scholarly journals Deterioration of visuospatial associative memory following a first psychotic episode: a long-term follow-up study

2017 ◽  
Vol 48 (1) ◽  
pp. 132-141 ◽  
Author(s):  
C. M. J. Wannan ◽  
C. F. Bartholomeusz ◽  
V. L. Cropley ◽  
T. E. Van Rheenen ◽  
A. Panayiotou ◽  
...  
Keyword(s):  
Associative Memory ◽  
Neuropsychological Test ◽  
Learning Task ◽  
First Episode ◽  
Psychotic Episode ◽  
Similar Degree ◽  
Associate Learning ◽  
Cross Sectional ◽  
Memory Ability

BackgroundCognitive deficits are a core feature of schizophrenia, and impairments in most domains are thought to be stable over the course of the illness. However, cross-sectional evidence indicates that some areas of cognition, such as visuospatial associative memory, may be preserved in the early stages of psychosis, but become impaired in later established illness stages. This longitudinal study investigated change in visuospatial and verbal associative memory following psychosis onset.MethodsIn total 95 first-episode psychosis (FEP) patients and 63 healthy controls (HC) were assessed on neuropsychological tests at baseline, with 38 FEP and 22 HCs returning for follow-up assessment at 5–11 years. Visuospatial associative memory was assessed using the Cambridge Neuropsychological Test Automated Battery Visuospatial Paired-Associate Learning task, and verbal associative memory was assessed using Verbal Paired Associates subtest of the Wechsler Memory Scale - Revised.ResultsVisuospatial and verbal associative memory at baseline did not differ significantly between FEP patients and HCs. However, over follow-up, visuospatial associative memory deteriorated significantly for the FEP group, relative to healthy individuals. Conversely, verbal associative memory improved to a similar degree observed in HCs. In the FEP cohort, visuospatial (but not verbal) associative memory ability at baseline was associated with functional outcome at follow-up.ConclusionsAreas of cognition that develop prior to psychosis onset, such as visuospatial and verbal associative memory, may be preserved early in the illness. Later deterioration in visuospatial memory ability may relate to progressive structural and functional brain abnormalities that occurs following psychosis onset.

scholarly journals Patterns and predictors of hospitalisation in first-episode psychosis

2001 ◽  
Vol 178 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Attila Sipos ◽  
Glynn Harrison ◽  
David Gunnell ◽  
Shazad Amin ◽  
Swaran P. Singh
Keyword(s):  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Psychiatric Services ◽  
First Episode ◽  
Psychotic Episode ◽  
Duration Of Untreated Illness ◽  
Specialist Services ◽  
Increased Risk ◽  
Episode Psychosis

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.

scholarly journals Characterization of depressive syndrome in schizophrenic outpatients

2002 ◽  
Vol 24 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Flávio Soares de Araújo ◽  
Kátia Petribú ◽  
Othon Bastos
Keyword(s):  
Clinical Features ◽  
Clinical Picture ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Depressive Syndrome ◽  
Psychosocial Stressors ◽  
First Episode ◽  
Psychotic Episode ◽  
Cross Sectional ◽  
Dsm Iv

OBJECTIVE: The authors carried out a cross-sectional study with the aim of characterizing and describing depressive pictures in schizophrenic patients seen at the Psychiatry Outpatient Clinic of the Federal University of Pernambuco (HC-UFPE). The patients had the diagnosis of schizophrenia confirmed on the basis of the operating criteria of the DSM-IV. METHODS: Those who where in the period of stabilization of the clinical picture were selected for the study defined according the following criteria:the last psychotic episode must be happened two months before at least, and during this period the alterations of the antipsychotics doses had been lower than 5 mg of haloperidol or equivalent doses of others neuroleptics. A total of one hundred and four patients took part. Following the identification of the depressive symptoms using the Calgary Depression Scale for Schizophrenia (CDSS), thirty-one patients (29.8%) fulfilled the diagnostic criteria described in the DSM-IV. Of these, 22.1% had the diagnosis of major depression and 7.7% of minor depression according the DSM-IV. Two groups were constituted: Group A, schizophrenics with a depressive syndrome, and Group B, schizophrenics without such a syndrome. An assessment was made of the distribution of the symptoms of the CDSS scores in both groups, the sociodemographic, clinical and therapeutic variables in relation to the frequency of the depressive syndrome, and the patients clinical course. For the investigation of certain clinical features, the following tools were used: problem list (psychosocial stressors) contained in axis IV of the DSM-IV intended to detect the presence of factors triggering the initial episode of schizophrenia and the Global Assessment of Functioning (GAF -- Axis V -- DSM-IV) to characterize the current functioning of the patients. CONCLUSIONS: The results obtained allowed the authors to draw the following conclusions: all the items that comprise the Brazilian version of the CDSS were statistically significant in characterizing the depressive syndrome; a comparison of the sociodemographic and therapeutic variables revealed no statistically significant differences between the two groups, and this was also the case with the majority of the clinical features. Statistically significant differences, however, were found in relation to the greater frequency of life events (psychosocial stressors) in triggering the first episode of schizophrenia and the higher incidence of affective disorders antecedents in family members (first and second degree) among the depressed patients. The mean duration of the depressive syndrome during follow-up of the patients was 5.30 months. The patients in whom there was a recurrence of the psychotic episode presented a delusional-hallucinatory clinical picture. This study seeks to contribute to the inclusion of the Postpsychotic Depressive Disorder (PSD) of Schizophrenia (DSM-IV), in the group of Schizophrenic Disorders.

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.

Functional brain-imaging correlates of negative affectivity and the onset of first-episode depression

2014 ◽  
Vol 45 (5) ◽  
pp. 1001-1009 ◽  
Author(s):  
C. G. Davey ◽  
S. Whittle ◽  
B. J. Harrison ◽  
J. G. Simmons ◽  
M. L. Byrne ◽  
...  
Keyword(s):  
Negative Affectivity ◽  
Brain Regions ◽  
Functional Brain Imaging ◽  
Anterior Cingulate ◽  
First Episode ◽  
Resting State Functional Connectivity ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Fmri Study

Background.The amygdala and subgenual anterior cingulate cortex (sACC) are key brain regions for the generation of negative affect. In this longitudinal fMRI study of adolescents we investigated how amygdala–sACC connectivity was correlated with negative affectivity (NA) both cross-sectionally and longitudinally, and examined its relationship to the onset of first-episode depression.Method.Fifty-six adolescents who were part of a larger longitudinal study of adolescent development were included. They had no history of mental illness at the time of their baseline scan (mean age 16.5 years) and had a follow-up scan 2 years later (mean age 18.8 years). We used resting-state functional-connectivity MRI to investigate whether cross-sectional and change measures of amygdala–sACC connectivity were (i) correlated with NA and its change over time, and (ii) related to the onset of first-episode depression.Results.The magnitude of amygdala connectivity with sACC showed significant positive correlation with NA at both time-points. Further analysis confirmed that change in amygdala–sACC connectivity between assessments was correlated with change in NA. Eight participants developed a first episode of depression between the baseline and follow-up assessments: they showed increased amygdala–sACC connectivity at follow-up.Conclusions.Amygdala–sACC connectivity is associated with NA in adolescence, with change in connectivity between these regions showing positive correlation with change in NA. Our observation that the onset of depression was associated with an increase in connectivity between the regions provides support for the neurobiological ‘scar’ hypothesis of depression.

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.

scholarly journals Brain volume in first-episode schizophrenia

2006 ◽  
Vol 188 (6) ◽  
pp. 510-518 ◽  
Author(s):  
R. Grant Steen ◽  
Courtney Mull ◽  
Robert Mcclure ◽  
Robert M. Hamer ◽  
Jeffrey A. Lieberman
Keyword(s):  
Brain Volume ◽  
Limit Of Detection ◽  
Meta Analysis ◽  
First Episode ◽  
Psychotic Episode ◽  
Healthy Controls ◽  
Brain Abnormalities ◽  
Cross Sectional ◽  
Brain Volumes ◽  
First Psychotic Episode

BackgroundStudies of people with schizophrenia assessed using magnetic resonance imaging (MRI) usually include patients with first-episode and chronic disease, yet brain abnormalities may be limited to those with chronic schizophrenia.AimsTo determine whether patients with a first episode of schizophrenia have characteristic brain abnormalities.MethodSystematic review and meta-analysis of 66 papers comparing brain volume in patients with a first psychotic episode with volume in healthy controls.ResultsAtotal of 52 cross-sectional studies included 1424 patients with a first psychotic episode; 16 longitudinal studies included 465 such patients. Meta-analysis suggests that whole brain and hippocampal volume are reduced (both P < 0.0001) and that ventricular volume is increased (P < 0.0001) in these patients relative to healthy controls.ConclusionsAverage volumetric changes are close to the limit of detection by MRI methods. It remains to be determined whether schizophrenia is a neurodegenerative process that begins at about the time of symptom onset, or whether it is better characterised as a neurodevelopmental process that produces abnormal brain volumes at an early age.

Social cognition, functional capacity and symptoms in the longitudinal prediction of outcome in subjects with first-episode schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S67-S67
Author(s):  
M. Nordentoft ◽  
R. Wills ◽  
D. Gotfredsen
Keyword(s):  
Antipsychotic Medication ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Schizophrenia Spectrum Disorders ◽  
National Guidelines ◽  
Term Outcome ◽  
Long Term Outcome

BackgroundSeveral national guidelines recommend continuous use of antipsychotic medication after a psychotic episode in order to minimize the risk of relapse. However some studies have identified a subgroup of patients who can obtain remission of psychotic symptoms while not being on antipsychotic medication for a long period of time. This study investigated the long-term outcome and characteristics of patients in remission of psychotic symptoms with no use of antipsychotic medication at the 10-year follow-up.MethodsThe study was a cohort study including 496 patients diagnosed with schizophrenia spectrum disorders (ICD 10: F20 and F22-29). Patients were included in the Danish OPUS Trial and followed up 10 years after inclusion, where patient data was collected on socio-demographic factors, psychopathology, level of functioning and medication.FindingsAmong the patients, 30% had remission of psychotic symptoms at the time of the 10-year follow up with no current use of antipsychotic medication. This favorable outcome was associated with female gender, high GAF-F score, participation in the labor market and absence of substance abuse.InterpretationResults from several RCTs advise against discontinuation of antipsychotic medication, but our results from the 10-year follow-up indicate that a subgroup do obtain long-term remission while not being on antipsychotic medication. Hence, guidelines on antipsychotic medication do not pay sufficient attention to patients who discontinue antipsychotic medication and are still able to obtain remission of psychotic symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Similar cognitive deficits in mice and humans in the chronic phase post-stroke identified using the touchscreen-based paired-associate learning task

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wei Zhen Chow ◽  
Lin Kooi Ong ◽  
Murielle G. Kluge ◽  
Prajwal Gyawali ◽  
Frederick R. Walker ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Paired Associate ◽  
Chronic Phase ◽  
Learning Task ◽  
Paired Associate Learning ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Associate Learning ◽  
Cross Sectional ◽  
Post Stroke

Abstract For many chronic stroke survivors, persisting cognitive dysfunction leads to significantly reduced quality of life. Translation of promising therapeutic strategies aimed at improving cognitive function is hampered by existing, disparate cognitive assessments in animals and humans. In this study, we assessed post-stroke cognitive function using a comparable touchscreen-based paired-associate learning task in a cross-sectional population of chronic stroke survivors (≥ 5 months post-stroke, n = 70), age-matched controls (n = 70), and in mice generated from a C57BL/6 mouse photothrombotic stroke model (at six months post-stroke). Cognitive performance of stroke survivors was analysed using linear regression adjusting for age, gender, diabetes, systolic blood pressure and waist circumference. Stroke survivors made significantly fewer correct choices across all tasks compared with controls. Similar cognitive impairment was observed in the mice post-stroke with fewer correct choices compared to shams. These results highlight the feasibility and potential value of analogous modelling of clinically meaningful cognitive impairments in chronic stroke survivors and in mice in chronic phase after stroke. Implementation of validated, parallel cross-species test platforms for cognitive assessment offer the potential of delivering a more useful framework for evaluating therapies aimed at improving long-term cognitive function post-stroke.

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