi Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| |
Collapse
|
23
|
Roy MA, Vallières C, Lehoux C, Leclerc LD, Demers MF, Achim AM. More intensive probing increases the detection of social anxiety disorders in schizophrenia. Psychiatry Res 2018; 268:358-360. [PMID: 30099275 DOI: 10.1016/j.psychres.2018.07.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/12/2018] [Accepted: 07/18/2018] [Indexed: 11/20/2022]
Abstract
This study examined the influence of the assessment methods in detecting social anxiety disorders (SAD). We used a two-stage procedure to elicit social anxiety symptoms (SAS) to diagnose SAD in 80 people with a schizophrenia spectrum psychotic disorder (SZSPD) from an early intervention program. We observed a 28.8% lifetime prevalence of SAD when considering only the SAS elicited using the SCID probes (first stage), and a significant increase to 48.8% after adding the probes from the Liebowitz Social Anxiety Scale (second stage). In conclusion, the LSAS can increase the sensitivity in detecting SAS and hence SAD comorbid to SZSPD.
Collapse
Affiliation(s)
- Marc-André Roy
- CIUSSS Capitale-Nationale, Institut Universitaire en Santé Mentale de Québec, Québec, Canada; Centre de recherche CERVO, Centre de recherche de l'Institut universitaire en santé mentale de Québec (F-4500), 2601, chemin de la Canardière, G1J 2G3 Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Québec, Canada.
| | - Chantal Vallières
- CIUSSS Capitale-Nationale, Institut Universitaire en Santé Mentale de Québec, Québec, Canada; Centre de recherche CERVO, Centre de recherche de l'Institut universitaire en santé mentale de Québec (F-4500), 2601, chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Catherine Lehoux
- CIUSSS Capitale-Nationale, Institut Universitaire en Santé Mentale de Québec, Québec, Canada; Centre de recherche CERVO, Centre de recherche de l'Institut universitaire en santé mentale de Québec (F-4500), 2601, chemin de la Canardière, G1J 2G3 Québec, Canada; CISSS Chaudière-Appalaches, Hôtel-Dieu de Lévis, Québec, Canada
| | | | - Marie-France Demers
- CIUSSS Capitale-Nationale, Institut Universitaire en Santé Mentale de Québec, Québec, Canada; Centre de recherche CERVO, Centre de recherche de l'Institut universitaire en santé mentale de Québec (F-4500), 2601, chemin de la Canardière, G1J 2G3 Québec, Canada; Faculté de pharmacie, Université Laval, Québec, Canada
| | - Amélie M Achim
- Centre de recherche CERVO, Centre de recherche de l'Institut universitaire en santé mentale de Québec (F-4500), 2601, chemin de la Canardière, G1J 2G3 Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Québec, Canada
| |
Collapse
|
24
|
Roy MA, Demers MF, Achim AM. Social anxiety disorder in schizophrenia: a neglected, yet potentially important comorbidity. J Psychiatry Neurosci 2018; 43:287-288. [PMID: 29947611 PMCID: PMC6019352 DOI: 10.1503/jpn.180081] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Marc-André Roy
- From the CIUSSS Capitale-Nationale; Institut Universitaire en Santé Mentale de Québec, Québec, Que., Canada (Roy, Demers); the Centre de recherche CERVO, Québec, Que., Canada (Roy, Demers); the Département de psychiatrie et neurosciences, Université Laval, Québec, Que., Canada (Roy, Achim); and the Faculté de pharmacie, Université Laval, Québec, Que., Canada (Demers)
| | - Marie-France Demers
- From the CIUSSS Capitale-Nationale; Institut Universitaire en Santé Mentale de Québec, Québec, Que., Canada (Roy, Demers); the Centre de recherche CERVO, Québec, Que., Canada (Roy, Demers); the Département de psychiatrie et neurosciences, Université Laval, Québec, Que., Canada (Roy, Achim); and the Faculté de pharmacie, Université Laval, Québec, Que., Canada (Demers)
| | - Amélie M Achim
- From the CIUSSS Capitale-Nationale; Institut Universitaire en Santé Mentale de Québec, Québec, Que., Canada (Roy, Demers); the Centre de recherche CERVO, Québec, Que., Canada (Roy, Demers); the Département de psychiatrie et neurosciences, Université Laval, Québec, Que., Canada (Roy, Achim); and the Faculté de pharmacie, Université Laval, Québec, Que., Canada (Demers)
| |
Collapse
|
25
|
Aikawa S, Kobayashi H, Nemoto T, Matsuo S, Wada Y, Mamiya N, Yamaguchi T, Katagiri N, Tsujino N, Mizuno M. Social anxiety and risk factors in patients with schizophrenia: Relationship with duration of untreated psychosis. Psychiatry Res 2018; 263:94-100. [PMID: 29510345 DOI: 10.1016/j.psychres.2018.02.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 02/17/2018] [Accepted: 02/17/2018] [Indexed: 11/28/2022]
Abstract
Social anxiety is commonly reported as a comorbid condition among people with schizophrenia. The aims of this study were to elucidate the associations between demographic/clinical features and social anxiety. A total of 207 outpatients with schizophrenia underwent assessments for social anxiety, psychiatric symptoms, social cognition, cognitive function, social functioning, and quality of life (QOL). To confirm the prediction model for social anxiety, we conducted multiple linear regressions using the Liebowitz Social Anxiety Scale (LSAS) score as an outcome variable and demographic/clinical variables as predictors. Of the 207 patients, 30 (14.5%) met the criteria for social anxiety disorder and 109 (52.7%) had a mean LSAS score higher than 30, suggesting that their social anxiety symptoms had reached a clinical level. Social anxiety was significantly correlated with psychiatric symptoms, social functioning, and QOL, whereas significant correlations with social cognition and cognitive function were not observed. A multiple regression analysis identified social functioning, gender, age of onset, and duration of untreated psychosis (DUP) as predictors that were most closely associated with the LSAS score. We confirmed that social anxiety symptoms were highly prevalent among outpatients with schizophrenia and were closely associated with social functioning and DUP, rather than social cognitive impairments.
Collapse
Affiliation(s)
- Sayaka Aikawa
- Department of Neuropsychiatry, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Hiroyuki Kobayashi
- Department of Neuropsychiatry, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; Department of Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo 108-8242, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan.
| | - Satoshi Matsuo
- Department of Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo 108-8242, Japan
| | - Yo Wada
- Department of Neuropsychiatry, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Noriyuki Mamiya
- Department of Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo 108-8242, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan
| |
Collapse
|
26
|
Thibaudeau É, Cellard C, Legendre M, Villeneuve K, Achim AM. Reliability of two social cognition tests: The combined stories test and the social knowledge test. Psychiatry Res 2018; 262:63-69. [PMID: 29407571 DOI: 10.1016/j.psychres.2018.01.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/23/2017] [Accepted: 01/12/2018] [Indexed: 12/17/2022]
Abstract
Deficits in social cognition are common in psychiatric disorders. Validated social cognition measures with good psychometric properties are necessary to assess and target social cognitive deficits. Two recent social cognition tests, the Combined Stories Test (COST) and the Social Knowledge Test (SKT), respectively assess theory of mind and social knowledge. Previous studies have shown good psychometric properties for these tests, but the test-retest reliability has never been documented. The aim of this study was to evaluate the test-retest reliability and the inter-rater reliability of the COST and the SKT. The COST and the SKT were administered twice to a group of forty-two healthy adults, with a delay of approximately four weeks between the assessments. Excellent test-retest reliability was observed for the COST, and a good test-retest reliability was observed for the SKT. There was no evidence of practice effect. Furthermore, an excellent inter-rater reliability was observed for both tests. This study shows a good reliability of the COST and the SKT that adds to the good validity previously reported for these two tests. These good psychometrics properties thus support that the COST and the SKT are adequate measures for the assessment of social cognition.
Collapse
Affiliation(s)
- Élisabeth Thibaudeau
- CERVO Brain Research Center, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada; École de Psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.
| | - Caroline Cellard
- CERVO Brain Research Center, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada; École de Psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.
| | - Maxime Legendre
- CERVO Brain Research Center, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada; École de Psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.
| | - Karèle Villeneuve
- CERVO Brain Research Center, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada; École de Psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.
| | - Amélie M Achim
- CERVO Brain Research Center, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada; Département de Psychiatrie et Neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, local 4873, G1V 0A6 Québec, Canada.
| |
Collapse
|
27
|
Green MF, Horan WP, Lee J, McCleery A, Reddy LF, Wynn JK. Social Disconnection in Schizophrenia and the General Community. Schizophr Bull 2018; 44. [PMID: 28637195 PMCID: PMC5814840 DOI: 10.1093/schbul/sbx082] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Social disability is a defining characteristic of schizophrenia and a substantial public health problem. It has several components that are difficult to disentangle. One component, social disconnection, occurs extensively in the general community among nonhelp-seeking individuals. Social disconnection is an objective, long-standing lack of social/family relationships and minimal participation in social activities. It is associated with negative health effects, including early mortality, and is distinct from subjective loneliness. These 2 topics, social disability in schizophrenia and social disconnection in the general community, have generated entirely distinct research literatures that differ in their respective knowledge gaps and emphases. Specifically, the consequences of social disability in schizophrenia are unknown but its determinants (ie, nonsocial cognition, social cognition, and social motivation) have been well-examined. Conversely, the health consequences of social disconnection in the general community are well-established, but the determinants are largely unknown. Social disconnection is a condition that presents substantial public health concerns, exists within and outside of current psychiatric diagnostic boundaries, and may be related to the schizophrenia spectrum. A comparison of these 2 literatures is mutually informative and it generates intriguing research questions that can be critically evaluated.
Collapse
Affiliation(s)
- Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA,To whom correspondence should be addressed; Semel Institute for Neuroscience and Human Behavior, UCLA, 760 Westwood Plaza, Rm 27–462, Los Angeles, CA 90024–1759, US; tel: 310-268-3376, fax: 818-991-7809, e-mail:
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA
| | - Junghee Lee
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA
| | - Amanda McCleery
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA
| | - L Felice Reddy
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA
| | - Jonathan K Wynn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA
| |
Collapse
|
28
|
Improving Theory of Mind in Schizophrenia by Targeting Cognition and Metacognition with Computerized Cognitive Remediation: A Multiple Case Study. SCHIZOPHRENIA RESEARCH AND TREATMENT 2017; 2017:7203871. [PMID: 28246557 PMCID: PMC5299218 DOI: 10.1155/2017/7203871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 12/15/2016] [Indexed: 12/28/2022]
Abstract
Schizophrenia is associated with deficits in theory of mind (ToM) (i.e., the ability to infer the mental states of others) and cognition. Associations have often been reported between cognition and ToM, and ToM mediates the relationship between impaired cognition and impaired functioning in schizophrenia. Given that cognitive deficits could act as a limiting factor for ToM, this study investigated whether a cognitive remediation therapy (CRT) that targets nonsocial cognition and metacognition could improve ToM in schizophrenia. Four men with schizophrenia received CRT. Assessments of ToM, cognition, and metacognition were conducted at baseline and posttreatment as well as three months and 1 year later. Two patients reached a significant improvement in ToM immediately after treatment whereas at three months after treatment all four cases reached a significant improvement, which was maintained through 1 year after treatment for all three cases that remained in the study. Improvements in ToM were accompanied by significant improvements in the most severely impaired cognitive functions at baseline or by improvements in metacognition. This study establishes that a CRT program that does not explicitly target social abilities can improve ToM.
Collapse
|
29
|
Vrbova K, Prasko J, Ociskova M, Holubova M. Comorbidity of schizophrenia and social phobia - impact on quality of life, hope, and personality traits: a cross sectional study. Neuropsychiatr Dis Treat 2017; 13:2073-2083. [PMID: 28831256 PMCID: PMC5548278 DOI: 10.2147/ndt.s141749] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The purpose of the study was to explore whether the comorbidity of social phobia affects symptoms severity, positive and negative symptoms, self-stigma, hope, and quality of life in patients with schizophrenia spectrum disorders. METHODS This is a cross-sectional study in which all participants completed the Internalized Stigma of Mental Illness (ISMI) scale, Adult Dispositional Hope Scale (ADHS), Liebowitz Social Anxiety Scale (LSAS), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Positive and Negative Syndrome Scale (PANSS), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Temperament and Character Inventory - Revised (TCI-R), and the demographic questionnaire. The disorder severity was assessed both by a psychiatrist (Clinical Global Impression Severity - the objective version [objCGI-S] scale) and by the patients (Clinical Global Impression Severity - the subjective version [subjCGI-S] scale). The patients were in a stabilized state that did not require changes in the treatment. Diagnosis of schizophrenia, schizoaffective disorder, or delusional disorder was determined according to the International Classification of Diseases 10th Revision (ICD-10) research criteria. A structured interview by Mini International Neuropsychiatric Interview was used to confirm the diagnosis. RESULTS The study included 61 patients of both genders. Clinically, the patients with comorbid social phobia had the earlier onset of the illness, more severe current psychopathology, more intense anxiety (general and social), and higher severity of depressive symptoms. The patients with comorbid social phobia showed the significantly lower quality of life compared to the patients without this comorbidity. The patients with comorbid social phobia also had a statistically lower mean level of hope and experienced a higher rate of the self-stigma. They also exhibited higher average scores of personality trait harm avoidance (HA) and a lower score of personality trait self-directedness (SD). CONCLUSION The study demonstrated differences in demographic factors, the severity of the disorder, self-stigma, hope, HA, and SD between patients with schizophrenia spectrum disorders with and without comorbid social phobia.
Collapse
Affiliation(s)
- Kristyna Vrbova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic
| | - Michaela Holubova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.,Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic
| |
Collapse
|
30
|
Social representations and contextual adjustments as two distinct components of the Theory of Mind brain network: Evidence from the REMICS task. Cortex 2016; 81:176-91. [DOI: 10.1016/j.cortex.2016.04.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 03/16/2016] [Accepted: 04/22/2016] [Indexed: 12/30/2022]
|
31
|
Attribution bias and social anxiety in schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2016; 4:1-3. [PMID: 28740807 PMCID: PMC5506709 DOI: 10.1016/j.scog.2016.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 12/15/2015] [Accepted: 01/15/2016] [Indexed: 11/23/2022]
Abstract
Studies on attribution biases in schizophrenia have produced mixed results, whereas such biases have been more consistently reported in people with anxiety disorders. Anxiety comorbidities are frequent in schizophrenia, in particular social anxiety disorder, which could influence their patterns of attribution biases. The objective of the present study was thus to determine if individuals with schizophrenia and a comorbid social anxiety disorder (SZ+) show distinct attribution biases as compared with individuals with schizophrenia without social anxiety (SZ−) and healthy controls. Attribution biases were assessed with the Internal, Personal, and Situational Attributions Questionnaire in 41 individual with schizophrenia and 41 healthy controls. Results revealed the lack of the normal externalizing bias in SZ+, whereas SZ− did not significantly differ from healthy controls on this dimension. The personalizing bias was not influenced by social anxiety but was in contrast linked with delusions, with a greater personalizing bias in individuals with current delusions. Future studies on attribution biases in schizophrenia should carefully document symptom presentation, including social anxiety.
Collapse
|
32
|
Scherzer P, Achim A, Léveillé E, Boisseau E, Stip E. Evidence from paranoid schizophrenia for more than one component of theory of mind. Front Psychol 2015; 6:1643. [PMID: 26579026 PMCID: PMC4627475 DOI: 10.3389/fpsyg.2015.01643] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/12/2015] [Indexed: 11/13/2022] Open
Abstract
We previously reported finding that performance was impaired on four out of five theory of mind (ToM) tests in a group of 21 individuals diagnosed with paranoid schizophrenia (pScz), relative to a non-clinical group of 29 individuals (Scherzer et al., 2012). Only the Reading the Mind in the Eyes Test did not distinguish between groups. A principal components analysis revealed that the results on the ToM battery could be explained by one general ToM factor with the possibility of a latent second factor. As well, the tests were not equally sensitive to the pathology. There was also overmentalization in some ToM tests and under-mentalisation in others. These results led us to postulate that there is more than one component to ToM. We hypothesized that correlations between the different EF measures and ToM tests would differ sufficiently within and between groups to support this hypothesis. We considered the relationship between the performance on eight EF tests and five ToM tests in the same diagnosed and non-clinical individuals as in the first study. The ToM tests shared few EF correlates and each had its own best EF predictor. These findings support the hypothesis of multiple ToM components.
Collapse
Affiliation(s)
- Peter Scherzer
- Département de Psychologie, Université du Québec à Montréal Montréal, QC, Canada ; Institut des sciences cognitives, Université du Québec à Montréal Montréal, QC, Canada
| | - André Achim
- Département de Psychologie, Université du Québec à Montréal Montréal, QC, Canada ; Institut des sciences cognitives, Université du Québec à Montréal Montréal, QC, Canada
| | - Edith Léveillé
- Département de Psychologie, Université du Québec à Montréal Montréal, QC, Canada ; Hôpital du Sacré-Coeur de Montréal et sa Fondation Montréal, QC, Canada
| | - Emilie Boisseau
- Département de Psychologie, Université du Québec à Montréal Montréal, QC, Canada ; Hôpital Rivière-des-Prairies Montréal, QC, Canada
| | - Emmanuel Stip
- Centre Hospitalier de l'Université de Montréal Montréal, QC, Canada
| |
Collapse
|
33
|
de la Asuncion J, Docx L, Sabbe B, Morrens M, de Bruijn ERA. Converging evidence of social avoidant behavior in schizophrenia from two approach-avoidance tasks. J Psychiatr Res 2015; 69:135-41. [PMID: 26343605 DOI: 10.1016/j.jpsychires.2015.08.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/18/2015] [Accepted: 08/07/2015] [Indexed: 01/11/2023]
Abstract
Many people with schizophrenia suffer from social impairments characterized by active social avoidance, which is related to social phobia common in schizophrenia, while motivational impairments can also result in passive social withdrawal. Although social avoidance is frequently reported in this population, this is the first study to directly compare approach-avoidance tendencies in schizophrenia patients (N = 37) and healthy controls (N = 29). Participants performed two tasks: a computerized approach-avoidance task (AAT) to assess response tendencies toward images of happy and angry faces with direct or averted gaze and a one-to-one personal space test (PST) to gauge more naturalistic approach-avoidance behaviors toward a real person bearing a neutral expression. The AAT results showed that both groups showed faster avoidance responses to angry faces and faster approach responses to happy faces with a direct gaze. Happy faces with averted gaze, however, resulted in faster avoidance responses in the patient group only. On the PST, the patients approached the experimenter less than healthy controls did. This measure of interpersonal distance was positively related to positive symptom severity. Delusions of reference and increased sensitivity to social rejection may explain the patients' avoidance tendencies in response to pictures of happy faces with averted gaze and in the presence of an actual person. The current findings demonstrate the importance of others adopting positive and unambiguous attitudes when interacting with schizophrenia patients to minimize behavioral avoidance patterns, which is particularly relevant for relatives and clinicians whose interactions with the patients are crucial to facilitating treatment and promoting healthy social relationships.
Collapse
Affiliation(s)
- Javier de la Asuncion
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Lise Docx
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Psychiatric Center Brothers Alexians, Provinciesteenweg 408, 2530 Boechout, Belgium
| | - Bernard Sabbe
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; University Psychiatric Center St Norbertushuis, Stationstraat 22c, 2570 Duffel, Belgium
| | - Manuel Morrens
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Psychiatric Center Brothers Alexians, Provinciesteenweg 408, 2530 Boechout, Belgium
| | - Ellen R A de Bruijn
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Clinical Psychology, Leiden Institute for Brain and Cognition (LIBC), Leiden University, Wassenaarseweg 52, 2333 AK Leiden, Netherlands
| |
Collapse
|
34
|
Castro-Nallar E, Bendall ML, Pérez-Losada M, Sabuncyan S, Severance EG, Dickerson FB, Schroeder JR, Yolken RH, Crandall KA. Composition, taxonomy and functional diversity of the oropharynx microbiome in individuals with schizophrenia and controls. PeerJ 2015; 3:e1140. [PMID: 26336637 PMCID: PMC4556144 DOI: 10.7717/peerj.1140] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 07/10/2015] [Indexed: 12/13/2022] Open
Abstract
The role of the human microbiome in schizophrenia remains largely unexplored. The microbiome has been shown to alter brain development and modulate behavior and cognition in animals through gut-brain connections, and research in humans suggests that it may be a modulating factor in many disorders. This study reports findings from a shotgun metagenomic analysis of the oropharyngeal microbiome in 16 individuals with schizophrenia and 16 controls. High-level differences were evident at both the phylum and genus levels, with Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria dominating both schizophrenia patients and controls, and Ascomycota being more abundant in schizophrenia patients than controls. Controls were richer in species but less even in their distributions, i.e., dominated by fewer species, as opposed to schizophrenia patients. Lactic acid bacteria were relatively more abundant in schizophrenia, including species of Lactobacilli and Bifidobacterium, which have been shown to modulate chronic inflammation. We also found Eubacterium halii, a lactate-utilizing species. Functionally, the microbiome of schizophrenia patients was characterized by an increased number of metabolic pathways related to metabolite transport systems including siderophores, glutamate, and vitamin B12. In contrast, carbohydrate and lipid pathways and energy metabolism were abundant in controls. These findings suggest that the oropharyngeal microbiome in individuals with schizophrenia is significantly different compared to controls, and that particular microbial species and metabolic pathways differentiate both groups. Confirmation of these findings in larger and more diverse samples, e.g., gut microbiome, will contribute to elucidating potential links between schizophrenia and the human microbiota.
Collapse
Affiliation(s)
- Eduardo Castro-Nallar
- Computational Biology Institute, George Washington University , Ashburn, VA , USA ; Center for Bioinformatics and Integrative Biology, Universidad Andrés Bello, Facultad de Ciencias Biológicas , Santiago , Chile
| | - Matthew L Bendall
- Computational Biology Institute, George Washington University , Ashburn, VA , USA
| | - Marcos Pérez-Losada
- Computational Biology Institute, George Washington University , Ashburn, VA , USA ; CIBIO-InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto , Vairão , USA ; Division of Emergency Medicine, Children's National Medical Center , Washington, D.C. , USA
| | - Sarven Sabuncyan
- Stanley Neurovirology Laboratory, Johns Hopkins School of Medicine , Baltimore, MD , USA
| | - Emily G Severance
- Stanley Neurovirology Laboratory, Johns Hopkins School of Medicine , Baltimore, MD , USA
| | | | | | - Robert H Yolken
- Stanley Neurovirology Laboratory, Johns Hopkins School of Medicine , Baltimore, MD , USA
| | - Keith A Crandall
- Computational Biology Institute, George Washington University , Ashburn, VA , USA
| |
Collapse
|
35
|
Roy MA, Achim AM, Vallières C, Labbé A, Mérette C, Maziade M, Demers MF, Bouchard RH. Comorbidity between anxiety disorders and recent-onset psychotic disorders. Schizophr Res 2015; 166:353-4. [PMID: 26004685 DOI: 10.1016/j.schres.2015.04.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 04/22/2015] [Accepted: 04/29/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Marc-André Roy
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, chemin de la Canardière (F-4500), Québec, Québec G1J 2G3, Canada; Département de psychiatrie et de neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine, Québec, Québec G1V 0A6, Canada; Clinique Notre-Dame-des-Victoires, 2525, De la Canardière (A1-2), Québec, PQ G1J 2G3, Canada.
| | - Amélie M Achim
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, chemin de la Canardière (F-4500), Québec, Québec G1J 2G3, Canada; Département de psychiatrie et de neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine, Québec, Québec G1V 0A6, Canada
| | - Chantal Vallières
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, chemin de la Canardière (F-4500), Québec, Québec G1J 2G3, Canada; Clinique Notre-Dame-des-Victoires, 2525, De la Canardière (A1-2), Québec, PQ G1J 2G3, Canada
| | - Annie Labbé
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, chemin de la Canardière (F-4500), Québec, Québec G1J 2G3, Canada
| | - Chantal Mérette
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, chemin de la Canardière (F-4500), Québec, Québec G1J 2G3, Canada; Département de psychiatrie et de neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine, Québec, Québec G1V 0A6, Canada
| | - Michel Maziade
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, chemin de la Canardière (F-4500), Québec, Québec G1J 2G3, Canada; Département de psychiatrie et de neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine, Québec, Québec G1V 0A6, Canada
| | - Marie-France Demers
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, chemin de la Canardière (F-4500), Québec, Québec G1J 2G3, Canada; Clinique Notre-Dame-des-Victoires, 2525, De la Canardière (A1-2), Québec, PQ G1J 2G3, Canada
| | - Roch-Hugo Bouchard
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, chemin de la Canardière (F-4500), Québec, Québec G1J 2G3, Canada; Département de psychiatrie et de neurosciences, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine, Québec, Québec G1V 0A6, Canada; Clinique Notre-Dame-des-Victoires, 2525, De la Canardière (A1-2), Québec, PQ G1J 2G3, Canada
| |
Collapse
|
36
|
Achim AM, Fossard M, Couture S, Achim A. Adjustment of speaker's referential expressions to an addressee's likely knowledge and link with theory of mind abilities. Front Psychol 2015; 6:823. [PMID: 26136711 PMCID: PMC4469820 DOI: 10.3389/fpsyg.2015.00823] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 05/30/2015] [Indexed: 11/13/2022] Open
Abstract
To communicate cooperatively, speakers must determine what constitutes the common ground with their addressee and adapt their referential choices accordingly. Assessing another person's knowledge requires a social cognition ability termed theory of mind (ToM). This study relies on a novel referential communication task requiring probabilistic inferences of the knowledge already held by an addressee prior to the study. Forty participants were asked to present 10 movie characters and the addressee, who had the same characters in a random order, was asked to place them in order. ToM and other aspects of social cognition were also assessed. Participants used more information when presenting likely unknown than likely known movie characters. They particularly increased their use of physical descriptors, which most often accompanied movie-related information. Interestingly, a significant relationship emerged between our ToM test and the increased amount of information given for the likely unknown characters. These results suggest that speakers use ToM to infer their addressee's likely knowledge and accordingly adapt their referential expressions.
Collapse
Affiliation(s)
- Amélie M Achim
- Département de Psychiatrie et de Neurosciences, Université Laval, Québec, QC Canada ; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC Canada
| | - Marion Fossard
- Institut des Sciences du Langage et de la Communication, Université de Neuchâtel, Neuchâtel Switzerland
| | - Sophie Couture
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC Canada ; École de Psychologie, Université Laval, Québec, QC Canada
| | - André Achim
- Département de Psychologie, Université du Québec à Montréal, Montreal, QC Canada
| |
Collapse
|
37
|
Sutliff S, Roy MA, Achim AM. Social anxiety disorder in recent onset schizophrenia spectrum disorders: The relation with symptomatology, anxiety, and social rank. Psychiatry Res 2015; 227:39-45. [PMID: 25818255 DOI: 10.1016/j.psychres.2015.02.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 01/02/2015] [Accepted: 02/19/2015] [Indexed: 01/08/2023]
Abstract
Social anxiety disorder (SAD) represents a common comorbidity in schizophrenia, but questions remain regarding how this comorbidity is related to symptomatology and self-perceptions. Forty-two patients with recent-onset schizophrenia were evaluated for SAD, and assessed with the Positive and Negative Syndrome Scale (PANSS), as well as the Social Comparison Scale (SCS), which assessed how participants perceived themselves in relation with others (i.e., social rank). Eighteen patients met criteria for SAD (SZ+) while 24 patients did not (SZ-). Analysis of symptoms using a five-factor model of the PANSS revealed that the SZ- group had more severe symptoms than SZ+ on the Cognitive/Disorganization factor. Further analyses of individual symptoms demonstrated that the SZ- group was more affected in attention, abstract thinking, and cognitive disorganization (Cognitive/Disorganization symptoms), while the SZ+ group was more severely affected in anxiety, suspiciousness/persecution, and active social avoidance. Interestingly, severity of social anxiety symptom ratings correlated with certain PANSS symptoms only in the SZ- group. Perception of social rank, which was reduced in SZ+, displayed a trend level correlation with the positive symptoms in SZ-. Overall, the results suggest that SZ+ and SZ- may have different clinical profiles that could be important to consider when tailoring treatments for these patients.
Collapse
Affiliation(s)
- Stephanie Sutliff
- Département de Psychiatrie et neurosciences, Université Laval, Centre de Recherche de l׳Institut Universitaire en Santé Mentale de Québec, Canada, 2601 Chemin de la Canardière, Québec, QC G1J 2G3
| | - Marc-André Roy
- Département de Psychiatrie et neurosciences, Université Laval, Centre de Recherche de l׳Institut Universitaire en Santé Mentale de Québec, Canada, 2601 Chemin de la Canardière, Québec, QC G1J 2G3
| | - Amélie M Achim
- Département de Psychiatrie et neurosciences, Université Laval, Centre de Recherche de l׳Institut Universitaire en Santé Mentale de Québec, Canada, 2601 Chemin de la Canardière, Québec, QC G1J 2G3.
| |
Collapse
|
38
|
Emotional perception and theory of mind in first episode psychosis: the role of obsessive-compulsive symptomatology. Psychiatry Res 2014; 220:112-7. [PMID: 25130778 DOI: 10.1016/j.psychres.2014.07.058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 07/12/2014] [Accepted: 07/24/2014] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to investigate the effects of comorbid obsessive-compulsive symptoms on emotional perception and theory of mind (ToM) in patients with first-episode psychosis. Participants were 65 patients with non-affective first episode psychosis (FEP) and 47 healthy controls. The patient group was divided into two subgroups, those with (FEP+; n=38) and those without obsessive-compulsive symptomatology (FEP-; n=27). Emotion perception and ToM were assessed with the Perception of Social Inference Test. Severity of psychotic and obsessive-compulsive symptoms was assessed with the Positive and Negative Syndrome Scale (PANSS) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), respectively. Deficits in emotion recognition and theory of mind were confirmed in patients with non-affective first-episode psychosis compared to healthy controls. In patients, comorbidity with obsessive-compulsive symptoms was associated with worse performance on certain aspects of social cognition (ToM 2nd order) compared to FEP- patients. Our findings of impaired emotion perception and ToM in patients with first-episode psychosis support the hypothesis that deficits are already present at illness onset. Presence of OCS appears to have further deleterious effects on social cognition, suggesting that these patients may belong to a schizo-obsessive subtype of schizophrenia characterized by more extensive neurobiological impairment.
Collapse
|
39
|
Premkumar P, Onwumere J, Wilson D, Sumich A, Castro A, Kumari V, Kuipers E. Greater positive schizotypy relates to reduced N100 activity during rejection scenes. Neuropsychologia 2014; 61:280-90. [PMID: 25010933 DOI: 10.1016/j.neuropsychologia.2014.06.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/06/2014] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Abstract
Social anxiety due to rejection sensitivity (RS) exacerbates psychosis-like experiences in the general population. While reduced dorsal anterior cingulate cortex (dACC) activity during social rejection in high schizotypy has suggested self-distancing from rejection, earlier stages of mental processing such as feature encoding could also contribute to psychosis-like experiences. This study aimed to determine the stage of mental processing of social rejection that relates to positive schizotypy. Forty-one healthy participants were assessed for schizotypy and RS. Event-related potential amplitudes (ERPs) were measured at frontal, temporal and parieto-occipital sites and their cortical sources (dACC, temporal pole and lingual gyrus) at early (N100) and late (P300 and late slow wave, LSW) timeframes during rejection, acceptance and neutral scenes. ERPs were compared between social interaction types. Correlations were performed between positive schizotypy (defined as the presence of perceptual aberrations, hallucinatory experiences and magical thinking), RS and ERPs during rejection. Amplitude was greater during rejection than acceptance or neutral conditions at the dACC-P300, parieto-occipital-P300, dACC-LSW and frontal-LSW. RS correlated positively with positive schizotypy. Reduced dACC N100 activity during rejection correlated with greater positive schizotypy and RS. Reduced dACC N100 activity and greater RS independently predicted positive schizotypy. An N100 deficit that indicates reduced feature encoding of rejection scenes increases with greater positive schizotypy and RS. Higher RS shows that a greater tendency to misattribute ambiguous social situations as rejecting also increases with positive schizotypy. These two processes, namely primary bottom-up sensory processing and secondary misattribution of rejection, combine to increase psychosis-like experiences.
Collapse
Affiliation(s)
- Preethi Premkumar
- Division of Psychology, School of Social Sciences, Nottingham Trent University, Burton Street, Nottingham NG1 4BU, UK.
| | - Juliana Onwumere
- King׳s College London, Department of Psychology, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - Daniel Wilson
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Alexander Sumich
- Division of Psychology, School of Social Sciences, Nottingham Trent University, Burton Street, Nottingham NG1 4BU, UK
| | - Antonio Castro
- Division of Psychology, School of Social Sciences, Nottingham Trent University, Burton Street, Nottingham NG1 4BU, UK
| | - Veena Kumari
- King׳s College London, Department of Psychology, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - Elizabeth Kuipers
- King׳s College London, Department of Psychology, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
40
|
Valeiras B, Rosato Siri MV, Codagnone M, Reinés A, Pasquini JM. Gender influence on schizophrenia-relevant abnormalities in a cuprizone demyelination model. Glia 2014; 62:1629-44. [PMID: 24890315 DOI: 10.1002/glia.22704] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 05/08/2014] [Accepted: 05/19/2014] [Indexed: 11/08/2022]
Abstract
The aim of this study was to determine whether early demyelination can impact behavior in young adulthood. For this purpose, albino Wistar rats of either sex were exposed to cuprizone (CPZ) in two different intoxication protocols: one group was intoxicated before weaning (CPZ-BW), from postnatal day 7 (P7) to P21, through maternal milk, whereas the other group was intoxicated after weaning (CPZ-AW), from P21 to P35. After treatment, rats were returned to a normal diet until P90 when behavioral studies were performed. Both treatments produced marked demyelination in the corpus callosum and retraction of cortical myelin fibers. The subsequent normal diet allowed for effective remyelination at P90. Interestingly, CPZ-AW correlated with significant behavioral and neurochemical changes in a gender-dependent manner. CPZ-AW treatment altered both the number of social activities and the latency to the first social interaction in males, while also highly compromising recognition-related activities. In addition, only P90 males treated AW showed a hyperdopaminergic striatum, confirmed by an increase in tyrosine hydroxylase expression and in dopamine levels. Our results suggest that the timing of demyelination significantly influences the development of altered behavior, particularly in adult males.
Collapse
Affiliation(s)
- Brenda Valeiras
- Department of Biological Chemistry, IQUIFIB, School of Pharmacy and Biochemistry, University of Buenos Aires, CONICET, Buenos Aires, Argentina
| | | | | | | | | |
Collapse
|
41
|
Vodušek VV, Parnas J, Tomori M, Škodlar B. The phenomenology of emotion experience in first-episode psychosis. Psychopathology 2014; 47:252-60. [PMID: 24481376 DOI: 10.1159/000357759] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 12/05/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although it has been suggested that disturbances in emotion experience and regulation play a central role in the aetiology and psychopathology of schizophrenia spectrum disorders, the phenomenology of emotion experience in schizophrenia remains under-researched. SAMPLING AND METHODS In-depth interviews were conducted twice with each of the 20 participants (firstly at admission and secondly 6 months later). Data collection and analysis were guided by the principles of phenomenological study of lived experience. RESULTS The emotion experiences described by our participants vary greatly in both quality and intensity, but appear to have a common phenomenology. Anxiety is reported as the basic emotion which buffers, transforms and sometimes supplants all others. Emotions in general are experienced as foreign, unstable and perturbing, thereby contributing greatly to feelings of ambivalence, perplexity and an unstable sense of self in general. CONCLUSIONS The findings of this study have important therapeutic and theoretical implications because they suggest that emotion experiences in schizophrenia spectrum disorders may underlie a wide range of psychopathological phenomena in both the cognitive and social functioning domains. Due to the relatively small sample size and its selection from psychotherapeutic units, the results may not be generalizable to all schizophrenia patients.
Collapse
Affiliation(s)
- V V Vodušek
- University Psychiatric Hospital Ljubljana, Ljubljana, Slovenia
| | | | | | | |
Collapse
|