The Influences of Antipsychotics Therapy at Cognitive Impairments in Schizophrenia Spectrum Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S133-S133
Author(s):  
J. Dedovic ◽  
A. Tomcuk ◽  
T. Mijatovic-Papic ◽  
N. Matkovic

Significant degree of cognitive impairment represents one of the basic cornerstones among clinical manifestations of the schizophrenia spectrum disorders and accordingly to some authors it is present in up to 75% patients with these syndromes. The aim of this study was to examine degree of cognitive impairment, firstly among patients on first generation antipsychotics therapy (FGA) compared to the patients on second generation antipsychotics therapy (SGA), and secondly to compare both groups of patients with healthy controls.Material and methodsProspective, parallel research was conducted, in which the sample of patients and employees of Specialized Psychiatric Hospital Kotor was tested with Montreal Cognition Scale (MoCA). There were 66 participants in the samples and they were divided on four subgroups: (1) patients with FGA; (2) patients with SGA; (3) patients with combined FGA and SGA; (4) Healthy controls.ResultsAll groups of patients had statistically significantly lower mean MoCA scores in the comparison with healthy controls. The fact that among 83.7% of patients was diagnosed significant degree of cognitive decline (MoCA score bellow 26) strongly speaks in favour of high sensitivity of MoCA test in detection of cognitive impairment among patients with schizophrenia spectrum psychotic disorders. In addition, the group of patients with FGA also had statistically significantly lower mean MoCA score compared to patients with SGA.DiscussionThe mechanisms of explanation of these results can be additionally enlightened with further studies on larger samples of patients, which would investigate the correlation between extrapyramidal symptomatology, anticholinergic therapy and cognitive deficit.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Frances Dark ◽  
Ellie Newman ◽  
Victoria Gore-Jones ◽  
Veronica De Monte ◽  
Marta I. Garrido ◽  
...  

Abstract Background Compensation and adaptation therapies have been developed to improve community functioning via improving neurocognitive abilities in people with schizophrenia. Various modes of delivering compensation and adaptation therapies have been found to be effective. The aim of this trial is to compare two different cognitive interventions, Compensatory Cognitive Training (CCT) and Computerised Interactive Remediation of Cognition–Training for Schizophrenia (CIRCuiTS). The trial also aims to identify if mismatch negativity (MMN) can predict an individual’s response to the compensation and adaptation programmes. Methods This study will use a randomised, controlled trial of two cognitive interventions to compare the impact of these programmes on measures of neurocognition and function. One hundred clinically stable patients aged between 18 and 65 years with a diagnosis of a schizophrenia spectrum disorder will be recruited. Participants will be randomised to either the CCT or the CIRCuiTS therapy groups. The outcome measures are neurocognition (BACS), subjective sense of cognitive impairment (SSTICS), social functioning (SFS), and MMN (measured by EEG) in people with schizophrenia spectrum disorders. Discussion This trial will determine whether different approaches to addressing the cognitive deficits found in schizophrenia spectrum disorders are of comparable benefit using the outcome measures chosen. This has implications for services where cost and lack of computer technology limit the implementation and dissemination of interventions to address cognitive impairment in routine practice. The trial will contribute to the emerging evidence of MMN as a predictor of response to cognitive interventions. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618000161224. Registered on 2 February 2018. Protocol version: 4.0, 18 June 2018.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S305-S305
Author(s):  
Andreas Rosén Rasmussen ◽  
Josef Parnas

Abstract Background Imagination is the formation of ideas or images of something known not to be present to the senses. Clinical psychopathology has few notions addressing this domain apart from obsession and rumination. Some classic psychopathological notions such as Jaspers’ concept of pseudohallucination or the pseudo-obsession are relevant to this area. In a recent research project, informed by contemporary philosophy of mind and phenomenology, we have developed novel concepts targeting subjective disturbances of imagination and fantasy life with a focus on the schizophrenia-spectrum. Patients describe a spatialization of images, i.e., stable imagery with an articulated spatial structure being liable to inspection ‘from afar in the mind’ and often undergoing an autonomous development independently of the will of the patient (‘like watching a movie in the head’). Other notions address tacit, non-psychotic erosions of the demarcation of fantasy life from perception and memory. A broad range of ideations (such as ‘daydreams’, ‘fears’, anticipations, intrusions, paranoid or suicidal ideation) may involve such structural disturbances of experience. Here, we present data from the first, cross-sectional study investigating the distribution of anomalies of imagination in different diagnostic groups and healthy controls as well as their association with positive symptoms, negative symptoms and disorders of basic selfhood. Methods The sample (N=81) included in- and outpatients with schizophrenia or another non-affective psychosis (N=32), outpatients with schizotypal disorder (N=15) or other mental illness (N=16) and healthy controls (N=18). The sample was 70% female with mean age 29.9 (SD 6.8; range 18–42) years. Anomalies of imagination were assessed with the Examination of anomalous fantasy and imagination (EAFI), which is an instrument recently developed in our group for a semi-structured interview exploring these experiences. The EAFI has shown very good reliability with average Kappa of 0.84. Disorders of basic self were assessed with the Examination of anomalous self experience (EASE) and positive, negative and general symptoms with the Positive and Negative Syndrome Scale (PANSS). Results Anomalies of imagination aggregated significantly (p < 0.000, Kruskall-Wallis test) in the schizophrenia-spectrum disorders compared to other mental illness with no significant difference between schizophrenia and schizotypal disorder. The group of healthy controls very rarely reported these anomalies and scored significantly lower (p < 0.000) than all diagnostic groups. In multivariate linear regression analysis (R2 = 0.66), EAFI score was significantly associated with EASE score (β = 0.62, p < 0.000), PANSS positive (β = 0.34, p = 0.01) and PANSS negative (β = 0.29, p = 0.02), but not PANSS general score (β = -0.29, p = 0.07). More than 79% of the schizophrenia-spectrum patients retrospectively reported the onset of these experiences to adolescence or earlier. Discussion The results of this cross-sectional study support that the subjective anomalies of imagination, targeted with the EAFI, are associated with the schizophrenia-spectrum. The association with disorders of basic self, which has been shown to have trait-like characteristics and to predict transition to schizophrenia-spectrum disorders, may reflect that the anomalies of imagination share a common experiential core-structure with self disorders. We suggest that the anomalies of imagination belong to an early onset level of psychopathology in the schizophrenia-spectrum and may have a relevance for differential diagnosis and early detection.


2016 ◽  
Vol 33 (S1) ◽  
pp. s253-s254
Author(s):  
M. Holubova ◽  
J. Prasko ◽  
K. Latalova ◽  
M. Ociskova ◽  
A. Grambal ◽  
...  

IntroductionSelf-stigma is a maladaptive psychosocial phenomenon that can disturb self-image and quality of life in psychiatric outpatients and may lead to dysphoria, social isolation and reduced adherence to treatment.ObjectivesSelf-stigma and QoL could be reflected as important factors for patients, who suffer from schizophrenia spectrum disorders, their caregivers and mental health specialists. Focus on reducing the self-stigma in supportive and educational therapy could be an important factor in promoting a higher QoL.AimsCurrent research moved attention to the relationship between demographic data, the severity of symptoms, self-stigma and quality of life in schizophrenic outpatients compared to the QoL in healthy controls.MethodsPatients who met ICD-10 criteria for schizophrenia spectrum disorder were recruited in the study. The Quality of Life Satisfaction and Enjoyment questionnaire (Q-LES-Q), Internalized Stigma of Mental Illness (ISMI) and severity of the disorder measured by objective and subjective Clinical Global Impression severity scales (CGI) were assessed.ResultsOne hundred and nine psychotic patients and 91 healthy controls participated in the study. Compared to the control group, there was a lower QoL and a higher score of self-stigma in psychotic patients. We found the correlation between the self-stigma, duration of disorder and QoL. The level of self-stigma correlated positively with total symptom severity score and negatively with the QoL. Stepwise regression analysis revealed that the objective severity and self-stigma score were significantly associated with the quality of life (Figure 2 and 3, Fig. 1).ConclusionsOur study suggests a negative impact of self-stigma level on the quality of life in patients suffering from schizophrenia spectrum disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
M. V. Karyakina ◽  
A. B. Shmukler

There are results of cluster analysis of neurocognitive impairments in 85 patients with schizophrenia spectrum disorders in the article. Three patient groups were discriminated based on the results. These groups differ from each other both by severity of general cognitive impairment and by severity of impairments of the specific cognitive functions. There are differences between groups by specific demographic and clinical parameters. However sensitivity analysis does not find influence of these clinical parameters on the cognitive differences between groups, which stay certain after symptoms are taken into account.


2019 ◽  
Vol 10 (1) ◽  
pp. 204380871982709
Author(s):  
Michal Hajdúk ◽  
Dana Krajčovičová ◽  
Miroslava Zimányiová ◽  
Viera Kořínková ◽  
Anton Heretik ◽  
...  

Rapid and accurate trustworthiness judgments are important during successful day-to-day social interactions because they can influence the decision whether to approach someone and initiate social interaction. The aim of the present study was to analyze associations between these judgments and self-reported and clinician-rated social functioning. The sample consisted of 48 patients with schizophrenia spectrum disorders and 35 healthy controls matched for age, gender, and educational level. A trustworthiness task, subjective, and clinician-rated scales for social functioning were administered to both samples. Trustworthiness judgments did not differ between patients and healthy controls. Both groups were able to discriminate between trustworthy and untrustworthy faces. Trustworthiness ratings were associated with self-reported and clinician-rated measures of interpersonal functioning in patients with schizophrenia. Despite the absence of differences between groups, in patients with schizophrenia, a tendency to mistrust based on facial appearance was related to worse functional outcome, predominantly in the domain of disturbed interpersonal functioning. This study highlights the importance of future research into social–cognitive biases in schizophrenia.


2020 ◽  
pp. 107385842093616
Author(s):  
Valentina Ciullo ◽  
Gianfranco Spalletta ◽  
Carlo Caltagirone ◽  
Nerisa Banaj ◽  
Daniela Vecchio ◽  
...  

Transcranial direct current stimulation (tDCS) has been implemented in neuropsychiatric disorders characterized by cognitive impairment. However, methodological heterogeneity challenges conclusive remarks. Through a critical analysis of previous conflicting findings and in the light of current neurobiological models of pathophysiology, we qualitatively assessed the effects of tDCS in neuropsychiatric disorders that share neurobiological underpinnings, as to evaluate whether stimulation can improve cognitive deficits in patients’ cohorts. We performed a systematic review of tDCS studies targeting cognitive functions in mental disorders and pathological cognitive aging. Data from 41 studies, comprising patients with diagnosis of mood disorders, schizophrenia-spectrum disorders, Alzheimer’s disease (AD), and mild cognitive impairment (MCI), were included. Results indicate that tDCS has the capacity to enhance processing speed, working memory, and executive functions in patients with mood and schizophrenia-spectrum disorders. The evidence of a positive effect on general cognitive functioning and memory is either inconclusive in AD, or weak in MCI. Future directions are discussed for developing standardized stimulation protocols and for translating the technique therapeutic potential into effective clinical practice.


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