1
|
Pousa E, Brébion G, López-Carrilero R, Ruiz AI, Grasa E, Barajas A, Cobo J, Gutiérrez-Zotes A, Lorente E, Barrigón ML, Ruiz-Delgado I, González-Higueras F, Frigola-Capell E, Ochoa S. Predictors of clinical insight in first-episode psychosis: Different patterns in men and women. Psychiatry Res 2024; 339:116036. [PMID: 38964140 DOI: 10.1016/j.psychres.2024.116036] [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: 01/23/2024] [Revised: 04/11/2024] [Accepted: 06/13/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND We aimed to explore gender-related differences in the associations of insight impairment with clinical symptoms, metacognition, and social cognition in psychosis. METHODS Regression analysis of several clinical insight dimensions was conducted on the data from 116 men and 56 women with first-episode psychosis. Various clinical symptoms and measures of metacognition and social cognition were entered as predictors. RESULTS In both men and women, delusions emerged as a strong predictor of all insight dimensions, and verbal hallucinations as a strong predictor of symptom relabelling. In men, certain negative symptoms as well as self-certainty, lack of self-reflectiveness, impaired theory of mind, attributional biases, and a jumping-to-conclusions bias were additional predictors of poor insight, while good insight was associated with depression, anxiety, avolition, blunted affect, and impaired emotional recognition. In women, poor insight was associated with a self-serving/externalising bias, impaired emotional recognition, and attention disorders. CONCLUSIONS Poor insight in first-episode psychosis is strongly linked to deficits in metacognition and social cognition, with marked differences between men and women with respect to the specific skills involved in the impairment. Meanwhile, good insight is linked to a variety of affective manifestations in men. These findings suggest new avenues for more targeted cognitive interventions to improve clinical insight in psychosis.
Collapse
Affiliation(s)
- Esther Pousa
- Department of Psychiatry, Hospital de La Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | | | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; MERITT, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Ada I Ruiz
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eva Grasa
- Department of Psychiatry, Hospital de La Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Ana Barajas
- Department of Research, Centre D'Higiene Mental Les Corts, Barcelona, Spain, Serra Húnter Programme, Government of Catalonia, Spain, Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Jesus Cobo
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Mental Health Department, Corporació Sanitaria Parc Tauli, Universitat Autònoma de Barcelona- Institutd'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Barcelona, Spain
| | - Alfonso Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain, University of Rovira i Virgili, Tarragona, Spain
| | - Ester Lorente
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Psychiatry Service, Hospital Clinico Universitario, Valencia, Spain
| | - María Luisa Barrigón
- Department of Psychiatry, IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain, Universidad Autonoma de Madrid, Madrid, Spain
| | | | | | - Eva Frigola-Capell
- Mental Health & Addiction Research Group, Fundació Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Institut d'Assistencia Sanitària, Girona, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; MERITT, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| |
Collapse
|
2
|
Mezquida G, Amoretti S, Bioque M, García-Rizo C, Sánchez-Torres AM, Pina-Camacho L, Lopez-Pena P, Mané A, Rodriguez-Jimenez R, Corripio I, Sarró S, Ibañez A, Usall J, García-Portilla MP, Vieta E, Mas S, Cuesta MJ, Parellada M, González-Pinto A, Berrocoso E, Bernardo M. Identifying risk factors for predominant negative symptoms from early stages in schizophrenia: A longitudinal and sex-specific study in first-episode schizophrenia patients. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:159-168. [PMID: 37716849 DOI: 10.1016/j.rpsm.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND People with schizophrenia and predominant negative symptoms (PNS) present a different clinical and functional profile from those without such symptomatology. Few studies have examined the risk factors and the incidence of PNS in first-episode schizophrenia patients (FES) and differentiating by sex. This study aims to assess prevalence, demographic and clinical characteristics related to PNS from early stages and to study if there are sex-specific features in terms of developing PNS. METHODS In a sample of 121 FES patients derived from a multicentre and naturalistic study, those who developed PNS at 12-months were identified. Environmental, clinical, functional, and cognitive ratings were examined longitudinally. Binary logistic regressions were applied to detect baseline risk factors for developing PNS at one-year follow-up. RESULTS In the present FES cohort, 24.8% of the patients (n=30) developed PNS (20% of the women, 27.6% of the men). Compared to non-PNS (75.2%, n=91), at baseline, PNS group had more negative (t=-6.347; p<0.001) and depressive symptoms (t=-5.026; p<0.001), poorer premorbid adjustment (t=-2.791; p=0.006) and functional outcome (t=-2.649; p<0.001), more amotivation (t=-7.333; p<0.001), more expressivity alterations (t=-4.417; p<0.001), worse cognitive reserve (t=2.581; p<0.011), a lower estimated intelligent quotient (t=2.417; p=0.017), worse verbal memory (t=2.608; p=0.011), and worse fluency (t=2.614; p=0.010). Regressions showed that the premorbid adjustment was the main predictor of PNS in females (p=0.007; Exp(B)=1.106) while in males were a worse verbal memory performance (p=0.031; Exp(B)=0.989) and more alterations in the motivation domain (p=0.001; Exp(B)=1.607). CONCLUSIONS A different baseline clinical profile and notable risk factors differences in the development of PNS between males and females were found. Results suggest that sex may be an important confounder in studies comparing schizophrenia patients with predominant and non-predominant negative symptomatology.
Collapse
Affiliation(s)
- Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain.
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Laura Pina-Camacho
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Purificación Lopez-Pena
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Universidad del País Vasco/Euskal Herriko Unibertsitatea, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain
| | - Anna Mané
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Hospital del Mar Medical Research Institute, Barcelona, Spain; Fundació Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Roberto Rodriguez-Jimenez
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CogPsy Group, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Salvador Sarró
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Angela Ibañez
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Judith Usall
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - María Paz García-Portilla
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, University of Oviedo; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA; Instituto de Neurociencias del Principado de Asturias (INEUROPA; Servicio de Psiquiatría, Oviedo, SESPA, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Sergi Mas
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Mara Parellada
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Universidad del País Vasco/Euskal Herriko Unibertsitatea, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain
| | - Esther Berrocoso
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| |
Collapse
|
3
|
Seitz-Holland J, Wojcik JD, Cetin-Karayumak S, Lyall AE, Pasternak O, Rathi Y, Vangel M, Pearlson G, Tamminga C, Sweeney JA, Clementz BA, Schretlen DA, Viher PV, Stegmayer K, Walther S, Lee J, Crow T, James A, Voineskos A, Buchanan RW, Szeszko PR, Malhotra AK, Kelly S, Shenton ME, Keshavan MS, Mesholam-Gately RI, Kubicki M. Cognitive deficits, clinical variables, and white matter microstructure in schizophrenia: a multisite harmonization study. Mol Psychiatry 2022; 27:3719-3730. [PMID: 35982257 PMCID: PMC10538303 DOI: 10.1038/s41380-022-01731-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 02/08/2023]
Abstract
Cognitive deficits are among the best predictors of real-world functioning in schizophrenia. However, our understanding of how cognitive deficits relate to neuropathology and clinical presentation over the disease lifespan is limited. Here, we combine multi-site, harmonized cognitive, imaging, demographic, and clinical data from over 900 individuals to characterize a) cognitive deficits across the schizophrenia lifespan and b) the association between cognitive deficits, clinical presentation, and white matter (WM) microstructure. Multimodal harmonization was accomplished using T-scores for cognitive data, previously reported standardization methods for demographic and clinical data, and an established harmonization method for imaging data. We applied t-tests and correlation analysis to describe cognitive deficits in individuals with schizophrenia. We then calculated whole-brain WM fractional anisotropy (FA) and utilized regression-mediation analyses to model the association between diagnosis, FA, and cognitive deficits. We observed pronounced cognitive deficits in individuals with schizophrenia (p < 0.006), associated with more positive symptoms and medication dosage. Regression-mediation analyses showed that WM microstructure mediated the association between schizophrenia and language/processing speed/working memory/non-verbal memory. In addition, processing speed mediated the influence of diagnosis and WM microstructure on the other cognitive domains. Our study highlights the critical role of cognitive deficits in schizophrenia. We further show that WM is crucial when trying to understand the role of cognitive deficits, given that it explains the association between schizophrenia and cognitive deficits (directly and via processing speed).
Collapse
Affiliation(s)
- Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Joanne D Wojcik
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Suheyla Cetin-Karayumak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Amanda E Lyall
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Carol Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brett A Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA, USA
| | - David A Schretlen
- Department of Psychiatry and Behavioral Sciences, Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Petra Verena Viher
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jungsun Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Tim Crow
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Anthony James
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Aristotle Voineskos
- Center for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, NY, USA
| | - Anil K Malhotra
- The Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Sinead Kelly
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Raquelle I Mesholam-Gately
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
4
|
Zhang J, Yang H, Li W, Li Y, Qin J, He L. Automatic Schizophrenia Detection Using Multimodality Media via a Text Reading Task. Front Neurosci 2022; 16:933049. [PMID: 35911987 PMCID: PMC9331283 DOI: 10.3389/fnins.2022.933049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Schizophrenia is a crippling chronic mental disease that affects people worldwide. In this work, an automatic schizophrenia detection algorithm is proposed based on the reading deficit of schizophrenic patients. From speech and video modalities, the automatic schizophrenia detection algorithm illustrates abnormal speech, head movement, and reading fluency during the reading task. In the speech modality, an acoustic model of speech emotional flatness in schizophrenia is established to reflect the emotional expression flatness of schizophrenic speech from the perspective of speech production and perception. In the video modality, the head-movement-related features are proposed to illustrate the spontaneous head movement caused by repeated reading and unconscious movement, and the reading-fluency-related features are proposed to convey the damaged degree of schizophrenic patients' reading fluency. The experimental data of this work are 160 segments of speech and video data recorded by 40 participants (20 schizophrenic patients and 20 normal controls). Combined with support vector machines and random forest, the accuracy of the proposed acoustic model, the head-movement-related features, and the reading-fluency-related features range from 94.38 to 96.50%, 73.38 to 83.38%, and 79.50 to 83.63%, respectively. The average accuracy of the proposed automatic schizophrenia detection algorithm reaches 97.50%. The experimental results indicate the effectiveness of the proposed automatic detection algorithm as an auxiliary diagnostic method for schizophrenia.
Collapse
Affiliation(s)
- Jing Zhang
- College of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Hui Yang
- College of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Wen Li
- College of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Yuanyuan Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Qin
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Ling He
- College of Biomedical Engineering, Sichuan University, Chengdu, China
- *Correspondence: Ling He
| |
Collapse
|
5
|
Brébion G, Núñez C, Lombardini F, Senior C, Sánchez Laforga AM, Siddi S, Usall J, Stephan-Otto C. Subclinical depression and anxiety impact verbal memory functioning differently in men and women -an fMRI study. J Psychiatr Res 2021; 140:308-315. [PMID: 34126425 DOI: 10.1016/j.jpsychires.2021.05.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 05/05/2021] [Accepted: 05/21/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Depressive symptoms are known to affect memory efficiency in various populations. More specifically, several studies conducted in patients suffering from schizophrenia have indicated that memory efficiency is affected by depressed mood in female patients and by anxiety in male patients. We investigated, using neuroimaging techniques, whether similar gender-specific associations with subclinical depression and anxiety could be observed in a non-clinical sample. METHOD Forty-five healthy Spanish-speaking individuals (23 females) were administered a verbal memory task. Lists of high- and low-frequency words were presented. Immediate free recall was requested after the learning of each list, and a yes/no recognition task was completed during the acquisition of the fMRI data. RESULTS Regression analyses revealed that higher depression scores in women, and higher anxiety scores in men, were associated with poorer recall. In women, higher depression scores were further associated with decreased cerebral activity in the right temporoparietal junction, left inferior occipitotemporal gyrus, bilateral thalamus, and left anterior cingulate during correct recognition of target words. In men, anxiety scores were not associated with any cerebral activity. CONCLUSIONS Subclinical depression in women appears to affect memory efficiency by impacting cerebral regions specifically recruited for the cognitive demands of the task, as well as cerebral regions more generally involved in arousal, decision-making, and emotional regulation. Anxiety in men might impact the encoding memory processes. The results, although preliminary, suggest that gender differences may need to be taken into account when developing strategies for the cognitive and pharmacological remediation of memory impairment.
Collapse
Affiliation(s)
- Gildas Brébion
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Christian Núñez
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | | | - Carl Senior
- School of Life & Health Sciences, Aston University, Birmingham, UK; University of Gibraltar, Gibraltar
| | | | - Sara Siddi
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Judith Usall
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Christian Stephan-Otto
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| |
Collapse
|
6
|
Lindgren M, Birling H, Kieseppä T, Tuulio-Henriksson A. Is cognitive performance associated with anxiety and depression in first-episode psychosis? J Affect Disord 2020; 263:221-227. [PMID: 31818780 DOI: 10.1016/j.jad.2019.11.161] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 11/01/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND In first-episode psychosis (FEP), symptoms of anxiety and depression are common. We examined whether cognitive performance is associated with these clinical measures in FEP during a one-year follow-up. METHODS Young adults with non-affective FEP (n = 52) were assessed two months after their first psychiatric contact for psychosis. Matched controls (n = 62) were administered a baseline assessment. 32 FEP subjects and 44 controls were assessed again at a one-year follow-up. In both assessments, a broad neuropsychological test battery was administered. Clinical evaluation was done with the Brief Psychiatric Rating Scale. Cross-sectional correlations were calculated at both time points. Cognitive test scores were used as independent variables in regression models, predicting both baseline and follow-up symptom levels. RESULTS At baseline, better performance especially in verbal memory and executive functioning was associated with elevated anxiety symptoms in FEP. In addition, better performance especially in verbal working memory was associated with depression. A year later, better cognitive performance was no longer associated with affective symptoms. LIMITATIONS Small sample sizes are a limitation. CONCLUSIONS In the FEP group, higher cognitive performance associated with affective symptoms. Right after getting severely ill, anxiety and depression may be a part of normal adaptive reactions to the situation and markers of an intact cognitive performance. This association seems to cease during the year following the FEP.
Collapse
Affiliation(s)
- Maija Lindgren
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), PO Box 30, FIN-00271Helsinki, Finland.
| | - Heli Birling
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Tuula Kieseppä
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), PO Box 30, FIN-00271Helsinki, Finland; Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Finland
| | | |
Collapse
|
7
|
Lindgren M, Holm M, Kieseppä T, Suvisaari J. Neurocognition and Social Cognition Predicting 1-Year Outcomes in First-Episode Psychosis. Front Psychiatry 2020; 11:603933. [PMID: 33343430 PMCID: PMC7746550 DOI: 10.3389/fpsyt.2020.603933] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/12/2020] [Indexed: 12/22/2022] Open
Abstract
Cognitive performance at illness onset may predict outcomes in first-episode psychosis (FEP), and the change in cognition may associate with clinical changes. Cognitive testing was administered to 54 FEP participants 2 months after entering treatment and to 39 participants after 1 year. We investigated whether baseline cognition predicted 1-year outcomes beyond positive, negative, and affective symptoms and whether the trajectory of cognition associated with clinical change. Baseline overall neurocognitive performance predicted the 1-year social and occupational level, occupational status, and maintaining of life goals. The domain of processing speed associated with the 1-year remission, occupational status, and maintaining of life goals. Baseline social cognition associated with occupational status a year later and the need for hospital treatment during the 1st year after FEP. Most of the associations were retained beyond baseline positive and affective symptom levels, but when accounting for negative symptoms, cognition no longer predicted 1-year outcomes, highlighting how negative symptoms overlap with cognition. The trajectory of neurocognitive performance over the year did not associate with changes in symptoms or functioning. Cognitive testing at the beginning of treatment provided information on the 1-year outcome in FEP beyond positive and affective symptom levels. In particular, the domains of processing speed and social cognition could be targets for interventions that aim to improve the outcome after FEP.
Collapse
Affiliation(s)
- Maija Lindgren
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Minna Holm
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| |
Collapse
|
8
|
Pu C, Qiu Y, Zhou T, Yang F, Lu Z, Wang C, Deng H, Zhao J, Shi C, Yu X. Gender differences of neurocognitive functioning in patients with first-episode schizophrenia in China. Compr Psychiatry 2019; 95:152132. [PMID: 31669790 DOI: 10.1016/j.comppsych.2019.152132] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/16/2019] [Accepted: 09/23/2019] [Indexed: 02/05/2023] Open
Abstract
AIMS To investigate the gender differences in neurocognitive functioning in patients with first-episode schizophrenia (FES) in China. METHODS A total of 449 Chinese patients with FES (210 males, 239 females) were included in this study. Participants' psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Neurocognitive functioning was assessed by 10 neuropsychological tests from a battery. Neurocognitive test scores were converted to scale scores and t-scores using normative data from Chinese populations. RESULTS Males were younger and less likely to be married, had an earlier age of illness onset and a longer duration of untreated psychosis (DUP), and scored higher on the PANSS negative, general and total scales than females. After controlling for potential confounders, females performed better than males in the verbal learning and memory domain (p=0.016). While most neurocognitive domains were correlated with PANSS negative scores for male patients with FES, for female patients with FES, negative associations were found between scores on the PANSS general subscales and neurocognitive domains. We also performed a case-control comparison with a group of patients with clinically stable schizophrenia (CSS) (n=60) who were matched by age, sex and education years with patients with FES (n=58). After controlling for potential confounders, no significant differences were found between patients with FES and patients with CSS in all neurocognitive domains. Female patients still performed better in the verbal learning and memory domain (t=2.14, p=0.034). No interaction effects of gender and disease were found. CONCLUSIONS Gender was an independent influence factor for the verbal learning and memory domain. Both female patients with first-episode schizophrenia and female patients with clinically stable schizophrenia performed better than male patients.
Collapse
Affiliation(s)
- Chengcheng Pu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China
| | - Yujia Qiu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China
| | - Tianhang Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China
| | - Fude Yang
- Beijing Hui-Long-Guan Hospital, Beijing, China
| | - Zheng Lu
- Tongji Hospital of Tongji University, Shanghai, China
| | - Chuanyue Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Hong Deng
- West China Hospital, Sichuan University, Chengdu, China
| | - Jingping Zhao
- Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Chuan Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China.
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China.
| |
Collapse
|
9
|
Brébion G, Stephan-Otto C, Ochoa S, Cuevas-Esteban J, Núñez-Navarro A, Usall J. Clinical and non-clinical hallucinations are similarly associated with source memory errors in a visual memory task. Conscious Cogn 2019; 76:102823. [PMID: 31586672 DOI: 10.1016/j.concog.2019.102823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/24/2019] [Accepted: 09/14/2019] [Indexed: 01/13/2023]
Abstract
Hallucinations have been found to be associated with various types of source memory failure in both schizophrenia patients and hallucination-prone healthy individuals. We investigated the associations of clinical and non-clinical hallucinations with source memory errors in a visual memory task that involved the remembering of picture presentation context. 59 schizophrenia patients and 61 healthy individuals took part in the study. Pictures were presented either at different locations or in association with different visual stimuli. The participants were required afterwards to recognize the target pictures among distractors, and then to remember their spatial location or the visual stimulus that was associated with them. Liberal response bias in picture recognition was associated with hallucination proneness and auditory-verbal hallucinations in subsamples of participants with significant non-clinical or clinical hallucinations. After controlling for overall memory performance, failure to remember the spatial location of the pictures was associated with visual hallucinations in male patients; failure to remember the associated visual stimulus was related to auditory-verbal hallucinations in female patients and to hallucination proneness in healthy women. The findings suggest that both clinical and non-clinical hallucinations are associated with loss of contextual information relative to the acquisition of events.
Collapse
Affiliation(s)
- Gildas Brébion
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Christian Stephan-Otto
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Susana Ochoa
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jorge Cuevas-Esteban
- Servei de Psiquiatria, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Araceli Núñez-Navarro
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Judith Usall
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| |
Collapse
|
10
|
Siddi S, Nuñez C, Senior C, Preti A, Cuevas-Esteban J, Ochoa S, Brébion G, Stephan-Otto C. Depression, auditory-verbal hallucinations, and delusions in patients with schizophrenia: Different patterns of association with prefrontal gray and white matter volume. Psychiatry Res Neuroimaging 2019; 283:55-63. [PMID: 30544051 DOI: 10.1016/j.pscychresns.2018.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/06/2018] [Accepted: 12/03/2018] [Indexed: 12/15/2022]
Abstract
Structural brain abnormalities, including decreased gray matter (GM) and white matter (WM) volume, have been observed in patients with schizophrenia. These decrements were found to be associated with positive and negative symptoms, but affective symptoms (depression and anxiety) were poorly explored. We hypothesized that abnormalities in GM and WM volume might also be related to affective symptoms. GM and WM volumes were calculated from high-resolution T1 structural images acquired from 24 patients with schizophrenia and 26 healthy controls, and the associations of positive, negative, and affective symptoms with the brain volumes that showed significant reduction in patients were investigated. Patients demonstrated GM volume reductions in the bilateral prefrontal cortex, and WM volume reductions in the right frontal and left corpus callosum. Prefrontal cortex volume was significantly and inversely associated with both auditory-verbal hallucinations and depression severity. WM volume alterations, in contrast, were related to alogia, anhedonia, and delusions. The combined impact of auditory-verbal hallucinations and depression on similar sub-regions of the prefrontal cortex suggests that depression is involved in hearing voices. Further, this adverse impact of depression on prefrontal GM volume may underlie the impairment demonstrated by these patients in cognitive tasks that rely on executive processes.
Collapse
Affiliation(s)
- Sara Siddi
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy.
| | - Christian Nuñez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Carl Senior
- School of Life & Health Sciences, Aston University, Birmingham, UK
| | - Antonio Preti
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy; Center of Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy
| | - Jorge Cuevas-Esteban
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain; Servei de Psiquiatria, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Gildas Brébion
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Christian Stephan-Otto
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| |
Collapse
|
11
|
Gender differences measured by the MATRICS consensus cognitive battery in chronic schizophrenia patients. Sci Rep 2017; 7:11821. [PMID: 28928440 PMCID: PMC5605539 DOI: 10.1038/s41598-017-12027-w] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 09/01/2017] [Indexed: 11/08/2022] Open
Abstract
Using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), previous study showed significant gender differences for cognitive deficits in immediate and delayed memory in schizophrenia patients. However, RBANS does not include reasoning and problem solving, and social cognition. These cognitive functions can significantly affect the outcomes and daily life in patients. This study examined the gender differences of cognition using the measurement and treatment research to improve cognition in schizophrenia (MATRICS) consensus cognitive battery (MCCB), especially focusing on reasoning and problem solving, and social cognition in schizophrenia patients. The results showed that healthy controls exemplified better cognition than patients in both genders in all examined MCCB scores. Male healthy controls had better reasoning and problem solving and working memory than females, but these gender differences were not presented in schizophrenia patients. Also, male schizophrenia patients showed worse cognition than females on social cognition, processing speed, verbal learning and visual learning. Our results support that male schizophrenia patients had more cognitive impairment than females on reasoning and problem solving, social cognition, processing speed, working memory, verbal learning and visual learning.
Collapse
|
12
|
Grimes KM, Zanjani A, Zakzanis KK. Memory impairment and the mediating role of task difficulty in patients with schizophrenia. Psychiatry Clin Neurosci 2017; 71:600-611. [PMID: 28294468 DOI: 10.1111/pcn.12520] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 01/08/2017] [Accepted: 03/07/2017] [Indexed: 02/04/2023]
Abstract
Using meta-analytic methods, we sought to synthesize the research literature on memory impairment in schizophrenia. Additionally, we compared performances across memory measures to determine if task difficulty (e.g., effortful encoding and retrieval vs non-effortful encoding and retrieval) could account for variance across studies. Our primary measures of interest included the California Verbal Learning Test, Wechsler Memory Scale, Rey Auditory Verbal Learning Test, Hopkins Verbal Learning Test, Rey-Osterrieth Complex Figure Test, and the Benton Visual Retention Test. We searched for all studies that met inclusion criteria using PubMed, PsycINFO, Scholars Portal Search, and Google Scholar. Studies were included if: (i) they were published after 1980; (ii) healthy controls were compared to patients with schizophrenia; (iii) at least one of the noted measures of interest was employed in the primary study; and (iv) the primary study included data that could be transformed to point estimate effect sizes (i.e., Cohen's d). Cohen's d was calculated between patients and healthy controls, along with overall 95% confidence intervals. A two-tailed independent samples t-test was conducted to assess if performance differed on various paired subtests of the same domain. Large effect sizes were found for all memory tests. No significant differences were found between subtests. In conclusion, patients with schizophrenia experience significant verbal and visual memory impairments, which are not explained by task difficulty. Patients were unable to learn or retrieve more reliably despite repetition and cuing strategies, suggesting that memory impairment in the illness is not a function of task difficulty.
Collapse
Affiliation(s)
- Kyrsten M Grimes
- Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Canada
| | - Anosha Zanjani
- Graduate School of Architecture, Columbia University, New York, USA
| | | |
Collapse
|
13
|
Fonctions cognitives sous-jacentes aux déficits de fluence verbale dans la schizophrénie : revue de la littérature. ANNALES MEDICO-PSYCHOLOGIQUES 2017. [DOI: 10.1016/j.amp.2016.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
14
|
Brébion G, Stephan-Otto C, Ochoa S, Roca M, Nieto L, Usall J. Impaired Self-Monitoring of Inner Speech in Schizophrenia Patients with Verbal Hallucinations and in Non-clinical Individuals Prone to Hallucinations. Front Psychol 2016; 7:1381. [PMID: 27683568 PMCID: PMC5022329 DOI: 10.3389/fpsyg.2016.01381] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/30/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Previous research has shown that various memory errors reflecting failure in the self-monitoring of speech were associated with auditory/verbal hallucinations in schizophrenia patients and with proneness to hallucinations in non-clinical individuals. METHOD We administered to 57 schizophrenia patients and 60 healthy participants a verbal memory task involving free recall and recognition of lists of words with different structures (high-frequency, low-frequency, and semantically organisable words). Extra-list intrusions in free recall were tallied, and the response bias reflecting tendency to make false recognitions of non-presented words was computed for each list. RESULTS In the male patient subsample, extra-list intrusions were positively associated with verbal hallucinations and inversely associated with negative symptoms. In the healthy participants the extra-list intrusions were positively associated with proneness to hallucinations. A liberal response bias in the recognition of the high-frequency words was associated with verbal hallucinations in male patients and with proneness to hallucinations in healthy men. Meanwhile, a conservative response bias for these high-frequency words was associated with negative symptoms in male patients and with social anhedonia in healthy men. CONCLUSION Misattribution of inner speech to an external source, reflected by false recollection of familiar material, seems to underlie both clinical and non-clinical hallucinations. Further, both clinical and non-clinical negative symptoms may exert on verbal memory errors an effect opposite to that of hallucinations.
Collapse
Affiliation(s)
- Gildas Brébion
- Research and Development Unit, Parc Sanitari Sant Joan de Déu and Centro de Investigación Biomédica en Red de Salud Mental Barcelona, Spain
| | - Christian Stephan-Otto
- Research and Development Unit, Parc Sanitari Sant Joan de Déu and Centro de Investigación Biomédica en Red de Salud Mental Barcelona, Spain
| | - Susana Ochoa
- Research and Development Unit, Parc Sanitari Sant Joan de Déu and Centro de Investigación Biomédica en Red de Salud Mental Barcelona, Spain
| | - Mercedes Roca
- Research and Development Unit, Parc Sanitari Sant Joan de Déu and Centro de Investigación Biomédica en Red de Salud Mental Barcelona, Spain
| | - Lourdes Nieto
- Research and Development Unit, Parc Sanitari Sant Joan de Déu and Centro de Investigación Biomédica en Red de Salud Mental Barcelona, Spain
| | - Judith Usall
- Research and Development Unit, Parc Sanitari Sant Joan de Déu and Centro de Investigación Biomédica en Red de Salud Mental Barcelona, Spain
| |
Collapse
|
15
|
A systematic review comparing sex differences in cognitive function in schizophrenia and in rodent models for schizophrenia, implications for improved therapeutic strategies. Neurosci Biobehav Rev 2016; 68:979-1000. [DOI: 10.1016/j.neubiorev.2016.06.029] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 06/11/2016] [Accepted: 06/20/2016] [Indexed: 01/07/2023]
|
16
|
Neural activity during object perception in schizophrenia patients is associated with illness duration and affective symptoms. Schizophr Res 2016; 175:27-34. [PMID: 27130563 DOI: 10.1016/j.schres.2016.04.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 04/05/2016] [Accepted: 04/14/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Abnormalities in visual processes have been observed in schizophrenia patients and have been associated with alteration of the lateral occipital complex and visual cortex. However, the relationship of these abnormalities with clinical symptomatology is largely unknown. METHODS We investigated the brain activity associated with object perception in schizophrenia. Pictures of common objects were presented to 26 healthy participants (age=36.9; 11 females) and 20 schizophrenia patients (age=39.9; 8 females) in an fMRI study. RESULTS In the healthy sample the presentation of pictures yielded significant activation (pFWE (cluster)<0.001) of the bilateral fusiform gyrus, bilateral lingual gyrus, and bilateral middle occipital gyrus. In patients, the bilateral fusiform gyrus and bilateral lingual gyrus were significantly activated (pFWE (cluster)<0.001), but not so the middle occipital gyrus. However, significant bilateral activation of the middle occipital gyrus (pFWE (cluster)<0.05) was revealed when illness duration was controlled for. Depression was significantly associated with increased activation, and anxiety with decreased activation, of the right middle occipital gyrus and several other brain areas in the patient group. No association with positive or negative symptoms was revealed. CONCLUSIONS Illness duration accounts for the weak activation of the middle occipital gyrus in patients during picture presentation. Affective symptoms, but not positive or negative symptoms, influence the activation of the right middle occipital gyrus and other brain areas.
Collapse
|
17
|
Longitudinal change in neurocognition and its relation to symptomatic and functional changes over 2years in individuals at clinical high-risk for psychosis. Schizophr Res 2016; 174:50-57. [PMID: 27068568 DOI: 10.1016/j.schres.2016.03.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 03/16/2016] [Accepted: 03/24/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Negative symptoms and functional disability represent the core of schizophrenia and both are associated with cognitive impairments. We explored the course of cognitive change and its relation to symptomatic and functional changes in individuals at clinical high-risk (CHR) for psychosis to identify cognitive indicators of long-term course. Such attempts may offer insight into the pathological changes associated with the development of illness in the prodromal state. METHODS Forty-seven CHR individuals completed neurocognitive, clinical, and functional assessments at baseline and 2-year follow-up; twenty-eight healthy controls were assessed for neurocognitive and functional measures at baseline and 2-year follow-up. The delta values of CHR individuals in neurocognitive, clinical, and functional domains were determined from differences between baseline and follow-up scores to estimate the degree of change. RESULTS Although overall longitudinal cognitive performance of CHR individuals improved, the magnitude of improvement was not statistically different from that of normal controls at the group level. However, the individual data yielded two groups of CHR subjects showing opposite trajectories of cognitive change in semantic fluency (i.e., improvement or decline), which was significantly associated with changes in negative symptoms and functioning. Moreover, the relationships between negative symptoms and functioning were more strengthened over time than baseline. CONCLUSIONS Our findings show that semantic fluency seems to be a neurocognitive indicator reflecting clinical courses in CHR individuals. The longitudinal relationship of negative symptoms and functioning with semantic fluency may represent ongoing pathological processes in neural systems involving aberrant fronto-temporal interaction in the early phase of schizophrenia.
Collapse
|
18
|
Mendrek A, Mancini-Marïe A. Sex/gender differences in the brain and cognition in schizophrenia. Neurosci Biobehav Rev 2015; 67:57-78. [PMID: 26743859 DOI: 10.1016/j.neubiorev.2015.10.013] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/17/2015] [Accepted: 10/26/2015] [Indexed: 01/03/2023]
Abstract
The early conceptualizations of schizophrenia have noted some sex/gender differences in epidemiology and clinical expression of the disorder. Over the past few decades, the interest in differences between male and female patients has expanded to encompass brain morphology and neurocognitive function. Despite some variability and methodological shortcomings, a few patterns emerge from the available literature. Most studies of gross neuroanatomy show more enlarged ventricles and smaller frontal lobes in men than in women with schizophrenia; finding reflecting normal sexual dimorphism. In comparison, studies of brain asymmetry and specific corticolimbic structures, suggest a disturbance in normal sexual dimorphism. The neurocognitive findings are somewhat consistent with this picture. Studies of cognitive functions mediated by the lateral frontal network tend to show sex differences in patients which are in the same direction as those observed in the general population, whereas studies of processes mediated by the corticolimbic system more frequently reveal reversal of normal sexual dimorphisms. These trends are faint and future research would need to delineate neurocognitive differences between men and women with various subtypes of schizophrenia (e.g., early versus late onset), while taking into consideration hormonal status and gender of tested participants.
Collapse
Affiliation(s)
- Adrianna Mendrek
- Department of Psychology, Bishop's University, Sherbrooke, QC, Canada; Department of Psychiatry, Université de Montréal, Montreal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
| | - Adham Mancini-Marïe
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada; Department of Psychiatry, Centre neuchâtelois de psychiatrie, Neuchâtel, Suisse
| |
Collapse
|
19
|
Yu M, Tang X, Wang X, Zhang X, Zhang X, Sha W, Yao S, Shu N, Zhang X, Zhang Z. Neurocognitive Impairments in Deficit and Non-Deficit Schizophrenia and Their Relationships with Symptom Dimensions and Other Clinical Variables. PLoS One 2015; 10:e0138357. [PMID: 26381645 PMCID: PMC4575183 DOI: 10.1371/journal.pone.0138357] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 08/28/2015] [Indexed: 11/18/2022] Open
Abstract
Background Deficit schizophrenia (DS) has been proposed as a pathophysiologically distinct subgroup within schizophrenia. Earlier studies focusing on neurocognitive function of DS patients have yielded inconsistent findings ranging from substantial deficits to no significant difference relative to non-deficit schizophrenia patients (NDS). The present study investigated the severity and characteristic patterns of neurocognitive impairments in DS and NDS patients and their relationships with clinical variables. Methods Attention, ideation fluency, cognitive flexibility and visuospatial memory function were assessed in 40 DS patients, 57 NDS patients, and 52 healthy controls by a comprehensive neuropsychological battery. Results Both schizophrenia subgroups had overall more severe cognitive impairments than controls while DS performed worse on every neuropsychological measure except the Stroop interference than the NDS patients with age and education as the covariates. Profile analysis found significantly different patterns of cognitive profiles between two patients group mainly due to their differences in attention and cognitive flexibility functions. Age, education, illness duration and negative symptoms were found to have the correlations with cognitive impairments in the NDS group, while only age and the negative symptoms were correlated with the cognitive impairments in the DS group. Multiple regression analyses revealed that sustained attention and cognitive flexibility were the core impaired cognitive domains mediating other cognitive functions in DS and NDS patients respectively. Conclusions DS patients exemplified worse in almost all cognitive domains than NDS patients. Sustained attention and cognitive flexibility might be the key impaired cognitive domains for DS and NDS patients respectively. The present study suggested the DS as a specific subgroup of schizophrenia.
Collapse
Affiliation(s)
- Miao Yu
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - XiaoWei Tang
- Department of Psychiatry, Wutaishan Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - Xiang Wang
- Medical Psychological Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - XiangRong Zhang
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
- Department of Geriatric Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
- * E-mail: (XRZ); (ZJZ)
| | - XiaoBin Zhang
- Department of Psychiatry, Wutaishan Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - WeiWei Sha
- Department of Psychiatry, Wutaishan Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - ShuQiao Yao
- Medical Psychological Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ni Shu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - XiangYang Zhang
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, United States of America
| | - ZhiJun Zhang
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
- * E-mail: (XRZ); (ZJZ)
| |
Collapse
|
20
|
Tyburski E, Sokołowski A, Chęć M, Pełka-Wysiecka J, Samochowiec A. Neuropsychological characteristics of verbal and non-verbal fluency in schizophrenia patients. Arch Psychiatr Nurs 2015; 29:33-8. [PMID: 25634872 DOI: 10.1016/j.apnu.2014.09.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/16/2014] [Accepted: 09/30/2014] [Indexed: 11/17/2022]
Abstract
This review paper provides analyses confirming correlation between various brain regions activity, particularly its prefrontal portions, and schizophrenia patients' performance in verbal fluency tests. Various factors modifying patients' performance in the aforementioned tasks were singled out and discussed. Systematically we have reviewed the results of non-verbal fluency tests conducted in the schizophrenic patients. The authors also summarizes findings of earlier studies stressing the role of semantic fluency as a predictor of first-episode psychosis. Verbal and non-verbal fluency tests engage complex cognitive processes and executive functions in patients. As a result, the interpretation of their results is often complicated and requires special competences. The tests are popular neuropsychological tools used for assessment of verbal memory, executive functions, visual-spatial abilities and psychomotor speed in patients with mental and neurological disorders. The aim of this paper is to discuss diagnostic tools used for measuring both types of fluency (verbal and non-verbal), test interpretation methods, as well as their usefulness in clinical diagnostics and scientific research.
Collapse
Affiliation(s)
- Ernest Tyburski
- Department of Clinical Psychology and Psychoprevention, Institute of Psychology, University of Szczecin
| | | | - Magdalena Chęć
- Department of Clinical Psychology and Psychoprevention, Institute of Psychology, University of Szczecin
| | | | - Agnieszka Samochowiec
- Department of Clinical Psychology and Psychoprevention, Institute of Psychology, University of Szczecin; Department of Psychiatry, Pomeranian Medical University in Szczecin.
| |
Collapse
|
21
|
Nakai T, Nagai T, Wang R, Yamada S, Kuroda K, Kaibuchi K, Yamada K. Alterations of GABAergic and dopaminergic systems in mutant mice with disruption of exons 2 and 3 of the Disc1 gene. Neurochem Int 2014; 74:74-83. [PMID: 24973713 DOI: 10.1016/j.neuint.2014.06.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/28/2014] [Accepted: 06/16/2014] [Indexed: 01/20/2023]
Abstract
Disrupted-in-schizophrenia-1 (DISC1) has been widely associated with several psychiatric disorders, including schizophrenia, mood disorders and autism. We previously reported that a deficiency of DISC1 may induce low anxiety and/or high impulsivity in mice with disruption of exons 2 and 3 of the Disc1 gene (Disc1(Δ2-3/Δ2-3)). It remains unclear, however, if deficiency of DISC1 leads to specific alterations in distinct neuronal systems. In the present study, to understand the role of DISC1 in γ-aminobutyric acid (GABA) interneurons and mesocorticolimbic dopaminergic (DAergic) neurons, we investigated the number of parvalbumin (PV)-positive interneurons, methamphetamine (METH)-induced DA release and the expression levels of GABAA, DA transporter (DAT) and DA receptors in wild-type (Disc1(+/+)) and Disc1(Δ2-3/Δ2-3) mice. Female Disc1(Δ2-3/Δ2-3) mice showed a significant reduction of PV-positive interneurons in the hippocampus, while no apparent changes were observed in mRNA expression levels of GABAA receptor subunits. METH-induced DA release was significantly potentiated in the nucleus accumbens (NAc) of female Disc1(Δ2-3/Δ2-3) mice, although there were no significant differences in the expression levels of DAT. Furthermore, the expression levels of DA receptor mRNA were upregulated in the NAc of female Disc1(Δ2-3/Δ2-3) mice. Male Disc1(Δ2-3/Δ2-3) mice showed no apparent differences in all experiments. DISC1 may play a critical role in gender-specific developmental alteration in GABAergic inhibitory interneurons and DAergic neurons.
Collapse
Affiliation(s)
- Tsuyoshi Nakai
- Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Taku Nagai
- Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Rui Wang
- Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Shinnosuke Yamada
- Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Keisuke Kuroda
- Department of Cell Pharmacology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Kozo Kaibuchi
- Department of Cell Pharmacology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Kiyofumi Yamada
- Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8560, Japan.
| |
Collapse
|
22
|
Rinaldi R, Lefebvre L, Trappeniers J. Language, executive functioning and symptomatology—Is fluency a transversal tool in schizophrenia? ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojpsych.2013.34038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|