Specific cognitive flexibility rehabilitation in schizophrenia

1993 ◽  
Vol 23 (1) ◽  
pp. 221-227 ◽  
Author(s):  
Ann Delahunty ◽  
Rodney Morice ◽  
Barry Frost
Keyword(s):  
Cognitive Flexibility ◽  
Test Performance ◽  
Rating Scale ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Training Approach ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Performance Gains

SynopsisA Cognitive Shift neurocognitive training module was developed in the attempt to ameliorate cognitive flexibility deficits in chronic schizophrenic patients. A procedural training approach hypothesized the exercise of specific neural network processes, identified from theories of frontal and prefrontal lobe functioning. Three male patients who underwent the intensive program demonstrated significant gains in Wisconsin Card Sorting Test performance, gains that were maintained at a six month reassessment. Expanded Brief Psychiatric Rating Scale (a measure of symptomatology) and Life Skills Profile (a measure of daily functioning) measures showed smaller improvements. The ability to improve cognitive flexibility could have important implications for the treatment of schizophrenia.

Symptomatic Response to Antipsychotics Differs between Recent Onset and Recurrent Chronic Schizophrenic Patients

1992 ◽  
Vol 26 (3) ◽  
pp. 417-422 ◽  
Author(s):  
Christine Hill ◽  
Nicholas A. Keks ◽  
Henry Jackson ◽  
Jayashri Kulkarni ◽  
Deborah Hannah ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Active Phase ◽  
Retardation Factor ◽  
Antipsychotic Treatment ◽  
Recent Onset ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
First Admission

The symptomatic response to standard antipsychotic treatment was assessed over the first 4 weeks of hospitalisation in 39 patients with DSM-III schizophrenia, active phase, using the Brief Psychiatric Rating Scale (BPRS). While highly significant improvement was noted overall, 36% of patients either did not improve or worsened. Furthermore there was no diminution in the withdrawal-retardation factor of the BPRS. Patients experiencing their first admission to hospital, all with recent-onset illness, were then compared with patients who presented with a recurrence and had illness of at least 3 years duration. Despite similarities in overall response, withdrawal-retardation scores did not diminish in recent-onset patients, in contrast to multiple admissions who demonstrated significant improvement. These findings suggest greater responsiveness of negative symptoms to treatment in patients with longstanding illness, and possibly a poorer prognosis in first admission patients with deficit manifestations.

Effect of an Open-Door Policy Combined with a Structured Activity Programme on the Residual Symptoms of Schizophrenic In-Patients

1994 ◽  
Vol 165 (S24) ◽  
pp. 52-57 ◽  
Author(s):  
Zhengshu Jin
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Control Group ◽  
Open Door Policy ◽  
Residual Symptoms ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
And Control ◽  
Experimental Group

Fifty female schizophrenic patients on the same locked ward were randomly assigned to experimental and control groups. Experimental group subjects were given as much autonomy and freedom as possible (they were permitted to leave the ward at will) and were encouraged to take part in collective activities. The control group were not permitted to leave the ward and did not take part in these activities. All patients were evaluated at enrolment and after six months – using Chinese versions of the Scale for Assessment of Negative Symptoms and the Brief Psychiatric Rating Scale – by psychiatrists who were blind to patients' treatment status. After the six-month intervention the severity of all types of both negative and positive symptoms and the mean dosage of medication in the experimental group were significantly less than in the control group.

Propranolol in Chronic Schizophrenia: A Controlled Study in Neuroleptic-Treated Patients

1980 ◽  
Vol 137 (2) ◽  
pp. 126-130 ◽  
Author(s):  
Leif H. Lindström ◽  
Eva Persson
Keyword(s):  
Rating Scale ◽  
Chronic Schizophrenia ◽  
Placebo Treatment ◽  
Controlled Study ◽  
Psychotic Symptoms ◽  
Double Blind ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
High Doses

The effect of propranolol at a dose level of 1,280–1,920 mg per day was studied with a double-blind crossover design in twelve chronic schizophrenics with persistent psychotic symptoms despite maintenance treatment with a depot neuroleptic. By use of a psychiatric rating scale (CPRS), an improvement was seen during the two week period of propranolol compared to placebo treatment in six patients, whereas three patients were unchanged and three deteriorated. The effect on total symptom scores for the whole group was significantly better after propranolol. The data indicate that propranolol in high doses has an antipsychotic effect in some schizophrenic patients when receiving neuroleptics.

An open trial of clozapine in neuroleptic-resistant childhood-onset schizophrenia

1997 ◽  
Vol 170 (6) ◽  
pp. 507-510 ◽  
Author(s):  
M. Turetz ◽  
T. Mozes ◽  
P. Toren ◽  
T. Chernauzan ◽  
R. Yoran-Hegesh ◽  
...  
Keyword(s):  
Rating Scale ◽  
Favourable Outcome ◽  
Childhood Onset ◽  
Conventional Antipsychotics ◽  
Syndrome Scale ◽  
Increased Risk ◽  
Childhood Onset Schizophrenia ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

BackgroundStudies performed with schizophrenic adults who were resistant to classical neuroleptics showed improvement in 30% of the patients when treated with clozapine. Very early onset schizophrenic patients benefit only partially from conventional antipsychotics and are at increased risk of developing extrapyramidal symptoms; clozapine may offer an alternative treatment for these patients.MethodEleven neuroleptic-resistant children (< 13 years) with schizophrenia were treated with clozapine. Improvement was monitored during the first 16 weeks using the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale and Clinical Global Impression. The mean clozapine dosage was 227.3 (s.d. 34.4) mg/day at the end of the 16 weeks.ResultsThere was an overall statistically significant reduction in all parameters, especially positive symptoms, implying a favourable outcome. Most of the improvement occurred during the first 6 to 8 weeks. The major side-effects were somnolence and drooling (no agranulocytosis).ConclusionClozapine may be a promising drug for the treatment of resistant childhood-onset schizophrenia.

scholarly journals Validation of the Italian version of Mini-ICF-APP, a short instrument for rating activity and participation restrictions in psychiatric disorders

2012 ◽  
Vol 22 (1) ◽  
pp. 81-91 ◽  
Author(s):  
M. Balestrieri ◽  
M. Isola ◽  
R. Bonn ◽  
T. Tam ◽  
A. Vio ◽  
...  
Keyword(s):  
Psychosocial Functioning ◽  
Convergent Validity ◽  
Rating Scale ◽  
Social Performance ◽  
International Classification Of Functioning ◽  
Italian Version ◽  
Participation Restrictions ◽  
Schizophrenic Patients ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

Aims.The assessment of limitations in social capacities can be done with the Mini-ICF-APP, a rating scale built in reference to the International Classification of Functioning, Disability and Health (ICF). The aim of this study was to assess the reliability and the convergent validity of the Italian version of this scale.Methods.We recruited 120 consecutive patients diagnosed with schizophrenia, major depression, bipolar I disorder and anxiety disorders. Included measures were the Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impression Scale (CGI-S), the Personal and Social Performance Scale (PSP) and the Social and Occupational Functioning Assessment Scale (SOFAS).Results.The median CGI-S and BPRS scores were 5 and 16.5. Mean Mini-ICF-APP total score was 18.1. Schizophrenics' Mini-ICF-APP score was higher, while that of anxious patients was lower than in the other diagnoses. Intra-class correlations (ICC) revealed a significant inter-rater agreement for total score (ICC 0.987) and for each item of the Mini-ICF-APP. The test–retest agreement was also highly significant (ICC 0.993). The total score of the Mini-ICF-APP obtained good negative correlations with PSP (rs = −0.767) and with SOFAS scores (rs = −0.790). The distribution items of the Mini-ICF-APP showed some skewness, indicating that self-care (item 12) and mobility (item 13) were amply preserved in most patients. The Mini-ICF-APP total score was significantly correlated with both CGI-S (rs = 0.777) and BPRS (rs = 0.729).Conclusions.As a short instrument, the Mini-ICF-APP scale seems to be well suited to everyday psychiatric practice as a means of monitoring changes in psychosocial functioning, in particular in schizophrenic patients.

scholarly journals Dopamine, Cognitive Flexibility and IQ: Synergistic COMT:DRD2 Gene-Gene Interactions

2021 ◽  
Author(s):  
Leor Zmigrod ◽  
Trevor William Robbins
Keyword(s):  
Cognitive Flexibility ◽  
Test Performance ◽  
Wisconsin Card Sorting Test ◽  
Gene Interactions ◽  
Nucleotide Polymorphisms ◽  
Card Sorting ◽  
Highly Educated ◽  
High Intelligence ◽  
Striatal Dopamine Receptor ◽  
Sorting Test

Cognitive flexibility has been hypothesized to be neurochemically rooted in dopamine neurotransmission. Nonetheless, underpowered sample sizes and contradictory meta-analytic findings have obscured the role of dopamine genes in cognitive flexibility and neglected potential gene-gene interactions. In this study, the largest neurocognitive-genetic one to date (N=1400), single nucleotide polymorphisms associated with elevated prefrontal dopamine levels (Catechol-O-methyltransferase, COMT; rs4680) and striatally-concentrated DRD2 receptor availability (C957T; rs6277) were both implicated in Wisconsin Card Sorting Test performance. Crucially, however, these genetic effects were only evident in low-IQ participants, suggesting high intelligence compensates for and eliminates the effect of dispositional dopamine functioning on flexibility. This interaction between cognitive systems may explain and resolve previous empirical inconsistencies in highly educated participant samples. Moreover, compensatory gene-gene interactions were discovered between COMT and DRD2, such that genotypes conferring either elevated prefrontal dopamine or striatal dopamine receptor availability are sufficient for cognitive flexibility, but neither is necessary. The study therefore has revealed a form of redundancy or substitutability amongst dopamine systems in shaping adaptable thought and action, thus defining boundary conditions for dopaminergic effects on flexible behaviour. These results inform theories of clinical disorders and psychopharmacological interventions and uncover complex fronto-striatal synergies in human flexible cognition.

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