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Ochoa S, Espinosa V, López-Carrilero R, Martinez I, Barrera ADH, Birulés I, Barajas A, Pélaez T, Díaz-Cutraro L, Coromina M, González-Rodríguez A, Verdaguer-Rodríguez M, Gutiérrez-Zotes A, Palma-Sevillano C, Montes C, Gallego J, Paya B, Casanovas F, Roldán M, Noval E, Varela Casals P, Salas-Sender M, Aznar A, Ayesa-Arriola R, Pousa E, Canal-Rivero M, Garrido-Torres N, Montserrat C, Muñoz-Lorenzo L, Crosas JM. Effectiveness of family metacognitive training in mothers with psychosis and their adolescent children: a multicenter study protocol. Front Psychol 2024; 15:1359693. [PMID: 38586292 PMCID: PMC10997187 DOI: 10.3389/fpsyg.2024.1359693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
Background More than half of women with psychosis take care of their children despite the difficulties caused by the disease. Additionally, these kids have a higher risk of developing a mental health disorder. However, no interventions have been developed to meet these needs. Metacognitive Training (MCT) is a psychological intervention that has demonstrated its efficacy in improving cognitive insight, symptom management and social cognition in people with first-episode psychosis (FEP). Additionally, MCT has shown better results in women than men with FEP. This study aims to adapt and evaluate the efficacy of MCT-F in mothers and adolescent children in an online group context with the main purpose of improving family relationships, cognitive awareness and symptoms in women with psychosis and increase their children's knowledge of the disease and their functioning. As secondary objectives, it also aims to evaluate improvements in metacognition, social cognition, symptoms, protective factors and self-perception of stigma. Materials and methods A quasi-experimental design with participants acting as their own control will be carried out. Forty-eight mothers with psychosis and their adolescent children (between 12 and 20 years old) recruited from a total of 11 adult mental health care centers will receive MCT-F. Participants will be evaluated 11 weeks before the intervention (T1), at baseline (T2), and post-intervention (T3) with a cognitive insight scale, as a primary outcome. Measures of metacognitive and social cognition, symptoms, cognitive functioning, family and social functioning, protective factors (self-esteem, resilience, and coping strategies) and self-perceived stigma will be addressed as secondary outcomes. Assessment will also address trauma and attachment in mothers and, lastly, the feasibility and acceptability of MCT-F in both participant groups. Discussion This will be the first investigation of the efficacy, acceptability, and viability of the implementation of MCT-F. The results of this study may have clinical implications, contributing to improving mothers' with psychosis and adolescents' functioning and better understanding of the disease, in addition to the possible protective and preventive effect in adolescents, who are known to be at higher risk of developing severe mental disorders.Clinical trial registration:https://clinicaltrials.gov/, identifier [NCT05358457].
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Affiliation(s)
- Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Victoria Espinosa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Irene Martinez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | | | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Facultat de Psicologia Departament de Cognició, Desenvolupament i Psicologia de l'Educació, Universistat de Barcelona, Barcelona, Spain
| | - Ana Barajas
- Departament de Psicologia, Facultat de Psicologia Clínica I de la Salut. Serra Húnter Programme, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Department of Psychology, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Marta Coromina
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Alexandre González-Rodríguez
- Department of Mental Health, CIBERSAM, Mutua Terrassa University Hospital, Fundació Docència i Recerca Mutua Terrassa, University of Barcelona, Terrassa, Spain
| | - Marina Verdaguer-Rodríguez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Alfonso Gutiérrez-Zotes
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitari Institut Pere Mata, Institut d’Investigació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Reus, Spain
| | - Carolina Palma-Sevillano
- Department of Psychology, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
- Hospital de Mataró, Consorci Sanitari del Maresme, Barcelona, Spain
| | - Cristian Montes
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), First-episode Psychosis Research Network of Andalusia (Red PEPSur), University of Seville, Seville, Spain
| | | | - Beatriz Paya
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | - Francesc Casanovas
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Barcelona, Spain
| | - María Roldán
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Barcelona, Spain
| | - Emma Noval
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | | | | | - Ana Aznar
- Centre d’Higiene Mental Les Corts, Barcelona, Spain
| | - Rosa Ayesa-Arriola
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | - Esther Pousa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Manuel Canal-Rivero
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), First-episode Psychosis Research Network of Andalusia (Red PEPSur), University of Seville, Seville, Spain
| | - Nathalia Garrido-Torres
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), First-episode Psychosis Research Network of Andalusia (Red PEPSur), University of Seville, Seville, Spain
| | - Clara Montserrat
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Josep María Crosas
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Catalonia, Spain
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Espinosa V, Arin-González P, Jiménez-Lafuente A, Pardo N, López-Carrilero R, Birulés I, Barajas A, Pélaez T, Díaz-Cutraro L, Verdaguer-Rodríguez M, Gutiérrez-Zotes A, Palma-Sevillano C, Varela-Casals P, Salas-Sender M, Aznar A, Ayesa-Arriola R, Pousa E, Canal-Rivero M, Garrido-Torres N, Montserrat C, Muñoz-Lorenzo L, Crosas JM, Ochoa S. Family Metacognitive Training (MCT-F): Adapting MCT to Mothers with Psychosis and Their Adolescent Children. Behav Sci (Basel) 2024; 14:97. [PMID: 38392450 PMCID: PMC10885955 DOI: 10.3390/bs14020097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Over half of women with psychosis are mothers. Research suggests that mothers with psychosis face unique challenges affecting both their mental health prognosis and their relationship with their children. Moreover, those children have a higher risk of developing a mental disorder. Notwithstanding, interventions specifically tailored to these families remain largely uncovered. Metacognitive Training (MCT) has demonstrated its efficacy in improving cognitive insight, symptom management, and social cognition in people with psychosis. However, there is no evidence of the efficacy of MCT in a family setting (MCT-F). This study describes the first adaptation of MCT for mothers with psychosis and their adolescent children in an online group setting. The phases (assessment, decision, adaptation, production, topical experts' integration) of the ADAPT-ITT model were systematically applied through a participatory approach (n = 22), including a first-person perspective and involving qualitative (e.g., topical expert literature review and consensus groups, interviews, thematic analyses) and quantitative methods. While MCT's core components were retained, participants guided adaptations both in content and delivery. The findings suggest the importance of community engagement and sharing decision-making processes to demonstrate the acceptability and feasibility of the adapted intervention. Employing a structured approach such as the ADAPT-ITT model ensures readiness of the new training for efficacy trials.
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Affiliation(s)
- Victoria Espinosa
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
| | | | | | - Nerea Pardo
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Department of Social and Quantitative Psychology, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain
| | - Ana Barajas
- Departament de Psicologia, Facultat de Psicologia Clínica I de la Salut. Serra Húnter Programme, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, 08022 Barcelona, Spain
| | - Marina Verdaguer-Rodríguez
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
| | - Alfonso Gutiérrez-Zotes
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, 43206 Reus, Spain
| | - Carolina Palma-Sevillano
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, 08022 Barcelona, Spain
- Hospital de Mataró, Consorci Sanitari del Maresme, 08301 Mataró, Spain
| | | | | | - Ana Aznar
- Centre d'Higiene Mental Les Corts, 08035 Barcelona, Spain
| | - Rosa Ayesa-Arriola
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, 39008 Santander, Spain
| | - Esther Pousa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), 08041 Barcelona, Spain
| | - Manuel Canal-Rivero
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (IBiS), University of Seville, First-Episode Psychosis Research Network of Andalusia (Red PEPSur), 41013 Sevilla, Spain
| | - Nathalia Garrido-Torres
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (IBiS), University of Seville, First-Episode Psychosis Research Network of Andalusia (Red PEPSur), 41013 Sevilla, Spain
| | - Clara Montserrat
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, 08003 Barcelona, Spain
| | - Laura Muñoz-Lorenzo
- Departamento de Psiquiatría, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Josep Maria Crosas
- Department of Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
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3
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López-Carrilero R, Lo Monaco M, Frígola-Capell E, Ferrer-Quintero M, Díaz-Cutraro L, Verdaguer-Rodríguez M, García-Mieres H, Vila-Badia R, Punsoda-Puche P, Birulés I, Peláez T, Pousa E, Grasa E, Barajas A, Ruiz-Delgado I, Barrigón ML, Gonzalez-Higueras F, Lorente-Rovira E, Gutiérrez-Zotes A, Cid J, Legido T, Ayesa-Arriola R, Moritz S, Ochoa S. Cognitive insight in first-episode psychosis: Exploring the complex relationship between executive functions and social cognition. Span J Psychiatry Ment Health 2024:S2950-2853(24)00009-7. [PMID: 38219901 DOI: 10.1016/j.sjpmh.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
Social cognition (SC) and executive function (EF) have been described as important variables for social functioning and recovery of patients with psychosis. However, the relationship between SC and EF in first-episode psychosis (FEP) deserves further investigation, especially focusing on gender differences. AIMS To investigate the relationship between EF and different domains of SC in FEP patients and to explore gender differences in the relationship between these domains. METHODS A cross-sectional study of 191 patients with new-onset psychosis recruited from two multicenter clinical trials. A comprehensive cognitive battery was used to assess SC (Hinting Task, Face Test and IPSAQ) and EF (TMT, WSCT, Stroop Test and digit span - WAIS-III). Pearson correlations and linear regression models were performed. RESULTS A correlation between Theory of Mind (ToM), Emotional Recognition (ER) and EF was found using the complete sample. Separating the sample by gender showed different association profiles between these variables in women and men. CONCLUSIONS A relationship between different domains of SC and EF is found. Moreover, women and men presented distinct association profiles between EF and SC. These results should be considered in order to improve the treatment of FEP patients and designing personalized interventions by gender.
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Affiliation(s)
- Raquel López-Carrilero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mercedes Lo Monaco
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Eva Frígola-Capell
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Marta Ferrer-Quintero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | - Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Marina Verdaguer-Rodríguez
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Helena García-Mieres
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Regina Vila-Badia
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain
| | - Trinidad Peláez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Esther Pousa
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Salut Mental Parc Taulí, Sabadell, Hospital Universitari, UAB Universitat Autònoma de Barcelona, Sabadell, Spain; Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ana Barajas
- Serra Húnter Programme, Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Centre d'Higiene Mental Les Corts, Department of Research, Barcelona, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Málaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Málaga, Spain
| | - María Luisa Barrigón
- Departamento de Psiquiatría, Hospital Universitario Virgen del Rocio, Sevilla, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | | | - Esther Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Alfonso Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, Reus, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Teresa Legido
- Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Rosa Ayesa-Arriola
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Unidad de Investigación en Psiquiatría (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Susana Ochoa
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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4
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Sastre-Buades A, Caro-Cañizares I, Ochoa S, Lorente-Rovira E, Barajas A, Gutiérrez-Zotes A, Sánchez-Alonso S, López-Carrilero R, Grasa E, Pousa E, Pélaez T, Cid J, González-Higueras F, Ruiz-Delgado I, Baca-Garcia E, Barrigon ML. Relationship between cognition and suicidal behavior in recent-onset psychosis. Schizophr Res 2023; 252:172-180. [PMID: 36652834 DOI: 10.1016/j.schres.2022.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/22/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023]
Abstract
Suicidal behavior (SB) is common in first-episode psychosis (FEP), and cognitive impairment has also been described in psychosis. Despite well-established risk factors for SB in psychosis, the role of cognition and insight remains unclear. This study aimed to explore the relationship between history of SB and cognition in recent-onset FEP, distinguishing between neurocognition, social cognition, and metacognition, and including cognitive insight (CI) as a metacognitive variable. The sample consisted of 190 participants with recent-onset FEP recruited from two multicentric studies. Two groups were formed based on presence/absence of a history of SB. Demographic, clinical, and cognitive data were compared by group, including significance level adjustments and size effect calculation. No differences were found regarding demographic, clinical, neurocognitive, social cognition, and metacognitive variables except for CI (18.18 ± 4.87; t = -3.16; p = 0.0020; d = -0.635), which showed a medium effect size. Small to medium effect size were found for attributional style (externalizing bias) (1.15 ± 3.94; t = 2.07; d = 0.482), theory of mind (ToM) (1.73 ± 0.22; t = 2.04; d = -0.403), jumping to conclusions bias (JTC) (23.3 %; X2 = 0.94; V = 0.178). In recent-onset psychosis, neurocognitive functioning was not related to the history of SB. As novelty, individuals with previous SB showed higher CI. Also, regarding social cognition and metacognition, individuals with prior SB tended to present extremely low externalizing bias, better ToM, and presence of JTC.
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Affiliation(s)
- Aina Sastre-Buades
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain
| | - Irene Caro-Cañizares
- Department of Psychology, Universidad a Distancia de Madrid (UDIMA), Collado-Villalba, Spain.
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | | | - Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Cerdanyola del Vallès, Spain; Serra Húnter Programme, Goverment of Catalonia, Barcelona, Spain.
| | - Alfonso Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovirai Virgili, Reus, Spain.
| | | | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Esther Pousa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain; Salut Mental Parc Taulí. Sabadell (Barcelona), Hospital Universitari - UAB Universitat Autònoma de Barcelona, Barcelona, Spain; Neuropsiquiatria i Addiccions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | | | | | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundación Jimenez Diaz Health Research Institute, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain; Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Spain; Department of Psychiatry, Hospital General de Villalba, Madrid, Spain; Carlos III Institute of Health, Madrid, Spain; Universidad Católica del Maule, Talca, Chile; Department of Psychiatry, Nimes University Hospital, Nimes, France.
| | | | - Maria Luisa Barrigon
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Fundación Jimenez Diaz Health Research Institute, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry, University Hospital Puerta de Hierro, Majadahonda, Spain.
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Ferrer-Quintero M, Fernández D, López-Carrilero R, Birulés I, Barajas A, Lorente-Rovira E, Díaz-Cutraro L, Verdaguer M, García-Mieres H, Sevilla-Llewellyn-Jones J, Gutiérrez-Zotes A, Grasa E, Pousa E, Huerta-Ramos E, Pélaez T, Barrigón ML, González-Higueras F, Ruiz-Delgado I, Cid J, Moritz S, Ochoa S. Author Correction: Persons with first episode psychosis have distinct profiles of social cognition and metacognition. Schizophr 2022; 8:3. [PMID: 35210466 PMCID: PMC8873396 DOI: 10.1038/s41537-021-00199-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/08/2021] [Indexed: 11/24/2022]
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6
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Ruiz-Delgado I, Moreno-Küstner B, García-Medina M, Barrigón ML, Gonzalez-Higueras F, López-Carrilero R, Barrios-Mellado I, Barajas A, Pousa E, Lorente-Rovira E, Grasa E, Cid J, Barrau-Sastre P, Moritz S, Ochoa S. Is Metacognitive Training effective for improving neurocognitive function in patients with a recent onset of psychosis? Psychiatry Res 2022; 318:114941. [PMID: 36375331 DOI: 10.1016/j.psychres.2022.114941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/29/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
Abstract
The aims are to assess improvements in memory, attention and executive function in first-episode psychosis after Metacognitive Training (MCT). A multicenter randomized clinical trial was performed with two arms: MCT and psychoeducational intervention. A total of 126 patients with a diagnosis of psychosis, less than 5 years from the onset of the disease, were included. Patients were assessed two or three moments (baseline, post-treatment, 6 months follow-up) depending on the test, with a battery of neurocognitive tests (TAVEC, TMTA-B, CPT, WCST, Stroop and premorbid IQ). General linear models for repeated measures were performed. A better improvement in the MCT was found by an interaction between group and time in CPT Hit index, TMTB, Stroop, recent memory and number of perseverations of the TAVEC. Considering three assessments, a better improvement was found in non-perseverative, perseverative and total errors of the WCST and TMTB. The MCT is an effective psychological intervention to improve several cognitive functions.
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Affiliation(s)
- Isabel Ruiz-Delgado
- UGC Salud Mental Hospital Regional de Málaga. Servicio Andaluz de Salud, Spain.
| | - Berta Moreno-Küstner
- PhD Department of Personality, Assessment and Psychological treatments. Faculty of Psychology,University of Málaga. Spain; Biomedical Research Institute of Malaga (IBIMA) Spain, GAP Research Group, Spain
| | | | - María Luisa Barrigón
- UGC Salud Mental Hospital Universitario Virgen del Rocio, Sevilla, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid Spain
| | | | - Raquel López-Carrilero
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat. Parc Sanitari Sant Joan de Déu, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid Spain
| | - Irene Barrios-Mellado
- UGC Salud Mental Hospital Universitario Virgen del Rocío. Servicio Andaluz de Salud, Spain
| | - Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellatera, Cerdanyola del Vallès, Spain; Serra Húnter Programme, Government of Catalonia, Barcelona, Spain
| | - Esther Pousa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid Spain; Servei de Psiquiatría Hospital de la Santa Creu i Sant Pau
| | - Esther Lorente-Rovira
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid Spain; Hospital Clínico Universitario, Valencia, Spain
| | - Eva Grasa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid Spain; Servei de Psiquiatría Hospital de la Santa Creu i Sant Pau; Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | - Paula Barrau-Sastre
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat. Parc Sanitari Sant Joan de Déu, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Universitat Barcelona, Barcelona, Spain
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Susana Ochoa
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat. Parc Sanitari Sant Joan de Déu, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid Spain.
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7
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Lorente-Rovira E, Grasa E, Ochoa S, Corripio I, Peláez T, López-Carrilero R, Gutiérrez-Gea Á, Morano-Guillén M, Villagrán JM, Bartels-Velthuis AA, Jenner JA, Sanjuán J. Different measures for auditory hallucinations in populations with psychosis. The Validation of the Spanish versions of the Auditory Vocal Hallucination Rating Scale (AVHRS) and the Positive and Useful Voices Inquiry (PUVI). Revista de Psiquiatría y Salud Mental (English Edition) 2022; 15:259-271. [PMID: 36513402 DOI: 10.1016/j.rpsmen.2020.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 03/11/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION An updated summary of the most used instruments assessing auditory hallucinations in population with psychosis, allows us to underline the scarceness and need of Spanish versions of important instruments. The aim of the study is to examine the psychometric characteristics of two different and complementary instruments for assessing auditory hallucinations, the Spanish version of the Auditory Vocal Hallucination Scale (AVHRS) and the Spanish version of the Positive and Useful Voices Inquiry (PUVI). MATERIALS AND METHODS A sample of 68 patients from four different centres, with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder presenting with auditory hallucinations were included. Apart from the AVHRS and the PUVI, the Psychotic Symptom Rating Scales-Auditory Hallucinations subscale (PSYRATS-AH) and the Positive and Negative Syndrome Scale (PANSS) were also administered to all patients, plus an acceptability questionnaire. RESULTS The Spanish version of the AVHRS showed a good internal consistency, a moderate to high inter-rater reliability, a medium to moderate test-retest reliability, and a good convergent and discriminant validity. The Spanish version of the PUVI showed a good internal consistency and a heterogeneous, but in general moderate, test-retest reliability. CONCLUSIONS The Spanish versions of the AVHRS and the PUVI have good psychometric properties and are well accepted among patients.
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Affiliation(s)
- Esther Lorente-Rovira
- Hospital Clínico, Valencia, Spain; INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain.
| | - Eva Grasa
- CIBERSAM, Madrid, Spain; Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU, Hospital Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Madrid, Spain
| | - Iluminada Corripio
- CIBERSAM, Madrid, Spain; Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU, Hospital Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Spain
| | - Trinidad Peláez
- CIBERSAM, Madrid, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | | | | | | | - José M Villagrán
- Hospital Jerez de la Frontera, Servicio Andaluz de Salud, Cádiz, Spain
| | - Agna A Bartels-Velthuis
- University of Groningen, the Netherlands; University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
| | - Jack A Jenner
- Jenner Consult, Haren, the Netherlands Groningen, the Netherlands
| | - Julio Sanjuán
- Hospital Clínico, Valencia, Spain; INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain; Faculty of Medicine, Valencia, Spain
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8
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Pousa E, Brébion G, López-Carrilero R, Ruiz AI, Grasa E, Barajas A, Peláez T, Alfonso-Gutiérrrez-Zotes, Lorente E, Barrigón ML, Ruiz-Delgado I, González-Higueras F, Cid J, Pérez-Solà V, Ochoa S. Clinical insight in first-episode psychosis: Clinical, neurocognitive and metacognitive predictors. Schizophr Res 2022; 248:158-167. [PMID: 36063607 DOI: 10.1016/j.schres.2022.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/29/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Poor insight is a major problem in psychosis, being detrimental for treatment compliance and recovery. Previous studies have identified various correlates of insight impairment, mostly in chronic samples. The current study aimed to determine clinical, neurocognitive, metacognitive, and socio-cognitive predictors of insight in first-episode psychosis. METHODS Regression analyses of different insight dimensions were conducted in 190 patients with first-episode psychosis. Measures of clinical symptoms, neurocognition, metacognition, social cognition, and 'jumping to conclusions' bias were entered as predictors. RESULTS Delusions, disorganisation, and certain negative symptoms were associated with unawareness in various domains, while depression was associated with greater awareness of illness. Deficit in theory of mind and self-reflective processes, as well as a 'jumping to conclusions' bias, contributed to poor insight. Several neuropsychological scores also contributed to this but their contribution was no longer observed in regression analyses that included all the previously identified clinical and cognitive predictors. A measure of perseverative errors was still associated with unawareness and misattribution of symptoms. CONCLUSION In models that account for 28 % to 50 % of the variance, poor insight in first-episode psychosis is mainly associated with delusions and certain negative symptoms. At the cognitive level it does not appear to result from neuropsychological impairment but rather from altered reasoning bias and dysfunction in metacognitive processes. Therapeutic strategies specifically directed at these mechanisms could help improve the evolution of insight in first episode psychosis.
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Affiliation(s)
- Esther Pousa
- Department of Psychiatry, Hospital de La Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain.
| | | | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; MERITT, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Ada I Ruiz
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eva Grasa
- Department of Psychiatry, Hospital de La Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Ana Barajas
- Department of Research, Centre D'Higiene Mental Les Corts, Barcelona, Spain; Serra Húnter Programme, Government of Catalonia, Spain; Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Trini Peláez
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Alfonso-Gutiérrrez-Zotes
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain; University of Rovira i Virgili, Tarragona, Spain
| | - Ester Lorente
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Psychiatry Service, Hospital Clinico Universitario, Valencia, Spain
| | - María Luisa Barrigón
- Department of Psychiatry, IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain; Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
| | | | | | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut D'Assistencia Sanitàri, Girona, Spain
| | - Victor Pérez-Solà
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; Departament de Psiquiatria I Medicina Legal, Universitat Autònoma de Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | | | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; MERITT, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
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9
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Díaz-Cutraro L, López-Carrilero R, García-Mieres H, Ferrer-Quintero M, Verdaguer-Rodriguez M, Barajas A, Grasa E, Pousa E, Lorente E, Barrigón ML, Ruiz-Delgado I, González-Higueras F, Cid J, Mas-Expósito L, Corripio I, Birulés I, Pélaez T, Luengo A, Beltran M, Torres-Hernández P, Palma-Sevillano C, Moritz S, Garety P, Ochoa S. The relationship between jumping to conclusions and social cognition in first-episode psychosis. Schizophrenia (Heidelb) 2022; 8:39. [PMID: 35853903 PMCID: PMC9261088 DOI: 10.1038/s41537-022-00221-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/17/2021] [Indexed: 04/24/2023]
Abstract
Jumping to conclusions (JTC) and impaired social cognition (SC) affect the decoding, processing, and use of social information by people with psychosis. However, the relationship between them had not been deeply explored within psychosis in general, and in first-episode psychosis (FEP) in particular. Our aim was to study the relationship between JTC and SC in a sample with FEP. We conducted a cross-sectional study with 121 patients with FEP, with measures to assess JTC (easy, hard, and salient probability tasks) and SC (emotional recognition, attributional style, and theory of mind). We performed Student's t-test and logistic regression in order to analyse these associations.We found a statistically significant and consistent relationship of small-moderate effect size between JTC (all three tasks) and impaired emotional recognition. Also, our results suggest a relationship between JTC and internal attributions for negative events. Relationships between JTC and theory of mind were not found. These results highlight the importance of psychological treatments oriented to work on a hasty reasoning style and on improving processing of social information linked to emotional recognition and single-cause attributions.
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Affiliation(s)
- Luciana Díaz-Cutraro
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Raquel López-Carrilero
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Helena García-Mieres
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Marta Ferrer-Quintero
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Social and Quantitative Psychology Department, University of Barcelona, Barcelona, Spain
| | - Marina Verdaguer-Rodriguez
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Ana Barajas
- Centre d'Higiene Mental Les Corts, Barcelona, Spain
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- 'Serra Húnter fellow', Barcelona, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Esther Pousa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Ester Lorente
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Psychiatry Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - María Luisa Barrigón
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Servicio Andaluz de Salud, Area de Gestión Sanitaria Sur Granada, Motril, Spain
- Department of Psychiatry, IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte. UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Málaga, Spain
| | | | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | | | - Iluminada Corripio
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Trinidad Pélaez
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Ana Luengo
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Psychiatry Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Meritxell Beltran
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | | | - Carolina Palma-Sevillano
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
- Hospital de Mataró, Consorci Sanitari del Maresme, Barcelona, Spain
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Philippa Garety
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Susana Ochoa
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
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Ferrer-Quintero M, Fernández D, López-Carrilero R, Birulés I, Barajas A, Lorente-Rovira E, Luengo A, Díaz-Cutraro L, Verdaguer M, García-Mieres H, Gutiérrez-Zotes A, Grasa E, Pousa E, Huerta-Ramos E, Pélaez T, Barrigón ML, Gómez-Benito J, González-Higueras F, Ruiz-Delgado I, Cid J, Moritz S, Sevilla-Llewellyn-Jones J, Ochoa S. Males and females with first episode psychosis present distinct profiles of social cognition and metacognition. Eur Arch Psychiatry Clin Neurosci 2022; 272:1169-1181. [PMID: 35802165 PMCID: PMC9508015 DOI: 10.1007/s00406-022-01438-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/23/2022] [Indexed: 12/01/2022]
Abstract
Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive, and metacognitive assessment. Subsequent latent profile analysis split by sex yielded two clusters common to both sexes (a Homogeneous group, 53% and 79.3%, and an Indecisive group, 18.3% and 8.6% of males and females, respectively), a specific male profile characterized by presenting jumping to conclusions (28.7%) and a specific female profile characterized by cognitive biases (12.1%). Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had lower self-esteem. These results suggest that males and females may benefit from specific targeted treatment and highlights the need to consider sex when planning interventions.
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Affiliation(s)
- M. Ferrer-Quintero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Departament de Psicologia Social I Psicologia Quantitativa, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - D. Fernández
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Fundació Sant Joan de Déu, Esplugues de Llobregat Barcelona, Spain ,Serra Húnter Fellow. Department of Statistics and Operations Research (DEIO), Universitat Politècnica de Catalunya BarcelonaTech (UPC), Barcelona, 08028 Spain ,Institute of Mathematics of UPC - BarcelonaTech (IMTech), Universitat Politècnica de Catalunya, Barcelona, 08028 Spain
| | - R. López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Fundació Sant Joan de Déu, Esplugues de Llobregat Barcelona, Spain
| | - I. Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Departament de Psicologia Social I Psicologia Quantitativa, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
| | - A. Barajas
- Departament de Psicologia, Facultat de Psicologia Clínica I de La Salut. Serra Hunter Fellow, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Barcelona, Spain ,Department of Research, Centre d’Higiene Mental Les Corts, Barcelona, Spain
| | - E. Lorente-Rovira
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Psychiatry Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - A. Luengo
- Psychiatry Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - L. Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,COMSAL research group, FPCEE, Blanquerna Ramon Llull University, Barcelona, Spain
| | - M. Verdaguer
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Departament de Psicologia, Facultat de Psicologia Clínica I de La Salut. Serra Hunter Fellow, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra, Barcelona, Spain ,Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - H. García-Mieres
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - A. Gutiérrez-Zotes
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Hospital Universitari Institut Pere Mata, Institut d’Investigació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, Reus, Spain
| | - E. Grasa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - E. Pousa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain ,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain ,Salut Mental Parc Taulí. Sabadell (Barcelona), Hospital Universitari–UAB Universitat Autònoma de Barcelona, Barcelona, Spain ,Neuropsiquiatria I Addicions, Hospital del Mar. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - E. Huerta-Ramos
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - T. Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - M. L. Barrigón
- Departament of Psychiatry, University Hospital Virgen del Rocio, Seville, Spain ,Psychiatry Service, Area de Gestión Sanitaria Sur Granada, Motril, Granada, Spain
| | - J. Gómez-Benito
- Departament de Psicologia Social I Psicologia Quantitativa, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain , GEIMAC, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | | | - I. Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte, Malaga, Spain
| | - J. Cid
- Mental Health and Addiction Research Group. IdiBGi. Institut d’Assistencia Sanitària, Girona, Spain
| | - S. Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - J. Sevilla-Llewellyn-Jones
- Institute of Psychiatry and Mental Health, Health Research Institute (IdISSC), Clinico San Carlos Hospital, Madrid, Spain
| | | | - S. Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregats, Dr. Pujades 42. Sant Boi de Llobregat 08830, Barcelona, Spain ,Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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11
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Ferrer-Quintero M, Fernández D, López-Carrilero R, Birulés I, Barajas A, Lorente-Rovira E, Díaz-Cutraro L, Verdaguer M, García-Mieres H, Sevilla-Llewellyn-Jones J, Gutiérrez-Zotes A, Grasa E, Pousa E, Huerta-Ramos E, Pélaez T, Barrigón ML, González-Higueras F, Ruiz-Delgado I, Cid J, Moritz S, Ochoa S. Persons with first episode psychosis have distinct profiles of social cognition and metacognition. NPJ Schizophr 2021; 7:61. [PMID: 34887442 PMCID: PMC8660816 DOI: 10.1038/s41537-021-00187-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/08/2021] [Indexed: 11/09/2022]
Abstract
Subjects with first-episode psychosis experience substantial deficits in social cognition and metacognition. Although previous studies have investigated the role of profiles of individuals in social cognition and metacognition in chronic schizophrenia, profiling subjects with first-episode psychosis in both domains remains to be investigated. We used latent profile analysis to derive profiles of the abilities in 174 persons with first-episode psychosis using the Beck's Cognitive Insight Scale, the Faces Test, the Hinting Task, the Internal, Personal and Situational Attributions Questionnaire, and the Beads Task. Participants received a clinical assessment and a neuropsychological assessment. The best-fitting model was selected according to the Bayesian information criterion (BIC). We assessed the importance of the variables via a classification tree (CART). We derived three clusters with distinct profiles. The first profile (33.3%) comprised individuals with low social cognition. The second profile (60.9%) comprised individuals that had more proneness to present jumping to conclusions. The third profile (5.7%) presented a heterogeneous profile of metacognitive deficits. Persons with lower social cognition presented worse clinical and neuropsychological features than cluster 2 and cluster 3. Cluster 3 presented significantly worst functioning. Our results suggest that individuals with FEP present distinct profiles that concur with specific clinical, neuropsychological, and functional challenges. Each subgroup may benefit from different interventions.
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Affiliation(s)
- M Ferrer-Quintero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - D Fernández
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Fundació Sant Joan de Déu, Esplugues de Llobregat (Barcelona), Barcelona, Spain.,Department of Statistics and Operations Research, Polytechnic University of Catalonia, Barcelona, Spain
| | - R López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Fundació Sant Joan de Déu, Esplugues de Llobregat (Barcelona), Barcelona, Spain
| | - I Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Barcelona, Spain
| | - A Barajas
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain.,Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain
| | - E Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Psychiatry Service, Hospital Clínico Universitario de Valencia, Barcelona, Spain
| | - L Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain
| | - M Verdaguer
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain
| | - H García-Mieres
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain
| | - J Sevilla-Llewellyn-Jones
- Institute of Psychiatry and Mental Health, Health Research Institute (IdISSC), Clinico San Carlos Hospital, Madrid, Spain
| | - A Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, Reus, Spain
| | - E Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Pousa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.,Salut Mental Parc Taulí. Sabadell (Barcelona), Hospital Universitari - UAB Universitat Autònoma de Barcelona, Barcelona, Spain.,Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - E Huerta-Ramos
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - T Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain.,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - M L Barrigón
- Department of Psychiatry, IIS-Fundación Jiménez Díaz Hospital (Madrid), Madrid, Spain.,Psychiatry Service, Area de Gestión Sanitaria Sur Granada, Motril (Granada), Spain
| | | | - I Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte, Málaga, Spain
| | - J Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | - S Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | | | - S Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Barcelona, Spain. .,Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
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12
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González-Blanch C, Birulés I, Pousa E, Barrigon ML, López-Carrilero R, Lorente-Rovira E, Ayesa-Arriola R, Setien-Suero E, Barajas A, Grasa EM, Ruiz-Delgado I, González-Higueras F, Cid J, Ochoa S. Moderators of cognitive insight outcome in metacognitive training for first-episode psychosis. J Psychiatr Res 2021; 141:104-110. [PMID: 34186271 DOI: 10.1016/j.jpsychires.2021.06.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/29/2021] [Accepted: 06/20/2021] [Indexed: 10/21/2022]
Abstract
Metacognitive training (MCT) is a promising treatment for improving cognitive insight associated with delusional beliefs in individuals with psychotic disorders. The aim of this study was to examine potential moderators of cognitive insight in individuals with first-episode psychosis (FEP) who received either MCT or psychoeducation. The present study was based on data from a randomized control trial comparing MCT to psychoeducation. Baseline sociodemographic and clinical characteristics in a sample of 122 patients with FEP were examined as potential moderators of the self-reflectiveness and self-certainty dimensions of cognitive insight using the SPSS PROCESS macro. The only variable that moderated self-reflectiveness at the post-treatment evaluation was age of onset (b = -0.27, p = .025). The effect of MCT in reducing self-certainty was stronger in women (b = -3.26, p = .018) and in individuals with average or above average baseline self-esteem (b = -0.30, p = .007). Overall, our findings support the generalization of MCT to a variety of sociodemographic and clinical profiles. While some patient profiles may require targeted interventions such as MCT to improve cognitive insight, others may do equally as well with less demanding interventions such as a psychoeducational group.
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Affiliation(s)
- César González-Blanch
- Mental Health Centre, University Hospital Marqués de Valdecilla, Santander, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain.
| | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; MERITT, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Universitat de Barcelona (UB), Barcelona, Spain
| | - Esther Pousa
- Salut Mental Parc Taulí. Sabadell (Barcelona), Hospital Universitari, UAB Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - María Luisa Barrigon
- Department of Psychiatry, IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain; Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; MERITT, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Esther Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Psychiatry Service, Hospital Clinico Universitario, Valencia, Spain
| | - Rosa Ayesa-Arriola
- IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Esther Setien-Suero
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Ana Barajas
- Department of Research, Centre D'Higiene Mental Les Corts, Barcelona, Spain; Serra Húnter Programme, Government of Catalonia, Spain; Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Eva M Grasa
- Department of Psychiatry, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | | | | | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut D'Assistencia Sanitàri, Girona, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; MERITT, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
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13
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Sastre-Buades A, Ochoa S, Lorente-Rovira E, Barajas A, Grasa E, López-Carrilero R, Luengo A, Ruiz-Delgado I, Cid J, González-Higueras F, Sánchez-Alonso S, Baca-García E, Barrigón ML. Jumping to conclusions and suicidal behavior in depression and psychosis. J Psychiatr Res 2021; 137:514-520. [PMID: 33812324 DOI: 10.1016/j.jpsychires.2021.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/09/2021] [Accepted: 03/11/2021] [Indexed: 12/24/2022]
Abstract
Suicidal behavior (SB) involves an impairment in decision-making (DM). Jumping to conclusions bias (JTC), described as the tendency to make hasty decisions based on insufficient information, could be considered as analogous of impaired DM. However, the link between JTC and SB in psychosis and other diagnoses (e.g., depression) has never been studied. This study aims to explore the presence of JTC and SB in a sample comprising 121 patients with psychosis and 101 with depression. Sociodemographic and clinical data were collected, including history of SB and symptom-severity scores. JTC was assessed by the beads task, and patients who reached decisions with the second bead or before were considered to exhibit JTC. Age, gender, diagnosis, educational level, symptom severity, substance use, and SB were compared according to JTC presence. Variables found to be significantly different in this comparison were included in a multivariate analysis. JTC was more prevalent in patients with depression than with psychosis: 55.6% in an 85:15 ratio and 64.6% in a 60:40 ratio. When multivariate logistic regression was applied to study the influence of diagnosis (psychosis versus depression), age, and SB, only SB remained statistically significant (OR 2.05; 95% CI 0.99-4.22; p = 0.05). The population studied was assembled by grouping different samples from previous research, and we have not included control variables such as other clinical variables, neurocognitive measurements, or personality traits. JTC may be more closely linked to SB, as a transdiagnostic variable, rather than to a specific diagnosis.
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Affiliation(s)
- Aina Sastre-Buades
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | | | - Ana Barajas
- Centre D'Higiene Mental Les Corts, Barcelona, Spain; Departament de Psicologia Clínica I de La Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Ana Luengo
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Málaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Málaga, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi. Institut D'Assistència Sanitària, Girona, Spain
| | | | | | - Enrique Baca-García
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles, Spain; Department of Psychiatry, General Hospital of Villalba, Madrid, Spain; Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain; Universidad Católica Del Maule, Talca, Chile
| | - Maria L Barrigón
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry. Centre Hospitalier Universitaire de Nîmes, France.
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14
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Díaz-Cutraro L, García-Mieres H, López-Carrilero R, Ferrer M, Verdaguer-Rodriguez M, Barrigón ML, Barajas A, Grasa E, Pousa E, Lorente E, Ruiz-Delgado I, González-Higueras F, Cid J, Palma-Sevillano C, Moritz S, Ochoa S. Jumping to conclusions is differently associated with specific subtypes of delusional experiences: An exploratory study in first-episode psychosis. Schizophr Res 2021; 228:357-359. [PMID: 33548835 DOI: 10.1016/j.schres.2020.12.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Spain; Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Helena García-Mieres
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Marta Ferrer
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University of Barcelona, Faculty of Psychology, Spain
| | - Marina Verdaguer-Rodriguez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Spain
| | - María Luisa Barrigón
- Jiménez Díaz Foundation University Hospital, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain
| | - Ana Barajas
- Centre d'Higiene Mental Les Corts, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; Serra Húnter, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Spain
| | - Esther Pousa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Spain
| | - Ester Lorente
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Spain
| | | | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | - Carolina Palma-Sevillano
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain; Hospital de Mataró, Consorci Sanitari del Maresme, Spain
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | | | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
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15
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Birulés I, López-Carrilero R, Cuadras D, Pousa E, Barrigón ML, Barajas A, Lorente-Rovira E, González-Higueras F, Grasa E, Ruiz-Delgado I, Cid J, de Apraiz A, Montserrat R, Pélaez T, Moritz S, Ochoa S. Cognitive Insight in First-Episode Psychosis: Changes during Metacognitive Training. J Pers Med 2020; 10:jpm10040253. [PMID: 33260823 PMCID: PMC7711871 DOI: 10.3390/jpm10040253] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 01/28/2023] Open
Abstract
Background: Metacognitive training (MCT) has demonstrated its efficacy in psychosis. However, the effect of each MCT session has not been studied. The aim of the study was to assess changes in cognitive insight after MCT: (a) between baseline, post-treatment, and follow-up; (b) after each session of the MCT controlled for intellectual quotient (IQ) and educational level. Method: A total of 65 patients with first-episode psychosis were included in the MCT group from nine centers of Spain. Patients were assessed at baseline, post-treatment, and 6 months follow-up, as well as after each session of MCT with the Beck Cognitive Insight Scale (BCIS). The BCIS contains two subscales: self-reflectiveness and self-certainty, and the Composite Index. Statistical analysis was performed using linear mixed models with repeated measures at different time points. Results: Self-certainty decreased significantly (p = 0.03) over time and the effect of IQ was negative and significant (p = 0.02). From session 4 to session 8, all sessions improved cognitive insight by significantly reducing self-certainty and the Composite Index. Conclusions: MCT intervention appears to have beneficial effects on cognitive insight by reducing self-certainty, especially after four sessions. Moreover, a minimum IQ is required to ensure benefits from MCT group intervention.
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Affiliation(s)
- Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (I.B.); (R.L.-C.); (D.C.); (A.d.A.); (R.M.); (T.P.)
- Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, 08035 Barcelona, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (I.B.); (R.L.-C.); (D.C.); (A.d.A.); (R.M.); (T.P.)
- Investigación Biomédica en Red de Salud Mental (CIBERSAM) Instituto de Salud Carlos III C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (E.L.-R.); (E.G.)
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Santa Rosa, 39-57, 3a planta 08950 Esplugues de Llobregat, Barcelona, Spain
- Institut de Recerca en Salut Mental Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - Daniel Cuadras
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (I.B.); (R.L.-C.); (D.C.); (A.d.A.); (R.M.); (T.P.)
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Santa Rosa, 39-57, 3a planta 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Esther Pousa
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
- Consorci Corporació Sanitària Parc Taulí de Sabadell, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain
| | - Maria Luisa Barrigón
- Psychiatry Service, Area de Gestión Sanitaria Sur Granada, Motril, 18600 Granada, Spain;
- Department of Psychiatry, IIS-Fundación Jiménez Díaz Hospital, 28040 Madrid, Spain
| | - Ana Barajas
- Centre d’Higiene Mental Les Corts, 08029 Barcelona, Spain; or
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, 08193 Barcelona, Spain
| | - Ester Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental (CIBERSAM) Instituto de Salud Carlos III C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (E.L.-R.); (E.G.)
- Psychiatry Service, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | | | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM) Instituto de Salud Carlos III C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (E.L.-R.); (E.G.)
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
- Institut d’Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Málaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud Psychiatry Service, Antequera, 29200 Málaga, Spain;
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d’Assistència Sanitària, 17190 Girona, Spain;
| | - Ana de Apraiz
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (I.B.); (R.L.-C.); (D.C.); (A.d.A.); (R.M.); (T.P.)
| | - Roger Montserrat
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (I.B.); (R.L.-C.); (D.C.); (A.d.A.); (R.M.); (T.P.)
- Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, 08035 Barcelona, Spain
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (I.B.); (R.L.-C.); (D.C.); (A.d.A.); (R.M.); (T.P.)
- Investigación Biomédica en Red de Salud Mental (CIBERSAM) Instituto de Salud Carlos III C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (E.L.-R.); (E.G.)
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, 20251 Hamburg, Germany;
| | | | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; (I.B.); (R.L.-C.); (D.C.); (A.d.A.); (R.M.); (T.P.)
- Investigación Biomédica en Red de Salud Mental (CIBERSAM) Instituto de Salud Carlos III C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; (E.L.-R.); (E.G.)
- Institut de Recerca en Salut Mental Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Correspondence: ; Tel.: +34-936-406-350 (ext. 12538)
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Siddi S, Preti A, Lara E, Brébion G, Vila R, Iglesias M, Cuevas-Esteban J, López-Carrilero R, Butjosa A, Haro JM. Comparison of the touch-screen and traditional versions of the Corsi block-tapping test in patients with psychosis and healthy controls. BMC Psychiatry 2020; 20:329. [PMID: 32576254 PMCID: PMC7313222 DOI: 10.1186/s12888-020-02716-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 06/04/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Working memory (WM) refers to the capacity system for temporary storage and processing of information, which is known to depend on the integrity of the prefrontal cortex. Impairment in working memory is a core cognitive deficit among individuals with psychotic disorders. The Corsi block-tapping test is a widely-used instrument to assess visuospatial working memory. The traditional version is composed of 9 square blocks positioned on a physical board. In recent years, the number of digital instruments has increased significantly; several advantages might derive from the use of a digital version of the Corsi test. METHODS This study aimed to compare the digital and traditional versions of the Corsi test in 45 patients with psychotic disorders and 45 healthy controls. Both groups completed a neuropsychological assessment involving attention and working memory divided into the two conditions. RESULTS Results were consistent between the traditional and digital versions of the Corsi test. The digital version, as well as the traditional version, can discriminate between patients with psychosis and healthy controls. Overall, patients performed worse with respect to the healthy comparison group. The traditional Corsi test was positively related to intelligence and verbal working memory, probably due to a more significant effort to execute the test. CONCLUSIONS The digital Corsi might be used to enhance clinical practice diagnosis and treatment.The digital version can be administered in a natural environment in real-time. Further, it is easy to administer while ensuring a standard procedure.
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Affiliation(s)
- Sara Siddi
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Antonio Preti
- Psychiatry Branch, Centro Medico Genneruxi, Cagliari, Italy ,grid.7763.50000 0004 1755 3242Center of Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy
| | - Elvira Lara
- grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain ,grid.411251.20000 0004 1767 647XDepartment of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Gildas Brébion
- grid.5841.80000 0004 1937 0247Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Regina Vila
- grid.5841.80000 0004 1937 0247Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Iglesias
- grid.411438.b0000 0004 1767 6330Servei de Psiquiatria, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia Spain
| | - Jorge Cuevas-Esteban
- grid.411438.b0000 0004 1767 6330Servei de Psiquiatria, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia Spain
| | - Raquel López-Carrilero
- grid.5841.80000 0004 1937 0247Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Butjosa
- grid.5841.80000 0004 1937 0247Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Maria Haro
- grid.5841.80000 0004 1937 0247Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Salas-Sender M, López-Carrilero R, Barajas A, Lorente-Rovira E, Pousa E, Barrigón ML, Grasa E, Ruiz-Delgado I, González-Higueras F, Cid J, Aznar A, Pélaez T, Birulés I, Moritz S, The Spanish Metacognition Study Group, Ochoa S. Gender differences in response to metacognitive training in people with first-episode psychosis. J Consult Clin Psychol 2020; 88:516-525. [DOI: 10.1037/ccp0000468] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lorente-Rovira E, Grasa E, Ochoa S, Corripio I, Peláez T, López-Carrilero R, Gutiérrez-Gea Á, Morano-Guillén M, Villagrán JM, Bartels-Velthuis AA, Jenner JA, Sanjuán J. Different measures for auditory hallucinations in populations with psychosis. The Validation of the Spanish versions of the Auditory Vocal Hallucination Rating Scale (AVHRS) and the Positive and Useful Voices Inquiry (PUVI). Rev Psiquiatr Salud Ment (Engl Ed) 2020; 15:S1888-9891(20)30027-6. [PMID: 32493672 DOI: 10.1016/j.rpsm.2020.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 11/08/2019] [Accepted: 03/11/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION An updated summary of the most used instruments assessing auditory hallucinations in population with psychosis, allows us to underline the scarceness and need of Spanish versions of important instruments. The aim of the study is to examine the psychometric characteristics of two different and complementary instruments for assessing auditory hallucinations, the Spanish version of the Auditory Vocal Hallucination Scale (AVHRS) and the Spanish version of the Positive and Useful Voices Inquiry (PUVI). MATERIALS AND METHODS A sample of 68 patients from four different centres, with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder presenting with auditory hallucinations were included. Apart from the AVHRS and the PUVI, the Psychotic Symptom Rating Scales-Auditory Hallucinations subscale (PSYRATS-AH) and the Positive and Negative Syndrome Scale (PANSS) were also administered to all patients, plus an acceptability questionnaire. RESULTS The Spanish version of the AVHRS showed a good internal consistency, a moderate to high inter-rater reliability, a medium to moderate test-retest reliability, and a good convergent and discriminant validity. The Spanish version of the PUVI showed a good internal consistency and a heterogeneous, but in general moderate, test-retest reliability. CONCLUSIONS The Spanish versions of the AVHRS and the PUVI have good psychometric properties and are well accepted among patients.
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Affiliation(s)
- Esther Lorente-Rovira
- Hospital Clínico, Valencia, Spain; INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain.
| | - Eva Grasa
- CIBERSAM, Madrid, Spain; Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU, Hospital Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Madrid, Spain
| | - Iluminada Corripio
- CIBERSAM, Madrid, Spain; Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU, Hospital Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Spain
| | - Trinidad Peláez
- CIBERSAM, Madrid, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | | | | | | | - José M Villagrán
- Hospital Jerez de la Frontera, Servicio Andaluz de Salud, Cádiz, Spain
| | - Agna A Bartels-Velthuis
- University of Groningen, the Netherlands; University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
| | - Jack A Jenner
- Jenner Consult, Haren, the Netherlands Groningen, the Netherlands
| | - Julio Sanjuán
- Hospital Clínico, Valencia, Spain; INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain; Faculty of Medicine, Valencia, Spain
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García-Mieres H, Villaplana A, López-Carrilero R, Grasa E, Barajas A, Pousa E, Feixas G, Ochoa S. The Role of Personal Identity on Positive and Negative Symptoms in Psychosis: A Study Using the Repertory Grid Technique. Schizophr Bull 2020; 46:572-580. [PMID: 32275754 PMCID: PMC7147580 DOI: 10.1093/schbul/sbz082] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND People with psychosis experience disruptions in personal identity that affect positive and negative symptoms, but the complexity of these phenomena needs to be addressed in an in-depth manner. Using the Personal Construct Theory, we examined whether distinct dimensions of personal identity, as measured with the Repertory Grid Technique along with other cognitive factors, might influence psychotic symptomatology. METHOD Eighty-five outpatients with schizophrenia-spectrum disorders completed a repertory grid, an observed-rated interview of psychotic symptoms, and measures of cognitive insight, depressive symptoms, neurocognition, and theory of mind. RESULTS Structural equation models revealed that interpersonal dichotomous thinking directly affected positive symptoms. Self-discrepancies influenced positive symptoms by mediation of depressive symptoms. Interpersonal cognitive differentiation and interpersonal cognitive richness mediated the impact of self-reflectivity and neurocognitive deficits in negative symptomatology. CONCLUSIONS This study is the first of its kind to examine the structure of personal identity in relation to positive and negative symptoms of psychosis. Results suggest interventions targeted to improving interpersonal dichotomous thinking, self-discrepancies, interpersonal cognitive differentiation, and interpersonal cognitive richness may be useful in improving psychotic symptoms.
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Affiliation(s)
- Helena García-Mieres
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain,The Institute of Neurosciences, University of Barcelona, Barcelona, Spain,Parc Sanitari Sant Joan de Déu, Sant Joan de Déu Research Institute, Sant Boi de Llobregat, Barcelona, Spain,To whom correspondence should be addressed; Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebrón, 171, 08035, Barcelona, Spain; tel: +34-93-3125123, fax: +34-93-556-96-74, ,
| | - Anna Villaplana
- Parc Sanitari Sant Joan de Déu, Sant Joan de Déu Research Institute, Sant Boi de Llobregat, Barcelona, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Joan de Déu Research Institute, Sant Boi de Llobregat, Barcelona, Spain
| | - Eva Grasa
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital Santa Creu i Sant Pau; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain,Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
| | - Ana Barajas
- Centro de Higiene Mental Les Corts, Barcelona, Spain
| | - Esther Pousa
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital Santa Creu i Sant Pau; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain,Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain,The Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Joan de Déu Research Institute, Sant Boi de Llobregat, Barcelona, Spain,Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
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González LE, López-Carrilero R, Barrigón ML, Grasa E, Barajas A, Pousa E, González-Higueras F, Ruiz-Delgado I, Cid J, Lorente-Rovira E, Pélaez T, Ochoa S. Neuropsychological functioning and jumping to conclusions in recent onset psychosis patients. Schizophr Res 2018; 195:366-371. [PMID: 28969933 DOI: 10.1016/j.schres.2017.09.039] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/13/2017] [Accepted: 09/24/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The reasoning bias of jumping to conclusions (JTC) consists of a tendency to make assumptions having little information. OBJECTIVE The aim of this study was to estimate the differences in neuropsychological functioning between recent onset psychotic patients who jump to conclusions and those who do not jump to conclusions. MATERIALS AND METHODS One hundred and twenty-two patients with a recent onset of a psychotic disorder were assessed with three JTC tasks and a neuropsychological battery exploring verbal learning, memory, attention, psychomotor speed, visuoperceptual abilities, working memory, problem solving, executive functioning. RESULTS A total of 29.7% (n=36) of the individuals jumped to conclusions in Task 1, 14.0% (n=17) in Task 2, and 15.7% (n=19) in Task 3. People who jump to conclusions in three tasks scored significantly worse in many neuropsychological domain deficits, including attention (p<0.001-0.020), psychomotor speed (p<0.001), working memory (p<0.001-0.040), and executive functioning (p<0.001-0.042). DISCUSSION The present study demonstrates that JTC is present even in early stages of the illness, and that there is a relationship between JTC and neuropsychological functioning.
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Affiliation(s)
- Lucas Elio González
- Hospital de Emergencias Psiquiátricas 'Torcuato de Alvear', Ciudad Autónoma de Buenos Aires, Argentina; Centro Integral de Psicoterapias con Soporte Empítico (CIPSE), Ciudad Autónoma de Buenos Aires, Argentina; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Maria Luisa Barrigón
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain; Autonoma University, Madrid, Spain; Psychiatry Service, Area de Gestión Sanitaria Sur Granada, Motril, Granada, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Spain
| | - Ana Barajas
- Centre d'Higiene Mental Les Corts, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Esther Pousa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Salut Mental Parc Taulí, Sabadell (Barcelona), Hospital Universitari - UAB Universitat Autònoma de Barcelona, Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud Málaga, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
| | - Esther Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | | | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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Ochoa S, López-Carrilero R, Barrigón ML, Pousa E, Barajas A, Lorente-Rovira E, González-Higueras F, Grasa E, Ruiz-Delgado I, Cid J, Birulés I, Esteban-Pinos I, Casañas R, Luengo A, Torres-Hernández P, Corripio I, Montes-Gámez M, Beltran M, De Apraiz A, Domínguez-Sánchez L, Sánchez E, Llacer B, Pélaez T, Bogas JL, Moritz S. Randomized control trial to assess the efficacy of metacognitive training compared with a psycho-educational group in people with a recent-onset psychosis. Psychol Med 2017; 47:1573-1584. [PMID: 28166848 DOI: 10.1017/s0033291716003421] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Aims were to assess the efficacy of metacognitive training (MCT) in people with a recent onset of psychosis in terms of symptoms as a primary outcome and metacognitive variables as a secondary outcome. METHOD A multicenter, randomized, controlled clinical trial was performed. A total of 126 patients were randomized to an MCT or a psycho-educational intervention with cognitive-behavioral elements. The sample was composed of people with a recent onset of psychosis, recruited from nine public centers in Spain. The treatment consisted of eight weekly sessions for both groups. Patients were assessed at three time-points: baseline, post-treatment, and at 6 months follow-up. The evaluator was blinded to the condition of the patient. Symptoms were assessed with the PANSS and metacognition was assessed with a battery of questionnaires of cognitive biases and social cognition. RESULTS Both MCT and psycho-educational groups had improved symptoms post-treatment and at follow-up, with greater improvements in the MCT group. The MCT group was superior to the psycho-educational group on the Beck Cognitive Insight Scale (BCIS) total (p = 0.026) and self-certainty (p = 0.035) and dependence self-subscale of irrational beliefs, comparing baseline and post-treatment. Moreover, comparing baseline and follow-up, the MCT group was better than the psycho-educational group in self-reflectiveness on the BCIS (p = 0.047), total BCIS (p = 0.045), and intolerance to frustration (p = 0.014). Jumping to Conclusions (JTC) improved more in the MCT group than the psycho-educational group (p = 0.021). Regarding the comparison within each group, Theory of Mind (ToM), Personalizing Bias, and other subscales of irrational beliefs improved in the MCT group but not the psycho-educational group (p < 0.001-0.032). CONCLUSIONS MCT could be an effective psychological intervention for people with recent onset of psychosis in order to improve cognitive insight, JTC, and tolerance to frustration. It seems that MCT could be useful to improve symptoms, ToM, and personalizing bias.
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Affiliation(s)
- S Ochoa
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - R López-Carrilero
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - M L Barrigón
- Department of Psychiatry,IIS-Fundación Jiménez Díaz Hospital,Madrid,Spain
| | - E Pousa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | - A Barajas
- Centre d'Higiene Mental Les Corts,Barcelona,Spain
| | - E Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | | | - E Grasa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | - I Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte, UGC Salud Mental Carlos Haya,Servicio Andaluz de Salud Málaga,Spain
| | - J Cid
- Mental Health & Addiction Research Group, IdiBGi. Institut d'Assistencia Sanitària,Girona,Spain
| | - I Birulés
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - I Esteban-Pinos
- Psychiatry Service, Area de Gestión Sanitaria Sur Granada,Motril,Granada,Spain
| | - R Casañas
- Centre d'Higiene Mental Les Corts,Barcelona,Spain
| | - A Luengo
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | | | - I Corripio
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | - M Montes-Gámez
- Unidad de Salud Mental Comunitaria Malaga Norte, UGC Salud Mental Carlos Haya,Servicio Andaluz de Salud Málaga,Spain
| | - M Beltran
- Mental Health & Addiction Research Group, IdiBGi. Institut d'Assistencia Sanitària,Girona,Spain
| | - A De Apraiz
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - L Domínguez-Sánchez
- Psychiatry Service, Area de Gestión Sanitaria Norte de Málaga,Antequera,Málaga,Spain
| | - E Sánchez
- Centre d'Higiene Mental Les Corts,Barcelona,Spain
| | - B Llacer
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | - T Pélaez
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - J L Bogas
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - S Moritz
- Department of Psychiatry and Psychotherapy,University Medical Center Hamburg,Hamburg,Germany
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Usall J, López-Carrilero R, Iniesta R, Roca M, Caballero M, Rodriguez-Jimenez R, Oliveira C, Bernardo M, Corripio I, Sindreu SD, González Piqueras JC, Felipe AE, Fernandez de Corres B, Ibáñez A, Huerta R. Double-blind, placebo-controlled study of the efficacy of reboxetine and citalopram as adjuncts to atypical antipsychotics for negative symptoms of schizophrenia. J Clin Psychiatry 2014; 75:608-15. [PMID: 25004184 DOI: 10.4088/jcp.13m08551] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 11/19/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE In this study, we assessed the efficacy of 2 pharmacodynamically different antidepressants, citalopram (a selective serotonin reuptake inhibitor) and reboxetine (a norepinephrine reuptake inhibitor), as adjunctive therapy to risperidone and olanzapine for the treatment of negative symptoms in schizophrenia. METHOD We performed a 6-month, multicenter, double-blind, randomized, placebo-controlled clinical trial. The recruitment period was from November 2008 to December 2011.The sample comprised 90 patients with a diagnosis of schizophrenia (DSM-IV criteria) who exhibited negative symptoms. The patients were recruited from 10 centers in different cities of the Spanish State. The primary efficacy measure was change in score on the negative subscale of the Positive and Negative Syndrome Scale (PANSS) between baseline and 6-month assessment. Other efficacy measures were changes in the PANSS subscales and total score, as well as the Scale for the Assessment of Negative Symptoms (SANS) subscales and total score. RESULTS For statistical analysis, we employed mixed-effects models. We did not find statistically significant differences between the placebo group and the 2 treatment groups at 6-month assessments for the PANSS total (P=.6511), any PANSS subscale (negative [P=.5533], positive [P=.1723], or general psychopathology [P=.2083]), or the SANS (P= .5884). Cohen d measure showed a small effect size below the 0.5 threshold for all comparisons. CONCLUSIONS In conclusion, our results do not support adjunctive use of citalopram or reboxetine with risperidone or olanzapine for the treatment of negative symptoms in schizophrenia. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01300364.
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Affiliation(s)
- Judith Usall
- Pare Sanitari Sant Joan de Deu C/Antoni Pujadas, 42 Sant Boi de Llobregat 08830, Barcelona, Spain
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23
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Farreny A, Aguado J, Ochoa S, Huerta-Ramos E, Marsà F, López-Carrilero R, Carral V, Haro JM, Usall J. REPYFLEC cognitive remediation group training in schizophrenia: Looking for an integrative approach. Schizophr Res 2012; 142:137-44. [PMID: 23017827 DOI: 10.1016/j.schres.2012.08.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 08/09/2012] [Accepted: 08/27/2012] [Indexed: 02/06/2023]
Abstract
BACKGROUND Overall results from Cognitive Remediation (CR) indicate robust and long-lasting effects with medium effect size on global cognition and functioning, and a small ES on symptoms present at post-treatment but not at follow-up. However, results are not the same in all CR therapies and in some cases no efficacy results are achieved. AIMS To develop an integrative intervention taking into account previous efficacious therapies. To evaluate the efficacy of our cognitive remediation group training: Problem Solving and Cognitive Flexibility training (REPYFLEC), with the aim of improving cognition and functioning in schizophrenia patients. METHOD Participants with a diagnosis of schizophrenia or schizoaffective disorder (n=62) were randomized to 32 group sessions of REPYFLEC CR, or to 32 group sessions of activities without specific objectives and focused on leisure. In both groups the sessions were conducted twice a week. Functioning and psychiatric symptoms were measured at baseline (week 0) and thereafter at 8, 16 and 40 weeks. Cognition was measured at weeks 0, 16 and 40. Mixed Models were used to estimate statistical differences. RESULTS Patients in the cognitive remediation group demonstrated significant improvements in executive function, negative symptoms and functioning at post-treatment compared with patients in the control group. At 6-month follow-up, significant improvements in executive function and functioning remained. CONCLUSION These results apparently show that REPYFLEC works as cognitive remediation training, improving executive thinking and functioning outcomes compared with a control group.
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Affiliation(s)
- Aida Farreny
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Boi de LLobregat, Barcelona, Spain.
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