The EVACO Project: A new battery for assessing social cognition disorders and related psychiatric disability in schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S78-S78 ◽  
Author(s):  
P. Roux ◽  
M. Urbach ◽  
S. Fonteneau ◽  
B. Aouizerate ◽  
F. Berna ◽  
...  

The relation of social cognitive disorders and schizophrenic symptoms are well-established. Yet, assessment methods have not reached a consensus. In addition, causal paths between neurocognition, social cognition, symptoms and functional expression are not clearly understood. During the past few years, some authoritative accounts proposed specialized batteries of tests and emphasized theory of mind, emotion recognition, and interpretation bias constructs:– NIMH's “Social cognition psychometric evaluation” battery (Pinkham AE, Penn DL, Green MF, Harvey PD. Schizophrenia Bulletin, 2015);– “Social cognition and functioning in schizophrenia” (Green MF, Lee J, Ochsner KN. Schizophrenia Bulletin, 2013).Interestingly, these accounts stemming either from expert consensus and psychometric considerations or from neuroscience knowledge recognized some difficulties in providing a fully usable set of instruments. The project described here (EVACO protocol, funded by the Programme Hospitalier de Recherche Clinique national) follows an alternative approach and aims at providing a psychometrically validated battery. Based on a cognitive neuropsychology view on schizophrenic functional disability, several tests were gathered and are assessed in a 12-months multi-center follow-up of 160 individuals with schizophrenia. The FondaMental foundation network of Expert Centers is involved in recruiting patients from eight centers (Clermont-Ferrand, Colombes, Créteil, Grenoble, Marseille, Montpellier, Strasbourg, Versailles). To-date, the first evaluation of the population has been achieved. Experience reports and inclusions follow-up demonstrate the good acceptability of this battery both on the patients and the evaluator's side. We emphasize the usefulness of this project to meet the clinicians’ needs of validated social cognition tools, by describing different scenarios of use.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2010 ◽  
Vol 41 (6) ◽  
pp. 1253-1261 ◽  
Author(s):  
S. M. Eack ◽  
M. F. Pogue-Geile ◽  
D. P. Greenwald ◽  
S. S. Hogarty ◽  
M. S. Keshavan

BackgroundCognitive rehabilitation has emerged as an effective treatment for addressing cognitive impairments and functional disability in schizophrenia; however, the degree to which changes in various social and non-social cognitive processes translate into improved functioning during treatment remains unclear. This research sought to identify the neurocognitive and social-cognitive mechanisms of functional improvement during a 2-year trial of cognitive enhancement therapy (CET) for early-course schizophrenia.MethodPatients in the early course of schizophrenia were randomly assigned to CET (n=31) or an enriched supportive therapy control (n=27) and treated for up to 2 years. A comprehensive neurocognitive assessment battery and the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) were completed annually, along with measures of functioning. Mediator analyses using mixed-effects growth models were conducted to examine the effects of neurocognitive and social-cognitive improvement on functional change.ResultsImprovements over 2 years in neurocognition and the emotion management branch of the MSCEIT were found to be significantly related to improved functional outcome in early-course schizophrenia patients. Neurocognitive improvement, primarily in executive functioning, and social-cognitive change in emotion management also mediated the robust effects of CET on functioning.ConclusionsImprovements in neurocognition and social cognition that result from cognitive rehabilitation are both significant mediators of functional improvement in early-course schizophrenia. Cognitive rehabilitation programs for schizophrenia may need to target deficits in both social and non-social cognition to achieve an optimal functional response.


2016 ◽  
Vol 33 (S1) ◽  
pp. S336-S336
Author(s):  
V. Maria Iulia ◽  
R.C. Delphine ◽  
H. Audrey ◽  
K. Arthur

IntroductionThe research interest in social cognition in bipolar disorder has increased in a significant way in the last decade showing major impairments, especially in mental state reasoning, even during euthymia (Samamé et al., 2012; Samamé et al., 2015). Social cognitive processes in humans describe the ways individuals draw inferences about other people's beliefs and the ways they weigh social situational factors in making these inferences (Green et al., 2008). A causal relationship between social cognition deficits and global functioning has been already established in schizophrenic populations (Green et al., 2015). But there is still little information regarding the relation between social cognition and social functioning in bipolar disorder.AimsTo review the relationship between general/social functioning and social cognitive impairments in bipolar patients.MethodsA systematic review of literature was conducted. Relevant articles were identified through literature searches in PubMed/Medline, EBSCOHost and Google Scholar databases dating from 2000 to 2015 using the keywords “bipolar”, “social cognition”, “theory of mind”, “mentalizing”, “emotion recognition”, “emotion processing”, “functioning” and “quality of life”.ResultsThe findings of the review will be discussed, regarding the specificity of the thymic state of the patients and the social cognition instruments used.ConclusionsTo the best of our knowledge, the present review is the first to explore specifically the relation between the social cognition deficits and the general/social functioning of bipolar patients. This exploration is of interest for a better comprehension of this disorder to improve the outcome of the patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. s241-s241
Author(s):  
A. Arous ◽  
J. Mrizak ◽  
R. Trabelsi ◽  
A. Aissa ◽  
H. Ben Ammar ◽  
...  

IntroductionExisting research shows that individuals with schizophrenia (SCZ) show substantial deficits in social cognitive domains, including facial emotion recognition (FER), empathy, and Theory of Mind (ToM). Their exact relationship with the different dimensions included in the “Clinician- Rated Dimensions of Psychosis Symptom Severity” of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) remains unexplored.ObjectivesTo investigate the relationship between different social cognition dimensions and the dimensions of psychosis included in the DSM-5.MethodsFifty-eight outpatients with stable SCZ completed the Intention-Inferencing Task (IIT), a non-verbal ToM task and the Questionnaire of Cognitive and Affective Empathy (QCAE). They also completed a newly developed and validated FER task constructed from photographs of the face of a famous Tunisian actress and evaluating the ability to correctly identify Ekman's six basic facial emotions. The clinician-rated dimensions of psychosis symptom severity was used to evaluate 8 dimensions of psychosis.ResultsThe patients presenting higher cognitive empathy capacities had less present abnormal psychomotor behaviour scores (P = 0.05). Higher levels of affective empathy were correlated to lower present delusions score (P = 0.037). Better scores in the IIT were correlated to less present negative scores (P = 0.013) and less impaired cognition scores (P = 0.009). FER task score didn’t correlated with any clinical dimension.ConclusionsOur results suggest the existence of specific relationships between social cognition dimensions and psychosis dimensions. Further studies are needed to confirm these relationships.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2017 ◽  
Vol 41 (S1) ◽  
pp. S39-S40
Author(s):  
P. Rocca

Social cognition (SC) refers broadly to the domains of cognitive functions that are employed in socially relevant situations. These disturbances have been found to be strongly related to disorganized and negative symptoms in schizophrenia. Each of the disorganization symptoms suggests a diminishment or absence of organization. There seems to be a loss of the ability to be directed toward or committed to a particular focal topic or goal. Such conditions are likely to impact patients’ drives or motivations to initiate goal-directed activities that could yield pleasurable opportunities. Moreover, it has been suggested that disorganized symptoms are an integral link in cognitive pathways, with connections between cognitive processes weakening as disorganized symptoms increase. Thus, it seems that when disorganized symptoms are present, people with schizophrenia are no longer able to effectively utilize the neurocognitive abilities necessary for performing social cognitive or metacognitive tasks. It is also in line with models of disorganization in schizophrenia (Bleuler, 1911) that a “loosening of associations”—similar to current conceptualizations of disorganized symptoms—is at the core of these cognitive disruptions. Previous research has linked disorganization to cognition (neurocognition and SC) and cognition to social functioning, although in separate studies. The present study was conducted to explore a model, where disorganization predicted social functioning both directly both through indirect effects on other determinants (neurocognition, SC and negative symptoms) in a large, and well-characterized sample of patients with schizophrenia recruited in the context of a multi-center study of the Italian Network for Research on Psychoses (NIRP).Disclosure of interestThe author declares that he has no competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. S581-S582
Author(s):  
M. Minyaycheva ◽  
K. Kiselnikova ◽  
O. Papsuev

IntroductionThere has been a special interest in roles of neurocognition, social cognition and motivation impairments in patients with schizophrenia and possible approaches to remediating these deficits. Clinical practice lacks a comprehensive tool to measure those deficits.ObjectiveTo build a comprehensive assessment battery to measure neurocognitive, social cognitive and motivational deficits in order to form targets for remediation programs and assess their efficiency.AimsTranslation and adaptation for Russian speaking subjects (if needed) of identified assessments upon authors’ agreement.MethodsBy consensus decision of 5 professionals in the field of clinical psychiatry, psychology and neuroscience a number of assessments were selected with the following criteria: 1. Relevance to domain assessed, 2. Appropriateness for Russian social context, 3. Reference rates in scientific papers, 4. Time consumed by each assessment.ResultsSix measures reflecting main domains (neurocognition, Theory of Mind, attributional style, social perception, emotion processing, motivation) were selected: 1. BACS (Brief Assessment of Cognition in Schizophrenia) (R.S. Keefe et al., 2008), 2. Hinting Task (R. Corcoran 1995), 3. AIHQ (Ambiguous Intentions Hostility Questionnaire) (D.R. Combs et al., 2007), 4. RAD–15 (Relationships Across Domains) (M. Sergi et al., 2004), 5. Ekman–60 (P. Ekman et al., 1976), 6. AES (Apathy Evaluation Scale) (R.S. Marin et al., 1991).ConclusionsThe battery built encompasses all targeted domains of neurocognition, social cognition and motivation. Time consumed by the battery estimates 130 ± 15 minutes, which is appropriate for clinical practice in a rehabilitation centre. Future research will focus on patients profiling and shaping of rehabilitation programs accordingly.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. S68-S68
Author(s):  
G. Sachs ◽  
B. Winklbaur ◽  
A. Erfurth

Social cognition is impaired in patients with schizophrenia [1]. This impairment is one of the core features of the illness and has a clear impact on functional outcome.While conventional antipsychotics might have a worsening effect on social cognition, e.g. on amygdala attenuation in fMRI studies on facial recognition [2], atypical antipsychotics might not show this effect [3].Social cognitive training [4] – such as the training of affect recognition [5] – is a promising approach in the treatment of schizophrenia.Holistic strategies including both treatment with atypical antipsychotics and social cognitive training can improve functional outcome in patients with schizophrenia [6].Disclosure of interestThe author has not supplied his declaration of competing interest.


2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697469
Author(s):  
Rebecca Ward ◽  
Fahmy W Hanna ◽  
Ann Shelley-Hitchen ◽  
Ellen Hodgson ◽  
Adrian Heald ◽  
...  

BackgroundWomen with gestational diabetes (GDM) have an elevated risk of developing type 2 diabetes (T2DM). NICE Guidance recommends women who develop GDM are screened 6 weeks post-partum and annually thereafter.AimTo evaluate conformity to guidance of screening in women with GDM by 6-week post-partum fasting plasma glucose (FPG) and annual FPG and determine time between delivery and development of T2DM.MethodRecords at a tertiary referral centre were used to identify women (n = 54) diagnosed with GDM by antenatal oral glucose tolerance test between July 1999 and January 2007. Data from laboratory records were used to collect investigations of glycaemic status during the follow-up period (median follow-up 12.4 years, range 9.5–17.1 years).ResultsOf 252 women, 102 (40.2%) did not have a FPG at 6 weeks (+/−2 weeks). Of these, median time to first test was 1.2 years (range 0.04–10.8 years), with only 43.1% followed-up within 1 year. In those who had a 6-week FPG, 17 (11.3%) women had no further tests. A total of 84 (33% of those with gestational diabetes in the index pregnancy) women were diagnosed with T2DM; median time from delivery to diagnosis was 5.2 years (range 0.35–15.95). We found the only significant factor for a follow-up test at 1-year post-partum was the use of insulin.ConclusionOur data suggest an alternative approach is needed for monitoring women with a history of GDM. This needs to be appropriate for a generally healthy group in which traditional screening mechanisms may not be adequate or sufficient.


2011 ◽  
Vol 7 (2) ◽  
pp. 161-164 ◽  
Author(s):  
George Chater-Cure ◽  
Caitlin Hoffman ◽  
Jared Knopman ◽  
Samuel Rhee ◽  
Mark M. Souweidane

Object Surgical treatment for periorbital inclusion cysts typically involves a brow, pterional, or partial bicoronal scalp incision for sufficient exposure. The authors have recently employed an endoscopy-assisted technique as an alternative approach intended to minimize the length of the skin incision and avoid scarring in the brow. Methods Children having typical clinical findings of a dermoid cyst located on the hairless forehead were selected to undergo endoscopy-assisted cyst removal. For suspected intradiploic lesions, MR imaging was used to assess osseous involvement. After induction of general anesthesia, a 1–2-cm curvilinear incision was made posterior to the hairline. A 30°-angled endoscope (4 mm) was then used for dissection in the subgaleal compartment. Subgaleal dissection was followed by a circumferential periosteal incision in which the authors used an angled needle-tip unipolar cautery. For lesions within the diploe, a high-speed air drill was used to expose the lesion. Complete removal was accomplished with curettage of either the skull or dural surface. Results Eight patients (5–33 months of age) underwent outpatient endoscopic resection. Seven cysts were extracranial, and 1 cyst extended through the inner table. In all patients complete excision of the cyst was achieved. There was negligible blood loss, no dural violation, and no postoperative infection. There have been no recurrences at a mean follow-up of 15 months. Conclusions Endoscopy-assisted resection of inclusion cysts of the scalp and calvaria is a safe and effective surgical approach. The technique results in negligible incisions with less apparent scarring compared with previously described incisions. This limited-access technique does not appear to be associated with a higher incidence of cyst recurrence.


2021 ◽  
Author(s):  
Olga Basso ◽  
Sydney K Willis ◽  
Elizabeth E Hatch ◽  
Ellen M Mikkelsen ◽  
Kenneth J Rothman ◽  
...  

Abstract STUDY QUESTION Do daughters of older mothers have lower fecundability? SUMMARY ANSWER In this cohort study of North American pregnancy planners, there was virtually no association between maternal age ≥35 years and daughters’ fecundability. WHAT IS KNOWN ALREADY Despite suggestive evidence that daughters of older mothers may have lower fertility, only three retrospective studies have examined the association between maternal age and daughter’s fecundability. STUDY DESIGN, SIZE, DURATION Prospective cohort study of 6689 pregnancy planners enrolled between March 2016 and January 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Pregnancy Study Online (PRESTO) is an ongoing pre-conception cohort study of pregnancy planners (age, 21-45 years) from the USA and Canada. We estimated fecundability ratios (FR) for maternal age at the participant’s birth using multivariable proportional probabilities regression models. MAIN RESULTS AND THE ROLE OF CHANCE Daughters of mothers ≥30 years were less likely to have previous pregnancies (or pregnancy attempts) or risk factors for infertility, although they were more likely to report that their mother had experienced problems conceiving. The proportion of participants with prior unplanned pregnancies, a birth before age 21, ≥3 cycles of attempt at study entry or no follow-up was greater among daughters of mothers <25 years. Compared with maternal age 25–29 years, FRs (95% CI) for maternal age <20, 20–24, 30–34, and ≥35 were 0.72 (0.61, 0.84), 0.92 (0.85, 1.00), 1.08 (1.00, 1.17), and 1.00 (0.89, 1.12), respectively. LIMITATIONS, REASONS FOR CAUTION Although the examined covariates did not meaningfully affect the associations, we had limited information on the participants’ mother. Differences by maternal age in reproductive history, infertility risk factors and loss to follow-up suggest that selection bias may partly explain our results. WIDER IMPLICATIONS OF THE FINDINGS Our finding that maternal age 35 years or older was not associated with daughter’s fecundability is reassuring, considering the trend towards delayed childbirth. However, having been born to a young mother may be a marker of low fecundability among pregnancy planners. STUDY FUNDING/COMPETING INTEREST(S) PRESTO was funded by NICHD Grants (R21-HD072326 and R01-HD086742) and has received in-kind donations from Swiss Precision Diagnostics, FertilityFriend.com, Kindara.com, and Sandstone Diagnostics. Dr Wise is a fibroid consultant for AbbVie, Inc. TRIAL REGISTRATION NUMBER n/a


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