Insight and Social Cognition in First Episode of Psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. S272-S272
Author(s):  
L. Martínez ◽  
A. Mané ◽  
R. Cortizo ◽  
I. Cáceres ◽  
D. Treen ◽  
...  
Keyword(s):  
Social Cognition ◽  
Pearson Correlation ◽  
Treatment Compliance ◽  
First Episode ◽  
Psychotic Episode ◽  
Emotional Perception ◽  
Linear Correlation Analysis ◽  
Competing Interest ◽  
Underlying Mechanisms ◽  
Insight Into

IntroductionImpairment of insight in psychotic disorder is associated with adverse impact in treatment compliance, outcome and social functioning although its underlying mechanisms are still unknown. Social cognition and more specifically Theory of mind have been proposed to be correlated to insight. However, the relationship between both factors is still not well defined.AimsTo study the association between social cognition and insight into mental illness in individuals with early psychosis included in the first episode of psychosis program of Hospital del Mar.MethodsFrom the 94 patients included in the first psychotic episode program between January 2011 and January 2016, thirty-eight patients were evaluated six months after the episode. The three initial items of SUMD (Scale Unawareness of Mental Disorder) were used to measure insight and MSCEIT (Mayer-Salovey-Caruso Emotional Intelligence Test) was used to assess social cognition. Linear correlation analysis by Pearson correlation was conducted.ResultsInsight results of SUMD six months after the first episode of psychosis were significantly associated with several subsections of MSCEIT, such as experiential area total punctuation (r = –0.574; P = 0.025), emotional facilitation section (r = –0.633; P = 0.011) and the facial emotion perception task (r = –0.572; P = 0.026).ConclusionsResults suggest an association between insight and emotional perception and facilitation performance in first episode patients, which may suggest a role of social cognition in psychosis insight impairment. Further research to better define the participation of social cognition in insight into psychosis alteration is mandatory to understand the etiology of insight, define treatment targets and consequently improve the disorder prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

No effect of cognitive performance on post-intervention improvement in emotion recognition

2017 ◽  
Vol 41 (S1) ◽  
pp. S190-S190
Author(s):  
V.P. Bozikas ◽  
S. Tsotsi ◽  
A. Dardagani ◽  
E. Dandi ◽  
E.I. Nazlidou ◽  
...  
Keyword(s):  
Emotion Recognition ◽  
Cognitive Performance ◽  
Neuropsychological Test ◽  
Emotion Perception ◽  
First Episode ◽  
Psychotic Episode ◽  
Post Intervention ◽  
Basic Emotions ◽  
The Difference ◽  
Competing Interest

Deficits in emotion perception in patients with first episode of psychosis have been reported by many researchers. Till now, training programs have focused mainly in patients with schizophrenia and not in first psychotic episode (FEP) patients. We used a new intervention for facial affect recognition in a group of 35 FEP patients (26 male). The emotion recognition intervention included coloured pictures of individuals expressing six basic emotions (happiness, sadness, anger, disgust, surprise, fear) and a neutral emotion. The patients were trained to detect changes in facial features, according to the emotion displayed. A comprehensive battery of neuropsychological tests was also administered, measuring attention, memory, working memory, visuospatial ability and executive function by using specific tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). We tried to explore whether cognitive performance can explain the difference noted between the original assessment of emotion recognition and the post-intervention assessment. According to our data, overall cognitive performance did not correlate with post-intervention change in emotion recognition. Specific cognitive domains did not correlate with this change, either. According the above mentioned results, no significant correlation between neuropsychological performance and post-intervention improvement in emotion recognition was noted. This finding may suggest that interventions for emotion recognition may target specific processes that underlie emotion perception and their effect can be independent of general cognitive function.Disclosure of interestThe authors have not supplied their declaration of competing interest.

From ADHD to psychosis… executive functions and time

2016 ◽  
Vol 33 (S1) ◽  
pp. S353-S353
Author(s):  
C.D.M. Isabel
Keyword(s):  
Executive Functions ◽  
Psychotic Disorders ◽  
Stressful Life Event ◽  
Auditory Hallucination ◽  
First Episode ◽  
Psychotic Episode ◽  
Positive Symptoms ◽  
Memory Work ◽  
First Psychotic Episode ◽  
Competing Interest

IntroductionCognitive impairment is present from the early stages of psychotic disorders. Alterations are found mainly in areas of attention, memory work and executive functions. During adolescence, ADHD patients often suffer from secondary disorders to lack of efficient procurement processes information by the poor development of executive functions.ObjectiveEvaluation of a patient whose diagnosis of ADD evolve to acute psychotic episode.MethodReview by clinical and psychometric tests developments in executive functions disorders.ResultsTwelve years old patient who comes to the hospital since 2012, was initially diagnosed with literacy difficulties and low academic performance, after MFF-20 speaks of Learning Disabilities. It presents lack of motivation, apathy, difficulty in scheduling and organization and adherence to schedules, so they diagnosed ADD. It is given treatment with methylphenidate and atomoxetine, presenting erratic path.After a year without treatment and the presence of a major stressful life event, at 17, has a first episode, consisting in mutiste attitude, phenomena of self-referenciality, experiences of control, enforcement and dissemination of ideas and auditory hallucination imperative type.ConclusionsThe presence of emocional dysregulation and alterations in the executive functions atribuyen to ADD, in this case, were premorbid symtomatology of a first psychotic episode. The presence of positive symptoms allows to clarify the diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Treatment Adherence in Psychosis: A 2 Years Follow-Up of First-Psychotic Episode Patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S271-S272
Author(s):  
S. Malta Vacas ◽  
R. Carvalho ◽  
M.J. Heitor
Keyword(s):  
Great Majority ◽  
First Episode ◽  
Psychotic Episode ◽  
Term Care ◽  
First Psychotic Episode ◽  
Effective Interventions ◽  
Episode Psychosis ◽  
Competing Interest

IntroductionMuch research on psychosis has focused on early detection and the development of effective interventions. However, the effectiveness of any intervention depends on the willingness of the patient to engage with an intervention in a sustained manner. Disengagement from treatment by patients with serious mental illness is a major concern of mental health services.ObjectivesThis study aims to examine the prevalence of disengagement in a longitudinal cohort of first episode psychosis (FEP) patients.MethodsRetrospective naturalistic 2 years follow-up study of FEP patients aged 18 to 35 admitted into the department of psychiatry of the Beatriz Angelo's hospital from 2012 to 2014. Data on socio-demographics, clinical characteristics, appointments and medication adherence and readmissions were collected.ResultsBetween 2012 and 2014 were admitted 56 patients with a FEP into the department of psychiatry of the Beatriz Angelo's hospital. The great majority of the patients (67.9%) disengaged from the treatment, both appointments and medication. Of those, 13.2% did not attend any appointment, 26.3% attended between one and three appointments and 60.5% attended at least 3 appointments before disengaged. About 23% were readmitted between the 2 years follow up period, 15.4% were readmitted more than once.ConclusionsThe evidence reviewed indicates that approximately 30% of individuals with FEP disengage from services. Continuity of care is of particular importance with FEP, given evidence suggesting that long-term care can improve symptoms and functioning and reduces relapse risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Social cognition and bipolar disorder: A preliminary study

2017 ◽  
Vol 41 (S1) ◽  
pp. S426-S426
Author(s):  
F.D.R. Ponte ◽  
T.D.A. Cardoso ◽  
M. Kunz ◽  
A.R. Rosa
Keyword(s):  
Bipolar Disorder ◽  
Social Cognition ◽  
Clinical Outcomes ◽  
Cross Sectional Study ◽  
First Episode ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Preliminary Study ◽  
Competing Interest ◽  
Cognition Impairment

AimTo assess the clinical outcomes associated with social cognition impairment in euthymic patients with bipolar disorder.MethodIt was a cross-sectional study with convenience sample. The diagnose of bipolar disorder was performed by psychiatrist, using DSM-IV criteria, at bipolar disorder program – Hospital de Clinicas de Porto Alegre (Brazil), where the sample was recruited. The social cognition was assessed by psychologists using the Reading the Mind in the Eyes Test.ResultsWe included 46 euthymic BD patients: BD I (n = 39), women (n = 32), age (49.11 ± 13.17), and years of education (10.56 ± 3.80). Patients with social cognition impairment were not different of patients without social cognition impairment regarding socio demographic factors (gender, age, educational level, marital status, and employment status). Patients with social cognitive impairment showed higher rates of BD I patients (P = 0.036) and higher proportion of hospitalization in the first episode (P = 0.033), as compared to patients without social cognition impairment.ConclusionThis is a preliminary study demonstrating that BD patients with social cognition impairment show worse clinical outcomes. Severe BD onset seems to be an important predictor of social cognition impairment. However, more studies are needed investigating social cognition impairment in subjects with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clozapine induced diarrhea

2017 ◽  
Vol 41 (S1) ◽  
pp. s502-s502
Author(s):  
S. Ramos-Perdigues ◽  
M.J. Gordillo ◽  
C. Caballero ◽  
S. Latorre ◽  
S.V. Boned ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Differential Diagnosis ◽  
Therapeutic Option ◽  
Disease Diagnosis ◽  
First Episode ◽  
Psychotic Episode ◽  
Histological Findings ◽  
Anticholinergic Effects ◽  
Severe Diarrhea ◽  
Competing Interest

IntroductionClozapine (CZP) is the only antipsychotic approved for resistant schizophrenia 1. Due to its side effects, CZP is not the first therapeutic option in a psychotic episode. Its anticholinergic effects often cause constipation, however, diarrhea have also been described in literature.ObjectivesWe describe a patient with two episodes of severe diarrhea after clozapine initiation, which lead to CZP discontinuation.AimsDiscuss about the differential diagnosis of diarrhea in CZP patients and the needing of a further studies for clarify the more appropriate management in CZP induced diarrhea.MethodsWe present a case report of a 46 years man diagnosed with schizoaffective disorder who presented two episodes of severe diarrhea with fever, which forced his transfer to internal medicine and UCI after CZP initiation.ResultsAt the first episode analytical, radiological and histological findings led to Crohn's disease diagnosis, which required budesonide and mesalazine treatment. In the second episode, the digestive team concluded that the episode was due to clozapine toxicity despite the controversial findings (clostridium toxin and Crohn's compatible biopsies)ConclusionsDiarrhea caused by CZP has been controversial in the literature. However due to the severity of digestive episodes and the paucity of alternative treatments further studies for a better understanding of its physiopathology are warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

How Could Affect Stress, PEP and Sex in Working Memory?

2017 ◽  
Vol 41 (S1) ◽  
pp. S98-S98
Author(s):  
C.-R. Maria Isabel ◽  
C.-R. Manuel ◽  
M. Andrea ◽  
R.-V. Miguel
Keyword(s):  
Working Memory ◽  
Social Cognition ◽  
Cognitive Processes ◽  
Cognitive Abilities ◽  
Visual Memory ◽  
Motor Coordination ◽  
First Episode ◽  
Control Group ◽  
General Functioning ◽  
Competing Interest

BackgroundThe first episode of psychosis is a crucial period when early intervention can alter the trajectory of the young person's ongoing mental health and general functioning. Cognitive abilities are nuclear for the social recovery. Stress impairs higher cognitive processes, dependent on the prefrontal cortex (PFC) and that involve maintenance and integration of information over extended periods, including working memory and attention. Different mechanism are involved such as HPA-Axis hyperactivity, affecting PFC. Recently, investigations show the different evolution of cognitive abilities between different sex in WM.MethodsA sample of 41 FEPs and 39 healthy subjects were evaluated. The variables assessed were verbal and visual memory, attention, working memory, processing speed, mental flexibility, verbal fluency, motor coordination, planning ability and intelligence.ResultsWe found an interaction between age (< 16 years and > 16 years) and group (psychosis vs. controls) in working memory (P = 0.04). There were no difference in men < 16 years old control group and men with same age plus psychosis (5.87 ± 1.57 vs. 5.83 ± 1; P = 0.1) in WM. However, this work was found to be significantly different in the univariant analysis of working memory in the group < 16 years old women control (7.30 ± 1.56) and women psychosis group (5.61 ± 1.91).ConclusionSocial cognition and stress seem to be directly relation. Some studies show that stress enhance cognition performance in men while impairing it in women. Stress affect a variety of cognitive processes such attention and working memory. Deficit in social cognition are present in the prodromal phases of psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Social cognition and bipolar disorder: A preliminary study

2017 ◽  
Vol 41 (S1) ◽  
pp. S425-S425
Author(s):  
F.D.R. Ponte ◽  
T.D.A. Cardoso ◽  
F.M. Lima ◽  
M. Kunz ◽  
A.R. Rosa
Keyword(s):  
Bipolar Disorder ◽  
Social Cognition ◽  
Clinical Outcomes ◽  
Cross Sectional Study ◽  
First Episode ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Preliminary Study ◽  
Competing Interest ◽  
Cognition Impairment

AimTo assess the clinical outcomes associated with social cognition impairment in euthymic patients with bipolar disorder.MethodIt was a cross-sectional study with convenience sample. The diagnose of bipolar disorder was performed by psychiatrist, using DSM-IV criteria, at bipolar disorder program – Hospital de Clinicas de Porto Alegre (Brazil), where the sample was recruited. The social cognition was assessed by psychologists using the Reading the Mind in the Eyes Test.ResultsWe included 46 euthymic BD patients: BD I (n = 39), women (n = 32), age (49.11 ± 13.17), and years of education (10.56 ± 3.80). Patients with social cognition impairment were not different of patients without social cognition impairment regarding socio demographic factors (gender, age, educational level, marital status, and employment status). Patients with social cognitive impairment showed higher rates of BD I patients (P = 0.036) and higher proportion of hospitalization in the first episode (P = 0.033), as compared to patients without social cognition impairment.ConclusionThis is a preliminary study demonstrating that BD patients with social cognition impairment show worse clinical outcomes. Severe BD onset seems to be an important predictor of social cognition impairment. However, more studies are needed investigating social cognition impairment in subjects with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A longitudinal evaluation of cognitive deficits in patients with first episode of psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. S190-S190
Author(s):  
A. Dardagani ◽  
P. Athanasis ◽  
A. Lagoudis ◽  
A. Ramnalis ◽  
E. Ntouros ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Deficits ◽  
Repeated Measures ◽  
Neuropsychological Test ◽  
First Episode ◽  
Psychotic Episode ◽  
Cognitive Domains ◽  
Mental Flexibility ◽  
Competing Interest ◽  
Over Time

It has been well documented in many studies till now that patients in their first episode of psychosis demonstrate cognitive deficits. However, it is yet to be made clear how these deficits progress. Deterioration, stability or even amelioration in some domains has been noted from researchers. The aim of this study was to examine the longitudinal course of cognitive deficits over time. We administered a comprehensive battery of neuropsychological test to a group of first psychotic episode patients at the acute phase, 6 months and 1 year later. The sample comprised of 25 patients (13 male) in the first episode of psychosis. Specific tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used. The cognitive domains of attention, memory, working memory, visuospatial ability and planning, mental flexibility/shifting were examined. Repeated measures ANOVA was used in order to detect changes in the patients’ performance over time. According to our data, there was an improvement from baseline to 6 months in attention, planning and visual working memory. There was no change in performance in these cognitive domains from 6 months to 1 year from baseline. Memory, mental flexibility/shifting and visuospatial memory remained stable over time. Our data suggest variability concerning neuropsychological performance in specific tests examining different domains. Evaluation of cognitive function in the first episode of psychosis needs more thorough and comprehensive research, in relation to its course over time.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Early Psychosis: Diagnosis and Treatment

2020 ◽  
Vol 09 ◽  
Author(s):  
Nataly S. Beck ◽  
Melanie L. Lean ◽  
Kate V. Hardy ◽  
Jacob S. Ballon
Keyword(s):  
United States ◽  
Early Identification ◽  
Mental Health Problems ◽  
The United States ◽  
Early Psychosis ◽  
Screening Tools ◽  
Diagnosis And Treatment ◽  
First Episode ◽  
Psychotic Episode ◽  
First Onset

Background: The typical age of onset for psychotic disorders is concurrent with the typical age of enrollment in higher education. College and graduate students often experience new academic and social demands that may leave them vulnerable to substance use and mental health problems, including the initial onset of a psychotic episode. Objective: To provide a current overview of the guidelines and literature for the diagnosis and treatment of first-onset psychosis with special consideration for the college and graduate student population in the United States. To highlight areas of need and provide recommendations for clinicians who work at educational institutions and their health services, along with general psychiatrists and psychologists who work with post-secondary education populations, to help close the treatment gap. Method: A review of interventions and best practice for the treatment of early psychosis in college students was conducted, informed by the authors’ current experience as clinicians with this population at a United States university. Results: Thorough psychiatric interviews and screening tools can help in the early identification of individuals at clinical high risk for and at first onset of psychosis. Coordinated specialty care services are the gold standard for early psychosis services, including psychotherapy (such as cognitive behavioral therapy and individual resiliency training), as well as support for a student to return to school or work. Individuals experiencing a first episode of psychosis in general respond better to lower doses of antipsychotics and may also experience more adverse effects. Conclusion: Return to a high level of functioning is possible in many cases of first onset of psychosis, and early identification and treatment is essential.

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