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Cui X, Xue T, Zhang Z, Yang H, Ren Y. A bibliometric and visual analysis of cognitive function in bipolar disorder from 2012 to 2022. Ann Gen Psychiatry 2024; 23:13. [PMID: 38637833 PMCID: PMC11027271 DOI: 10.1186/s12991-024-00498-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: 01/10/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Bipolar disorder (BD) is a chronic psychiatric disorder that combines hypomania or mania and depression. The study aims to investigate the research areas associated with cognitive function in bipolar disorder and identify current research hotspots and frontier areas in this field. METHODOLOGY Publications related to cognitive function in BD from 2012 to 2022 were searched on the Web of Science Core Collection (WoSCC) database. VOSviewer, CiteSpace, and Scimago Graphica were used to conduct this bibliometric analysis. RESULTS A total of 989 articles on cognitive function in BD were included in this review. These articles were mainly from the United States, China, Canada, Spain and the United Kingdom. Our results showed that the journal "Journal of Affective Disorders" published the most articles. Apart from "Biploar disorder" and "cognitive function", the terms "Schizophrenia", "Meta analysis", "Rating scale" were also the most frequently used keywords. The research on cognitive function in bipolar disorder primarily focused on the following aspects: subgroup, individual, validation and pathophysiology. CONCLUSIONS The current concerns and hotspots in the filed are: "neurocognitive impairment", "subgroup", "1st degree relative", "mania", "individual" and "validation". Future research is likely to focus on the following four themes: "Studies of the bipolar disorder and cognitive subgroups", "intra-individual variability", "Validation of cognitive function tool" and "Combined with pathology or other fields".
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Affiliation(s)
- Xiaohong Cui
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Tailian Xue
- Department of Psychology, School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Zhiyong Zhang
- Department of Psychology, School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, Shanxi, China.
| | - Hong Yang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China
| | - Yan Ren
- Department of Psychiatry, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital, Taiyuan, 030032, China.
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2
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Deng F, Bueber MA, Cao Y, Tang J, Bai X, Cho Y, Lee J, Lin Z, Yang Q, Keshavan MS, Stone WS, Qian M, Yang LH, Phillips MR. Assessing social cognition in patients with schizophrenia and healthy controls using the reading the mind in the eyes test (RMET): a systematic review and meta-regression. Psychol Med 2024; 54:847-873. [PMID: 38173096 DOI: 10.1017/s0033291723003501] [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: 01/05/2024]
Abstract
The reading the mind in the eyes test (RMET) - which assesses the theory of mind component of social cognition - is often used to compare social cognition between patients with schizophrenia and healthy controls. There is, however, no systematic review integrating the results of these studies. We identified 198 studies published before July 2020 that administered RMET to patients with schizophrenia or healthy controls from three English-language and two Chinese-language databases. These studies included 41 separate samples of patients with schizophrenia (total n = 1836) and 197 separate samples of healthy controls (total n = 23 675). The pooled RMET score was 19.76 (95% CI 18.91-20.60) in patients and 25.53 (95% CI 25.19-25.87) in controls (z = 12.41, p < 0.001). After excluding small-sample outlier studies, this difference in RMET performance was greater in studies using non-English v. English versions of RMET (Chi [Q] = 8.54, p < 0.001). Meta-regression analyses found a negative association of age with RMET score and a positive association of years of schooling with RMET score in both patients and controls. A secondary meta-analysis using a spline construction of 180 healthy control samples identified a non-monotonic relationship between age and RMET score - RMET scores increased with age before 31 and decreased with age after 31. These results indicate that patients with schizophrenia have substantial deficits in theory of mind compared with healthy controls, supporting the construct validity of RMET as a measure of social cognition. The different results for English versus non-English versions of RMET and the non-monotonic relationship between age and RMET score highlight the importance of the language of administration of RMET and the possibility that the relationship of aging with theory of mind is different from the relationship of aging with other types of cognitive functioning.
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Affiliation(s)
- Fei Deng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- University of Nottingham School of Economics (Ningbo China), Zhejiang, China
| | - Marlys A Bueber
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yourong Cao
- Guangxi Medical University School of Public Health, Guangxi, China
- The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Jeff Tang
- New York University, New York, NY, USA
| | - Xinyu Bai
- Guangxi Medical University School of Public Health, Guangxi, China
- Guangxi Academy of Medical Sciences & The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Young Cho
- New York State Psychiatric Institute, New York, NY, USA
| | - Jiwon Lee
- Teachers College, Columbia University, New York, NY, USA
| | - Zhuozhi Lin
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Qi Yang
- Ningxia Medical University School of Public Health, Ningxia, China
| | - Matcheri S Keshavan
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - William S Stone
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Min Qian
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lawrence H Yang
- New York University, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
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3
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Varo C, Amoretti S, Sparacino G, Jiménez E, Solé B, Bonnin CDM, Montejo L, Serra M, Torrent C, Salagre E, Benabarre A, Salgado-Pineda P, Montoro Salvatierra I, Sáiz PA, García-Portilla MP, Sánchez-Gistau V, Pomarol-Clotet E, Ramos-Quiroga JA, Pacchiarotti I, Garcia-Rizo C, Undurraga J, Reinares M, Martinez-Aran A, Vieta E, Verdolini N. Emotional intelligence: a comparison between patients after first episode mania and those suffering from chronic bipolar disorder type I. Psychol Med 2023; 53:3065-3076. [PMID: 35574736 PMCID: PMC10235671 DOI: 10.1017/s0033291721005122] [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: 07/07/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Deficits in emotional intelligence (EI) were detected in patients with bipolar disorder (BD), but little is known about whether these deficits are already present in patients after presenting a first episode mania (FEM). We sought (i) to compare EI in patients after a FEM, chronic BD and healthy controls (HC); (ii) to examine the effect exerted on EI by socio-demographic, clinical and neurocognitive variables in FEM patients. METHODS The Emotional Intelligence Quotient (EIQ) was calculated with the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). Performance on MSCEIT was compared among the three groups using generalized linear models. In patients after a FEM, the influence of socio-demographic, clinical and neurocognitive variables on the EIQ was examined using a linear regression model. RESULTS In total, 184 subjects were included (FEM n = 48, euthymic chronic BD type I n = 75, HC n = 61). BD patients performed significantly worse than HC on the EIQ [mean difference (MD) = 10.09, standard error (s.e.) = 3.14, p = 0.004] and on the understanding emotions branch (MD = 7.46, s.e. = 2.53, p = 0.010). FEM patients did not differ from HC and BD on other measures of MSCEIT. In patients after a FEM, EIQ was positively associated with female sex (β = -0.293, p = 0.034) and verbal memory performance (β = 0.374, p = 0.008). FEM patients performed worse than HC but better than BD on few neurocognitive domains. CONCLUSIONS Patients after a FEM showed preserved EI, while patients in later stages of BD presented lower EIQ, suggesting that impairments in EI might result from the burden of disease and neurocognitive decline, associated with the chronicity of the illness.
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Affiliation(s)
- Cristina Varo
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Silvia Amoretti
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Giulio Sparacino
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Esther Jiménez
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Brisa Solé
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Caterina del Mar Bonnin
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Laura Montejo
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Maria Serra
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Estela Salagre
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Antoni Benabarre
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Pilar Salgado-Pineda
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- FIDMAG Germanes Hospitalàries Research Foundation, c/Dr. Pujades 38, 08830, Sant Boi de Llobregat, Barcelona, Spain
| | - Irene Montoro Salvatierra
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, CIBERSAM, Reus, Tarragona, Spain
| | - Pilar A. Sáiz
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Deparment of Psychiatry, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Mental Health Services of Principado de Asturias, SESPA, Oviedo, Spain
| | - María Paz García-Portilla
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Deparment of Psychiatry, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Mental Health Services of Principado de Asturias, SESPA, Oviedo, Spain
| | - Vanessa Sánchez-Gistau
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, CIBERSAM, Reus, Tarragona, Spain
| | - Edith Pomarol-Clotet
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- FIDMAG Germanes Hospitalàries Research Foundation, c/Dr. Pujades 38, 08830, Sant Boi de Llobregat, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabella Pacchiarotti
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Clemente Garcia-Rizo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Juan Undurraga
- Department of Neurology and Psychiatry, Faculty of Medicine, Clinica Alemana Universidad del Desarrollo, Santiago, Chile
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago, Chile
| | - María Reinares
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
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Bora E, Verim B, Akgul O, Ildız A, Ceylan D, Alptekin K, Özerdem A, Akdede BB. Clinical and developmental characteristics of cognitive subgroups in a transdiagnostic sample of schizophrenia spectrum disorders and bipolar disorder. Eur Neuropsychopharmacol 2023; 68:47-56. [PMID: 36640733 DOI: 10.1016/j.euroneuro.2022.12.005] [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: 08/24/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023]
Abstract
Evidence suggests that neurocognitive dysfunction is a transdiagnostic feature of individuals across the continuum between schizophrenia and bipolar disorder. However, there is significant heterogeneity of neuropsychological and social-cognitive abilities in schizophrenia, schizoaffective disorder, and bipolar disorder. The current study aimed to investigate the clinical and developmental characteristics of cognitive subgroups within the schizo-bipolar spectrum. 147 clinically stable patients with schizophrenia, schizoaffective or bipolar disorder were assessed using clinical rating scales for current psychotic and affective symptoms, and a comprehensive neuropsychological battery including measures of social cognition (Hinting and Reading the mind from the Eyes (RMET) task)). Developmental history and premorbid academic functioning were also evaluated. The study also included 36 healthy controls. Neurocognitive subgroups were investigated using latent class analysis (LCA). The optimal number of clusters was determined based on the Bayesian information criterion. A logistic regression analysis was conducted to investigate the predictors of membership to the globally impaired subgroup. LCA revealed two neurocognitive clusters including globally impaired (n = 89, 60.5%) and near-normal cognitive functioning (n = 58, 39.5%) subgroups. The near-normal cognitive functioning subgroup was not significantly different from healthy controls. The globally impaired subgroup had a higher score of developmental abnormalities (p<0.001), poorer premorbid academic functioning, mothers who were less educated and more severe disorganized speech (p = 0.001) and negative symptoms (p = 0.004) compared to the near-normal cognitive functioning group. History of developmental abnormalities and persistent disorganization rather than diagnosis are significant predictors of the subgroup of individuals with global cognitive impairment in the schizophrenia-bipolar disorder continuum.
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Affiliation(s)
- Emre Bora
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey.
| | - Burcu Verim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Ozge Akgul
- Department of Psychology, İzmir Demokrasi University, İzmir, Turkey
| | - Ayşegül Ildız
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Deniz Ceylan
- Department of Psychiatry and Psychology, Koc University, Istanbul, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Ayşegül Özerdem
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Berna Binnur Akdede
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
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5
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Christiani CJ, Hemager N, Ellersgaard D, Thorup AAE, Spang KS, Burton BK, Gregersen M, Søndergaard A, Greve A, Gantriis DL, Mors O, Plessen KJ, Nordentoft M, Jepsen JRM. Heterogeneity of social cognitive and language functions in children at familial high-risk of severe mental illness; The Danish High Risk and Resilience Study VIA 7. Eur Child Adolesc Psychiatry 2022; 31:991-1002. [PMID: 33559734 DOI: 10.1007/s00787-021-01722-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Cognitive heterogeneity characterizes individuals with schizophrenia and bipolar disorder; however, little is known of cognitive heterogeneity within young children at familial high-risk of schizophrenia or bipolar disorder. This study aimed to investigate heterogeneity across social cognitive and language functions in children at familial high-risk of schizophrenia or bipolar disorder, i.e. severe mental illness (FHR-SMI). This may help designate subgroups in need of intervention initiatives. A data-driven, hierarchical cluster analysis was applied across a sample of 322 children at FHR-SMI (FHR-SZ, n = 200; FHR-BP, n = 120) on measures of Theory of Mind, facial emotion recognition, social cognitive processing speed, receptive and pragmatic language. We examined differences between subgroups as well as differences between subgroups and a control group. Exploratively, the subgroups were compared in terms of social responsiveness and global functioning. A Typical-High Functioning Subgroup with intact social cognitive and language functioning (34.5%), a Mildly Impaired Subgroup with selective impairments in explicit Theory of Mind and language functioning (58.7%), and a Significantly Impaired Subgroup with social cognitive and language functioning impairments (6.8%) were identified. The subgroups differed significantly from each other and overall compares to the controls. The Significantly and Mildly Impaired Subgroups presented with poorer social responsiveness and global functioning than the Typical-High Functioning Subgroup. In young children with FHR-SMI, three subgroups with relatively homogeneous social cognitive and language functioning profiles were observed. Only a small proportion of children at FHR-SMI displayed large social cognitive and language functioning impairments in middle childhood.
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Affiliation(s)
- Camilla Jerlang Christiani
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark. .,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.
| | - Nicoline Hemager
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Ditte Ellersgaard
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Anne A E Thorup
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Katrine Søborg Spang
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Birgitte Klee Burton
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Maja Gregersen
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Anne Søndergaard
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte Lou Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin J Plessen
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital, Lausanne, Switzerland
| | - Merete Nordentoft
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Risskov, Aarhus, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Danish High Risk and Resilience Study VIA7, Copenhagen Research Centre for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, 4, 2900, Hellerup, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.,Mental Health Services-Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Glostrup, Denmark
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6
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Navarra-Ventura G, Vicent-Gil M, Serra-Blasco M, Cobo J, Fernández-Gonzalo S, Goldberg X, Jodar M, Crosas JM, Palao D, Lahera G, Vieta E, Cardoner N. Higher order theory of mind in patients with bipolar disorder and schizophrenia/schizoaffective disorder. Eur Arch Psychiatry Clin Neurosci 2022; 272:497-507. [PMID: 33948693 DOI: 10.1007/s00406-021-01265-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 04/22/2021] [Indexed: 02/07/2023]
Abstract
Some evidence suggests that patients with bipolar disorder (BD) have better Theory of Mind (ToM) skills than patients with schizophrenia/schizoaffective disorder (SCH). However, this difference is not consistently reported across studies, so rather than being global, it may be restricted to specific aspects of ToM. Our primary objective was to compare higher order ToM performance between BD and SCH patients using the Hinting Task (HT). Ninety-four remitted patients were recruited (BD = 47, SCH = 47). Intelligence quotient (IQ), attention, memory, executive functions, and processing speed were also assessed. Patients with BD performed better on the HT than patients with SCH, even when the analysis was adjusted for IQ and neurocognition (p < 0.001, [Formula: see text] = 0.144). Regression analysis in the total sample showed that a diagnosis of SCH and lower IQ were associated with lower HT scores (R2 = 0.316, p < 0.001). In the BD group, verbal memory and processing speed were the main predictors of HT performance (R2 = 0.344, p < 0.001). In the SCH group, no variable was significant in explaining HT performance. In the context of previous studies that found no significant differences in the most basic aspects of ToM (e.g., understand other people's thoughts/beliefs), our results suggest that differences between the two disorders might be limited to the more challenging aspects (e.g., understand the intended meaning of indirect requests). No causal inferences can be made in this cross-sectional study. However, regression analyses show that whereas in BD patients, ToM functioning would be partially modulated by neurocognitive performance, in SCH patients, it could be largely independent of the well-known neurocognitive impairment.
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Affiliation(s)
- Guillem Navarra-Ventura
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Muriel Vicent-Gil
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain
| | - Maria Serra-Blasco
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Cobo
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sol Fernández-Gonzalo
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain
| | - Ximena Goldberg
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Jodar
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain.,Department of Neurology, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain
| | - Josep Maria Crosas
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain
| | - Diego Palao
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Guillermo Lahera
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Faculty of Medicine and Health Sciences, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Institute of Neuroscience, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Narcís Cardoner
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain. .,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Cerdanyola del Vallès, Bellaterra, Catalonia, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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7
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Hemager N, Christiani CJ, Thorup AAE, Spang KS, Ellersgaard D, Burton BK, Gregersen M, Greve AN, Wang Y, Nudel R, Mors O, Plessen KJ, Nordentoft M, Jepsen JRM. Neurocognitive heterogeneity in 7-year-old children at familial high risk of schizophrenia or bipolar disorder: The Danish high risk and resilience study - VIA 7. J Affect Disord 2022; 302:214-223. [PMID: 35085674 DOI: 10.1016/j.jad.2022.01.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/19/2022] [Accepted: 01/23/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Studies of neurocognitive heterogeneity in young children at familial high-risk of bipolar disorder (FHR-BP) or schizophrenia (FHR-SZ) are important to investigate inter-individual neurocognitive differences. We aimed to identify neurocognitive subgroups, describe prevalence of FHR-BP or FHR-SZ children herein, and examine risk ratios (RR) compared with controls. METHODS In a population-based cohort of 514 7-year-old children (197 FHR-SZ, 118 FHR-BP, and 199 matched controls) we used hierarchical cluster analyses to identify subgroups across 14 neurocognitive indices. RESULTS Three neurocognitive subgroups were derived: A Mildly Impaired (30%), Typical (51%), and Above Average subgroup (19%). The Mildly Impaired subgroup significantly underperformed controls (Cohen d = 0.11-1.45; Ps < 0.001) except in set-shifting (P = .84). FHR-SZ children were significantly more prevalent in the Mildly Impaired subgroup; FHR-BP children were more so in the Above Average subgroup (X2 (2, N = 315) = 9.64, P < .01). 79.7% FHR-BP and 64.6% FHR-SZ children demonstrated typical or above average neurocognitive functions. Neurocognitive heterogeneity related significantly to concurrent functioning, psychopathology severity, home environment adequacy, and polygenic scores for schizophrenia (Ps <. 01). Compared with controls, FHR-SZ and FHR-BP children had a 93% (RR, 1.93; 95% CI, 1.40-2.64) and 8% (RR, 1.08; 95% CI, 0.71-1.66) increased risk of Mildly Impaired subgroup membership. LIMITATIONS Limitations include the cross-sectional design and smaller FHR-BP sample size. CONCLUSIONS Identification of neurocognitive heterogeneity in preadolescent children at FHR-BP or FHR-SZ may ease stigma and enable pre-emptive interventions to enhance neurocognitive functioning and resilience to mental illness in the impaired sub-population.
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Affiliation(s)
- Nicoline Hemager
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
| | - Camilla Jerlang Christiani
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Anne Amalie Elgaard Thorup
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Katrine Søborg Spang
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Ditte Ellersgaard
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Maja Gregersen
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Yunpeng Wang
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ron Nudel
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Mental Health Center Sct. Hans, Mental Health Services, Institute of Biological Psychiatry, Capital Region of Denmark, Roskilde, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin Jessica Plessen
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital Lausanne, Lausanne, Switzerland
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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8
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Varo C, Solé B, Jiménez E, Bonnín CM, Torrent C, Valls E, Lahera G, Martínez-Arán A, Carvalho AF, Miskowiak KW, Vieta E, Reinares M. Identifying social cognition subgroups in euthymic patients with bipolar disorder: a cluster analytical approach. Psychol Med 2022; 52:159-168. [PMID: 32546284 DOI: 10.1017/s0033291720001865] [Citation(s) in RCA: 8] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is associated with social cognition (SC) impairments even during remission periods although a large heterogeneity has been described. Our aim was to explore the existence of different profiles on SC in euthymic patients with BD, and further explore the potential impact of distinct variables on SC. METHODS Hierarchical cluster analysis was conducted using three SC domains [Theory of Mind (ToM), Emotional Intelligence (EI) and Attributional Bias (AB)]. The sample comprised of 131 individuals, 71 patients with BD and 60 healthy control subjects who were compared in terms of SC performance, demographic, clinical, and neurocognitive variables. A logistic regression model was used to estimate the effect of SC-associated risk factors. RESULTS A two-cluster solution was identified with an adjusted-performance group (N = 48, 67.6%) and a low-performance group (N = 23, 32.4%) with mild deficits in ToM and AB domains and with moderate difficulties in EI. Patients with low SC performance were mostly males, showed lower estimated IQ, higher subthreshold depressive symptoms, longer illness duration, and poorer visual memory and attention. Low estimated IQ (OR 0.920, 95% CI 0.863-0.981), male gender (OR 5.661, 95% CI 1.473-21.762), and longer illness duration (OR 1.085, 95% CI 1.006-1.171) contributed the most to the patients clustering. The model explained up to 35% of the variance in SC performance. CONCLUSIONS Our results confirmed the existence of two discrete profiles of SC among BD. Nearly two-thirds of patients exhibited adjusted social cognitive abilities. Longer illness duration, male gender, and lower estimated IQ were associated with low SC performance.
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Affiliation(s)
- C Varo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Jiménez
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C M Bonnín
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Valls
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - G Lahera
- Faculty of Medicine, University of Alcalá, IRyCIS, CIBERSAM, Madrid, Spain
| | - A Martínez-Arán
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A F Carvalho
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - K W Miskowiak
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - E Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Reinares
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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9
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From phone use to speeding and driving under influence: Identifying clusters of driving risk behaviors as an opportunity for targeted interventions. J Psychiatr Res 2021; 143:556-562. [PMID: 33218750 DOI: 10.1016/j.jpsychires.2020.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/16/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022]
Abstract
Identifying the profile of risky behaviors among drivers is central to propose effective interventions. Due to the multidimensional and overlapping aspects of risky driving behaviors, cluster analysis can provide additional insights in order to identify specific subgroups of risk. This study aimed to identify clusters of driving risk behavior (DRB) among car drivers, and to verify intra-cluster differences concerning clinical and sociodemographic variables. We approached a total of 12,231 drivers and we included 6392 car drivers. A cluster algorithm was used to identify groups of car drivers in relation to the DRB: driving without a seat belt (SB), exceeding the speed limit (SPD), using a cell phone while driving (CELL), and driving after drinking alcohol (DUI). The algorithm classified drivers within five different DRB profiles. In cluster 1 (20.1%), subjects with a history of CELL. In cluster 2 (41.4%), drivers presented no DRB. In cluster 3 (9.3%), all drivers presented SPD. In cluster 4 (12.5%), drivers presented all DRB. In cluster 5 (16.6%), all drivers presented DUI. Clusters with DUI-related offenses (4 and 5) comprised more men (81.9 and 78.8%, respectively) than the overall sample (63.4%), with more binge drinking (50.9 and 45.7%) and drug use in the previous year (13.5 and 8.6%). Cluster 1 had a high years of education (14.4 ± 3.4) and the highest personal income (Md = 3000 IQR [2000-5000]). Cluster 2 had older drivers (46.6 ± 15), and fewer bingers (10.9%). Cluster 4 had the youngest drivers (34.4 ± 11.4) of all groups. Besides reinforcing previous literature data, our study identified five unprecedented clusters with different profiles of drivers regarding DRB. We identified an original and heterogeneous group of drivers with only CELL misuse, as well as other significant differences among clusters. Hence, our findings show that targeted interventions must be developed for each subgroup in order to effectively produce safe behavior in traffic.
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10
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Group and sex differences in social cognition in bipolar disorder, schizophrenia/schizoaffective disorder and healthy people. Compr Psychiatry 2021; 109:152258. [PMID: 34252633 DOI: 10.1016/j.comppsych.2021.152258] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 06/11/2021] [Accepted: 06/21/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Impairment of social cognition is documented in bipolar disorder (BD) and schizophrenia/schizoaffective disorder (SCH). In healthy individuals, women perform better than men in some of its sub-domains. However, in BD and SCH the results are mixed. Our aim was to compare emotion recognition, affective Theory of Mind (ToM) and first- and second-order cognitive ToM in BD, SCH and healthy subjects, and to investigate sex-related differences. METHODS 120 patients (BD = 60, SCH = 60) and 40 healthy subjects were recruited. Emotion recognition was assessed by the Pictures of Facial Affect (POFA) test, affective ToM by the Reading the Mind in the Eyes Test (RMET) and cognitive ToM by several false-belief stories. Group and sex differences were analyzed using parametric (POFA, RMET) and non-parametric (false-belief stories) tests. The impact of age, intelligence quotient (IQ) and clinical variables on patient performance was examined using a series of linear/logistic regressions. RESULTS Both groups of patients performed worse than healthy subjects on POFA, RMET and second-order false-belief (p < 0.001), but no differences were found between them. Instead, their deficits were related to older age and/or lower IQ (p < 0.01). Subthreshold depression was associated with a 6-fold increased risk of first-order false-belief failure (p < 0.001). Sex differences were only found in healthy subjects, with women outperforming men on POFA and RMET (p ≤ 0.012), but not on first/second-order false-belief. LIMITATIONS The cross-sectional design does not allow for causal inferences. CONCLUSION BD and SCH patients had deficits in emotion recognition, affective ToM, and second-order cognitive ToM, but their performance was comparable to each other, highlighting that the differences between them may be subtler than previously thought. First-order cognitive ToM remained intact, but subthreshold depression altered their normal functioning. Our results suggest that the advantage of healthy women in the emotional and affective aspects of social cognition would not be maintained in BD and SCH.
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11
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Miskowiak KW, Varo C. Social cognition in bipolar disorder: A proxy of psychosocial function and novel treatment target? Eur Neuropsychopharmacol 2021; 46:37-38. [PMID: 33813264 DOI: 10.1016/j.euroneuro.2021.03.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 01/06/2023]
Affiliation(s)
- Kamilla Woznica Miskowiak
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Cristina Varo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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12
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Cognitive heterogeneity in the offspring of patients with schizophrenia or bipolar disorder: a cluster analysis across family risk. J Affect Disord 2021; 282:757-765. [PMID: 33601716 DOI: 10.1016/j.jad.2020.12.090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/13/2020] [Accepted: 12/22/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Neurocognitive impairment is considered to lie on a continuum of severity across schizophrenia (SZ) and bipolar disorder (BP), possibly reflecting a gradient of neurodevelopmental load. Cluster analyses have identified different levels of impairment across the two disorders, from none to widespread and severe. We for the first time used this approach to examine cognitive function pooling together children and adolescents at familial risk of SZ or BP. METHODS 220 participants, 49 offspring of individuals with schizophrenia (SZO), 90 offspring of individuals with bipolar disorder (BPO) and 81 offspring of healthy control parents (HC), aged 6 to 17 years, underwent a comprehensive clinical and cognitive assessment. Cognitive measures were used to group SZO and BPO using K-means clustering. Cognitive performance within each of the clusters was compared to that of HC and clinical variables were compared between clusters. RESULTS We identified three cognitive subgroups: a moderate impairment group, a mild impairment group, and a cognitively intact group. Both SZO and BPO were represented in each of the clusters, yet not evenly, with a larger proportion of the SZO in the moderately impaired cluster, but also a subgroup of BPO showing moderate cognitive dysfunction. LIMITATIONS Participants have yet to reach the age of onset for the examined disorders. CONCLUSIONS The findings point to a range of neurodevelopmental loadings across youth at familial risk of both SZ and BP. They have therefore important implications for the stratification of cognitive functioning and the possibility to tailor interventions to individual levels of impairment.
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13
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Chakrabarty T, Torres IJ, Su WW, Sawatzky R, Keramatian K, Yatham LN. Cognitive subgroups in first episode bipolar I disorder: Relation to clinical and brain volumetric variables. Acta Psychiatr Scand 2021; 143:151-161. [PMID: 33089491 DOI: 10.1111/acps.13245] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/17/2020] [Accepted: 10/08/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Distinct cognitive subgroups are seen in patients with long duration bipolar I disorder (BDI), possibly reflective of underlying pathophysiological differences. It is unknown whether such cognitive heterogeneity is present at illness onset. We applied latent class analysis (LCA) to cognitive test scores in first episode BDI patients. Exploratory analysis elucidated whether impaired subgroups were characterized by 'early neurodevelopmental' (low premorbid IQ and intracranial volume) versus 'later neurodevelopmental' (decline from premorbid to current IQ, changes in relative grey (GM)/white (WM) matter volumes) pathology. METHODS Recently recovered first manic episode BDI patients (n = 91) and healthy controls (HC, n = 63) comprised the study sample. LCA identified subgroups based on processing speed, verbal memory, non-verbal memory, executive functioning, attention and working memory scores. Subgroups were compared amongst each other and HC on premorbid/current IQ, intracranial (ICV), total brain and regional volumes. RESULTS Three cognitive subgroups emerged: (i) globally impaired (GI, n = 31), scoring 0.5-1 SD below demographically corrected norms across domains, (ii) selectively impaired (SI, n = 47), with predominant processing speed deficits and (iii) high performing (HP, n = 13), with above-average cognitive performance. GI patients showed a 'later neurodevelopmental' pattern, with normal ICV, significant decline from premorbid to current IQ, higher total GM and lower total WM (with respect to total brain volume) versus SI and HC (p = 0.003). GI patients had higher left frontal pole GM versus HC (p < 0.05, FWE corrected). CONCLUSIONS A globally impaired patient subgroup is identifiable in first episode BDI, possibly characterized by unique neurodevelopmental pathologic processes proximal to illness onset.
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Affiliation(s)
- Trisha Chakrabarty
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Ivan J Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,British Columbia Mental Health and Substance Use Services, Vancouver, BC, Canada
| | - Weizhong W Su
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Richard Sawatzky
- School of Nursing, Trinity Western University, Langley, BC, Canada.,Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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14
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Giurgi-Oncu C, Bredicean C, Frandeș M, Enătescu V, Papavă I, Riviș I, Ursoniu S. Social Inferences as Mediators of Wellbeing in Depression. Neuropsychiatr Dis Treat 2021; 17:1679-1687. [PMID: 34079265 PMCID: PMC8166309 DOI: 10.2147/ndt.s309009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/29/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Depression is an increasingly prevalent chronic mental health condition that involves a range of potentially negative implications, in the long term. Theory of Mind (ToM) serves to form and maintain social relationships, by accurately identifying thoughts and emotions in others. Defective ToM abilities have been noted in people with a history of clinical depression. PURPOSE To identify whether impairments of emotion recognition are correlated with a lower subjective feeling of wellbeing in people diagnosed with a chronic depressive illness. PATIENTS AND METHODS In a cross-sectional analysis of a recurrent depressive disorder (RDD, as per WHO ICD-10 nosology) cohort (n=57), the BECK depression scale and the "Reading the mind in the eyes" test were employed for the diagnosis of clinical symptoms, and for the evaluation of individual ToM skills, respectively. Wellbeing was quantified using the FANLCT scale. RESULTS The wellbeing of service-users decreased significantly, in correlation with their defective emotion recognition abilities. Additionally, a low capacity for the correct perception of emotions in other people appears to significantly influence the social relationships status, with scores of 14.00 (10.00-18.50) at low capacity vs 23.00 (17.58-24.75) at normal capacity (Mann-Whitney U-test, p < 0.001). Our study findings indicate that a normal ability for a correct recognition of emotions in others is significantly and strongly correlated with adequate social relationships (Spearman r = 0.757, p < 0.05). CONCLUSION Wellbeing is significantly correlated with the individual ability for a correct recognition of emotions in others.
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Affiliation(s)
- Cătălina Giurgi-Oncu
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.,"Pius Brînzeu" County Emergency Clinical Hospital, Timișoara, Romania
| | - Cristina Bredicean
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.,"Dr. Victor Popescu" Military Clinical Emergency Hospital, Timișoara, Romania
| | - Mirela Frandeș
- Department of Functional Sciences, Discipline of Medical Informatics and Biostatistics, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Virgil Enătescu
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.,"Pius Brînzeu" County Emergency Clinical Hospital, Timișoara, Romania
| | - Ion Papavă
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania.,"Pius Brînzeu" County Emergency Clinical Hospital, Timișoara, Romania
| | - Ioana Riviș
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Sorin Ursoniu
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
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15
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Konstantakopoulos G, Ioannidi N, Psarros C, Patrikelis P, Stefanatou P, Kravariti E. The impact of neurocognition on mentalizing in euthymic bipolar disorder versus schizophrenia. Cogn Neuropsychiatry 2020; 25:405-420. [PMID: 33050828 DOI: 10.1080/13546805.2020.1829579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: Theory of mind (ToM) or mentalizing deficits have been found in schizophrenia (SZ) and bipolar disorder (BD), but their relationships to patients' coexistent neurocognitive deficits are still unclear. The present study aimed to explore the possible differential involvement of neurocognitive deficits in ToM impairments in SZ and euthymic BD. Methods: Fifty-three euthymic patients with BD type I, 54 clinically stable patients with SZ, and 53 healthy participants were assessed with an advanced ToM task (Faux Pas Recognition Test) which measures cognitive and affective ToM components, and a comprehensive battery of neuropsychological measures. The three groups were matched for gender, age and education. Results: Patients with BD showed significant impairment, comparable to that in SZ, only in the cognitive facet of ToM, whereas SZ patients had significantly poorer performance than both BD patients and healthy participants in overall and affective ToM. In both SZ and euthymic BD, ToM performance was related to deficits in particular cognitive functions. After controlling for coexistent neurocognitive deficits, overall and affective ToM in SZ were still impaired whereas the cognitive ToM impairment in BD and SZ did not remained statistically significant. Conclusions: Our findings suggest a different profile of ToM deficits between SZ and BD and an independence of ToM dysfunction from concurrent neurocognitive deficits in SZ but not in BD.
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Affiliation(s)
- George Konstantakopoulos
- First Department of Psychiatry, National & Kapodistrian University of Athens, Eginition Hospital, Athens, Greece.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nikoleta Ioannidi
- First Department of Psychiatry, National & Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Constantin Psarros
- First Department of Psychiatry, National & Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Panayiotis Patrikelis
- Department of Neurosurgery, National & Kapodistrian University of Athens, Evangelismos Hospital, Athens, Greece
| | - Pentagiotissa Stefanatou
- First Department of Psychiatry, National & Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Eugenia Kravariti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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16
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Maleki G, Zabihzadeh A, Richman MJ, Demetrovics Z, Mohammadnejad F. Decoding and reasoning mental states in major depression and social anxiety disorder. BMC Psychiatry 2020; 20:463. [PMID: 32972392 PMCID: PMC7517604 DOI: 10.1186/s12888-020-02873-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major depression (MDD) and social anxiety (SAD) disorders are debilitating psychiatric conditions characterized by disturbed interpersonal relationships. Despite these impairments in social relationships, research has been limited in simultaneously evaluating the dysfunction in MDD or SAD within two aspects of theory of mind (ToM): decoding mental states (i.e., Affective ToM) and reasoning mental states (i.e., cognitive ToM). Taking this into consideration, the current study assesses both decoding and reasoning mental states abilities in MDD, SAD, and healthy controls (HC). METHODS Subjects included 37 patients with MDD, 35 patients with SAD, and 35 HCs. ToM was measured with the Reading the Mind in the Eyes Test (RMET) and the Faux Pas Task, which assess decoding and reasoning mental states, respectively. RESULTS Results revealed that in decoding of mental states, both the SAD and MDD groups had lower scores than the HC group; there was no significant difference between the SAD and MDD groups in decoding mental states. Conversely, in reasoning mental states, the SAD and HC groups had higher scores than the MDD group; no differences were found between the SAD and HC groups. CONCLUSIONS Clinicians and researchers should further consider parsing generalized impairment in ToM into two aspects: decoding and reasoning of mental states by using the aforementioned measurements. By further understanding the two aspects, we can create a potentially new clinical profile for mental health disorders, such as in this context with both decoding and reasoning mental state impairment in MDD and just a decoding impairment in SAD.
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Affiliation(s)
- Gheysar Maleki
- Department of Clinical Psychology, Shahid Behashti University, District 1, Evin, Daneshjou Boulevard, Tehran, 1983969411, Iran.
| | - Abbas Zabihzadeh
- Department of Clinical Psychology, Shahid Behashti University, District 1, Evin, Daneshjou Boulevard, Tehran, 1983969411, Iran
| | - Mara J Richman
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
- Endeavor Psychology, Boston, MA, USA
- Department of Clinical Psychology and Addiction, Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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17
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Sjølie C, Meyn EK, Raudeberg R, Andreassen OA, Vaskinn A. Nonsocial cognitive underpinnings of theory of mind in schizophrenia. Psychiatry Res 2020; 289:113055. [PMID: 32446008 DOI: 10.1016/j.psychres.2020.113055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 04/30/2020] [Indexed: 12/30/2022]
Abstract
Social cognition is a mediator between nonsocial cognition and functional outcome in schizophrenia. However, the relationship between specific nonsocial cognitive and social cognitive domains is less clear. The aim of this study was to investigate which specific nonsocial cognitive domains best predict theory of mind (ToM) performance in schizophrenia. We indexed ToM by a composite score of the video-based Movie for the Assessment of Social Cognition test (MASCtot) in a sample of 91 individuals with schizophrenia. Nonsocial cognition was measured with the nonsocial cognitive subtests of the MATRICS Consensus Cognitive Battery (MCCB) and the Wechsler Abbreviated Scale of Intelligence (WASI IQ). Bivariate and multiple regression analyses were applied. We found statistically significant bivariate associations between MASCtot and five nonsocial cognitive tests, measuring intelligence, speed of processing, verbal or visual memory, and non-verbal working memory. Together, they accounted for 17% of the variation in MASCtot, but none of the five tests made significant unique contributions to MASCtot in the regression analysis. Our results confirm that nonsocial cognition and ToM are associated, albeit distinct, constructs. The findings suggest that cognitive remediation must include social cognitive targets in order to achieve improved ToM and better functioning.
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Affiliation(s)
- Charlotte Sjølie
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Emilie K Meyn
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Rune Raudeberg
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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18
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Neurocognitive heterogeneity across the spectrum of psychopathology: need for improved approaches to deficit detection and intervention. CNS Spectr 2020; 25:436-444. [PMID: 31131779 DOI: 10.1017/s1092852919001081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Neurocognition is one of the strongest predictors of clinical and functional outcomes across the spectrum of psychopathology, yet there remains a dearth of unified neurocognitive nosology and available neurocognition-targeted interventions. Neurocognitive deficits manifest in a transdiagnostic manner, with no psychiatric disorder uniquely affiliated with one specific deficit. In fact, recent research has identified that essentially all investigated disorders are comprised of 3-4 neurocognitive profiles. This within-disorder neurocognitive heterogeneity has hampered the development of novel, neurocognition-targeted interventions, as only a portion of patients with any given disorder possess neurocognitive deficits that would warrant neurocognitive intervention. The development of criteria and terminology to characterize these neurocognitive deficit syndromes would provide clinicians with the opportunity to more systematically identify and treat their patients and provide researchers the opportunity to develop neurocognition-targeted interventions for patients. This perspective will summarize recent work and discuss possible approaches for neurocognition-focused diagnosis and treatment in psychiatry.
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19
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Bora E. A comparative meta-analysis of neurocognition in first-degree relatives of patients with schizophrenia and bipolar disorder. Eur Psychiatry 2020; 45:121-128. [DOI: 10.1016/j.eurpsy.2017.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 06/12/2017] [Accepted: 06/13/2017] [Indexed: 12/29/2022] Open
Abstract
AbstractObjective:Cognitive impairment is a familial and heritable aspect of major psychoses and might be a shared vulnerability marker for schizophrenia and BP. However, it is not clear whether some aspects of cognitive deficits are uniquely associated with risk for specific diagnoses.Methods:A novel meta-analysis of cognitive functions in first-degree relatives of probands with bipolar disorder (BP-Rel) and schizophrenia (Sch-Rel) was conducted. Current meta-analysis included 20 studies and compared cognitive functions of 1341 Sch-Rel, 939 BP-Rel and 1427 healthy controls.Results:Sch-Rel was associated with cognitive deficits in all domains (d = 0.20–0.58) and BP-Rel underperformed healthy controls in processing speed, verbal fluency and speed based executive function tests (d = 0.33–0.41). Sch-Rel underperformed BP-Rel in general intellectual ability, working memory, verbal memory, planning, processing speed and fluency (d = 0.24–0.42).Conclusions:Inefficiency in processing information and impaired processing speed might be common vulnerability factors for major psychoses. On the other hand, low performance in accuracy based tasks and deficits in general intellectual ability, verbal learning, planning and working memory might be more specifically associated with risk for schizophrenia.
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20
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Bora E, Özerdem A. A meta-analysis of neurocognition in youth with familial high risk for bipolar disorder. Eur Psychiatry 2020; 44:17-23. [DOI: 10.1016/j.eurpsy.2017.02.483] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 02/11/2017] [Accepted: 02/12/2017] [Indexed: 12/11/2022] Open
Abstract
AbstractObjective:Neuropsychological impairment, including deficits in social cognition is evident in subjects at genetic high-risk for psychosis. However, findings in youth at genetic risk to bipolar disorder (BP) have been suggested to be less supportive of premorbid deficits. We aimed to conduct a meta-analysis of cognitive deficits in youth with familiar risk for bipolar disorder (FHR-BD).Methods:A novel meta-analysis of FHR-BD (mean age 10–25), including 18 studies (786 offsprings/siblings of patients with BD and 794 healthy controls), was conducted.Results:Both general cognition (d = 0.29, CI = 0.15–0.44) and social cognition (d = 0.23, CI = 0–0.45) were impaired in FHR-BD. In comparison to controls, FHR-BD had significant deficits in several cognitive domains, including visual memory (d = 0.35), verbal memory (d = 0.21), processing speed (d = 0.26) and sustained attention (d = 0.36). There was no significant difference between FHR-BD and controls in planning and working memory.Conclusions:Cognitive deficits are evident in individuals who are at genetic high-risk for developing BD. Neurodevelopmental abnormalities are likely playing a role not only in schizophrenia but also in BD.
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21
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Smucny J, Iosif AM, Eaton NR, Lesh TA, Ragland JD, Barch DM, Gold JM, Strauss ME, MacDonald AW, Silverstein SM, Carter CS. Latent Profiles of Cognitive Control, Episodic Memory, and Visual Perception Across Psychiatric Disorders Reveal a Dimensional Structure. Schizophr Bull 2020; 46:154-162. [PMID: 30953588 PMCID: PMC6942157 DOI: 10.1093/schbul/sbz025] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Although meta-analyses suggest that schizophrenia (SZ) is associated with a more severe neurocognitive phenotype than mood disorders such as bipolar disorder, considerable between-subject heterogeneity exists in the phenotypic presentation of these deficits across mental illnesses. Indeed, it is unclear whether the processes that underlie cognitive dysfunction in these disorders are unique to each disease or represent a common neurobiological process that varies in severity. Here we used latent profile analysis (LPA) across 3 distinct cognitive domains (cognitive control, episodic memory, and visual integration; using data from the CNTRACS consortium) to identify distinct profiles of patients across psychotic illnesses. LPA was performed on a sample of 223 psychosis patients (59 with Type I bipolar disorder, 88 with SZ, and 76 with schizoaffective disorder). Seventy-three healthy control participants were included for comparison but were not included in sample LPA. Three latent profiles ("Low," "Moderate," and "High" ability) were identified as the underlying covariance across the 3 domains. The 3-profile solution provided highly similar fit to a single continuous factor extracted by confirmatory factor analysis, supporting a unidimensional structure. Diagnostic ratios did not significantly differ between profiles, suggesting that these profiles cross diagnostic boundaries (an exception being the Low ability profile, which had only one bipolar patient). Profile membership predicted Brief Psychiatric Rating Scale and Young Mania Rating Scale symptom severity as well as everyday communication skills independent of diagnosis. Biological, clinical and methodological implications of these findings are discussed.
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Affiliation(s)
- Jason Smucny
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
| | - Ana-Maria Iosif
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
| | - Nicholas R Eaton
- Department of Psychology, State University of New York Stony Brook, Stony Brook, NY
| | - Tyler A Lesh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
| | - J Daniel Ragland
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
| | - Deanna M Barch
- Department of Psychology, Washington University in St. Louis, St. Louis, MO
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, Catonsville, MD
| | - Milton E Strauss
- Department of Psychology, University of New Mexico, Albuquerque, NM
| | | | - Steven M Silverstein
- Departments of Psychiatry and Ophthalmology, Rutgers – The State University of New Jersey, New Brunswick, NJ
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA
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22
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A Systematic Review of Studies Reporting Data-Driven Cognitive Subtypes across the Psychosis Spectrum. Neuropsychol Rev 2019; 30:446-460. [PMID: 31853717 DOI: 10.1007/s11065-019-09422-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 12/02/2019] [Indexed: 10/25/2022]
Abstract
The delineation of cognitive subtypes of schizophrenia and bipolar disorder may offer a means of determining shared genetic markers and neuropathology among individuals with these conditions. We systematically reviewed the evidence from published studies reporting the use of data-driven (i.e., unsupervised) clustering methods to delineate cognitive subtypes among adults diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder. We reviewed 24 studies in total, contributing data to 13 analyses of schizophrenia spectrum patients, 8 analyses of bipolar disorder, and 5 analyses of mixed samples of schizophrenia and bipolar disorder participants. Studies of bipolar disorder most consistently revealed a 3-cluster solution, comprising a subgroup with 'near-normal' (cognitively spared) cognition and two other subgroups demonstrating graded deficits across cognitive domains. In contrast, there was no clear consensus regarding the number of cognitive subtypes among studies of cognitive subtypes in schizophrenia, while four of the five studies of mixed diagnostic groups reported a 4-cluster solution. Common to all cluster solutions was a severe cognitive deficit subtype with cognitive impairments of moderate to large effect size relative to healthy controls. Our review highlights several key factors (e.g., symptom profile, sample size, statistical procedures, and cognitive domains examined) that may influence the results of data-driven clustering methods, and which were largely inconsistent across the studies reviewed. This synthesis of findings suggests caution should be exercised when interpreting the utility of particular cognitive subtypes for biological investigation, and demonstrates much heterogeneity among studies using unsupervised clustering approaches to cognitive subtyping within and across the psychosis spectrum.
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23
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Quidé Y, Wilhelmi C, Green MJ. Structural brain morphometry associated with theory of mind in bipolar disorder and schizophrenia. Psych J 2019; 9:234-246. [DOI: 10.1002/pchj.322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/04/2019] [Accepted: 09/30/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Yann Quidé
- School of Psychiatry University of New South Wales Sydney Australia
- Neuroscience Research Australia Randwick Australia
| | | | - Melissa J. Green
- School of Psychiatry University of New South Wales Sydney Australia
- Neuroscience Research Australia Randwick Australia
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24
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Miranda AR, Franchetto Sierra J, Martínez Roulet A, Rivadero L, Serra SV, Soria EA. Age, education and gender effects on Wisconsin card sorting test: standardization, reliability and validity in healthy Argentinian adults. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:807-825. [PMID: 31744387 DOI: 10.1080/13825585.2019.1693491] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological assessment of executive functioning. The aim of this study was to provide norm values and analyze the psychometric properties of WCST in healthy Argentinian adults aged from 18 to 89 years old (N = 235). Descriptive statistics are reported as means, standard deviations and percentiles, with the effects of age, education and gender being investigated by ANOVA, and with the effect sizes being calculated. The psychometrics were studied using the WCST structure, reliability, convergent validity, and discriminant validity, and WCST norms adjusted for age and educational level are proposed. This instrument is a reliable and valid tool for the assessment of executive functions. However, as the age- and educational-related effects were demonstrated, these characteristics need to be considered before interpreting WCST scores. Regarding gender, no differences were found. Our results expand the geographical and sociocultural applicability of WCST.
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Affiliation(s)
- Agustín R Miranda
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA , Córdoba, Argentina
| | - Juliana Franchetto Sierra
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Amparo Martínez Roulet
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Luisina Rivadero
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Silvana V Serra
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Elio A Soria
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA , Córdoba, Argentina.,Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Cátedra de Biología Celular, Histología y Embriología, Instituto de Biología Celular , Cordoba, Argentina
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25
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Bora E, Can G, Ildız A, Ulas G, Ongun CH, Inal NE, Ozerdem A. Neurocognitive heterogeneity in young offspring of patients with bipolar disorder: The effect of putative clinical stages. J Affect Disord 2019; 257:130-135. [PMID: 31301613 DOI: 10.1016/j.jad.2019.07.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/26/2019] [Accepted: 07/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is associated with significant cognitive heterogeneity. In recent years, a number of studies have investigated cognitive subgroups in BD using data-driven methods and found that BD includes several subgroups including a severely impaired and a neurocognitively intact cluster. Studies in offspring of BD (BDoff) are particularly important to establish the timing of emergence of cognitive subgroups but studies investigating cognitive heterogeneity in BDoff are lacking. Our aim was to investigate cognitive heterogeneity in BDoff and the relationship between cognitive heterogeneity and putative clinical stages of BD. METHODS Seventy-one euthymic BDoff and 50 healthy controls were assessed using clinical measures and a battery of neuropsychological tests. Neurocognitive subgroups were investigated using latent class analysis. RESULTS Three neurocognitive subgroups, including a severe impairment group, a good performance cluster, and a subgroup characterized by intermediate/selective impairment was found. Both severe and intermediate level impairment subgroups underperformed healthy controls in processing speed, verbal fluency, visual memory and working memory. Deficits in verbal memory and executive functions were only evident in severe impairment subgroup. The putative stage of the illness had no significant effect on cognitive clustering of BDoff. Trait impulsivity scores were significantly increased in severe and intermediate impairment clusters but not in the cognitively good functioning subgroup of BDoff. LIMITATIONS The cross-sectional nature of the study was the main consideration. CONCLUSION These results suggest that cognitive heterogeneity is premorbid characteristic of BD and cognitive subgroups of BDoff emerge prior to the onset of illness and prodromal symptoms.
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Affiliation(s)
- Emre Bora
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Mithatpaşa Cad. No:1606 Inciraltı Yerleskesi 35340 Balcova, Izmir, Turkey; Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne, Australia.
| | - Gunes Can
- Department of Psychiatry, Mardin State Hospital, Mardin, Turkey
| | - Aysegul Ildız
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Gozde Ulas
- Department of Child and Adolescent Psychiatry, Çankırı State Hospital, Çankırı, Turkey
| | | | - Neslihan Emiroglu Inal
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Aysegul Ozerdem
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Mithatpaşa Cad. No:1606 Inciraltı Yerleskesi 35340 Balcova, Izmir, Turkey; Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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26
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The Accuracy of INECO Frontal Screening in the Diagnosis of Executive Dysfunction in Frontotemporal Dementia and Alzheimer Disease. Alzheimer Dis Assoc Disord 2019; 32:314-319. [PMID: 29734264 DOI: 10.1097/wad.0000000000000255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Executive dysfunction is a common symptom in neurodegenerative disorders and is in need of easy-to-apply screening tools that might identify it. The aims of the present study were to examine some of the psychometric characteristics of the Brazilian version of the INECO frontal screening (IFS), and to investigate its accuracy to diagnose executive dysfunction in dementia and its accuracy to differentiate Alzheimer disease (AD) from the behavioral variant of frontotemporal dementia (bvFTD). METHODS Patients diagnosed with bvFTD (n=18) and AD (n=20), and 15 healthy controls completed a neuropsychological battery, the Neuropsychiatric Inventory, the Cornell Scale for Depression in Dementia, the Clinical Dementia Rating, and the IFS. RESULTS The IFS had acceptable internal consistency (α=0.714) and was significantly correlated with general cognitive measures and with neuropsychological tests. The IFS had adequate accuracy to differentiate patients with dementia from healthy controls (AUC=0.768, cutoff=19.75, sensitivity=0.80, specificity=0.63), but low accuracy to differentiate bvFTD from AD (AUC=0.594, cutoff=16.75, sensitivity=0.667, specificity=0.600). CONCLUSION The present study suggested that the IFS may be used to screen for executive dysfunction in dementia. Nonetheless, it should be used with caution in the differential diagnosis between AD and bvFTD.
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27
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Espinós U, Fernández-Abascal EG, Ovejero M. Theory of mind in remitted bipolar disorder: Interpersonal accuracy in recognition of dynamic nonverbal signals. PLoS One 2019; 14:e0222112. [PMID: 31509553 PMCID: PMC6738608 DOI: 10.1371/journal.pone.0222112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 08/21/2019] [Indexed: 11/25/2022] Open
Abstract
A relatively unexplored aspect in bipolar disorder (BD) is the ability to accurately judge other´s nonverbal behavior. To explore this aspect of social cognition in this population is particularly meaningful, as it may have an influence in their social and interpersonal functioning. The aim of this research was to study interpersonal accuracy (IPA) in remitted BDs, that is, the specific skills that fall under the general term Theory of Mind (ToM). Study participants included 119 remitted individuals with BD (70 BD I and 49 BD II), and they were compared with a group of 39 persons diagnosed with unipolar depression (UD) and 119 control participants. The MiniPONS was used to test the whole spectrum of nonverbal cues as facial expressions, body language and voice. Results indicated a superiority of the control group with statistically significant differences both in the performance in the MiniPONS (number of right answers) and in each of the areas evaluated by this test. BD groups, in recognition of the meaning of gestures in face, body and voice intonation, performed significantly worse than controls. ANCOVA analysis controlling the effect of age shows that control group performed significantly better compared to clinical groups, and there were no differences between UD and BD groups. The results indicate a deficit in IPA and suggest that better comprehension of deficiencies in interpersonal accuracy in BD may help to develop new training programs to improve in these patients the understanding of others, which might have a positive impact in their psychosocial functionality, and thus lead to the objective of functional rehabilitation.
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Affiliation(s)
- Usue Espinós
- Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
- * E-mail:
| | | | - Mercedes Ovejero
- Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain
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28
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Carruthers SP, Van Rheenen TE, Gurvich C, Sumner PJ, Rossell SL. Characterising the structure of cognitive heterogeneity in schizophrenia spectrum disorders. A systematic review and narrative synthesis. Neurosci Biobehav Rev 2019; 107:252-278. [PMID: 31505202 DOI: 10.1016/j.neubiorev.2019.09.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/19/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022]
Abstract
The aim of the present review was to systematically summarise our current understanding of the structure of the cognitive heterogeneity that exists within schizophrenia spectrum disorder (SSD). Fifty-two relevant studies were identified from January 1980 to March 2019 that investigated cognitive subgroups within SSD. Twenty-five studies employed classification criteria based on current neuropsychological function, 14 studies employed various data-driven subgrouping methodologies and 13 studies investigated putative cognitive symptom trajectories. Despite considerable methodological variability, three distinct cognitive subgroups reliability emerged; a relatively intact cognitive subgroup characterised by high cognitive performance, an intermediate cognitive subgroup defined by mixed or moderate levels of cognitive function/dysfunction and a globally impaired subgroup characterised by severe cognitive deficits. Whilst preliminary evidence suggests that these subgroups may have further investigative relevance in and of themselves, additional research is required and discussed. A set of reporting guidelines are also presented to overcome the methodological inconsistencies identified in the reviewed literature.
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Affiliation(s)
- Sean P Carruthers
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia.
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, 3053, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred Hospital, Melbourne, 3004, Australia
| | - Philip J Sumner
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia; St Vincent's Hospital, Melbourne, Victoria, 3065, Australia
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Hanlon FM, Yeo RA, Shaff NA, Wertz CJ, Dodd AB, Bustillo JR, Stromberg SF, Lin DS, Abrams S, Liu J, Mayer AR. A symptom-based continuum of psychosis explains cognitive and real-world functional deficits better than traditional diagnoses. Schizophr Res 2019; 208:344-352. [PMID: 30711315 PMCID: PMC6544465 DOI: 10.1016/j.schres.2019.01.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/10/2019] [Accepted: 01/19/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Patients with psychotic spectrum disorders share overlapping clinical/biological features, making it often difficult to separate them into a discrete nosology (i.e., Diagnostic and Statistical Manual of Mental Disorders [DSM]). METHODS The current study investigated whether a continuum classification scheme based on symptom burden would improve conceptualizations for cognitive and real-world dysfunction relative to traditional DSM nosology. Two independent samples (New Mexico [NM] and Bipolar and Schizophrenia Network on Intermediate Phenotypes [B-SNIP]) of patients with schizophrenia (NM: N = 93; B-SNIP: N = 236), bipolar disorder Type I (NM: N = 42; B-SNIP: N = 195) or schizoaffective disorder (NM: N = 15; B-SNIP: N = 148) and matched healthy controls (NM: N = 64; B-SNIP: N = 717) were examined. Linear regressions examined how variance differed as a function of classification scheme (DSM diagnosis, negative and positive symptom burden, or a three-cluster solution based on symptom burden). RESULTS Symptom-based classification schemes (continuous and clustered) accounted for a significantly larger portion of captured variance of real-world functioning relative to DSM diagnoses across both samples. The symptom-based classification schemes accounted for large percentages of variance for general cognitive ability and cognitive domains in the NM sample. However, in the B-SNIP sample, symptom-based classification schemes accounted for roughly equivalent variance as DSM diagnoses. A potential mediating variable across samples was the strength of the relationship between negative symptoms and impaired cognition. CONCLUSIONS Current results support suggestions that a continuum perspective of psychopathology may be more powerful for explaining real-world functioning than the DSM diagnostic nosology, whereas results for cognitive dysfunction were sample dependent.
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Affiliation(s)
- Faith M Hanlon
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
| | - Ronald A Yeo
- Department of Psychology, University of New Mexico, 2001 Redondo S Dr., Albuquerque, NM 87106, USA.
| | - Nicholas A Shaff
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
| | - Christopher J Wertz
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
| | - Andrew B Dodd
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
| | - Juan R Bustillo
- Department of Psychiatry, University of New Mexico School of Medicine, MSC09 5030, 1 University of New Mexico, Albuquerque, NM 87131, USA.
| | - Shannon F Stromberg
- Psychiatry and Behavioral Health Clinical Program, Presbyterian Healthcare System, 1325 Wyoming Blvd. NE, Albuquerque, NM 87112, USA.
| | - Denise S Lin
- Department of Psychiatry, University of New Mexico School of Medicine, MSC09 5030, 1 University of New Mexico, Albuquerque, NM 87131, USA.
| | - Swala Abrams
- Department of Psychiatry, University of New Mexico School of Medicine, MSC09 5030, 1 University of New Mexico, Albuquerque, NM 87131, USA.
| | - Jingyu Liu
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
| | - Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA; Department of Psychology, University of New Mexico, 2001 Redondo S Dr., Albuquerque, NM 87106, USA; Department of Psychiatry, University of New Mexico School of Medicine, MSC09 5030, 1 University of New Mexico, Albuquerque, NM 87131, USA; Department of Neurology, University of New Mexico School of Medicine, MSC10 5620, 1 University of New Mexico, Albuquerque, NM 87131, USA.
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30
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Varo C, Jiménez E, Solé B, Bonnín CM, Torrent C, Lahera G, Benabarre A, Saiz PA, de la Fuente L, Martínez-Arán A, Vieta E, Reinares M. Social cognition in bipolar disorder: the role of sociodemographic, clinical, and neurocognitive variables in emotional intelligence. Acta Psychiatr Scand 2019; 139:369-380. [PMID: 30786002 DOI: 10.1111/acps.13014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The main aims of this study were to examine the differences in the Emotional Intelligence (EI), the emotional domain of social cognition (SC), between euthymic patients with bipolar disorder (BD) and healthy controls (HC) and to evaluate the contribution of sociodemographic, clinical, and neuropsychological variables to EI. METHODS We recruited 202 patients with BD and 50 HC. EI was evaluated using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). The sociodemographic, clinical, and neurocognitive variables that showed a significant association with EI were entered into hierarchical multiple regression analysis. RESULTS BD patients obtained significantly lower scores compared to HC in the Emotional Intelligence Quotient (EIQ) and in the Understanding Emotions branch score. The best fitting model for the variables associated with EI in the patients group was a linear combination of gender, estimated IQ, family history of affective diagnosis, and executive function. The model, including these previous variables, explained up to 27.6% of the observed variance (R2 = 0.276, F = 16.406, P < 0.001). CONCLUSIONS The identification of variables associated with deficit in EI, such as male gender, lower estimated IQ, family history of affective diagnosis. and lower executive function performance, may help in selecting treatment targets to improve SC, and especially EI, in patients with BD.
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Affiliation(s)
- C Varo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Jiménez
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C M Bonnín
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - G Lahera
- Faculty of Medicine, University of Alcalá, IRyCIS, CIBERSAM, Madrid, Spain
| | - A Benabarre
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - P A Saiz
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - L de la Fuente
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - A Martínez-Arán
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Reinares
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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Associations of oxytocin and vasopressin plasma levels with neurocognitive, social cognitive and meta cognitive function in schizophrenia. Psychiatry Res 2018; 270:1010-1016. [PMID: 29609987 DOI: 10.1016/j.psychres.2018.03.048] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 11/22/2022]
Abstract
Many with schizophrenia experiences deficits in social cognition, neurocognition and metacognition. Yet the biological mechanisms which may underpin these cognitive deficits are poorly understood. Two candidate causes of these deficits are disturbances in oxytocin (OT) and vasopressin (VP). To explore this we assessed plasma OT and VP in 34 schizophrenia patients and 31 healthy controls. We also concurrently assessed social cognition using the Reading the Mind from the Eyes test, neurocognition using the Wisconsin Card Sorting Test and metacognition using the Metacognitive Assessment Scale-Abbreviated. Group comparisons revealed lower plasma OT levels in the schizophrenia group. Plasma VP levels did not differ between groups. Correlations revealed that lower levels of OT were associated with poorer levels of metacognitive functioning in the schizophrenia group but not poorer social cognition or neurocognition. In a stepwise multiple regression, plasma OT level, neurocognition and social cognition contributed uniquely to the prediction of metacognition in the schizophrenia group. Results may suggest that disturbance in OT is linked with deficits in metacognition and may interact with other forms of cognitive deficits, interfering with the person's abilities to form a complex and integrated sense of self and others.
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32
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López-Navarro E. Contributions of executive functions components to affective and cognitive theory of mind in outpatients diagnosed with schizophrenia. Psychiatry Res 2018; 269:124-125. [PMID: 30145292 DOI: 10.1016/j.psychres.2018.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/26/2018] [Accepted: 08/10/2018] [Indexed: 11/29/2022]
Abstract
Aim was to use a well-stablished Executive Functions (EF) model to test if different EF domains predict performance in affective and cognitive Theory of Mind (ToM) in schizophrenia. Fifty-four outpatients diagnosed with DSM-IV-TR schizophrenia disorder were recruited. Assessment consisted in Trail Making Test Part B (TMT-B) to assess Shifting, WAIS Backwards Digits to assess Updating, Stroop Test Non-congruent trials to assess Inhibition, Reading the Mind in the Eyes Test (RMET), and Hinting Test. Stroop Test Non-congruent predicted RMET scores, while TMT-B predicted Hinting Test scores. Findings suggest that cognitive and affective ToM performance are associated to specific EF processes.
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Affiliation(s)
- Emilio López-Navarro
- EvoCog Group - Associated Unit to CSIC, Department of Psychology, University of Balearic Islands, Ctra Valldemossa km 7,5, Balearic Islands, Spain.
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Bora E, Akgül Ö, Ceylan D, Özerdem A. Neurological soft signs in bipolar disorder in comparison to healthy controls and schizophrenia: A meta-analysis. Eur Neuropsychopharmacol 2018; 28:1185-1193. [PMID: 30170709 DOI: 10.1016/j.euroneuro.2018.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/23/2018] [Accepted: 08/07/2018] [Indexed: 12/29/2022]
Abstract
Neurological soft signs (NSS) are subtle deficits in motor coordination, sensory integration, and sequencing of complex motor acts. Increased NSS is a well-established feature of patients with schizophrenia but a relatively smaller number of studies have investigated NSS in bipolar disorder (BD). Some authors but not others suggested that NSS can distinguish schizophrenia from BD. We conducted a meta-analysis of 18 studies to quantitatively review NSS in BD in comparison to schizophrenia and healthy controls. The current meta-analysis compared NSS scores of 725 BD patients and 634 healthy controls, and 391 BD and 471 schizophrenia patients. Patients with BD had significantly higher NSS scores (d = 1.14, CI = 0.89-1.44) than healthy controls and increased scores in BD was evident in all aspects of NSS (d = 0.88-0.99). BD was associated with a less severe increase in NSS compared to schizophrenia, however, between-group difference was modest (d = 0.42, CI = 0.18-0.65). The results of this meta-analysis demonstrated that BD is characterized by a robust increase in NSS which is only moderately less severe than schizophrenia. Increased NSS is a common feature of both disorders.
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Affiliation(s)
- Emre Bora
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Mithatpaşa cad. no 1606 inciraltı yerleşkesi, 35340 Balçova, Izmir, Turkey; Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, 3053 Carlton South, Victoria, Australia.
| | - Özge Akgül
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Deniz Ceylan
- Vocational School of Health Services, Izmir Economy University, Izmir Turkey
| | - Ayşegül Özerdem
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Mithatpaşa cad. no 1606 inciraltı yerleşkesi, 35340 Balçova, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
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34
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Sex-specific association of a common GNAS polymorphism with self-reported cognitive empathy in healthy volunteers. PLoS One 2018; 13:e0206114. [PMID: 30365517 PMCID: PMC6203261 DOI: 10.1371/journal.pone.0206114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 10/08/2018] [Indexed: 11/19/2022] Open
Abstract
Background In a recent study, we found associations of a common oxytocin receptor (OXTR) polymorphism with inter-individual differences in empathy, especially with emotional empathy in women. Many other studies found specific associations of oxytocin, arginine-vasopressin, serotonin and dopamine receptor gene polymorphisms with various aspects of trait empathy. As all these receptors belong to the guanine-binding protein (G protein) coupled receptor family, it is a reasonable assumption, that alterations in genes encoding G protein subunits also influence the signal transduction in empathy related circuits. However, to the best of our knowledge, these genomic variations have not yet been studied in genetic research on empathy. Methods Here, we analysed associations of a common polymorphism of the GNAS gene (C393T) in a previously characterized sample of 421 healthy blood donors (231 M, 190 F; age 18–74). The GNAS gene encodes the G protein adenylyl cyclase stimulator (Gαs) G protein subunit, which activates cyclic adenosine monophosphate (cAMP)-dependent pathways by stimulating the adenylyl cyclase. Cognitive and emotional aspects of dispositional empathy were tested using Davis’ Interpersonal Reactivity Index (IRI). Results In the complete sample, associations of C393T genotype with IRI empathy scores, including cognitive empathy (p = 0.055) and perspective taking (p = 0.057) scores did not reach a level of significance. None of the IRI scores was near to being significantly associated with C393T genotype for men alone. In females, however, genotype was significantly associated with cognitive empathy (r = -.204, p = 0.005) and perspective taking (r = -.209, p = 0.004), accounting for 4.2% and 4.4% of variability. The association of genotype with perspective taking remained significant after adjustment for multiple comparisons (p = 0.045). The 393C-allele, which had been identified as a risk factor in several medical conditions such as hypertension, obesity and diabetes, was associated with higher cognitive empathy compared to the T allele in our sample. Conclusions The results suggest a significant association of GNAS C393T genotypes with the cognitive empathic capacity of perspective taking. This association could only be found in female participants.
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Eblin JJ, Meyer GJ, Mihura JL, Viglione DJ, O'Gorman ET. Development and preliminary validation of a brief behavioral measure of psychotic propensity. Psychiatry Res 2018; 268:340-347. [PMID: 30098541 DOI: 10.1016/j.psychres.2018.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/24/2018] [Accepted: 08/01/2018] [Indexed: 12/01/2022]
Abstract
Extensive research demonstrates that the dimensional assessment of psychotic manifestations is a primary strength of the Rorschach inkblot task, which provides an in vivo sample of problem-solving behavior and normative standards concerning the logic and coherence of thought processes and the typicality of perceptual representations. This article presents foundational research for the Thought and Perception Assessment System (TPAS), a Rorschach-based system designed to assess solely for disordered thinking and perceptual aberrations using either the standard 10-card set of inkblots or alternative 3-, 4-, and 5-card short forms. Using data from three patient samples (ns = 61, 93, and 133) and one nonpatient sample (n = 118), we document the equivalence of mean scores across the full and short-form card sets. We also document satisfactory interrater reliability and validity for the full and short forms, as well as strong part-whole reliability coefficients between the short forms and the full form. Consistent with psychometric theory and the principle of aggregation, each type of coefficient decreased as a function of decreasing the number of cards. We discuss implications and future applications in research and clinical assessment.
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Affiliation(s)
- Joshua J Eblin
- Department of Psychology, Mail Stop 948, University of Toledo, 2801 Bancroft Street, Toledo, OH 43606, USA
| | - Gregory J Meyer
- Department of Psychology, Mail Stop 948, University of Toledo, 2801 Bancroft Street, Toledo, OH 43606, USA.
| | - Joni L Mihura
- Department of Psychology, Mail Stop 948, University of Toledo, 2801 Bancroft Street, Toledo, OH 43606, USA
| | - Donald J Viglione
- Department of Clinical Psychology, Alliant International University, California School of Professional Psychology, 10455 Pomerado Road, San Diego, CA 92131, USA
| | - Emily T O'Gorman
- Department of Psychology, Mail Stop 948, University of Toledo, 2801 Bancroft Street, Toledo, OH 43606, USA
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36
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Hemager N, Plessen KJ, Thorup A, Christiani C, Ellersgaard D, Spang KS, Burton BK, Gregersen M, Søndergaard A, Greve AN, Gantriis DL, Poulsen G, Seidman LJ, Mors O, Nordentoft M, Jepsen JRM. Assessment of Neurocognitive Functions in 7-Year-Old Children at Familial High Risk for Schizophrenia or Bipolar Disorder: The Danish High Risk and Resilience Study VIA 7. JAMA Psychiatry 2018; 75:844-852. [PMID: 29926086 PMCID: PMC6143091 DOI: 10.1001/jamapsychiatry.2018.1415] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
IMPORTANCE Children at familial high risk of schizophrenia spectrum disorders (FHR-SZ) or bipolar disorder (FHR-BP) exhibit neurocognitive impairments. Large studies of neurocognition in young children at familial high risk at the same age are important to differentiate the pathophysiology and developmental trajectory of these 2 groups. OBJECTIVE To characterize neurocognitive functions in 7-year-old children with FHR-SZ or FHR-BP and a control population. DESIGN, SETTING, AND PARTICIPANTS This multisite population-based cohort study collected data from January 1, 2013, to January 31, 2016, in the first wave of the Danish High Risk and Resilience Study VIA 7 at 2 university hospital research sites in Copenhagen and Aarhus using Danish registries. Participants (n = 514) included 197 children with FHR-SZ, 118 with FHR-BP, and 199 controls matched with the FHR-SZ group for age, sex, and municipality. Assessors were blinded to risk status. EXPOSURES Parents with schizophrenia, bipolar disorder, or neither diagnosis. MAIN OUTCOMES AND MEASURES Neurocognitive functions were measured across 23 tests. Four neurocognitive domains were derived by principal component analysis, including processing speed and working memory, verbal functions, executive and visuospatial functions, and declarative memory and attention. RESULTS A total of 514 children aged 7 years were included in the analysis (46.3% girls), consisting of 197 children with FHR-SZ (46.2% girls), 118 with FHR-BP (46.6% girls), and 199 controls (46.2% girls). Children with FHR-SZ were significantly impaired compared with controls on processing speed and working memory (Cohen d = 0.50; P < .001), executive and visuospatial functions (Cohen d = 0.28; P = .03), and declarative memory and attention (Cohen d = 0.29; P = .02). Compared with children with FHR-BP, children with FHR-SZ performed significantly poorer in processing speed and working memory (Cohen d = 0.40; P = .002), executive and visuospatial functions (Cohen d = 0.35; P = .008), and declarative memory and attention (Cohen d = 0.31; P = .03). Children with FHR-BP and controls did not differ. CONCLUSIONS AND RELEVANCE Children with FHR-SZ had widespread neurocognitive impairments, supporting the hypothesis of neurocognitive functions as endophenotypes of schizophrenia. The absence of neurocognitive deficits in children with FHR-BP suggests distinct neurodevelopmental manifestations in these familial high-risk groups at this age. Early detection of children with FHR-SZ and cognitive impairments is warranted to investigate associations of neurocognition with transition to psychosis, add to the knowledge of their developmental pathophysiology, and inform early intervention programs.
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Affiliation(s)
- Nicoline Hemager
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Kerstin J. Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Service of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Lausanne, Switzerland
| | - Anne Thorup
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Camilla Christiani
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Ditte Ellersgaard
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Katrine Søborg Spang
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Maja Gregersen
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Anne Søndergaard
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte Lou Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Gry Poulsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Larry J. Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Center for Neuropsychiatric Schizophrenia Research, Mental Health Services, Capital Region of Denmark, Copenhagen,Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services, Capital Region of Denmark, Copenhagen
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37
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Wang YY, Wang Y, Zou YM, Ni K, Tian X, Sun HW, Lui SSY, Cheung EFC, Suckling J, Chan RCK. Theory of mind impairment and its clinical correlates in patients with schizophrenia, major depressive disorder and bipolar disorder. Schizophr Res 2018; 197:349-356. [PMID: 29122405 DOI: 10.1016/j.schres.2017.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/30/2017] [Accepted: 11/01/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although Theory of Mind (ToM) impairment has been observed in patients with a wide range of mental disorders, the similarity and uniqueness of these deficits across diagnostic groups has not been thoroughly investigated. METHODS We recruited 35 participants with schizophrenia (SCZ), 35 with bipolar disorder (BD), 35 with major depressive disorder (MDD), and 35 healthy controls in this study. All participants were matched in age, gender proportion and IQ estimates. The Yoni task, capturing both the cognitive and affective components of ToM at the first- and second-order level was administered. Repeated-measure ANOVA and MANOVA were conducted to compare the group differences in ToM performance. A network was then constructed with ToM performances, psychotic and depressive symptoms, and executive function as nodes exploring the clinical correlates of ToM. RESULTS Overall, ToM impairments were observed in all patient groups compared with healthy controls, with patients with SCZ performing worse than those with BD. In second-order conditions, patients with SCZ and MDD showed deficits in both cognitive and affective conditions, while patients with BD performed significantly poorer in cognitive conditions. Network analysis showed that second-order affective ToM performance was associated with psychotic and depressive symptoms as well as executive dysfunction, while second-order affective ToM performance and negative symptoms showed relatively high centrality in the network. CONCLUSIONS Patients with SCZ, MDD and BD exhibited different types and severity of impairments in ToM sub-components. Impairment in higher-order affective ToM appears to be closely related to clinical symptoms in both psychotic and affective disorders.
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Affiliation(s)
- Yan-Yu Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, Weifang Medical University, Shandong 261053, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100048, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China.
| | - Ying-Min Zou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100048, China
| | - Ke Ni
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100048, China; Mental Health Center of Qiqihar city, Heilongjiang 161006, China
| | - Xue Tian
- Department of Psychology, Weifang Medical University, Shandong 261053, China
| | - Hong-Wei Sun
- Department of Psychology, Weifang Medical University, Shandong 261053, China
| | - Simon S Y Lui
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - John Suckling
- Department of Psychiatry, University of Cambridge and Cambridgeshire and Peterborough NHS Trust, Cambridge CB2 0SZ, United Kingdom
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100048, China.
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Bora E. Neurocognitive features in clinical subgroups of bipolar disorder: A meta-analysis. J Affect Disord 2018; 229:125-134. [PMID: 29306692 DOI: 10.1016/j.jad.2017.12.057] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/17/2017] [Accepted: 12/27/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE There is a significant cognitive heterogeneity in bipolar disorder (BD). The aim of this systematic review was to examine the potential distinctive neuropsychological of features of clinical subgroups of BD. A literature search investigating cognitive differences between potential subtypes of BD was conducted. METHODS It was possible to conduct a meta-analysis of studies investigating the relationship between cognitive deficits and subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)), subgroups based on history of psychosis (PBD and NPBD). The cognitive domains investigated in this meta-analysis included verbal memory, visual memory, processing speed, executive functions speed (EF-speed), EF-accuracy, attention, working memory, social cognition. Current meta-analysis included 48 reports and compared cognitive performances of 1211 BD-I and 836 BD-II patients. It also compared cognitive functioning in 1017 PBD and 744 NPBD patients. RESULTS Both history of psychosis (d = 0.19) and BD-I (d = 0.17) diagnosis were associated with modestly more pronounced global cognitive impairment. In specific domains, BD-I significantly underperformed BD-II in verbal memory, processing speed, EF-speed, EF-accuracy (d = 0.15-0.26). PBD was associated with significantly impaired cognition compared to NPBD in verbal memory, processing speed, EF-speed, EF-accuracy, working memory and social cognition (d = 0.12-0.28). CONCLUSION In BD, history of psychosis and full-manic episode are modestly associated with increased cognitive deficits. Neurocognitive differences between clinical subtypes of BD are quite subtle and are not distinctive. Furthermore, other factors reflecting differences in illness severity can explain observed between-group differences. Most of the cognitive heterogeneity in BD cannot be explained by proposed subtypes of BD.
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Affiliation(s)
- Emre Bora
- Dokuz Eylül University, Faculty of Medicine, Department of Psychiatry, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia.
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Eddy CM. Social cognition and self-other distinctions in neuropsychiatry: Insights from schizophrenia and Tourette syndrome. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:69-85. [PMID: 29195921 DOI: 10.1016/j.pnpbp.2017.11.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/16/2017] [Accepted: 11/27/2017] [Indexed: 02/08/2023]
Abstract
Impairments in social cognition may reflect dysfunction of disorder specific or disorder general mechanisms. Although cross-disorder comparison may prove insightful, few studies have compared social cognition in different neuropsychiatric disorders. Parallel investigation of schizophrenia and Tourette syndrome (TS) is encouraged by similarities including the presence of problematic social behavior, echophenomena, emotional dysregulation and dopamine dysfunction. Focusing on tests of social cognition administered in both disorders, this review aims to summarize behavioral, neurophysiological and neuroimaging findings, before exploring how these may contribute to clinical symptoms. Studies investigating social cognition (imitation, emotion recognition, and understanding of beliefs or intentions) in patients with schizophrenia or TS were identified through Web of Science and PubMed searches. Although findings indicate that social cognitive deficits are more apparent in schizophrenia, adults with TS can exhibit similar task performance to patients with paranoia. In both disorders, behavioral and neuroimaging findings raise the possibility of increased internal simulation of others' actions and emotions, in combination with a relative under-application of mentalizing. More specifically, dysfunction in neurobiological substrates such as temporo-parietal junction and inferior frontal gyrus may underlie problems with self-other distinctions in both schizophrenia and TS. Difficulties in distinguishing between actions and mental states linked to the self and other may contribute to a range of psychiatric symptoms, including emotional dysregulation, paranoia, social anhedonia and socially disruptive urges. Comparing different patient populations could therefore reveal common neuro-cognitive risk factors for the development of problematic social behaviors, in addition to markers of resilience, coping strategies and potential neuro-compensation mechanisms.
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Affiliation(s)
- Clare M Eddy
- BSMHFT National Centre for Mental Health, Birmingham, and College of Medical and Dental Sciences, University of Birmingham, UK.
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Besnard J, Pivette M, Lambrichts A, Lalaux N, Allain P. Environmental dependency phenomena in schizophrenia: a pilot study. Cogn Neuropsychiatry 2018; 23:59-73. [PMID: 29377770 DOI: 10.1080/13546805.2018.1426447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Environmental dependency phenomena refer to the enslavement of patients' performances under the characteristics of the tasks and were first described in case of prefrontal lobe damage. Two forms of environmental dependency, executive and social, may be dissociated, which involve respectively dorsolateral and orbital prefrontal cortex (PFC) dysfunction. Schizophrenia is widely considered to be caused by PFC dysfunction, but no study to date has addressed environmental dependency in this pathology. METHODS We compared patients (N = 17) and healthy controls (N = 28) on a task dedicated to the study of environmental dependency. RESULTS Our results demonstrate the presence of environmental dependency in schizophrenia. Each form of environmental dependency can be highlighted independently, as previously demonstrated by studies with prefrontal patients. CONCLUSIONS These findings suggest specific prefrontal dysfunction for each subgroup of patients and demonstrate a dissociation between socio-cognitive and neurocognitive performance in schizophrenia. Additionally, we found relationships between symptomatology and environmental dependency. This pilot study supports the relevance of studying environmental dependency to highlight specific patterns of prefrontal disorders in schizophrenia, which may contribute to a better understanding of PFC dysfunction in schizophrenia.
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Affiliation(s)
- Jeremy Besnard
- a Laboratoire de Psychologie des Pays de la Loire, UPRES EA 4638, Université d'Angers , Angers , France
| | - Marina Pivette
- a Laboratoire de Psychologie des Pays de la Loire, UPRES EA 4638, Université d'Angers , Angers , France.,b Secteur de psychiatrie Générale 17, Etablissement Public de Santé Mentale , Armentières , France
| | - Agnes Lambrichts
- b Secteur de psychiatrie Générale 17, Etablissement Public de Santé Mentale , Armentières , France
| | - Nicolas Lalaux
- b Secteur de psychiatrie Générale 17, Etablissement Public de Santé Mentale , Armentières , France
| | - Philippe Allain
- a Laboratoire de Psychologie des Pays de la Loire, UPRES EA 4638, Université d'Angers , Angers , France
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Bora E, Yalincetin B, Akdede BB, Alptekin K. Duration of untreated psychosis and neurocognition in first-episode psychosis: A meta-analysis. Schizophr Res 2018. [PMID: 28634088 DOI: 10.1016/j.schres.2017.06.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Neurocognitive impairment is a well-established feature of first-episode psychosis (FEP). Neurotoxicity hypothesis of psychosis suggests that untreated psychosis before the initiation of first effective treatment is associated with loss of acquired cognitive abilities. However, the outcome of the studies investigating the relationship between duration of untreated psychosis (DUP) and cognitive impairment in FEP remains inconclusive. No previous meta-analysis investigating the relationship between DUP and cognitive impairment in FEP has been published. Following the systematic review of FEP studies, a random-effects meta-analysis of the relationship between DUP and neurocognition in schizophrenia was conducted. Current meta-analysis included 27 studies including 3127 patients with first-episode psychosis. Overall, DUP and cognitive abilities were not significantly related, with the exception of evidence for a weak relationship with a single cognitive domain. There was a very small but significant association between longer DUP and reduced performance in planning/problem-solving ability (r=-0.09, CI=-0.14 to -0.03). Current findings do not provide support for the neurotoxicity hypothesis of psychosis.
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Affiliation(s)
- Emre Bora
- Dokuz Eylül University, Faculty of Medicine, Department of Psychiatry, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton, South, Victoria 3053, Australia.
| | - Berna Yalincetin
- Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey
| | - Berna Binnur Akdede
- Dokuz Eylül University, Faculty of Medicine, Department of Psychiatry, Izmir, Turkey; Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey
| | - Koksal Alptekin
- Dokuz Eylül University, Faculty of Medicine, Department of Psychiatry, Izmir, Turkey; Department of Neurosciences, Dokuz Eylül University, Izmir 35340, Turkey
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42
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Relationship between insight and theory of mind in schizophrenia: A meta-analysis. Schizophr Res 2017; 190:11-17. [PMID: 28302393 DOI: 10.1016/j.schres.2017.03.029] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 11/21/2022]
Abstract
Poor insight in schizophrenia has been associated with executive dysfunction and deficits in general cognitive ability. The overall outcome of available neurocognitive studies suggests that there is a significant but modest relationship between cognitive deficits and poor insight in schizophrenia. However, social cognitive abilities, particularly, theory of mind (ToM), might also play a role in poor insight in schizophrenia. A novel meta-analysis of the relationship between ToM and insight in schizophrenia was conducted. Current meta-analysis included 16 studies including 1085 patients with schizophrenia-spectrum disorders. There was a significant association between ToM and clinical insight (r=0.28, CI=0.20-0.36). By contrast, there was no significant relationship between ToM and cognitive insight. Current findings suggest that there is a small but significant relationship between ToM and clinical insight in schizophrenia. ToM impairment is one of the factors contributing to poor insight in schizophrenia.
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43
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Yu J, Mahendran R, Abdullah FNM, Kua EH, Feng L. Self-reported sleep problems among the elderly: A latent class analysis. Psychiatry Res 2017; 258:415-420. [PMID: 28867406 DOI: 10.1016/j.psychres.2017.08.078] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/26/2017] [Accepted: 08/27/2017] [Indexed: 01/05/2023]
Abstract
The present study utilized a person-centered approach to examine the different profiles of problem sleepers in a community sample of elderly. In addition, this study also explores how demographic and psychiatric variables may be related to these different profiles of sleep problems. A total of 515 participants (Mean age = 67 years, SD = 5) were administered self-report measures of sleep problems, depression and anxiety. Among them, 230 who reported significant problems in any of five selected sleep components were entered into a latent class analysis. The remaining 285 participants were assigned to a comparison control group. The profiles of 'inadequate sleep', 'disturbed sleep', 'trouble falling asleep' and 'multiple problems' were identified. The 'multiple problems' group had significantly higher levels of depression and anxiety relative to the control group. Regression analyses indicated that these different profiles had contributed to a significant increase in variance explained in anxiety but not depression levels, on top of the severity of sleep problems and demographic variables. Although sleep problems occur among the elderly with considerable heterogeneity, they can generally be classified into four different profiles. Furthermore, the inclusion of sleep problem profiles can significantly enhance the prediction of anxiety symptoms.
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Affiliation(s)
- Junhong Yu
- Department of Psychological Medicine, National University Hospital, Singapore.
| | - Rathi Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Ee-Heok Kua
- Department of Psychological Medicine, National University Hospital, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lei Feng
- Department of Psychological Medicine, National University Hospital, Singapore.
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44
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Russo M, Van Rheenen TE, Shanahan M, Mahon K, Perez-Rodriguez MM, Cuesta-Diaz A, Larsen E, Malhotra AK, Burdick KE. Neurocognitive subtypes in patients with bipolar disorder and their unaffected siblings. Psychol Med 2017; 47:2892-2905. [PMID: 28587689 PMCID: PMC5856455 DOI: 10.1017/s003329171700143x] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Our previous work revealed substantial heterogeneity in the cognitive profile of bipolar disorder (BD) due to the presence of three underlying cognitive subgroups characterized as: globally impaired, selectively impaired, or cognitively intact. In an effort to determine whether these subgroups are differentially related to genetic risk for the illness, we investigated whether cognitive deficits were more pronounced in unaffected siblings (UAS) of BD probands within identified clusters. METHODS Cluster analysis was used to identify cognitive clusters in BD (N = 60). UAS (N = 49) were classified into groups according to their proband sibling's cluster assignment; comparisons were made across all clusters and healthy controls (HCs; N = 71). RESULTS Three cognitive clusters in BD emerged: a globally impaired (36.7%), a selectively impaired (30%), and a cognitively intact cluster (33.3%). UAS showed a qualitatively similar pattern to their BD siblings; UAS of the globally impaired BD cluster showed verbal memory and general cognitive impairments relative to HCs. In contrast, UAS of the other two clusters did not differ from HCs. CONCLUSIONS This study corroborates findings from prior work regarding the presence of cognitive heterogeneity in BD. UAS of subjects in the globally impaired BD cluster presented with a qualitatively similar cognitive profile to their siblings and performed worse than all other BD clusters and UAS groups. This suggests that inherited risk factors may be contributing to cognitive deficits more notably in one subgroup of patients with BD, pointing toward differential causes of cognitive deficits in discrete subgroups of patients with the disorder.
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Affiliation(s)
- M. Russo
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - T. E. Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Brain and Psychological Sciences Research Centre, School of Health Sciences, Swinburne University, Melbourne, Australia
- Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | - M. Shanahan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - K. Mahon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - M. M. Perez-Rodriguez
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - A. Cuesta-Diaz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - E. Larsen
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - A. K. Malhotra
- Zucker Hillside Hospital – Northwell Health System, Glen Oaks, NY, USA
| | - K. E Burdick
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
- James J Peters Veteran Administration (VA) Hospital, Bronx, NY, USA
- Brigham and Women’s Hospital, Boston, MA, USA
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45
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Bora E, Özerdem A. Meta-analysis of longitudinal studies of cognition in bipolar disorder: comparison with healthy controls and schizophrenia. Psychol Med 2017; 47:2753-2766. [PMID: 28585513 DOI: 10.1017/s0033291717001490] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Bipolar disorder (BP) is associated with significant cognitive impairment. Recent evidence suggests that cognitive deficits are already evident after first-episode mania. However, it is not clear whether BP is associated with further decline in cognitive functions in individuals with established illness. Aim of this meta-analytic review was to examine longitudinal neurocognitive changes in BP and to compare trajectory of cognitive deficits in BP with schizophrenia and healthy controls. METHODS Electronic databases were searched for the studies published between January 1987 and November 2016. In total 22 reports were included in the current meta-analysis. The main analysis assessed the longitudinal change in cognition in 643 patients with BP. Further analyses were conducted in studies investigating cognitive changes in BP along with healthy controls (459 BP and 367 healthy controls) and schizophrenia (172 BP and 168 schizophrenia). RESULTS There was no cognitive decline overtime neither in short-term (mean duration = 1.5 years) nor in long-term (mean duration = 5.5 years) follow-up studies in BP. In contrast, there was evidence for modest improvements in task performance in memory and working memory at follow-up. The trajectory of cognitive functioning in BP was not significantly different from changes in schizophrenia and healthy controls. CONCLUSIONS Together with the findings in early BP and individuals at genetic risk for BP, current findings suggest that neurodevelopmental factors might play a significant role in cognitive deficits in BP and do not support the notion of progressive cognitive decline in most patients with BP.
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Affiliation(s)
- E Bora
- Faculty of Medicine,Department of Psychiatry,Dokuz Eylül University,Izmir,Turkey
| | - A Özerdem
- Faculty of Medicine,Department of Psychiatry,Dokuz Eylül University,Izmir,Turkey
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46
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Cerquera A, Gjini K, Bowyer SM, Boutros N. Comparing EEG Nonlinearity in Deficit and Nondeficit Schizophrenia Patients: Preliminary Data. Clin EEG Neurosci 2017; 48:376-382. [PMID: 28618836 DOI: 10.1177/1550059417715388] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Electroencephalogram (EEG) contains valuable information obtained noninvasively that can be used for assessment of brain's processing capacity of patients with psychiatric disorders. The purpose of the present work was to evaluate possible differences in EEG complexity between deficit (DS) and nondeficit (NDS) subtypes of schizophrenia as a reflection of the cognitive processing capacities in these groups. A particular nonlinear metric known as Lempel-Ziv complexity (LZC) was used as a computational tool in order to determine the randomness in EEG alpha band time series from 3 groups (deficit schizophrenia [n = 9], nondeficit schizophrenia [n = 10], and healthy controls [n = 10]) according to time series randomness. There was a significant difference in frontal EEG complexity between the DS and NDS subgroups ( p = .013), with DS group showing less complexity. A significant positive correlation was found between LZC values and Positive and Negative Syndrome Scale (PANSS) general psychopathology scores (ie, larger frontal EEG complexity correlated with more severe psychopathology), explained partially by the emotional component subscore of the PANSS. These findings suggest that cognitive processing occurring in the frontal networks in DS is less complex compared to NDS patients as reflected by EEG complexity measures. The data also suggest that there may be a relationship between the degree of emotionality and the complexity of the frontal EEG signal.
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Affiliation(s)
- Alexander Cerquera
- 1 Facultad de Ingeniería Electrónica y Biomédica-Research Group Complex Systems, Universidad Antonio Nariño, Bogota, Colombia
| | - Klevest Gjini
- 2 Division of Neurosurgery, Seton Brain and Spine Institute, Austin, TX, USA
| | - Susan M Bowyer
- 3 Department of Neurology, Henry Ford Hospital and Wayne State University, Detroit, MI, USA
| | - Nash Boutros
- 4 Department of Psychiatry, University of Missouri-Kansas City, Kansas City, USA
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47
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Affective and cognitive theory of mind in borderline personality disorder: The role of comorbid depression. Psychiatry Res 2017; 257:144-149. [PMID: 28755605 DOI: 10.1016/j.psychres.2017.07.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 07/16/2017] [Accepted: 07/16/2017] [Indexed: 11/20/2022]
Abstract
Disturbed interpersonal relationships and misreading of others' intentions are core symptoms of borderline personality disorder (BPD). Despite these impairments, some studies have found an enhanced theory of mind (ToM) in BPD patients. Taking this into consideration, the current study attempts to further understand these discrepancies by separating ToM into two domains: affective and cognitive. Moreover, the study considered the role of comorbid symptoms of depression in these patients. Subjects were 21 patients with BPD, 23 patients with BPD and comorbid major depressive disorder (MDD), and 25 healthy controls (HC). ToM was measured with the Reading the Mind in the Eyes Test (RMET) and the Faux Pas Task, which assessed the affective and cognitive aspects of ToM, respectively. In addition, all participants were evaluated with the Beck Depression Inventory (BDI). Results showed that in both BPD groups (i.e., BPD without MDD and BPD with MDD) affective ToM scores were higher than in the HC group; however, in the cognitive ToM, the HC group performed better than the both BPD groups. Also, overall the BPD group with MDD had decreased ToM skills. Finally, BPD groups received greater scores on the BDI as compared to the HC group.
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48
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Bora E, Binnur Akdede B, Alptekin K. Neurocognitive impairment in deficit and non-deficit schizophrenia: a meta-analysis. Psychol Med 2017; 47:2401-2413. [PMID: 28468693 DOI: 10.1017/s0033291717000952] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Most studies suggested that patients with deficit schizophrenia have more severe impairment compared with patients with non-deficit schizophrenia. However, it is not clear whether deficit and non-deficit schizophrenia are associated with differential neurocognitive profiles. METHODS The aim of this meta-analytic review was to compare cognitive performances of deficit and non-deficit patients with each other and with healthy controls. In the current meta-analysis, differences in cognitive abilities between 897 deficit and 1636 non-deficit patients with schizophrenia were examined. Cognitive performances of 899 healthy controls were also compared with 350 patients with deficit and 592 non-deficit schizophrenia. RESULTS Both deficit (d = 1.04-1.53) and non-deficit (d = 0.68-1.19) schizophrenia were associated with significant deficits in all cognitive domains. Deficit patients underperformed non-deficit patients in all cognitive domains (d = 0.24-0.84) and individual tasks (d = 0.39-0.93). The relationship between deficit syndrome and impairment in olfaction, social cognition, verbal fluency, and speed-based cognitive tasks were relatively stronger. CONCLUSIONS Our findings suggest that there is consistent evidence for a significant relationship between deficit syndrome and more severe cognitive impairment in schizophrenia.
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Affiliation(s)
- E Bora
- Department of Psychiatry,Dokuz Eylul University School of Medicine,Izmir,Turkey
| | - B Binnur Akdede
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health,Carlton South, Victoria 3053,Australia
| | - K Alptekin
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health,Carlton South, Victoria 3053,Australia
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49
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Sparding T, Silander K, Pålsson E, Östlind J, Ekman CJ, Sellgren CM, Joas E, Hansen S, Landén M. Classification of cognitive performance in bipolar disorder. Cogn Neuropsychiatry 2017; 22:407-421. [PMID: 28789589 DOI: 10.1080/13546805.2017.1361391] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To understand the etiology of cognitive impairment associated with bipolar disorder, we need to clarify potential heterogeneity in cognitive functioning. To this end, we used multivariate techniques to study if the correlation structure of cognitive abilities differs between persons with bipolar disorder and controls. METHOD Clinically stable patients with bipolar disorder (type I: n = 64; type II: n = 44) and healthy controls (n = 86) were assessed with a wide range of cognitive tests measuring executive function, speed, memory, and verbal skills. Data were analysed with multivariate techniques. RESULTS A distinct subgroup (∼30%) could be identified that performed significantly poorer on tests concerning memory function. This cognitive phenotype subgroup did not differ from the majority of bipolar disorder patients with respect to other demographic or clinical characteristics. CONCLUSIONS Whereas the majority of patients performed similar to controls, a subgroup of patients with bipolar disorder differed substantially from healthy controls in the correlation pattern of low-level cognitive abilities. This suggests that cognitive impairment is not a general trait in bipolar disorder but characteristic of a cognitive subgroup. This has important clinical implications for cognitive rehabilitation and remediation.
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Affiliation(s)
- Timea Sparding
- a Department of Psychiatry and Neurochemistry , Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - Katja Silander
- b Department of Psychology , University of Gothenburg , Gothenburg , Sweden
| | - Erik Pålsson
- a Department of Psychiatry and Neurochemistry , Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - Josefin Östlind
- a Department of Psychiatry and Neurochemistry , Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - Carl Johan Ekman
- c Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Carl M Sellgren
- d Center for Experimental Drugs and Diagnostics, Center for Genomic Medicine and Department of Psychiatry, Massachusetts General Hospital , Boston , MA , USA
| | - Erik Joas
- a Department of Psychiatry and Neurochemistry , Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - Stefan Hansen
- b Department of Psychology , University of Gothenburg , Gothenburg , Sweden
| | - Mikael Landén
- a Department of Psychiatry and Neurochemistry , Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.,e Department of Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden
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50
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Varo C, Jimenez E, Solé B, Bonnín CM, Torrent C, Valls E, Morilla I, Lahera G, Martínez-Arán A, Vieta E, Reinares M. Social cognition in bipolar disorder: Focus on emotional intelligence. J Affect Disord 2017; 217:210-217. [PMID: 28427032 DOI: 10.1016/j.jad.2017.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 03/31/2017] [Accepted: 04/07/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The present study aims to characterize emotional intelligence (EI) variability in a sample of euthymic bipolar disorder (BD) patients through the Mayer- Salovey-Caruso Emotional Intelligence Test (MSCEIT). METHOD A total of 134 euthymic BD outpatients were recruited and divided into three groups according to the total Emotional Intelligence Quotient (EIQ) score of the MSCEIT, following a statistical criterion of scores 1.5SDs above/below the normative group mean, as follows: a low performance (LP) group (EIQ <85), a normal performance (NP) group (85≤EIQ≤115), and a high performance (HP) group (EIQ >115). Afterwards, main sociodemographic, clinical, functional and neurocognitive variables were compared between the groups. RESULTS Three groups were identified: 1) LP group (n=16, 12%), 2) NP group (n=93, 69%) and 3) HP group (n=25, 19%). There were significant differences between the groups in premorbid intelligence quotient (IQ) (p=0.010), axis II comorbidity (p=0.008), subthreshold depressive symptoms (p=0.027), general functioning (p=0.013) and in four specific functional domains: autonomy, occupation, interpersonal relations and leisure time. Significant differences in neurocognitive performance were found between groups with the LP group showing the lowest attainments. LIMITATIONS The cross-sectional design of the study. CONCLUSION Our results suggest that EI variability among BD patients, assessed through MSCEIT, is lower than expected. EI could be associated with premorbid IQ, subthreshold depressive symptoms, neurocognitive performance and general functioning. The identification of different profiles of SC may help guide specific interventions for distinct patient subgroups aimed at improving social cognition, neurocognitive performance and psychosocial functioning.
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Affiliation(s)
- C Varo
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Jimenez
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C M Bonnín
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Torrent
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Valls
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - I Morilla
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - G Lahera
- Faculty of Medicine, University of Alcalá, IRyCIS, CIBERSAM, Madrid, Spain
| | - A Martínez-Arán
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - M Reinares
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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