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Nuechterlein KH, Nasrallah H, Velligan D. Measuring Cognitive Impairments Associated With Schizophrenia in Clinical Practice: Overview of Current Challenges and Future Opportunities. Schizophr Bull 2024:sbae051. [PMID: 39088730 DOI: 10.1093/schbul/sbae051] [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] [Indexed: 08/03/2024]
Abstract
BACKGROUND Cognitive impairment associated with schizophrenia (CIAS) negatively impacts daily functioning, quality of life, and recovery, yet effective pharmacotherapies and practical assessments for clinical practice are lacking. Despite the pivotal progress made with establishment of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) for clinical research, implementation of the full MCCB is too time-consuming and cost-ineffective for most clinicians in clinical practice. STUDY DESIGN Here we discuss current assessments in relation to delivery format (interview-based and performance-based), validity, ease of use for clinicians and patients, reliability/reproducibility, cost-effectiveness, and suitability for clinical implementation. Key challenges and future opportunities for improving cognitive assessments are also presented. STUDY RESULTS Current assessments that require 30 min to complete would have value in clinical settings, but the associated staff training and time required might preclude their application in most clinical settings. Initial profiling of cognitive deficits may require about 30 min to assist in the selection of evidence-based treatments; follow-up monitoring with brief assessments (10-15 min in duration) to detect treatment-related effects on global cognition may complement this approach. Guidance on validated brief cognitive tests for the strategic monitoring of treatment effects on CIAS is necessary. CONCLUSIONS With increased advancements in technology-based and remote assessments, development of validated formats of remote and in-person assessment, and the necessary training models and infrastructure required for implementation, are likely to be of increasing clinical relevance for future clinical practice.
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Affiliation(s)
- Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - Henry Nasrallah
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati School of Medicine, Cincinnati, OH
| | - Dawn Velligan
- Division of Schizophrenia and Related Disorders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX
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Mélissa B, Sabrina G, Charles-Edouard G, Hind Z, Consortium S, Kingsada P, Stéphane P, Alexandre D. Clinical characteristics associated with functioning trajectories following admission to a psychiatric institution: A prospective cohort study of individuals with psychosis. Psychiatry Res 2024; 339:116062. [PMID: 38968920 DOI: 10.1016/j.psychres.2024.116062] [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: 02/23/2024] [Revised: 05/26/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
Psychotic disorders can be severely enabling, and functional recovery is often difficult to achieve. Admission to a psychiatric unit represents a key opportunity to implement strategies that will improve functional outcomes. In the current literature, there is a lack of consensus on which factors influence functional recovery. Therefore, the present longitudinal cohort study aimed to identify factors associated with functional trajectories following hospital admission for acute psychosis. A sample of 453 individuals with acute psychosis was extracted from the Signature Biobank database. Participants were followed for up to a year following admission. Various clinical indicators were documented over time. Functional trajectories were calculated based on the World Health Organization Disability Assessment Schedule 2.0. Three groups were identified: "improving", "stable", and "worsening" function. Individuals with a more severe symptomatic presentation at baseline were found to have better functional improve more over time. Over time, individuals in the "improving" and "stable" groups had significant improvements in their psychiatric symptoms. Finally, individuals following a "worsening" functional trajectory initially improved in terms of psychotic symptoms, but it did not persist over time. These results highlight the importance of studying function as a key component of recovery rather than solely focusing on relapse prevention.
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Affiliation(s)
- Beaudoin Mélissa
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal. Montreal, QC, Canada; Faculty of Medicine, McGill University. Montreal, QC, Canada; Research center of the Institut universitaire en santé mentale de Montréal. Montreal, QC, Canada.
| | - Giguère Sabrina
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal. Montreal, QC, Canada; Research center of the Institut universitaire en santé mentale de Montréal. Montreal, QC, Canada
| | - Giguère Charles-Edouard
- Research center of the Institut universitaire en santé mentale de Montréal. Montreal, QC, Canada
| | - Ziady Hind
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal. Montreal, QC, Canada; Research center of the Institut universitaire en santé mentale de Montréal. Montreal, QC, Canada
| | - Signature Consortium
- Research center of the Institut universitaire en santé mentale de Montréal. Montreal, QC, Canada
| | - Phraxayavong Kingsada
- Research center of the Institut universitaire en santé mentale de Montréal. Montreal, QC, Canada; Services et recherche psychiatrique AD. Montreal, QC, Canada
| | - Potvin Stéphane
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal. Montreal, QC, Canada; Research center of the Institut universitaire en santé mentale de Montréal. Montreal, QC, Canada
| | - Dumais Alexandre
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal. Montreal, QC, Canada; Research center of the Institut universitaire en santé mentale de Montréal. Montreal, QC, Canada; Services et recherche psychiatrique AD. Montreal, QC, Canada; Institut national de psychiatrie légale Philippe-Pinel. Montreal, QC, Canada.
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3
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Hotte-Meunier A, Penney D, Mendelson D, Thibaudeau É, Moritz S, Lepage M, Sauvé G. Effects of metacognitive training (MCT) on social cognition for schizophrenia spectrum and related psychotic disorders: a systematic review and meta-analysis. Psychol Med 2024; 54:914-920. [PMID: 37772399 DOI: 10.1017/s0033291723002611] [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] [Indexed: 09/30/2023]
Abstract
BACKGROUND Individuals with schizophrenia spectrum and related psychotic disorders (SSD) experience significant impairments in social cognition that impede functioning. Social cognition is a multidimensional construct consisting of four domains: 1. theory of mind, 2. emotion processing, 3. attributional style and 4. social perception. Metacognitive training (MCT) is an intervention designed to target cognitive biases in psychosis containing two modules addressing social cognition. METHODS A systematic review and meta-analysis was conducted to investigate the effects of MCT on social cognition and two of its domains: theory of mind and emotion processing. Ten electronic databases were scoured from 2007 to 1 February 2022 for MCT studies reporting social cognition outcomes for people with SSD (1050 identified, 282 assessed). Effect sizes were calculated using Cohen's d in R. RESULTS Nine studies were included in the meta-analysis (nMCT = 212, ncontrol = 194). MCT had a small but positive effect on global social cognition (d = 0.28 [95% CI 0.07-0.49]) and theory of mind (d = 0.27 [95% CI 0.01-0.52]). MCT showed no evidence of an effect on emotion processing (d = 0.03 [95% CI -0.26 to 0.32]). CONCLUSION MCT has a small but significant effect on social cognition for people with SSD. Our results add to other recent meta-analyses showing significant effects of MCT on clinically relevant outcomes such as positive symptoms, cognitive biases and cognitive insight. We recommend that future studies on MCT report outcomes on all four domains of social cognition. TRIAL REGISTRATION PROSPERO (in the process of registration) available at https://www.crd.york.ac.uk/prospero/#recordDetails.
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Affiliation(s)
- Adèle Hotte-Meunier
- Douglas Mental Health University Institute, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Danielle Penney
- Douglas Mental Health University Institute, Montreal, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Daniel Mendelson
- Douglas Mental Health University Institute, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Élisabeth Thibaudeau
- Douglas Mental Health University Institute, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg, Hamburg, Germany
| | - Martin Lepage
- Douglas Mental Health University Institute, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Geneviève Sauvé
- Douglas Mental Health University Institute, Montreal, Canada
- Department of Education and Pedagogy, Université du Québec à Montréal, Montreal, Canada
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Jarvis AL, Keage HAD, Wong S, Weightman M, Stephens RG. Evidence for a multidimensional account of cognitive and affective theory of mind: A state-trace analysis. Mem Cognit 2024; 52:525-535. [PMID: 38015409 PMCID: PMC11021350 DOI: 10.3758/s13421-023-01481-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/29/2023]
Abstract
Theory of mind (ToM) has been argued to be a multidimensional construct, with ToM inferences depending on distinct processes across affective and cognitive ToM tasks and across first-order cognitive and second-order cognitive ToM tasks. Behavioural evidence for a multidimensional account has primarily depended on dissociations identified via analysis of variance, a statistical approach insufficient for assessing dimensionality. Instead, state-trace analysis (STA) is a more appropriate statistical technique to uncover dimensionality. The current study first applied STA to two summary datasets that had previously identified key dissociations between cognitive and affective ToM; these reanalyses did not support a multidimensional account of ToM. Next, STA was applied to a more detailed dataset to reveal whether ToM is based on multiple processes in a sample of 115 older adults aged 60-85 years (M = 68.5, SD = 5.92, 61.7% female) with higher or lower emotion perception ability. Participants made ToM judgements about different social exchanges (e.g., sarcasm or lying). STA results supported a multidimensional account of ToM across first-order cognitive, second-order cognitive, and affective ToM subdomains. These results lay a more rigorous foundation for subsequent studies to further examine the dimensionality of ToM and to apply formal modelling, progressing the field's understanding and measurement of the cognitive processes driving ToM judgements.
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Affiliation(s)
- Amy L Jarvis
- Justice and Society Unit, University of South Australia, Adelaide, Australia.
| | - Hannah A D Keage
- Justice and Society Unit, University of South Australia, Adelaide, Australia
| | - Stephanie Wong
- Justice and Society Unit, University of South Australia, Adelaide, Australia
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Michael Weightman
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Pérez-Romero N, Campos-Jara C, Pesce C, Araya Sierralta S, Cerda-Vega E, Ramirez-Campillo R, Campos-Jara R, Martínez-Salazar C, Arellano-Roco C, Contreras-Osorio F. Effects of physical exercise on executive functions of individuals with schizophrenia spectrum disorders: Protocol for a systematic review and meta-analysis. PLoS One 2024; 19:e0296273. [PMID: 38165903 PMCID: PMC10760781 DOI: 10.1371/journal.pone.0296273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/04/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION Executive functions are commonly impaired in individuals with schizophrenia spectrum disorders. Physical exercise has the potential for improving executive functions and can be easily implemented as a therapeutic method. However, there are only few systematic reviews of exercise effects in schizophrenia including cognitive outcomes, and no meta-analytical syntheses of effects on "cool" and "hot" executive functions. The purpose of this systematic review and meta-analysis will be to determine the effects of physical exercise on "cool" and "hot" executive functions of adults with schizophrenia spectrum disorders. METHODS AND ANALYSIS This protocol was guided by PRISMA-P guidelines. Studies will be searched using combinations of keywords and medical terms in the Web of Science, PubMed, Scopus, and EBSCO databases. Inclusion criteria will be determined as per PICOS approach. The risk of bias will be assessed using the Cochrane RoB2 tool. The certainty of evidence (per outcome) will be assessed using the GRADE method. The meta-analyses will be performed using the DerSimonian and Laird random effects model. Effect sizes (Hedges' g) with 95% confidence intervals will be calculated for each main outcome. CONCLUSIONS The results of this review may be useful for mental health professionals to design treatment plans for adults with schizophrenia spectrum disorders, offering potential benefits related to the quality of life and cognitive abilities of this population. PROSPERO REGISTRATION NUMBER CRD42023392295.
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Affiliation(s)
- Nuria Pérez-Romero
- Exercise and Rehabilitation Sciences Institute, Postgraduate, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Chile
| | - Christian Campos-Jara
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Santiago, Chile
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | | | - Enrique Cerda-Vega
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Santiago, Chile
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Santiago, Chile
| | | | - Cristian Martínez-Salazar
- Department of Physical Education, Sports, and Recreation, Pedagogy in Physical Education, School of Education and Social Sciences and Humanities, Universidad de La Frontera, Temuco, Chile
| | - Cristián Arellano-Roco
- Laboratorio de Neuromecanica Aplicada, Escuela de kinesiología, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
| | - Falonn Contreras-Osorio
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile, Santiago, Chile
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6
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Burke T, Holleran L, Mothersill D, Lyons J, O'Rourke N, Gleeson C, Cannon DM, McKernan DP, Morris DW, Kelly JP, Hallahan B, McDonald C, Donohoe G. Bilateral anterior corona radiata microstructure organisation relates to impaired social cognition in schizophrenia. Schizophr Res 2023; 262:87-94. [PMID: 37931564 DOI: 10.1016/j.schres.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/25/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE The Corona Radiata (CR) is a large white matter tract in the brain comprising of the anterior CR (aCR), superior CR (sCR), and posterior CR (pCR), which have associations with cognition, self-regulation, and, in schizophrenia, positive symptom severity. This study tested the hypothesis that the microstructural organisation of the aCR, as measured by Fractional Anisotropy (FA) using Diffusion Tensor Imaging (DTI), would relate to poorer social cognitive outcomes and higher positive symptom severity for people with schizophrenia, when compared to healthy participants. We further hypothesised that increased positive symptoms would relate to poorer social cognitive outcomes. METHODS Data were derived from n = 178 healthy participants (41 % females; 36.11 ± 12.36 years) and 58 people with schizophrenia (30 % females; 42.4 ± 11.1 years). The Positive and Negative Symptom Severity Scale measured clinical symptom severity. Social Cognition was measured using the Reading the Mind in the Eyes Test (RMET) Total Score, as well as the Positive, Neutral, and Negative stimuli valence. The ENIGMA-DTI protocol tract-based spatial statistics (TBSS) was used. RESULTS There was a significant difference in FA for the CR, in individuals with schizophrenia compared to healthy participants. On stratification, both the aCR and pCR were significantly different between groups, with patients showing reduced white matter tract microstructural organisation. Significant negative correlations were observed between positive symptomatology and reduced microstructural organisation of the aCR. Performance for RMET negative valence items was significantly correlated bilaterally with the aCR, but not the sCR or pCR, and no relationship to positive symptoms was observed. CONCLUSIONS These data highlight specific and significant microstructural white-matter differences for people with schizophrenia, which relates to positive clinical symptomology and poorer performance on social cognition stimuli. While reduced FA is associated with higher positive symptomatology in schizophrenia, this study shows the specific associated with anterior frontal white matter tracts and reduced social cognitive performance. The aCR may have a specific role to play in frontal-disconnection syndromes, psychosis, and social cognitive profile within schizophrenia, though further research requires more sensitive, specific, and detailed consideration of social cognition outcomes.
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Affiliation(s)
- Tom Burke
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Laurena Holleran
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - David Mothersill
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Psychology Department, School of Business, National College of, Ireland
| | - James Lyons
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Nathan O'Rourke
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Christina Gleeson
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - Dara M Cannon
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Declan P McKernan
- Pharmacology & Therapeutics and Galway Neuroscience Centre, National University of Ireland Galway, H91 W5P7 Galway, Ireland
| | - Derek W Morris
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland
| | - John P Kelly
- Pharmacology & Therapeutics and Galway Neuroscience Centre, National University of Ireland Galway, H91 W5P7 Galway, Ireland
| | - Brian Hallahan
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Colm McDonald
- Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland; Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Gary Donohoe
- School of Psychology, University of Galway, Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Galway, Ireland.
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Lemmers-Jansen I, Velthorst E, Fett AK. The social cognitive and neural mechanisms that underlie social functioning in individuals with schizophrenia - a review. Transl Psychiatry 2023; 13:327. [PMID: 37865631 PMCID: PMC10590451 DOI: 10.1038/s41398-023-02593-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 10/23/2023] Open
Abstract
In many individuals with a diagnosis of schizophrenia social functioning is impaired across the lifespan. Social cognition has emerged as one of the possible factors that may contribute to these challenges. Neuroimaging research can give further insights into the underlying mechanisms of social (cognitive) difficulties. This review summarises the evidence on the associations between social cognition in the domains of theory of mind and emotion perception and processing, and individuals' social functioning and social skills, as well as associated neural mechanisms. Eighteen behavioural studies were conducted since the last major review and meta-analysis in the field (inclusion between 7/2017 and 1/2022). No major review has investigated the link between the neural mechanisms of social cognition and their association with social functioning in schizophrenia. Fourteen relevant studies were included (from 1/2000 to 1/2022). The findings of the behavioural studies showed that associations with social outcomes were slightly stronger for theory of mind than for emotion perception and processing. Moreover, performance in both social cognitive domains was more strongly associated with performance on social skill measures than questionnaire-based assessment of social functioning in the community. Studies on the underlying neural substrate of these associations presented mixed findings. In general, higher activation in various regions of the social brain was associated with better social functioning. The available evidence suggests some shared regions that might underlie the social cognition-social outcome link between different domains. However, due to the heterogeneity in approaches and findings, the current knowledge base will need to be expanded before firm conclusions can be drawn.
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Affiliation(s)
- Imke Lemmers-Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute for Brain and Behaviour (iBBA) Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eva Velthorst
- GGZ Noord-Holland-Noord, Heerhugowaard, The Netherlands
| | - Anne-Kathrin Fett
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Department of Psychology, City, University of London, London, UK.
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8
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Fares-Otero NE, Alameda L, Pfaltz MC, Martinez-Aran A, Schäfer I, Vieta E. Examining associations, moderators and mediators between childhood maltreatment, social functioning, and social cognition in psychotic disorders: a systematic review and meta-analysis. Psychol Med 2023; 53:5909-5932. [PMID: 37458216 PMCID: PMC10520610 DOI: 10.1017/s0033291723001678] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 07/24/2023]
Abstract
Childhood maltreatment (CM) has been related to social functioning and social cognition impairment in people with psychotic disorders (PD); however, evidence across different CM subtypes and social domains remains less clear. We conducted a systematic review and meta-analysis to quantify associations between CM, overall and its different subtypes (physical/emotional/sexual abuse, physical/emotional neglect), and domains of social functioning and social cognition in adults with PD. We also examined moderators and mediators of these associations. A PRISMA-compliant systematic search was performed on 24 November 2022 (PROSPERO CRD42020175244). Fifty-three studies (N = 13 635 individuals with PD) were included in qualitative synthesis, of which 51 studies (N = 13 260) with 125 effects sizes were pooled in meta-analyses. We found that CM was negatively associated with global social functioning and interpersonal relations, and positively associated with aggressive behaviour, but unrelated to independent living or occupational functioning. There was no meta-analytic evidence of associations between CM and social cognition. Meta-regression analyses did not identify any consistent moderation pattern. Narrative synthesis identified sex and timing of CM as potential moderators, and depressive symptoms and maladaptive personality traits as possible mediators between CM and social outcomes. Associations were of small magnitude and limited number of studies assessing CM subtypes and social cognition are available. Nevertheless, adults with PD are at risk of social functioning problems after CM exposure, an effect observed across multiple CM subtypes, social domains, diagnoses and illness stages. Maltreated adults with PD may thus benefit from trauma-related and psychosocial interventions targeting social relationships and functioning.
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Affiliation(s)
- Natalia E. Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Luis Alameda
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, University Hospital (CHUV), Lausanne, Switzerland
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Psychiatry, CIBERSAM, Institute of Biomedicine of Sevilla (IBIS), University Hospital Virgen del Rocio, University of Seville, Seville, Spain
| | - Monique C. Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
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9
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Huang YL, Chen TT, Dziobek I, Tseng HH. Mentalizing in a movie for the assessment of social cognition (MASC): the validation in a taiwanese sample. BMC Psychol 2023; 11:287. [PMID: 37740240 PMCID: PMC10517527 DOI: 10.1186/s40359-023-01321-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND The present study evaluated the psychometrics properties of a sensitive video-based test used in the evaluation of mentalizing skills, that is, the Movie for the Assessment of Social Cognition-Taiwanese version (MASC-TW). METHODS We recruited two independent samples of nonclinical participants (N = 167) and adult patients with schizophrenia (N = 41). The MASC-TW and two other social cognition measures, namely the Chinese version of Theory of Mind task (ToM) and the Taiwanese version of the Diagnostic Analysis of Nonverbal Accuracy-2 (DANAV-TW-2), and an executive function measure of the Wisconsin Card Sorting Test (WCST), were administered to both groups. RESULTS The MASC proved to be a reliable measure of mentalizing capacity, high Cronbach's α value of 0.87. The intraclass correlation coefficient for the MASC-TW total correct scores was 0.85 across three waves of data collection. Across the entire sample, the scores on the MASC-TW were significantly correlated with verbal and nonverbal scores for the ToM task and recognition of facial and prosodic emotion on the DANAV-TW-2. Both executive function and emotion recognition emerged as noteworthy predictors of mentalizing, indicating that these two variables might play crucial roles in the development of mentalizing capacities. Finally, a receiver operating characteristic analysis revealed that in patients with schizophrenia, the MASC was the most accurate discriminator of diagnostic groups, highlighting the validity of the MASC. CONCLUSIONS Overall, the MASC-TW is an ecologically valid and useful tool for assessing mentalizing abilities in a Taiwanese population.
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Affiliation(s)
- Yu-Lien Huang
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan.
| | - Tzu-Ting Chen
- Department of Psychology, Fo Guang University, Yilan, Taiwan
| | - Isabel Dziobek
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Huai-Hsuan Tseng
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
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10
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Bershad AK, de Wit H. Social Psychopharmacology: Novel Approaches to Treat Deficits in Social Motivation in Schizophrenia. Schizophr Bull 2023; 49:1161-1173. [PMID: 37358825 PMCID: PMC10483474 DOI: 10.1093/schbul/sbad094] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
BACKGROUND AND HYPOTHESIS Diminished social motivation is a negative symptom of schizophrenia and leads to severe functional consequences for many patients suffering from the illness. However, there are no effective medications available to treat this symptom. Despite the lack of approved treatments for patients, there is a growing body of literature on the effects of several classes of drugs on social motivation in healthy volunteers that may be relevant to patients. The aim of this review is to synthesize these results in an effort to identify novel directions for the development of medications to treat reduced social motivation in schizophrenia. STUDY DESIGN In this article, we review pharmacologic challenge studies addressing the acute effects of psychoactive drugs on social motivation in healthy volunteers and consider how these findings may be applied to deficits in social motivation in schizophrenia. We include studies testing amphetamines and 3,4-methylenedioxymethamphetamine (MDMA), opioids, cannabis, serotonergic psychedelics, antidepressants, benzodiazepines, and neuropeptides. STUDY RESULTS We report that amphetamines, MDMA, and some opioid medications enhance social motivation in healthy adults and may represent promising avenues of investigation in schizophrenia. CONCLUSIONS Given the acute effects of these drugs on behavioral and performance-based measures of social motivation in healthy volunteers, they may be particularly beneficial as an adjunct to psychosocial training programs in patient populations. It remains to be determined how these medications affect patients with deficits in social motivation, and in which contexts they may be most effectively administered.
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Affiliation(s)
- Anya K Bershad
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Los Angeles, CAUSA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, ILUSA
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11
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Tian Y, Zhou H, Wang D, Zhang X. Association of Alexithymia With Positive Symptoms in Chinese Chronic Schizophrenia Patients With and Without Obesity. Psychiatry Investig 2023; 20:689-695. [PMID: 37409369 PMCID: PMC10460978 DOI: 10.30773/pi.2023.0004] [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: 01/05/2023] [Revised: 03/19/2023] [Accepted: 04/04/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE A growing body of research suggests the presence of alexithymia (a form of social cognitive impairment) in patients with schizophrenia (SCZ), which may be related to their psychopathological symptoms. Patients with SCZ exhibit high rates of obesity. Interestingly, studies of the general population have found that alexithymia acts a pivotal role in the development and maintenance of obesity. However, little is known regarding the relationship between obesity, alexithymia, and clinical symptoms in SCZ patients. The study was aim to explore the relationship between obesity, alexithymia, and clinical symptoms in SCZ patients. METHODS Demographic and clinical data were collected from 507 patients with chronic SCZ. Their symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS), and alexithymia was assessed with the Toronto Alexithymia Scale (TAS). RESULTS Compare with nonobese SCZ patients, obese SCZ patients scored higher on PANSS positive symptoms, TAS total score, difficulty identifying feelings, and difficulty describing feelings (all p<0.05). Correlation analysis revealed a significant association between difficulty identifying feelings and positive symptoms in SCZ patients. Further correlation analysis showed that this association was only present in obese SCZ patients (p<0.05). CONCLUSION Obesity may moderate the association between alexithymia and positive symptoms in chronic SCZ patients.
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Affiliation(s)
- Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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12
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Ponce-Correa F, Caqueo-Urízar A, Berrios R, Escobar-Soler C. Defining recovery in schizophrenia: A review of outcome studies. Psychiatry Res 2023; 322:115134. [PMID: 36871410 DOI: 10.1016/j.psychres.2023.115134] [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: 07/22/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/07/2023]
Abstract
Schizophrenia is a chronic disorder with a heterogenous course and different ways in which recovery is measured or perceived. Recovery in schizophrenia is a complex process that it can be defined either from a clinical perspective focused on sustained symptom and functional remission, or from a patient-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. Until now, studies analysed these domains separately, without examining their mutual relations and changes over time. Therefore, this meta-analysis aimed to examine the relationship of global measures of subjective recovery with each of the components of clinical recovery such as symptom severity and functioning, in patients with schizophrenia spectrum disorders. The results showed that the association between different indicators of personal recovery and remission are weak and inverse (dIG+ = -0.18, z = -2.71, p < 0.01), however, this finding is not substantial according to the sensitivity indicators. With respect to functionality and personal recovery, there was a moderate relationship (dIG+ = 0.26, z = 7.894, p < 0.01) with adequate sensitivity indices. In addition, a low consensus exists between subjective measures that are more related to the patient's perspective and clinical measures based on experts and clinician's viewpoint.
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Affiliation(s)
- Felipe Ponce-Correa
- Programa Doctorado en Psicología, Escuela de Psicología y Filosofía, Facultad de Ciencias Sociales y Jurídicas, Universidad de Tarapacá, Avenida 18 de Septiembre N 2222, Casilla 7-D, Arica, Chile
| | | | - Raúl Berrios
- Departamento de administración, Facultad de administración y economía, Universidad de Santiago de Chile, Chile
| | - Carolang Escobar-Soler
- Programa Doctorado en Psicología, Escuela de Psicología y Filosofía, Facultad de Ciencias Sociales y Jurídicas, Universidad de Tarapacá, Avenida 18 de Septiembre N 2222, Casilla 7-D, Arica, Chile
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13
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Zhang W, Du JL, Fang XY, Ni LY, Zhu YY, Yan W, Lu SP, Zhang RR, Xie SP. Shared and distinct structural brain alterations and cognitive features in drug-naïve schizophrenia and bipolar disorder. Asian J Psychiatr 2023; 82:103513. [PMID: 36827938 DOI: 10.1016/j.ajp.2023.103513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/21/2023] [Accepted: 02/08/2023] [Indexed: 02/13/2023]
Abstract
Our study aimed to examine the shared and distinct structural brain alterations, including cortical thickness(CT) and local gyrification index(LGI), and cognitive impairments between the early course stage of drug-naïve schizophrenia(SZ) and bipolar disorder(BD) patients when compared to healthy controls(HCs), and to further explore the correlation between altered brain structure and cognitive impairments. We included 72 SZ patients, 35 BD patients and 43 HCs. The cognitive function was assessed using the MATRICS Consensus Cognitive Battery. Cerebral cortex analyses were performed with FreeSurfer. Furthermore, any structural aberrations related to cognition impairments were examined. Cognitive impairments existed in SZ and BD patients and were much more severe and widespread in SZ patients, compared to HCs. There were no significant differences in LGI among three groups. Compared to HCs, SZ had thicker cortex in left pars triangularis, and BD showed thinner CT in left postcentral gyrus. In addition, BD showed thinner cortex in left pars triangularis, left pars opercularis, left insula and right fusiform gyrus compared to SZ. Moreover, our results indicated that CT in many brain areas were significantly correlated with cognitive function in HCs, but only CT of left pars triangularis was correlated with impaired social cognition found in SZ. The findings suggest that changes of CT in the left pars triangularis and left postcentral gyrus may be potential pathophysiological mechanisms of the cognition impairments in SZ and BD, respectively, and the divergent CT of partly brain areas in BD vs. SZ may help distinguish them in early phases.
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Affiliation(s)
- Wei Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Jing-Lun Du
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Xing-Yu Fang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Long-Yan Ni
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Yuan-Yuan Zhu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Wei Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Shui-Ping Lu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Rong-Rong Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
| | - Shi-Ping Xie
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
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14
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Li S, Chan SY, Higgins A, Hall MH. Sensory gating, neurocognition, social cognition and real-life functioning: a 2-year follow-up of early psychosis. Psychol Med 2023; 53:2540-2552. [PMID: 37310299 DOI: 10.1017/s0033291721004463] [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: 11/07/2022]
Abstract
BACKGROUND Diminished sensory gating (SG) is a robust finding in psychotic disorders, but studies of early psychosis (EP) are rare. It is unknown whether SG deficit leads to poor neurocognitive, social, and/or real-world functioning. This study aimed to explore the longitudinal relationships between SG and these variables. METHODS Seventy-nine EP patients and 88 healthy controls (HCs) were recruited at baseline. Thirty-three and 20 EP patients completed 12-month and 24-month follow-up, respectively. SG was measured using the auditory dual-click (S1 & S2) paradigm and quantified as P50 ratio (S2/S1) and difference (S1-S2). Cognition, real-life functioning, and symptoms were assessed using the MATRICS Consensus Cognitive Battery, Global Functioning: Social (GFS) and Role (GFR), Multnomah Community Ability Scale (MCAS), Awareness of Social Inference Test (TASIT), and the Positive and Negative Syndrome Scale (PANSS). Analysis of variance (ANOVA), chi-square, mixed model, correlation and regression analyses were used for group comparisons and relationships among variables controlling for potential confounding variables. RESULTS In EP patients, P50 ratio (p < 0.05) and difference (p < 0.001) at 24-month showed significant differences compared with that at baseline. At baseline, P50 indices (ratio, S1-S2 difference, S1) were independently associated with GFR in HCs (all p < 0.05); in EP patients, S2 amplitude was independently associated with GFS (p = 0.037). At 12-month and 24-month, P50 indices (ratio, S1, S2) was independently associated with MCAS (all p < 0.05). S1-S2 difference was a trending predictor of future function (GFS or MCAS). CONCLUSIONS SG showed progressive reduction in EP patients. P50 indices were related to real-life functioning.
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Affiliation(s)
- Shen Li
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
- Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
- Department of Psychiatry, College of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Shi Yu Chan
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
- Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
- Translational Neurosciences, Singapore Institute for Clinical Sciences 117609, Singapore
| | - Amy Higgins
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
- Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
| | - Mei-Hua Hall
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
- Psychosis Neurobiology Laboratory, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
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15
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Pishdadian S, Martins F, Milanovic M, Doell FK, Kidd SA, Grossman MJ. Emotion regulation relates to clinical characteristics and quality of life but not daily functioning in psychosis spectrum outpatients. J Psychiatr Res 2023; 161:289-297. [PMID: 36947960 DOI: 10.1016/j.jpsychires.2023.03.022] [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: 12/15/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Abstract
Difficulties in emotion regulation (ER) can negatively impact the clinical course and outcomes of a range of psychiatric conditions, including psychosis spectrum disorders. Individuals with psychosis may exhibit poorer ER abilities, which have been associated with increased severity and distress of psychotic symptoms. A paucity of research has investigated the clinical correlates of ER in psychosis and the influence of these difficulties on indices of recovery, such as daily functioning and quality of life. In the present study, 59 outpatients presenting for Cognitive Behaviour Therapy for psychosis (CBTp) in a large psychiatric hospital completed an intake assessment of clinician-rated and self-reported measures prior to treatment. Poor ER abilities were positively correlated with positive symptoms (overall and delusions), social anxiety, depression, and self-reflectiveness and negatively correlated with quality of life and personal recovery. Multiple regression analyses showed ER was a significant predictor of quality of life but not daily functioning, which was predicted most by cognition and psychiatric symptoms. Overall, findings support the clinical utility of assessing emotion dysregulation in psychosis and provide a more nuanced understanding of how such challenges differentially influence recovery in psychosis, which can further inform treatment planning and intervention.
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Affiliation(s)
- Sara Pishdadian
- Complex Care and Recovery Program, 1051 Queen Street West, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H3, Canada; Department of Psychology, 4700 Keele Street, York University, Toronto, ON, M3J 1P3, Canada
| | - Felicia Martins
- Complex Care and Recovery Program, 1051 Queen Street West, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H3, Canada; Department of Psychology, 1265, Military Trail, University of Toronto Scarborough, Toronto, ON, M1C 1A4, Canada
| | - Melissa Milanovic
- Complex Care and Recovery Program, 1051 Queen Street West, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H3, Canada
| | - Faye K Doell
- Complex Care and Recovery Program, 1051 Queen Street West, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H3, Canada
| | - Sean A Kidd
- Complex Care and Recovery Program, 1051 Queen Street West, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H3, Canada
| | - Michael J Grossman
- Complex Care and Recovery Program, 1051 Queen Street West, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H3, Canada.
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Rocca P, Rucci P, Montemagni C, Rossi A, Bertolino A, Aguglia E, Altamura CA, Amore M, Andriola I, Bellomo A, Brasso C, Carpiniello B, Del Favero E, Dell'Osso L, Di Fabio F, Fabrazzo M, Fagiolini A, Giordano GM, Marchesi C, Martinotti G, Monteleone P, Pompili M, Roncone R, Rossi R, Siracusano A, Tenconi E, Vita A, Zeppegno P, Galderisi S, Maj M. Does social cognition change? Evidence after 4 years from the Italian Network for Research on Psychoses. Eur Psychiatry 2023; 66:e10. [PMID: 36628577 PMCID: PMC9970151 DOI: 10.1192/j.eurpsy.2022.2356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Deficits in social cognition (SC) are significantly related to community functioning in schizophrenia (SZ). Few studies investigated longitudinal changes in SC and its impact on recovery. In the present study, we aimed: (a) to estimate the magnitude and clinical significance of SC change in outpatients with stable SZ who were assessed at baseline and after 4 years, (b) to identify predictors of reliable and clinically significant change (RCSC), and (c) to determine whether changes in SC over 4 years predicted patient recovery at follow-up. METHODS The reliable change index was used to estimate the proportion of true change in SC, not attributable to measurement error. Stepwise multiple logistic regression models were used to identify the predictors of RCSC in a SC domain (The Awareness of Social Inference Test [TASIT]) and the effect of change in TASIT on recovery at follow-up. RESULTS In 548 participants, statistically significant improvements were found for the simple and paradoxical sarcasm of TASIT scale, and for the total score of section 2. The reliable change index was 9.8. A cut-off of 45 identified patients showing clinically significant change. Reliable change was achieved by 12.6% and RCSC by 8% of participants. Lower baseline TASIT sect. 2 score predicted reliable improvement on TASIT sect. 2. Improvement in TASIT sect. 2 scores predicted functional recovery, with a 10-point change predicting 40% increase in the probability of recovery. CONCLUSIONS The RCSC index provides a conservative way to assess the improvement in the ability to grasp sarcasm in SZ, and is associated with recovery.
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Affiliation(s)
- Paola Rocca
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Cristiana Montemagni
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessandro Bertolino
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | | | - Mario Amore
- Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Ileana Andriola
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Antonello Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Claudio Brasso
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Elisa Del Favero
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - Liliana Dell'Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Fabio Di Fabio
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Michele Fabrazzo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Fagiolini
- Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
| | | | - Carlo Marchesi
- Psychiatry Unit, Department of Neuroscience, University of Parma, Parma, Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, G. D'Annunzio University, Chieti, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Rita Roncone
- Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alberto Siracusano
- Psychiatry and Clinical Psychology Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Elena Tenconi
- Psychiatric Clinic, Department of Neurosciences, University of Padua, Padua, Italy
| | - Antonio Vita
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy.,Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Patrizia Zeppegno
- Psychiatric Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Lemvigh CK, Glenthøj BY, Fagerlund B. A nation-wide twin study of social cognition in schizophrenia spectrum disorders. SCHIZOPHRENIA 2022; 8:12. [PMID: 35236855 PMCID: PMC8891357 DOI: 10.1038/s41537-022-00223-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/16/2021] [Indexed: 11/18/2022]
Abstract
We examined social cognition in 32 monozygotic (MZ) and 21 dizygotic (DZ) twin pairs concordant or discordant for a schizophrenia spectrum diagnosis and healthy control (HC) twin pairs (29 MZ/20 DZ). All participants were recruited through the Danish registers. Patients showed several deficits in the ability to detect sarcasm. Impairments were also observed in the unaffected MZ co-twins, indicating that social cognitive deficits could be a genetic vulnerability indicator of the disease. Worse social cognition was associated with lower intelligence and higher levels of psychopathology in patients.
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18
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Chao PY, Hsieh WL, Yeh ST, Hsieh CJ, Liu CY, Liu WI. Factors associated with personal recovery among psychiatric nursing home residents. J Psychiatr Ment Health Nurs 2022; 29:852-860. [PMID: 34957650 DOI: 10.1111/jpm.12814] [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: 05/31/2021] [Revised: 11/29/2021] [Accepted: 12/17/2021] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Poor recovery will cause harm to the quality of life and well-being of residents and that the scope of influence includes the self, family and society. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The factors associated with personal recovery are empowerment, social support and global functioning. This pioneer study contributes new evidence that personal recovery is mainly predicted by empowerment, social support and global function, with empowerment exhibiting the highest predictive value. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support. Mental health professionals should shift to empowerment-oriented care to improve individuals' personal recovery, such as offering more opportunities to achieve autonomy, encouraging individuals' involvement in decision-making and promoting individuals' motivation for achieving their goals. ABSTRACT: Introduction Individuals diagnosed with mental illness have a need for recovery. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. Aim The study aimed to identify the factors associated with personal recovery among psychiatric nursing home residents. Methods This was a cross-sectional study with convenience sampling. Participants were recruited from a psychiatric nursing home in Northern Taiwan between April and June 2018. Data were collected through self-reported, structured questionnaires with verified reliability and validity. Descriptive and hierarchical regression analyses were performed. The present study followed the STROBE guidelines. Results The study included 158 participants. The factors associated with recovery according to bivariate associations were religious belief, psychotic symptoms, global function, social support and empowerment. In the hierarchical regression, empowerment, social support and global function were the main predictive factors of recovery, with the explained variation reaching 40.8%. Empowerment exhibited the highest predictive value for the recovery. Implications for clinical practice Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support.
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Affiliation(s)
- Pei-Yi Chao
- Department of nursing, Bali Psychiatric Center, New Taipei City, Taiwan
| | - Wen Ling Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Shin Ting Yeh
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Chia Jung Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Wen-I Liu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
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Schoeneman Patel SE, Haut KM, Guty E, Dodell-Feder D, Saxena A, Nahum M, Hooker CI. Social cognition training improves recognition of distinct facial emotions and decreases misattribution errors in healthy individuals. Front Psychiatry 2022; 13:1026418. [PMID: 36424990 PMCID: PMC9680726 DOI: 10.3389/fpsyt.2022.1026418] [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: 08/23/2022] [Accepted: 10/13/2022] [Indexed: 11/09/2022] Open
Abstract
Facial emotion recognition is a key component of social cognition. Impaired facial emotion recognition is tied to poor psychological wellbeing and deficient social functioning. While previous research has demonstrated the potential for social cognition training to improve overall facial emotion recognition, questions remain regarding what aspects of emotion recognition improve. We report results from a randomized controlled trial that evaluates whether computerized social cognition training can improve recognition of distinct facial emotions in healthy participants. This investigation was designed to better understand the therapeutic potential of social cognition training for individuals with neuropsychiatric disorders. Fifty-five healthy adult participants were randomly assigned to an internet-based intervention during which they either completed social cognition training (SCT) or played control computer games (CON) for 10.5 h over 2-3 weeks. Facial emotion recognition was measured with the Penn ER-40, which was conducted before and after training. The following variables were collected and analyzed: facial emotion recognition accuracy for each emotion (i.e., anger, fear, happy, neutral (no emotional expression), and sad), reaction times for each emotion, and response error types (i.e., frequency of an emotion being chosen incorrectly, frequency of an emotion being missed, and frequency of an emotion being confused for another particular emotion). ANOVAs and t-tests were used to elucidate intervention effects both within and between groups. Results showed that the SCT group improved their accuracy for angry and neutral faces. They also improved their reaction times for neutral, fearful, and sad faces. Compared to the CON group, the SCT group had significantly faster reaction times to neutral faces after training. Lastly, the SCT group decreased their tendency to confuse angry faces for no emotional expression and to confuse no emotional expression for sad faces. In contrast, the CON group did not significantly improve their accuracy or reaction times on any emotional expression, and they did not improve their response error types. We conclude that social cognition training can improve recognition of distinct emotions in healthy participants and decrease response error patterns, suggesting it has the potential to improve impaired emotion recognition and social functioning in individuals with facial emotion recognition deficits.
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Affiliation(s)
- Samantha Evy Schoeneman Patel
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kristen M. Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Erin Guty
- Department of Psychology, Pennsylvania State University, State College, PA, United States
- The Charleston Consortium Psychology Internship, Ralph H. Johnson Veterans Affairs Medical Center, Medical University of South Carolina, Charleston, SC, United States
| | - David Dodell-Feder
- Department of Psychology, University of Rochester, Rochester, NY, United States
- Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, United States
| | - Abhishek Saxena
- Department of Psychology, University of Rochester, Rochester, NY, United States
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Christine I. Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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20
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Scheffler F, Phahladira L, Hendrikse CB, du Plessis S, Asmal L, Luckhoff HK, Smit AM, Olivier MR, Emsley R. The associations of cannabis and methamphetamine use with cognitive performance over the first 2 years of treatment in schizophrenia spectrum disorders. Early Interv Psychiatry 2022; 16:1230-1239. [PMID: 35108745 DOI: 10.1111/eip.13272] [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: 02/23/2021] [Revised: 08/19/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Abstract
AIM Cognitive deficits are a core feature of schizophrenia, and comorbid substance use may be a contributory factor. Methamphetamine use has been associated with cognitive impairment in schizophrenia, while associations with cannabis use are less clear-cut. This study aimed to investigate the associations of cannabis and methamphetamine use with cognitive performance in first-episode schizophrenia spectrum disorders over the first 2 years of treatment. METHODS This was a longitudinal cohort study in 81 patients treated with flupenthixol decanoate according to a standardized protocol over 24 months. Cognitive performance was assessed with the Measurement and Treatment Research to Improve Cognition in Schizophrenia Cognitive Consensus Battery at four time points, and urine testing for cannabis and methamphetamine was conducted at six time points. We used linear mixed-effect models for repeated measures to assess visit-wise changes in composite cognitive scores in patients (n = 91) compared to matched controls without psychiatric or medical disorders (n = 100). Linear regression models were constructed to examine pre-treatment and end-point effects in patients. RESULTS Compared to controls, patients exhibited greater cognitive impairments at baseline, which improved with treatment, but remained significantly lower throughout. The number of positive methamphetamine, but not cannabis, tests predicted less cognitive improvement in patients. CONCLUSIONS Our findings suggest a negative association between methamphetamine and cognition, but not cannabis.
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Affiliation(s)
- Freda Scheffler
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | | | - Stefan du Plessis
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Laila Asmal
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Hilmar K Luckhoff
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - M Riaan Olivier
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Robin Emsley
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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21
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Pishdadian S, Parlar ME, Heinrichs RW, McDermid Vaz S. An ecologically sensitive measure of executive cognition (the Breakfast Task) improves prediction of functional outcome in schizophrenia. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:907-914. [PMID: 32976722 DOI: 10.1080/23279095.2020.1821029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Previous work has found that the Breakfast Task (BT), a computerized, ecologically informed executive ability measure, is sensitive to group differences in aging, acquired brain injury, and Parkinson's disease. We investigated whether this measure improves the prediction of functional status over and above standard measures of general intellectual ability, relationship perception, life skills, and symptom severity in individuals with schizophrenia. Regression analyses were conducted to evaluate the joint and incremental validity of the BT in predicting functional disability scores on the World Health Organization Disability Assessment Scale (WHODAS 2.0). Analyses with combined patient (n = 25) and control (n = 32) participants showed that participant status (patients versus control) was the only significant predictor of functional outcome. However, in the patient data, the proportion of variance accounted for improved significantly (model R2 of 4% vs. 25%) when BT scores were added to a model containing clinical (Brief Psychiatric Rating Scale), social (Relationships Across Domains), intellectual (Wechsler Abbreviated Scale of Intelligence), and life skills (Canadian Objective Assessment of Life Skills) measures. Results suggest that the BT, a tool that captures complex executive functioning, improves the prediction of disability in patients with schizophrenia and has potential assessment applications.
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Affiliation(s)
| | | | | | - Stephanie McDermid Vaz
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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22
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Jarsch M, Semenkova A, Monsch AU, Kressig RW, Sollberger M. Eine Lücke, die es zu schließen gilt: Die Untersuchung sozial-kognitiver Fähigkeiten an deutschsprachigen Memory-Kliniken. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2022. [DOI: 10.1024/1016-264x/a000358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung: Die Untersuchung sozial-kognitiver Fähigkeiten kann zur Diagnostik kognitiver Störungen beitragen. In diesem Zusammenhang stellt sich die Frage, inwieweit sozial-kognitive Fähigkeiten in deutschsprachigen Memory-Kliniken (MK) untersucht werden. Wir führten dazu eine Befragung in 87 deutschsprachigen MK in Deutschland, österreich und der Schweiz durch. Es zeigte sich, dass die Untersuchung sozial-kognitiver Fähigkeiten mehrheitlich befürwortet wird, jedoch nur selten erfolgt. Die Mehrheit der MK könnte sich jedoch vorstellen, in Zukunft sozial-kognitive Diagnostik durchzuführen, vorausgesetzt, dass hierfür adäquate psychometrische Testverfahren vorliegen. Die Forderung der MK nach psychometrischen sozial-kognitiven Tests gewinnt an Bedeutung angesichts der Tatsache, dass die kürzlich publizierten ICD-11-Kriterien (International Statistical Classification of Diseases and Related Health Problems) die Untersuchung sozial-kognitiver Fähigkeiten bei der Abklärung einer kognitiven Störung empfehlen.
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Affiliation(s)
- Marianne Jarsch
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
- Fakultät für Psychologie, Universität Basel, Schweiz
| | - Anna Semenkova
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
- Fakultät für Psychologie, Universität Basel, Schweiz
| | - Andreas U. Monsch
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
- Fakultät für Psychologie, Universität Basel, Schweiz
| | - Reto W. Kressig
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
| | - Marc Sollberger
- Memory Clinic, Universitäre Altersmedizin FELIX PLATTER und Universität Basel, Schweiz
- Neurologische Klinik, Universitätsspital und Universität Basel, Schweiz
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23
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Hazani R, Lavidor M, Weller A. Treatments for Social Interaction Impairment in Animal Models of Schizophrenia: A Critical Review and Meta-analysis. Schizophr Bull 2022; 48:1179-1193. [PMID: 35925025 PMCID: PMC9673263 DOI: 10.1093/schbul/sbac093] [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] [Indexed: 12/14/2022]
Abstract
BACKGROUND While pharmacological treatments for positive symptoms of schizophrenia are widely used, their beneficial effect on negative symptoms, particularly social impairment, is insufficiently studied. Therefore, there is an increasing interest in preclinical research of potentially beneficial treatments, with mixed results. The current review aims to evaluate the efficacy of available treatments for social deficits in different animal models of schizophrenia. STUDY DESIGN A systematic literature search generated 145 outcomes for the measures "total time" and "number" of social interactions. Standardized mean differences (SMD) and 95% confidence interval (CI) were calculated, and heterogeneity was tested using Q statistics in a random-effect meta-analytic model. Given the vast heterogeneity in effect sizes, the animal model, treatment group, and sample size were all examined as potential moderators. STUDY RESULTS The results showed that in almost all models, treatment significantly improved social deficit (total time: SMD = 1.24; number: SMD = 1.1). The moderator analyses discovered significant subgroup differences across models and treatment subgroups. Perinatal and adult pharmacological models showed the most substantial influence of treatments on social deficits, reflecting relative pharmacological validity. Furthermore, atypical antipsychotic drugs had the highest SMD within each model subgroup. CONCLUSIONS Our findings indicate that the improvement in social interaction behaviors is dependent on the animal model and treatment family used. Implications for the preclinical and clinical fields are discussed.
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Affiliation(s)
- Reut Hazani
- To whom correspondence should be addressed; Department of Psychology, Bar-Ilan University, Ramat-Gan 5290002, Israel; tel: 972-3-531-8548, fax: 972-3-738-4173, e-mail:
| | - Michal Lavidor
- Psychology Department and Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Aron Weller
- Psychology Department and Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
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24
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Raucher-Chéné D, Lavigne KM, Lepage M. Episodic Memory and Schizophrenia: From Characterization of Relational Memory Impairments to Neuroimaging Biomarkers. Curr Top Behav Neurosci 2022; 63:115-136. [PMID: 35902545 DOI: 10.1007/7854_2022_379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Episodic memory research in schizophrenia has a long history already which has clearly established significant impairments and strong associations with brain measures and functional outcome. The purpose of this chapter is not to make an exhaustive review of the recent literature but to highlight some relatively recent developments in the cognitive neuroscience field of episodic memory and schizophrenia. Hence, we present a contemporary view focusing specifically of relational memory which represents a form of episodic memory that refers to associations or binding among items or elements presented together. We describe the major tasks used and illustrate how their combination with brain imaging has: (1) favored the use of experimental memory tasks to isolate specific processes with specific neural correlates, (2) led to a distributed view of the neural correlates of memory impairments in schizophrenia where multiple regions are contributing, and (3) made possible the identification of fMRI biomarkers specific to episodic memory. We then briefly propose what we see as the next steps for memory research in schizophrenia so that the impact of this work can be maximized.
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Affiliation(s)
- Delphine Raucher-Chéné
- Cognition, Health, and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France.,Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
| | - Katie M Lavigne
- Douglas Research Centre, Verdun, QC, Canada.,Department of Psychiatry, McGill University, Montréal, QC, Canada.,McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Martin Lepage
- Douglas Research Centre, Verdun, QC, Canada. .,Department of Psychiatry, McGill University, Montréal, QC, Canada.
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25
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Raucher-Chéné D, Lavigne KM, Makowski C, Lepage M. Altered Surface Area Covariance in the Mentalizing Network in Schizophrenia: Insight Into Theory of Mind Processing. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:706-715. [PMID: 32919946 DOI: 10.1016/j.bpsc.2020.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Theory of mind (ToM), the cognitive capacity to attribute mental states to self and others, is robustly affected in schizophrenia. The neural substrates of ToM impairment have been largely studied with functional imaging, but little is known about structural abnormalities. We compared structural covariance (between-subjects correlations of brain regional measures) of magnetic resonance imaging-based cortical surface area between patients with schizophrenia and healthy control subjects and between schizophrenia subgroups based on the patients' ToM ability to examine ToM-specific effects on structural covariance in schizophrenia. METHODS T1-weighted structural images were acquired on a 3T magnetic resonance imaging scanner, and ToM was assessed with the Hinting Task for 104 patients with schizophrenia and 69 healthy control subjects. The sum of surface area was computed for 12 regions of interest selected and compared between groups to examine structural covariance within the often reported mentalizing network: rostral and caudal middle frontal gyrus, inferior parietal lobule, precuneus, and middle and superior temporal gyrus. High and low ToM groups were defined using a median split on the Hinting Task. RESULTS Cortical surface contraction was observed in the schizophrenia group, predominantly in temporoparietal regions. Patients with schizophrenia also exhibited significantly stronger covariance between the right rostral middle frontal gyrus and the right superior temporal gyrus than control subjects (r = 4.015; p < .001). Direct comparisons between high and low ToM subgroups revealed stronger contralateral frontotemporal covariances in the low ToM group. CONCLUSIONS Our results provide evidence for structural changes underlying ToM impairments in schizophrenia that need to be confirmed to develop new therapeutic perspectives.
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Affiliation(s)
- Delphine Raucher-Chéné
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Cognition, Health, and Society Laboratory EA 6291, University of Reims Champagne-Ardenne, Reims, France; Academic Department of Psychiatry, University Hospital of Reims, Etablissement Public de Santé Mentale de la Marne, Reims, France
| | - Katie M Lavigne
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Carolina Makowski
- Center for Multimodal Imaging and Genetics, University of California, San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California, San Diego School of Medicine, La Jolla, California
| | - Martin Lepage
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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26
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Morese R, Brasso C, Stanziano M, Parola A, Valentini MC, Bosco FM, Rocca P. Efforts for the Correct Comprehension of Deceitful and Ironic Communicative Intentions in Schizophrenia: A Functional Magnetic Resonance Imaging Study on the Role of the Left Middle Temporal Gyrus. Front Psychol 2022; 13:866160. [PMID: 35774960 PMCID: PMC9237627 DOI: 10.3389/fpsyg.2022.866160] [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: 01/30/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
Deficits in social cognition and more specifically in communication have an important impact on the real-life functioning of people with schizophrenia (SZ). In particular, patients have severe problems in communicative-pragmatics, for example, in correctly inferring the speaker's communicative intention in everyday conversational interactions. This limit is associated with morphological and functional alteration of the left middle temporal gyrus (L-MTG), a cerebral area involved in various communicative processes, in particular in the distinction of ironic communicative intention from sincere and deceitful ones. We performed an fMRI study on 20 patients with SZ and 20 matched healthy controls (HCs) while performing a pragmatic task testing the comprehension of sincere, deceitful, and ironic communicative intentions. We considered the L-MTG as the region of interest. SZ patients showed difficulties in the correct comprehension of all types of communicative intentions and, when correctly answering to the task, they exhibited a higher activation of the L-MTG, as compared to HC, under all experimental conditions. This greater involvement of the L-MTG in the group of patients could depend on different factors, such as the increasing inferential effort required in correctly understanding the speaker's communicative intentions, and the higher integrative semantic processes involved in sentence processing. Future studies with a larger sample size and functional connectivity analysis are needed to study deeper the specific role of the L-MTG in pragmatic processes in SZ, also in relation to other brain areas.
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Affiliation(s)
- R. Morese
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - C. Brasso
- Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy
- Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliera Universitaria “Città della Salute e della Scienza di Torino”, Turin, Italy
| | - M. Stanziano
- Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A. Parola
- Research Group on Inferential Processes in Social Interaction (GIPSI), Department of Psychology, University of Turin, Turin, Italy
| | - M. C. Valentini
- Struttura Complessa di Neuroradiologia, Dipartimento Diagnostica per Immagini e Radiologia interventistica, Azienda Ospedaliera Universitaria “Città della Salute e della Scienza di Torino”, Turin, Italy
| | - F. M. Bosco
- Research Group on Inferential Processes in Social Interaction (GIPSI), Department of Psychology, University of Turin, Turin, Italy
| | - P. Rocca
- Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy
- Struttura Complessa di Psichiatria Universitaria, Dipartimento di Neuroscienze e Salute Mentale, Azienda Ospedaliera Universitaria “Città della Salute e della Scienza di Torino”, Turin, Italy
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Mistarz N, Andersen K, Nielsen AS, Goudriaan AE, Michel TM, Skøt L, Anhøj SJ, Mellentin AI. Pharmacological compounds targeting emotional cognition in alcohol use disorder: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2022; 116:110535. [PMID: 35182608 DOI: 10.1016/j.pnpbp.2022.110535] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/28/2022] [Accepted: 02/10/2022] [Indexed: 01/15/2023]
Abstract
Non-emotional (e.g., executive functions) and emotional cognitive (e.g., facial emotion recognition) impairments are a well-known aspect of alcohol use disorder (AUD). These deficits may impede on treatment outcomes, increase the risk of relapse, and lead to socio-occupational disabilities. Previous systematic reviews have examined the effectiveness of cognitive enhancing pharmacological agents (CEPAs) targeting non-emotional, but not emotional, cognition in AUD. Our aim was to systematically review the effectiveness of CEPAs targeting emotional cognition in subclinical and clinical AUD populations. A qualitative synthesis of controlled trials was conducted, and the studies were assessed for risk of bias. Eight studies were eligible (15 ≤ ns ≤ 143), and they all had a moderate risk of bias. Modafinil and nalmefene were the most examined agents, with the findings suggesting a potential beneficial effect of the agents on implicit emotional domains (i.e., reward processing). Methodological shortcomings and heterogeneous findings across the studies do not allow inferences about the effectiveness of these compounds in AUD. Future studies should examine CEPAs targeting emotional cognition in more detail.
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Affiliation(s)
- Nicolaj Mistarz
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark.
| | - Kjeld Andersen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anette Søgaard Nielsen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anneke E Goudriaan
- Amsterdam University Medical Centre, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Addiction Research, Department of Research, Arkin, Amsterdam, the Netherlands
| | - Tanja Maria Michel
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Lotte Skøt
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Simon Jesper Anhøj
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Angelina Isabella Mellentin
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
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El Ray LA, Fathy H, Mattar Y, Badie Taher D. Emotion identification and mentalization in non-psychotic first-degree relatives of young adult patients with schizophrenia disorder. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00495-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abstract
Background
Social cognition is a multi-factorial construct defined as the ability to process social information for adaptive functioning. A large body of evidence acknowledges deficits in social cognition as important features in schizophrenia and that such impairment represent a trait deficit. The aim of this study is to assess two social cognitive functions (emotional identification and mentalization) in young non-psychotic first-degree relatives of patients with schizophrenia; and to compare their performance with that of young patients with schizophrenia as well as with young healthy controls. This a comparative, cross-sectional study including 30 young patients with age range 15–25 with schizophrenia disorder, Thirty young non-psychotic siblings of the patients and 30 young healthy subjects. The patients were subjected to PANNNS to assess severity of psychotic symptoms. Selected tests for assessment of basic cognitive abilities and social cognitive functions (using Reading Mind in the Eye Test, Emotion Identification Test and Emotional Intelligence scale) were used for the three groups.
Results
the relatives group show better performance than the patients groups and worse performance than the control group in subtests of basic cognition and social cognition functions using Reading Mind in the Eye Test and Ekman, in addition, there was negative correlation between severity of negative psychotic features and facial emotional identification as measured by Ekman.
Conclusion
Youth who are first-degree relatives of schizophrenia patients show social cognitive deficits, supporting the hypothesis of the role of social cognition impairment as endophenotypic trait in schizophrenia disorder.
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Cavieres Á, López-Silva P. Social Perception Deficit as a Factor of Vulnerability to Psychosis: A Brief Proposal for a Definition. Front Psychol 2022; 13:805795. [PMID: 35645890 PMCID: PMC9131014 DOI: 10.3389/fpsyg.2022.805795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
Disturbances in social cognition are a core feature of schizophrenia. While most research in the field has focused on emotion perception, social knowledge, theory of mind, and attribution styles, the domain of social perception has received little specific attention. In this paper, we suggest that this issue can be explained by the lack of a precise and unitary definition of the concept, this leads to the existence of different competing uses of the concept and their conflation with other domains of social cognition. Relying on resources coming from the ecological approach to psychology and the phenomenological tradition in psychiatry, we propose that the concept of Social Perception should be used to refer to low-level pre-reflective processes underlying the awareness of interpersonal interactions with and between others. Clinical data suggests that people with schizophrenia have problems perceiving social situations as opportunities for social engagement, so, in order to fulfil this explanatory need, we propose that the term should be used to capture this important-yet neglected-domain of social cognition. We conclude with the discussion of some future directions for research derived from our proposal.
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Affiliation(s)
- Álvaro Cavieres
- Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
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30
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Trapp W, Heid A, Röder S, Wimmer F, Hajak G. Cognitive Remediation in Psychiatric Disorders: State of the Evidence, Future Perspectives, and Some Bold Ideas. Brain Sci 2022; 12:brainsci12060683. [PMID: 35741569 PMCID: PMC9221116 DOI: 10.3390/brainsci12060683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 12/10/2022] Open
Abstract
Many people with psychiatric disorders experience impairments in cognition. These deficits have a significant impact on daily functioning and sometimes even on the further course of their disease. Cognitive remediation (CR) is used as an umbrella term for behavioral training interventions to ameliorate these deficits. In most but not all studies, CR has proven effective in improving cognition and enhancing everyday functional outcomes. In this paper, after quickly summarizing the empirical evidence, practical advice to optimize the effects of CR interventions is provided. We advocate that CR interventions should be as fun and motivating as possible, and therapists should at least consider using positively toned emotional stimuli instead of neutral stimuli. Participants should be screened for basic processing deficits, which should be trained before CR of higher-order cognitive domains. CR should stimulate metacognition and utilize natural settings to invoke social cognition. Wherever possible, CR tasks should link to tasks that participants face in their everyday life. Therapists should consider that participants might also benefit from positive side effects on symptomatology. Finally, the CR approach might even be utilized in settings where the treatment of cognitive impairments is not a primary target.
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Affiliation(s)
- Wolfgang Trapp
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (G.H.)
- Fachhochschule des Mittelstands, Department of Psychology, University of Applied Sciences, 96050 Bamberg, Germany
- Correspondence:
| | - Andreas Heid
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (G.H.)
| | - Susanne Röder
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (G.H.)
| | - Franziska Wimmer
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (G.H.)
| | - Göran Hajak
- Department of Psychiatry and Psychotherapy, Social Foundation Bamberg, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (G.H.)
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De Donatis D, Porcelli S, De Ronchi D, Merlo Pich E, Kas MJ, Bilderbeck A, Serretti A. Social withdrawal and neurocognitive correlates in schizophrenia. Int Clin Psychopharmacol 2022; 37:102-109. [PMID: 35102081 PMCID: PMC8969845 DOI: 10.1097/yic.0000000000000395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/16/2022] [Indexed: 11/26/2022]
Abstract
Poor neurocognitive performance has been associated with poor functional outcome in schizophrenia (SCZ) in past studies. Nonetheless, the likely association between neurocognition and social withdrawal has never been investigated. The aim of our study was to investigate in a large and heterogeneous sample of SCZ patient cross-sectional associations between neurocognitive domains and social withdrawal. The sample included 761 SCZ patients who completed the baseline visit in the CATIE study. Neurocognition was assessed by a comprehensive battery of tests resulting in five domain scores and a composite score. Social withdrawal was measured by a specific item of the Heinrichs-Carpenter Quality of Life Scale. Social withdrawal was associated with a lower score in the neurocognitive composite score and in 'Verbal memory,' 'Processing speed' and 'Working memory' scores. 'Verbal memory' score showed the strongest association with social withdrawal. Eight percent of the total variance of social withdrawal was explained by these three cognitive domains and additional clinical and sociodemographic factors (education years, PANSS positive symptoms score, and employment). Our results confirmed the wide heterogeneity and specificity of the correlation between neurocognitive domains and indicators of functional outcome in SCZ, underlining the role of certain neurocognitive abilities in social withdrawal.
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Affiliation(s)
- Domenico De Donatis
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Stefano Porcelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Diana De Ronchi
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | | | - Martien J. Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | | | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
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Pu C, Lei L, Yang F, Deng H, Sheng J, Liu Z, Hu S, Wang L, Wu B, Bo Q, Inoue Y, Yu X. Effectiveness and safety of blonanserin for improving social and cognitive functions in patients with first-episode schizophrenia: a study protocol for a prospective, multicentre, single-arm clinical trial. BMJ Open 2022; 12:e054079. [PMID: 35443947 PMCID: PMC9021809 DOI: 10.1136/bmjopen-2021-054079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Both the pharmacological characteristics of blonanserin and its related small sample size studies suggest that blonanserin could alleviate social and cognitive dysfunctions in patients with schizophrenia. However, no large sample size studies have been performed so far. This study aimed to investigate the effectiveness and safety of blonanserin in improving social and cognitive functions in patients with first-episode schizophrenia. METHODS AND ANALYSIS This is a prospective, multicentre, single-arm clinical trial. A total of 188 patients with first-episode schizophrenia will be enrolled and will undergo a 0-7 day washout period before blonanserin administration. Doses of blonanserin will first be set to 4 mg P.O. twice per day after meals and gradually increased to 8-16 mg/d P.O., depending on patient's age and symptoms, for 26 weeks. Maximum dose of blonanserin will not be exceeding 24 mg/day. The primary endpoint of the study is the changes of Personal and Social Performance (PSP) score in patients from baseline to week 26. Secondary endpoints include changes in MATRICS consensus cognitive battery (MCCB), Paced Auditory Serial Addition Test (PASAT), grooved pegboard test (GPT), Positive and Negative Syndrome Scale (PANSS) total score and PANSS 5-factor subscale scores. Other endpoints include changes of serum brain-derived neurotrophic factor (BDNF) at corresponding visits and MRI results. Moreover, incidence of adverse events, changes in endocrine and metabolic profiles, renal, hepatic and sexual functions and extrapyramidal symptoms will be strictly monitored and recorded. ETHICS AND DISSEMINATION The study was approved by the ethics committee of the leading site Peking University Sixth Hospital (No. 2018-18), and all included patients are requested to provide written informed consent before enrolment. The study will be conducted according to the principles of the Declaration of Helsinki and follow the principles for clinical research. TRIAL REGISTRATION NUMBER NCT03784222.
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Affiliation(s)
- Chengcheng Pu
- Department of Clinical Research, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lei Lei
- Medical Department, Sumitomo Pharma (Suzhou) Co, Shanghai, China
| | - Fude Yang
- Psychiatry Research Center, Beijing Huilongguan Hospital, Beijing, China
| | - Hong Deng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jianhua Sheng
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai, China
| | - Zhening Liu
- Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Shaohua Hu
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lina Wang
- Department of Psychiatry and Imaging-Genetics and Co-morbidity (PNGC-Lab), Tianjin Anding Hospital, Tianjin, China
| | - Bin Wu
- Department of Psychiatry, Xi'an Mental Health Center, Xi'an, China
| | - Qijing Bo
- Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yoshifumi Inoue
- Medical Affairs Department, Sumitomo Dainippon Pharma Co, Osaka, Japan
| | - Xin Yu
- Department of Clinical Research, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Kubota R, Okubo R, Ikezawa S, Matsui M, Adachi L, Wada A, Fujimaki C, Yamada Y, Saeki K, Sumiyoshi C, Kikuchi A, Omachi Y, Takeda K, Hashimoto R, Sumiyoshi T, Yoshimura N. Sex Differences in Social Cognition and Association of Social Cognition and Neurocognition in Early Course Schizophrenia. Front Psychol 2022; 13:867468. [PMID: 35496257 PMCID: PMC9051335 DOI: 10.3389/fpsyg.2022.867468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Both impairment and sex differences in social cognition and neurocognition have been documented in schizophrenia. However, whether sex differences exist in the association between social cognition and neurocognition are not known. We aimed to investigate the contribution of areas of neurocognition to theory of mind (ToM) and hostility bias, representing social cognition, according to sex in early course schizophrenia. Methods In this cross-sectional study, we assessed neurocognition using the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS) and assessed the ToM and hostility bias subdomains of social cognition using the Social Cognition Screening Questionnaire (SCSQ) in 131 participants (65 female, 66 male) diagnosed with schizophrenia within 5 years of onset. Sex differences were analyzed using t-tests. The associations of neurocognitive subdomains with ToM and hostility bias according to sex were analyzed using multiple regression analysis. Results were adjusted by age, estimated premorbid intelligence quotient, and symptomatology. Results No sex differences were found in ToM (p = 0.071) or hostility bias (p = 0.057). Higher verbal fluency was significantly associated with higher ToM in females (p < 0.01), whereas higher executive function was significantly associated with higher ToM in males (p < 0.05). Higher verbal fluency was significantly associated with lower hostility bias in females (p < 0.05), whereas neurocognition and hostility bias were not significantly associated in males. Conclusion The results suggest that neurocognition associated with social cognition differ according to sex. These differences should be considered for more effective treatment of social cognition.
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Affiliation(s)
- Ryotaro Kubota
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Ryo Okubo
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
- *Correspondence: Ryo Okubo,
| | - Satoru Ikezawa
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Endowed Institute for Empowering Gifted Minds, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Satoru Ikezawa,
| | - Makoto Matsui
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Leona Adachi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Ayumu Wada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Chinatsu Fujimaki
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Yuji Yamada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Koji Saeki
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Chika Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Akiko Kikuchi
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshie Omachi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Kazuyoshi Takeda
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naoki Yoshimura
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
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Emotional Processing Profile in Patients with First Episode Schizophrenia: The Influence of Neurocognition. J Clin Med 2022; 11:jcm11072044. [PMID: 35407652 PMCID: PMC8999810 DOI: 10.3390/jcm11072044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 02/01/2023] Open
Abstract
This study sought to investigate the influence of neurocognition on the emotional processing profiles of patients with first-episode schizophrenia, using the 4-branch Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) (Perceiving Emotions; Facilitating Emotions; Understanding Emotions and Managing Emotions). A sample of 78 patients with first-episode schizophrenia and a group of 90 non-psychiatric control subjects were included in this work. The initial results showed that patients had lower scores than controls for the “Understanding Emotions” and “Managing Emotions” MSCEIT branches. However, after controlling for neurocognition, the only deficits were found on the “Managing Emotions” branch of the MSCEIT. This branch can be considered as measuring a more sophisticated level of emotional processing, which may constitute a deficit in itself. In conclusion, patients with first-episode schizophrenia present deficits in social cognition at the highest level that seem to be independent from neurocognition. These findings support the inclusion of the “Managing Emotions” branch of the MSCEIT as part of the MCCB.
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Lee SC, Lin GH, Shih CL, Chen KW, Liu CC, Kuo CJ, Hsieh CL. Error patterns of facial emotion recognition in patients with schizophrenia. J Affect Disord 2022; 300:441-448. [PMID: 34979185 DOI: 10.1016/j.jad.2021.12.130] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/28/2021] [Accepted: 12/30/2021] [Indexed: 11/30/2022]
Abstract
Error patterns of facial emotion recognition (FER) indicate how individuals misinterpret others' facial expressions, which helps clinicians to manage related deficits. However, previous investigations are limited and may have been biased due to methodological issues (e.g., no consideration of response bias). This study aimed to propose a detectability index (d') for adjusting response bias and examine the error patterns of FER in patients with schizophrenia. Responses to 168 photos showing seven basic emotions, obtained from 351 patients with schizophrenia and 101 healthy adults, were extracted from a previous study. The differences in the d's between the two groups (Δd') were calculated to examine the error patterns of FER among the seven emotions. The findings were generally overlapped with those identified by the traditional confusion matrix. Four error patterns were found. First, the patients were insensitive to some negative emotions (i.e., sadness [Δd' = 0.83] and fear [Δd' = 0.72]). Second, they misrecognized happy faces as showing negative emotions (e.g., disgust [Δd' = 0.43] and sadness [Δd' = 0.37]). Third, they misinterpreted surprised faces as all the other emotions (Δd' = 0.41-0.87), except neutral. Fourth, they confused some negative emotions (e.g., misrecognizing fear as anger [Δd' = 0.87]). Our findings suggest that patients with schizophrenia show four error patterns of FER compared to healthy adults. Accordingly, interventions could be selected to improve their sensitivity to faces with negative emotions, differentiation of faces among positive and negative emotions, understanding of surprised faces, and discrimination of faces with negative emotions.
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Affiliation(s)
- Shih-Chieh Lee
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan
| | - Gong-Hong Lin
- Master Program in Long-term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ching-Lin Shih
- Institute of Education & Center for Teacher Education, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Kuan-Wei Chen
- Department of Occupational Therapy, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chian-Jue Kuo
- Songde Branch (Taipei City Psychiatric Center), Taipei City Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan; Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Battaglia AM, Gicas KM, Mamak M, Goldberg JO. Mistakes in interpersonal perceptions: Social cognition in aggressive forensic psychiatry patients. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2022; 32:21-34. [PMID: 35178800 DOI: 10.1002/cbm.2228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND While there is an established link between untreated psychosis and aggression, an enhanced understanding of the role of social cognition is still needed. AIMS To examine social cognitive functioning among patients in a specialist forensic mental health service who had been deemed not criminally responsible for acts of violence due to a psychotic disorder. It was hypothesised, first, that such patients would show reduced social cognitive functioning compared with healthy, nonviolent comparison participants and, second, that those who continued to be aggressive while inpatients would demonstrate significant reductions compared to the now nonaggressive group. METHODS The study samples were of 10 recently aggressive and 15 not-recently aggressive patients and 20 healthy, nonviolent comparison participants. Each completed the Toronto Empathy Questionnaire (TEQ), the Reading the Mind in the Eyes Test-Revised (RMET) and the Interpersonal Perception Task-15 (IPT-15). RESULTS There was no significance between group differences on the RMET and TEQ. The patient group as a whole, however, showed significant interpersonal misperceptions, with specific misperceptions on IPT-15 deception and kinship subscales, while at the same time lacking self-awareness of their errors. Misperceptions on the IPT-15 competition subscale were unique to recently aggressive patients. CONCLUSIONS Select aspects of reduced social cognitive functioning were found among not criminally responsible patients with psychosis who had committed violent acts and who continued to act aggressively while forensic inpatients. These findings enhance our understanding of the role of social cognition in predisposing toward violence and the potential importance of incorporating interventions which improve social cognition directly. We suggest also the potential for future research using virtual reality technologies in treatment.
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Affiliation(s)
| | - Kristina M Gicas
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Mini Mamak
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Joel O Goldberg
- Department of Psychology, York University, Toronto, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Antonucci LA, Fazio L, Pergola G, Blasi G, Stolfa G, Di Palo P, Mucci A, Rocca P, Brasso C, di Giannantonio M, Maria Giordano G, Monteleone P, Pompili M, Siracusano A, Bertolino A, Galderisi S, Maj M. Joint structural-functional magnetic resonance imaging features are associated with diagnosis and real-world functioning in patients with schizophrenia. Schizophr Res 2022; 240:193-203. [PMID: 35032904 DOI: 10.1016/j.schres.2021.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/20/2021] [Accepted: 12/22/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Earlier evidence suggested that structural-functional covariation in schizophrenia patients (SCZ) is associated with cognition, a predictor of functioning. Moreover, studies suggested that functional brain abnormalities of schizophrenia may be related with structural network features. However, only few studies have investigated the relationship between structural-functional covariation and both diagnosis and functioning in SCZ. We hypothesized that structural-functional covariation networks associated with diagnosis are related to real-world functioning in SCZ. METHODS We performed joint Independent Component Analysis on T1 images and resting-state fMRI-based Degree Centrality (DC) maps from 89 SCZ and 285 controls. Structural-functional covariation networks in which we found a main effect of diagnosis underwent correlation analysis to investigate their relationship with functioning. Covariation networks showing a significant association with both diagnosis and functioning underwent univariate analysis to better characterize group-level differences at the spatial level. RESULTS A structural-functional covariation network characterized by frontal, temporal, parietal and thalamic structural estimates significantly covaried with temporo-parietal resting-state DC. Compared with controls, SCZ had reduced structural-functional covariation within this network (pFDR = 0.005). The same measure correlated positively with both social and occupational functioning (both pFDR = 0.042). Univariate analyses revealed grey matter deviations in SCZ compared with controls within this structural-functional network in hippocampus, cerebellum, thalamus, orbito-frontal cortex, and insula. No group differences were found in DC. CONCLUSIONS Findings support the existence of a phenotypical association between group-level differences and inter-individual heterogeneity of functional deficits in SCZ. Given that only the joint structural/functional analysis revealed this association, structural-functional covariation may be a potentially relevant schizophrenia phenotype.
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Affiliation(s)
- Linda A Antonucci
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Leonardo Fazio
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giulio Pergola
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Stolfa
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Piergiuseppe Di Palo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Claudio Brasso
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | | | | | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Escobedo-Aedo PJ, Forjan-González A, Sánchez-Escribano Martínez A, Ruiz-Ruano VG, Sánchez-Alonso S, Mata-Iturralde L, Muñoz-Lorenzo L, Baca-García E, David AS, Lopez-Morinigo JD. Investigating the Role of Insight, Decision-Making and Mentalizing in Functional Outcome in Schizophrenia: A Cross-Sectional Study. Behav Sci (Basel) 2022; 12:bs12020028. [PMID: 35200280 PMCID: PMC8868582 DOI: 10.3390/bs12020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Recovery has become a priority in schizophrenia spectrum disorders (SSDs). This study aimed to investigate predictors of objective—general functioning and disability—and subjective—quality of life (QoL)—measures of functional outcomes in SSD. Methods: Sample: n = 77 SSD outpatients (age 18–64, IQ > 70) participating in a randomised controlled trial. Baseline data were used to build three multivariable linear regression models on: (i) general functioning—General Assessment of Functioning (GAF); (ii) disability—the World Health Organization Disability Assessment Schedule (WHODAS-2.0); and (iii) QoL—Satisfaction Life Domains Scale (SLDS). Results: Young age and being employed (R2 change = 0.211; p = 0.001), late adolescence premorbid adjustment (R2 change = 0.049; p = 0.0050), negative symptoms and disorganization (R2 change = 0.087; p = 0.025) and Theory of Mind (R2 change = 0.066, p = 0.053) predicted general functioning. Previous suicidal behaviour (R2 change = 0.068; p = 0.023) and negative and depressive symptoms (R2 change = 0.167; p = 0.001) were linked with disability. Previous suicidal behaviour (R2 change = 0.070, p = 0.026), depressive symptoms (R2 change = 0.157; p < 0.001) and illness recognition (R2 change = 0.046, p = 0.044) predicted QoL. Conclusions: Negative, disorganization and depressive symptoms, older age, unemployment, poor premorbid adjustment, previous suicide attempts and illness awareness appear to underlie a poor global functional outcome in SSD. Achieving recovery in SSD appears to require both symptomatic remission (e.g., through antipsychotics) and measures to improve mastery and relieve low mood.
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Affiliation(s)
- Paula Jhoana Escobedo-Aedo
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain; (P.J.E.-A.); (A.F.-G.); (A.S.-E.M.); (V.G.R.-R.); (S.S.-A.); (L.M.-I.); (L.M.-L.); (E.B.-G.)
| | - Ana Forjan-González
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain; (P.J.E.-A.); (A.F.-G.); (A.S.-E.M.); (V.G.R.-R.); (S.S.-A.); (L.M.-I.); (L.M.-L.); (E.B.-G.)
| | - Adela Sánchez-Escribano Martínez
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain; (P.J.E.-A.); (A.F.-G.); (A.S.-E.M.); (V.G.R.-R.); (S.S.-A.); (L.M.-I.); (L.M.-L.); (E.B.-G.)
| | - Verónica González Ruiz-Ruano
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain; (P.J.E.-A.); (A.F.-G.); (A.S.-E.M.); (V.G.R.-R.); (S.S.-A.); (L.M.-I.); (L.M.-L.); (E.B.-G.)
- Departamento de Psiquiatría, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Sergio Sánchez-Alonso
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain; (P.J.E.-A.); (A.F.-G.); (A.S.-E.M.); (V.G.R.-R.); (S.S.-A.); (L.M.-I.); (L.M.-L.); (E.B.-G.)
| | - Laura Mata-Iturralde
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain; (P.J.E.-A.); (A.F.-G.); (A.S.-E.M.); (V.G.R.-R.); (S.S.-A.); (L.M.-I.); (L.M.-L.); (E.B.-G.)
| | - Laura Muñoz-Lorenzo
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain; (P.J.E.-A.); (A.F.-G.); (A.S.-E.M.); (V.G.R.-R.); (S.S.-A.); (L.M.-I.); (L.M.-L.); (E.B.-G.)
| | - Enrique Baca-García
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain; (P.J.E.-A.); (A.F.-G.); (A.S.-E.M.); (V.G.R.-R.); (S.S.-A.); (L.M.-I.); (L.M.-L.); (E.B.-G.)
- Departamento de Psiquiatría, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28007 Madrid, Spain
- Psychology Department, Universidad Católica del Maule, Talca 3460000, Chile
| | - Anthony S. David
- Division of Psychiatry, Faculty of Brain Sciences, Institute of Mental Health, University College London, London WC1E 6BT, UK;
| | - Javier-David Lopez-Morinigo
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain; (P.J.E.-A.); (A.F.-G.); (A.S.-E.M.); (V.G.R.-R.); (S.S.-A.); (L.M.-I.); (L.M.-L.); (E.B.-G.)
- Departamento de Psiquiatría, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28007 Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, 28009 Madrid, Spain
- Correspondence:
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Musa Salech G, Lillo P, van der Hiele K, Méndez-Orellana C, Ibáñez A, Slachevsky A. Apathy, Executive Function, and Emotion Recognition Are the Main Drivers of Functional Impairment in Behavioral Variant of Frontotemporal Dementia. Front Neurol 2022; 12:734251. [PMID: 35095710 PMCID: PMC8792989 DOI: 10.3389/fneur.2021.734251] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The cognitive and neuropsychiatric deficits present in patients with behavioral variant frontotemporal dementia (bvFTD) are associated with loss of functionality in the activities of daily living (ADLs). The main purpose of this study was to examine and explore the association between the cognitive and neuropsychiatric features that might prompt functional impairment of basic, instrumental, and advanced ADL domains in patients with bvFTD. Methods: A retrospective cross-sectional study was conducted with 27 patients with bvFTD in its early stage (<2 years of evolution) and 32 healthy control subjects. A neuropsychological assessment was carried out wherein measures of cognitive function and neuropsychiatric symptoms were obtained. The informant-report Technology-Activities of Daily Living Questionnaire was used to assess the percentage of functional impairment in the different ADL domains. To identify the best determinants, three separate multiple regression analyses were performed, considering each functional impairment as the dependent variable and executive function, emotion recognition, disinhibition, and apathy as independent variables. Results: For the basic ADLs, a model that explains 28.2% of the variability was found, in which the presence of apathy (β = 0.33, p = 0.02) and disinhibition (β = 0.29, p = 0.04) were significant factors. Concerning instrumental ADLs, the model produced accounted for 63.7% of the functional variability, with the presence of apathy (β = 0.71, p < 0.001), deficits in executive function (β = -0.36, p = 0.002), and lack of emotion recognition (β = 0.28, p = 0.017) as the main contributors. Finally, in terms of advanced ADLs, the model found explained 52.6% of the variance, wherein only the presence of apathy acted as a significant factor (β = 0.59, p < 0.001). Conclusions: The results of this study show the prominent and transverse effect of apathy in the loss of functionality throughout all the ADL domains. Apart from that, this is the first study that shows that the factors associated with loss of functionality differ according to the functional domain in patients with bvFTD in its early stage. Finally, no other study has analyzed the impact of the lack of emotion recognition in the functionality of ADLs. These results could guide the planning of tailored interventions that might enhance everyday activities and the improvement of quality of life.
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Affiliation(s)
- Gada Musa Salech
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Institute of Biomedical Sciences (ICBM), Neurosciences Department, East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Departamento de Neurología, Clínica Universidad de los Andes, Santiago, Chile
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Department of Neurology South, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Unidad de Neurología, Hospital San José, Santiago, Chile
| | - Karin van der Hiele
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | | | - Agustín Ibáñez
- Cognitive Neuroscience Center (CNC), National Scientific and Technical Research Council (CONICET), Universidad de San Andrés, Buenos Aires, Argentina
- The Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Institute of Biomedical Sciences (ICBM), Neurosciences Department, East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN), Department of Neurology, Hospital del Salvador & University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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Changes in social functioning over the course of psychotic disorders-A meta-analysis. Schizophr Res 2022; 239:55-82. [PMID: 34844096 DOI: 10.1016/j.schres.2021.11.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/15/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022]
Abstract
In this meta-analysis we investigated changes in social functioning and its moderators in patients with a psychotic disorder but different durations of illness at baseline. We included longitudinal studies assessing the course of five domains of social functioning in patients with a psychotic disorder. Effect sizes of change between baseline and follow-up within these domains were analyzed in four subgroups based on durations of psychotic disorder at baseline: less than 2 years, between 2 and 5 years, between 5 and 10 years, and more than 10 years. The influence of baseline confounders was analyzed using meta-regression and sensitivity analysis. We included 84 studies analyzing 33,456 participants. We found a medium improvement (d = 0.60) in overall social functioning over time, with a greater improvement for studies investigating patients with a duration of illness of less than 5 years. We found minor improvement in specific domains of social functioning, such as vocational functioning (d = 0.31), prosocial behavior (d = 0.36), activities (d = 0.15), and independence (d = 0.25). Improvement in social functioning was associated with lower baseline levels of negative symptoms, higher baseline levels of quality of life, and, specifically, improved vocational functioning, with rehabilitation and combined treatment. Social functioning in patients with psychotic disorders improves over time, especially for patients with shorter illness durations. Reduction of negative symptoms and improving quality of life might reinforce improvement of social functioning.
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Metternich B, Wagner K, Geiger MJ, Schulze-Bonhage A, Hirsch M, Schönenberg M. Affective Empathy, Theory of Mind and Social Functioning in Patients With Focal Epilepsy. Front Psychiatry 2022; 13:887411. [PMID: 35898635 PMCID: PMC9309689 DOI: 10.3389/fpsyt.2022.887411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Social cognition comprises basic and more complex functions, such as theory of mind (ToM) and affective empathy. Although everyday social interactions may be impaired if such higher-order social cognitive functions are compromised, associations between social functioning and social cognition in people with focal epilepsy (PWFE) are still poorly understood. We used a novel, naturalistic approach to investigate ToM in PWFE by applying the Movie for the Assessment of Social Cognition (MASC). Furthermore, we studied affective empathy, the relationship between social cognitive parameters and measures of social functioning, as well as between epilepsy focus and ToM. METHODS Thirty patients with either temporal (TLE) or frontal lobe epilepsy (FLE) were compared to 29 healthy control subjects (HC). In addition to the MASC, we applied questionnaire measures assessing empathy and everyday social functioning. RESULTS PWFE, especially with FLE, performed significantly worse than HC on the MASC. Perceived social integration and social activities, but not affective empathy, were reduced in PWFE. Regression analyses revealed associations between perceived social integration, clinical group status, affective empathy and ToM. CONCLUSION PWFE displayed ToM deficits during a naturalistic task, whereas affective empathy was unimpaired. FLE may be associated with especially compromised ToM performance. Social cognition and social functioning appear to be interrelated in PWFE, whose self-perceived levels of social integration and social activities are lower than those of HC. More research into the association between social cognition and social functioning in PWFE is needed, in order to develop tailored intervention programs for these patients.
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Affiliation(s)
- Birgitta Metternich
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Kathrin Wagner
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Maximilian J Geiger
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Martin Hirsch
- Department of Neurosurgery, Epilepsy Center, Medical Center - University of Freiburg, Freiburg, Germany
| | - Michael Schönenberg
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
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Gebreegziabhere Y, Habatmu K, Mihretu A, Cella M, Alem A. Cognitive impairment in people with schizophrenia: an umbrella review. Eur Arch Psychiatry Clin Neurosci 2022; 272:1139-1155. [PMID: 35633394 PMCID: PMC9508017 DOI: 10.1007/s00406-022-01416-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/11/2022] [Indexed: 01/08/2023]
Abstract
Cognitive impairment is one of the core symptoms of schizophrenia. Quite a number of systematic reviews were published related to cognitive impairment in people with schizophrenia (PWS). This umbrella review, therefore, aimed at reviewing and synthesizing the findings of systematic reviews related to domains of cognition impaired and associated factors in PWS. We searched four electronic databases. Data related to domains, occurrence, and associated factors of cognitive impairment in PWS were extracted. The quality of all eligible systematic reviews was assessed using A MeaSurement Tool to Assess methodological quality of systematic Review (AMSTAR) tool. Results are summarized and presented in a narrative form. We identified 63 systematic reviews fulfilling the eligibility criteria. The included reviews showed that PWS had lower cognitive functioning compared to both healthy controls and people with affective disorders. Similar findings were reported among psychotropic free cases and people with first episode psychosis. Greater impairment of cognition was reported in processing speed, verbal memory, and working memory domains. Greater cognitive impairment was reported to be associated with worse functionality and poor insight. Cognitive impairment was also reported to be associated with childhood trauma and aggressive behaviour. According to our quality assessment, the majority of the reviews had moderate quality. We were able to find a good number of systematic reviews on cognitive impairment in PWS. The reviews showed that PWS had higher impairment in different cognitive domains compared to healthy controls and people with affective disorders. Impairment in domains of memory and processing speed were reported frequently.
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Affiliation(s)
- Yohannes Gebreegziabhere
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia. .,Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Kassahun Habatmu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Awoke Mihretu
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England UK
| | - Atalay Alem
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Comparative study of emotion recognition and theory of mind between major depressive disorder and schizophrenia. J Affect Disord 2021; 295:1445-1448. [PMID: 34563391 DOI: 10.1016/j.jad.2021.09.023] [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: 01/29/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Social cognition as a transdiagnostic construct between major depressive disorder (MDD) and schizophrenia (SCZ) is not well understood. This may be attributed to the variability of social cognitive measures indexing the same construct. This study aims to compare emotion recognition and theory of mind domains, known to be impaired in SCZ, between MDD and SCZ. METHODS Three groups of participants (NTotal = 150) were enrolled in this study: MDD (n = 51), SCZ (n = 50) and healthy controls (HC; n = 49). Emotion recognition was assessed on the Bell Lysaker Emotion Recognition Task (BLERT) and Penn Emotion Recognition Task (ER40); theory of mind was measured on The Awareness of Social Inference Test (TASIT). Mixed ANCOVAs were utilised to compare social cognitive performance across the groups. RESULTS SCZ performed poorer in all 3 social cognition tasks compared to both MDD and HC. No statistically significant difference in social cognitive performance was observed between MDD and HC. CONCLUSIONS This study serves as an effort towards employing the same standardised social cognitive measures for direct comparison of performance patterns across diagnostic groups. Future work is needed to extend this in larger samples of different illness severity and diagnostic categories.
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Abdo MMM, Mohamed AS, Hammed MAE, Hashem RE, El Nagar ZM. Affective theory of the mind and suicide in women with borderline personality disorder and schizophrenia: a comparative study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00142-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Theory of mind (ToM) is one of the essential components of social cognition. Affective ToM enables us to interpret other’s feelings and behaviors. Borderline personality disorder (BPD) and schizophrenia are two distinct mental disorders, yet they have a mutual deficit in interpreting emotions, thoughts, and intentions which may lead to a higher incidence of suicidality. Studies that involved social cognition, particularly ToM in schizophrenia, or BPD have controversial results. Therefore, this study aimed at comparing affective ToM functioning in female patients with BPD, schizophrenia, and healthy controls. In addition, identifying the possible impact and any correlation exists between the affective ToM and liability for suicide in those patients. Sixty individuals were recruited from the Institute of Psychiatry, Ain Shams University, Cairo, Egypt, and assigned into 3 groups where group A involved 20 BPD patients, group B involved 20 schizophrenic patients, and group C were healthy persons as a control. Assessment of affective ToM was done using Reading the Mind in the Eyes Test (RMET), and probability of suicide was measured using Suicide Probability Scale (SPS).
Results
Regarding ToM, the three groups were assessed using RMET and the results revealed a significantly higher mean score (hypermentalization) in BPD patients than both schizophrenic patients and controls. While schizophrenic patients had significantly lower mean scores than the control group (hypomentalization). As well, BPD patients had a significantly higher suicide probability total score than Schizophrenic patients and in all subdomains except for the hostility subdomain that was significantly higher in schizophrenic patients. Interestingly, in BPD, the suicide probability total score was positively correlated with RMET.
Conclusions
BPD patients have enhanced affective ToM and hypermentalization that is significantly associated with increased suicide probability in those patients, while in schizophrenia, hypomentalization could not be linked to increased suicide probability. Rehabilitation and proper management of ToM abnormalities might be a crucial tool in suicide prevention in mental illnesses, particularly, BPD.
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Raucher-Chéné D, Thibaudeau E, Sauvé G, Lavigne KM, Lepage M. Understanding others as a mediator between verbal memory and negative symptoms in schizophrenia-spectrum disorder. J Psychiatr Res 2021; 143:429-435. [PMID: 34656875 DOI: 10.1016/j.jpsychires.2021.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/05/2021] [Accepted: 10/10/2021] [Indexed: 11/17/2022]
Abstract
From the onset of schizophrenia, verbal memory (VM) deficits and negative symptoms are strongly associated, and both additively predict functional outcomes. Emotion recognition (ER) and theory of mind (ToM; the ability to infer others' mental states), two components of social cognition, are also particularly affected in schizophrenia. Explanatory models of negative symptoms have integrated these cognitive impairments as potential precursors and previous studies revealed relationships between ER and/or ToM and VM, as well as with negative symptoms, but the organization of these associations remains unclear. We aimed to determine whether impairments in VM and social cognition sequentially pave the way for negative symptoms in schizophrenia. To this end, we used mediation analyses. One hundred and forty participants with a diagnosis of schizophrenia or schizoaffective disorder were recruited. First, correlational analyses were conducted between our variables of interest. The mediating effect of social cognition between VM and negative symptoms was then examined using the PROCESS macro. Variables of interest were significantly correlated (r = |0.166| to |0.391|), except for ER and negative symptoms. Only the serial multiple mediation model with 2 mediators (ER followed by ToM) revealed a significant indirect effect of VM on negative symptoms (β = - 0.160, 95% CI = -.370 to -.004). This relationship was selective for expressive negative symptoms (e.g., blunted affect and alogia). This study illustrates the richness of the relationship between cognitive deficits and negative symptoms and provides additional information for the involvement of social cognition in negative symptoms' etiology.
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Affiliation(s)
- Delphine Raucher-Chéné
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Cognition, Health, and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
| | - Elisabeth Thibaudeau
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Department of Education and Pedagogy, Université du Québec À Montréal, Canada
| | - Geneviève Sauvé
- Douglas Mental Health University Institute, Montreal, Canada; Department of Education and Pedagogy, Université du Québec À Montréal, Canada
| | - Katie M Lavigne
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
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Lakhani S, Bhola P, Mehta UM. The conceptualization and assessment of social cognition in personality and common mental disorders. Asian J Psychiatr 2021; 65:102829. [PMID: 34537534 DOI: 10.1016/j.ajp.2021.102829] [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: 05/13/2021] [Revised: 08/06/2021] [Accepted: 08/26/2021] [Indexed: 12/16/2022]
Abstract
Social Cognition is a crucial transdiagnostic construct with clinical and functional relevance across a range of neuropsychiatric disorders. Most research has focused on schizophrenia and autism spectrum disorders and has informed frameworks for assessing social cognition in schizophrenia. The current review focuses on the more recent developments pertaining to personality and common mental disorders (PCMDs). Two main questions are addressed: 1. What are the important domains and patterns of social cognition impairments among the personality and common mental disorders? 2. What are the trends in the assessment of social cognition among personality and common mental disorders? We synthesize research findings on the conceptualization of SC and the application of these frameworks for assessment with PCMDs. We have outlined a typology of criteria and guidelines for selecting and developing measures of SC in the PCMDs. We conclude that there is a need for a reconceptualization of social cognition or PCMDs with a focus on higher-order processes and suggest that mentalization could be a suitable framework to understand and examine social cognition in the PCMDs. Future efforts to develop, adapt and use more complex, nuanced, sensitive, and culturally valid measures of social cognition in interpersonal contexts can aid the detection of subtle, context-dependent, and dynamic impairments across these disorders. Social cognition is a promising transdiagnostic construct and warrants more conceptual clarity and research on the varied patterns of impairments across disorders.
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Affiliation(s)
- Sheetal Lakhani
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - Poornima Bhola
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India.
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
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Spanish adaptation and validation of the Social Attribution Task-Multiple choice (SAT-MC) versions I and II for children and adolescents. ACTAS ESPANOLAS DE PSIQUIATRIA 2021; 49:236-243. [PMID: 34734639 PMCID: PMC9330267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022]
Abstract
Social cognition is progressively acquired from childhood to early adulthood. Nevertheless there is a shortage of social cognition scales with normative data for Spanish children and adolescents. Social Attribution Task-Multiple Choice (SAT-MC) and its alternate version SAT-MC-II are social cognition instruments that measure mentalization skills in adults with psychosis. This study aimed to report psycho- metric characteristics and normative data of the Spanish version of SAT-MC and SAT-MC-II in a sample of minors.
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Uono S, Sato W, Sawada R, Kawakami S, Yoshimura S, Toichi M. Schizotypy is associated with difficulties detecting emotional facial expressions. ROYAL SOCIETY OPEN SCIENCE 2021; 8:211322. [PMID: 34849248 PMCID: PMC8611324 DOI: 10.1098/rsos.211322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
People with schizophrenia or subclinical schizotypal traits exhibit impaired recognition of facial expressions. However, it remains unclear whether the detection of emotional facial expressions is impaired in people with schizophrenia or high levels of schizotypy. The present study examined whether the detection of emotional facial expressions would be associated with schizotypy in a non-clinical population after controlling for the effects of IQ, age, and sex. Participants were asked to respond to whether all faces were the same as quickly and as accurately as possible following the presentation of angry or happy faces or their anti-expressions among crowds of neutral faces. Anti-expressions contain a degree of visual change that is equivalent to that of normal emotional facial expressions relative to neutral facial expressions and are recognized as neutral expressions. Normal expressions of anger and happiness were detected more rapidly and accurately than their anti-expressions. Additionally, the degree of overall schizotypy was negatively correlated with the effectiveness of detecting normal expressions versus anti-expressions. An emotion-recognition task revealed that the degree of positive schizotypy was negatively correlated with the accuracy of facial expression recognition. These results suggest that people with high levels of schizotypy experienced difficulties detecting and recognizing emotional facial expressions.
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Affiliation(s)
- Shota Uono
- Department of Neurodevelopmental Psychiatry, Habilitation, and Rehabilitation, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Wataru Sato
- Kokoro Research Center, Kyoto University, 46 Shimoadachi, Sakyo-ku, Kyoto 606-8501, Japan
| | - Reiko Sawada
- Faculty of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
- The Organization for Promoting Neurodevelopmental Disorder Research, 40 Shogoin-Sannocho, Sakyo-ku, Kyoto 606-8392, Japan
| | - Sayaka Kawakami
- Faculty of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Sayaka Yoshimura
- Department of Neurodevelopmental Psychiatry, Habilitation, and Rehabilitation, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Motomi Toichi
- Faculty of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
- The Organization for Promoting Neurodevelopmental Disorder Research, 40 Shogoin-Sannocho, Sakyo-ku, Kyoto 606-8392, Japan
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Lysaker PH, Hasson-Ohayon I, Wiesepape C, Huling K, Musselman A, Lysaker JT. Social Dysfunction in Psychosis Is More Than a Matter of Misperception: Advances From the Study of Metacognition. Front Psychol 2021; 12:723952. [PMID: 34721183 PMCID: PMC8552011 DOI: 10.3389/fpsyg.2021.723952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Many with psychosis experience substantial difficulties forming and maintaining social bonds leading to persistent social alienation and a lack of a sense of membership in a larger community. While it is clear that social impairments in psychosis cannot be fully explained by symptoms or other traditional features of psychosis, the antecedents of disturbances in social function remain poorly understood. One recent model has proposed that deficits in social cognition may be a root cause of social dysfunction. In this model social relationships become untenable among persons diagnosed with psychosis when deficits in social cognition result in inaccurate ideas of what others feel, think or desire. While there is evidence to support the influence of social cognition upon social function, there are substantial limitations to this point of view. Many with psychosis have social impairments but not significant deficits in social cognition. First person and clinical accounts of the phenomenology of psychosis also do not suggest that persons with psychosis commonly experience making mistakes when trying to understand others. They report instead that intersubjectivity, or the formation of an intimate shared understanding of thoughts and emotions with others, has become extraordinarily difficult. In this paper we explore how research in metacognition in psychosis can transcend these limitations and address some of the ways in which intersubjectivity and more broadly social function is compromised in psychosis. Specifically, research will be reviewed on the relationship between social cognitive abilities and social function in psychosis, including measurement strategies and limits to its explanatory power, in particular with regard to challenges to intersubjectivity. Next, we present research on the integrated model of metacognition in psychosis and its relation to social function. We then discuss how this model might go beyond social cognitive models of social dysfunction in psychosis by describing how compromises in intersubjectivity occur as metacognitive deficits leave persons without an integrated sense of others' purposes, relative positions in the world, possibilities and personal complexities. We suggest that while social cognitive deficits may leave persons with inaccurate ideas about others, metacognitive deficits leave persons ill equipped to make broader sense of the situations in which people interact and this is what leaves them without a holistic sense of the other and what makes it difficult to know others, share experiences, and sustain relationships. The potential of developing clinical interventions focused on metacognition for promoting social recovery will finally be explored.
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Affiliation(s)
- Paul H. Lysaker
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Courtney Wiesepape
- Department of Psychology, Indiana State University, Terre Haute, IN, United States
| | - Kelsey Huling
- School of Psychological Sciences, University of Indianapolis, Indianapolis, IN, United States
| | - Aubrie Musselman
- Department of Psychology, Indiana State University, Terre Haute, IN, United States
| | - John T. Lysaker
- Department of Philosophy, Emory University, Atlanta, GA, United States
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Social Cognition and Interaction Training (SCIT) versus Training in Affect Recognition (TAR) in patients with schizophrenia: A randomized controlled trial. J Psychiatr Res 2021; 142:101-109. [PMID: 34332374 DOI: 10.1016/j.jpsychires.2021.07.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/03/2021] [Accepted: 07/18/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Training in Affect Recognition (TAR) is a "targeted" and computer-aided program that has been shown to effectively attenuate facial affect recognition deficits and improve social functioning in patients with schizophrenia. Social Cognition and Interaction Training (SCIT) is a group "broad-based" intervention, that has also been shown to improve emotion recognition, theory of mind (ToM), and social functioning. To date, no study has compared the efficacy of two different social cognitive interventions. OBJECTIVES We aim to compare the efficacy of TAR and SCIT on schizophrenia patients' performance on facial affect recognition, theory of mind, attributional style and social functioning before, after treatment, and three months thereafter. METHODS One hundred outpatients with a diagnosis of schizophrenia were randomly assigned to the TAR or SCIT condition and completed pre- (T0) and posttreatment (T1) assessments and a 3-month follow up (T2) of emotion recognition (ER-40), theory of mind (Hinting Task), attributional style (AIHQ) and social functioning (PSP). RESULTS The entire sample, receiving TAR or SCIT, showed improvements in theory of mind, attributional style, clinical symptoms and social functioning. This effect was maintained at three-months. The TAR intervention was more efficacious than the SCIT program in improving the recognition of facial emotions (ER-40). The TAR intervention also demonstrated a lower drop-out rate than the SCIT intervention. CONCLUSIONS There were improvements in social cognition, symptomatology and functioning of patients in the entire sample, receiving SCIT or TAR. Both TAR and SCIT appear as valuable treatments for people with schizophrenia and social cognitive deficits.
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