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Fresán A, Domínguez T, Flores Y, Nieto L, Sheinbaum T, Robles R, Medalia A. Psychometric properties of the Spanish version of the measure of insight into cognition-self-report in psychosis-risk and non-clinical Mexican young adults. Early Interv Psychiatry 2024. [PMID: 38767060 DOI: 10.1111/eip.13559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/24/2024] [Accepted: 05/09/2024] [Indexed: 05/22/2024]
Abstract
AIM Cognitive disturbances typically precede the onset of overt psychotic symptoms and represent a neurobiological marker for psychosis risk that is also associated with poor functional outcomes. The Measure of Insight into Cognition-Self Report (MIC-SR) is a widely used 12-item questionnaire that assesses the perceived frequency of cognitive impairment in the domains of executing functioning, attention, and memory. However, the MIC-SR is not available in Spanish, one of the most widely spoken languages worldwide. The present study aimed to provide a Spanish version of the MIC-SR and examine its psychometric properties in psychosis-risk and non-clinical Mexican young adults. METHODS The sample comprised 621 participants who completed a battery of self-report measures via an online survey. Of the participants, 478 were non-clinical, and 143 met the screening criteria for a clinical high-risk for psychosis (CHR-positive). RESULTS Confirmatory Factor Analyses supported a one-factor model, consistent with the findings for the original MIC-SR. The results showed adequate fit indices for the general model and the independent models for both groups, with high Cronbach's alpha coefficients. Furthermore, the CHR-positive group showed more frequent subjective cognitive problems on each of the 12 items, higher total scores, and higher average frequency than the non-clinical group. CONCLUSION To our knowledge, this is the first translation of the MIC-SR into Spanish. Using the MIC-SR at the CHR stage may contribute to our understanding of cognitive processes associated with the onset of a psychotic disorder and provide valuable information in the context of detection and early intervention efforts.
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Affiliation(s)
- Ana Fresán
- Laboratorio de Epidemiología Clínica, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Tecelli Domínguez
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico
| | - Yvonne Flores
- Laboratorio de Neuromodulación, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muniz, Mexico City, Mexico
| | - Lourdes Nieto
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico
| | - Tamara Sheinbaum
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Rebeca Robles
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico
| | - Alice Medalia
- Cognitive Health Services, Columbia University Irving Medical Center, New York, New York, USA
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Sanchez-Gistau V, Cabezas A, Manzanares N, Sole M, Corral L, Vilella E, Gutierrez-Zotes A. Cognitive biases in first-episode psychosis with and without attention-deficit/hyperactivity disorder. Front Psychol 2023; 14:1127535. [PMID: 37476090 PMCID: PMC10355119 DOI: 10.3389/fpsyg.2023.1127535] [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: 12/19/2022] [Accepted: 05/26/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction Psychotic disorders such schizophrenia and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with social cognitive deficits. Specifically, biased interpretation of social information can result in interpersonal difficulties. Cognitive biases are prevalent in psychosis, but no previous study has investigated whether the type and severity of cognitive biases differ between subjects experiencing first-episode psychosis (FEP) with (FEP-ADHD+) and without ADHD (FEP-ADHD-). Methods A total of 121 FEP outpatients at the Early Intervention Service of Reus were screened for childhood ADHD through the Diagnostic Interview for ADHD (DIVA). Cognitive biases were assessed by the Cognitive Biases Questionnaire for Psychosis (CBQp). CBQp scores of FEPs groups were compared with those of healthy controls (HCs) with an analysis of covariance. Spearman correlation analysis explored associations between CBQp scores and psychopathology. Results Thirty-one FEPs met the criteria for childhood ADHD and reported significantly more cognitive bias [median (interquartile range): 47 (38-56)] than FEP-ADHD- [42 (37-48)] and HCs [38 (35.5-43)]. CBQp scores did not differ between FEP-ADHD-and HCs when adjusted for age and sex. After controlling for clinical differences, Intentionalising (F = 20.97; p < 0.001) and Emotional Reasoning biases (F = 4.17; p = 0.04) were more strongly associated with FEP-ADHD+ than FEP-ADHD-. Cognitive biases were significantly correlated with positive psychotic symptoms in both groups but only with depressive symptoms in FEP-ADHD- (r = 0.258; p = 0.03) and with poor functioning in FEP-ADHD+ (r = -0.504; p = 0.003). Conclusion Cognitive bias severity increased from HCs to FEP-ADHD-patients to FEP-ADHD+ patients. FEP-ADHD+ patients may be a particularly vulnerable group in which metacognitive targeted interventions are needed.
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Affiliation(s)
- Vanessa Sanchez-Gistau
- Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV- CERCA), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
| | - Angel Cabezas
- Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV- CERCA), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
| | - Nuria Manzanares
- Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
| | - Montse Sole
- Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV- CERCA), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
| | - Lia Corral
- Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV- CERCA), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV- CERCA), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
| | - Alfonso Gutierrez-Zotes
- Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV- CERCA), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
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Bucci P, Mucci A, Giordano GM, Caporusso E, Giuliani L, Gibertoni D, Rossi A, Rocca P, Bertolino A, Galderisi S. Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01641-7. [PMID: 37380743 DOI: 10.1007/s00406-023-01641-7] [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: 02/06/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Abstract
The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ (n = 601), the agreement between patients and their informants on CAI ratings, to explore patients' insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet's agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients' and informants' ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative.
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Affiliation(s)
- Paola Bucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulia M Giordano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Edoardo Caporusso
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Dino Gibertoni
- Research and Innovation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Moritz S, Xie J, Penney D, Bihl L, Hlubek N, Elmers J, Beblo T, Hottenrott B. The magnitude of neurocognitive impairment is overestimated in depression: the role of motivation, debilitating momentary influences, and the overreliance on mean differences. Psychol Med 2023; 53:2820-2830. [PMID: 35022092 PMCID: PMC10235659 DOI: 10.1017/s0033291721004785] [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: 06/02/2021] [Revised: 10/11/2021] [Accepted: 11/01/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Meta-analyses agree that depression is characterized by neurocognitive dysfunctions relative to nonclinical controls. These deficits allegedly stem from impairments in functionally corresponding brain areas. Increasingly, studies suggest that some performance deficits are in part caused by negative task-taking attitudes such as poor motivation or the presence of distracting symptoms. A pilot study confirmed that these factors mediate neurocognitive deficits in depression. The validity of these results is however questionable given they were based solely on self-report measures. The present study addresses this caveat by having examiners assess influences during a neurocognitive examination, which were concurrently tested for their predictive value on performance. METHODS Thirty-three patients with depression and 36 healthy controls were assessed on a battery of neurocognitive tests. The examiner completed the Impact on Performance Scale, a questionnaire evaluating mediating influences that may impact performance. RESULTS On average, patients performed worse than controls at a large effect size. When the total score of the Impact on Performance Scale was accounted for by mediation analysis and analyses of covariance, group differences were reduced to a medium effect size. A total of 30% of patients showed impairments of at least one standard deviation below the mean. CONCLUSIONS This study confirms that neurocognitive impairment in depression is likely overestimated; future studies should consider fair test-taking conditions. We advise researchers to report percentages of patients showing performance deficits rather than relying solely on overall group differences. This prevents fostering the impression that the majority of patients exert deficits, when in fact deficits are only true for a subgroup.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jingyuan Xie
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Danielle Penney
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Ouest-de-l’Île-de-Montréal, Douglas Mental Health University Institute, Montreal, Canada
| | - Lisa Bihl
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Niklas Hlubek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Elmers
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld, Germany
| | - Birgit Hottenrott
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Luis-Ruiz S, Sánchez-Castañeda C, Garolera M, Miserachs-González S, Ramon-Krauel M, Lerin C, Sanchez C, Miró N, Martínez S, Jurado MA. Influence of Executive Function Training on BMI, Food Choice, and Cognition in Children with Obesity: Results from the TOuCH Study. Brain Sci 2023; 13:brainsci13020346. [PMID: 36831888 PMCID: PMC9954074 DOI: 10.3390/brainsci13020346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Children with obesity have a higher risk of future health and psychological problems. Executive functions (EFs) play a key role in successful dietetic and exercise planning; therefore, new treatments aimed at improving EFs may optimize outcomes. OBJECTIVES This study evaluates the impact of EF training on body mass index (BMI), food choice, and cognition in children with obesity. We also examine their real-life executive functioning, emotional state, and quality of life. METHODS Randomized controlled double-blind trial. Forty-six children with obesity were randomly allocated into an executive functions training or a control task training group and attended 30-45 min of daily training (5/week over 6 weeks), with both groups receiving counseling on diet and wearing an activity/sleep tracker. Participants were evaluated at baseline and after treatment. RESULTS BMI decreased over time in the whole sample, although there were no differences between groups at post-training in BMI, food choice, and cognition. Both groups showed significant improvements in attention, speed, cognitive flexibility, and inhibitory control. Additionally, there were some benefits in real-life executive functioning and self-esteem. Over the 6 weeks, participants showed worse food choices in both groups. CONCLUSIONS EFs training showed a lack of significant effects. The executive function enhancement alone did not explain these changes, as there were no significant differences between the experimental groups. It might be that the control task training could also produce some benefits, and multi-component interventions might be useful for weight loss.
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Affiliation(s)
- Sandra Luis-Ruiz
- Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), 08035 Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Cristina Sánchez-Castañeda
- Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), 08035 Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Maite Garolera
- Neuropsychology Unit, Consorci Sanitari de Terrassa, 08227 Terrassa, Spain
| | - Sara Miserachs-González
- Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), 08035 Barcelona, Spain
| | - Marta Ramon-Krauel
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
- Endocrinology Department, Hospital Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
| | - Carles Lerin
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
- Endocrinology Department, Hospital Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
| | - Consuelo Sanchez
- Paediatric Endocrinology Unit, Consorci Sanitari de Terrassa, 08227 Terrassa, Spain
| | - Núria Miró
- Diabetes Education Unit, Consorci Sanitari de Terrassa, 08227 Terrassa, Spain
| | - Sònia Martínez
- Pharmacy and Nutrition Unit, Consorci Sanitari de Terrassa, 08227 Terrassa, Spain
| | - Maria Angeles Jurado
- Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), 08035 Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-312-50-55
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Dalkner N, Moore RC, Depp CA, Ackerman RA, Pinkham AE, Harvey PD. Negative mood states as a correlate of cognitive performance and self-assessment of cognitive performance in bipolar disorder versus schizophrenia. Schizophr Res 2023; 252:1-9. [PMID: 36608492 PMCID: PMC9974828 DOI: 10.1016/j.schres.2022.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/15/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Mood states have been reported to manifest a cross-sectional correlation with self-assessment accuracy across functional domains and psychiatric conditions. Ecological momentary assessment (EMA) provides a strategy to examine the momentary course and correlates of mood states. This study tested the association of moods assessed longitudinally with accuracy of immediate self-assessments of cognitive test performance in participants with schizophrenia and bipolar disorder. METHODS 240 well-diagnosed participants with schizophrenia and bipolar disorder completed a subset of tests from the MATRICS Consensus Cognitive Battery and an immediate self-assessment of cognitive performance. Differences between actual and self-reported performance were used to index the accuracy of self-assessment. Daily smartphone EMA, 3× per day for 30 days, sampled participants´ momentary moods (sad, happy, relaxed, anxious), aggregated into positive affect and negative affect (NA). RESULTS Bipolar participants had better cognitive performance, but both samples had equivalent mis-estimation. Repeated-measures analyses found that NA did not manifest significant variability over time either between or within participants in the two diagnostic groups. Within-group analyses found that higher average NA was associated with greater mis-estimation and poorer cognitive performance in participants with bipolar disorder, but not in those with schizophrenia. CONCLUSION Negative moods had a significant association with impairments in self-assessment of cognitive performance in participants with bipolar disorder. Our study did not confirm previous cross-sectional findings of more accurate self-assessment associated with greater NA in schizophrenia. These findings suggest that cross-sectional assessments, particularly self-reports, may lead to different results than aggregated data from longitudinal evaluations.
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Affiliation(s)
- Nina Dalkner
- Medical University Graz, Austria; University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Colin A Depp
- UCSD Health Sciences Center, La Jolla, CA, USA; San Diego VA Medical Center La Jolla, CA, USA
| | | | | | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, USA; Bruce W. Carter VA Medical Center, Miami, FL, USA.
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7
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Long-COVID or long before? Neurocognitive deficits in people with COVID-19. Psychiatry Res 2022; 317:114822. [PMID: 36116186 PMCID: PMC9452399 DOI: 10.1016/j.psychres.2022.114822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/18/2022] [Accepted: 09/01/2022] [Indexed: 01/04/2023]
Abstract
In connection with COVID-19 disease, evidence of persisting psychiatric and neurocognitive effects is accumulating. To examine long COVID symptoms, baseline data from 2015 (i.e., before the pandemic) and follow-up data from 2021 from 428 participants were compared. Participants with COVID-19 reported more subjective neurocognitive complaints in the follow-up, but this did not correspond to the test performance. Also, greater depressive symptoms compared with the no-COVID group were reported. However, these complaints must be put into perspective when considering the baseline data, since complaints were present before the COVID infection. Thus, premorbid performance as well as psychological factors should be considered when discussing long COVID.
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8
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Allott K, Gao CX, Fisher C, Hetrick SE, Filia KM, Menssink JM, Herrman HE, Rickwood DJ, Parker AG, McGorry PD, Cotton SM. The Neuropsychological Symptoms Self-Report: psychometric properties in an adolescent and young adult mental health cohort. Child Adolesc Ment Health 2022; 27:111-121. [PMID: 33913237 DOI: 10.1111/camh.12473] [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] [Accepted: 03/26/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Subjective cognitive symptoms are common in young people receiving mental health treatment and are associated with poorer outcomes. The aim of this study was to determine the psychometric properties of the Neuropsychological Symptoms Self-Report (NSSR), an eight-item measure recently developed to provide a snapshot of young people's perceived change in cognitive functioning in relation to mental health treatment. METHOD The sample included 633 youth aged 12-25 years (Mage = 18.2, 66.5% female, 88.6% Australian-born) who had sought mental health treatment in primary headspace services. At three-month follow-up, participants completed the NSSR and self-report measures of depression and anxiety. RESULTS Excellent internal consistency was found: Cronbach's alpha = 0.93. The NSSR had negative correlations with self-reported anxiety (r = -.33, p < .001) and depression (r = -.48, p < .001) symptoms, suggesting a link with affective symptoms, but still independence of constructs. Exploratory and confirmatory factor analyses supported a single-factor model. Item response theory (IRT) analysis suggested good model fit (homogeneity, data integrity, scalability, local independence and monotonicity) for all items. There was some evidence of measurement noninvariance (for item thresholds) by sex and age, but not diagnosis. IRT models also supported briefer six- and three-item versions of the NSSR. CONCLUSION In busy clinical practice, clinicians need a rapid and reliable method for determining whether cognitive symptoms are of concern and in need of further assessment and treatment. Study findings support the NSSR as a brief, psychometrically sound measure for assessing subjective cognitive functioning in adolescents and young adults receiving mental health treatment.
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Affiliation(s)
- Kelly Allott
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Caroline X Gao
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Caroline Fisher
- Department of Psychology, Royal Melbourne Hospital, Melbourne Health, Parkville, Vic., Australia.,The Melbourne Clinic, Richmond, Vic., Australia
| | - Sarah E Hetrick
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Kate M Filia
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Jana M Menssink
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Helen E Herrman
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Debra J Rickwood
- headspace National Youth Mental Health Foundation, Melbourne, Vic., Australia.,Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Alexandra G Parker
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia.,Institute for Health and Sport, Victoria University, Melbourne, Vic., Australia
| | - Patrick D McGorry
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
| | - Sue M Cotton
- Orygen, Parkville, Vic., Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Vic., Australia
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9
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Donix M, Seidlitz A, Buthut M, Löck S, Meissner G, Matthes C, Troost EG, Baumann M, Raschke F, Linn J, Krause M. Subjective memory impairment in glioma patients with curative radiotherapy. Radiother Oncol 2022; 171:101-106. [DOI: 10.1016/j.radonc.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/04/2022] [Accepted: 04/10/2022] [Indexed: 11/26/2022]
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10
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Masuzawa T, Hashimoto T, Yotsumoto K. Subjectively-assessed cognitive impairment and neurocognition associations in schizophrenia inpatients. Schizophr Res Cogn 2022; 27:100218. [PMID: 34631436 PMCID: PMC8489151 DOI: 10.1016/j.scog.2021.100218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022] Open
Abstract
Cognitive impairment affects real-world functioning in people with schizophrenia who often face difficulties in their activities of daily living. Subjectively-assessed cognitive impairment can be evaluated through data on the patient's daily difficulties, as reported by the patient. However, the specific neurocognitive functions responsible for these cognitive impairments have not been clarified. We examined cognitive functioning in patients with schizophrenia using the Schizophrenia Cognition Rating Scale Japanese version (SCoRS-J) and the Brief Assessment of Cognition in Schizophrenia Japanese version (BACS-J). This study aimed to investigate the relationship between subjectively-assessed cognitive impairment and objectively assessed neurocognition in patients with schizophrenia. The results showed that patients' global rating scores of the SCoRS-J were significantly correlated with the BACS-J attention scores (r = −0.376, p < 0.008), which indicates that the difficulties patients perceived in their daily lives are due to deficits in attentional functioning, as measured by neurocognitive testing. Thus, our findings indicate that improving attentional functioning may also alleviate difficulties in patients' daily lives.
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Affiliation(s)
- Tatsuhiko Masuzawa
- Kansai Seishonen Sanatoryumu, Nishiwaki 838, Iwaoka, Kobe 6512403, Japan
- Corresponding author at: Kansai Seishonen Sanatoryumu, 838 Nishiwaki, Iwaoka, Kobe, Hyogo 6512403, Japan.
| | - Takeshi Hashimoto
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10- 2, Tomogaoka, Suma, Kobe 6540142, Japan
| | - Kayano Yotsumoto
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, 7-10- 2, Tomogaoka, Suma, Kobe 6540142, Japan
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Ballantyne EC, King JP, Green SM. Preliminary Support for a Cognitive Remediation Intervention for Women During the Menopausal Transition: A Pilot Study. Front Glob Womens Health 2021; 2:741539. [PMID: 35005701 PMCID: PMC8733617 DOI: 10.3389/fgwh.2021.741539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Menopause is associated with physical and emotional symptoms, and subjective cognitive concerns that are generally not borne out on objective cognitive measures. This discrepancy suggests that a psychological rather than biological mechanism likely mediates the cognitive concerns of women in menopause. The current study assessed the feasibility and effectiveness of a cognitive remediation intervention with the goal of reducing subjective perceptions of cognitive difficulty during the menopause. Methods: Twenty-seven menopausal women (M age = 53.74, SD = 4.14) completed a 5-week group-based intervention (with a post-group booster) consisting of 2-h weekly sessions. Participants completed pre- and post-intervention measures capturing subjective cognitive ability, mood, anxiety, stress, personality, and objective cognitive tests. The primary variable of interest was self-reported cognitive confidence measured by the Memory and Cognitive Confidence Scale (MACCS). Results: All but one MACCS subscale significantly decreased over the course of treatment (with lower scores associated with higher confidence) and effect sizes ranged from small to large (d = -0.39 to -0.91) with gains maintained at 1-month follow-up. Interestingly, no change in objective cognitive test performance was observed, indicating increases in subjective cognitive confidence in the absence of objective cognitive improvement. There was no change in mood, anxiety, or stress scores. Two-level HLM analyses revealed that those with higher baseline neuroticism, as measured by the NEO Personality Inventory, had smaller decreases in post-group MACCS High Standards subscale relative to those with lower baseline neuroticism (p = 0.027, d = -0.45). Those with higher baseline depression scores on the Depression Anxiety Stress Scale (DASS-21) had a smaller decrease in post-intervention MACCS Total Score relative to those with lower depression ratings. Conclusion: To our knowledge, this is the first feasibility study of its kind targeting perceptions of cognitive impairment during menopause. Although generally well-tolerated, recruitment and scheduling difficulties were flagged as challenges to engagement while a small sample size and lack of control group limit conclusions about efficacy. Providing current results could be replicated with enhanced methods, these results provide support that cognitive remediation is a feasible and credible treatment, and may improve quality of life for women in menopause. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03311880.
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Affiliation(s)
- Elena C. Ballantyne
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Jelena P. King
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Sheryl M. Green
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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12
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A cognitive model of delusion propensity through dysregulated correlation detection. Schizophr Res 2021; 237:93-100. [PMID: 34509105 DOI: 10.1016/j.schres.2021.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND We present a novel account of delusion propensity that integrates the roles of working memory (WM), decision criteria, and information gathering biases. This framework emphasises the role of aberrant correlation detection, which leads to the spurious perception of relationships between one's experiences. The frequency of such outcomes is moderated by the scaling of one's decision criteria which, for reasons discussed, must also account for WM capacity. The proposed dysregulated correlation detection account posits that propensity for delusional ideation is influenced by disturbances in this mechanism. METHODS Hypotheses were tested using a novel task that required participants (N = 92) to identify correlation between binary manipulations of simple shapes, presented as sequential pairs. Decision criteria and correlation detection were assessed under a Signal Detection Theory framework, while WM capacity was assessed through the Automated Operation Span Task and delusion propensity was measured using the Peters Delusion Inventory. Structural equation modeling was conducted to evaluate the proposed model. RESULTS Consistent with the central hypothesis, an interaction between decision criteria and WM was found to contribute significantly to delusion propensity through its effect on correlation detection accuracy. Greater delusion propensity was observed among participants with more liberal decision criteria, which was also in accordance with hypotheses. At the same time, the total effect of WM on delusion propensity was not found to be significant. CONCLUSIONS These findings provide preliminary support for the proposed dysregulated correlation detection account of propensity for delusional ideation.
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Levis M, Levis A. Contrasting narratives: a randomised control study comparing Conflict Analysis and narrative disclosure. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2021. [DOI: 10.1080/03069885.2021.1970111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Maxwell Levis
- White River Junction VA Medical Center, Hartford, VT, USA
- Psychiatry Department, Dartmouth College, Hanover, NH, USA
- Museum of the Creative Process, Manchester, VT, USA
| | - Albert Levis
- Museum of the Creative Process, Manchester, VT, USA
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14
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Evaluation of a new online cognitive assessment tool in breast cancer survivors with cognitive impairment: a prospective cohort study. Support Care Cancer 2021; 30:21-31. [PMID: 34347183 DOI: 10.1007/s00520-021-06397-1] [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: 12/02/2020] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Currently cancer-related cognitive impairment (CRCI) is mainly assessed by means of questionnaires, which is very laborious for the patients and the supervising physician. We evaluated a new online cognitive assessment tool, the MyCognition Quotient (MyCQ, Cambridge) in breast cancer survivors with CRCI, and compared the results with a psychometric test measuring cognitive complaints, depression, and anxiety. MATERIALS AND METHODS In this prospective study, 46 adult patients between 18 and 70 years old with a diagnosis of BC were studied, all complaining of disturbing cognitive impairment. They participated in a physical cognitive rehabilitation program. The patients had an online cognitive assessment (MyCQ Med by MyCognition) every 4 weeks on their home computer. In addition patients were assessed in the outpatient clinic by the principal investigator at baseline, after 3 and 6 months using the following validated neuro-psychological surveys: the Hospital Anxiety and Depression Scale (HADS), Beck Cognitive Insight Scale (BCIS), and Cognitive Failure Questionnaire (CFQ). MyCQ scores were correlated with the results of these surveys. RESULTS Only weak correlations could be found between overall MyCQ or the MyCQ subtests with the psychometric tests (between - 0.43 and 0.458) at baseline and when combining data at time point 0, 3, and 6 months. Linear mixed models showed there was a significant association between Latency Choice Reaction Time and CFQ (continuous; p = 0.026). An AUC of 0.640 and a cut-off of 481.5 ms in Latency Choice Reaction Time were found to distinguish patients with CFQ below 44 to patients with CFQ above 44 (sensitivity 0.63 and specificity 0.73). In Latency Coding an AUC of 0.788 and a cut-off of 1316 ms were found to distinguish non-depressive patients from patients likely to present with depressive symptoms (sensitivity 0.75 and specificity 0.76). CONCLUSION MyCQ cannot replace the various psychometric tests. However, abnormal Latency in cognitive tests, Choice Reaction Time and Coding, seems promising to be used as a screening tool to detect specific aspects of abnormal cognitive functioning in patients with cognitive complaints and depressive symptoms.
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15
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Levis M, Levis AJ. Contextual assessment: evaluating a novel self-guided online therapeutic assessment. Int J Psychiatry Clin Pract 2021; 25:206-215. [PMID: 32701050 PMCID: PMC11151187 DOI: 10.1080/13651501.2020.1794010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 05/20/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Paper introduces Conflict Analysis (CA), an online self-guided therapeutic assessment. CA combines a diagnostic self-report scale with narrative exercises and self-analytical tasks. CA automatically generates detailed diagnostic records and frameworks for changes. OBJECTIVE To evaluate therapeutic and diagnostic benefits associated with CA over time. METHODS This online study compared CA over 2 weeks on outcome measures predicting psychotherapy outcome. Novel scale measuring perceived diagnostic benefit and perceived therapeutic benefit was delivered at post and follow-up. Cohort (n = 59, average age = 35, 50% female) was either in therapy or interested to start therapy in near future. RESULTS Repeated-measure ANOVAs suggest that scores significantly changed on measures predicting negative affect, depression, performance and appearance self-esteem, insight, and growth initiative. Agreement rates on items measuring perceived diagnostic and therapeutic benefits were at least 74.5% for both post and follow-up. CONCLUSIONS Evidence supports further exploration of CA as a self-guided diagnostic and therapeutic resource.Key pointsResults demonstrate feasibility and utility of online self-guided therapeutic assessment.Described model is associated with increased perceived diagnostic and therapeutic benefits.Described model illustrates therapeutic benefits over time.Results demonstrate that even self-guided assessment can have therapeutic implications.
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Affiliation(s)
- Maxwell Levis
- White River Junction VA Medical Center, White River Junction, VT, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
- Museum of the Creative Process, Manchester, VT, USA
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16
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Myklebost SB, Nordgreen T, Hammar Å. An open pilot study of an internet-delivered intervention targeting self-perceived residual cognitive symptoms after major depressive disorder. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1595-1604. [PMID: 33813984 DOI: 10.1080/23279095.2021.1901706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Residual cognitive symptoms are associated with reduced daily life functioning, quality of life and represent a risk factor for relapse of major depressive disorder (MDD). There are few studies targeting self-perceived residual cognitive symptoms after MDD. The current open pilot study examines clinical outcomes and feasibility of a novel internet-delivered cognitive enhancement treatment for mood disorders specifically tailored to target self-perceived residual cognitive symptoms after MDD. A total of 43 adults with self-perceived residual cognitive symptoms after MDD were included. Participants were assessed pre- and post-treatment and at 6-month follow-up. The intervention consists of 10 modules that includes psychoeducation, cognitive strategies, and attention training, coupled with weekly therapist guidance. Results showed a significant reduction from pre- to post-treatment in self-perceived residual cognitive symptoms (d = 0.98) and rumination (d = 0.63). Results remained significant at the 6-month follow-up (d = 1.06; d = 0.86). Reliable change in self-perceived residual cognitive symptoms were obtained in 60% of the participants from pre- to post-treatment. Completion rates (86%) and treatment satisfaction (97%) were high. This open pilot study supports that targeting self-perceived residual cognitive symptoms after MDD through internet-delivered cognitive enhancement therapy for mood disorders may be feasible and provide stable reductions in self-perceived residual cognitive symptoms and rumination.
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Affiliation(s)
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Åsa Hammar
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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17
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Petrazzuoli F. Different diagnostic strategies for different settings. GERIATRIC CARE 2021. [DOI: 10.4081/gc.2021.9538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Diagnostic strategies should always take into consideration the setting in which they are administered. The predictive value, positive or negative of a clinical sign or diagnostic test has a different weight in family medicine than in the hospital setting. Many tests have not been formally evaluated in primary care; unfortunately, very often low prevalence settings are used to conduct screening in these populations, and often result in unrealistically high prevalence estimates for chronic disease and these results are then used to conclude that General Practitioners are not good at detecting diseases. In primary care, the prevalence and incidence of disease differs from what appears in the hospital setting, and severe disease occurs less frequently in general practice than in hospital because there is no preventive selection. This requires a specific probability-based decision-making process, based by the knowledge of patients and the community. In primary care, the diagnostic strategy should begin with complaints and symptoms and address uncertainty and complexity, using step-by-step strategies, including watchful waiting, presumptive symptomatic treatment, and focusing on low-tech strategies.
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18
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Glenthøj LB, Mariegaard L, Kristensen TD, Wenneberg C, Medalia A, Nordentoft M. Self-perceived cognitive impairments in psychosis ultra-high risk individuals: associations with objective cognitive deficits and functioning. NPJ SCHIZOPHRENIA 2020; 6:31. [PMID: 33188204 PMCID: PMC7666210 DOI: 10.1038/s41537-020-00124-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/08/2020] [Indexed: 02/06/2023]
Abstract
There is a scarcity of evidence on subjectively reported cognitive difficulties in individuals at ultra-high risk (UHR) for psychosis and whether these self-perceived cognitive difficulties may relate to objective cognitive deficits, psychopathology, functioning, and adherence to cognitive remediation (CR). Secondary, exploratory analyses to a randomized, clinical trial were conducted with 52 UHR individuals receiving a CR intervention. Participants completed the Measure of Insight into Cognition—Self Report (MIC-SR), a measure of daily life cognitive difficulties within the domains of attention, memory, and executive functions along with measures of neuropsychological test performance, psychopathology, functioning, and quality of life. Our study found participants with and without objectively defined cognitive deficits reported self-perceived cognitive deficits of the same magnitude. No significant relationship was revealed between self-perceived and objectively measured neurocognitive deficits. Self-perceived cognitive deficits associated with attenuated psychotic symptoms, overall functioning, and quality of life, but not with adherence to, or neurocognitive benefits from, a CR intervention. Our findings indicate that UHR individuals may overestimate their cognitive difficulties, and higher levels of self-perceived cognitive deficits may relate to poor functioning. If replicated, this warrants a need for both subjective and objective cognitive assessment in at-risk populations as this may guide psychoeducational approaches and pro-functional interventions. Self-perceived cognitive impairments do not seem to directly influence CR adherence and outcome in UHR states. Further studies are needed on potential mediator between self-perceived cognitive deficits and functioning and quality of life.
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Affiliation(s)
- Louise Birkedal Glenthøj
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark. .,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark.
| | - Lise Mariegaard
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark
| | - Tina Dam Kristensen
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark
| | - Christina Wenneberg
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark
| | - Alice Medalia
- Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900, Hellerup, Denmark.,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600, Glostrup, Denmark
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19
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Allott K, Gao C, Hetrick SE, Filia KM, Menssink JM, Fisher C, Hickie IB, Herrman HE, Rickwood DJ, Parker AG, Mcgorry PD, Cotton SM. Subjective cognitive functioning in relation to changes in levels of depression and anxiety in youth over 3 months of treatment. BJPsych Open 2020; 6:e84. [PMID: 32753079 PMCID: PMC7453798 DOI: 10.1192/bjo.2020.68] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Subjective cognitive difficulties are common in mental illness and have a negative impact on role functioning. Little is understood about subjective cognition and the longitudinal relationship with depression and anxiety symptoms in young people. AIMS To examine the relationship between changes in levels of depression and anxiety and changes in subjective cognitive functioning over 3 months in help-seeking youth. METHOD This was a cohort study of 656 youth aged 12-25 years attending Australian headspace primary mental health services. Subjective changes in cognitive functioning (rated as better, same, worse) reported after 3 months of treatment was assessed using the Neuropsychological Symptom Self-Report. Multivariate multinomial logistic regression analysis was conducted to evaluate the impact of baseline levels of and changes in depression (nine-item Patient Health Questionnaire; PHQ9) and anxiety symptoms (seven-item Generalised Anxiety Disorder scale; GAD7) on changes in subjective cognitive function at follow-up while controlling for covariates. RESULTS With a one-point reduction in PHQ9 at follow-up, there was an estimated 11-18% increase in ratings of better subjective cognitive functioning at follow-up, relative to stable cognitive functioning. A one-point increase in PHQ9 from baseline to follow-up was associated with 7-14% increase in ratings of worse subjective cognitive functioning over 3 months, relative to stable cognitive functioning. A similar attenuated pattern of findings was observed for the GAD7. CONCLUSIONS A clear association exists between subjective cognitive functioning outcomes and changes in self-reported severity of affective symptoms in young people over the first 3 months of treatment. Understanding the timing and mechanisms of these associations is needed to tailor treatment.
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Affiliation(s)
- Kelly Allott
- Orygen, Australia; and Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Caroline Gao
- Orygen; Centre for Youth Mental Health, The University of Melbourne; and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Sarah E Hetrick
- Department of Psychological Medicine, University of Auckland, New Zealand
| | - Kate M Filia
- Orygen; and Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Jana M Menssink
- Orygen; and Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Caroline Fisher
- Department of Psychology, Royal Melbourne Hospital, Melbourne Health; and The Melbourne Clinic, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Australia
| | - Helen E Herrman
- Orygen; and Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Debra J Rickwood
- headspace National Youth Mental Health Foundation; and Faculty of Health, University of Canberra, Australia
| | - Alexandra G Parker
- Orygen; Centre for Youth Mental Health, The University of Melbourne; and Institute for Health and Sport, Victoria University, Australia
| | - Patrick D Mcgorry
- Orygen; and Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Sue M Cotton
- Orygen; and Centre for Youth Mental Health, The University of Melbourne, Australia
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20
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Mascherek A, Werkle N, Göritz AS, Kühn S, Moritz S. Lifestyle Variables Do Not Predict Subjective Memory Performance Over and Above Depression and Anxiety. Front Psychol 2020; 11:484. [PMID: 32265791 PMCID: PMC7096346 DOI: 10.3389/fpsyg.2020.00484] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 03/02/2020] [Indexed: 11/24/2022] Open
Abstract
The diagnostic value of subjective cognitive complaints for cognitive functioning in a clinical setting remains unresolved today. However, consensus exists on the relation between subjective cognitive complaints (SCC) and mood variables such as anxiety and depression. Hence, SCC have also been discussed as potential proxies of psychopathology rather than representing cognitive functioning. In order to shed more light on yet still unexplained variance in subjective cognitive complaints, the relation between lifestyle variables (such as nutrition habits, exercise, alcohol consumption, smoking, quality of sleep, and Body Mass Index) and subjective complaints of selective attention as well as subjective memory performance were assessed, additionally to the influence of objective memory performance, measures of anxiety, and depression. A sample of 877 (554 women) healthy, middle-aged individuals (51 years on average, age range 35–65) was assessed in the present study. In a logistic regression framework results revealed that the effect of lifestyle variables on subjective complaints of selective attention as well as subjective memory performance was rendered non-significant. Instead, subjective complaints of selective attention and subjective memory performance were significantly determined by measures of both, anxiety and depression. One unit increase in anxiety or depression led to an increase of 6 or 15% in subjective memory performance complaints, respectively. For subjective complaints of selective attention, a one unit increase in anxiety or depression led to an increase of 11 or 26%, respectively. The strong relation between SCC and measures of depression and anxiety corroborates the notion of SCC being indicative of mental health and general well-being.
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Affiliation(s)
- Anna Mascherek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Nathalie Werkle
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anja S Göritz
- Department of Psychology, Albert-Ludwigs-Universität Freiburg, Freiburg im Breisgau, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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21
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Hammar Å, Semkovska M, Borgen IMH, Myklebost S, Ronold EH, Sveen T, Ueland T, Porter R, Johnson SL. A pilot study of cognitive remediation in remitted major depressive disorder patients. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:172-182. [DOI: 10.1080/23279095.2020.1726919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Åsa Hammar
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Maria Semkovska
- Health Research Institute and Department of Psychology, University of Limerick, Limerick, Ireland
| | - Ida M. H. Borgen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Sunniva Myklebost
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Eivind H Ronold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Thea Sveen
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Torill Ueland
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- NORMENT, Oslo University Hospital, Oslo, Norway
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Sheri L. Johnson
- Department of Psychology, University of California, Berkeley, CA, USA
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Raffard S, Lebrun C, Bayard S, Macgregor A, Capdevielle D. Self-Awareness Deficits of Cognitive Impairment in Individuals With Schizophrenia. Really? Front Psychiatry 2020; 11:731. [PMID: 32848912 PMCID: PMC7406784 DOI: 10.3389/fpsyt.2020.00731] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/13/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Misestimation of cognitive functioning has been largely described in individuals with schizophrenia. There is large evidence that correlations between subjectively assessed cognitive functioning and objectively determined cognitive functioning are weak in non clinical individuals and may be more closely related to other psychoaffective or clinical factors than to objective neuropsychological functioning. Surprisingly, no study to date has compared the associations between cognitive complaint and objective measures of cognitive functioning in individuals with schizophrenia and healthy controls. The main objective of this study was to 1) compare cognitive complaint between individuals with schizophrenia and non clinical controls, 2) explore the relationships between cognitive complaint and psychoaffective and clinical factors in the clinical group and 3) compare the relationships between subjective awareness of cognitive functioning and objective neuropsychological assessment in individuals with schizophrenia and non-clinical participants. METHOD In this study 30 individuals with schizophrenia and 20 non-clinical matched controls were included. In addition to objective cognitive measures and subjective cognition assessed by the Subjective Scale To Investigate Cognition In Schizophrenia, measures of psychotic symptoms, depression, and anxiety were included. RESULTS Schizophrenia patients reported higher cognitive complaints in comparison with controls. In individuals with schizophrenia, cognitive complaint subscores were differently associated with depression, anxiety, and negative symptoms. When depression was controlled for, the same number of correlations between self-rated measures of cognition and objective measures of cognition were found in both groups, but accuracy of self-assessment of cognition was lower in the schizophrenia group.When the schizophrenia group was divided into a high cognitive complaint group (SZ High CC) and a low cognitive complaint group (SZ Low CC), findings indicated that self-assessment of cognition in the SZ high CC was highly accurate (correlations with large effect sizes). By contrast the SZ low CC group severely misjudge their cognition. CONCLUSION A significant proportion of patients with schizophrenia can accurately estimate their cognitive skills. Self-awareness of cognitive deficits in individuals with schizophrenia is an heterogenous phenomenon and misestimation of cognitive functioning might have been overestimated, partly due to secondary psychoaffective factors. Caution is warranted before jumping to the conclusion that all individuals with schizophrenia misjudge their cognitive functioning.
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Affiliation(s)
- Stéphane Raffard
- Univ Paul Valéry Montpellier 3, Univ Montpellier, EPSYLON EA 4556, Montpellier, France.,Service Universitaire de Psychiatrie Adulte, Hôpital de la Colombière CHU Montpellier, Montpellier, France
| | - Cindy Lebrun
- Univ Paul Valéry Montpellier 3, Univ Montpellier, EPSYLON EA 4556, Montpellier, France
| | - Sophie Bayard
- Univ Paul Valéry Montpellier 3, Univ Montpellier, EPSYLON EA 4556, Montpellier, France
| | - Alexandra Macgregor
- Service Universitaire de Psychiatrie Adulte, Hôpital de la Colombière CHU Montpellier, Montpellier, France
| | - Delphine Capdevielle
- Service Universitaire de Psychiatrie Adulte, Hôpital de la Colombière CHU Montpellier, Montpellier, France.,Inserm, U1061, Montpellier, France.,University of Montpellier, Montpellier, France
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23
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Hallion LS, Tolin DF, Billingsley AL, Kusmierski SN, Diefenbach GJ. "Cold" Cognitive Control and Attentional Symptoms in Anxiety: Perceptions Versus Performance. Behav Ther 2019; 50:1150-1163. [PMID: 31735249 DOI: 10.1016/j.beth.2019.04.002] [Citation(s) in RCA: 5] [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: 10/22/2018] [Revised: 04/08/2019] [Accepted: 04/12/2019] [Indexed: 01/15/2023]
Abstract
Clinically significant anxiety is associated with an array of attentional symptoms (e.g., difficulty concentrating; unwanted thought) that are subjectively experienced as severe. However, neuropsychological findings are mixed with respect to the presence of cognitive deficits that can account for these symptoms. Contextualizing predictions from established clinical theories (e.g., Attentional Control Theory) within contemporary, neurobiologically derived models of cognitive control (Dual Mechanisms of Control Theory), the present study investigated the relationship between "cold" proactive and reactive cognitive control, task effort, and subjective attentional symptoms (difficulty concentrating; unwanted thought) in a mixed clinical sample of individuals with generalized anxiety disorder (GAD) and/or obsessive-compulsive disorder (OCD) and a comparison sample of healthy controls. Clinical status moderated the relationship between attentional symptoms (attentional focusing and trait worry) and proactive cognitive control response time. Clinical status also moderated the relationship between trait worry and task effort. Higher trait worry was associated with slower proactive control and lower effort in healthy participants, but faster proactive control in clinical participants. Self-reported attentional focusing showed differential validity vis-à-vis proactive control response time in clinical versus healthy participants. Post-hoc conditional effects analysis suggested more accurate self-appraisals in healthy controls, but was not significant after correction for multiple comparisons. Preliminary evidence suggested that differences in task effort in anxious versus healthy adults may relate to subjective attentional symptoms in GAD and OCD.
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Affiliation(s)
- Lauren S Hallion
- University of Pittsburgh; Institute of Living, Hartford Hospital.
| | - David F Tolin
- Institute of Living, Hartford Hospital; Yale University School of Medicine
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Moritz S, Gawęda Ł, Heinz A, Gallinat J. Four reasons why early detection centers for psychosis should be renamed and their treatment targets reconsidered: we should not catastrophize a future we can neither reliably predict nor change. Psychol Med 2019; 49:2134-2140. [PMID: 31337458 DOI: 10.1017/s0033291719001740] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Since the 1990s, facilities for individuals at putative risk for psychosis have mushroomed and within a very short time have become part of the standard psychiatric infrastructure in many countries. The idea of preventing a severe mental disorder before its exacerbation is laudable, and early data indeed strongly suggested that the sooner the intervention, the better the outcome. In this paper, the authors provide four reasons why they think that early detection or prodromal facilities should be renamed and their treatment targets reconsidered. First, the association between the duration of untreated psychosis and outcome is empirically established but has become increasingly weak over the years. Moreover, its applicability to those who are considered at risk remains elusive. Second, instruments designed to identify future psychosis are prone to many biases that are not yet sufficiently controlled. None of these instruments allows an even remotely precise prognosis. Third, the rate of transition to psychosis in at-risk patients is likely lower than initially thought, and evidence for the success of early intervention in preventing future psychosis is promising but still equivocal. Perhaps most importantly, the treatment is not hope-oriented. Patients are more or less told that schizophrenia is looming over them, which may stigmatize individuals who will never, in fact, develop psychosis. In addition self-stigma has been associated with suicidality and depression. The authors recommend that treatment of help-seeking individuals with mental problems but no established diagnosis should be need-based, and the risk of psychosis should be de-emphasized as it is only one of many possible outcomes, including full remission. Prodromal clinics should not be abolished but should be renamed and restructured. Such clinics exist, but the transformation process needs to be facilitated.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Łukasz Gawęda
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Psychopathology and Early Intervention Lab, II Department of Psychiatry, The Medical University of Warsaw, Warsaw, Poland
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Charitéplatz, Berlin, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Graux J, Thillay A, Morlec V, Sarron PY, Roux S, Gaudelus B, Prost Z, Brénugat-Herné L, Amado I, Morel-Kohlmeyer S, Houy-Durand E, Franck N, Carteau-Martin I, Danset-Alexandre C, Peyroux E. A Transnosographic Self-Assessment of Social Cognitive Impairments (ACSO): First Data. Front Psychiatry 2019; 10:847. [PMID: 31824350 PMCID: PMC6881457 DOI: 10.3389/fpsyt.2019.00847] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/25/2019] [Indexed: 11/16/2022] Open
Abstract
Social cognition refers to the mental operations underlying social interactions. Given the major role of social cognitive deficits in the disability associated with severe psychiatric disorders, they therefore constitute a crucial therapeutic target. However, no easily understandable and transnosographic self-assessment scale evaluating the perceived difficulties is available. This study aimed to analyze the psychometric qualities of a new self-administered questionnaire (ACSo) assessing subjective complaints in different domains of social cognition from 89 patients with schizophrenia, schizoaffective disorders, bipolar disorders or autism. The results revealed satisfactory internal validity and test-retest properties allowing the computation of a total score along with four sub scores (attributional biases, social perception and knowledge, emotional perception and theory of mind). Moreover, the ACSo total score was correlated with other subjective assessments traditionally used in cognitive remediation practice but not with objective neuropsychological assessments of social cognition. In summary, the ACSo is of interest to complete the objective evaluation of social cognition processes with a subjective assessment adapted to people with serious mental illness or autism spectrum disorder.
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Affiliation(s)
- Jérôme Graux
- Pôle de Psychiatrie et d'Addictologie, CHRU de Tours, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Alix Thillay
- Pôle de Psychiatrie et d'Addictologie, CHRU de Tours, Tours, France
| | - Vivien Morlec
- Pôle de Psychiatrie et d'Addictologie, CHRU de Tours, Tours, France
| | | | - Sylvie Roux
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Baptiste Gaudelus
- Reference Center for Cognitive Remediation and Psychosocial Rehabilitation (SUR-CL3R), Le Vinatier Hospital, Lyon, France
| | - Zelda Prost
- Reference Center for Cognitive Remediation and Psychosocial Rehabilitation (SUR-CL3R), Le Vinatier Hospital, Lyon, France
| | - Lindsay Brénugat-Herné
- Reference Center for Cognitive Remediation and Psychosocial Rehabilitation, INSERM U894, Hôpital Sainte Anne, Paris, France
| | - Isabelle Amado
- Reference Center for Cognitive Remediation and Psychosocial Rehabilitation, INSERM U894, Hôpital Sainte Anne, Paris, France
| | - Shasha Morel-Kohlmeyer
- Pôle de Psychiatrie et d'Addictologie, CHRU de Tours, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Emmanuelle Houy-Durand
- Pôle de Psychiatrie et d'Addictologie, CHRU de Tours, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Nicolas Franck
- Reference Center for Cognitive Remediation and Psychosocial Rehabilitation (SUR-CL3R), Le Vinatier Hospital, Lyon, France.,Resource Center for Cognitive Remediation and Psychosocial Rehabilitation of Lyon (CRR), UMR 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France
| | | | - Charlotte Danset-Alexandre
- Reference Center for Cognitive Remediation and Psychosocial Rehabilitation, INSERM U894, Hôpital Sainte Anne, Paris, France
| | - Elodie Peyroux
- Reference Center for Cognitive Remediation and Psychosocial Rehabilitation (SUR-CL3R), Le Vinatier Hospital, Lyon, France
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Abstract
BACKGROUND Treatment-resistant depression (TRD) is a serious chronic condition disabling patients functionally and cognitively. Chronic vagus nerve stimulation (VNS) is recognized for the management of TRD, but few studies have examined its long-term effects on cognitive dysfunction in unipolar and bipolar resistant depression. OBJECTIVE The purpose of this study was to assess the course of cognitive functions and clinical symptoms in a cohort of patients treated with VNS for TRD. METHODS In 14 TRD patients with VNS, standardized clinical and neuropsychological measures covering memory, attention/executive functions, and psychomotor speed were analyzed prestimulation and up to 2 years poststimulation. RESULTS Vagus nerve stimulation patients significantly improved on cognitive and clinical measures. Learning and memory improved rapidly after 1 month of stimulation, and other cognitive functions improved gradually over time. Cognitive improvements were sustained up to 2 years of treatment. At 1 month, improvement in Montgomery-Åsberg Depression Rating Scale scores was not correlated with changes in any of the cognitive scores, whereas at 12 months, the change in Montgomery-Åsberg Depression Rating Scale score was significantly correlated with several measures (Stroop interference, verbal fluency, and Rey-Osterrieth Complex Figure delayed recall). CONCLUSIONS In recent years, a growing interest in cognitive dysfunction in depression has emerged. Our results suggest that chronic VNS produces sustained clinical and cognitive improvements in TRD patients, with some mental functions improving as soon as 1 month after the initiation of the VNS therapy. Vagus nerve stimulation seems a very promising adjunctive therapy for TRD patients with cognitive impairment.
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Dysfunction by Disclosure? Stereotype Threat as a Source of Secondary Neurocognitive Malperformance in Obsessive-Compulsive Disorder. J Int Neuropsychol Soc 2018; 24:584-592. [PMID: 29553002 DOI: 10.1017/s1355617718000097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES There is mixed evidence regarding whether patients with obsessive-compulsive disorder (OCD) display substantial neurocognitive deficits. Several studies implicate poor motivation, comorbid disorders, or distraction due to obsessive thoughts as potential causes of secondary malperformance. The present study examined the impact of stereotype threat (i.e., confrontation with a negative stereotype may impair performance) on neuropsychological functioning in individuals with OCD. We hypothesized that a stereotype threat cue emphasizing neurocognitive deficits in OCD (as is often conveyed in disclosure and consent documents that inform patients about the purpose of a study) would compromise patients' test performance relative to a control group who did not receive such cue. METHODS Fifty participants with either a verified or a likely diagnosis of OCD were recruited online and randomly assigned to either an experimental condition aimed to elicit stereotype threat or a control condition. Both groups underwent (objective) memory and attention (Go/NoGo task) assessments and completed questionnaires capturing psychopathology, cognitive complaints, and self-stigma. RESULTS As hypothesized, patients in the stereotype threat condition performed worse on the Go/NoGo task. Groups did not differ on any other measures. CONCLUSIONS Stereotype threat negatively impacted neuropsychological performance on an attention task. The threat cue was perhaps too weak or the stereotype threat was already internalized by the patients and "saturated" at baseline so that no effect emerged on the other measures. Implications for clinical trials are discussed. (JINS, 2018, 24, 584-592).
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Schneider BC, Cludius B, Lutz W, Moritz S, Rubel JA. An Investigation of Module-Specific Effects of Metacognitive Training for Psychosis. ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2018. [DOI: 10.1027/2151-2604/a000336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Metacognitive training for psychosis (MCT) is a group training program that targets cognitive biases, which play a role in the pathogenesis of delusions. It remains unclear to what extent individual MCT modules lead to within- or between-session changes in positive symptoms, sadness, cognitive biases, or theory of mind (ToM) distortions. A one-armed open-label intervention study was conducted with 176 psychiatric inpatients with psychotic symptoms. Patients were asked to fill out a questionnaire on cognitive biases, symptoms, and ToM distortions before and after each session. Multilevel (ML) modeling was used to assess associations between participation in a respective module and subsequent changes in self-reported symptoms. ML analyses indicated an overall improvement in all outcomes as well as within-session decreases in positive symptoms for a module addressing ToM distortions with a small effect. Two MCT modules addressing cognitive biases (jumping to conclusions, a bias against disconfirmatory evidence) were associated with reductions in the module-specific bias with a small and small to medium effect, respectively. The study provides initial evidence regarding module-specific associations with positive symptoms, cognitive biases, and ToM distortions in MCT.
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Affiliation(s)
- Brooke C. Schneider
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Barbara Cludius
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Lutz
- Department of Psychology, University of Trier, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Moritz S, Schneider BC, Peth J, Arlt S, Jelinek L. Metacognitive Training for Depression (D-MCT) reduces false memories in depression. A randomized controlled trial. Eur Psychiatry 2018; 53:46-51. [DOI: 10.1016/j.eurpsy.2018.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/08/2018] [Accepted: 05/24/2018] [Indexed: 01/04/2023] Open
Abstract
AbstractMetacognitive Training for Depression (D-MCT) is a highly standardized group program targeted at depression-related (“Beckian”) emotional as well as cognitive biases, including mood-congruent and false memory. While prior results are promising with respect to psychopathological outcomes (depression), it is unclear whether D-MCT also meets its goal of improving cognitive biases, such as false memories.In the framework of a randomized controlled trial (registered trial, DRKS00007907), we investigated whether D-MCT is superior to an active control condition (health training, HT) in reducing the susceptibility of depressed patients for false memories. False memories were examined using parallel versions of a visual variant of the Deese-Roediger McDermott paradigm.Both groups committed less false memories at post assessment after 4 weeks compared to baseline. Relative to HT, D-MCT led to a significant decrease in high-confident false memories over time.The study presents first evidence that D-MCT decreases the susceptibility of depressed patients for false memories, particularly for errors made with high confidence that are presumably the most “toxic” in terms of mood-congruent memory distortions.
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Hurford IM, Ventura J, Marder SR, Reise SP, Bilder RM. A 10-minute measure of global cognition: Validation of the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS). Schizophr Res 2018; 195:327-333. [PMID: 28918221 DOI: 10.1016/j.schres.2017.08.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 08/07/2017] [Accepted: 08/18/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Schizophrenia is marked by a global cognitive impairment that contributes significantly to chronic disability and unemployment. As new treatments are developed for cognition in schizophrenia, clinicians require easily administered instruments to assess cognition. We previously developed a very brief cognitive battery (Bell et al., 2005). The Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) was developed specifically to provide clinicians with a way to assess cognition in their patients with schizophrenia. Here, we report the results of a validity study comparing B-CATS to a larger neurocognitive battery, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) battery. METHODS Outpatients with schizophrenia (N=91) were administered the B-CATS and the non-overlapping tests of the MATRICS battery at two time points separated by 1month. They were also administered the UCSD Performance-based Skills Assessment-Brief (UPSA-B), a measure of functional capacity. RESULT The B-CATS has an administration time of approximately 10min. It demonstrates good test-retest reliability and internal consistency. It correlates 0.76 (p<0.01) with the MATRICS battery. The shorter B-CATS and the MATRICS battery correlate with the UPSA-B at 0.50 and 0.58 respectively. CONCLUSION A 10-minute version of the B-CATS correlates highly with the "gold standard" neurocognitive battery that has an administration time of over 60min. Both measures correlate moderately with a measure of functional capacity. This brief battery was designed to allow clinicians to monitor cognitive change and better inform treatment decisions.
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Affiliation(s)
- Irene M Hurford
- Department of Psychiatry, University of Pennsylvania, United States.
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, United States
| | - Stephen R Marder
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, United States; VA Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, United States
| | | | - Robert M Bilder
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, United States; Department of Psychology, UCLA, United States
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Moritz S, Bentall RP, Kolbeck K, Roesch-Ely D. Monocausal attribution and its relationship with reasoning biases in schizophrenia. Schizophr Res 2018; 193:77-82. [PMID: 28732799 DOI: 10.1016/j.schres.2017.06.057] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/20/2017] [Accepted: 06/27/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Aberrant attributional styles are counted to a set of circumscribed cognitive biases that are implicated in the pathogenesis of (paranoid) psychosis. However, evidence for a specific profile (e.g., an exaggerated self-serving bias, other-blaming bias) has become equivocal over the years. More recently, one-sided (monocausal) attributions have been reported in patients with psychosis. METHODS We compared a large sample of patients with diagnosed schizophrenia (n=145) to nonclinical controls (n=30) on a revised version of the Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R). In this task, participants have to assign probability estimates to each of three potential causes (i.e., myself, others, circumstances) for a specific (negative or positive) event. RESULTS Participants with schizophrenia displayed an abolished self-serving bias and showed a significant preference for one-sided/monocausal attributions, which was neither correlated with jumping to conclusions nor overconfidence in errors. School education correlated with less monocausal attributions. We did not find any congruence between attributional styles with core delusional ideas. CONCLUSIONS Our study corroborates earlier investigations showing that monocausal attributions may play a role in the pathogenesis of psychosis; this bias unlikely represents an epiphenomenon of established biases. Unexpectedly, attributional styles (e.g., external-blaming) did not shape delusional contents. The true prevalence of monocausal attributions in psychosis is perhaps underestimated in the study, as groups were equated on school education, which was correlated with monocausal attributions.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Richard P Bentall
- School of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Katharina Kolbeck
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniela Roesch-Ely
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany
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Moritz S, Mahlke CI, Westermann S, Ruppelt F, Lysaker PH, Bock T, Andreou C. Embracing Psychosis: A Cognitive Insight Intervention Improves Personal Narratives and Meaning-Making in Patients With Schizophrenia. Schizophr Bull 2018; 44:307-316. [PMID: 29106693 PMCID: PMC5814991 DOI: 10.1093/schbul/sbx072] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Schizophrenia is a complex psychiatric disorder with unknown and presumably heterogeneous etiology. While the disorder can have various outcomes, research is predominantly "deficit-oriented" emphasizing the hardship that the disorder inflicts on sufferers as well as their families and society. Beyond symptom reduction, imparting patients with hope and meaning in life is increasingly considered an important treatment target, which may raise self-esteem, and reduce self-stigma and suicidal ideation. The present study compared a psychotherapeutic treatment aimed at improving cognitive insight, individualized metacognitive intervention (MCT+), with an active control in order to elucidate if personal meaning-making and hope can be improved in patients with psychosis across time. A total of 92 patients were randomized to either individualized metacognitive therapy (MCT+) or CogPack (neuropsychological training) and followed up for up to 6 months. The "Subjective Sense in Psychosis Questionnaire" (SUSE) was administered which covers different salutogenetic vs pathogenetic views of the disorder, valence of symptom experiences and the consequences of psychosis. Patients in the MCT+ group showed a significant positive shift in attitudes towards the consequences of their illness over time relative to patients in the active control condition. There was some evidence that MCT+ also enhanced meaning-making. The perceived negative consequences of psychosis were highly correlated with depression and low self-esteem, as well as suicidality. The study shows that a cognitive insight training can improve meaning-making in patients and help them come to terms with their diagnosis.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Candelaria I Mahlke
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Westermann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Friederike Ruppelt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paul H Lysaker
- Department of Psychiatry, Roudebush VA Medical Center and The Indiana University School of Medicine, Indianapolis, IN
| | - Thomas Bock
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christina Andreou
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Gender Research and Early Detection, University of Basel Psychiatric Clinics, Basel, Switzerland
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Kühn S, Berna F, Lüdtke T, Gallinat J, Moritz S. Fighting Depression: Action Video Game Play May Reduce Rumination and Increase Subjective and Objective Cognition in Depressed Patients. Front Psychol 2018; 9:129. [PMID: 29483888 PMCID: PMC5816361 DOI: 10.3389/fpsyg.2018.00129] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 01/26/2018] [Indexed: 11/13/2022] Open
Abstract
Cognitive deficits are common in depression and may persist following the resolution of affective symptoms. However, therapeutic strategies that successfully target cognitive impairments are lacking. Recent work has demonstrated that playing action video games leads to improvements in cognition, in particular executive function, in healthy individuals. We therefore set out to test whether playing video games can reduce symptoms associated with depression. We focussed on depressive symptoms and on rumination, since rumination is a good predictor of depression and may contribute to triggering depression. We recruited 68 clinically depressed individuals (mean age: 46 years, 47 females) that were randomized into the training group playing a fast paced action video game for 6 weeks or a waitlist control group. Before and after training participants completed online questionnaires and a neuropsychological test battery. Only participants who actually played the game were included in the analysis. The final sample consisted of n = 21 training group and n = 29 waitlist control group. The training group showed significantly higher subjective cognitive ability, as well as lower self-reported rumination at posttest in contrast to the control group (although these findings do not survive Bonferroni correction). On a subsample with cognitive performance data (n = 19) we detected an improvement in executive function (Trail Making Task A and B) in the training compared with the control group. The results show that the fast paced action video game employed in the present study improved Trail Making performance and may reduce rumination and enhance subjective cognitive ability. Future research may focus on the investigation of the precise cognitive profile of effects.
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Affiliation(s)
- Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fabrice Berna
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thies Lüdtke
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Training in a comprehensive everyday-like virtual reality environment compared to computerized cognitive training for patients with depression. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.10.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Berg JE. Psychometric testing of immigrants and natives in an acute psychiatry facility. Ment Illn 2017; 9:6987. [PMID: 29383216 PMCID: PMC5768086 DOI: 10.4081/mi.2017.6987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 09/05/2017] [Accepted: 09/05/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- John E Berg
- Faculty of Health Sciences, Oslo and Akershus University Hospital, Oslo, Norway
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Passerieux C, Bulot V, Hardy-Baylé MC, Roux P. Assessing cognitive-related disability in schizophrenia: Reliability, validity and underlying factors of the evaluation of cognitive processes involved in disability in schizophrenia scale. Disabil Rehabil 2017; 40:1953-1959. [DOI: 10.1080/09638288.2017.1312568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Christine Passerieux
- Service Universitaire de Psychiatrie d’adultes, Centre Hospitalier de Versailles, Le Chesnay, France
- EA4047 HANDIReSP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
- Fondation FondaMental, Créteil, France
| | - Virginie Bulot
- Service Universitaire de Psychiatrie d’adultes, Centre Hospitalier de Versailles, Le Chesnay, France
- EA4047 HANDIReSP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
- Fondation FondaMental, Créteil, France
| | - Marie-Christine Hardy-Baylé
- Service Universitaire de Psychiatrie d’adultes, Centre Hospitalier de Versailles, Le Chesnay, France
- EA4047 HANDIReSP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
- Fondation FondaMental, Créteil, France
| | - Paul Roux
- Service Universitaire de Psychiatrie d’adultes, Centre Hospitalier de Versailles, Le Chesnay, France
- EA4047 HANDIReSP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
- Fondation FondaMental, Créteil, France
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Moritz S, Balzan RP, Bohn F, Veckenstedt R, Kolbeck K, Bierbrodt J, Dietrichkeit M. Subjective versus objective cognition: Evidence for poor metacognitive monitoring in schizophrenia. Schizophr Res 2016; 178:74-79. [PMID: 27591821 DOI: 10.1016/j.schres.2016.08.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with schizophrenia display a number of cognitive biases, particularly a tendency to jump to conclusions, which are implicated in the pathogenesis of the disorder. The present study contrasted the degree of objective reasoning biases with subjective cognitive insight. We expected that patients with schizophrenia would display greater objective than subjective impairment suggestive of poor metacognitive awareness. METHODS Patients with schizophrenia (n=140) and healthy controls (n=60) underwent a test battery encompassing a cognitive bias paradigm (beads task) as well as neurocognitive tests (story recall, trail-making tests). In addition, they were administered the Beck Cognitive Insight Scale (BCIS), a subjective measure of (meta)cognitive awareness. RESULTS Corroborating prior research on decision making, draws to decisions were significantly delayed in controls relative to patients, whereas the core jumping to conclusion parameter (i.e., decision after one or two pieces of information) bordered significance. Patients with schizophrenia showed a lowered decision threshold and impaired neurocognition relative to nonclinical controls. Despite poor cognitive performance and prior psychotic episodes, patients with schizophrenia showed similar scores on the self-confidence subscale of the BCIS and reported even higher levels of self-reflectiveness relative to healthy controls. DISCUSSION The study demonstrates that patients with schizophrenia show severe cognitive biases and neurocognitive deficits but display only partial awareness herein. Raising cognitive insight in a non-insulting fashion and elevating patients' corrigibility as well as willingness to consider others' feedback and advice may help to narrow this gap and improve psychiatric symptomatology.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ryan P Balzan
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Francesca Bohn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ruth Veckenstedt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Kolbeck
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Bierbrodt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mona Dietrichkeit
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Significantly improved neurocognitive function in major depressive disorders 6 weeks after ECT. J Affect Disord 2016; 202:10-5. [PMID: 27253211 DOI: 10.1016/j.jad.2016.03.062] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/02/2016] [Accepted: 03/12/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cognitive side effects may occur after electroconvulsive treatment (ECT) in depressive disorder patients. Previous studies have been limited by small numbers of cognitive functions assessed. The present study reports the first results from a prospective project monitoring cognitive effects of ECT using a comprehensive neuropsychological test battery and subjective report of everyday cognitive function. METHODS Thirty-one patients with major depressive disorder were assessed with the MATRICS Consensus Cognitive Battery (MCCB). Subjective cognitive complaints were described with the Everyday Memory Questionnaire (EMQ). Severity of depression symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS). These assessments were performed prior to and 6 weeks after non-standardized ECT. RESULTS Compared to baseline, the mean depression severity level was nearly halved and there were significant improvements in mean levels of Speed of Processing, Attention/Vigilance, and Visual Learning 6 weeks after ECT. The other cognitive domains were not altered from baseline. There was no significant change in subjective cognitive complaints. At baseline, there were several significant correlations between the MADRS and MCCB scores. There was no strong association between the EMQ and MCCB scores at either assessment point, but the post-ECT EMQ score was significantly correlated with depression severity. LIMITATIONS Major limitations were low N and lack of uniform ECT procedure. CONCLUSIONS There was significant improvement in Speed of Processing, Attention/Vigilance, and Visual Learning 6 weeks after ECT. Cognitive tests scores were related to severity of depression, but not to subjective memory complaints.
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Diener C, Bornschlegl M, Menke B, Petermann F. Subjektive Einschätzung und objektive kognitive Leistung bei psychisch Gesunden. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2016. [DOI: 10.1024/1016-264x/a000186] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Neuropsychologische Untersuchungen verweisen auf uneinheitliche Zusammenhänge zwischen der subjektiven und objektiven kognitiven Leistungsbeurteilung. Bei 286 psychisch Gesunden wurden objektive kognitive Leistungswerte in der deutschen Adaptation der Neuropsychological Assessment Battery (NAB) sowie der Fragebogen zur subjektiven Einschätzung der geistigen Leistungsfähigkeit (FLei) erhoben. Trotz sehr guter Reliabilitäten des FLei limitierten Bodeneffekte die Aufdeckung richtungskonformer Zusammenhänge mit objektiven Leistungswerten in den Bereichen Aufmerksamkeit, Gedächtnis und exekutiven Funktionen. Dennoch erwies sich die Gedächtnisleistung als sensitivste Einzeldomäne für einen positiven Zusammenhang zwischen subjektiver und objektiver Leistungseinschätzung. Dabei moderierte das subjektive Wohlbefinden (WHO-5-Index) den Zusammenhang beider (subjektiver/objektiver) Ebenen im Gedächtnisbereich und in der kognitiven Gesamtleistung. Vor dem Hintergrund dieses Ergebnismusters sollten zukünftige Zusammenhangsanalysen insbesondere bei Personen mit psychischen Belastungen zu weiteren klinisch relevanten Befunden führen.
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Affiliation(s)
- Carsten Diener
- Fakultät für Angewandte Psychologie, SRH Hochschule Heidelberg
| | - Mona Bornschlegl
- Zentrum für Klinische Psychologie und Rehabilitation (ZKPR), Universität Bremen
| | - Barbara Menke
- Fakultät für Angewandte Psychologie, SRH Hochschule Heidelberg
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation (ZKPR), Universität Bremen
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Cruz BF, Resende CBD, Carvalhaes CF, Cardoso CS, Teixeira AL, Keefe RS, Rocha FL, Salgado JV. Interview-based assessment of cognition is a strong predictor of quality of life in patients with schizophrenia and severe negative symptoms. ACTA ACUST UNITED AC 2016; 38:216-21. [PMID: 27304257 PMCID: PMC7194260 DOI: 10.1590/1516-4446-2015-1776] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/24/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To analyze the correlation between quality of life, symptoms, and cognition assessed by the interview-based Schizophrenia Cognition Rating Scale (SCoRS). METHODS Seventy-nine outpatients diagnosed with schizophrenia were evaluated with the Quality of Life Scale - Brazilian version (QLS-BR), the SCoRS, and symptoms scales (Positive and Negative Syndrome Scale [PANSS]). After determining the potential explanatory variables using Spearman's correlation and Student's t test results, we ran simple, multivariate, and decision-tree regression analyses to assess the impact of SCoRS and PANSS ratings on mean overall quality of life. RESULTS Cognitive deficits and negative symptoms were the best predictors of quality of life. A low degree of negative symptoms (PANSS negative < 11) was a strong predictor of better quality of life (QLS ∼ 75), regardless of SCoRS rating. Among participants with more severe negative symptoms, elevated cognitive impairment (interviewer SCoRS ∼ 44) was a predictor of worse quality of life (QLS ∼ 44). CONCLUSIONS Cognitive impairment determined by interview-based assessment seems to be a strong predictor of quality of life in subjects with severe negative symptoms. These results support the usefulness of SCoRS for cognitive assessment that is relevant to the everyday life of patients with schizophrenia.
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Affiliation(s)
- Breno F Cruz
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Camilo B de Resende
- Grupo de Pesquisa em Psiquiatria e Cognição, Instituto Raul Soares, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, MG, Brazil
| | - Carolina F Carvalhaes
- Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Belo Horizonte, MG, Brazil
| | - Clareci S Cardoso
- Departamento de Epidemiologia, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, MG, Brazil
| | - Antonio L Teixeira
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Departamento de Medicina Interna, UFMG, Belo Horizonte, MG, Brazil
| | - Richard S Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Fábio L Rocha
- Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Belo Horizonte, MG, Brazil
| | - João V Salgado
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Grupo de Pesquisa em Psiquiatria e Cognição, Instituto Raul Soares, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, MG, Brazil.,Departamento de Morfologia, UFMG, Belo Horizonte, MG, Brazil
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Jamal F, Haque QS, Singh S. Interrelation of Glycemic Status and Neuropsychiatric Disturbances in Farmers with Organophosphorus Pesticide Toxicity. Open Biochem J 2016; 10:27-34. [PMID: 27688820 PMCID: PMC5041135 DOI: 10.2174/1874091x01610010027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/14/2016] [Accepted: 01/15/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Diverse group of agro-chemicals are indiscriminately sprayed by the farmers for pest control to enhance crop yield. About 25 million agricultural workers in the developing world suffer from at least one episode of poisoning each year, mainly by anticholinesterase- like organophosphates (OPs). OBJECTIVE The present study was aimed to establish the OP toxicity in 187 occupationally exposed pesticide sprayers of mango plantation in rural Malihabad, Lucknow, in terms of neuro-cognitive impairment, mental health status, clinical symptoms, diabetes, and hematological factors. METHOD The exposed group was compared to 187 pesticides-unexposed normal healthy persons engaged in normal usual agricultural work (age, sex and education corresponding to age group of selected subject group) from Rural Malihabad, Lucknow (India). Neuro-cognitive impairment was measured using the Subjective Neurocognition Inventory and mental health status using the General Health questionnaire-28. The subjects were also tested for biochemical and enzymatic parameters. RESULTS The exposed farmers showed alterations in enzymatic and clinical parameters. While the rates of anxiety / insomnia and severe depression were also significantly higher in the pesticide sprayers, disorders affecting psychomotor speed, selective attention, divided attention, verbal memory, nonverbal memory, prospective memory, spatial functioning, and initiative/energy were all lower in the sprayers. Pesticide sprayers showed a number of clinical symptoms like eczema, saliva secretion, fatigue, headache, sweating, abdominal pain, nausea, superior distal muscle weakness, inferior distal muscle weakness, hand tingling and etc. which all significantly correlated with the number of working years. CONCLUSION These findings suggested that farmers who work with OPs are prone to neuro-psychological disorders and diabetes.
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Affiliation(s)
- Farrukh Jamal
- Department of Biochemistry, Dr. Ram Manohar Lohia Avadh University, Faizabad-224001, India
| | - Quazi S Haque
- Department of Biochemistry, Dr. Ram Manohar Lohia Avadh University, Faizabad-224001, India
| | - Sangram Singh
- Department of Biochemistry, Dr. Ram Manohar Lohia Avadh University, Faizabad-224001, India
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Mohn C, Rund BR. Neurocognitive profile in major depressive disorders: relationship to symptom level and subjective memory complaints. BMC Psychiatry 2016; 16:108. [PMID: 27095362 PMCID: PMC4837617 DOI: 10.1186/s12888-016-0815-8] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 04/11/2016] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The MATRICS Consensus Cognitive Battery (MCCB) was developed for schizophrenia patients, but is also being used to assess neurocognitive function in bipolar disorder. This study aims to describe neurocognitive differences in major depressive disorder patients and healthy controls with the MCCB, and to describe the relationship between depression symptom severity, subjective cognitive complaints, and objective cognitive test performance. METHODS Thirty-three patients with major depressive disorder and 33 pairwise matched healthy controls were assessed with the MCCB. The patients were also assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Everyday Memory Questionnaire (EMQ). RESULTS On all neurocognitive domains, the depression patients scored significantly lower than the controls. The level of impairment ranged from 21.0% (Working Memory) to 58.0% (Speed of Processing). There were significant associations between neurocognitive test performance and depression symptom severity, but not with subjective cognitive complaints. CONCLUSIONS The MCCB was applicable in this study of major depressive disorder, and revealed significant neurocognitive dysfunction in this group. At least one fifth of the patients were impaired on all cognitive domains, with Speed of Processing and Reasoning/Problem Solving being most strongly affected. The objective test scores were significantly related to depression severity, but not to subjective cognitive complaints.
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Affiliation(s)
- Christine Mohn
- Research Department, Vestre Viken Hospital Trust, Wergelands gate 10, 3004, Drammen, Norway.
| | - Bjørn Rishovd Rund
- Research Department, Vestre Viken Hospital Trust, Wergelands gate 10, 3004 Drammen, Norway ,Department of Psychology, University of Oslo, Oslo, Norway
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Burton CZ, Harvey PD, Patterson TL, Twamley EW. Neurocognitive insight and objective cognitive functioning in schizophrenia. Schizophr Res 2016; 171:131-6. [PMID: 26811232 PMCID: PMC4762729 DOI: 10.1016/j.schres.2016.01.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/08/2016] [Accepted: 01/11/2016] [Indexed: 11/26/2022]
Abstract
Neurocognitive impairment is a core component of schizophrenia affecting everyday functioning; the extent to which individuals with schizophrenia show awareness of neurocognitive impairment (neurocognitive insight) is unclear. This study investigated neurocognitive insight and examined the cross-sectional relationships between neurocognitive insight and objective neurocognition and functional capacity performance in a large outpatient sample. 214 participants with schizophrenia-spectrum disorders completed measures of neurocognition, functional capacity, and self-reported neurocognitive problems. Latent profile analysis classified participants with regard to neuropsychological performance and self-report of neurocognitive problems. The resulting classes were then compared on executive functioning performance, functional capacity performance, and psychiatric symptom severity. More than three quarters of the sample demonstrated objective neurocognitive impairment (global deficit score≥0.50). Among the participants with neurocognitive impairment, 54% were classified as having "impaired" neurocognitive insight (i.e., reporting few neurocognitive problems despite having objective neurocognitive impairment). Participants with impaired vs. intact neurocognitive insight did not differ on executive functioning measures or measures of functional capacity or negative symptom severity, but those with intact neurocognitive insight reported higher levels of positive and depressive symptoms. A substantial portion of individuals with schizophrenia and objectively measured neurocognitive dysfunction appear unaware of their deficits. Patient self-report of neurocognitive problems, therefore, is not likely to reliably assess neurocognition. Difficulty self-identifying neurocognitive impairment appears to be unrelated to executive functioning, negative symptoms, and functional capacity. For those with intact neurocognitive insight, improving depressive and psychotic symptoms may be a valuable target to reduce illness burden.
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Affiliation(s)
- Cynthia Z. Burton
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, San Diego, CA, 92120, USA
| | - Philip D. Harvey
- University of Miami Miller School of Medicine, Department of Psychiatry and Behavioral Sciences, 1120 NW 14th Street, Suite 1450, Miami, FL, 33136, USA,Miami VA Healthcare System, Research Service, 1201 NW 16th Street, Miami, FL, 33125, USA
| | - Thomas L. Patterson
- University of California, San Diego Department of Psychiatry, 9500 Gilman Drive, MC: 0603, La Jolla, CA, 92093, USA
| | - Elizabeth W. Twamley
- University of California, San Diego Department of Psychiatry, 9500 Gilman Drive, MC: 0603, La Jolla, CA, 92093, USA,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Drive (116A), San Diego, CA, 92161, USA
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Affiliation(s)
- Ryan P. Balzan
- School of Psychology, Flinders University, GPO Box 2100 Adelaide, SA 5001, Australia
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45
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Moritz S, Göritz AS, Gallinat J, Schafschetzy M, Van Quaquebeke N, Peters MJV, Andreou C. Subjective competence breeds overconfidence in errors in psychosis. A hubris account of paranoia. J Behav Ther Exp Psychiatry 2015; 48:118-24. [PMID: 25817242 DOI: 10.1016/j.jbtep.2015.02.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/20/2015] [Accepted: 02/23/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Overconfidence in errors is a well-replicated cognitive bias in psychosis. However, prior studies have sometimes failed to find differences between patients and controls for more difficult tasks. We pursued the hypothesis that overconfidence in errors is exaggerated in participants with a liability to psychosis relative to controls only when they feel competent in the respective topic and/or deem the question easy. Whereas subjective competence likely enhances confidence in those with low psychosis liability as well, we still expected to find more 'residual' caution in the latter group. METHODS We adopted a psychometric high-risk approach to circumvent the confounding influence of treatment. A total of 2321 individuals from the general population were administered a task modeled after the "Who wants to be a millionaire" quiz. Participants were requested to endorse one out of four response options, graded for confidence, and were asked to provide ratings regarding subjective competence for the knowledge domain as well as the subjective difficulty of each item. RESULTS In line with our assumption, overconfidence in errors was increased overall in participants scoring high on the Paranoia Checklist core paranoia subscale (2 SD above the mean). This pattern of results was particularly prominent for items for which participants considered themselves competent and which they rated as easy. LIMITATIONS Results need to be replicated in a clinical sample. DISCUSSION In support of our hypothesis, subjective competence and task difficulty moderate overconfidence in errors in psychosis. Trainings that teach patients the fallibility of human cognition may help reduce delusional ideation.
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Affiliation(s)
- Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany.
| | - Anja S Göritz
- Occupational and Consumer Psychology, Freiburg University, Freiburg, Germany
| | - Jürgen Gallinat
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany
| | - Milena Schafschetzy
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany
| | - Niels Van Quaquebeke
- Department of Management and Economics, Kuehne Logistics University, Hamburg, Germany
| | - Maarten J V Peters
- Clinical Psychological Science, Section Forensic Psychology, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands
| | - Christina Andreou
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany
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Moritz S, Thoering T, Kühn S, Willenborg B, Westermann S, Nagel M. Metacognition-augmented cognitive remediation training reduces jumping to conclusions and overconfidence but not neurocognitive deficits in psychosis. Front Psychol 2015; 6:1048. [PMID: 26283990 PMCID: PMC4522518 DOI: 10.3389/fpsyg.2015.01048] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 07/09/2015] [Indexed: 01/06/2023] Open
Abstract
The majority of patients with schizophrenia display neurocognitive deficits (e.g., memory impairment) as well as inflated cognitive biases (e.g., jumping to conclusions). Both cognitive domains are implicated in the pathogenesis of the disorder and are known to compromise functional outcome. At present, there is a dearth of effective treatment options. A total of 90 patients with schizophrenia were recruited online (a diagnosis of schizophrenia had been confirmed in a large subgroup during a previous hospital admission). Subsequent to a baseline assessment encompassing psychopathology, self-reported cognition as well as objective memory and reasoning tests, patients were randomized to one of three conditions: standard cognitive remediation (mybraintraining), metacognition-augmented cognition remediation (CR) condition (variant of mybraintraining which encouraged patients to reduce speed of decision-making and attenuate response confidence when participants made high-confidence judgements and hasty incorrect decisions) and a waitlist control group. Patients were retested after 6 weeks and again 3 months after the second assessment. Groups did not differ on psychopathology and neurocognitive parameters at any timepoint. However, at follow-up the metacognitive-augmented CR group displayed a significant reduction on jumping to conclusions and overconfidence. Treatment adherence correlated with a reduction of depression; gains in the training exercises from the standard mybraintraining condition were correlated with improved objective memory performance. The study suggests that metacognition-augmented CR may ameliorate cognitive biases but not neurocognition. The study ties in well with prior research showing that neurocognitive dysfunctions are rather resistant to change; the failure to detect significant improvement of CR or metacognition-augmented CR on psychopathology and neurocognition over time may partly be attributed to a number of methodological limitations of our study (low psychopathology and chronicity of participants, low “dosage,” narrow range of tests, self-report psychopathology scales).
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Affiliation(s)
- Steffen Moritz
- Clinical Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Teresa Thoering
- Clinical Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Simone Kühn
- Clinical Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf Hamburg, Germany ; Center for Lifespan Psychology, Max Planck Institute for Human Development Berlin, Germany
| | - Bastian Willenborg
- Clinical Neuropsychology, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf Hamburg, Germany ; Department of Psychiatry and Psychotherapy, University of Lübeck Lübeck, Germany
| | - Stefan Westermann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern Bern, Switzerland
| | - Matthias Nagel
- Department of Psychiatry and Psychotherapy, University of Lübeck Lübeck, Germany ; Asklepios Medical Center Hamburg-North-Wandsbek, Department of Psychiatry and Psychotherapy Hamburg, Germany
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Metakognitives Training bei Schizophrenie. PSYCHOTHERAPEUT 2015. [DOI: 10.1007/s00278-015-0003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schneider BC, Thoering T, Cludius B, Moritz S. Self-Reported Symptoms of Attention-Deficit/Hyperactivity Disorder: Rate of Endorsement and Association with Neuropsychological Performance in an Adult Psychiatric Sample. Arch Clin Neuropsychol 2015; 30:186-91. [DOI: 10.1093/arclin/acv015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2015] [Indexed: 11/13/2022] Open
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Potvin S, Pelletier J, Stip E. La conscience des déficits neurocognitifs dans la schizophrénie : une méta-analyse. ACTA ACUST UNITED AC 2014. [DOI: 10.7202/1027839ar] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Contexte La schizophrénie est un trouble allant de pair avec un manque d’autocritique par rapport aux délires et aux hallucinations. En contrepartie, on en sait beaucoup moins en ce qui concerne la conscience des patients par rapport à leurs déficits cognitifs, qui sont des symptômes clés de ce trouble psychiatrique. Afin de faire la synthèse de l’état de la connaissance à ce sujet, nous avons effectué une méta-analyse de 22 études comprenant 1609 patients. Les analyses ont révélé que les patients rapportent davantage de plaintes subjectives que les sujets sains. La corrélation entre la cognition subjective et objective s’est avérée faible toutefois. Les études utilisant la Scale to Investigate Cognition in Schizophrenia ont produit des corrélations plus fortes que celles utilisant d’autres échelles de plaintes subjectives. La relation entre la cognition subjective et les symptômes dépressifs s’est avérée comparable à la relation entre la cognition subjective et la cognition objective. Enfin, une relation faible a été observée entre la cognition subjective et l’autocritique par rapport aux symptômes positifs. Les résultats de la présente méta-analyse montrent que les patients atteints de la schizophrénie se plaignent de déficits cognitifs, mais qu’ils n’ont pas une représentation claire de la nature de ceux-ci, ce qui confirme l’existence de déficits méta-cognitifs dans la schizophrénie.
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Affiliation(s)
- Stéphane Potvin
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Université de Montréal, Montréal, Canada
- Département de psychiatrie, Faculté de médecine, Université de Montréal, Montréal, Canada
| | - Julie Pelletier
- Département de psychiatrie, Faculté de médecine, Université de Montréal, Montréal, Canada
| | - Emmanuel Stip
- Département de psychiatrie, Faculté de médecine, Université de Montréal, Montréal, Canada
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Université de Montréal, Montréal, Canada
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Shen C, Popescu FC, Hahn E, Ta TT, Dettling M, Neuhaus AH. Neurocognitive pattern analysis reveals classificatory hierarchy of attention deficits in schizophrenia. Schizophr Bull 2014; 40:878-85. [PMID: 23934819 PMCID: PMC4059438 DOI: 10.1093/schbul/sbt107] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Attention deficits, among other cognitive deficits, are frequently observed in schizophrenia. Although valid and reliable neurocognitive tasks have been established to assess attention deficits in schizophrenia, the hierarchical value of those tests as diagnostic discriminants on a single-subject level remains unclear. Thus, much research is devoted to attention deficits that are unlikely to be translated into clinical practice. On the other hand, a clear hierarchy of attention deficits in schizophrenia could considerably aid diagnostic decisions and may prove beneficial for longitudinal monitoring of therapeutic advances. To propose a diagnostic hierarchy of attention deficits in schizophrenia, we investigated several facets of attention in 86 schizophrenia patients and 86 healthy controls using a set of established attention tests. We applied state-of-the-art machine learning algorithms to determine attentive test variables that enable an automated differentiation between schizophrenia patients and healthy controls. After feature preranking, hypothesis building, and hypothesis validation, the polynomial support vector machine classifier achieved a classification accuracy of 90.70% ± 2.9% using psychomotor speed and 3 different attention parameters derived from sustained and divided attention tasks. Our study proposes, to the best of our knowledge, the first hierarchy of attention deficits in schizophrenia by identifying the most discriminative attention parameters among a variety of attention deficits found in schizophrenia patients. Our results offer a starting point for hierarchy building of schizophrenia-associated attention deficits and contribute to translating these concepts into diagnostic and therapeutic practice on a single-subject level.
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Affiliation(s)
- Christina Shen
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
| | - Florin C. Popescu
- Fraunhofer Institute for Open Communication Systems FOKUS, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
| | - Tam T.M. Ta
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
| | - Michael Dettling
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
| | - Andres H. Neuhaus
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany;,*To whom correspondence should be addressed; Department of Psychiatry and Psychotherapy, Charité University Medicine, Campus Benjamin Franklin, Eschenallee 3, 14050 Berlin, Germany; tel: 49-30-8445-8412, fax: 49-30-8445-8393; e-mail:
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