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Flaaten CB, Melle I, Gardsjord E, Bjella T, Engen MJ, Vaskinn A, Åsbø G, Wold KF, Widing L, Lyngstad SH, Haatveit B, Simonsen C, Ueland T. Course of intellectual functioning in schizophrenia and bipolar disorder: a 10-year follow-up study. Psychol Med 2023; 53:2662-2670. [PMID: 35256030 PMCID: PMC10123835 DOI: 10.1017/s0033291721004645] [Citation(s) in RCA: 1] [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] [Received: 03/26/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Intellectual functioning (IQ) is lower in schizophrenia patients compared to healthy controls, with bipolar patients intermediate between the two. Declines in IQ mark the onset of schizophrenia, while stability is generally found post-onset. There are to date few studies on long-term IQ development in bipolar disorder. This study presents 10-year follow-up data on IQ, including premorbid IQ estimates, to track the developmental course from pre-onset levels to long-term outcomes in both patient groups compared to healthy controls. METHODS We included 139 participants with schizophrenia, 76 with bipolar disorder and 125 healthy controls. Mixed model analyses were used to estimate developmental slopes for IQ scores from estimated premorbid level (NART IQ) through baseline (WASI IQ) measured within 12 months post-onset, to 10-year follow-up (WASI IQ), with pairwise group comparisons. The best fit was found using a model with a breakpoint at baseline assessment. RESULTS Only the schizophrenia group had significant declines from estimated premorbid to baseline IQ levels compared to controls. When comparing patient groups, schizophrenia patients had steeper declines than the bipolar group. Increases in IQ were found in all groups over the follow-up period. CONCLUSIONS Trajectories of IQ from premorbid level to 10-year follow-up indicated declines from estimated premorbid level to illness onset in both patient groups, followed by increases during the follow-up period. Schizophrenia patients had a steeper decline than bipolar patients. During follow-up, increases indicate developmental improvement for both patient groups, but with a maintained lag compared to healthy controls due to lower premorbid levels.
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Affiliation(s)
- Camilla Bärthel Flaaten
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erlend Gardsjord
- Division of Mental Health and Addiction, Unit for Early Intervention in Psychosis, Oslo University Hospital, Oslo, Norway
| | - Thomas Bjella
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Magnus Johan Engen
- Division of Mental Health and Addiction, Nydalen DPS, Oslo University Hospital, Oslo, Norway
| | - Anja Vaskinn
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Gina Åsbø
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin Fjelnseth Wold
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Line Widing
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Siv Hege Lyngstad
- Division of Mental Health and Addiction, Nydalen DPS, Oslo University Hospital, Oslo, Norway
| | - Beathe Haatveit
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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Rosen AS, King LC, Kinney DI, Nitch SR, Glassmire DM. Are TOPF and WRAT WR Interchangeable Measures among Psychiatric Inpatients? Arch Clin Neuropsychol 2022; 37:641-653. [PMID: 35034118 DOI: 10.1093/arclin/acab098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/16/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine whether Test of Premorbid Functioning (TOPF) and Wide Range Achievement Test-Word Reading subtest (WRAT WR) are interchangeable measures, and the relationship between these measures and intelligence, among patients with schizophrenia. METHOD In this archival study, the authors examined neuropsychology referrals of an inpatient forensic state hospital. Patients with a schizophrenia spectrum disorder (SSD) who received the Wechsler Adult Intelligence Scale-Fourth Edition or the Wechsler Abbreviated Scale of Intelligence-Second Edition and either TOPF or WRAT WR were considered for inclusion. The final sample consisted of 119 individuals (73.1% male). RESULTS Although there was a linear relationship between most TOPF variables and WRAT WR, their concordance was weak (concordance correlation coefficients [CCC] < 0.90). Poor concordance was also observed between current FSIQ and all standard scores (SS) derived from word reading measures. FSIQ-word reading measure discrepancy scores differed significantly from a hypothesized mean of 0 (mean discrepancy range = -7.42 to -16.60). Discrepancies greater than one standard deviation (>1 SD) were highest among demographics-based SS (i.e. TOPF Predicted and Simple without TOPF). Performance-based SS, particularly TOPF Actual and WRAT4 WR, had the fewest discrepancy scores >1 SD fromFSIQ. CONCLUSIONS TOPF and WRAT WR should not be used interchangeably among institutionalized patients with SSDs. TOPF and WRAT WR were discrepant from FSIQ, with demographic variables producing higher SS relative to performance-based variables. Future research is needed to determine which of these measures more accurately estimates intelligence among inpatients withSSDs.
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Affiliation(s)
- Alexis S Rosen
- Department of Psychology, Department of State Hospitals-Patton, Patton, CA 92369, USA
| | - Loren C King
- Department of Psychology, Department of State Hospitals-Patton, Patton, CA 92369, USA
| | - Dominique I Kinney
- Department of Psychology, Department of State Hospitals-Patton, Patton, CA 92369, USA
| | - Stephen R Nitch
- Department of Psychology, Department of State Hospitals-Patton, Patton, CA 92369, USA
| | - David M Glassmire
- Department of Psychology, Department of State Hospitals-Patton, Patton, CA 92369, USA
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Watt S, Gow B, Norton K, Crowe SF. Investigating Discrepancies between Predicted and Observed Wechsler Adult Intelligence Scale‐Version IV Full‐Scale Intelligence Quotient Scores in a Non‐Clinical Sample. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Stephanie Watt
- School of Psychology and Public Health, La Trobe University,
| | - Bennie Gow
- School of Psychology and Public Health, La Trobe University,
| | - Kate Norton
- School of Psychology and Public Health, La Trobe University,
| | - Simon F. Crowe
- School of Psychology and Public Health, La Trobe University,
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Stability of Estimated Premorbid Cognitive Ability over Time after Minor Stroke and Its Relationship with Post-Stroke Cognitive Ability. Brain Sci 2019; 9:brainsci9050117. [PMID: 31121963 PMCID: PMC6562568 DOI: 10.3390/brainsci9050117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022] Open
Abstract
Considering premorbid or “peak” adult intelligence (IQ) is important when examining post-stroke cognition. The stability of estimated premorbid IQ and its relationship to current cognitive ability in stroke is unknown. We investigated changes in estimated premorbid IQ and current cognitive ability up to three years post-stroke. Minor stroke patients (NIHSS < 8) were assessed at one to three months, one and three years’ post-stroke. The National Adult Reading Test (NART) and Addenbrooke’s Cognitive Examination-Revised (ACE-R) were used to estimate premorbid IQ (NART IQ) and current cognitive ability respectively at each time-point. Baseline demographics, vascular and stroke characteristics were included. Of the 264 patients recruited (mean age 66), 158 (60%), 151 (57%), and 153 (58%) completed cognitive testing at each time-point respectively. NART IQ initially increased (mean difference (MD) = 1.32, 95% CI = 0.54 to 2.13, p < 0.001) before decreasing (MD = −4.269, 95% CI = −5.12 to −3.41, p < 0.001). ACE-R scores initially remained stable (MD = 0.29, 95% CI = −0.49 to 1.07, p > 0.05) before decreasing (MD = −1.05, 95% CI = −2.08 to −0.01, p < 0.05). Adjusting for baseline variables did not change the relationship between NART IQ and ACE-R with time. Increases in NART IQ were associated with more education. For ACE-R, older age was associated with declines, and higher NART IQ and more education was associated with increases. Across 3 years, we observed fluctuations in estimated premorbid IQ and minor changes in current cognitive ability. Future research should aim to identify variables associated with these changes. However, studies of post-stroke cognition should account for premorbid IQ.
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Intelligence decline between present and premorbid IQ in schizophrenia: Schizophrenia Non-Affected Relative Project (SNARP). Eur Neuropsychopharmacol 2019; 29:653-661. [PMID: 30885440 DOI: 10.1016/j.euroneuro.2019.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 02/04/2019] [Accepted: 03/02/2019] [Indexed: 01/30/2023]
Abstract
Schizophrenia patients (SCZ) display widespread cognitive deficits that are strongly associated with functional outcomes. Cognitive impairments occur along a genetic continuum among SCZ, their unaffected first-degree relatives (FRs) and healthy controls (HCs). Although SCZ impairs the premorbid intelligence quotient (IQ) and causes a subsequent intelligence decline (ID), a decrease in present IQ from the premorbid level, it remains unclear when during the illness course these impairments develop. Differences in premorbid and present IQ and ID were investigated among 125 SCZ, 61 FRs and 107 HCs, using analysis of covariance and a paired t-test. Furthermore, these subjects were classified into preserved and deteriorated IQ groups based on the degree of ID, and we investigated which factors contribute to this classification. We found significant differences in premorbid and present IQ among the diagnostic groups. Compared with HCs, SCZ and FRs displayed lower premorbid and present IQ. There was no significant difference in premorbid IQ between SCZ and FRs, but SCZ had a significantly lower present IQ than FRs. Only SCZ showed a significant ID. As most FRs and HCs did not display an ID, there were fewer subjects with deteriorated IQ among FRs and HCs than among SCZ. Subjects with preserved IQ showed higher educational attainment than those with deteriorated IQ among SCZ and FRs. These findings suggest that the impairment of premorbid IQ and the ID in SCZ become evident before and around the time of onset, respectively, and different pathophysiological mechanisms might be related to these impairments.
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Menkes MW, Armstrong K, Blackford JU, Heckers S, Woodward ND. Neuropsychological functioning in early and chronic stages of schizophrenia and psychotic bipolar disorder. Schizophr Res 2019; 206:413-419. [PMID: 31104720 PMCID: PMC6530584 DOI: 10.1016/j.schres.2018.10.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/09/2018] [Accepted: 10/16/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Neuropsychological impairment is common in schizophrenia and psychotic bipolar disorder. It has been hypothesized that the pathways leading to impairment differ between disorders. Cognitive impairment in schizophrenia is believed to result largely from atypical neurodevelopment, whereas bipolar disorder is increasingly conceptualized as a neuroprogressive disorder. The current investigation tested several key predictions of this hypothesis. METHODS Current neuropsychological functioning and estimated premorbid intellectual ability were assessed in healthy individuals (n = 260) and a large, cross-sectional sample of individuals in the early and chronic stages of psychosis (n = 410). We tested the following hypotheses: 1) cognitive impairment is more severe in schizophrenia in the early stage of psychosis; and 2) cognitive decline between early and chronic stages is relatively greater in psychotic bipolar disorder. Additionally, individuals with psychosis were classified as neuropsychologically normal, deteriorated, and compromised (i.e. below average intellectual functioning) to determine if the frequencies of neuropsychologically compromised and deteriorated patients were higher in schizophrenia and psychotic bipolar disorder, respectively. RESULTS Neuropsychological impairment in the early stage of psychosis was more severe in schizophrenia. Psychotic bipolar disorder was not associated with relatively greater cognitive decline between illness stages. The frequency of neuropsychologically compromised patients was higher in schizophrenia; however, substantial portions of both schizophrenia and psychotic bipolar disorder patients were classified as neuropsychologically compromised and deteriorated. CONCLUSIONS While schizophrenia is associated with relatively greater neurodevelopmental involvement, psychotic bipolar disorder and schizophrenia cannot be strictly dichotomized into purely neuroprogressive and neurodevelopmental illness trajectories; there is evidence of both processes in each disorder.
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Affiliation(s)
- Margo W. Menkes
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN,Research Service, Tennessee Valley HealthCare System, US Department of Veterans Affairs
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Neil D. Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
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Adery LH, Ichinose M, Torregrossa LJ, Wade J, Nichols H, Bekele E, Bian D, Gizdic A, Granholm E, Sarkar N, Park S. The acceptability and feasibility of a novel virtual reality based social skills training game for schizophrenia: Preliminary findings. Psychiatry Res 2018; 270:496-502. [PMID: 30326433 PMCID: PMC6314809 DOI: 10.1016/j.psychres.2018.10.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 07/16/2018] [Accepted: 10/07/2018] [Indexed: 11/25/2022]
Abstract
Social impairment is a core feature of schizophrenia that presents a major barrier toward recovery. Some of the psychotic symptoms are partly ameliorated by medication but the route to recovery is hampered by social impairments. Since existing social skills interventions tend to suffer from lack of availability, high-burden and low adherence, there is a dire need for an effective, alternative strategy. The present study examined the feasibility and acceptability of Multimodal Adaptive Social Intervention in Virtual Reality (MASI-VR) for improving social functioning and clinical outcomes in schizophrenia. Out of eighteen patients with schizophrenia who enrolled, seventeen participants completed the pre-treatment assessment and 10 sessions of MASI-VR, but one patient did not complete the post-treatment assessments. Therefore, the complete training plus pre- and post-treatment assessment data are available from sixteen participants. Clinical ratings of symptom severity were obtained at pre- and post-training. Retention rates were very high and training was rated as extremely satisfactory for the majority of participants. Participants exhibited a significant reduction in overall clinical symptoms, especially negative symptoms following 10 sessions of MASI-VR. These preliminary results support the feasibility and acceptability of a novel virtual reality social skills training program for individuals with schizophrenia.
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Affiliation(s)
- Laura H Adery
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Megan Ichinose
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | | | - Joshua Wade
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Heathman Nichols
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Esube Bekele
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Dayi Bian
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Alena Gizdic
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Eric Granholm
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Nilanjan Sarkar
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA; Global Academy for Future Civilizations, Kyung Hee University, Seoul, Korea.
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Hidese S, Matsuo J, Ishida I, Hiraishi M, Teraishi T, Ota M, Hattori K, Kunugi H. Association between lower estimated premorbid intelligence quotient and smoking behavior in patients with schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2018; 15:7-13. [PMID: 30310770 PMCID: PMC6176847 DOI: 10.1016/j.scog.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/26/2018] [Accepted: 09/30/2018] [Indexed: 12/18/2022]
Abstract
Aim We aimed to investigate the involvement of premorbid intelligence quotient in higher prevalence of smoking in patients with schizophrenia. Methods Participants included 190 patients with schizophrenia (mean ± standard deviation age: 37.7 ± 10.8 years; 88 males and 102 females) and 312 healthy individuals (mean ± standard deviation age: 38.1 ± 13.8; 166 males and 146 females), matched for age, sex, and ethnicity (Japanese). Premorbid intelligence quotient was estimated using the Japanese Adult Reading Test and distress symptoms were assessed using the Hopkins Symptom Check List. Current smoking information was collected according to self-declarations. Results As expected, the smoking rate was higher, while mean education level and Japanese Adult Reading Test scores were significantly lower, in patients with schizophrenia than in healthy individuals (p < 0.01). The mean education level and Japanese Adult Reading Test scores were significantly lower in the smoker group than in the non-smoker group in both patients and healthy individuals (p < 0.05). In the patient group alone, Hopkins Symptom Check List subscale and total scores were significantly higher in the smoker group than in the non-smoker group (p < 0.05). A multivariate regression analysis showed that the Japanese Adult Reading Test score was a significant and negative predictor for smoking (p < 0.001, odds ratio = 0.97; 95% confidence interval: 0.96–0.99). Conclusion Our results suggest that lower estimated premorbid intelligence quotient is an important variable in elucidating smoking behavior in humans and may be associated with higher prevalence of smoking in patients with schizophrenia. Lower premorbid intelligence quotient (IQ) was observed in patients with schizophrenia who were smokers. Lower education level was observed in patients with schizophrenia who were smokers. Lower premorbid IQ and education level were also seen in smokers in the healthy group. Distress symptoms were higher in smokers with schizophrenia. In total, premorbid IQ was a negative predictor for smoking.
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Key Words
- ANCOVA, Analysis of covariance
- CI, Confidence interval
- Distress symptom
- Education level
- HSCL, Hopkins Symptom Check List
- IQ, Intelligence quotient
- JART, Japanese Adult Reading Test
- MANCOVA, Multivariate analysis of covariance
- NART, National Adult Reading Test
- OR, Odds ratio
- PANSS, Positive and Negative Syndrome Scale
- PSQI, Pittsburgh Sleep Quality Index
- Premorbid intelligence quotient
- Schizophrenia
- Smoking
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Affiliation(s)
- Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Junko Matsuo
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Ikki Ishida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Moeko Hiraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Toshiya Teraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Kotaro Hattori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Ogawa-Higashi, 4-1-1, Kodaira, Tokyo, 187-8502, Japan
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Perioperative Research into Memory (PRiMe): Cognitive impairment following a severe burn injury and critical care admission, part 1. Burns 2018; 44:1167-1178. [PMID: 29752016 DOI: 10.1016/j.burns.2018.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/20/2018] [Accepted: 04/10/2018] [Indexed: 12/14/2022]
Abstract
INTRODUCTION An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns. METHODS A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks. RESULTS 15 patients (11M, 4F; 41±14 years; TBSA 38.4%±18.5) and comparators (11M, 4F; 40±13 years) were recruited. Burns patients reported worse QoL (Neuro-QoL Short Form v2, patient 30.1±8.2, control 38.7±3.2, p=0.0004) and cognitive function (patient composite z-score 0.01, IQR -0.11 to 0.33, control 0.13, IQR 0.47-0.73, p=0.02). Compared to estimated premorbid FSIQ, patients dropped an equivalent of 8 IQ points (p=0.002). Cognitive function negatively correlated with burn severity (rBaux score, p=0.04). QoL strongly correlated with depressive symptoms (Rho=-0.67, p=0.009) but not cognitive function. CONCLUSIONS Severe burns injuries are associated with a significant, global, cognitive deficit. Patients also report worse QoL, depression and post-traumatic stress. Perceived QoL from cognitive impairment was more closely associated with depression than cognitive impairment.
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Whitford V, O'Driscoll GA, Titone D. Reading deficits in schizophrenia and their relationship to developmental dyslexia: A review. Schizophr Res 2018; 193:11-22. [PMID: 28688740 DOI: 10.1016/j.schres.2017.06.049] [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: 03/01/2017] [Revised: 06/23/2017] [Accepted: 06/23/2017] [Indexed: 12/12/2022]
Abstract
Although schizophrenia and developmental dyslexia are considered distinct disorders in terms of clinical presentation and functional outcome, they both involve disruption in the processes that support skilled reading, including language, auditory perception, visual perception, oculomotor control, and executive function. Further, recent work has proposed a common neurodevelopmental basis for the two disorders, as suggested by genetic and pathophysiological overlap. Thus, these lines of research suggest that reading may be similarly impacted in schizophrenia and dyslexia. In this review, we survey research on reading abilities in individuals with schizophrenia, and review the potential mechanisms underlying reading deficits in schizophrenia that may be shared with those implicated in dyslexia. Elucidating the relationship between reading impairment in schizophrenia and dyslexia could allow for a better understanding of the pathophysiological underpinnings of schizophrenia, and could facilitate remediation of cognitive deficits that impact day-to-day functioning.
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Affiliation(s)
- Veronica Whitford
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, 43 Vassar Street, Cambridge, MA 02139, United States; Graduate School of Education, Harvard University, 13 Appian Way, Cambridge, MA 02138, United States.
| | - Gillian A O'Driscoll
- Department of Psychology, McGill University, 1205 Doctor Penfield Avenue, Montreal, QC H3A 1B1, Canada; Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Verdun, QC H4H 1R3, Canada; Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC H3A 2B4, Canada.
| | - Debra Titone
- Department of Psychology, McGill University, 1205 Doctor Penfield Avenue, Montreal, QC H3A 1B1, Canada; Centre for Research on Brain, Language and Music, McGill University, 3640 de la Montagne Street, Montreal, QC H3G 2A8, Canada.
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Ohi K, Sumiyoshi C, Fujino H, Yasuda Y, Yamamori H, Fujimoto M, Sumiyoshi T, Hashimoto R. A Brief Assessment of Intelligence Decline in Schizophrenia As Represented by the Difference between Current and Premorbid Intellectual Quotient. Front Psychiatry 2017; 8:293. [PMID: 29312019 PMCID: PMC5743746 DOI: 10.3389/fpsyt.2017.00293] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 12/11/2017] [Indexed: 01/25/2023] Open
Abstract
Patients with schizophrenia elicit several clinical features, such as psychotic symptoms, cognitive impairment, and subtle decline of intelligence. The latter two features become evident around the onset of the illness, although they may exist even before the disease onset in a substantial proportion of cases. Here, we review the literature concerning intelligence decline (ID) during the progression of schizophrenia. ID can be estimated by comparing premorbid and current intellectual quotient (IQ) by means of the Adult Reading Test and Wechsler Adult Intelligence Scale (WAIS), respectively. For the purpose of brief assessment, we have recently developed the WAIS-Short Form, which consists of Similarities and Symbol Search and well reflects functional outcomes. According to the degree of ID, patients were classified into three distinct subgroups; deteriorated, preserved, and compromised groups. Patients who show deteriorated IQ (deteriorated group) elicit ID from a premorbid level (≥10-point difference between current and premorbid IQ), while patients who show preserved or compromised IQ do not show such decline (<10-point difference). Furthermore, the latter patients were divided into patients with preserved and compromised IQ based on an estimated premorbid IQ score >90 or below 90, respectively. We have recently shown the distribution of ID in a large cohort of schizophrenia patients. Consistent with previous studies, approximately 30% of schizophrenia patients had a decline of less than 10 points, i.e., normal intellectual performance. In contrast, approximately 70% of patients showed deterioration of IQ. These results indicate that there is a subgroup of schizophrenia patients who have mild or minimal intellectual deficits, following the onset of the disorder. Therefore, a careful assessment of ID is important in identifying appropriate interventions, including medications, cognitive remediation, and social/community services.
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Affiliation(s)
- Kazutaka Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Uchinada, Japan
| | - Chika Sumiyoshi
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
| | - Haruo Fujino
- Graduate School of Education, Oita University, Oita, Japan
| | - Yuka Yasuda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomiki Sumiyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan
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Olsen JP, Fellows RP, Rivera-Mindt M, Morgello S, Byrd DA. Reading Ability as an Estimator of Premorbid Intelligence: Does It Remain Stable Among Ethnically Diverse HIV+ Adults? Clin Neuropsychol 2015; 29:1034-52. [PMID: 26689235 DOI: 10.1080/13854046.2015.1122085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
UNLABELLED The Wide Range Achievement Test, 3rd edition, Reading Recognition subtest (WRAT-3 RR) is an established measure of premorbid ability. Furthermore, its long-term reliability is not well documented, particularly in diverse populations with CNS-relevant disease. OBJECTIVE We examined test-retest reliability of the WRAT-3 RR over time in an HIV+ sample of predominantly racial/ethnic minority adults. METHOD Participants (N = 88) completed a comprehensive neuropsychological battery, including the WRAT-3 RR, on at least two separate study visits. Intraclass correlation coefficients (ICCs) were computed using scores from baseline and follow-up assessments to determine the test-retest reliability of the WRAT-3 RR across racial/ethnic groups and changes in medical (immunological) and clinical (neurocognitive) factors. Additionally, Fisher's Z tests were used to determine the significance of the differences between ICCs. RESULTS The average test-retest interval was 58.7 months (SD = 36.4). The overall WRAT-3 RR test-retest reliability was high (r = .97, p < .001) and remained robust across all demographic, medical, and clinical variables (all r's > .92). ICCs did not differ significantly between the subgroups tested (all Fisher's Z p's > .05). CONCLUSIONS Overall, this study supports the appropriateness of word-reading tests, such as the WRAT-3 RR, for use as stable premorbid IQ estimates among ethnically diverse groups. Moreover, this study supports the reliability of this measure in the context of change in health and neurocognitive status and in lengthy inter-test intervals. These findings offer strong rationale for reading as a "hold" test, even in the presence of a chronic, variable disease such as HIV.
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Affiliation(s)
- James P Olsen
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,c Department of Psychology , Fordham University , New York , NY , USA
| | - Robert P Fellows
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Monica Rivera-Mindt
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,b Department of Psychiatry , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,c Department of Psychology , Fordham University , New York , NY , USA
| | - Susan Morgello
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,d Department of Neuroscience , The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Desiree A Byrd
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,b Department of Psychiatry , The Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Power BD, Dragovic M, Badcock JC, Morgan VA, Castle D, Jablensky A, Stefanis NC. No additive effect of cannabis on cognition in schizophrenia. Schizophr Res 2015; 168:245-51. [PMID: 26235754 DOI: 10.1016/j.schres.2015.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/18/2015] [Accepted: 06/28/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND We aimed to examine the association between lifetime cannabis use and estimates of both premorbid and current cognitive function in psychotic disorders in an Australian cohort. METHODS In an Australian multicenter cohort, 1237 participants with an established ICD-10 diagnosis of psychotic disorder were categorised according to history of lifetime cannabis use (non-users, n=354; cannabis users, n=221; cannabis dependency, n=662). Groups were analyzed according to available indices of cognitive ability: the National Adult Reading Test - Revised (NART-R) for ability prior to illness onset; and the Digit Symbol Coding Test (DSCT) for current ability. Two-way analysis of variance was conducted without any covariate, followed by a two-way analysis of covariance (using age, age at onset of psychiatric illness, premorbid IQ and the Socio-Economic Index for Areas (SEIFA) rankings). RESULTS Whilst there appeared to be a significant association between cannabis use and mean DSCT (higher DSCT scores in cannabis using groups) F(2,1080)=9.478, p<0.001, η2=0.017), once covariates were used in the analysis there were no significant differences between groups in mean DSCT scores (F(2,1011)=0.929, p=0.395, η2=0.002). Similarly there were no differences between groups in mean NART scores once, age, age at illness onset and SEIFA rankings were used as covariates (F(2,1032)=1.617, p=0.199, η2=0.003). CONCLUSIONS Confounding variables underpin the association between cannabis use and cognitive function in psychotic disorders. Taken together, it would appear that cannabis use or dependence has no additive effect on cognitive dysfunction in these disorders.
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Affiliation(s)
- Brian D Power
- School of Medicine Fremantle, The University of Notre Dame Australia, Fremantle, Australia; South Metropolitan Area Health Service, Perth, Australia; Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia.
| | - Milan Dragovic
- Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Johanna C Badcock
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Vera A Morgan
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - David Castle
- St. Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Assen Jablensky
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Nikos C Stefanis
- Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
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Morgan VA, McGrath JJ, Jablensky A, Badcock JC, Waterreus A, Bush R, Carr V, Castle D, Cohen M, Galletly C, Harvey C, Hocking B, McGorry P, Neil AL, Saw S, Shah S, Stain HJ, Mackinnon A. Psychosis prevalence and physical, metabolic and cognitive co-morbidity: data from the second Australian national survey of psychosis. Psychol Med 2014; 44:2163-76. [PMID: 24365456 PMCID: PMC4045165 DOI: 10.1017/s0033291713002973] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 11/05/2013] [Accepted: 11/09/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND There are insufficient data from nationwide surveys on the prevalence of specific psychotic disorders and associated co-morbidities. METHOD The 2010 Australian national psychosis survey used a two-phase design to draw a representative sample of adults aged 18-64 years with psychotic disorders in contact with public treatment services from an estimated resident population of 1 464 923 adults. This paper is based on data from 1642 participants with an International Classification of Diseases (ICD)-10 psychotic disorder. Its aim is to present estimates of treated prevalence and lifetime morbid risk of psychosis, and to describe the cognitive, physical health and substance use profiles of participants. RESULTS The 1-month treated prevalence of psychotic disorders was 3.10 cases per 1000 population aged 18-64 years, not accounting for people solely accessing primary care services; lifetime morbid risk was 3.45 per 1000. Mean premorbid intelligence quotient was approximately 0.5 s.d.s below the population mean; current cognitive ability (measured with a digit symbol coding task) was 1.6 s.d.s below the population mean. For both cognitive tests, higher scores were significantly associated with better independent functioning. The prevalence of the metabolic syndrome was high, affecting 60.8% of participants, and pervasive across diagnostic groups. Of the participants, two-thirds (65.9%) were current smokers, 47.4% were obese and 32.4% were sedentary. Of the participants, half (49.8%) had a lifetime history of alcohol abuse/dependence and 50.8% lifetime cannabis abuse/dependence. CONCLUSIONS Our findings highlight the need for comprehensive, integrative models of recovery to maximize the potential for good health and quality of life for people with psychotic illness.
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Affiliation(s)
- V. A. Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - J. J. McGrath
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - A. Jablensky
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - J. C. Badcock
- School of Psychology, The University of Western Australia, Crawley, Western Australia
- Clinical Research Centre, North Metropolitan Health Service-Mental Health, Mount Claremont, WA, Australia
| | - A. Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - R. Bush
- School of Population Health, The University of Queensland, Ipswich, QLD, Australia
| | - V. Carr
- School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
| | - D. Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- St Vincent's Hospital, Melbourne, VIC, Australia
| | - M. Cohen
- Hunter New England Mental Health, Newcastle, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - C. Galletly
- School of Medicine, University of Adelaide, Adelaide, SA, Australia
- Ramsay Health Care (SA) Mental Health Services, Adelaide, SA, Australia
- Northern Sector, Adelaide Metro Mental Health Directorate, Adelaide, SA, Australia
| | - C. Harvey
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- Psychosocial Research Centre, North West Area Mental Health Services, Coburg, VIC, Australia
| | - B. Hocking
- SANE Australia, Melbourne, VIC, Australia
| | - P. McGorry
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- Orygen Youth Health Research Centre, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - A. L. Neil
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - S. Saw
- Australian Government Department of Health and Ageing, Canberra, ACT, Australia
| | - S. Shah
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - H. J. Stain
- Centre for Rural and Remote Mental Health, University of Newcastle, Newcastle, NSW, Australia
- School of Medicine, Pharmacy and Health, Durham University, Durham, UK
| | - A. Mackinnon
- Orygen Youth Health Research Centre, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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Abbott G, Byrne LK. Schizotypal traits are associated with poorer identification of emotions from dynamic stimuli. Psychiatry Res 2013; 207:40-4. [PMID: 23541245 DOI: 10.1016/j.psychres.2013.03.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 02/18/2013] [Accepted: 03/04/2013] [Indexed: 12/19/2022]
Abstract
Recent research suggests that the emotion recognition difficulties seen in schizophrenia may also be present to a lesser degree in non-clinical individuals who report attenuated expressions of schizophrenia-like symptoms (schizotypy). However, evidence in non-clinical samples primarily comes from studies employing static facial emotion tasks, and it is not clear whether poorer emotion recognition in schizotypy persists when people have access to a broader range of emotional cues more representative of typical face-to-face social interactions. A community sample of 151 adults completed measures of schizotypal traits, IQ, and a task that assessed emotion recognition using dynamic video-based stimuli. Global schizotypy and positive schizotypal traits were each associated with poorer emotion recognition. Negative schizotypy was not associated with emotion recognition overall, but was associated with errors in recognising positive emotions. It appears that poorer emotion recognition in schizotypy is not limited to single-channel stimuli, but can be seen even when multiple emotional cues are available. Thus, individuals with high levels of schizotypal traits, and positive features in particular, may have greater difficulty when it comes to 'reading' the emotions of others in everyday social interactions.
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Affiliation(s)
- Gavin Abbott
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood 3125, Australia
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Alba-Ferrara L, de Erausquin GA, Hirnstein M, Weis S, Hausmann M. Emotional prosody modulates attention in schizophrenia patients with hallucinations. Front Hum Neurosci 2013; 7:59. [PMID: 23459397 PMCID: PMC3586698 DOI: 10.3389/fnhum.2013.00059] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 02/14/2013] [Indexed: 11/13/2022] Open
Abstract
Recent findings have demonstrated that emotional prosody (EP) attracts attention involuntarily (Grandjean et al., 2008). The automat shift of attention toward emotionally salient stimuli can be overcome by attentional control (Hahn et al., 2010). Attentional control is impaired in schizophrenia, especially in schizophrenic patients with hallucinations because the "voices" capture attention increasing the processing load and competing for top-down resources. The present study investigates how involuntary attention is driven by implicit EP in schizophrenia with auditory verbal hallucinations (AVH) and without (NAVH). Fifteen AVH patients, 12 NAVH patients and 16 healthy controls (HC) completed a dual-task dichotic listening paradigm, in which an emotional vocal outburst was paired with a neutral vocalization spoken in male and female voices. Participants were asked to report the speaker's gender while attending to either the left or right ear. NAVH patients and HC revealed shorter response times for stimuli presented to the attended left ear than the attended right ear. This laterality effect was not present in AVH patients. In addition, NAVH patients and HC showed faster responses when the EP stimulus was presented to the unattended ear, probably because of less interference between the attention-controlled gender voice identification task and involuntary EP processing. AVH patients did not benefit from presenting emotional stimuli to the unattended ear. The findings suggest that similar to HC, NAVH patients show a right hemispheric bias for EP processing. AVH patients seem to be less lateralized for EP and therefore might be more susceptible to interfering involuntary EP processing; regardless which ear/hemisphere receives the bottom up input.
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Affiliation(s)
- L. Alba-Ferrara
- Department of Psychiatry and Neurosciences, Roskamp Laboratory of Brain Development, Modulation and Repair, Morsani College of Medicine, University of South FloridaTampa, FL, USA
- Department of Psychology, Durham UniversityDurham, UK
| | - G. A. de Erausquin
- Department of Psychiatry and Neurosciences, Roskamp Laboratory of Brain Development, Modulation and Repair, Morsani College of Medicine, University of South FloridaTampa, FL, USA
| | - M. Hirnstein
- Department of Psychology, Durham UniversityDurham, UK
- Department of Biological and Medical Psychology, University of BergenBergen, Norway
| | - S. Weis
- Department of Psychology, Durham UniversityDurham, UK
| | - M. Hausmann
- Department of Psychology, Durham UniversityDurham, UK
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Abstract
Cognitive models propose that auditory verbal hallucinations arise through inner speech misidentification. However, such models cannot explain why the voices in hallucinations often have identities different from the hearer. This study investigated whether a general voice identity recognition difficulty might be present in schizophrenia and related to auditory verbal hallucinations. Twenty-five schizophrenia patients and 13 healthy controls were tested on recognition of famous voices. Signal detection theory was used to calculate perceptual sensitivity and response criterion measures. Schizophrenia patients obtained fewer hits and had lower perceptual sensitivity to detect famous voices than healthy controls did. There were no differences between groups in false alarm rate or response criterion. A symptom-based analysis demonstrated that especially those patients with auditory verbal hallucinations performed poorly in the task. The results indicate that patients with hallucinations are impaired at voice identity recognition because of decreased sensitivity, which may result in inner speech misidentification.
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18
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Leeson VC, Sharma P, Harrison M, Ron MA, Barnes TRE, Joyce EM. IQ trajectory, cognitive reserve, and clinical outcome following a first episode of psychosis: a 3-year longitudinal study. Schizophr Bull 2011; 37:768-77. [PMID: 19934212 PMCID: PMC3122279 DOI: 10.1093/schbul/sbp143] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Comparison of current and estimated premorbid IQ in schizophrenia suggests that there are subgroups with low IQ, deteriorated IQ (DIQ), or preserved IQ and that this is established by psychosis onset. There are no controlled studies examining the trajectory of these IQ subgroups longitudinally or their relationship with clinical and social outcomes. Of 129 individuals with first-episode schizophrenia or schizoaffective disorder, 25% showed stable low IQ, 31% showed stable IQ in the average/high range, and 44% demonstrated intellectual deterioration by 10 points or more. Patients in the low and deteriorated groups were equally impaired on tests of memory and executive function compared with the preserved average/high-IQ group and controls and showed more negative and disorganization symptoms than the preserved average/high-IQ group. Sixty patients and 27 controls were assessed again 1 and 3 years later. There was no evidence that those with IQ deterioration at baseline continued on a declining cognitive trajectory or that those with preserved average/high IQ experienced subsequent IQ decline. The low IQ group showed no change in IQ, whereas both the DIQ and the preserved IQ groups improved. However, the rate of improvement of these 2 subgroups was no greater than that of the healthy controls, suggesting that this reflected practice effects. Both the low and the deteriorated groups had longer index admissions, more core negative symptoms, and worse occupational outcomes at 3 years. These data suggest that following psychosis onset, IQ is stable and that it is IQ at psychosis onset rather than premorbid IQ predicts a more severe illness.
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Affiliation(s)
- Verity C Leeson
- UCL Institute of Neurology, The National Hospital for Neurologyand Neurosurgery, University College London, Queen Square, London, UK.
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Roux P, Christophe A, Passerieux C. The emotional paradox: Dissociation between explicit and implicit processing of emotional prosody in schizophrenia. Neuropsychologia 2010; 48:3642-9. [DOI: 10.1016/j.neuropsychologia.2010.08.021] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 08/13/2010] [Accepted: 08/22/2010] [Indexed: 11/27/2022]
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Diminished humour perception in schizophrenia: relationship to social and cognitive functioning. J Psychiatr Res 2010; 44:434-40. [PMID: 19892368 DOI: 10.1016/j.jpsychires.2009.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 09/04/2009] [Accepted: 10/02/2009] [Indexed: 01/24/2023]
Abstract
This study attempted to confirm that humour recognition deficits previously found in schizophrenia are specific to the condition and not attributable to other parameters such as depression or anxiety. Secondarily, we explored any possible cognitive or social functioning correlates to humour recognition deficits. A total of 60 participants (20 outpatients with schizophrenia, 20 psychiatric control participants and 20 control participants) underwent a 64-question humour task in addition to a battery of standard cognitive tests and Social Functioning Scales. In order to compare the three groups of participants, we conducted an analysis of variance (ANOVA) and post-hoc t-tests on neuropsychological measures, social functioning measures, and the primary outcome, humour recognition. The schizophrenia group showed significant and substantial deficits in humour recognition compared to the healthy control group, t(38)=5.1, P<0.001, ES=-1.55 and the psychiatric control group, t(38)=3.6, P=0.001. In the schizophrenia group, humour recognition correlated positively with general intellectual functioning (NART) r=.45, P=0.04, social reasoning (WAIS-III Comprehension) r=.54, P=0.01, executive functioning (WCST-CC) r=.69, P=0.001 and social adjustment ratings (SASS scores), r=.54, P=0.02. These findings support the assertion that humour recognition deficits in schizophrenia are specific to the condition and not attributable to other factors such as depression or anxiety. Furthermore, humour recognition deficits in schizophrenia may perhaps be preferentially associated with deficiencies in set shifting and semantic cognition.
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Korver N, Nieman DH, Becker HE, van de Fliert JR, Dingemans PH, de Haan L, Spiering M, Schmitz N, Linszen DH. Symptomatology and neuropsychological functioning in cannabis using subjects at ultra-high risk for developing psychosis and healthy controls. Aust N Z J Psychiatry 2010; 44:230-6. [PMID: 20180725 DOI: 10.3109/00048670903487118] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The relationship between cannabis use and psychosis has been studied intensively. Few data, however, are available on the relationship between cannabis use, ultra-high risk for developing psychosis and neurocognition. The aim of the present cross-sectional study was therefore to investigate the relationship between cannabis use, ultra-high-risk (UHR) symptoms and cognitive functioning in UHR patients and healthy controls. METHODS A total of 63 ultra-high-risk patients (34 cannabis users) and 58 control subjects (28 cannabis users) were assessed with clinical measures and a neuropsychological test battery. Patients were eligible for the study if they were between the ages of 12 and 35 years and if they fell into one or more of the following inclusion groups: familial risk and reduced functioning, attenuated psychotic symptoms, brief limited intermittent psychotic symptoms and basic symptoms. Control subjects were eligible for the study if they were between the ages 12 and 35, had no present or past psychiatric illness, no family history of psychiatric illness, no drug use in the non-cannabis-using group, and use of at least four joints per week in the cannabis-using control group. RESULTS In the UHR and the control group, cannabis users experienced more basic symptoms and UHR symptoms than the non-cannabis users. Moreover, cannabis users in the control group performed at the level of the UHR subjects on a test of verbal memory and verbal fluency. Frequency of cannabis use correlated with severity of several UHR symptoms. CONCLUSIONS Cannabis-using UHR patients have more basic symptoms than non-using patients. In addition, healthy cannabis users have more subclinical UHR and basic symptoms and more neuropsychological dysfunctions than non-cannabis users. More frequent cannabis use was related to increased severity of certain UHR symptoms.
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Affiliation(s)
- Nikie Korver
- Department of Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
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Takei K, Yamasue H, Abe O, Yamada H, Inoue H, Suga M, Muroi M, Sasaki H, Aoki S, Kasai K. Structural disruption of the dorsal cingulum bundle is associated with impaired Stroop performance in patients with schizophrenia. Schizophr Res 2009; 114:119-27. [PMID: 19505800 DOI: 10.1016/j.schres.2009.05.012] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Revised: 05/03/2009] [Accepted: 05/13/2009] [Indexed: 12/15/2022]
Abstract
Previous diffusion tensor imaging (DTI) studies have shown structural abnormalities of the cingulum bundle (CB) in patients with schizophrenia. However, regional specificity and functional relevance of the pregenual and dorsal CB subdivisions has not been fully studied. In the current study, 31 patients with schizophrenia and 65 age- and gender-matched healthy subjects underwent DTI to measure fractional anisotropy (FA) and mean diffusivity (MD) in cross sections of dorsal and pregenual CB tractography. To test the hypothesis of region-specific association with neurocognition, all of the patients and 31 controls performed the Stroop task, which is assumed to mainly involve dorsal cingulate function. The verbal memory subscale of Wechsler Memory Scale-Revised and premorbid IQs estimated from the Japanese version of the National Adult Reading Test, which were non-specific to dorsal cingulate function, were also employed as control neurocognitive indices. Significant bilateral FA reductions in the pregenual and dorsal CB, and bilateral MD increases in the dorsal CB were observed in the patients compared with the controls. As predicted, significant associations between DTI measures and neurocognition were found in the schizophrenia group only: double-dissociable correlation between higher MD in the dorsal, not in the pregenual CB, and a longer reaction time in the Stroop task, not verbal memory or premorbid IQs. The current DTI study suggests that structural disruption of the dorsal CB has region-specific functional relevance to selective attention deficits, although structural disruption also exists in the pregenual CB in patients with schizophrenia.
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Affiliation(s)
- Kunio Takei
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
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Schretlen DJ, Winicki JM, Meyer SM, Testa SM, Pearlson GD, Gordon B. Development, Psychometric Properties, and Validity of the Hopkins Adult Reading Test (HART). Clin Neuropsychol 2009; 23:926-43. [DOI: 10.1080/13854040802603684] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dragovic M, Waters FAV, Jablensky A. Estimating premorbid intelligence in schizophrenia patients: demographically based approach. Aust N Z J Psychiatry 2008; 42:814-8. [PMID: 18696286 DOI: 10.1080/00048670802277214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of the present study was to provide a useful and quick estimate of premorbid intelligence that can be used in the population of schizophrenia patients. METHOD Regression analysis (stepwise procedure) was used to identify which of five demographic variables significantly predicted National Adult Reading Test (NART) scores in schizophrenia patients. The new regression equation was subsequently assessed in an independent patient sample. The results were compared with scores obtained for an equation developed in healthy populations. RESULTS Age, occupation, and education contributed significantly to the equation, which accurately predicted NART scores in the patient sample. The equation developed in healthy people, however, consistently underestimated NART scores. CONCLUSIONS Equations developed in healthy people are not accurate predictors of NART scores. By contrast, the new equation acknowledges the educational and occupational characteristics typical of individuals with schizophrenia. The equation should be used cautiously, but can be used as a rapid estimate when it is not possible to conduct a cognitive assessment using more traditional approaches.
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Affiliation(s)
- Milan Dragovic
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Claremont, WA, Australia.
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Tallberg IM, Wenneborg K, Almkvist O. Reading words with irregular decoding rules: A test of premorbid cognitive function? Scand J Psychol 2006; 47:531-9. [PMID: 17107502 DOI: 10.1111/j.1467-9450.2006.00547.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The present study investigated the relation between level of general cognitive function and the oral reading of irregular words in Swedish. Swedish is an orthographically regular language, so many irregular words are loan words from other languages. A test comprising such words (irregularly spelled words (ISW)) was designed, and tested on a sample of 48 healthy Swedish adults, stratified according to age, gender, and level of education. The results confirmed that the ability to read words that do not follow the regular rules for decoding in Swedish was positively related to general cognitive level. ISW in combination with demographic variables gave a good estimate of general cognitive function and a better estimate than demographic variables alone. Exposure to written and spoken vocabulary during the lifespan may be indexed by ISW performance, for factor analysis suggested that this may constitute a discrete factor contributing to cognitive function.
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Affiliation(s)
- Ing-Mari Tallberg
- CLINTEC Department, Division of Logopedics and Phoniatrics, Karolinska Insitutet, Sweden.
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Whyte MC, Brett C, Harrison LK, Byrne M, Miller P, Lawrie SM, Johnstone EC. Neuropsychological performance over time in people at high risk of developing schizophrenia and controls. Biol Psychiatry 2006; 59:730-9. [PMID: 16388781 DOI: 10.1016/j.biopsych.2005.08.028] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2004] [Revised: 10/20/2004] [Accepted: 08/11/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Neuropsychological assessments of relatives of schizophrenics have shown subtle impairments in verbal memory, executive and intellectual function, which are stable in those beyond the age of maximum risk for the disorder. We sought to: (1) determine baseline neurocognitive predictors of psychosis, and (2) compare performance over time between relatives within the age of maximum risk, and controls. METHODS (1) and (2) were examined in 118 individuals at familial high risk of schizophrenia (HR) and 30 controls (C), using one-way analyses of variance (ANOVAs) and repeated measures analyses of covariance (ANCOVAs), controlling for intelligence quotient, time between and number of assessments, and correcting for multiple comparisons. RESULTS HR who became ill (n = 13) performed nonsignificantly less well at baseline than HR who did not (n = 105) on a test of verbal learning (t(109) = 2.1, p = .03). Across assessments, C performed significantly better than the entire HR group on immediate (F(3,133) = 5.11, p = .002) and delayed (F(3,133) = 5.02, p = .002) story recall. There were no significant interactions of time by group. CONCLUSIONS Results suggest greater verbal memory impairment in HR who go on to develop schizophrenia. Stable differences between groups over time suggest a trait deficit, which is relatively unaffected by the presence of psychotic symptoms and psychosis onset. Alternatively, small numbers may have precluded detection of group by time interactions.
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Affiliation(s)
- Marie-Claire Whyte
- Division of Psychiatry, University of Edinburgh, Morningside Park, Edinburgh, United Kingdom
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Lebowitz BK, Shear PK, Steed MA, Strakowski SM. Stability of estimated IQ across mood state in patients with bipolar disorder. Bipolar Disord 2006; 8:81-4. [PMID: 16411984 DOI: 10.1111/j.1399-5618.2006.00245.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The goal of this study was to assess the impact of mania symptoms on the stability of the American version of the National Adult Reading Test (ANART), a measure that provides a putative estimate of premorbid intellectual functioning. METHODS The ANART was administered to a sample of 10 inpatients with bipolar disorder who were experiencing an acute episode of mania. During a subsequent follow-up visit during which these individuals exhibited at most minimal mood symptoms, the ANART was re-administered. RESULTS ANART estimated intelligence quotient (IQ) scores during mania and affective stability were assessed in the 10 patients using a paired sample t-test. Within-subject performance across the two mood states did not significantly differ [t(9) = -1.24, p = 0.25]. Additionally, the greatest individual difference across mood states was only 3.68 points, and the average estimated IQ difference across mood states was 1.66. CONCLUSIONS While the results are preliminary and based on a small sample, the highly consistent scores achieved across mood states in this study suggest that the ANART is a reliable indicator of premorbid IQ.
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Affiliation(s)
- Brian K Lebowitz
- Center for Bipolar Disorders Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH 45221-0376, USA
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Abstract
BACKGROUND Studies of chronic schizophrenia suggest that there are subgroups with different profiles of cognitive impairment. AIMS To determine whether such heterogeneity is present at illness onset and any relationship to clinical variables. METHOD Ninety-three community patients with first-episode schizophrenia and 50 healthy volunteers were assessed for premorbid (Revised National Adult Reading Test) and current IQ, memory and executive function. RESULTS Half of those with schizophrenia had preserved IQ in the normal range but there was evidence of a specific impairment in spatial working memory even in those with high/average IQ; 37 out of 93 (40%) had generalised cognitive decline. Those with low premorbid IQ were significantly younger at illness onset. For the entire group, age at onset correlated positively with premorbid but not current IQ. CONCLUSIONS At illness onset, cognitive heterogeneity is present in people with schizophrenia, with a high proportion having undergone general cognitive decline. However, working memory impairment may be a common feature. Lower premorbid IQ is a risk factor for an earlier onset.
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Affiliation(s)
- Eileen M Joyce
- Institute of Neurology, University College London, Box 19, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
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Roe D, Chopra M, Wagner B, Katz G, Rudnick A. The Emerging Self in Conceptualizing and Treating Mental Illness. J Psychosoc Nurs Ment Health Serv 2004; 42:32-40. [PMID: 14982107 DOI: 10.3928/02793695-20040201-06] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
1. The course of severe mental illnesses is more heterogeneous than previously thought and is influenced by many complex, interacting factors. 2. The experience of self and capacity to cope of people with mental illnesses contribute to the recovery process. 3. Changes in traditional treatment models and a focus on broader societal interventions are needed to facilitate recovery. 4. Psychiatric nurses play an important role in these new developments as evident, for example, in the 3R Program (relapse, recovery, and rehabilitation).
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Affiliation(s)
- David Roe
- Bar-Ilan University, School of Social Work, Ramat Gan, Israel.
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Puri BK, Richardson AJ, Higgins CJ, Treasaden IH. Reduction in IQ in patients with schizophrenia who have seriously and dangerously violently offended. Schizophr Res 2002; 53:267-8. [PMID: 11738540 DOI: 10.1016/s0920-9964(01)00196-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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