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Kjærstad HL, Varo C, Meluken I, Vieta E, Vinberg M, Kessing LV, Miskowiak KW. Emotional cognition subgroups in unaffected first-degree relatives of patients with mood disorders. Psychol Med 2023; 53:2328-2338. [PMID: 37310310 DOI: 10.1017/s0033291721004165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) or bipolar disorder (BD) exhibit difficulties with emotional cognition even during remission. There is evidence for aberrant emotional cognition in unaffected relatives of patients with these mood disorders, but studies are conflicting. We aimed to investigate whether emotional cognition in unaffected first-degree relatives of patients with mood disorders is characterised by heterogeneity using a data-driven approach. METHODS Data from 94 unaffected relatives (33 of MDD patients; 61 of BD patients) and 203 healthy controls were pooled from two cohort studies. Emotional cognition was assessed with the Social Scenarios Test, Facial Expression Recognition Test and Faces Dot-Probe Test. Hierarchical cluster analysis was conducted using emotional cognition data from the 94 unaffected relatives. The resulting emotional cognition clusters and controls were compared for emotional and non-emotional cognition, demographic characteristics and functioning. RESULTS Two distinct clusters of unaffected relatives were identified: a relatively 'emotionally preserved' cluster (55%; 40% relatives of MDD probands) and an 'emotionally blunted' cluster (45%; 29% relatives of MDD probands). 'Emotionally blunted' relatives presented with poorer neurocognitive performance (global cognition p = 0.010), heightened subsyndromal mania symptoms (p = 0.004), lower years of education (p = 0.004) and difficulties with interpersonal functioning (p = 0.005) than controls, whereas 'emotionally preserved' relatives were comparable to controls on these measures. CONCLUSIONS Our findings show discrete emotional cognition profiles that occur across healthy first-degree relatives of patients with MDD and BD. These emotional cognition clusters may provide insight into emotional cognitive markers of genetically distinct subgroups of individuals at familial risk of mood disorders.
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Affiliation(s)
- Hanne Lie Kjærstad
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Cristina Varo
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Iselin Meluken
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Maj Vinberg
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Mental Health Services, Capital Region of Denmark, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Lars Vedel Kessing
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Mental Health Services, Capital Region of Denmark, Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Functional assessment short test (FAST): Self-administration in outpatient mental health settings. J Psychiatr Res 2023; 160:258-262. [PMID: 36871369 DOI: 10.1016/j.jpsychires.2023.02.029] [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: 12/01/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/07/2023]
Abstract
The Functional Assessment Short Test (FAST) is a clinician-administered assessment scale of psychosocial dysfunction across various domains typically impacted in individuals with bipolar disorder. The FAST is formally validated as a clinician-administered measure, but support for self-administration would allow its wider use. Therefore, this study aimed to determine whether the FAST could reliably serve as a self-report measure in individuals seeking mental health treatment. Participants completed both the self-report and clinician-administered versions of the FAST as part of their routine outpatient clinical care at the Bipolar Disorders Clinic at The University of Texas Health Austin (UTHA). We investigated correlations between self-report and clinician-administered FAST scores. There were significant positive correlations between self-report and clinician-administered scores in a diverse group of 84 individuals undergoing outpatient mental health treatment (Total FAST scores rS = 0.75; p < .001). These findings support using the FAST as a self-report scale, further increasing its utility to measure functional disability in mental health conditions such as bipolar disorder. Self-report application will increase the utility of the FAST in busy clinical workflows and, therefore, contribute to a more comprehensive clinical assessment of recovery and spur interventions that improve psychosocial functioning and quality of life.
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Serafim SD, Goularte JF, Caldieraro MA, Lima FM, Dalpiaz G, Rabelo-da-Ponte FD, Torrent C, Solé B, Vieta E, Rosa AR. Validity and Reliability of the Digital Functioning Assessment Short Test (D-FAST) in the Brazilian Sample. Clin Pract Epidemiol Ment Health 2022; 18:e174501792210121. [PMID: 37274864 PMCID: PMC10156048 DOI: 10.2174/17450179-v18-e2210121] [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: 04/11/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 06/07/2023]
Abstract
Background The COVID-19 pandemic has caused major disruptions in all aspects of daily functioning, from school and work to interactions with friends and family. The Functioning Assessment Short Test (FAST) is an interviewer-administered scale validated in the psychiatric sample with no previous study assessing its validity and reliability in a digital format. Thus, we aimed to analyse the psychometric properties of the digital version of the FAST and understand the implications of COVID-19 and restrictive measures on functioning. Methods Data were collected using an online survey. The psychometric properties of the digital FAST were assessed by confirmatory factor analysis, Cronbach's alpha, and discriminant functional by cluster analysis in a community sample. Results Out of the total sample, 2,543 (84.1%) were female, and the mean (SD) age was 34.28 (12.46) years. The digital FAST retained the six factors structure observed in the original version, with Cronbach's alpha above 0.9. In addition, we showed evidence of discriminant validity by differentiating three clusters of psychosocial functioning. Clinical and demographic differences between groups explained, in part, the heterogeneity of functioning, thus providing support for the construct validity of the instrument. Conclusion The digital FAST is a simple and easy-to-understand instrument that provides a multidimensional assessment of functioning without the need for an interviewer. Furthermore, our findings may help to better understand the psychosocial implications of the pandemic and the importance of planning specific interventions to rehabilitee the affected group.
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Affiliation(s)
- Silvia Dubou Serafim
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, University Federal of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, RS, Brazil
- Postgraduate Program in Psychiatry and Behavioral Sciences, University Federal of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Jeferson Ferraz Goularte
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, University Federal of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, RS, Brazil
- Postgraduate Program in Psychiatry and Behavioral Sciences, University Federal of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marco Antonio Caldieraro
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, University Federal of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, RS, Brazil
- Postgraduate Program in Psychiatry and Behavioral Sciences, University Federal of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flavia Moreira Lima
- Hospital de Clínicas de Porto Alegre, University Federal of Rio Grande do Sul
, Porto Alegre, Rio Grande do Sul, RS, Brazil
| | - Giovana Dalpiaz
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, University Federal of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, RS, Brazil
- Postgraduate Program in Psychiatry and Behavioral Sciences, University Federal of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Francisco Diego Rabelo-da-Ponte
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, University Federal of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, RS, Brazil
- Postgraduate Program in Psychiatry and Behavioral Sciences, University Federal of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, c/Villarroel, 170, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Brisa Solé
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, c/Villarroel, 170, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, c/Villarroel, 170, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Adriane Ribeiro Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, University Federal of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, RS, Brazil
- Postgraduate Program in Psychiatry and Behavioral Sciences, University Federal of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Departament of Pharmacology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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