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Guzman A, Klein H, Keefe RS, Horan WP, Harvey PD. Location-based differences in cognition and functional capacity: Consistent levels of impairment in participants with schizophrenia compared to healthy controls. Psychiatry Res 2024; 340:116121. [PMID: 39191129 DOI: 10.1016/j.psychres.2024.116121] [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: 06/02/2024] [Revised: 07/23/2024] [Accepted: 07/30/2024] [Indexed: 08/29/2024]
Abstract
Cognitive performance manifests regional differences, correlated with education. There is less information available about regional differences in performance-based measures of functional capacity. In multi-national trials focused on cognitive enhancement, it may be impossible to validate every measure in all locations. It is unknown if regional differences in healthy controls' (HC) performance affects relative levels of impairment in participants with schizophrenia (SCZ). A multi-site study comparing SCZ and HC administered the MATRICS Consensus Cognitive Battery (MCCB) and Virtual Reality Functional Capacity Assessment Tool (VRFCAT) to 164 HC participants and 164 with SCZ across three sites (Columbia, SC, Miami, and San Diego) and a representative sample of HC (n = 390) completed the VRFCAT in Durham, NC. Performance was compared between HC and SCZ participants at the validation sites. There were statistically significant cross-site differences in HC performance on both the MCCB and VRFCAT. Differences between HC and SCZ on MCCB and VRFCAT were substantial at all three sites, indicating that regional variations in HC performance did not induce reduced differences from SCZ participants. Regional differences were smaller than diagnostic group differences, suggesting that relative impairments of participants with SCZ is consistently preserved across performance differences in HC.
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Affiliation(s)
- Ashlee Guzman
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | | | | | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, USA.
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2
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Cavalcante DA, Noto M, Cerqueira RDO, Costa GO, Coutinho L, Malinovski F, Fonseca AO, Santoro ML, Ota V, Cordeiro Q, Bressan RA, Belangero S, Gadelha A, Noto C. GAPi: A description of the initiative for early psychosis intervention in Latin America and the short- to medium-term outcomes in early psychosis patients. Asian J Psychiatr 2024; 98:104104. [PMID: 38878447 DOI: 10.1016/j.ajp.2024.104104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 05/19/2024] [Accepted: 05/29/2024] [Indexed: 08/03/2024]
Abstract
INTRODUCTION Schizophrenia is a debilitating disorder that affects a significant proportion of the population and leads to impaired functionality and long-term challenges. The first episode of psychosis (FEP) is a critical intervention stage for improving long-term outcomes. The GAPi program was established in São Paulo, Brazil to provide early intervention services and evaluate biomarkers in individuals with FEP. This article delineates the objectives of the GAPi program, detailing its innovative research protocol, examining the clinical outcomes achieved, and discussing the operational challenges encountered during its initial decade of operation. METHODS The study comprised a prospective cohort of antipsychotic-naïve individuals with first-episode psychosis aged between 16 and 35 years. Participants were recruited from a public psychiatric facility in São Paulo. Emphasizing the initiative's commitment to early intervention, clinical assessments were systematically conducted at baseline and at two months, one year, two years, and five years of treatment to capture both short- and medium-term outcomes. Various assessment tools were utilized, including structured interviews, symptom scales, the Addiction Severity Index, and functional assessments. RESULTS A total of 232 patients were enrolled in the cohort. Among them, 65.95 % completed the 2-month follow-up. Most patients presented with schizophrenia spectrum disorders, followed by bipolar disorder and major depressive disorder with psychotic features. Treatment response rates and remission rates were evaluated at different time points, with promising outcomes observed. The program also assessed socio-demographic factors, substance use, family history, and genetic and biomarker profiles, providing valuable data for research. DISCUSSION The GAPi program has emerged as the largest ongoing cohort of antipsychotic-naïve first-episode psychosis in Latin America, contributing to the understanding of early psychosis in low- and middle-income countries. Despite operational challenges, the program has demonstrated efficacy in reducing the duration of untreated psychosis and in improving clinical outcomes. A multidisciplinary approach, including pharmacological treatment, psychosocial interventions, and family involvement, has been instrumental in enhancing treatment adherence and long-term prognosis. CONCLUSION The GAPi program represents a valuable model for early intervention in first-episode psychosis and provides insights into the pathophysiology, treatment, and long-term outcomes of individuals with schizophrenia and related disorders. Continued research and resource allocation are essential for addressing operational challenges and expanding early intervention services in low- and middle-income countries.
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Affiliation(s)
- Daniel A Cavalcante
- Grupo de Atenção às Psicose Iniciais (GAPi), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), Health Ministry, Brazil; Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil
| | - Mariane Noto
- Grupo de Atenção às Psicose Iniciais (GAPi), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), Health Ministry, Brazil; Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil
| | - Raphael de O Cerqueira
- Grupo de Atenção às Psicose Iniciais (GAPi), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), Health Ministry, Brazil; Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil
| | - Giovany Oliveira Costa
- Grupo de Atenção às Psicose Iniciais (GAPi), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), Health Ministry, Brazil; Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil; Genetic Division, Department of Morphology and Genetics, UNIFESP, Brazil
| | - Luccas Coutinho
- Programa de Esquizofrenia (PROESQ), UNIFESP, Brazil; Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil
| | - Fernando Malinovski
- Programa de Esquizofrenia (PROESQ), UNIFESP, Brazil; Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil
| | - Ana Olívia Fonseca
- Grupo de Atenção às Psicose Iniciais (GAPi), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), Health Ministry, Brazil; Programa de Esquizofrenia (PROESQ), UNIFESP, Brazil
| | - Marcos Leite Santoro
- Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil; Genetic Division, Department of Morphology and Genetics, UNIFESP, Brazil
| | - Vanessa Ota
- Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil; Genetic Division, Department of Morphology and Genetics, UNIFESP, Brazil
| | - Quirino Cordeiro
- Grupo de Atenção às Psicose Iniciais (GAPi), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), Health Ministry, Brazil
| | - Rodrigo A Bressan
- Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), Health Ministry, Brazil; Programa de Esquizofrenia (PROESQ), UNIFESP, Brazil; Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil; Instituto Ame Sua Mente, Brazil
| | - Sintia Belangero
- Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil; Genetic Division, Department of Morphology and Genetics, UNIFESP, Brazil
| | - Ary Gadelha
- Grupo de Atenção às Psicose Iniciais (GAPi), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), Health Ministry, Brazil; Programa de Esquizofrenia (PROESQ), UNIFESP, Brazil; Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil
| | - Cristiano Noto
- Grupo de Atenção às Psicose Iniciais (GAPi), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil; Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), Health Ministry, Brazil; Programa de Esquizofrenia (PROESQ), UNIFESP, Brazil; Laboratório de Neurociências Integrativas (LINC), UNIFESP, Brazil.
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Melzer-Ribeiro DL, Napolitano IC, Leite SA, Alencar de Souza JA, Vizzotto ADB, Di Sarno ES, Fortes M, Gomes ML, de Oliveira GM, Avrichir BS, Talib LL, Correll CU, Elkis H. Randomized, double-blind, sham-controlled trial to evaluate the efficacy and tolerability of electroconvulsive therapy in patients with clozapine-resistant schizophrenia. Schizophr Res 2024; 268:252-260. [PMID: 38151432 DOI: 10.1016/j.schres.2023.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/29/2023]
Abstract
There is no established treatment for patients with clozapine-resistant schizophrenia (CRS). Clozapine augmentation strategies with antipsychotics or others substances are effective in comparison with placebo while and Electroconvulsive therapy (ECT) showed to be effective in comparison with treatment as usual (TAU) but not with placebo (sham-ECT). In the present double- blind randomized controlled trial, we compared 40 outpatients who received 20 sessions of ECT (n = 21) or sham-ECT (n = 19) (age = 37.40 ± 9.62, males = 77.5 %, illness duration = 14.95 ± 8.32 years, mean total Positive and Negative Syndrome Scale (PANSS) = 101.10 ± 24.91) who fulfilled well-defined CRS criteria including baseline clozapine plasma levels ≥350 ng/mL. The primary outcome was the ≥50 % PANSS Total Score reduction; secondary outcomes were the scores of the PANSS subscales, PANSS five-factor dimensions, PANSS-6 and the Calgary Depression Rating Scale (CDRS). Treatment response was analyzed by percentage reduction, Linear Mixed Models and effect sizes. At baseline both groups showed no differences except for years of school education (included as a covariate). At endpoint, only 1/19 of the completers (5.26 %) in the ECT group and 0/17 in the sham-ECT group showed a ≥50 % total PANSS score reduction. Both groups showed no significant differences of the total PANSS score (F = 0.12; p = 0.73), Positive (F = 0.27, p = 0.61), Negative (F = 0.25, p = 0.62), and General Psychopathology scores (F = 0.01, p = 0.94) as well for all PANSS five factors, the PANSS-6 and CDRS. Thus, the present study found no evidence that ECT is better than Sham-ECT in patients with CRS. Future sham-ECT controlled studies with larger sample sizes are warranted to test the efficacy of ECT for patients with CRS.
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Affiliation(s)
- D L Melzer-Ribeiro
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - I C Napolitano
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - S A Leite
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - J A Alencar de Souza
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - A D B Vizzotto
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - E S Di Sarno
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - M Fortes
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - M L Gomes
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - G M de Oliveira
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - B S Avrichir
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - L L Talib
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil
| | - C U Correll
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - H Elkis
- Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP), Brazil.
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Hasse-Sousa M, Martins DS, Petry-Perin C, Britto MJSD, Remus IB, Lapa CDO, Reckziegel RDFX, Sales SCD, Jesus LSD, Philippsen M, Massuda R, Van Rheenen TE, Gama CS, Czepielewski LS. The role of semantic clustering in the relationship between verbal memory and psychosocial functioning in schizophrenia and bipolar disorder: Possible distinct cognitive pathway compared to healthy controls. J Affect Disord 2023; 320:330-339. [PMID: 36162669 DOI: 10.1016/j.jad.2022.09.077] [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: 11/24/2021] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Verbal memory (VM) is impaired in schizophrenia (SZ) and bipolar disorder (BD), and predicts psychosocial functioning. However, there is a lack of research exploring the role of VM component processes, including semantic clustering, in these disorders. Semantic clustering might impact this association, as effective semantic memory strategies may reflect unimpaired executive control, leading to an adequate functioning. We aimed to investigate VM components in SZ and BD, and the role of semantic clustering in the relationship between VM and functioning. METHODS We included 495 participants (156 SZ, 172 BD, and 167 healthy controls (HC)) that underwent an assessment using the Hopkins Verbal Learning Test - Revised for VM and the Functioning Assessment Short Test for psychosocial functioning. We compared groups through ANOVAs and investigated the effect of semantic clustering in the relationship between VM total immediate free recall and functioning through linear regression models. RESULTS SZ had worse overall VM performance compared to BD, which performed worse than HCs. HCs used more semantic clustering than SZ and BD, but there were no differences between the two clinical groups. In HCs, semantic clustering impacted the relationship between VM performance and functioning, while no interaction was observed in SZ or BD. LIMITATIONS Cross-sectional design; no medication effects or other cognitive functions were assessed. CONCLUSIONS SZ and BD may use an alternative cognitive pathway in which the relationship between VM and functioning is independent of complex cognitive processes such as semantic clustering, supporting the cognitive remediation targeting of VM in these disorders.
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Affiliation(s)
- Mathias Hasse-Sousa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Dayane Santos Martins
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina Petry-Perin
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Julia Silva de Britto
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isadora Bosini Remus
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Clara de Oliveira Lapa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ramiro de Freitas Xavier Reckziegel
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sarah Corrêa de Sales
- Psychosis Treatment and Research Program, Department of Forensic Medicine and Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - Letícia Stephane de Jesus
- Psychosis Treatment and Research Program, Department of Forensic Medicine and Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - Marielli Philippsen
- Psychosis Treatment and Research Program, Department of Forensic Medicine and Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - Raffael Massuda
- Psychosis Treatment and Research Program, Department of Forensic Medicine and Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, VIC, Australia
| | - Clarissa Severino Gama
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Letícia Sanguinetti Czepielewski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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5
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Martins DS, Hasse-Sousa M, Reckziegel RDFX, Lapa CDO, Petry-Perin C, Britto MJ, Remus IB, Gama CS, Czepielewski LS. A five-year follow-up of the verbal memory performance of individuals with bipolar disorder and schizophrenia: evidence of unchanging deficits under treatment. Cogn Neuropsychiatry 2023; 28:19-35. [PMID: 36254742 DOI: 10.1080/13546805.2022.2133694] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Bipolar disorder (BD) and schizophrenia (SZ) are chronic and heterogeneous mental disorders that present cognitive and functional impairments. Verbal memory is considered an important predictor of functioning and a domain vulnerable to the aging process. However, only few studies investigate the progression of memory longitudinally in BD and SZ, especially in lower- and middle-income countries. Therefore, we aim to evaluate the course of verbal memory in individuals with BD and SZ. METHODS We assessed 31 individuals with BD and 27 individuals with SZ under treatment at outpatient clinics at baseline and after five years. They were assessed through a sociodemographic questionnaire, memory and estimated IQ (eIQ) instruments, and clinical scales. RESULTS Individuals with SZ showed worse verbal memory performance in comparison to BD, however, we did not observe changes over time within patient groups. Individuals with BD with higher eIQ showed a better verbal memory performance, while no effect of eIQ was found for subjects with SZ. CONCLUSION Patients with SZ and BD showed different levels of verbal memory impairment, although they had similar unchanging trajectories after 5 years under psychiatric treatment. This finding indicates a relative stable cognitive course for both disorders.
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Affiliation(s)
- Dayane Santos Martins
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mathias Hasse-Sousa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ramiro de Freitas Xavier Reckziegel
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Clara de Olivera Lapa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina Petry-Perin
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Maria Julia Britto
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Isadora Bosini Remus
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Clarissa Severino Gama
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leticia Sanguinetti Czepielewski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Nuechterlein KH, Green MF, Kern RS. The MATRICS Consensus Cognitive Battery: An Update. Curr Top Behav Neurosci 2022; 63:1-18. [PMID: 36306054 DOI: 10.1007/7854_2022_395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Through a series of NIMH-supported consensus-building meetings of experts and empirical comparisons of candidate tests, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative developed a battery of standardized cognitive measures to allow reliable evaluation of results from clinical trials of promising interventions for core cognitive deficits in this disorder. Ten tests in seven cognitive domains were selected for the MATRICS Consensus Cognitive Battery (MCCB). The MCCB has now been translated into 39 languages/dialects and has been employed in more than 145 clinical trials. It has become the standard cognitive change measure for studies of both pharmacological and training-based interventions seeking to improve cognitive deficits in schizophrenia. We summarize its applications and its relationship to the subsequent development of the NIMH RDoC Matrix.
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Affiliation(s)
- Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA. .,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.,VISN 22 Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Robert S Kern
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.,VISN 22 Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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7
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Cruz BF, de Oliveira AM, Del-Ben CM, Corcoran R, Salgado JV. Validation of the Brazilian version of the Hinting Task and Facial Emotion Recognition Test (FERT-100) in patients with schizophrenia. Dement Neuropsychol 2022; 16:300-308. [PMID: 36619846 PMCID: PMC9762393 DOI: 10.1590/1980-5764-dn-2021-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/03/2022] [Accepted: 02/21/2022] [Indexed: 01/11/2023] Open
Abstract
Social cognition is an especially relevant domain in schizophrenia due to its association with functional impairment. However, we still do not have studies that have validated instruments with internationally established psychometric qualities for the Brazilian population. Objectives This study aimed to present psychometric qualities and contribute to the validation of the Brazilian version of the Hinting Task and Facial Emotion Recognition Test (FERT-100). Methods A total of 104 stabilized patients living in the community diagnosed with schizophrenia and 89 controls were evaluated. We assess the psychometric properties of Hinting Task and FERT-100 for discriminant construct validity, divergent construct validity, convergent construct validity, concurrent criterion validity, and reliability. Results There is a statistically significant difference between patients and controls regarding social cognition (Hinting Task: Z=6.85, p<0.001; FERT-100: t=4.88, p<0.001). The main predictors of variation in social cognition were the neurocognitive domains. The associations between social cognition tests and other studied variables are similar to what is found in the literature. Social cognition maintains correlation with functional capacity even when neurocognition is taken into account. Conclusions The validity of the Brazilian version of Hinting Task and FERT-100 can be determined, since the relationship of these tests with other clinical variables is similar to that observed in the literature.
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Affiliation(s)
- Breno Fiuza Cruz
- Universidade Federal de Minas Gerais, Faculdade de Medicina,
Departamento de Saúde Mental, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Instituto de Ciências
Biológicas, Programa de Pós-graduação em Neurociências, Belo Horizonte MG,
Brazil
| | - Amanda Margarida de Oliveira
- Universidade Federal de Minas Gerais, Instituto de Ciências
Biológicas, Programa de Pós-graduação em Neurociências, Belo Horizonte MG,
Brazil
| | - Cristina Marta Del-Ben
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão
Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto
SP, Brazil
| | - Rhiannon Corcoran
- University of Liverpool, Department of Primary Care and Mental
Health, Liverpool, United Kingdom
| | - João Vinícius Salgado
- Universidade Federal de Minas Gerais, Instituto de Ciências
Biológicas, Programa de Pós-graduação em Neurociências, Belo Horizonte MG,
Brazil
- Universidade Federal de Minas Gerais, Instituto de Ciências
Biológicas, Departamento de Morfologia, Belo Horizonte MG, Brazil
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8
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Haile YG, Habatmu K, Derese A, Gouse H, Lawrie SM, Cella M, Alem A. Assessing cognition in people with severe mental disorders in low- and middle-income countries: a systematic review of assessment measures. Soc Psychiatry Psychiatr Epidemiol 2022; 57:435-460. [PMID: 34145463 PMCID: PMC8934327 DOI: 10.1007/s00127-021-02120-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 06/02/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cognitive difficulties are common in people with severe mental disorders (SMDs) and various measures of cognition are of proven validity. However, there is a lack of systematic evidence regarding the psychometric properties of these measures in low- and middle-income countries (LMICs). OBJECTIVE To systematically review the psychometric properties of cognitive measures validated in people with SMDs in LMICs. METHODS We conducted a systematic review of the literature by searching from four electronic databases. Two authors independently screened studies for their eligibility. Measurement properties of measures in all included studies were extracted. All eligible measures were assessed against criteria set for clinical and research recommendations. Results are summarized narratively and measures were grouped by measurement type and population. RESULTS We identified 23 unique measures from 28 studies. None of these was from low-income settings. Seventeen of the measures were performance-based. The majority (n = 16/23) of the measures were validated in people with schizophrenia. The most commonly reported measurement properties were: known group, convergent, and divergent validity (n = 25/28). For most psychometric property, studies of methodological qualities were found to be doubtful. Among measures evaluated in people with schizophrenia, Brief Assessment of Cognition in Schizophrenia, Cognitive Assessment Interview, MATRICS Consensus Cognitive Battery, and CogState Schizophrenia Battery were with the highest scores for clinical and research recommendation. CONCLUSIONS Studies included in our review provide only limited quality evidence and future studies should consider adapting and validating measures using stronger designs and methods. Nonetheless, validated assessments of cognition could help in the management and allocating therapy in people with SMDs in LMICs.
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Affiliation(s)
- Yohannes Gebreegziabhere Haile
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Kassahun Habatmu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andualem Derese
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, College of Health Sciences, Haremaya University, Harar, Ethiopia
| | - Hetta Gouse
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Stephen M Lawrie
- Department of Psychiatry, University of Edinburgh, Edinburgh, Scotland, UK
| | - Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Atalay Alem
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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9
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Pillny M, Krkovic K, Buck L, Lincoln TM. From Memories of Past Experiences to Present Motivation? A Meta-analysis on the Association Between Episodic Memory and Negative Symptoms in People With Psychosis. Schizophr Bull 2022; 48:307-324. [PMID: 34635918 PMCID: PMC8886596 DOI: 10.1093/schbul/sbab120] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Based on findings from cognitive science, it has been theorized that the reductions in motivation and goal-directed behavior in people with psychosis could stem from impaired episodic memory. In the current meta-analysis, we investigated this putative functional link between episodic memory deficits and negative symptoms. We hypothesized that episodic memory deficits in psychosis would be related to negative symptoms in general but would be more strongly related to amotivation than to reduced expressivity. We included 103 eligible studies (13,622 participants) in the analyses. Results revealed significant, moderate negative associations of episodic memory with negative symptoms in general (k = 103; r = -.23; z = -13.40; P ≤ .001; 95% CI [-.26; -.20]), with amotivation (k = 16; r = -.18; z = -6.6; P ≤ .001; 95% CI [-.23; -.13]) and with reduced expressivity (k = 15; r = -.18; z = -3.30; P ≤.001; 95% CI[-.29; -.07]). These associations were not moderated by sociodemographic characteristics, positive symptoms, depression, antipsychotic medication or type of negative symptom scale. Although these findings provide sound evidence for the association between episodic memory deficits and amotivation, the rather small magnitude and the unspecific pattern of this relationship also indicate that episodic memory deficits are unlikely to be the only factor relevant to amotivation. This implicates that future research should investigate episodic memory in conjunction with other factors that could account for the association of episodic memory deficits and amotivation in psychosis.
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Affiliation(s)
- Matthias Pillny
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Katarina Krkovic
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Laura Buck
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
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10
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Vita A, Gaebel W, Mucci A, Sachs G, Erfurth A, Barlati S, Zanca F, Giordano GM, Birkedal Glenthøj L, Nordentoft M, Galderisi S. European Psychiatric Association guidance on assessment of cognitive impairment in schizophrenia. Eur Psychiatry 2022; 65:e58. [PMID: 36059109 PMCID: PMC9532219 DOI: 10.1192/j.eurpsy.2022.2316] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Impairment in a wide range of cognitive abilities has been consistently reported in individuals with schizophrenia. Both neurocognitive and social cognitive deficits are thought to underlie severe functional disabilities associated with schizophrenia. Despite the key role in schizophrenia outcome, cognition is still poorly assessed in both research and clinical settings. Methods In this guidance paper, we provide a systematic review of the scientific literature and elaborate several recommendations for the assessment of cognitive functions in schizophrenia both in research settings and in real-world clinical practice. Results Expert consensus and systematic reviews provided guidance for the optimal assessment of cognitive functions in schizophrenia. Based on the reviewed evidence, we recommend a comprehensive and systematic assessment of neurocognitive and social cognitive domains in schizophrenia, in all phases of the disorder, as well as in subjects at risk to develop psychosis. This European Psychiatric Association guidance recommends not only the use of observer reports but also self-reports and interview-based cognitive assessment tools. The guidance also provides a systematic review of the state of the art of assessment in the first episode of psychosis patients and in individuals at risk for psychosis. Conclusion The comprehensive review of the evidence and the recommendations might contribute to advance the field, allowing a better cognitive assessment, and avoiding overlaps with other psychopathological dimensions. The dissemination of this guidance paper may promote the development of shared guidelines concerning the assessment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to obtain recovery.
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11
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Havlik F, Michalec J, Kališová L, Děchtěrenko F, Chlebovcová M, Vaškovicová M, Bezdicek O. The normative data study of the Czech MATRICS consensus cognitive battery. Clin Neuropsychol 2021; 35:S50-S64. [PMID: 34369309 DOI: 10.1080/13854046.2021.1962410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The MATRICS consensus cognitive battery (MCCB) is a widely used neuropsychological battery for the assessment of cognitive dysfunction in schizophrenia. However, the accuracy of measurement is dependent on suitable normative data which are in the Czech Republic lacking. METHOD The Czech academic research translation of the MCCB battery was administered to a sample of healthy volunteers aged 17 to 62 years (N = 573) and the effects of age, education and sex were examined. In addition, a comparison was made to examine the differences between the US and current normative data. RESULTS Consistent with previous studies, significant effects of age, sex and education were found, however, in sex and education in distinct MCCB-domains. By comparing the original and current normative data, significant differences with small to large effect sizes were revealed in all domains except for Verbal Learning. CONCLUSIONS We present nationally specific MCCB regression-based and tabular normative data applicable in research and clinical settings.
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Affiliation(s)
- Filip Havlik
- Prague College of Psychosocial Studies, Prague, Czech Republic.,Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiří Michalec
- Department of Psychiatry, First Faculty of Medicine Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Lucie Kališová
- Department of Psychiatry, First Faculty of Medicine Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Filip Děchtěrenko
- Institute of Psychology, The Czech Academy of Sciences, Prague, Czech Republic
| | - Miriama Chlebovcová
- Department of Psychiatry, First Faculty of Medicine Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Michaela Vaškovicová
- Department of Psychiatry, First Faculty of Medicine Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ondrej Bezdicek
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine Charles University and General University Hospital in Prague, Prague, Czech Republic
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12
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Mononitrate Isosorbide as an Adjunctive Therapy in Schizophrenia: A Randomized Controlled Crossover Trial. J Clin Psychopharmacol 2021; 41:260-266. [PMID: 33857028 DOI: 10.1097/jcp.0000000000001388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Schizophrenia is a complex disabling mental disorder, and many patients present poor response to available treatments. Accumulating evidence about the role of the glutamate/nitric oxide pathway in mediating the positive and negative symptoms of schizophrenia suggests potential benefits of drugs that modulate this system. The aim of this study was to test the efficacy of isosorbide mononitrate (ISMN) as an adjunctive therapy for symptomatic outpatients with schizophrenia. METHODS This was a 2-month randomized, double-blind, placebo-controlled trial with 24 schizophrenia patients. Participants were treated with ISMN 50 mg for 1 month and placebo for another month in a crossover design. The Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale, Global Assessment of Functioning, and MATRICS Cognitive Consensual Battery were used for symptom assessment and arterial spin labeling was used to assess brain activation patterns. RESULTS We found significant differences in the total, general, and positive subscales of the PANSS, Global Assessment of Functioning scores, and Clinical Global Impression scores during treatment with ISMN relative to placebo. No treatment effects were found comparing scores in the MATRICS Cognitive Consensual Battery and the negative subscale of the PANSS between the active and placebo conditions. A post hoc analysis of neuroimaging data showed reduced activity in the thalamus in subgroup of patients with severe psychopathology. CONCLUSIONS Schizophrenia patients with persistent symptoms showed significant improvement after 4 weeks of treatment with ISMN 50 mg/d compared with placebo. Isosorbide mononitrate added beneficial effects to antipsychotic treatment in terms of positive symptoms and functioning.
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13
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Bezdicek O, Michalec J, Kališová L, Kufa T, Děchtěrenko F, Chlebovcová M, Havlík F, Green MF, Nuechterlein KH. Profile of cognitive deficits in schizophrenia and factor structure of the Czech MATRICS Consensus Cognitive Battery. Schizophr Res 2020; 218:85-92. [PMID: 32089475 DOI: 10.1016/j.schres.2020.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/28/2020] [Accepted: 02/09/2020] [Indexed: 01/10/2023]
Abstract
We aimed to validate the Czech version of the MATRICS Consensus Cognitive Battery (MCCB). The MCCB is a test battery designed to assess cognitive treatment effects in clinical trials of patients with schizophrenia. The valid, reliable and replicable measurement of cognition in schizophrenia is of substantial importance for such clinical trial studies. We performed a psychometric analysis of the MCCB composite and domain scores based on ROC analysis of 67 schizophrenia patients and 67 age- and education-matched healthy controls from a total sample of 220 controls. Also, we correlated MCCB variables with scales measuring psychosocial functioning (Personal and Social Performance scale; PSP). The internal consistency of all 10 tests in the MCCB battery was good (Cronbach's α = 0.85 (95% CI [0.83, 0.88])). The discriminative validity for the detection of neurocognitive dysfunction in schizophrenia based on the area under the curve of MCCB composite T-score was ≥90% (95% CI [0.85, 0.96]) and all MCCB domains showed ps < .001. The MCCB global composite and the Speed of Processing domain score significantly predicted the PSP ratings. A confirmatory factor analysis on the whole control sample (N = 220) showed an optimal fit for a 6-factor in comparison to 1-factor solution. In conclusion, we found high discriminative validity for the Czech MCCB version, similar to the differentiation of schizophrenia versus healthy control groups in the original MCCB studies. We also established the factorial validity of the MCCB and showed that the overall composite of the MCCB predicts psychosocial functioning in the patient group.
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Affiliation(s)
- Ondrej Bezdicek
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Czech Republic.
| | - Jiří Michalec
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Lucie Kališová
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Tomáš Kufa
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | | | - Miriama Chlebovcová
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Filip Havlík
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Czech Republic
| | - Michael F Green
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA.
| | - Keith H Nuechterlein
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA.
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14
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Liang S, Yu W, Ma X, Luo S, Zhang J, Sun X, Luo X, Zhang Y. Psychometric properties of the MATRICS Consensus Cognitive Battery (MCCB) in Chinese patients with major depressive disorder. J Affect Disord 2020; 265:132-138. [PMID: 32090734 DOI: 10.1016/j.jad.2020.01.052] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 12/13/2019] [Accepted: 01/13/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Major depression disorder (MDD) is often associated with cognitive impairment. The development of an accurate and effective battery to measure cognitive deficit is necessary for both research and clinical practice in MDD. Our study was designed to test the psychometric properties of the MATRICS Consensus Cognitive Battery (MCCB) in patients with MDD. METHOD Forty-eight patients with MDD, forty-three euthymic patients with bipolar disorder (BD) and thirty-two remitted patients with schizophrenia (SCH) were recruited from Tianjin Anding Hospital in Tianjin, China. The MCCB, the Montreal Cognitive Assessment (MoCA) and the Hamilton Depression Rating Scale-17 (HDRS-17) were administered to assess cognitive impairment and depressive symptoms at both baseline and one month later. RESULT Our findings showed that the MCCB had good internal consistency and acceptable reliability in Chinese MDD patients. Our findings revealed a high correlation between the MCCB and the MoCA, indicating good concurrent validity of the MCCB. Furthermore, the MCCB showed high discriminant ability between MDD patients and healthy controls, and a principal component analysis of the MCCB in MDD patients revealed four domains with acceptable internal structure. LIMITATIONS We did not consider confounding factors, such as the course, severity of symptoms and medication treatments, which might bias the cognitive assessment. In addition, the use of the MoCA as a reference scale for mild cognitive impairment could weaken the concurrent validity of the MCCB in MDD patients. CONCLUSION Our findings demonstrated that the MCCB may be clinically useful as a cognitive impairment rating battery in Chinese patients with MDD.
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Affiliation(s)
- Sixiang Liang
- Tianjin Anding Hospital, Tianjin 300222, China; The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wenwen Yu
- Tianjin Anding Hospital, Tianjin 300222, China
| | - Xiaojuan Ma
- Tianjin Medical College, Tianjin 300222, China
| | - Shuqing Luo
- Department of Obstetrics, Baoding Second Central Hospital, Hebei 072750, China
| | - Jian Zhang
- Tianjin Anding Hospital, Tianjin 300222, China
| | - Xia Sun
- Tianjin Anding Hospital, Tianjin 300222, China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, United States
| | - Yong Zhang
- Tianjin Anding Hospital, Tianjin 300222, China.
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15
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Cury MEG, Berberian A, Scarpato BS, Kerr-Gaffney J, Santos FH, Claudino AM. Scrutinizing Domains of Executive Function in Binge Eating Disorder: A Systematic Review and Meta-Analysis. Front Psychiatry 2020; 11:288. [PMID: 32362845 PMCID: PMC7181673 DOI: 10.3389/fpsyt.2020.00288] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/24/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Cognitive deficits are implicated in theoretical explanatory models for binge eating disorder (BED). Furthermore, evidence suggest that alterations in executive function may underlie symptoms in BED. The current systematic review and meta-analysis provides an update on executive functioning in individuals with BED. METHODS Literature searches (up to November 2019) were conducted in electronic databases combining binge eating or BED with executive functions. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines was used. Studies of any design comparing adults with BED with those without BED in executive function domains were selected. Methodological quality of studies was based on the Newcastle-Ottawa scale. RESULTS Of 1,983 citations identified, 28 case-control studies met inclusion criteria for this review. Six meta-analyses that examined four domains (decision-making, cognitive flexibility, inhibitory control, and working memory) were conducted. The only meta-analysis to show a significant difference in executive functioning between BED and obese controls was working memory (SMD = 0.32, 95% IC: -0.60, -0.03; p = 0.028), with an effect size of small magnitude. Qualitative inspection of the literature indicated mixed findings for control inhibition, decision making and cognitive flexibility in individuals with BED compared to controls (obese or normal weight). In addition, people with BED showed poorer problem solving performance, but similar planning abilities to obese controls. CONCLUSIONS Individuals with BED were found to show worse performance on working memory tasks compared to obese individuals without the disorder. The findings did not provide definitive evidence of alterations in other aspects of executive functioning. Interest in executive functioning in people with BED is increasing but is limited by insufficient data from small studies with varied methodology. Future studies should focus on using similar tests and outcome measures, in order to enable more pertinent comparisons across studies.
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Affiliation(s)
- Maria Elisa Gisbert Cury
- Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Arthur Berberian
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Bruno Sini Scarpato
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Jess Kerr-Gaffney
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Flavia H Santos
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Angélica Medeiros Claudino
- Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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16
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Shi C, Kang L, Yao S, Ma Y, Li T, Liang Y, Cheng Z, Xu Y, Shi J, Xu X, Zhang C, Franklin DR, Heaton RK, Jin H, Yu X. What is the optimal neuropsychological test battery for schizophrenia in China? Schizophr Res 2019; 208:317-323. [PMID: 30718121 PMCID: PMC6544499 DOI: 10.1016/j.schres.2019.01.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/22/2019] [Accepted: 01/26/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND The MATRICS consensus cognitive battery (MCCB) has been widely used to evaluate cognitive deficits in schizophrenia (SCZ), however, no study has formally examined the validity of the MCCB in Chinese SCZ. This study compared Chinese SCZ patients with healthy Chinese controls on the MCCB and some additional neurocognitive tests to determine if the Chinese MCCB is an optimal battery to assess the cognitive deficits in Chinese SCZ patients. METHOD The study enrolled and examined 230 patients met DSM-IV criteria for SCZ and 656 healthy controls matched for gender, age and education. Besides the MCCB, we also included some additional neurocognitive tests that have been widely used in patients with schizophrenia. We selected MCCB and non-MCCB tests with large effect size, to assemble a new "optimal battery" and compared its performance with that of the standard MCCB. RESULTS Comparing the putative "optimal" battery with the original MCCB, more patients with SCZ were identified as cognitively impaired according to the criteria of GDS ≥ 0.50 for the optimal battery (166 vs 135, or 72.2% vs 58.7%). The rate of cognitive impairment according to MCCB GDS in patients with SCZ who were currently working, ever worked and never worked are 45.5%, 61.6% and 70.8% (p = 0.051), whereas the optimal battery GDS showed 56.4%, 74.8%, 91.7% (p = 0.003), respectively. CONCLUSIONS Our study needs validation with independent samples but suggests that the current "optimal" cognitive battery could be more sensitive than the widely used MCCB in detecting SCZ related cognitive impairment in China.
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Affiliation(s)
- Chuan Shi
- Peking University Sixth Hospital, Beijing, China,Peking University Institute of Mental Health, Beijing, China,NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,The National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lan Kang
- Peking University Sixth Hospital, Beijing, China,Peking University Institute of Mental Health, Beijing, China,NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,The National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Shuqiao Yao
- The Medical Psychological Research Center, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yibin Ma
- Peking University Sixth Hospital, Beijing, China,Peking University Institute of Mental Health, Beijing, China,NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,The National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Tao Li
- Peking University Sixth Hospital, Beijing, China,Peking University Institute of Mental Health, Beijing, China,NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,The National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ying Liang
- Peking University Sixth Hospital, Beijing, China,Peking University Institute of Mental Health, Beijing, China,NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,The National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhang Cheng
- Peking University Sixth Hospital, Beijing, China,Peking University Institute of Mental Health, Beijing, China,NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,The National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yifeng Xu
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianguo Shi
- Xian Mental Health Center, New Qujiang District, Xian, Shanxi, China
| | - Xiufeng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Congpei Zhang
- The First Haerbin Psychiatric Hospital, Haerbin, Heilongjiang, China
| | - Donald R. Franklin
- Department of Psychiatry, University of California at San Diego, San Diego, CA, USA
| | - Robert K. Heaton
- Department of Psychiatry, University of California at San Diego, San Diego, CA, USA
| | - Hua Jin
- Department of Psychiatry, University of California at San Diego, San Diego, CA, USA.
| | - Xin Yu
- Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China; The National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), Beijing, China.
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17
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Gomes J, Trevizol A, Ducos D, Gadelha A, Ortiz B, Fonseca A, Akiba H, Azevedo C, Guimaraes L, Shiozawa P, Cordeiro Q, Lacerda A, Dias A. Effects of transcranial direct current stimulation on working memory and negative symptoms in schizophrenia: a phase II randomized sham-controlled trial. Schizophr Res Cogn 2018; 12:20-28. [PMID: 29552509 PMCID: PMC5852322 DOI: 10.1016/j.scog.2018.02.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/01/2018] [Accepted: 02/04/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND The lack of efficacy of pharmacological treatments for cognitive and negative symptoms in schizophrenia highlights the need for new interventions. We investigated the effects of tDCS on working memory and negative symptoms in patients with schizophrenia. METHOD Double-blinded, randomized, sham-controlled clinical trial, investigating the effects of 10 sessions of tDCS in schizophrenia subjects. Stimulation used 2 mA, for 20 min, with electrodes of 25 cm2 wrapped in cotton material soaked in saline solution. Anode was positioned over the left DLPFC and the cathode in the contralateral area. Twenty-four participants were assessed at baseline, after intervention and in a three-months follow-up. The primary outcome was the working memory score from MATRICS and the secondary outcome the negative score from PANSS. Data were analyzed using generalized estimating equations. RESULTS We did not find group ∗ time interaction for the working memory (p = 0.720) score or any other cognitive variable (p > 0.05). We found a significant group ∗ time interaction for PANSS negative (p < 0.001, d = 0.23, CI.95 = -0.59-1.02), general (p = 0.011) and total scores (p < 0.001). Exploratory analysis of PANSS 5 factors suggests tDCS effect on PANSS negative (p = 0.012), cognitive (p = 0.016) and depression factors (p = 0.029). CONCLUSION The results from this trial highlight the therapeutic effects of tDCS for treatment of persistent symptoms in schizophrenia, with reduction of negative symptoms. We were not able to confirm the superiority of active tDCS over sham to improve working memory performance. Larger sample size studies are needed to confirm these findings.
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Affiliation(s)
- J.S. Gomes
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A.P. Trevizol
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
- Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD), Sao Paulo State Secretariat of Health, Sao Paulo, Brazil
| | - D.V. Ducos
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A. Gadelha
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - B.B. Ortiz
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A.O. Fonseca
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - H.T. Akiba
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - C.C. Azevedo
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - L.S.P. Guimaraes
- Epidemiology and Biostatistics Unity, Clinical Hospital of Porto Alegre, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - P. Shiozawa
- Department of Psychiatry, Santa Casa School of Medicine, Sao Paulo, Brazil
| | - Q. Cordeiro
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A. Lacerda
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Research and Clinical Trials Sinapse-Bairral, Instituto Bairral de Psiquiatria, Itapira, Brazil
| | - A.M. Dias
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
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18
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Gomes JS, Ducos DV, Gadelha A, Ortiz BB, Van Deusen AM, Akiba HT, Guimaraes LSP, Cordeiro Q, Trevizol AP, Lacerda A, Dias AM. Hemoencephalography self-regulation training and its impact on cognition: A study with schizophrenia and healthy participants. Schizophr Res 2018; 195:591-593. [PMID: 28882685 DOI: 10.1016/j.schres.2017.08.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/19/2017] [Accepted: 08/21/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cognitive impairments in schizophrenia are strongly correlated to functional outcome and recovery rates, with no pharmacological agent approved for its treatment. Neurofeedback has emerged as a non-pharmacological approach to enhance neuroplasticity, which consists in inducing voluntary control of brain responses through operant conditioning. METHOD The effects of hemoencephalography neurofeedback (HEG-NFBK) in 4 brain sites (F7, Fp1, Fp2 and F8) was studied in 8 patients with schizophrenia (SCH, mean age 36.5±9.98) and 12 health controls (mean age 32.17±5.6). We analyzed groups' performance (10 sessions) and cognitive differences in 3 time points (baseline, after training and follow-up) with generalized estimated equations. For SCH we also evaluate the impact on psychopathology. RESULTS We found a group∗time interaction for HEG-NFBK performance in the left hemisphere sites (F7 an Fp1) and a near-to-significant in the right frontotemporal region (F8), with no group differences and a significant time effect. Most of cognitive domains improved after intervention, including information processing speed, attention processing, working memory, executive functioning, verbal and visual learning. No group∗time interaction was found. Results suggest that both groups benefit from HEG-NFBK training regardless of cognitive differences at baseline. No significant time effects were found for Calgary and PANSS total scale and subscales (positive, negative neither general). CONCLUSION To our knowledge, this is the first controlled trial showing effects of NFBK on cognitive performance improvement in schizophrenia. Further research investigating the effects of HEG-NFBK training in schizophrenia should be performed.
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Affiliation(s)
- J S Gomes
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - D V Ducos
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A Gadelha
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - B B Ortiz
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - H T Akiba
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - L S P Guimaraes
- Epidemiology and Biostatistics Unity, Clinical Hospital of Porto Alegre, Federal University of Rio Grande do Sul, Brazil
| | - Q Cordeiro
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A P Trevizol
- Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil; Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD), São Paulo State Secretariat of Health, São Paulo, Brazil
| | - A Lacerda
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - A M Dias
- Clinical Neuroscience Lab, Federal University of Sao Paulo, Sao Paulo, Brazil; Center for Neuromodulation Studies, Dep. of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
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19
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Martini LC, Barbosa Neto JB, Petreche B, Fonseca AO, Santos FVD, Magalhães L, Marques AG, Soares C, Cordeiro Q, Attux C, Bressan RA. Schizophrenia and work: aspects related to job acquisition in a follow-up study. ACTA ACUST UNITED AC 2017; 40:35-40. [PMID: 28832749 PMCID: PMC6899422 DOI: 10.1590/1516-4446-2016-2128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 04/03/2017] [Indexed: 11/27/2022]
Abstract
Objective: Work is considered one of the main forms of social organization; however, few individuals with schizophrenia find work opportunities. The purpose of this study was to evaluate the relationship between schizophrenia symptoms and job acquisition. Method: Fifty-three individuals diagnosed with schizophrenia from an outpatient treatment facility were included in an 18-month follow-up study. After enrollment, they participated in a prevocational training group. At the end of training (baseline) and 18 months later, sociodemographic, clinical data and occupational history were collected. Positive and negative symptoms (Positive and Negative Syndrome Scale – PANSS), depression (Calgary Depression Scale), disease severity (Clinical Global Impression – CGI), functionality (Global Assessment of Functioning – GAF), personal and social performance (Personal and Social Performance – PSP) and cognitive functions (Measurement and Treatment Research to Improve Cognition in Schizophrenia – MATRICS battery) were applied at baseline and at the end of the study. Results: Those with some previous work experience (n=19) presented lower scores on the PANSS, Calgary, GAF, CGI and PSP scales (p < 0.05) than those who did not work. Among those who worked, there was a slight worsening in positive symptoms (positive PANSS). Conclusions: Individuals with less severe symptoms were more able to find employment. Positive symptom changes do not seem to affect participation at work; however, this calls for discussion about the importance of employment support.
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Affiliation(s)
- Larissa C Martini
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jair B Barbosa Neto
- Departamento de Medicina, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Beatriz Petreche
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ana O Fonseca
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Fernanda V Dos Santos
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Lílian Magalhães
- Departamento de Terapia Ocupacional, UFSCar, São Carlos, SP, Brazil
| | - Alessandra G Marques
- Departamento de Psiquiatria, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Camila Soares
- Departamento de Psiquiatria, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Quirino Cordeiro
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.,Departamento de Psiquiatria, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Cecília Attux
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Rodrigo A Bressan
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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