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Jordà-Baleri T, Garriga M, Mezquida G, Cuesta MJ, Martinez-Aran A, Garcia-Rizo C, Lobo A, González-Pinto A, Diaz-Caneja CM, Roldán A, Vieta E, Baeza I, Trabsa A, Montalvo I, Tortorella A, Menculini G, Verdolini N, Ramos-Quiroga JA, Sánchez Torres AM, Bernardo M, Amoretti S. Sex differences in prolactin levels and clinical outcomes in patients with a first psychotic episode. Psychoneuroendocrinology 2024; 169:107112. [PMID: 39106582 DOI: 10.1016/j.psyneuen.2024.107112] [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: 10/28/2023] [Revised: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 08/09/2024]
Abstract
AIM To analyze the clinical, neurocognitive, and functional impact of prolactin levels according to sex in patients with a First Episode Psychosis (FEP). METHODS We measured prolactin levels in 221 non-affective FEP patients treated with antipsychotics (AP) and 224 healthy controls, at baseline and 2-year follow-up. We examined whether the relationships between clinical and functional variables were mediated by prolactin, controlling for antipsychotic use, according to sex. RESULTS Prolactin levels were higher in patients when compared to controls at both time points. Baseline factors associated with prolactin were chlorpromazine equivalents, attention, and executive functioning. In the FEP group, prolactin levels were associated with functioning and diminished expression in males, and with working memory in females. Prolactin levels (p=0.0134) played a role as a mediator between negative symptomatology (p=0.086) and functional outcome (p=0.008) only in FEP male patients at baseline. CONCLUSIONS Prolactin plays a role in the functionality and clinical symptomatology of FEP patients. Our results suggest that pharmacological counselling in patients with hyperprolactinemia at baseline and negative symptomatology might improve their functional and clinical outcomes.
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Affiliation(s)
- Teresa Jordà-Baleri
- Bipolar and Depressive Disorders 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, Catalonia, Spain
| | - Marina Garriga
- Bipolar and Depressive Disorders 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, Catalonia, 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
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders 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, Catalonia, Spain
| | - Clemente Garcia-Rizo
- 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 Health Research Institute, OSI Araba, University Hospital, University of the Basque Country, Vitoria, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Covadonga M Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, 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); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Catalonia, Spain.
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)-ISCIII, Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain
| | - Amira Trabsa
- Hospital del Mar Medical Research Institute; Universitat Pompeu Fabra, MELIS Department, CIBERSAM, ISCIII, Barcelona, Spain
| | - Itziar Montalvo
- Mental Health Department, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Unitat de Neurociència Traslacional, Departament de Medicina, Universitat Autònoma de Barcelona, CIBERSAM, ISCIII. 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
| | - Norma Verdolini
- Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Italy
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - 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
| | - 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); Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Catalonia, 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; Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Department of Psychiatry, Hospital Universitari Vall d'Hebron; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
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Martínez-Cao C, García-Fernández A, González-Blanco L, Sáiz PA, Bobes J, García-Portilla MP. Anticholinergic load: A commonly neglected and preventable risk to cognition during schizophrenia treatment? Schizophr Res Cogn 2024; 37:100317. [PMID: 38745931 PMCID: PMC11092394 DOI: 10.1016/j.scog.2024.100317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/05/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
Background Cognitive impairment is a widespread feature of schizophrenia, affecting nearly 80 % of patients. Prior research has linked the anticholinergic burden of psychiatric medications to these cognitive deficits. However, the impact of the anticholinergic burden from medications for physical morbidity remains underexplored. This study aimed to evaluate the anticholinergic burden of psychiatric and physical medications in patients with schizophrenia and assess its impact on cognitive function. Methods A total of 178 patients with schizophrenia were recruited. The assessments included an ad hoc questionnaire for collecting demographic and clinical data. Anticholinergic burden was evaluated using the cumulative Drug Burden Index (cDBI) for each participant, and cognitive function was assessed using MATRICS. Psychopathology was measured using the PANSS, CDSS, CAINS, and the CGI-S. Statistical analysis included Student's t-tests, ANOVA, Pearson correlations, and multiple linear regressions. Results The average cDBI was 1.3 (SD = 0.9). The model developed explained 40.80 % of the variance. The variable with the greatest weight was the cDBI (B = -11.148, p = 0.010). Negative-expression (B = -2.740, p = 0.011) and negative-experiential (B = -1.175, p = 0.030) symptoms were also associated with lower global cognitive score. However, more years of education (B = 5.140, p < 0.001) and cigarettes per day (B = 1.331, p < 0.001) predicted a better global cognitive score. Conclusion This study identified specific predictors of global cognition in schizophrenia, with anticholinergic burden emerging as the strongest factor. Our findings underscore the importance of considering the anticholinergic burden of treatments, in addition to negative symptoms, when designing interventions to optimize or maintain cognitive function in patients with schizophrenia.
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Affiliation(s)
- Clara Martínez-Cao
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- University Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
| | - Ainoa García-Fernández
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- University Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
| | - Leticia González-Blanco
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- University Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
- Health Service of the Principality of Asturias (SESPA), Oviedo, Spain
- Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Spain
| | - Pilar A. Sáiz
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- University Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
- Health Service of the Principality of Asturias (SESPA), Oviedo, Spain
- Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Spain
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- University Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
- Health Service of the Principality of Asturias (SESPA), Oviedo, Spain
- Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Spain
| | - María Paz García-Portilla
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- University Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
- Health Service of the Principality of Asturias (SESPA), Oviedo, Spain
- Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Spain
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Wehr S, Weigel L, Davis J, Galderisi S, Mucci A, Leucht S. Clinical Assessment Interview for Negative Symptoms (CAINS): A Systematic Review of Measurement Properties. Schizophr Bull 2024; 50:747-756. [PMID: 37951838 PMCID: PMC11283189 DOI: 10.1093/schbul/sbad137] [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] [Indexed: 11/14/2023]
Abstract
BACKGROUND AND HYPOTHESIS Negative symptoms are very important for the overall loss of functioning observed in patients with schizophrenia. There is a need for valid tools to assess these symptoms. STUDY DESIGN We used the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) systematic review guideline to evaluate the quality of the clinical assessment interview for negative symptoms (CAINS) as a clinician-rated outcome measurement (ClinROM). STUDY RESULTS The search strategy resulted in the retrieval of 13 articles, 11 of which were included in this evaluation. In terms of risk of bias, most articles reported on measures of internal consistency and construct validity, which were overall of good quality. Structural validity, reliability, measurement error, and cross-cultural validity were reported with less than optimum quality. There was a risk of bias in ClinROM development. According to the updated criteria of good measurement properties, structural validity, internal consistency, and reliability showed good results. In contrast, hypothesis testing was somewhat poorer. Results for cross-cultural validity were indeterminate. According to the updated GRADE approach from the COSMIN group the scale received a moderate grade. CONCLUSIONS The COSMIN standard allows a judgment of the CAINS as an instrument with the potential to be recommended for use, but which requires further research to assess its quality, in particular in the domains of content validity, internal consistency, and cross-cultural validity.
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Affiliation(s)
- Sophia Wehr
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lucia Weigel
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - John Davis
- Psychiatric Institute, University of Illinois at Chicago, Chicago, IL
- Maryland Psychiatric Research Center, Baltimore, MD
| | - Silvana Galderisi
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Armida Mucci
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
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Cernvall M, Bengtsson J, Bodén R. The Swedish version of the Motivation and Pleasure Scale self-report (MAP-SR): psychometric properties in patients with schizophrenia or depression. Nord J Psychiatry 2024; 78:339-346. [PMID: 38436927 DOI: 10.1080/08039488.2024.2324060] [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: 12/22/2021] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE Negative symptoms are commonly regarded as a symptom dimension belonging to schizophrenia spectrum disorders but are also present in depression. The recently developed Clinical Assessment Interview for Negative Symptoms (CAINS) has shown to be reliable and valid. A corresponding self-report questionnaire has also been developed, named the Motivation and Pleasure Scale - Self Report (MAP-SR). The purpose was to evaluate the psychometric properties of the Swedish version of the MAP-SR in patients with either schizophrenia or depression. MATERIALS AND METHODS The MAP-SR was translated to Swedish. Participants were 33 patients with schizophrenia spectrum disorders and 52 patients with a depressive disorder and they completed the MAP-SR, the CAINS and other measures assessing adjacent psychopathology, functioning and cognition. RESULTS The internal consistency for the MAP-SR was adequate in both groups (schizophrenia spectrum α = .93, depressive disorder α = .82). Furthermore, the MAP-SR had a large correlation to the motivation and pleasure subscale of the CAINS in patients with schizophrenia disorders (r = -0.75, p < .001), however among patients with depression this correlation was medium-to-large (r = -0.48, p < 0.001). CONCLUSIONS Findings suggest that the Swedish version of the MAP-SR shows promise as a useful measure of motivation and pleasure, especially in patients with schizophrenia spectrum disorders. Furthermore, results also suggest that the MAP-SR does not assess negative symptoms specifically, but that there is an overlap between depressive and negative symptoms.
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Affiliation(s)
- Martin Cernvall
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Johan Bengtsson
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Robert Bodén
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
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5
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Martínez-Cao C, Sánchez-Lasheras F, García-Fernández A, González-Blanco L, Zurrón-Madera P, Sáiz PA, Bobes J, García-Portilla MP. PsiOvi Staging Model for Schizophrenia (PsiOvi SMS): A New Internet Tool for Staging Patients with Schizophrenia. Eur Psychiatry 2024; 67:e36. [PMID: 38599765 PMCID: PMC11059252 DOI: 10.1192/j.eurpsy.2024.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND One of the challenges of psychiatry is the staging of patients, especially those with severe mental disorders. Therefore, we aim to develop an empirical staging model for schizophrenia. METHODS Data were obtained from 212 stable outpatients with schizophrenia: demographic, clinical, psychometric (PANSS, CAINS, CDSS, OSQ, CGI-S, PSP, MATRICS), inflammatory peripheral blood markers (C-reactive protein, interleukins-1RA and 6, and platelet/lymphocyte [PLR], neutrophil/lymphocyte [NLR], and monocyte/lymphocyte [MLR] ratios). We used machine learning techniques to develop the model (genetic algorithms, support vector machines) and applied a fitness function to measure the model's accuracy (% agreement between patient classification of our model and the CGI-S). RESULTS Our model includes 12 variables from 5 dimensions: 1) psychopathology: positive, negative, depressive, general psychopathology symptoms; 2) clinical features: number of hospitalizations; 3) cognition: processing speed, visual learning, social cognition; 4) biomarkers: PLR, NLR, MLR; and 5) functioning: PSP total score. Accuracy was 62% (SD = 5.3), and sensitivity values were appropriate for mild, moderate, and marked severity (from 0.62106 to 0.6728). DISCUSSION We present a multidimensional, accessible, and easy-to-apply model that goes beyond simply categorizing patients according to CGI-S score. It provides clinicians with a multifaceted patient profile that facilitates the design of personalized intervention plans.
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Affiliation(s)
- Clara Martínez-Cao
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), University of Oviedo, Oviedo, Spain
| | - Fernando Sánchez-Lasheras
- Department of Mathematics, University of Oviedo, Oviedo, Spain
- Institute of Space Sciences and Technologies of Asturias (ICTEA), University of Oviedo, Oviedo, Spain
| | - Ainoa García-Fernández
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), University of Oviedo, Oviedo, Spain
| | - Leticia González-Blanco
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), University of Oviedo, Oviedo, Spain
- Health Service of the Principality of Asturias (SESPA), Oviedo, Spain
- Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Madrid, Spain
| | - Paula Zurrón-Madera
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), University of Oviedo, Oviedo, Spain
- Health Service of the Principality of Asturias (SESPA), Oviedo, Spain
| | - Pilar A. Sáiz
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), University of Oviedo, Oviedo, Spain
- Health Service of the Principality of Asturias (SESPA), Oviedo, Spain
- Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Madrid, Spain
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), University of Oviedo, Oviedo, Spain
- Health Service of the Principality of Asturias (SESPA), Oviedo, Spain
- Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Madrid, Spain
| | - María Paz García-Portilla
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), University of Oviedo, Oviedo, Spain
- Health Service of the Principality of Asturias (SESPA), Oviedo, Spain
- Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Madrid, Spain
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Fuentes-Claramonte P, Garcia-Leon MA, Salgado-Pineda P, Ramiro N, Soler-Vidal J, Torres ML, Cano R, Argila-Plaza I, Panicali F, Sarri C, Jaurrieta N, Sánchez M, Boix-Quintana E, Albacete A, Maristany T, Sarró S, Raduà J, McKenna PJ, Salvador R, Pomarol-Clotet E. Do the negative symptoms of schizophrenia reflect reduced responsiveness to reward? Examination using a reward prediction error (RPE) task. Psychol Med 2023; 53:7106-7115. [PMID: 36987680 PMCID: PMC10719670 DOI: 10.1017/s0033291723000521] [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: 11/15/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND A leading theory of the negative symptoms of schizophrenia is that they reflect reduced responsiveness to rewarding stimuli. This proposal has been linked to abnormal (reduced) dopamine function in the disorder, because phasic release of dopamine is known to code for reward prediction error (RPE). Nevertheless, few functional imaging studies have examined if patients with negative symptoms show reduced RPE-associated activations. METHODS Matched groups of DSM-5 schizophrenia patients with high negative symptom scores (HNS, N = 27) or absent negative symptoms (ANS, N = 27) and healthy controls (HC, N = 30) underwent fMRI scanning while they performed a probabilistic monetary reward task designed to generate a measure of RPE. RESULTS In the HC, whole-brain analysis revealed that RPE was positively associated with activation in the ventral striatum, the putamen, and areas of the lateral prefrontal cortex and orbitofrontal cortex, among other regions. Group comparison revealed no activation differences between the healthy controls and the ANS patients. However, compared to the ANS patients, the HNS patients showed regions of significantly reduced activation in the left ventrolateral and dorsolateral prefrontal cortex, and in the right lingual and fusiform gyrus. HNS and ANS patients showed no activation differences in ventral striatal or midbrain regions-of-interest (ROIs), but the HNS patients showed reduced activation in a left orbitofrontal cortex ROI. CONCLUSIONS The findings do not suggest that a generalized reduction of RPE signalling underlies negative symptoms. Instead, they point to a more circumscribed dysfunction in the lateral frontal and possibly the orbitofrontal cortex.
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Affiliation(s)
- Paola Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Instituto de Salud Carlos III, Barcelona, Spain
| | - Maria Angeles Garcia-Leon
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Instituto de Salud Carlos III, Barcelona, Spain
| | - Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Instituto de Salud Carlos III, Barcelona, Spain
| | | | - Joan Soler-Vidal
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Instituto de Salud Carlos III, Barcelona, Spain
- Benito Menni CASM, Sant Boi de Llobregat, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | | | - Ramon Cano
- Hospital Mare de Déu de la Mercè, Barcelona, Spain
| | | | | | - Carmen Sarri
- Benito Menni CASM, Sant Boi de Llobregat, Barcelona, Spain
| | | | - Manel Sánchez
- Hospital Sagrat Cor, Martorell, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Auria Albacete
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Teresa Maristany
- Diagnostic Imaging Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Instituto de Salud Carlos III, Barcelona, Spain
| | - Joaquim Raduà
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Instituto de Salud Carlos III, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institute, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Peter J. McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Instituto de Salud Carlos III, Barcelona, Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Instituto de Salud Carlos III, Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Instituto de Salud Carlos III, Barcelona, Spain
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Bengtsson J, Rad P, Cernvall M, Bodén R. Psychometric properties of the Clinical Assessment Interview for Negative Symptoms (CAINS) in patients with depression and its relationship to affective symptoms. Ann Gen Psychiatry 2023; 22:42. [PMID: 37885022 PMCID: PMC10604520 DOI: 10.1186/s12991-023-00474-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND There is a conceptual overlap between negative and depressive symptoms, requiring further exploration to advance the understanding of negative symptoms. The aim of this study was to examine psychometric properties of the Clinical Assessment Interview for Negative Symptoms (CAINS) in patients with depression, and to explore the relationship between the negative and affective symptoms domains. METHODS Fifty-one patients with a depressive episode were included and interviewed with the CAINS and the Brief Psychiatric Rating Scale-Expanded (BPRS-E). Self-reported depressive symptoms were collected with the Montgomery-Asberg Depression Rating Scale (MADRS-S). Inter-rater agreement, internal consistency and validity measures were examined, as were correlations between negative and affective symptoms. RESULTS The intraclass correlation for the CAINS motivation and pleasure subscale (CAINS-MAP) was 0.98 (95% CI 0.96-0.99) and that for the expressional subscale (CAINS-EXP) was 0.81 (95% CI 0.67-0.89). Cronbach's alpha was 0.71 (95% CI 0.57-0.82) for the CAINS-MAP and 0.86 (95% CI 0.79-0.92) for the CAINS-EXP. The correlation with the negative symptoms subscale of the BPRS-E was 0.35 (p = 0.011, blinded/different raters) or 0.55 (p < 0.001, not blinded/same rater). The CAINS-MAP correlated with the affective symptoms subscale of the BPRS-E (r = 0.39, p = 0.005) and the MADRS-S total score (r = 0.50, p < 0.001), but not with anxiety symptoms. CONCLUSIONS Negative symptoms in depression can be assessed with the CAINS with good inter-rater agreement and acceptable internal consistency and validity. There are associations between negative and depressive symptoms that call for further exploration.
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Affiliation(s)
- Johan Bengtsson
- Department of Medical Sciences, Psychiatry, Uppsala University, Entrance 10, Uppsala University Hospital, 751 85, Uppsala, Sweden.
| | - Parya Rad
- Uppsala University Hospital, Uppsala, Sweden
| | - Martin Cernvall
- Department of Medical Sciences, Psychiatry, Uppsala University, Entrance 10, Uppsala University Hospital, 751 85, Uppsala, Sweden
| | - Robert Bodén
- Department of Medical Sciences, Psychiatry, Uppsala University, Entrance 10, Uppsala University Hospital, 751 85, Uppsala, Sweden
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Martínez-Cao C, García-Fernández A, González-Blanco L, Zurrón-Madera P, Sáiz PA, García-Portilla MP, Bobes J. What factors should we modify to promote high functioning and prevent functional decline in people with schizophrenia? Front Psychiatry 2023; 14:1181758. [PMID: 37333927 PMCID: PMC10272392 DOI: 10.3389/fpsyt.2023.1181758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
Background Since research in schizophrenia mainly focuses on deficits and risk factors, we need studies searching for high-functioning protective factors. Thus, our objective was to identify protective (PFs) and risk factors (RFs) separately associated with high (HF) and low functioning (LF) in patients with schizophrenia. Methods We collected information (sociodemographic, clinical, psychopathological, cognitive, and functional) from 212 outpatients with schizophrenia. Patients were classified according to their functional level (PSP) as HF (PSP > 70, n = 30) and LF (PSP ≤ 50, n = 95). Statistical analysis consisted of Chi-square test, Student's t-test, and logistic regression. Results HF model: variance explained: 38.4-68.8%; PF: years of education (OR = 1.227). RFs: receiving a mental disability benefit (OR = 0.062) and scores on positive (OR = 0.719), negative-expression (OR = 0.711), and negative-experiential symptoms (OR = 0.822), and verbal learning (OR = 0.866). LF model: variance explained: 42.0-56.2%; PF: none; RFs: not working (OR = 6.900), number of antipsychotics (OR = 1.910), and scores on depressive (OR = 1.212) and negative-experiential symptoms (OR = 1.167). Conclusion We identified specific protective and risk factors for high and low functioning in patients with schizophrenia and confirmed that high functioning factors are not necessarily the opposite of those associated with low functioning. Only negative experiential symptoms are a shared and inverse factor for high and low functioning. Mental health teams must be aware of protective and risk factors and try to enhance or reduce them, respectively, to help their patients improve or maintain their level of functioning.
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Affiliation(s)
- Clara Martínez-Cao
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Ainoa García-Fernández
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Leticia González-Blanco
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Oviedo, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Paula Zurrón-Madera
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Oviedo, Spain
| | - Pilar A. Sáiz
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Oviedo, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - María Paz García-Portilla
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Oviedo, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Julio Bobes
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA) Oviedo, Oviedo, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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Wang LL, Tam MHW, Ho KKY, Hung KSY, Wong JOY, Lui SSY, Chan RCK. Bridge centrality network structure of negative symptoms in people with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2023; 273:589-600. [PMID: 35972557 DOI: 10.1007/s00406-022-01474-w] [Citation(s) in RCA: 4] [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: 02/04/2022] [Accepted: 08/02/2022] [Indexed: 11/03/2022]
Abstract
Negative symptoms are complex psychopathology. Although evidence generally supported the NIMH five consensus domains, research seldom examined measurement invariance of this model, and domain-specific correspondence across multiple scales. This study aimed to examine the interrelationship between negative symptom domains captured by different rating scales, and to examine the domain-specific correspondence across multiple scales. We administered the Brief Negative Symptom Scale (BNSS), the Self-evaluation of Negative Symptoms (SNS), and the Scale for Assessment of Negative Symptoms (SANS) to 204 individuals with schizophrenia. We used network analysis to examine the interrelationship between negative symptom domains. Besides regularized partial correlation network, we estimated bridge centrality indices to investigate domain-specific correspondence, while taking each scale as an independent community. The regularized partial correlation network showed that the SNS nodes clustered together, whereas the SANS and the BNSS nodes intermingled together. The SANS attention domain lied at the periphery of the network according to the Fruchterman-Reingold algorithm. The SANS anhedonia-asociality (strength = 1.48; EI = 1.48) and the SANS affective flattening (strength = 1.06; EI = 1.06) had the highest node strength and EI. Moreover, the five nodes of the BNSS bridged the nodes of the SANS and the SNS. BNSS blunted affect (strength = 0.76; EI = 0.76) and SANS anhedonia-asociality (strength = 0.76; EI = 0.74) showed the highest bridge strength and bridge EI. The BNSS captures negative symptoms and bridges the symptom domains measured by the SANS and the SNS. The three scales showed domain-specific correspondence.
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Affiliation(s)
- Ling-Ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Michelle H W Tam
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Karen K Y Ho
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Karen S Y Hung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Jessica O Y Wong
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China.
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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10
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Li SB, Liu C, Zhang JB, Wang LL, Hu HX, Chu MY, Wang Y, Lv QY, Lui SSY, Cheung EFC, Yi ZH, Chan RCK. Revisiting the latent structure of negative symptoms in schizophrenia: Evidence from two second-generation clinical assessments. Schizophr Res 2022; 248:131-139. [PMID: 36037646 DOI: 10.1016/j.schres.2022.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 07/15/2022] [Accepted: 08/20/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Negative symptoms are core symptom of schizophrenia, and many previous research studied the latent structure of negative symptoms based on a single measurement scale. Applying two second-generation negative symptom scales to the same sample can address measurement-invariance of latent structure. METHODS Three-hundred-and-five schizophrenia patients were assessed using the CAINS and the BNSS. Confirmatory Factor Analysis (CFA) tested four competing factor-models: (1) a 1-factor model; (2) a 2-factor model comprising the motivation and pleasure (MAP) domain and the diminished expression (EXP) domain; (3) a 5-factor model comprising anhedonia, avolition, asociality, blunted affect and alogia; (4) a hierarchical model comprising the "first-order" 5-domain factors and the "second-order" MAP & EXP factors. RESULTS The CFA results for the data of the CAINS showed that the 2-factor model had the best data fit over the other competing models. The CFA using the BNSS data in the same sample also supported the superiority of the 2-factor model. Lastly, after combining the items of the BNSS and CAINS together in the same sample for CFA, the 2-factor model prevailed over the other competing models. CONCLUSIONS The 2-factor model appears to be measurement-invariant latent structure of negative symptoms. The novel method of combining the items of the CAINS and BNSS might have circumvented the possible imperfect construct of a single scale. Our findings support the MAP and EXP factors as the latent structure for negative symptoms.
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Affiliation(s)
- Shuai-Biao Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Liu
- Nantong Fourth People's Hospital, Jiangsu, China
| | | | - Ling-Ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hui-Xin Hu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Min-Yi Chu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qin-Yu Lv
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychiatry, Huashan Hospital, Fudan University, School of Medicine, Shanghai, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Zheng-Hui Yi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychiatry, Huashan Hospital, Fudan University, School of Medicine, Shanghai, China; Institute of Mental Health, Fudan University, Shanghai, China.
| | - Raymond C K Chan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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11
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Giordano GM, Caporusso E, Pezzella P, Galderisi S. Updated perspectives on the clinical significance of negative symptoms in patients with schizophrenia. Expert Rev Neurother 2022; 22:541-555. [PMID: 35758871 DOI: 10.1080/14737175.2022.2092402] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Negative symptoms in schizophrenia are associated with poor response to available treatments, poor quality of life, and functional outcome. Therefore, they represent a substantial burden for people with schizophrenia, their families, and health-care systems. AREAS COVERED In this manuscript, we will provide an update on the conceptualization, assessment, and treatment of this complex psychopathological dimension of schizophrenia. EXPERT OPINION Despite the progress in the conceptualization of negative symptoms and in the development of state-of-the-art assessment instruments made in the last decades, these symptoms are still poorly recognized, and not always assessed in line with current conceptualization. Every effort should be made to disseminate the current knowledge on negative symptoms, on their assessment instruments and available treatments whose efficacy is supported by research evidence. Longitudinal studies should be promoted to evaluate the natural course of negative symptoms, improve our ability to identify the different sources of secondary negative symptoms, provide effective interventions, and target primary and persistent negative symptoms with innovative treatment strategies. Further research is needed to identify pathophysiological mechanisms of primary negative symptoms and foster the development of new treatments.
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12
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Strauss GP, Raugh IM, Zhang L, Luther L, Chapman HC, Allen DN, Kirkpatrick B, Cohen AS. Validation of accelerometry as a digital phenotyping measure of negative symptoms in schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:37. [PMID: 35853890 PMCID: PMC9261099 DOI: 10.1038/s41537-022-00241-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/24/2022] [Indexed: 05/05/2023]
Abstract
Negative symptoms are commonly assessed via clinical rating scales; however, these measures have several inherent limitations that impact validity and utility for their use in clinical trials. Objective digital phenotyping measures that overcome some of these limitations are now available. The current study evaluated the validity of accelerometry (ACL), a passive digital phenotyping method that involves collecting data on the presence, vigor, and variability of movement. Outpatients with schizophrenia (SZ: n = 50) and demographically matched healthy controls (CN: n = 70) had ACL continuously recorded from a smartphone and smartband for 6 days. Active digital phenotyping assessments, including surveys related to activity context, were also collected via 8 daily surveys throughout the 6 day period. SZ participants had lower scores on phone ACL variables reflecting vigor and variability of movement compared to CN. ACL variables demonstrated convergent validity as indicated by significant correlations with active digital phenotyping self-reports of time spent in goal-directed activities and clinical ratings of negative symptoms. The discriminant validity of ACL was demonstrated by low correlations with clinical rating scale measures of positive, disorganized, and total symptoms. Collectively, findings suggest that ACL is a valid objective measure of negative symptoms that may complement traditional approaches to assessing the construct using clinical rating scales.
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Affiliation(s)
| | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Luyu Zhang
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Hannah C Chapman
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Daniel N Allen
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Brian Kirkpatrick
- Department of Psychiatry and Behavioral Sciences, University of Nevada, Reno School of Medicine, Las Vegas, NV, USA
| | - Alex S Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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The role of BDNF and NGF plasma levels in first-episode schizophrenia: A longitudinal study. Eur Neuropsychopharmacol 2022; 57:105-117. [PMID: 35219096 DOI: 10.1016/j.euroneuro.2022.02.003] [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: 09/09/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/21/2022]
Abstract
Neurotrophins have been proposed to be involved in biological mechanisms which might underlie different clinical outcomes in schizophrenia. The aims of the present study were to examine the BDNF/NGF plasma levels in a cohort of first-episode schizophrenia (FES) patients in remission as potential biological predictors of relapse; to study the associations between these neurotrophins and the symptomatology severity through different stages after a FES in two independent cohorts. 2EPs-Cohort: 69 first-episode in clinical remission were included. BDNF/NGF plasma levels and symptom severity were measured at enrollment and at 3-year or at the time of the second episode/relapse. FLAMM-PEPs-Cohort: 65 first-episodes were also included. BDNF/NGF and symptom severity were obtained at enrollment and 2-year follow-up. Symptomatology was assessed with the Marder-PANSS-Factor scores. Plasma neurotrophins did not differ significantly over time and neither BDNF/NGF were predictors of relapse. Besides, in remission stages, baseline BDNF levels showed significant correlations with both positive and negative symptoms (p<0.05); NGF, with negative symptomatology (p<0.01). Similarly, in the FLAMM-PEPs-Cohort, baseline BDNF/NGF levels showed significant correlations with negative symptoms (and not positive symptomatology) at follow-up (p<0.05). In both cohorts, lower levels correlated with higher symptom severity. Findings did not support a role for BDNF/NGF plasma levels as biomarkers of relapse in FES patients. Nevertheless, baseline BDNF/NGF may lead to be considered potentially useful biomarkers of long-term severity in schizophrenia and of the underlying illness traits, specially of negative symptomatology severity. More longitudinal studies in FES samples and adding a control group are warranted to replicate these findings.
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García-Fernández L, Romero-Ferreiro V, Sánchez-Pastor L, Dompablo M, Martínez-Gras I, Espejo-Saavedra JM, Rentero D, Aparicio AI, Alvarez-Mon MA, Lahera G, Lee J, Santos JL, Rodriguez-Jimenez R. Impact of Negative Symptoms on Functioning and Quality of Life in First Psychotic Episodes of Schizophrenia. J Clin Med 2022; 11:jcm11040983. [PMID: 35207256 PMCID: PMC8879613 DOI: 10.3390/jcm11040983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
Negative symptoms are not considered a unitary construct encompassing two different domains, diminished expression, and avolition-apathy. The aim of this study was to explore the relationships between each domain and psychosocial functioning and quality of life in people with a first psychotic episode of schizophrenia. In total, 61 outpatients were assessed with the Clinical Assessment Interview for Negative Symptoms (CAINS), The Functioning Assesment Short Test (FAST) and The Quality of Life Scale (QLS). The mean global score for CAINS was 21.5 (SD: 15.6), with a CAINS Avolition-Apathy (MAP) score of 17.0 (SD: 11.8), and CAINS Diminished Expression (EXP) score of 4.5 (SD: 5.0). The mean FAST score was 31.9 (SD: 18.9), and 41.1 (SD: 17.9) for QLS. Linear regression analysis revealed a significant (F(4,53) = 15.65, p < 0.001) relationship between MAP and EXP CAINS’ score and FAST score. CAINS-MAP was more predictive of FAST scores (β = 0.44, p = 0.001) than CAINS-EXP (β = 0.37, p = 0.007). Linear regression analysis for QLS revealed a significant model (F(4,56) = 29.29, p < 0.001). The standardized regression weight for the CAINS-MAP was around three times greater (β = −0.63, p < 0.001) than for CAINS-EXP (β = −0.24, p = 0.024). The two different domains are associated differently with functionality and quality of life.
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Affiliation(s)
- Lorena García-Fernández
- Clinical Medicine Department, Universidad Miguel Hernández, 03550 Alicante, Spain;
- Psychiatry Department, Hospital Universitario de San Juan, 03550 Alicante, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 28029 Madrid, Spain; (V.R.-F.); (M.D.); (D.R.); (A.I.A.); (G.L.); (J.L.S.)
| | - Verónica Romero-Ferreiro
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 28029 Madrid, Spain; (V.R.-F.); (M.D.); (D.R.); (A.I.A.); (G.L.); (J.L.S.)
- Quality and Academic Compliance Unit, Universidad Europea de Madrid, 28670 Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas 12), 28041 Madrid, Spain; (L.S.-P.); (I.M.-G.); (J.M.E.-S.)
| | - Luis Sánchez-Pastor
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas 12), 28041 Madrid, Spain; (L.S.-P.); (I.M.-G.); (J.M.E.-S.)
| | - Mónica Dompablo
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 28029 Madrid, Spain; (V.R.-F.); (M.D.); (D.R.); (A.I.A.); (G.L.); (J.L.S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas 12), 28041 Madrid, Spain; (L.S.-P.); (I.M.-G.); (J.M.E.-S.)
- Cardenal Cisneros, Centro de Enseñanza Superior Adscrito a la Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Isabel Martínez-Gras
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas 12), 28041 Madrid, Spain; (L.S.-P.); (I.M.-G.); (J.M.E.-S.)
- RETIC (Network of Addictive Conditions), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Juan Manuel Espejo-Saavedra
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas 12), 28041 Madrid, Spain; (L.S.-P.); (I.M.-G.); (J.M.E.-S.)
- Legal Medicine, Psychiatry and Pathology Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - David Rentero
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 28029 Madrid, Spain; (V.R.-F.); (M.D.); (D.R.); (A.I.A.); (G.L.); (J.L.S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas 12), 28041 Madrid, Spain; (L.S.-P.); (I.M.-G.); (J.M.E.-S.)
| | - Ana Isabel Aparicio
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 28029 Madrid, Spain; (V.R.-F.); (M.D.); (D.R.); (A.I.A.); (G.L.); (J.L.S.)
- Psychiatry Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain
- Neurobiological Research Group, Institute of Technology, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain;
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Guillermo Lahera
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 28029 Madrid, Spain; (V.R.-F.); (M.D.); (D.R.); (A.I.A.); (G.L.); (J.L.S.)
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain;
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore 539747, Singapore;
- North Region & Department of Psychosis, Institute of Mental Health, Singapore 539747, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 639798, Singapore
| | - Jose Luis Santos
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 28029 Madrid, Spain; (V.R.-F.); (M.D.); (D.R.); (A.I.A.); (G.L.); (J.L.S.)
- Psychiatry Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain
- Neurobiological Research Group, Institute of Technology, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - Roberto Rodriguez-Jimenez
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 28029 Madrid, Spain; (V.R.-F.); (M.D.); (D.R.); (A.I.A.); (G.L.); (J.L.S.)
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas 12), 28041 Madrid, Spain; (L.S.-P.); (I.M.-G.); (J.M.E.-S.)
- Legal Medicine, Psychiatry and Pathology Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-91-390-85-36
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Martínez-Cao C, García-Álvarez L, Bobes-Bascarán T, de la Fuente-Tomás L, Fernández-Egea E, Velasco Á, González-Blanco L, Zurrón-Madera P, Fonseca-Pedrero E, Sáiz-Martínez PA, García-Portilla MP, Bobes J. Validation of a European Spanish adaptation of the Apathy Evaluation Scale-self-rated version (AES-S) in patients with schizophrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:22-28. [PMID: 35256069 DOI: 10.1016/j.rpsmen.2020.04.007] [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: 12/22/2019] [Accepted: 04/16/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Apathy is a negative symptom of schizophrenia and is associated with poor real world functioning. Therefore, it is important to have validated psychometric instruments to assess this symptom. This is the first study to validate the Spanish adaptation of the self-rated version of the Apathy Assessment Scale (AES-S) in patients with schizophrenia. MATERIALS AND METHODS Naturalistic, cross-sectional, validation study in 104 patients with schizophrenia evaluated using the following scales: Clinical Global Impression-Severity (CGI-S), Personal and Social Performance (PSP), Clinical Assessment Interview for Negative Symptoms (CAINS), Self-report of Negative Symptoms (SNS), Motivation and Pleasure Scale-Self-Report (MAP-SR), Calgary Depression Scale for Schizophrenia (CDSS), and Apathy Evaluation Scale-self-rated version (AES-S). RESULTS Reliability: Internal consistency (Cronbach's alpha) was 0.908. Convergent validity: The Pearson correlation coefficient between AES-S and CAINS-MAP total scores was -0.483 (p<0.001). For SNS, total and avolition subscale scores were -0.803 and -0.639 (p<0.001), respectively. With the MAP-SR, the correlation coefficient was -0.727 (p<0.001). Divergent validity: The Pearson correlation coefficient between AES-S and PSP total scores was 0.504 (p<0.001). Furthermore, with the CDSS, the correlation coefficient was -0.431 (p<0.001). Discriminant validity: The AES-S discriminated between different levels of illness severity according to CGI-S scores. Factor analysis: A three-component solution explained 57.32% of the variance. Pearson correlations between coefficients were 1-2=0.265, 1-3=0.464, and 2-3=0.060. CONCLUSION The Spanish AES-S is a reliable and valid instrument for assessing apathy in Spanish patients with schizophrenia. It seems to be appropriate for use in everyday clinical practice as a means of monitoring apathy in these patients.
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Affiliation(s)
| | | | | | | | | | - Ángela Velasco
- Dpto. Psiquiatría, CIBERSAM, Universidad de Oviedo, Oviedo, Spain
| | | | | | | | | | | | - Julio Bobes
- Dpto. Psiquiatría, CIBERSAM, ISPA, Universidad de Oviedo, Oviedo, Spain
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García-Álvarez L, Martínez-Cao C, Bobes-Bascarán T, Portilla A, Courtet P, de la Fuente-Tomás L, Velasco Á, González-Blanco L, Zurrón-Madera P, Fonseca-Pedrero E, Sáiz PA, García-Portilla MP, Bobes J. Validation of a European Spanish-version of the Self-Evaluation of Negative Symptoms (SNS) in patients with schizophrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:14-21. [PMID: 35256068 DOI: 10.1016/j.rpsmen.2022.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 04/28/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Negative symptoms can be grouped into five domains: apathy/avolition, anhedonia, asociality, alogia, and affective flattening. There are few validate self-rated measures that assess these five dimensions. Therefore, this study aimed to validate the Self-Evaluation of Negative Symptoms (SNS) in Spanish patients with schizophrenia. MATERIAL AND METHODS Cross-sectional, validation study in 104 outpatients with schizophrenia evaluated using the Spanish version of the following scales: Clinical Assessment Interview for Negative Symptoms (CAINS), Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale for Schizophrenia (CGI-SCH), Personal and Social Performance (PSP), Motivation and Pleasure Scale - Self-Report (MAP-SR), 36-item Short-Form Health Survey (SF-36) and the Self-Evaluation of Negative Symptoms (SNS). RESULTS RELIABILITY Internal consistency (Cronbach's alpha) was 0.915. Convergent validity: The Pearson correlation coefficient between MAP-SR and SNS Total scores was 0.660 (p<0.001). For PANSS-N, the correlation was 0.437 (p<0.005) and with the CAINS-Total was 0.478 (p<0.005). Divergent validity: The Pearson correlation coefficient between SNS and PSP was r=-0.372 (p≤0.001), and with SF-36 Physical and Mental Summary Component scores were r=-0.213 (p=0.066) and r=-0.144 (p=0.219), respectively. Discriminant validity: SNS Total scores were significantly statistically different according to the severity of the negative symptomatology rated by the CGI-SCH negative scale (p<0.001). CONCLUSION The SNS is a reliable and valid instrument to self-rate the five domains of negative symptoms in patients with schizophrenia and seems to be appropriate for use in everyday clinical practice as a complementary measure to the evaluation performed by the clinician.
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Affiliation(s)
- Leticia García-Álvarez
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Clara Martínez-Cao
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Teresa Bobes-Bascarán
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | - Almudena Portilla
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | | | - Lorena de la Fuente-Tomás
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Ángela Velasco
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Leticia González-Blanco
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | - Paula Zurrón-Madera
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | - Eduardo Fonseca-Pedrero
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Departamento Ciencias de la Educación, Universidad de la Rioja, Longroño, Spain
| | - Pilar A Sáiz
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | - María Paz García-Portilla
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain.
| | - Julio Bobes
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
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17
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Laraki Y, Lebrun C, Merenciano M, Eisenblaetter M, Attal J, Macgregor A, Decombe A, Capdevielle D, Raffard S. Validation of the French Clinical Assessment Interview for Negative Symptoms in a Sample of Stable French Individuals With Schizophrenia. Front Psychiatry 2022; 13:836600. [PMID: 35432043 PMCID: PMC9010618 DOI: 10.3389/fpsyt.2022.836600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The Clinical Assessment Interview for Negative Symptoms (CAINS) is an interview-based instrument evaluating the existence and severity of negative symptoms in people diagnosed with schizophrenia or schizoaffective disorder. The aim of this study is to translate and validate a French version of the CAINS in a French sample of outpatients diagnosed with schizophrenia or schizoaffective disorder. METHODS In this study, we included 84 outpatients with a diagnosis of schizophrenia from the University Department of Adult Psychiatry in Montpellier, France. All participants were assessed for the severity of negative symptoms as well as level of depression. Psychometric properties of the French CAINS were investigated including its factor structure, internal consistency, and interrater and test-retest reliabilities. We also determined the discriminant and convergent validity. RESULTS Exploratory factor analysis and parallel analysis reproduced the two-factor model, and explained 43.55% of the total score variation with good internal consistency (Cronbach α of 0.87). Both interrater and test-retest reliabilities were high for the CAINS and its subscales (intraclass correlation coefficient range, 0.89-0.99). The standard errors of measurement and minimal detectable change were also investigated. Convergent validity of the CAINS was underpinned by correlations obtained with various measures of negative symptoms. Adequate discriminant validity was established by showing that the CAINS did not correlate with positive symptoms. CONCLUSION Overall, our results obtained were similar to those found in the original study of the CAINS. Structural analyses also replicated the two-factor model of the CAINS. Our results indicate that the French CAINS has robust psychometric properties and is a valid tool for evaluating negative symptoms in French-speaking individuals diagnosed with schizophrenia.
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Affiliation(s)
- Yasmine Laraki
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France.,Université Paul Valéry Montpellier 3, EPSYLON EA, Montpellier, France
| | - Cindy Lebrun
- Université Paul Valéry Montpellier 3, EPSYLON EA, Montpellier, France
| | - Marine Merenciano
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France
| | | | - Jerôme Attal
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France
| | - Alexandra Macgregor
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France
| | - Amandine Decombe
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France
| | - Delphine Capdevielle
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France.,IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Stéphane Raffard
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France.,Université Paul Valéry Montpellier 3, EPSYLON EA, Montpellier, France
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18
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Fuentes-Claramonte P, Ramiro N, Torres L, Argila-Plaza I, Salgado-Pineda P, Soler-Vidal J, García-León MÁ, Albacete A, Bosque C, Panicalli F, Boix E, Munuera J, Tristany J, Sarró S, Bernardo M, Salvador R, McKenna PJ, Pomarol-Clotet E. Negative schizophrenic symptoms as prefrontal cortex dysfunction: Examination using a task measuring goal neglect. NEUROIMAGE: CLINICAL 2022; 35:103119. [PMID: 35870381 PMCID: PMC9421442 DOI: 10.1016/j.nicl.2022.103119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 06/10/2022] [Accepted: 07/12/2022] [Indexed: 11/29/2022] Open
Abstract
Negative schizophrenic symptoms have been considered to reflect prefrontal cortex dysfunction. Functional imaging support for this theory is however weak, perhaps due to the tasks used. We examined negative symptom patients using a novel executive task measuring volitional behaviour. Comparison to patients without negative symptoms revealed prefrontal hypoactivation.
Background The negative symptoms of schizophrenia have been proposed to reflect prefrontal cortex dysfunction. However, this proposal has not been consistently supported in functional imaging studies, which have also used executive tasks that may not capture key aspects of negative symptoms such as lack of volition. Method Twenty-four DSM-5 schizophrenic patients with high negative symptoms (HNS), 25 with absent negative symptoms (ANS) and 30 healthy controls underwent fMRI during performance of the Computerized Multiple Elements Test (CMET), a task designed to measure poor organization of goal directed behaviour or ‘goal neglect’. Negative symptoms were rated using the PANSS and the Clinical Assessment Interview for Negative Symptoms (CAINS). Results On whole brain analysis, the ANS patients showed no significant clusters of reduced activation compared to the healthy controls. In contrast, the HNS patients showed hypoactivation compared to the healthy controls in the left anterior frontal cortex, the right dorsolateral prefrontal cortex (DLPFC), the anterior insula bilaterally and the bilateral inferior parietal cortex. When compared to the ANS patients, the HNS patients showed reduced activation in the left anterior frontal cortex, the left DLPFC and the left inferior parietal cortex. After controlling for disorganization scores, differences remained in clusters in the left anterior frontal cortex and the bilateral inferior parietal cortex. Conclusions This study provides evidence that reduced prefrontal activation, perhaps especially in the left anterior frontal cortex, is a brain functional correlate of negative symptoms in schizophrenia. The simultaneous finding of reduced inferior parietal cortex activation was unexpected, but could reflect this region’s involvement in cognitive control, particularly the ‘regulative’ component of this.
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Affiliation(s)
- Paola Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
| | - Núria Ramiro
- Psychiatry department, Hospital Sant Rafael, Barcelona, Spain
| | - Llanos Torres
- Hospital Mare de Dèu de la Mercé, Unitat Polivalent, Barcelona, Spain
| | | | - Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
| | - Joan Soler-Vidal
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain; Benito Menni Complex Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
| | - María Ángeles García-León
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
| | - Auria Albacete
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
| | - Clara Bosque
- Benito Menni Complex Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
| | - Francesco Panicalli
- Benito Menni Complex Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
| | - Ester Boix
- Mental Health Department, Hospital de Mataró, Mataró, Spain
| | - Josep Munuera
- Diagnostic Imaging Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
| | - Miquel Bernardo
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain; Barcelona Clínic Schizophrenia Unit, Hospital Clínic of Barcelona, Institute of Neuroscience, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
| | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain.
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
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19
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Bengtsson J, Bodén R, Neider D, Cernvall M. A blinded validation of the Swedish version of the Clinical Assessment Interview for Negative Symptoms (CAINS). Nord J Psychiatry 2022; 76:44-51. [PMID: 34126848 DOI: 10.1080/08039488.2021.1933174] [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] [Indexed: 10/21/2022]
Abstract
PURPOSE The Clinical Assessment Interview for Negative Symptoms (CAINS) was developed in order to advance the assessment of negative symptoms. The aim of this study was to validate the Swedish version of the CAINS. MATERIALS AND METHODS Thirty-four out-patients with a schizophrenia spectrum disorder were recruited. All patients were videotaped while interviewed with the CAINS and the Brief Psychiatric Rating Scale (BPRS). Another rater watched the video recordings in the reverse order, enabling a blinded design. The patients also filled in self-reported measures of depression, quality of life, and social and vocational functioning. We calculated inter-rater agreement and internal consistency for the CAINS. We also calculated validity measures by correlating the subscales Motivation and Pleasure (CAINS-MAP) and Expression (CAINS-EXP) to subscales of the BPRS. RESULTS The blinded inter-rater agreement for the CAINS total score was high (ICC = 0.92) but slightly lower for the expression subscale (ICC = 0.76). Cronbach's alpha was 0.84 for the total score. Convergent validity with the negative symptoms subscale of BPRS was different for the blinded and the unblinded data, with a CAINS-MAP correlation of 0.10 (p = 0.580) and a CAINS-EXP correlation of 0.48 (p = 0.004) in the blinded data. The unblinded data had a CAINS-MAP correlation of 0.38 (p = 0.026) and a CAINS-EXP correlation of 0.87 (p < 0.001). Self-rated measures of anhedonia correlated to CAINS-MAP with a coefficient of 0.68 (p < 0.001), while the CAINS-EXP only had a correlation of 0.16 (p = 0.366) to these measures. CONCLUSION The Swedish version of the CAINS displays adequate psychometric properties in line with earlier validation studies.
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Affiliation(s)
- Johan Bengtsson
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Robert Bodén
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | | | - Martin Cernvall
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
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20
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Kulenović AD, Mešević ES, Ribić E, Repišti S, Radojičić T, Jovanović N. Factor structure and internal consistency of the Clinical Assessment Interview for Negative Symptoms (CAINS) on a sample of persons with psychotic disorders in Bosnia and Herzegovina. J Neural Transm (Vienna) 2021; 129:905-911. [PMID: 34878600 PMCID: PMC9217762 DOI: 10.1007/s00702-021-02435-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022]
Abstract
The assessment of negative symptoms is crucial for development of adequate therapeutic interventions. This is a challenging task due to complex clinical presentation and lack of reliable and valid instruments. This study examined the psychometric characteristics of the Clinical Assessment Interview for Negative Symptoms (CAINS). The sample consisted of 81 persons with schizophrenia or schizoaffective disorder recruited from two health institutions in the Sarajevo Canton: the Clinical Center of the University of Sarajevo and the Psychiatric Hospital of the Sarajevo Canton. The 13 CAINS items grouped into four factors (expression, motivation and satisfaction in the recreational domain, motivation and satisfaction with social relationships, motivation and satisfaction with job and education). The four-factor solution accounted for 87.83% of the variance of manifest items. The reliabilities of extracted factors were as follows: for motivation and satisfaction with social relationships α = 0.897, for motivation and satisfaction with job and education α = 0.961, for Motivation and satisfaction in the recreation domain α = 0.981, and for expression α = 0.938. The highest correlation between factors was found between Motivation and satisfaction with recreation and Motivation and satisfaction with social relationships. On the other hand, the lowest correlation was found between motivation and satisfaction with social relations and motivation and satisfaction with job and education. In conclusion, the study showed that the latent structure of CAINS is adequate, clearly interpretable, and consisted of four factors. The measure can be used for assessment of the negative symptoms in outpatients with psychosis in Bosnia and Herzegovina.
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Affiliation(s)
- Alma Džubur Kulenović
- Department for Psychiatry, Clinical Center of University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
| | - Eldina Smajic Mešević
- Department for Research and Development, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Emina Ribić
- Department for Research and Development, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Selman Repišti
- Clinic for Psychiatry, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Tamara Radojičić
- Clinic for Psychiatry, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Nikolina Jovanović
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Bart's and London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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21
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Cuesta MJ, Sánchez-Torres AM, Lorente-Omeñaca R, Moreno-Izco L, Peralta V. Cognitive, community functioning and clinical correlates of the Clinical Assessment Interview for Negative Symptoms (CAINS) in psychotic disorders. Eur Arch Psychiatry Clin Neurosci 2021; 271:1537-1546. [PMID: 32895741 DOI: 10.1007/s00406-020-01188-x] [Citation(s) in RCA: 6] [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: 05/26/2020] [Accepted: 08/20/2020] [Indexed: 12/16/2022]
Abstract
Negative symptoms are a core dimension of schizophrenia and other psychoses that account for a large degree of the poor functional outcomes related to these disorders. Newer assessment scales for negative symptoms, such as the Clinical Assessment Interview for Negative Symptoms (CAINS), provide evidence for separate dimensions of motivational and pleasure (MAP) and expression (EXP) dimensions. This study was aimed at extending the analysis of the clinical, functional and cognitive correlates of CAINS dimensions in a sample of patients with psychotic disorders (n = 98) and 50 healthy controls.A psychopathological evaluation was conducted by using the Comprehensive Assessment of Symptoms and History (CASH). To assess the extrapyramidal signs, the UKU scale was used. Community functioning was evaluated by means of real-world and functional attainment measures. Additionally, a full neuropsychological test battery was administered. Pearson correlation and hierarchical multiple linear regression analyses were performed to identify the influencing and predictive factors associated with the CAINS dimensions.The MAP and EXP dimensions showed strong associations with the Scale for the Assessment of Negative Symptoms (SANS) items and were not significantly associated with extra-pyramidal or cognitive deficits. The MAP and EXP CAINS dimensions revealed good predictive validity for real-world functioning and functional attainment measures.These findings suggest that the CAINS scale endorses good convergent validity for the assessment of negative symptoms and is very useful in the prediction of psychosocial functioning. In addition, the CAINS dimensions might provide advantages over old assessment scales on disentangling the complex associations between negative symptoms and cognitive impairment.
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Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Victor Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud, Osasunbidea, Pamplona, Spain
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22
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Galderisi S, Mucci A, Dollfus S, Nordentoft M, Falkai P, Kaiser S, Giordano GM, Vandevelde A, Nielsen MØ, Glenthøj LB, Sabé M, Pezzella P, Bitter I, Gaebel W. EPA guidance on assessment of negative symptoms in schizophrenia. Eur Psychiatry 2021; 64:e23. [PMID: 33597064 PMCID: PMC8080207 DOI: 10.1192/j.eurpsy.2021.11] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background During the last decades, a renewed interest for negative symptoms (NS) was brought about by the increased awareness that they interfere severely with real-life functioning, particularly when they are primary and persistent. Methods In this guidance paper, we provide a systematic review of the evidence and elaborate several recommendations for the conceptualization and assessment of NS in clinical trials and practice. Results Expert consensus and systematic reviews have provided guidance for the optimal assessment of primary and persistent negative symptoms; second-generation rating scales, which provide a better assessment of the experiential domains, are available; however, NS are still poorly assessed both in research and clinical settings. This European Psychiatric Association (EPA) guidance recommends the use of persistent negative symptoms (PNS) construct in the context of clinical trials and highlights the need for further efforts to make the definition of PNS consistent across studies in order to exclude as much as possible secondary negative symptoms. We also encourage clinicians to use second-generation scales, at least to complement first-generation ones. The EPA guidance further recommends the evidence-based exclusion of several items included in first-generation scales from any NS summary or factor score to improve NS measurement in research and clinical settings. Self-rated instruments are suggested to further complement observer-rated scales in NS assessment. Several recommendations are provided for the identification of secondary negative symptoms in clinical settings. Conclusions The dissemination of this guidance paper may promote the development of national guidelines on negative symptom assessment and ultimately improve the care of people with schizophrenia.
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Affiliation(s)
- S Galderisi
- Department of Psychiatry, Campania University Luigi Vanvitelli, Naples, Italy
| | - A Mucci
- Department of Psychiatry, Campania University Luigi Vanvitelli, Naples, Italy
| | - S Dollfus
- CHU de Caen, Service de Psychiatrie, 14000Caen, France.,Normandie Univ, UNICAEN, ISTS EA 7466, GIP Cyceron, 14000Caen, France.,Normandie Univ, UNICAEN, UFR de Médecine, 14000Caen, France
| | - M Nordentoft
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark
| | - P Falkai
- Department of Psychiatry, University of Munich, Munich, Germany
| | - S Kaiser
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - G M Giordano
- Department of Psychiatry, Campania University Luigi Vanvitelli, Naples, Italy
| | - A Vandevelde
- CHU de Caen, Service de Psychiatrie, 14000Caen, France.,Normandie Univ, UNICAEN, ISTS EA 7466, GIP Cyceron, 14000Caen, France.,Normandie Univ, UNICAEN, UFR de Médecine, 14000Caen, France
| | - M Ø Nielsen
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark.,Center for Neuropsychiatric Schizophrenia Research, CNSR, Glostrup, Denmark
| | - L B Glenthøj
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, Copenhagen, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Glostrup, Denmark
| | - M Sabé
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - P Pezzella
- Department of Psychiatry, Campania University Luigi Vanvitelli, Naples, Italy
| | - I Bitter
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - W Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
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23
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Ristić I, Jerotić S, Zebić M, Savić B, Vuković V, Russo M, Voskresenski T, Jovanović N, Marić NP. Factorial Structure of the Serbian Version of the Clinical Assessment Interview for Negative Symptoms - Evidence for Three Factors of Negative Symptoms. Front Psychol 2020; 11:570356. [PMID: 33192856 PMCID: PMC7649283 DOI: 10.3389/fpsyg.2020.570356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction: Negative symptoms are a common occurrence in patients with psychosis spectrum disorders. Previous analysis of the latent structure of the Clinical Assessment Interview for Negative Symptoms (CAINS) - which was developed to advance the assessment of negative symptomatology - showed two underlying sub-domains (Motivation and Pleasure; Expression). Recent findings indicate that a more complex structure might be more applicable. Aim: To evaluate the psychometric properties of the Serbian version of the CAINS in a sample of outpatients (N = 67) with psychosis spectrum disorders. Materials and Methods: Negative symptoms and general level of psychopathology were assessed with Serbian translations of the CAINS, the 53-item version of the Brief Symptom Inventory (BSI), and the 24-item version of the Brief Psychiatric Rating Scale (BPRS). Principal component analysis (PCA) was carried out on the CAINS items, and correlation analyses were done to assess its convergent and discriminant validity. Results: Our results showed an excellent internal consistency (Cronbach's alpha = 0.92). PCA revealed a three-component solution consisting of Expressiveness and Motivation for Social and Family Relationships (Factor 1), Motivation for Vocational Activities (Factor 2), and Motivation for Recreation (Factor 3). Convergent validity was supported by significant correlations with the Negative symptoms domain of the BPRS (Factor 1, 0.695, p < 0.01; Factor 2, 0.352, p < 0.05; Factor 3, 0.452, p < 0.01). When assessing discriminant validity, weak correlations were found with BPRS and BSI scores. Conclusion: The Serbian version of CAINS is a valid, reliable and useful tool for the assessment of negative symptomatology. Our findings support a three-factor structure of CAINS, which indicates that the construct is more complex than envisaged by the original conceptualization of two distinct factors.
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Affiliation(s)
- Ivan Ristić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia
| | - Stefan Jerotić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia
| | - Mirjana Zebić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia
| | - Bojana Savić
- Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia
| | - Vuk Vuković
- Special Hospital for Psychiatric Diseases 'Dr Slavoljub Bakalović', Psychiatry, Vršac, Serbia
| | - Manuela Russo
- Unit for Social and Community Psychiatry - WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
| | - Tatjana Voskresenski
- Special Hospital for Psychiatric Diseases 'Dr Slavoljub Bakalović', Psychiatry, Vršac, Serbia
| | - Nikolina Jovanović
- Unit for Social and Community Psychiatry - WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
| | - Nađa P Marić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Psychiatry, Belgrade, Serbia
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24
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Dal Santo F, González-Blanco L, García-Álvarez L, de la Fuente-Tomás L, Velasco Á, Álvarez-Vázquez CM, Martínez-Cao C, Sáiz PA, García-Portilla MP, Bobes J. Cognitive impairment and C-reactive protein in clinically stable schizophrenia outpatients: a focus on sex differences. Sci Rep 2020; 10:15963. [PMID: 32994460 PMCID: PMC7524709 DOI: 10.1038/s41598-020-73043-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022] Open
Abstract
Although previous findings identified an association between C-reactive protein (CRP) levels, and impaired cognitive functions in patients with schizophrenia (SZ), little is currently known about the relationship between inflammation, cognition, and sex in SZ. The current study aimed to explore the association between peripheral inflammation and cognitive impairment in SZ as a function of sex. The sample included 132 clinically stable patients with SZ, of whom 82 were males (62.1%) and 50 females (37.9%). Sociodemographic data were collected, an accurate assessment was performed using the Positive and Negative Syndrome (PANSS), Clinical Assessment Interview for Negative Symptoms (CAINS), and Calgary Depression (CDS) scales, and the MATRICS Consensus Cognitive Battery (MCCB), and CRP levels were tested. A Pearson correlation and multiple regression analyses, including potential confounding factors, were performed. We found an inverse association between CRP levels and performance on visual learning (r = − 0.386, p = 0.006) domain in female patients only, whereas no correlations were found in males. The regression model for women retained age (β = − 0.319, p = 0.017), the CAINS-MAP score (β = − 0.247, p = 0.070), and the CRP (β = − 0.321, p = 0.013) as predictors of visual learning. Our results suggest the possible existence of sex-specific modulation of the association between systemic inflammation and the cognitive features of the illness.
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Affiliation(s)
- Francesco Dal Santo
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Leticia González-Blanco
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain. .,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain. .,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. .,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain. .,Centro de Salud Mental La Corredoria, Alfredo Blanco s/n, Oviedo, Spain.
| | - Leticia García-Álvarez
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain.,Departamento de Psicología, Universidad de Oviedo, Oviedo, Spain
| | - Lorena de la Fuente-Tomás
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Ángela Velasco
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Clara María Álvarez-Vázquez
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | | | - Pilar A Sáiz
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - María Paz García-Portilla
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Julio Bobes
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
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25
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García-Álvarez L, Martínez-Cao C, Bobes-Bascarán T, Portilla A, Courtet P, de la Fuente-Tomás L, Velasco Á, González-Blanco L, Zurrón-Madera P, Fonseca-Pedrero E, Sáiz PA, García-Portilla MP, Bobes J. Validation of a European Spanish-version of the Self-Evaluation of Negative Symptoms (SNS) in patients with schizophrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 15:S1888-9891(20)30036-7. [PMID: 32517967 DOI: 10.1016/j.rpsm.2020.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/11/2020] [Accepted: 04/28/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Negative symptoms can be grouped into five domains: apathy/avolition, anhedonia, asociality, alogia, and affective flattening. There are few validate self-rated measures that assess these five dimensions. Therefore, this study aimed to validate the Self-Evaluation of Negative Symptoms (SNS) in Spanish patients with schizophrenia. MATERIAL AND METHODS Cross-sectional, validation study in 104 outpatients with schizophrenia evaluated using the Spanish version of the following scales: Clinical Assessment Interview for Negative Symptoms (CAINS), Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale for Schizophrenia (CGI-SCH), Personal and Social Performance (PSP), Motivation and Pleasure Scale - Self-Report (MAP-SR), 36-item Short-Form Health Survey (SF-36) and the Self-Evaluation of Negative Symptoms (SNS). RESULTS RELIABILITY Internal consistency (Cronbach's alpha) was 0.915. Convergent validity: The Pearson correlation coefficient between MAP-SR and SNS Total scores was 0.660 (p<0.001). For PANSS-N, the correlation was 0.437 (p<0.005) and with the CAINS-Total was 0.478 (p<0.005). Divergent validity: The Pearson correlation coefficient between SNS and PSP was r=-0.372 (p≤0.001), and with SF-36 Physical and Mental Summary Component scores were r=-0.213 (p=0.066) and r=-0.144 (p=0.219), respectively. Discriminant validity: SNS Total scores were significantly statistically different according to the severity of the negative symptomatology rated by the CGI-SCH negative scale (p<0.001). CONCLUSION The SNS is a reliable and valid instrument to self-rate the five domains of negative symptoms in patients with schizophrenia and seems to be appropriate for use in everyday clinical practice as a complementary measure to the evaluation performed by the clinician.
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Affiliation(s)
- Leticia García-Álvarez
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Clara Martínez-Cao
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Teresa Bobes-Bascarán
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | - Almudena Portilla
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | | | - Lorena de la Fuente-Tomás
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Ángela Velasco
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain
| | - Leticia González-Blanco
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | - Paula Zurrón-Madera
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | - Eduardo Fonseca-Pedrero
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Departamento Ciencias de la Educación, Universidad de la Rioja, Longroño, Spain
| | - Pilar A Sáiz
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
| | - María Paz García-Portilla
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain.
| | - Julio Bobes
- Departamento de Psiquiatría, University of Oviedo, Oviedo, Spain; Institute of Health Research of Principado de Asturias (ISPA), Oviedo, Spain; Institute of Neurosciences of Principado de Asturias (INEUROPA), Oviedo, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Health Service of Principado de Asturias (SESPA), Oviedo, Spain
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26
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Martínez-Cao C, García-Álvarez L, Bobes-Bascarán T, de la Fuente-Tomás L, Fernández-Egea E, Velasco Á, González-Blanco L, Zurrón-Madera P, Fonseca-Pedrero E, Sáiz-Martínez PA, García-Portilla MP, Bobes J. Validation of a European Spanish adaptation of the Apathy Evaluation Scale-self-rated version (AES-S) in patients with schizophrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 15:S1888-9891(20)30033-1. [PMID: 32507728 DOI: 10.1016/j.rpsm.2020.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/10/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Apathy is a negative symptom of schizophrenia and is associated with poor real world functioning. Therefore, it is important to have validated psychometric instruments to assess this symptom. This is the first study to validate the Spanish adaptation of the self-rated version of the Apathy Assessment Scale (AES-S) in patients with schizophrenia. MATERIALS AND METHODS Naturalistic, cross-sectional, validation study in 104 patients with schizophrenia evaluated using the following scales: Clinical Global Impression-Severity (CGI-S), Personal and Social Performance (PSP), Clinical Assessment Interview for Negative Symptoms (CAINS), Self-report of Negative Symptoms (SNS), Motivation and Pleasure Scale-Self-Report (MAP-SR), Calgary Depression Scale for Schizophrenia (CDSS), and Apathy Evaluation Scale-self-rated version (AES-S). RESULTS Reliability: Internal consistency (Cronbach's alpha) was 0.908. Convergent validity: The Pearson correlation coefficient between AES-S and CAINS-MAP total scores was -0.483 (p<0.001). For SNS, total and avolition subscale scores were -0.803 and -0.639 (p<0.001), respectively. With the MAP-SR, the correlation coefficient was -0.727 (p<0.001). Divergent validity: The Pearson correlation coefficient between AES-S and PSP total scores was 0.504 (p<0.001). Furthermore, with the CDSS, the correlation coefficient was -0.431 (p<0.001). Discriminant validity: The AES-S discriminated between different levels of illness severity according to CGI-S scores. Factor analysis: A three-component solution explained 57.32% of the variance. Pearson correlations between coefficients were 1-2=0.265, 1-3=0.464, and 2-3=0.060. CONCLUSION The Spanish AES-S is a reliable and valid instrument for assessing apathy in Spanish patients with schizophrenia. It seems to be appropriate for use in everyday clinical practice as a means of monitoring apathy in these patients.
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Affiliation(s)
| | | | | | | | | | - Ángela Velasco
- Dpto. Psiquiatría, CIBERSAM, Universidad de Oviedo, Oviedo, Spain
| | | | | | | | | | | | - Julio Bobes
- Dpto. Psiquiatría, CIBERSAM, ISPA, Universidad de Oviedo, Oviedo, Spain
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27
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Mezquida G, Penadés R, Cabrera B, Savulich G, Lobo A, González-Pinto A, Penzol M, Corripio I, Fernandez-Egea E, Gassó P, Cuesta M, Bernardo M. Association of the brain-derived neurotrophic factor Val66Met polymorphism with negative symptoms severity, but not cognitive function, in first-episode schizophrenia spectrum disorders. Eur Psychiatry 2020; 38:61-69. [DOI: 10.1016/j.eurpsy.2016.04.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/18/2016] [Accepted: 04/24/2016] [Indexed: 12/12/2022] Open
Abstract
AbstractObjectiveA functional polymorphism of the brain-derived neurotrophic factor gene (BDNF) Val66Met has been associated with cognitive function and symptom severity in patients with schizophrenia. It has been suggested that the Val66Met polymorphism has a role as a modulator in a range of clinical features of the illness, including symptoms severity, therapeutic responsiveness, age of onset, brain morphology and cognitive function. However, little work has been done in first-episode schizophrenia (FES) spectrum disorders. The objective of this study is to investigate the association of the BDNF Val66Met polymorphism on cognitive function and clinical symptomatology in FES patients.MethodsUsing a cross-sectional design in a cohort of 204 patients with FES or a schizophrenia spectrum disorder and 204 healthy matched controls, we performed BDNF Val66Met genotyping and tested its relationship with cognitive testing (attention, working memory, learning/verbal memory and reasoning/problem-solving) and assessment of clinical symptom severity.ResultsThere was no significant influence of the BDNF allele frequency on cognitive factor scores in either patients or controls. An augmented severity of negative symptoms was found in FES patients that carried the Met allele.ConclusionsThe results of this study suggest that in patients with a first-episode of schizophrenia or a schizophrenia spectrum disorder, the BDNF Val66Met polymorphism does not exert an influence on cognitive functioning, but is associated with negative symptoms severity. BDNF may serve as suitable marker of negative symptomatology severity in FES patients within the schizophrenia spectrum.
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28
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Edwards CJ, Garety P, Hardy A. The relationship between depressive symptoms and negative symptoms in people with non-affective psychosis: a meta-analysis. Psychol Med 2019; 49:2486-2498. [PMID: 31530319 DOI: 10.1017/s0033291719002381] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The negative symptoms of psychosis and depressive symptomatology share several features, e.g. low motivation, apathy and reduced activity. Understanding the associations between these two sets of symptoms will support improved assessment and the development of interventions targeting these difficulties in people with psychosis. This is the first large systematic review and meta-analysis to quantify the relationship between these two categories of symptoms, as measured in studies to date. PsycInfo, Embase and Medline were systematically searched to identify eligible studies. Inclusion criteria ensured the studies measured both depression and negative symptoms using validated measures in a sample of over 8000 participants with non-affective psychosis diagnoses. The search led to 2020 records being screened and 56 included in the meta-analysis and review. Both meta-analyses and meta-regressions were conducted to explore the main effect and potential moderating variables. A clear pattern emerges showing that higher ratings of negative symptoms are associated with higher levels of depressive symptoms, with a small effect [standardised effect size = 0.19, p < 0.05). This did not vary greatly with the measures used (SES = 0.19-0.26) and was not moderated by demographic variables or quality ratings. Interestingly, higher depressive symptoms predict a significant relationship with co-occurring negative symptoms. However, higher negative symptoms predict that it is less likely there will be a relationship with co-occurring depressive symptoms. Heterogeneity was high across these analyses. The findings support the adoption of a symptom-specific approach to understanding the interplay between negative and depressive symptoms in psychosis, to improve assessment and intervention.
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Affiliation(s)
- Clementine Jane Edwards
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Philippa Garety
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Amy Hardy
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
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29
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Strauss GP, Esfahlani FZ, Galderisi S, Mucci A, Rossi A, Bucci P, Rocca P, Maj M, Kirkpatrick B, Ruiz I, Sayama H. Network Analysis Reveals the Latent Structure of Negative Symptoms in Schizophrenia. Schizophr Bull 2019; 45:1033-1041. [PMID: 30256991 PMCID: PMC6737465 DOI: 10.1093/schbul/sby133] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Prior studies using exploratory factor analysis provide evidence that negative symptoms are best conceptualized as 2 dimensions reflecting diminished motivation and expression. However, the 2-dimensional model has yet to be evaluated using more complex mathematical techniques capable of testing structure. In the current study, network analysis was applied to evaluate the latent structure of negative symptoms using a community-detection algorithm. Two studies were conducted that included outpatients with schizophrenia (SZ; Study 1: n = 201; Study 2: n = 912) who were rated on the Brief Negative Symptom Scale (BNSS). In both studies, network analysis indicated that the 13 BNSS items divided into 6 negative symptom domains consisting of anhedonia, avolition, asociality, blunted affect, alogia, and lack of normal distress. Separation of these domains was statistically significant with reference to a null model of randomized networks. There has been a recent trend toward conceptualizing the latent structure of negative symptoms in relation to 2 distinct dimensions reflecting diminished expression and motivation. However, the current results obtained using network analysis suggest that the 2-dimensional conceptualization is not complex enough to capture the nature of the negative symptom construct. Similar to recent confirmatory factor analysis studies, network analysis revealed that the latent structure of negative symptom is best conceptualized in relation to the 5 domains identified in the 2005 National Institute of Mental Health consensus development conference (anhedonia, avolition, asociality, blunted affect, and alogia) and potentially a sixth domain consisting of lack of normal distress. Findings have implications for identifying pathophysiological mechanisms and targeted treatments.
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Affiliation(s)
| | - Farnaz Zamani Esfahlani
- Department of Systems Science and Industrial Engineering & Center for Collective Dynamics of Complex Systems, Binghamton University, Binghamton, NY
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Bucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Paola Rocca
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Brian Kirkpatrick
- Department of Psychiatry and Behavioral Sciences, University of Nevada, Reno School of Medicine, Reno, NV
| | - Ivan Ruiz
- Department of Psychology, University of Georgia, Athens, GA
| | - Hiroki Sayama
- Department of Systems Science and Industrial Engineering & Center for Collective Dynamics of Complex Systems, Binghamton University, Binghamton, NY
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Assessing negative symptoms in schizophrenia: Validity of the clinical assessment interview for negative symptoms in Singapore. Schizophr Res 2019; 206:177-182. [PMID: 30558979 DOI: 10.1016/j.schres.2018.11.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/25/2018] [Accepted: 11/23/2018] [Indexed: 11/20/2022]
Abstract
This study aimed to examine the validity of the Clinical Assessment Interview for Negative Symptoms (CAINS) in Singapore. 274 participants with schizophrenia were assessed on the CAINS, Scale for the Assessment of Negative Symptoms (SANS), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Social and Occupational Functioning Assessment Scale (SOFAS) and the Simpson-Angus Extrapyramidal Side Effects Scale (SES). Factor analyses were conducted and Cronbach's coefficient alpha was calculated. Spearman's correlation coefficient was used to assess correlations. The 2-factor model of the CAINS failed to fit our data. Exploratory factor analysis of a randomly selected split-half of the sample yielded four factors: motivation-pleasure (MAP) social, MAP vocational, MAP recreational and expression (EXP), accounting for 73.94% of the total variance. Confirmatory factor analysis on the remaining sample supported this factor structure. Cronbach's alpha for the CAINS was 0.770. Significant correlations were observed between the CAINS total and the SANS total and PANSS negative subscale scores. Good divergent validity was shown by insignificant correlations with PANSS positive subscale score and CDSS total score. The MAP social and recreational factor scores had moderate correlations with the SANS anhedonia-asociality subscale scores, whereas the MAP vocational factor had the highest correlation with the avolition-apathy subscale of the SANS. EXP factor score correlated strongly with the SANS affective flattening and alogia subscales scores. In conclusion, the CAINS has good psychometric properties and can be used by clinicians to assess negative symptoms in individuals with schizophrenia in the local population.
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Li Y, Li WX, Zou YM, Yang ZY, Xie DJ, Yang Y, Lui SSY, Strauss GP, Cheung EFC, Chan RCK. Revisiting the persistent negative symptoms proxy score using the Clinical Assessment Interview for Negative Symptoms. Schizophr Res 2018; 202:248-253. [PMID: 29996973 DOI: 10.1016/j.schres.2018.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/18/2018] [Accepted: 07/01/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The present study aimed to validate a severity cut-off of negative symptoms for persistent negative symptoms (PNS) identification using the Clinical Assessment Interview for Negative Symptoms (CAINS). METHOD A total of 206 patients with schizophrenia were recruited and divided into the PNS group (n = 57) and the Non-PNS group (n = 149) using PNS criteria based on the SANS and the SAPS. To determine the appropriate cut-offs on the CAINS in identifying PNS, Receiver Operating Characteristic (ROC) curve analysis was conducted in the PNS and Non-PNS groups. RESULTS Our results showed that the cutoffs for identifying PNS on the CAINS total score, the Motivation and Pleasure (MAP) subscale score and the Expression (EXP) subscale score were 25, 17, and 5 respectively. Area Under the Curve (AUC) analysis indicated excellent discrimination of the PNS group from the Non-PNS group using the cut-off for the CAINS total score. However, discrimination was somewhat better for the MAP subscale score than the EXP subscale score. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of the MAP subscale were 81.54% and 97.16%. CONCLUSION We found that the cut-off scores derived from the CAINS to identify PNS are comparable to existing scales. The CAINS offers an alternative means in identifying PNS patients in clinical trials that overcomes methodological and conceptual limitations of older scales.
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Affiliation(s)
- Ying Li
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; Haidian District Mental Health Prevent-Treatment Hospital, Beijing, China
| | - Wen-Xiu Li
- Haidian District Mental Health Prevent-Treatment Hospital, Beijing, China
| | - Ying-Min Zou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhuo-Ya Yang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dong-Jie Xie
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yin Yang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Simon S Y Lui
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Gregory P Strauss
- Department of Psychology, University of Georgia, United States of America
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Gonzalez-Blanco L, Maria P Garcia-Portilla, Garcia-Alvarez L, Lorena de la Fuente-Tomas, Garcia CI, Pilar A Saiz, Julio Bobes. Elevated C-reactive protein as a predictor of a random one-year clinical course in the first ten years of schizophrenia. Psychiatry Res 2018; 269:688-691. [PMID: 30273893 DOI: 10.1016/j.psychres.2018.08.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 06/22/2018] [Accepted: 08/13/2018] [Indexed: 02/06/2023]
Abstract
We investigate whether C-reactive protein (CRP) levels could predict the clinical course of patients with schizophrenia in a prospective study of 50 stable outpatients during a random 1-year period within the first 10 years of illness. Positive, negative, depressive, and cognitive symptoms were evaluated. Patients with low-grade inflammation (CRP = 3-10 mg/L; 28%) at baseline showed significant worsening of PANSS-positive and general psychopathology at 1-year follow-up compared with those with CRP ≤ 3 mg/L. Elevated CRP may be a biomarker of poor 1-year clinical course in patients with schizophrenia.
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Affiliation(s)
- Leticia Gonzalez-Blanco
- Department of Psychiatry, University of Oviedo, Julian Claveria 6, Oviedo 33006, Spain; Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
| | - Maria P Garcia-Portilla
- Department of Psychiatry, University of Oviedo, Julian Claveria 6, Oviedo 33006, Spain; Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain.
| | - Leticia Garcia-Alvarez
- Department of Psychiatry, University of Oviedo, Julian Claveria 6, Oviedo 33006, Spain; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
| | - Lorena de la Fuente-Tomas
- Department of Psychiatry, University of Oviedo, Julian Claveria 6, Oviedo 33006, Spain; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
| | - Celso Iglesias Garcia
- Department of Psychiatry, University of Oviedo, Julian Claveria 6, Oviedo 33006, Spain; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Servicio de Salud del Principado de Asturias, Langreo, Spain
| | - Pilar A Saiz
- Department of Psychiatry, University of Oviedo, Julian Claveria 6, Oviedo 33006, Spain; Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, Julian Claveria 6, Oviedo 33006, Spain; Servicio de Salud del Principado de Asturias, Oviedo, Spain; Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
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Xie DJ, Shi HS, Lui SSY, Shi C, Li Y, Ho KKY, Hung KSY, Li WX, Yi ZH, Cheung EFC, Kring AM, Chan RCK. Cross Cultural Validation and Extension of the Clinical Assessment Interview for Negative Symptoms (CAINS) in the Chinese Context: Evidence from a Spectrum Perspective. Schizophr Bull 2018; 44:S547-S555. [PMID: 29471331 PMCID: PMC6188520 DOI: 10.1093/schbul/sby013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The Clinical Assessment Interview for Negative Symptoms (CAINS) was designed in accordance with the recent theory and research in social affective neuroscience and to address the psychometric and conceptual limitations of other instruments assessing negative symptoms. The present study aimed to provide a large-scale validation of the CAINS in China and examine its applicability and validity evidence across the schizophrenia spectrum. Using confirmatory factor analysis, our results replicated the original findings in the US development samples that the CAINS possesses a stable 2-factor structure, namely "motivation/pleasure" and "expression". We also found significant correlations between the CAINS and other negative symptom measures. The CAINS demonstrated good discriminant validity in differentiating negative symptoms in people with schizophrenia, nonpsychotic first-degree relatives and people with social anhedonia. People with schizophrenia exhibited significantly higher CAINS subscale scores than first-degree relatives and healthy controls. In addition, first-degree relatives had higher "motivation/pleasure" scores than healthy controls. The "motivation/pleasure" subscale scores of individuals with social anhedonia were also significantly higher than healthy controls.
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Affiliation(s)
- Dong-jie Xie
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hai-song Shi
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,North China Electric Power University, Beijing, China
| | - Simon S Y Lui
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Chuan Shi
- Peking University Sixth Hospital, Beijing, China,Peking University Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Ying Li
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Haidian District Mental Health Prevent-Treatment Hospital, Beijing, China
| | - Karen K Y Ho
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Karen S Y Hung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Wen-xiu Li
- Haidian District Mental Health Prevent-Treatment Hospital, Beijing, China
| | - Zheng-hui Yi
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Ann M Kring
- Department of Psychology, University of California, Berkeley, CA
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,To whom correspondence should be addressed; Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing 100101, China; tel/fax: +86(0)10-64836274, e-mail:
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Can interleukin-2 and interleukin-1β be specific biomarkers of negative symptoms in schizophrenia? REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2018; 12:9-16. [PMID: 29724678 DOI: 10.1016/j.rpsm.2018.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Evidence suggests the existence of cytokine disturbances in patients with schizophrenia but their association with psychopathology is still unclear. The aim of the current study was to determine if pro-inflammatory cytokine levels (tumor necrosis factor-α, interleukin (IL)-6, IL-2, IL-1β, IL-1RA) are increased in stable outpatients compared with healthy subjects, and to analyze if they could be specific biomarkers of clinical dimensions in schizophrenia. METHODS We studied 73 stable outpatients with schizophrenia in their first 10 years of illness and 73 age- and sex-matched healthy controls. An accurate assessment of clinical dimensions (positive, negative, depressive, cognitive) was performed in patients. RESULTS Only IL-6 levels were significantly increased in patients after controlling for body mass index, waist circumference, smoking, and psychopharmacological treatment, compared with healthy subjects. After adjusting for several confounders, multiple linear regression models identified that Positive and Negative Syndrome Scale negative symptoms, general psychopathology, and global severity are predicted by IL-1β concentrations, while motivation and pleasure domain of Clinical Assessment Interview for Negative Symptoms and Personal and Social Performance global functioning scores are predicted by IL-2 levels. Cognitive performance, positive, and depressive symptom severity did not correlate with any cytokine. CONCLUSIONS Our findings suggested that IL-6 concentrations are elevated in stable patients with schizophrenia. Whereas IL-2 specifically marks severity of the motivation and pleasure domain of negative symptoms, IL-1β is not specific to this dimension as it also predicts severity of general and global symptomatology.
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González-Blanco L, García-Portilla MP, García-Álvarez L, de la Fuente-Tomás L, Iglesias García C, Sáiz PA, Rodríguez-González S, Coto-Montes A, Bobes J. Oxidative stress biomarkers and clinical dimensions in first 10 years of schizophrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2018; 11:130-140. [PMID: 29691142 DOI: 10.1016/j.rpsm.2018.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/17/2018] [Accepted: 03/06/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Several studies have described increased oxidative stress parameters in patients with schizophrenia. The objectives of the current study were to identify potential oxidative stress biomarkers in stable patients during first 10 years of schizophrenia and determine if they are associated with specific clinical dimensions. MATERIAL AND METHODS Seventy-three clinically stable outpatients with schizophrenia and 73 sex and age-matched healthy controls were recruited. Sociodemographic, clinical and biological data were collected at enrollment. Blood biomarkers included homocysteine, the percentage of hemolysis, lipid peroxidation subproducts, and as an antioxidant biomarker, catalase activity in erythrocytes. RESULTS Comparative analyses after controlling for smoking and metabolic syndrome evidenced a significant increase in catalase activity in patients. Also, lower lipid peroxidation levels showed an association with negative symptoms. CONCLUSIONS In conclusion, compensatory antioxidant mechanisms might be increased in stable patients with schizophrenia at early stages. Furthermore, there may be an inverse relationship between oxidative stress and negative dimension.
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Affiliation(s)
- Leticia González-Blanco
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, España; Servicio de Salud del Principado de Asturias, Oviedo, España; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, España.
| | - María Paz García-Portilla
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, España; Servicio de Salud del Principado de Asturias, Oviedo, España; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, España
| | - Leticia García-Álvarez
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, España; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, España
| | | | - Celso Iglesias García
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, España; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, España; Servicio de Salud del Principado de Asturias, Langreo, España
| | - Pilar A Sáiz
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, España; Servicio de Salud del Principado de Asturias, Oviedo, España; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, España
| | | | - Ana Coto-Montes
- Departamento de Morfología y Biología Celular, Universidad de Oviedo, Oviedo, España
| | - Julio Bobes
- Área de Psiquiatría, Universidad de Oviedo, Oviedo, España; Servicio de Salud del Principado de Asturias, Oviedo, España; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, España
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Mezquida G, Cabrera B, Bioque M, Amoretti S, Lobo A, González-Pinto A, Espliego A, Corripio I, Vieta E, Castro-Fornieles J, Bergé D, Escartí MJ, Ibañez Á, Penadés R, Sánchez-Torres AM, Bernardo M. The course of negative symptoms in first-episode schizophrenia and its predictors: A prospective two-year follow-up study. Schizophr Res 2017; 189:84-90. [PMID: 28185786 DOI: 10.1016/j.schres.2017.01.047] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/24/2017] [Accepted: 01/26/2017] [Indexed: 12/13/2022]
Abstract
AIMS This study aimed to investigate the course of negative symptoms and its stability over a two-year period following a first-episode schizophrenia (FES) and the possible predictors of higher severity in this symptomatology after this period. METHODS In this longitudinal two-year prospective follow-up study we included 268 patients with a FES, according to DSM-IV. Analysis of variance was conducted in patients who completed the full follow-up to study changes in negative symptoms over three visits. Regression analyses were conducted to show correlates and potential predictors of negative symptoms at two-year follow-up. RESULTS There was a significant effect for time in negative symptomatology, which was less severe at one-year follow-up after a FES and remained stable up to two years (Time 1>Time 2>Time 3); F(2,151)=20.45, p<0.001. Poorer premorbid adjustment (p=0.01) and higher negative symptoms at baseline (p<0.001) made a significant contribution to the changes in the negative symptoms severity at two-years after a FES (R2=0.21, p<0.001). CONCLUSIONS We found a reduction in the negative symptomatology at one-year after a FES. This change remained stable at two-year. Our results suggested that the presence of this symptomatology early in the course of the illness, together with a poorer premorbid adjustment, predict more severe negative symptoms at mid-term outcome.
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Affiliation(s)
- Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Antonio Lobo
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Araba University Hospital, Bioaraba Research Institute, Spain; University of the Basque Country (UPV-EHU), Spain
| | - Ana Espliego
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), 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
| | - Eduard Vieta
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Psychiatry and Psychology, Clinical Institute for the Neurosciences (ICN), Hospital Clinic of Barcelona, Spain; Department of Medicine, University of Barcelona, Spain
| | - Josefina Castro-Fornieles
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Spain
| | - Daniel Bergé
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Hospital del Mar Medical Research Institute (IMIM) - UAB, Neurosciences, Psychiatry, Barcelona, Spain
| | - Maria J Escartí
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Valencia Clinic Hospital, Valencia, Spain
| | - Ángela Ibañez
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Rafael Penadés
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit (BCSU), Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Spain.
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Lincoln TM, Dollfus S, Lyne J. Current developments and challenges in the assessment of negative symptoms. Schizophr Res 2017; 186:8-18. [PMID: 26960948 DOI: 10.1016/j.schres.2016.02.035] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 02/18/2016] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
Reliable and valid assessment of negative symptoms is crucial to further develop etiological models and improve treatments. Our understanding of the concept of negative symptoms has undergone significant advances since the introduction of quantitative assessments of negative symptoms in the 1980s. These include the conceptualization of cognitive dysfunction as separate from negative symptoms and the distinction of two main negative symptom factors (avolition and diminished expression). In this review we provide an overview of existing negative symptom scales, focusing on both observer-rated and self-rated measurement of negative symptoms. We also distinguish between measures that assess negative symptoms as part of a broader assessment of schizophrenia symptoms, those specifically developed for negative symptoms and those that assess specific domains of negative symptoms within and beyond the context of psychotic disorders. We critically discuss strengths and limitations of these measures in the light of some existing challenges, i.e. observed and subjective symptom experiences, the challenge of distinguishing between primary and secondary negative symptoms, and the overlap between negative symptoms and related factors (e.g. personality traits and premorbid functioning). This review is aimed to inform the ongoing development of negative symptom scales.
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Affiliation(s)
- Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, University of Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany.
| | - Sonia Dollfus
- CHU de Caen, Service universitaire de Psychiatrie, Centre Esquirol, Avenue Côte de Nacre, Caen F-14000, France; UNICAEN, UFR Médecine, F-14074 Caen, France
| | - John Lyne
- Royal College of Surgeons in Ireland, North Dublin Mental Health Services, Ashlin Centre, Beaumont Road, Dublin 9, Ireland; Dublin and East Treatment and Early Care Team, Avila House, Blackrock Business Park, Blackrock, Co. Dublin, Ireland
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Jang SK, Park SC, Choi KH, Yi JS, Park JK, Lee JS, Lee SH. Validation of the Korean Version of the Clinical Assessment Interview for Negative Symptoms. Psychiatry Investig 2017; 14:413-419. [PMID: 28845167 PMCID: PMC5561398 DOI: 10.4306/pi.2017.14.4.413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/30/2016] [Accepted: 06/14/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Clinical Assessment Interview for Negative Symptoms (CAINS) has recently been developed to improve measurement of negative symptoms in schizophrenia. We performed a multi-center study to validate the Korean version of the CAINS (CAINS-K) and explore potential cultural variation. METHODS One hundred eighty schizophrenia patients diverse in demographic and illness profile were recruited from four centers in Korea. Along with the CAINS-K, the Scale for the Assessment of Negative Symptoms (SANS), Brief Psychiatric Rating Scale (BPRS), Calgary Depression Scale for Schizophrenia (CDSS), a self-report measure of behavioral inhibition and activation (BIS/BAS) and neurocognitive tasks were administered to verify external validities. RESULTS The CAINS-K showed high internal-consistency (0.92) and inter-rater reliability (0.77). Exploratory Factor Analysis replicated a two-factor structure of the original scale including motivation/pleasure and expression deficits dimensions. Korean patients tended to report lower pleasure compared to American patients in the prior study. The CAINS-K showed an adequate convergent validity with the SANS, negative symptoms of the BPRS, and BAS. A divergent validity was supported as the CAINS-K showed zero or only weak correlations with other symptoms of the BPRS, depression from the CDSS, and neurocognitive tasks. CONCLUSION The CAINS-K demonstrated high internal consistency and adequate external validities, and is expected to promote studies on negative symptoms in Korean patients with schizophrenia.
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Affiliation(s)
- Seon-Kyeong Jang
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
| | - Seon-Cheol Park
- Department of Psychiatry, Inje University College of Medicine and Haeundae Paik Hospital, Busan, Republic of Korea
| | - Kee-Hong Choi
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Jung-Seo Yi
- Department of Psychiatry, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Joong-Kyu Park
- Department of Rehabilitation Psychology, Daegu University, Daegu, Republic of Korea
| | - Jung Suk Lee
- Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
- Department of Psychiatry, Inje University College of Medicine, Goyang, Republic of Korea
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39
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Crespo-Facorro B, Bernardo M, Argimon JM, Arrojo M, Bravo-Ortiz MF, Cabrera-Cifuentes A, Carretero-Román J, Franco-Martín MA, García-Portilla P, Haro JM, Olivares JM, Penadés R, del Pino-Montes J, Sanjuán J, Arango C. Eficacia, eficiencia y efectividad en el tratamiento multidimensional de la esquizofrenia: proyecto Rethinking. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 10:4-20. [DOI: 10.1016/j.rpsm.2016.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/29/2016] [Accepted: 09/20/2016] [Indexed: 01/20/2023]
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40
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Strauss GP, Gold JM. A Psychometric Comparison of the Clinical Assessment Interview for Negative Symptoms and the Brief Negative Symptom Scale. Schizophr Bull 2016; 42:1384-1394. [PMID: 27174556 PMCID: PMC5049528 DOI: 10.1093/schbul/sbw046] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In 2005, the National Institute of Mental Health held a consensus development conference on negative symptoms of schizophrenia. Among the important conclusions of this meeting were that there are at least 5 commonly accepted domains of negative symptoms (blunted affect, alogia, avolition, anhedonia, asociality) and that new rating scales were needed to adequately assess these constructs. Two next-generation negative symptom scales resulted from this meeting: the Brief Negative Symptom Scale (BNSS) and Clinical Assessment Interview for Negative Symptoms (CAINS). Both measures are becoming widely used and studies have demonstrated good psychometric properties for each scale. The current study provides the first direct psychometric comparison of these scales. Participants included 65 outpatients diagnosed with schizophrenia or schizoaffective disorder who completed clinical interviews, questionnaires, and neuropsychological testing. Separate raters completed the BNSS and CAINS within the same week. Results indicated that both measures had good internal consistency, convergent validity, and discriminant validity. High correspondence was observed between CAINS and BNSS blunted affect and alogia items. Moderate convergence occurred for avolition and asociality items, and low convergence was seen among anhedonia items. Findings suggest that both scales have good psychometric properties, but that there are important distinctions among the items related to motivation and pleasure.
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Affiliation(s)
- Gregory P Strauss
- Department of Psychology, State University of New York at Binghamton, Binghamton, NY;
| | - James M Gold
- Department of Psychiatry and Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
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41
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Jang SK, Choi HI, Park S, Jaekal E, Lee GY, Cho YI, Choi KH. A Two-Factor Model Better Explains Heterogeneity in Negative Symptoms: Evidence from the Positive and Negative Syndrome Scale. Front Psychol 2016; 7:707. [PMID: 27242619 PMCID: PMC4863882 DOI: 10.3389/fpsyg.2016.00707] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 04/27/2016] [Indexed: 11/24/2022] Open
Abstract
Acknowledging separable factors underlying negative symptoms may lead to better understanding and treatment of negative symptoms in individuals with schizophrenia. The current study aimed to test whether the negative symptoms factor (NSF) of the Positive and Negative Syndrome Scale (PANSS) would be better represented by expressive and experiential deficit factors, rather than by a single factor model, using confirmatory factor analysis (CFA). Two hundred and twenty individuals with schizophrenia spectrum disorders completed the PANSS; subsamples additionally completed the Brief Negative Symptom Scale (BNSS) and the Motivation and Pleasure Scale—Self-Report (MAP-SR). CFA results indicated that the two-factor model fit the data better than the one-factor model; however, latent variables were closely correlated. The two-factor model’s fit was significantly improved by accounting for correlated residuals between N2 (emotional withdrawal) and N6 (lack of spontaneity and flow of conversation), and between N4 (passive social withdrawal) and G16 (active social avoidance), possibly reflecting common method variance. The two NSF factors exhibited differential patterns of correlation with subdomains of the BNSS and MAP-SR. These results suggest that the PANSS NSF would be better represented by a two-factor model than by a single-factor one, and support the two-factor model’s adequate criterion-related validity. Common method variance among several items may be a potential source of measurement error under a two-factor model of the PANSS NSF.
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Affiliation(s)
| | - Hye-Im Choi
- Department of Psychology, Korea University Seoul, South Korea
| | - Soohyun Park
- Department of Psychology, Korea University Seoul, South Korea
| | - Eunju Jaekal
- Department of Psychology, Korea University Seoul, South Korea
| | - Ga-Young Lee
- Department of Psychology, Korea University Seoul, South Korea
| | - Young Il Cho
- Department of Psychology, Sungshin Women's University Seoul, South Korea
| | - Kee-Hong Choi
- Department of Psychology, Korea University Seoul, South Korea
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