Determinants of neurological dysfunction in first episode schizophrenia

2000 ◽  
Vol 30 (6) ◽  
pp. 1433-1441 ◽  
Author(s):  
S. BROWNE ◽  
M. CLARKE ◽  
M. GERVIN ◽  
A. LANE ◽  
J. L. WADDINGTON ◽  
...  
Keyword(s):  
Social Adjustment ◽  
Significant Proportion ◽  
Hand Preference ◽  
Direct Consequence ◽  
Neurological Impairment ◽  
Neurological Dysfunction ◽  
First Episode ◽  
Neurological Functioning ◽  
History Of ◽  
First Episode Schizophrenia

Background. Although it is well recognized that individuals with schizophrenia display evidence of subtle neurological impairment, its aetiopathological and clinical significance continues to be unclear.Methods. Patients presenting with a first episode of schizophrenia or schizophreniform psychosis (DSM-IV criteria) were examined using two previously validated neurological examinations. The majority (N = 35) were examined prior to their ‘first ever’ dose of neuroleptic while the remaining patients (N = 21) had been medicated for less than one month. The manner in which neurological functioning is influenced by symptomatology and handedness was ascertained.Results. The majority of patients who were examined neuroleptic-naive displayed evidence of neurodysfunction. A combination of relative hand preference and symptomatology explained a significant proportion of the variance in neurological functioning. Mixed handedness among adults at the time of first presentation with schizophrenia was associated with more severe neurological impairment and a history of poorer scholastic attainment and pre-morbid social adjustment.Conclusions. Neurological soft signs are an intrinsic part of schizophrenia rather than a direct consequence of treatment. Early developmental processes are associated with the level of subsequent neurological impairment in first episode schizophrenia. However, symptomatology appears to have an influence on the apparent severity of neurological impairment.

scholarly journals Dysexecutive Behavior in First-episode Schizophrenia

2021 ◽  
Author(s):  
Gricel Orellana ◽  
Andrea Slachevsky ◽  
Fernando Henriquez
Keyword(s):  
Executive Function ◽  
Social Adjustment ◽  
Wisconsin Card Sorting Test ◽  
First Episode ◽  
Card Sorting ◽  
Dysexecutive Syndrome ◽  
Behavior Understanding ◽  
History Of ◽  
Therapeutic Tools ◽  
First Episode Schizophrenia

Abstract Background: Dysexecutive syndrome is a prominent and functionally significant cognitive feature of schizophrenia. This study assesses and correlates executive function deficits and dysexecutive behavior in first-episode schizophrenia patients and healthy participants.Methods: We evaluated 22 FES patients (aged 17−29 years, history of single episode of schizophrenia, treated with atypical antipsychotics) and 20 controls matched for gender, age, and education. EF was evaluated using the Modified Six Elements Test, Modified Wisconsin Card Sorting Test, and Frontal Assessment Battery. DB was evaluated using the Dysexecutive Questionnaire (DEX) and Behavioral Dysexecutive Syndrome Inventory (BDSI).Results: FES patients had marked executive function impairments and dysexecutive behavior as compared to controls. Our findings suggest that executive function scores on standardized neuropsychological tests may be ecologically valid predictors of dysexecutive behavior.Conclusions: Dysexecutive behavior is common during first-episode schizophrenia and may be a primary impairment throughout disease progression. The present results inform clinical practice by providing insight into first-episode schizophrenia specific features of dysexecutive behavior. Understanding the associations between executive function and dysexecutive behavior helps to explain the social adjustment disorders associated with schizophrenia. This knowledge may be used to improve diagnostic and therapeutic tools; for example, clarifying the implications of specific DEX and BDSI dimensions could increase the efficacy of individual or familial psychotherapy interventions.

scholarly journals Anterior cingulate grey-matter deficits and cannabis use in first-episode schizophrenia

2007 ◽  
Vol 190 (3) ◽  
pp. 230-236 ◽  
Author(s):  
Philip R. Szeszko ◽  
Delbert G. Robinson ◽  
Serge Sevy ◽  
Sanjiv Kumra ◽  
Claudia I. Rupp ◽  
...  
Keyword(s):  
White Matter ◽  
Healthy Volunteers ◽  
Grey Matter ◽  
Magnetic Resonance Images ◽  
Cannabis Use ◽  
Anterior Cingulate ◽  
First Episode ◽  
History Of ◽  
First Episode Schizophrenia ◽  
First Episode Of Schizophrenia

BackgroundDespite the high prevalence of cannabis use in schizophrenia, few studies have examined the potential relationship between cannabis exposure and brain structural abnormalities in schizophrenia.AimsTo investigate prefrontal grey and white matter regions in patients experiencing a first episode of schizophrenia with an additional diagnosis of cannabis use or dependence (n=20) compared with similar patients with no cannabis use (n=31) and healthy volunteers (n=56).MethodVolumes of the superior frontal gyrus, anterior cingulate gyrus and orbital frontal lobe were outlined manually from contiguous magnetic resonance images and automatically segmented into grey and white matter.ResultsPatients who used cannabis had less anterior cingulate grey matter compared with both patients who did not use cannabis and healthy volunteers.ConclusionsA defect in the anterior cingulate is associated with a history of cannabis use among patients experiencing a first episode of schizophrenia and could have a role in poor decision-making and in choosing more risky outcomes.

scholarly journals Premorbid Adjustment and IQ in Patients With First-Episode Psychosis: A Multisite Case-Control Study of Their Relationship With Cannabis Use

2019 ◽  
Vol 46 (3) ◽  
pp. 517-529 ◽  
Author(s):  
Laura Ferraro ◽  
Caterina La Cascia ◽  
Diego Quattrone ◽  
Lucia Sideli ◽  
Domenica Matranga ◽  
...  
Keyword(s):  
Social Adjustment ◽  
Psychotic Disorders ◽  
Social Factor ◽  
First Episode Psychosis ◽  
Cannabis Use ◽  
First Episode ◽  
Episode Psychosis ◽  
History Of ◽  
History Of Use ◽  
And Control

Abstract Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = −0.3, 95% CI = [−0.5; −0.2]) and never-users (Mdiff = −0.4, 95% CI = [−0.6; −0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders.

MRI abnormalities in first-episode schizophrenia: Association with neurological impairment

1995 ◽  
Vol 15 (1-2) ◽  
pp. 87-88 ◽  
Author(s):  
J. Pieri ◽  
B.K. Gupta ◽  
W.W. Bagwell ◽  
G.L. Haas ◽  
J.A. Sweeney ◽  
...  
Keyword(s):  
Neurological Impairment ◽  
First Episode ◽  
First Episode Schizophrenia

The history of childhood trauma among individuals with ultra high risk for psychosis is as common as among patients with first-episode schizophrenia

2013 ◽  
Vol 7 (4) ◽  
pp. 414-420 ◽  
Author(s):  
Seda Şahin ◽  
Çağrı Yüksel ◽  
Julide Güler ◽  
Gülşah Karadayı ◽  
Elçin Akturan ◽  
...  
Keyword(s):  
High Risk ◽  
Childhood Trauma ◽  
First Episode ◽  
History Of Childhood ◽  
Ultra High Risk ◽  
History Of ◽  
First Episode Schizophrenia

scholarly journals Unveiling the Metabolic Profile of First-Episode Drug-Naïve Schizophrenia Patients: Baseline Characteristics of a Longitudinal Study Among Han Chinese

2021 ◽  
Vol 12 ◽  
Author(s):  
Qi Zhang ◽  
Hui He ◽  
Xia Bai ◽  
Liping Jiang ◽  
Wei Chen ◽  
...  
Keyword(s):  
Metabolic Profile ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Medical Conditions ◽  
Metabolic Disturbances ◽  
Cognitive Assessments ◽  
Laboratory Assessment ◽  
History Of ◽  
Drug Naïve ◽  
First Episode Schizophrenia

Objective: Metabolic and other medical conditions are frequently comorbid with schizophrenia. As they might be the side-effects of antipsychotic treatment, studying first-episode drug-naïve schizophrenia (FDSZ) provides a unique opportunity to investigate a direct pathogenic link between metabolic changes and schizophrenia. Here, we presented the methods and baseline unique metabolic profile of FDSZ patients without medical comorbidities unveiling subthreshold indices of metabolic disturbances.Method: Drug-naïve individuals diagnosed with schizophrenia but without any previous medical conditions were invited to participate in the study. Participants were submitted to structured psychiatric and cognitive assessments, laboratory and neuroimaging tests. Subjects will be followed after antipsychotic treatment at 6, 24 and 48 weeks.Results: During an 8-month-period, out of 103 patients presenting with first episode psychosis, 67 subjects (43.3% men, 56.7% women) were enrolled in the study. They had a mean ± SD age of 32.1 ± 8.7 years, with a mean BMI of 21.1 kg/m2 and 11.3 ± 3.6 years of schooling. Less than 1/3 reported a family history of mental illness. Upon laboratory assessment, 10.4%, 7.5%, and 11.9% of patients were identified with hyperhomocysteinemia, hypertriglyceridemia and hyperprolactinemia, respectively, with percentages of women relatively higher than men except for hypertriglyceridemia.Conclusions: First episode schizophrenia patients, especially women, present subclinical metabolic abnormalities, independent of antipsychotic treatment.

scholarly journals Clinical correlates of first episode schizophrenia-a comparative study

2018 ◽  
Vol 6 (2) ◽  
pp. 551
Author(s):  
Kathir M. ◽  
Pugazhendhi K. ◽  
Ravishankar J.
Keyword(s):  
Family History ◽  
Negative Symptoms ◽  
Suicide Attempts ◽  
Social Withdrawal ◽  
First Episode ◽  
Positive Symptoms ◽  
Major Mental Disorder ◽  
History Of ◽  
Drug Naïve ◽  
First Episode Schizophrenia

Background: Schizophrenia is a major mental disorder which has to be assessed early and managed actively even though long term functional outcome remains relatively poor. The aim of the study is to analyze negative symptoms, suicidal risk and substance use in first episode schizophrenics in comparison with multi-episode schizophrenics.Methods: 30 patients with drug naive first episode schizophrenia and 30 patients with multi episode schizophrenia, who attended the outpatient department of Psychiatry, Government Stanley Medical College, Chennai, Tamilnadu, India were studied to compare predisposing factors and spectrum of symptoms for Schizophrenia for a period of one year (January 2010-December 2010). Psychiatric questionnaire by Michael C. Hilton, DAST by Harvey A. Skinner, AUDIT by WHO, Suicide risk scale by National Health and Medical Research Council, PANSS by SR Kay were used to assess patients.Results: Unemployment and family history of suicide attempts were observed more in drug naive first episode schizophrenics. 90% of these patients had completed their primary education while 47% of multi-episode schizophrenics were illiterates. Positive symptoms (delusions, hallucinatory behaviour and suspiciousness) and negative symptoms (blunted affect, emotional withdrawal and social withdrawal) were observed more in first episode schizophrenics while PANSS, DAST, AUDIT scores did not find any differences between both the groups.Conclusions: In our study, the first episode schizophrenia patients were more educated, more unemployed and had more family history of suicide, elevated sub score of positive symptoms as measured by PANSS. Relative assessment of violence and serious behavior problems that are related to positive symptoms must be done and managed with anti psychotics.

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