scholarly journals T189. FREE THYROXIN CONCENTRATIONS MODERATE THE RESPONSE TO A COGNITIVE REMEDIATION THERAPY IN PEOPLE WITH EARLY PSYCHOSIS: PRELIMINARY FINDINGS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S303-S304
Author(s):  
Francesc Estrada ◽  
Josep Maria Crosas ◽  
Maribel Ahuir ◽  
Sara Pérez ◽  
Wanda Zabala ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Cognitive Remediation ◽  
Early Psychosis ◽  
Cognitive Tasks ◽  
First Episode ◽  
Cognitive Changes ◽  
Cognitive Domains ◽  
Episode Psychosis ◽  
Changes Over Time ◽  
Over Time

Abstract Background Cognitive deficits are a common cause of functional disability in people with psychotic disorders. Cognitive remediation produces moderate improvements in cognitive performance in people with schizophrenia, although there is variability in the responses between patients. As previous longitudinal studies suggest that free thyroxin (FT4) levels influence attention cognitive tasks in patients with early psychosis, we aimed to conduct a pilot study to explore whether thyroid hormones might predict the response to cognitive remediation therapy (CRT) in patients with first-episode psychosis. Methods 27 patients (8 women; 19 men) with first-episode psychosis aged between 18 and 35 years old were randomized to receive a computerized CRT for three months (2 sessions/week) (N=14) or treatment as usual (TAU) (N=13). A full cognitive battery (CANTAB Schizophrenia) was administered at baseline and follow-up (3 months later, after the CRT/TAU period). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Data were analyzed on an intention-to-treat basis. Correlation analyses were conducted to explore the association between TSH and FT4 levels and cognitive changes over time. An ANOVA for repeated measures was used to compare longitudinal changes over time by the experimental group while adjusting for TSH and FT4 levels. Significance was defined as p<0.05. Results TSH concentrations were not associated with cognitive changes over time. FT4 concentrations were associated with cognitive worsening over time in cognitive tasks dealing with reaction time (simple median movement time [r= 0.60, p= 0.003]; simple median reaction time [r= 0.44, p= 0.039]), sustained attention (signal detection for the rapid visual processing task [r= -0.46, p= 0.028]) and verbal memory (immediate recognition [r= -0.54, p= 0.008]; delayed recognition [r= -0.48, p= 0.019]). The ANOVA for repeated measures did not show time by group effects although a time by FT4 significant effect was found for cognitive tasks dealing with these cognitive domains (p<0.05 for all). Discussion Although a direct effect of the CRT on cognitive improvement was not found, baseline FT4 concentrations appeared to predict the response to CRT in people with early psychosis. Significant associations were found for cognitive domains dealing with attention processes, which are in accordance with previous studies exploring the association between thyroid function and cognitive functioning in early psychotic patients. Our preliminary findings suggest that the determination of thyroid function status might be important for establishing which patients could show cognitive improvements over time. If these results are replicated in larger studies, the determination of thyroid status might help identify those individuals more prone for showing cognitive improvements, and allowing the implementation of a personalized medicine approach in the field of cognitive rehabilitation in psychosis.

scholarly journals The Implementation and Review of Cognitive Remediation Training for First Episode Psychosis in Singapore

2021 ◽  
Vol 12 ◽  
Author(s):  
Nigel Ian Ming Chong ◽  
Yogeswary Maniam ◽  
Yi Chian Chua ◽  
Charmaine Tang
Keyword(s):  
Verbal Memory ◽  
Cognitive Abilities ◽  
Statistical Significance ◽  
Real Life ◽  
Cognitive Remediation ◽  
First Episode Psychosis ◽  
Early Psychosis ◽  
First Episode ◽  
Educational Approach ◽  
Episode Psychosis

Objective: Early intervention in patients with first episode psychosis (FEP) can improve cognitive abilities, with both short- and long-term benefits. In this paper, we describe the implementation and review of cognitive remediation training (CRT) in an Asian FEP population. The outcomes of the training are also evaluated and discussed.Methods: This naturalistic paper describes in detail the real-life implementation and conduct of CRT in an early psychosis intervention service. One hundred and nine patients with FEP underwent a 24-session CRT programme, using Cogpack and Neuropsychological Educational Approach to Remediation. The program is evaluated with pre- and post-CRT assessment scores which included Montreal Cognitive Assessment and Brief Assessment of Cognition in Schizophrenia. The rates of improvement on these cognitive assessments were evaluated using paired t-tests, with statistical significance set at p ≤ 0.05.Results: Of the 109 patients who underwent CRT, a total of 92 (84.4%) completed all 24 sessions. Paired t-tests between pre- and post-CRT assessments scores revealed that participants significantly improved on majority of the measures, including verbal memory, digit sequencing, and symbol coding.Conclusion: As with other cognitive remediation programmes, CRT has shown to improve cognitive functioning in patients with FEP. The results support the use of CRT in an Asian context and may serve as guidance for the implementation of similar training programmes in other Asian early psychosis intervention services.

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.

A Methodological Perspective on the Longitudinal Cognitive Change after Stroke

2017 ◽  
Vol 44 (5-6) ◽  
pp. 311-319 ◽  
Author(s):  
Jae-Sung Lim ◽  
Maengseok Noh ◽  
Beom Joon Kim ◽  
Moon-Ku Han ◽  
SangYun Kim ◽  
...  
Keyword(s):  
Cognitive Change ◽  
Multiple Outcomes ◽  
Cognitive Changes ◽  
Cognitive Domains ◽  
Domain Specific ◽  
Cognitive Levels ◽  
Methodological Considerations ◽  
Changes Over Time ◽  
Over Time

Background/Aims: Most studies of poststroke cognitive impairment (PSCI) have analyzed cognitive levels at specific time points rather than their changes over time. Furthermore, they seldom consider correlations between cognitive domains. We aimed to investigate the effects of these methodological considerations on determining significant PSCI predictors in a longitudinal stroke cohort. Methods: In patients who underwent neuropsychological tests at least twice after stroke, we adopted a multilevel hierarchical mixed-effects model with domain-specific cognitive changes and a multivariate model for multiple outcomes to reflect their correlations. Results: We enrolled 375 patients (median follow-up of 34.1 months). Known predictors of PSCI were generally associated with cognitive levels; however, most of the statistical significances disappeared when cognitive changes were set as outcomes, except age for memory, prior stroke and baseline cognition for executive/attention domain, and baseline cognition for visuospatial function. The multivariate analysis which considered multiple outcomes simultaneously further altered these associations. Conclusions: This study shows that defining outcomes as changes over time and reflecting correlations between outcomes may affect the identification of predictors of PSCI.

scholarly journals Clinical characterization of dysautonomia in long COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicolas Barizien ◽  
Morgan Le Guen ◽  
Stéphanie Russel ◽  
Pauline Touche ◽  
Florent Huang ◽  
...  
Keyword(s):  
Mixed Models ◽  
Repeated Measures ◽  
Physical Medicine ◽  
Persistent Symptoms ◽  
Index Changes ◽  
Changes Over Time ◽  
And Control ◽  
Testing Group ◽  
Over Time

AbstractIncreasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement of the autonomic nervous system, expressed by a dysautonomia, which can aggregate all these neurological symptoms has not been prominently reported. Here, we hypothesize that dysautonomia, could occur in secondary COVID-19 infection, also referred to as “long COVID” infection. 39 participants were included from December 2020 to January 2021 for assessment by the Department of physical medicine to enhance their physical capabilities: 12 participants with COVID-19 diagnosis and fatigue, 15 participants with COVID-19 diagnosis without fatigue and 12 control participants without COVID-19 diagnosis and without fatigue. Heart rate variability (HRV) during a change in position is commonly measured to diagnose autonomic dysregulation. In this cohort, to reflect HRV, parasympathetic/sympathetic balance was estimated using the NOL index, a multiparameter artificial intelligence-driven index calculated from extracted physiological signals by the PMD-200 pain monitoring system. Repeated-measures mixed-models testing group effect were performed to analyze NOL index changes over time between groups. A significant NOL index dissociation over time between long COVID-19 participants with fatigue and control participants was observed (p = 0.046). A trend towards significant NOL index dissociation over time was observed between long COVID-19 participants without fatigue and control participants (p = 0.109). No difference over time was observed between the two groups of long COVID-19 participants (p = 0.904). Long COVID-19 participants with fatigue may exhibit a dysautonomia characterized by dysregulation of the HRV, that is reflected by the NOL index measurements, compared to control participants. Dysautonomia may explain the persistent symptoms observed in long COVID-19 patients, such as fatigue and hypoxia. Trial registration: The study was approved by the Foch IRB: IRB00012437 (Approval Number: 20-12-02) on December 16, 2020.

Suicide Prevention in First Episode Psychosis: The Development of a Randomised Controlled Trial of Cognitive Therapy for Acutely Suicidal Patients With Early Psychosis

2003 ◽  
Vol 37 (4) ◽  
pp. 414-420 ◽  
Author(s):  
P.J.R. Power ◽  
R.J. Bell ◽  
R. Mills ◽  
T. Herrman-Doig ◽  
M. Davern ◽  
...  
Keyword(s):  
Early Intervention ◽  
Treatment Group ◽  
Young People ◽  
Controlled Trial ◽  
First Episode Psychosis ◽  
Early Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Randomised Controlled ◽  
Suicidal Patients

Background: Young people with early psychosis are at particularly high risk of suicide. However, there is evidence that early intervention can reduce this risk. Despite these advances, first episode psychosis patients attending these new services still remain at risk. To address this concern, a program called LifeSPAN was established within the Early Psychosis Prevention and Intervention Centre (EPPIC). The program developed and evaluated a number of suicide prevention strategies within EPPIC and included a cognitively oriented therapy (LifeSPAN therapy) for acutely suicidal patients with psychosis. We describe the development of these interventions in this paper. Method: Clinical audit and surveys provided an indication of the prevalence of suicidality among first episode psychosis patients attending EPPIC. Second, staff focus groups and surveys identified gaps in service provision for suicidal young people attending the service. Third, a suicide risk monitoring system was introduced to identify those at highest risk. Finally, patients so identified were referred to and offered LifeSPAN therapy whose effectiveness was evaluated in a randomised controlled trial. Results: Fifty-six suicidal patients with first episode psychosis were randomly assigned to standard clinical care or standard care plus LifeSPAN therapy. Forty-two patients completed the intervention. Clinical ratings and measures of suicidality and risk were assessed before, immediately after the intervention, and 6 months later. Benefits were noted in the treatment group on indirect measures of suicidality, e.g., hopelessness. The treatment group showed a greater average improvement (though not significant) on a measure of suicide ideation. Conclusions: Early intervention in psychosis for young people reduces the risk of suicide. Augmenting early intervention with a suicide preventative therapy may further reduce this risk.

scholarly journals Are There Gender Differences in Social Cognition in First-Episode Psychosis?

Women ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 204-211
Author(s):  
Marina Verdaguer-Rodríguez ◽  
Raquel López-Carrilero ◽  
Marta Ferrer-Quintero ◽  
Helena García-Mieres ◽  
Luciana Díaz-Cutraro ◽  
...  
Keyword(s):  
Gender Differences ◽  
Social Cognition ◽  
Attributional Style ◽  
Social Cognitive ◽  
First Episode Psychosis ◽  
Test Theory ◽  
First Episode ◽  
Cognitive Domains ◽  
Episode Psychosis ◽  
The Social

The aim of this study was to explore gender differences in social cognition in a sample of first-episode psychosis (FEP). An observational descriptive study was performed with 191 individuals with FEP. Emotion perception was assessed using the Faces Test, theory of mind was assessed using the Hinting Task, and attributional style was assessed using the Internal, Personal and Situational Attributions Questionnaire. No gender differences were found in any of the social cognitive domains. Our results suggest that men and women with FEP achieve similar performances in social cognition. Therefore, targeting specific needs in social cognition regarding gender may not be required in early interventions for psychosis.

scholarly journals Evolution of impulsive–compulsive behaviors and cognition in Parkinson’s disease

2019 ◽  
Vol 267 (1) ◽  
pp. 259-266
Author(s):  
Aleksander H. Erga ◽  
Guido Alves ◽  
Ole Bjørn Tysnes ◽  
Kenn Freddy Pedersen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Short Form ◽  
Population Based ◽  
Self Report ◽  
Cognitive Changes ◽  
Compulsive Behaviors ◽  
Changes Over Time ◽  
Over Time

Abstract The longitudinal course of ICBs in patients with Parkinson’s disease (PwP) relative to controls has not been explored as of yet. The aim of this study is to determine the frequency, evolution and associated cognitive and clinical features of impulsive and compulsive behaviors (ICBs) over 4 years of prospective follow-up in a population-based cohort with early Parkinson’s disease (PD). We recruited 124 cognitively intact participants with early PD and 156 matched controls from the Norwegian ParkWest study. ICBs were assessed using the self-report short form version of the Questionnaire for Impulsive–Compulsive Disorders in PD. Cognitive changes were examined in PwP with and without ICBs who completed the 4-year follow-up. Generalized linear mixed modelling and mixed linear regression were used to analyze clinical factors and cognitive changes associated with ICBs in PwP over time. ICBs were more common in PwP than controls at all visits, with an age-adjusted odds ratio (OR) varying between 2.5 (95% CI 1.1–5.6; p = 0.022) and 5.1 (95% CI 2.4–11.0; p < 0.001). The 4-year cumulative frequency of ICBs in PwP was 46.8% and 23.3% developed incident ICBs during the study period, but the presence of ICBs was non-persistent in nearly 30%. ICBs were independently associated with younger age (OR 0.95, 95% CI 0.91–0.99: p = 0.008) and use of dopamine agonist (OR 4.1, 95% CI 1.56–10.69). Cognitive changes over time did not differ between patients with and without ICBs. In conclusion, ICBs are common in PwP, but are often non-persistent and not associated with greater cognitive impairment over time.

Sign in / Sign up

Export Citation Format

Share Document