Examination and Comparison of Cognitive and Executive Functions in Clinically Stable Schizophrenia Disorder, Bipolar Disorder, and Major Depressive Disorder

Engagement in a virtual group-based walking intervention for persons with schizophrenia: a qualitative study

BACKGROUND

Exercise is beneficial for persons with schizophrenia; however, high dropout rates limit the impact of interventions. Virtual exercise programs have the potential to improve engagement; however, few intervention studies of virtual programs have been conducted in this population.

METHODS

This study examined qualitative data from 15 adults with schizophrenia who participated in a pilot randomized controlled trial of Virtual PACE-Life, a live, video-delivered group walking intervention guided by self-determination theory. Interviews elicited feedback on the intervention, barriers and facilitators to engagement, recommendations for intervention refinement, and preferences for exercise programming modality. Rapid qualitative analysis was used to explore similarities and differences between completers (i.e., those that attended ≥ 50% of virtual walking sessions; n = 9) and non-completers (i.e., those that attended < 50% of virtual walking sessions; n = 6).

RESULTS

Both groups viewed Virtual PACE-Life positively but found the virtual exercise sessions challenging and inadequate for facilitating social interaction. Work obligations impacted completers' attendance whereas technological issues and forgetting impacted non-completers' attendance at virtual walking sessions. Completers preferred virtual exercise programs and non-completers preferred in-person exercise programs.

CONCLUSIONS

These findings suggest that future virtual group-based walking programs should prioritize enhancing the social aspect, offering scheduling choices, and regularly assessing the perceived difficulty of exercise sessions. These modifications not only have the potential to improve intervention engagement but they also may increase participant autonomy and relatedness, core components of self-determination theory.

The effectiveness of acceptance and commitment therapy in reducing the symptoms of complicated grief, corona disease anxiety, and improving the quality of life in the survivors of the deceased due to COVID-19

BACKGROUND

COVID-19 is an infectious disease that has threatened the physical and mental health of people and in many cases leads to death. The present study investigated the effectiveness of acceptance and commitment therapy (ACT) in reducing the symptoms of complicated grief, and corona disease anxiety, and improving the quality of life in the survivors of the deceased due to COVID-19.

MATERIALS AND METHODS

The research method was an experimental design with pre-test, post-test, and follow-up with a control group and random assignment to the intervention and the control groups. Thirty-eight people who met the study criteria were selected as a sample and assigned to the two intervention and control groups using a simple randomization method (19 people in each group). Measures included the complex grief scale, the coronavirus anxiety scale, and the short form of the World Health Organization quality of life scale. Then, mixed analysis of variance was used to compare the average variables between the two groups. Also, the independent t-test was used to compare the mean quantitative outcomes between the two groups.

RESULTS

The results showed that there were significant changes over time between the experimental and control groups (with a small effect coefficient) in complicated grief symptoms (P < 0.05), corona disease anxiety (P = 0.001), and quality of life (P = 0.001). Also, the results of all three variables showed that there were significant differences between pre-test and post-test (P < 0.05) and between pre-test and follow-up (P value < 0.05), but the difference between post-test and follow-up was insignificant.

CONCLUSIONS

ACT has significant effects on reducing the symptoms of complicated grief and corona disease anxiety as well as on improving the quality of life in the survivors of the deceased due to COVID-19.

Executive Functions and Public Health: A Narrative Review

Executive functions (EFs) skills are necessary for regulating the thoughts, emotions, and actions which are associated with many aspects of daily functioning. Executive dysfunction (EDFs) is present in a wide range of mental disorders. New study indicates that EFs may predict health behavior and make it easier to engage in a variety of healthy activities. In this narrative review, EFs and public health are briefly discussed. In general, 133 articles met the inclusion criteria (published 2018-2023) which were reviewed. EFs affect the mental and physical health. Besides individual problems, people with mental problems have heavy costs to society. Mental health cannot be considered separately from general health. Consequently, preventive and therapeutic approaches to mental health should be considered not only at the level of the whole society, but also at the global level.

Features of cognitive impairment and related risk factors in patients with major depressive disorder: A case-control study

BACKGROUND

Cognitive impairment (CI) is a common symptom contributing to functional loss in major depressive disorder (MDD). However, the features of CI and its related risk factors in young and middle-aged MDD patients remain unclear.

METHODS

In this case-control study, 18- to 55-year-old acute-onset MDD patients and healthy controls (HCs) were recruited from nine centers in China. MDD patients were diagnosed based on the DSM-IV, the Mini-International Neuropsychiatric Interview, and a 17-item Hamilton Rating Scale for Depression score ≥ 14. Cognitive function, including attention/vigilance, learning, memory, processing speed and executive function, was assessed with a neuropsychological battery and compared between MDD patients and HCs. MDD patients scoring 1.5 SDs below the mean HC score in at least 2 domains were defined as having CI. Logistic regression analysis was used to identify risk factors for CI in MDD patients.

RESULTS

Compared with HCs (n = 302), MDD patients (n = 631) showed significant impairment in all cognitive domains (P < 0.001); 168 MDD patients (26.6%) had CI. Male sex (OR: 1.712; 95% CI: 1.165-2.514; P < 0.01) was positively correlated with CI; age of first onset (OR: 0.974; 95% CI: 0.957-0.991; P < 0.05) and comorbid anxiety disorders (OR: 0.514; 95% CI: 0.332-0.797; P < 0.01) were negatively correlated with CI.

LIMITATIONS

Biomarkers and neuroimaging were not used to investigate the possible biological mechanism and neural basis of CI in MDD.

CONCLUSIONS

CI was prominent in adults with acute-onset MDD; male sex and younger age of first onset were independent risk factors, and comorbid anxiety disorders were a protective factor.

Prefrontal Cortex Activation During Verbal Fluency Task and Tower of London Task in Schizophrenia and Major Depressive Disorder

Background: Cognitive dysfunction is a common clinical feature of mental disorders. A number of functional near-infrared spectroscopy (fNIRS) studies have shown reduced prefrontal activation during the verbal fluency task (VFT) in schizophrenia (SZ) and major depressive disorder (MDD). However, no studies have examined and compared the brain activation patterns during the Tower of London (TOL), which is another classic, high-sensitivity executive function testing tool, in these two serious mental disorders. This study aimed to assess the characteristics of brain activation during the two different cognitive tasks in SZ and MDD patients. Methods: This study recruited 30 patients with SZ, 30 patients with MDD, and 30 demographically matched healthy controls (HCs). The hemodynamic changes of the prefrontal cortex (PFC) were measured using 32-channel fNIRS during performance of the TOL task and VFT task. Results: SZ patients showed poorer VFT performance than MDD patients and HCs, and the two patient groups showed poorer TOL performance than HCs. Compared to HCs, both of the patient groups exhibited a significant decreased activation in the extensive PFC. Particularly in certain channels in the dorsolateral PFC (DLPFC), SZ patients exhibited significantly decreased hemodynamic changes than the MDD patients. Conclusions: Patients with SZ and MDD have different levels of impairment in different cognitive domains and different patterns of brain activation during the two cognitive tasks. Further research is needed to determine the use of fNIRS for clinical evaluation and diagnosis.