Cognitive markers related to long-term remission status in Schizophrenia Spectrum Disorders

AbstractBackgroundCognitive disturbances are widely pronounced in schizophrenia and schizophrenia spectrum disorders. Whilst cognitive deficits are well established in the prodromal phase and are known to deteriorate at the onset of schizophrenia, there is a certain discrepancy of findings regarding the cognitive alterations over the course of the illness.MethodsWe bring together the results of the longitudinal studies identified through PubMed which have covered more than 3 years follow-up and to reflect on the potential factors, such as sample characteristics and stage of the illness which may contribute to the various trajectories of cognitive changes.ResultsA summary of recent findings comprising the changes of the cognitive functioning in schizophrenia patients along the longitudinal course of the illness is provided. The potential approaches for addressing cognition in the course of schizophrenia are discussed.ConclusionsGiven the existing controversies on the course of cognitive changes in schizophrenia, differentiated approaches specifically focusing on the peculiarities of the clinical features and changes in specific cognitive domains could shed light on the trajectories of cognitive deficits in schizophrenia and spectrum disorders.

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Schizophrenia Spectrum Disorders in Relation to the Totality of Psychosis: From First Episode to Long-Term Outcome

Handbook of Schizophrenia Spectrum Disorders, Volume II ◽

10.1007/978-94-007-0831-0_10 ◽

2011 ◽

pp. 269-279 ◽

Cited By ~ 2

Author(s):

Tara Kingston ◽

Olabisi Owoeye ◽

Anthony Kinsella ◽

Vincent Russell ◽

Eadbhard O’Callaghan ◽

...

Keyword(s):

First Episode ◽

Schizophrenia Spectrum Disorders ◽

Term Outcome ◽

Long Term Outcome ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

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Approved and emerging smoking cessation treatments for people with schizophrenia spectrum disorders: A narrative review

Health Psychology Research ◽

10.4081/hpr.2020.9237 ◽

2020 ◽

Vol 8 (2) ◽

Author(s):

Pasquale Caponnetto ◽

Riccardo Polosa

Keyword(s):

Smoking Cessation ◽

Behavioral Treatment ◽

Behavioural Therapy ◽

Schizophrenia Spectrum Disorders ◽

Smoking Cessation Treatment ◽

Schizophrenia Spectrum ◽

Cessation Treatment ◽

Original Contribution ◽

Spectrum Disorders

This review focuses on smoking cessation treatments for people with schizophrenia spectrum disorders. It concludes with comments on the significance of the research and why it constitutes an original contribution. We searched PubMed (National Library of Medicine), and PsycINFO (Ovid) (2006-2020) for studies on schizophrenic disorder (schizophrenia or psychotic or psychosis or severe mental illness) and smoking cessation treatment (smoking cessation treatment or varenicline or tobacco cessation or reduction or bupropion or NRT or behavioral treatment or e-cigarette). Studies found evidence suggesting that pharmacotherapy combined with behavioural therapy for smoking cessation is effective amongst smokers with schizophrenia spectrum disorders, although more long-term research is required. This review summarised and critically reviewed also studies on vaping as a smoking cessation strategy for smokers with schizophrenia spectrum disorders and evidence suggests that they may effective as smoking cessation tool and may be less harmful alternatives to combustible cigarette smoking. Consequently, e-cigarettes could be considered as an applicable instrument for Tobacco Harm Reduction (THR) and smoking cessation. Overall, there are very few studies of e-cigarettes for smoking cessation in patients with schizophrenia and these studies are very small. They have promising results, but more research is needed.

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O6.2. A NETWORK FOR COGNITIVE, MOTOR, AND PSYCHOPATHOLOGICAL ALTERATIONS IN SCHIZOPHRENIA SPECTRUM DISORDERS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa028.031 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S13-S14

Author(s):

Bernardo Moura ◽

Geeske van Rooijen ◽

Frederike Schirmbeck ◽

Johanna Wigman ◽

Peter Van Harten ◽

...

Keyword(s):

Network Analysis ◽

Graphical Model ◽

Clinical Manifestations ◽

Schizophrenia Spectrum Disorders ◽

Psychopathological Symptoms ◽

Remission Status ◽

Schizophrenia Spectrum ◽

Assessment And Treatment ◽

Spectrum Disorders ◽

Motor Alterations

Abstract Background Schizophrenia spectrum disorders are complex syndromes involving multiple clinical manifestations. Besides psychopathological symptoms, cognitive and motor alterations are also highly relevant in the context of the comprehension, assessment, and treatment of these disorders. Moreover, these three domains of clinical manifestations display complex reciprocal interactions that require further characterization. This work aims to use network analysis to investigate the associations between cognitive, motor, and psychopathological alterations in schizophrenia spectrum disorders. This approach might prove to be advantageous in identifying key variables for the assessment and treatment of these disorders. Methods A sample of 732 patients with schizophrenia spectrum disorders from a multi-site cohort study was included in the analysis. We estimated a network using a regularized Gaussian Graphical Model and conducted network stability analyses. Twenty-six nodes were included, encompassing items from the Positive and Negative Syndrome Scale, multiple neuropsychological tests, and clinician-assessed extrapyramidal symptoms’ scores. The results were further explored with centrality analyses and network comparisons between subgroups defined according to illness duration and remission status. Results We found that the estimated network was densely interconnected. Furthermore, nodes representing symptoms of disorganization were very central and, therefore, pivotal in connecting other psychopathological symptoms to cognitive and motor alterations. The estimated network for the subgroup of patients in remission showed a more sparse density and a different structure from the network of non-remitted patients. Discussion In conclusion, in the context of a broader representation of schizophrenia spectrum disorders’ manifestations, our results of a network analysis confirm a close association between different symptom domains and unveil a highly influential role of disorganization symptoms. Moreover, structural differences in networks occur according to remission status. These results are relevant for research in nosology, clinical assessment, and treatment approaches.

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Electrocardiographic signs of autonomic imbalance in medicated patients with first-episode schizophrenia spectrum disorders – relations to first treatment discontinuation and five-year remission status

European Psychiatry ◽

10.1016/j.eurpsy.2010.12.002 ◽

2012 ◽

Vol 27 (3) ◽

pp. 213-218 ◽

Cited By ~ 2

Author(s):

Robert Bodén ◽

Leif Lindström ◽

Pentti Rautaharju ◽

Johan Sundström

Keyword(s):

Heart Rate ◽

Small Sample ◽

First Episode ◽

Autonomic Balance ◽

Schizophrenia Spectrum Disorders ◽

Prognostic Information ◽

Remission Status ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

First Episode Schizophrenia

AbstractPurposeTo explore measures in electrocardiograms (ECG) influenced by autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent first antipsychotic pharmacotherapy discontinuation and five-year remission status.Subjects and methodsTwelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the Positive and Negative Syndrome Scale.ResultsPatients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy and with non-remission five years later.Discussion and conclusionIn this longitudinal cohort study, simple ECG measures influenced by autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. As this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.

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FC19-02 - Electrocardiographic signs of autonomic imbalance in first-episode schizophrenia spectrum disorders— relations to first treatment discontinuation and five-year remission status

European Psychiatry ◽

10.1016/s0924-9338(11)73620-3 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1916-1916 ◽

Cited By ~ 1

Author(s):

R. Bodén ◽

L. Lindström ◽

P. Rautaharju ◽

J. Sundström

Keyword(s):

Heart Rate ◽

Left Ventricular ◽

First Episode ◽

Healthy Controls ◽

Autonomic Balance ◽

Schizophrenia Spectrum Disorders ◽

Remission Status ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

First Episode Schizophrenia

IntroductionSchizophrenia has since over a hundred years been associated with autonomic dysregulation, but the prognostic importance of this phenomenon is unclear.Objectives/aimsTo explore measures in electrocardiograms (ECG) reflecting autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent outcome. Three aspects of routine ECG measures were investigated:1)differences between patients with first-episode schizophrenia spectrum disorders and healthy controls,2)relations to early discontinuation of first antipsychotic medication and finally3)associations to symptomatic remission status five years later.MethodsTwelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization and left ventricular hypertrophy. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the Positive and Negative Syndrome Scale.ResultsPatients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy (hazard ratios 1.3–2.4) and with non-remission five years later (odds ratios 2.9–6.4).ConclusionIn this longitudinal cohort study, simple ECG measures reflecting autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. However, as this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.

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Long-term effectiveness of electroconvulsive therapy in adolescents with schizophrenia spectrum disorders

European Child & Adolescent Psychiatry ◽

10.1007/s00787-014-0602-3 ◽

2014 ◽

Vol 24 (5) ◽

pp. 517-524 ◽

Cited By ~ 7

Author(s):

Itziar Flamarique ◽

Inmaculada Baeza ◽

Elena de la Serna ◽

Alexandre Pons ◽

Miguel Bernardo ◽

...

Keyword(s):

Electroconvulsive Therapy ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

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Predicting first-episode psychosis patients who will never relapse over 10 years

Psychological Medicine ◽

10.1017/s0033291718003070 ◽

2018 ◽

Vol 49 (13) ◽

pp. 2206-2214 ◽

Cited By ~ 2

Author(s):

Christy LM Hui ◽

William G Honer ◽

Edwin HM Lee ◽

WC Chang ◽

Sherry KW Chan ◽

...

Keyword(s):

First Episode Psychosis ◽

First Episode ◽

Psychotic Episode ◽

Positive Symptoms ◽

Schizophrenia Spectrum Disorders ◽

Medication Discontinuation ◽

Schizophrenia Spectrum ◽

Episode Psychosis ◽

Spectrum Disorders

AbstractBackgroundAlthough relapse in psychosis is common, a small proportion of patients will not relapse in the long term. We examined the proportion and predictors of patients who never relapsed in the 10 years following complete resolution of positive symptoms from their first psychotic episode.MethodPatients who previously enrolled in a 12-month randomized controlled trial on medication discontinuation and relapse following first-episode psychosis (FEP) were followed up after 10 years. Relapse of positive symptoms was operationalized as a change from a Clinical Global Impression scale positive score of <3 for at least 3 consecutive months to a score of ⩾3 (mild or more severe). Baseline predictors included basic demographics, premorbid functioning, symptoms, functioning, and neurocognitive functioning.ResultsOut of 178 first-episode patients, 37 (21%) never relapsed during the 10-year period. Univariate predictors (p ⩽ 0.1) of patients who never relapsed included a duration of untreated psychosis (DUP) ⩽30 days, diagnosed with non-schizophrenia spectrum disorders, having less severe negative symptoms, and performing better in logical memory immediate recall and verbal fluency tests. A multivariate logistic regression analysis further suggested that the absence of any relapsing episodes was significantly related to better short-term verbal memory, shorter DUP, and non-schizophrenia spectrum disorders.ConclusionsTreatment delay and neurocognitive function are potentially modifiable predictors of good long-term prognosis in FEP. These predictors are informative as they can be incorporated into an optimum risk prediction model in the future, which would help with clinical decision making regarding maintenance treatment in FEP.

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