Social Withdrawal of Persons With Vascular Dementia Associated With Disturbance of Basic Daily Activities, Apathy, and Impaired Social Judgment

2013 ◽  
Vol 14 (2) ◽  
pp. 108-113 ◽  
Author(s):  
Yukiko Honda ◽  
Kenichi Meguro ◽  
Mitsue Meguro ◽  
Kyoko Akanuma
Keyword(s):  
Vascular Dementia ◽  
Cognitive Abilities ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Self Care ◽  
Elderly Subjects ◽  
Social Activities ◽  
Explanatory Variables ◽  
Frontal Lobe Function ◽  
Institutionalized Patients

Patients with vascular dementia (VaD) are often isolated, withdrawn from society because of negative symptoms and functional disabilities. The aim of this study was to detect factors associated with social withdrawal in patients with VaD. The participants were 36 institutionalized patients with VaD. Social withdrawal was assessed with the social withdrawal of the Multidimensional Observation Scale for Elderly Subjects (MOSES). Possible explanatory variables were the MOSES items depression and self-care, Cognitive Abilities Screening Instrument (CASI), apathy evaluation scale (AES), and Behavioral Pathology in Alzheimer’s Disease Frequency-Weighted Severity Scale (BEHAVE-ADFW). Multiple regression analyses were conducted for two groups: Analysis 1 was performed in all patients (N = 36) and Analysis 2 was performed in the patients with the ability to move by themselves (i.e., independent walking or independent movement with a cane or a wheelchair; n = 28). In Analysis 1, MOSES item social withdrawal was correlated with AES and MOSES item self-care. In Analysis 2, MOSES item social withdrawal was correlated with AES and CASI domain abstraction and judgment. Decreased social activities of VaD were not related to general cognitive function or depression. Disturbed activities of daily living (ADLs) for self-care may involve decreased frontal lobe function, indicating that comprehensive rehabilitation for both ADL and dementia are needed to improve the social activities of patients with VaD.

scholarly journals The efficacy of cariprazine in negative symptoms of schizophrenia: Post hoc analyses of PANSS individual items and PANSS-derived factors

2019 ◽  
Vol 58 ◽  
pp. 1-9 ◽  
Author(s):  
Wolfgang Fleischhacker ◽  
Silvana Galderisi ◽  
István Laszlovszky ◽  
Balázs Szatmári ◽  
Ágota Barabássy ◽  
...  
Keyword(s):  
Negative Symptom ◽  
Repeated Measures ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Partial Agonist ◽  
Factor Models ◽  
Symptom Improvement ◽  
Symptom Dimensions ◽  
Intent To Treat ◽  
Post Hoc

AbstractBackground:Negative symptoms in schizophrenia are heterogeneous and multidimensional; effective treatments are lacking. Cariprazine, a dopamine D3-preferring D3/D2 receptor partial agonist and serotonin 5-HT1A receptor partial agonist, was significantly more effective than risperidone in treating negative symptoms in a prospectively designed trial in patients with schizophrenia and persistent, predominant negative symptoms.Methods:Using post hoc analyses, we evaluated change from baseline at week 26 in individual items of the Positive and Negative Syndrome Scale (PANSS) and PANSS-derived factor models using a mixed-effects model for repeated measures (MMRM) in the intent-to-treat (ITT) population (cariprazine = 227; risperidone = 227).Results:Change from baseline was significantly different in favor of cariprazine versus risperidone on PANSS items N1-N5 (blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking) (P <.05), but not on N6 (lack of spontaneity/flow of conversation) or N7 (stereotyped thinking). On all PANSS-derived negative symptom factor models evaluated (PANSS-Factor Score for Negative Symptoms, Liemburg factors, Khan factors, Pentagonal Structure Model Negative Symptom factor), statistically significant improvement was demonstrated for cariprazine versus risperidone (P <.01). Small and similar changes in positive/depressive/EPS symptoms suggested that negative symptom improvement was not pseudospecific. Change from baseline was significantly different for cariprazine versus risperidone on PANSS-based factors evaluating other relevant symptom domains (disorganized thoughts, prosocial function, cognition; P <.05).Conclusions:Since items representing different negative symptom dimensions may represent different fundamental pathophysiological mechanisms, significant improvement versus risperidone on most PANSS Negative Subscale items and across all PANSS-derived factors suggests broad-spectrum efficacy for cariprazine in treating negative symptoms of schizophrenia.

scholarly journals T222. IMPAIRED COST-BENEFIT COMPUTATION IN SOCIAL CONTEXT IN PATIENTS WITH SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S317-S317
Author(s):  
Chao Yan ◽  
Yu-xin Shao ◽  
Xuan Wang ◽  
Min-yi Chu ◽  
Qin-yu Lv ◽  
...  
Keyword(s):  
Social Context ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Cost Benefit ◽  
Clinical Intervention ◽  
Lower Percentage ◽  
Healthy Controls ◽  
Significant Group ◽  
Job Interview ◽  
Bonus Points

Abstract Background Social withdrawal is one of core negative symptoms in schizophrenia, which dampens their social outcomes and prognosis. However, the underlying behavioral mechanisms of this symptom are poorly understood. In the present study, we aimed to explore the capacity of cost-benefit computation under social context in schizophrenia patients. Methods We recruited twenty-six patients, who met the criteria for diagnosis of schizophrenia, and thirty-one healthy controls matched for their age and gender ratio. All the participants were administrated to Effortful Job Interview Task, which is a novel behavioral paradigm where participants were asked to make an effort to get job offers. Before their taking effort, they were required to decide whether they would like to get involved in a less challenging job interview with no bonus point or a more challenging one with varied bonus points (i.e., 5, 15, 25 points, higher points indicate higher chance of getting a job offer). Results In healthy controls, there was a main effect of prize on the choice percentage of challenging job interview (F (2, 90) = 68.577, p &lt;0.001), with higher percentage of picking challenging interview under large (25) and medium (15) bonus points than low bonus point (5). Schizophrenia patients, however, exhibited lower percentage of challenging interview choices under medium (p =.015) and large (p &lt;.01) bonus points than healthy controls, as reflected by a significant Group x Prize interaction effect (F (2, 110) = 6.478, p &lt;0.01). In addition, we observe significant negative correlations between percentage of challenging interview choices under large bonus and amotivation sub-score on the Scale for the Assessment of Negative Symptoms (r = -0.49, p = 0.01). Interestingly, patients with schizophrenia displayed spared experience of pleasantness when they received a job offer as compared with healthy controls (p = .09). But, they showed blunted aversive experience towards the outcomes of failure as compared to healthy controls (p &lt; .01). Discussion These findings suggest that impaired social cost-benefit computation may play a central role in the symptoms of social withdrawal in schizophrenia, which may facilitate the clinical intervention of negative symptoms.

16. APOE polymorphism affects specific cognitive abilities among non demented elderly subjects

2009 ◽  
Vol 44 (1-2) ◽  
pp. 130-131
Author(s):  
A. Montesanto ◽  
S. De Blasi ◽  
C. Martino ◽  
A.C. Bruni ◽  
G. Passarino
Keyword(s):  
Cognitive Abilities ◽  
Elderly Subjects ◽  
Apoe Polymorphism ◽  
Specific Cognitive Abilities

scholarly journals The Profile of Hippocampal Metabolites Differs between Alzheimer's Disease and Subcortical Ischemic Vascular Dementia, as Measured by Proton Magnetic Resonance Spectroscopy

2012 ◽  
Vol 32 (5) ◽  
pp. 805-815 ◽  
Author(s):  
Akihiko Shiino ◽  
Toshiyuki Watanabe ◽  
Yoshitomo Shirakashi ◽  
Emi Kotani ◽  
Masahiro Yoshimura ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Vascular Dementia ◽  
Characteristic Curve ◽  
Elderly Subjects ◽  
Resonance Spectroscopy ◽  
Concentration Changes

Alzheimer's disease (AD) and subcortical ischemic vascular dementia (SIVD) have overlapping pathologies and risk factors, but their underlying neurodegenerative mechanisms are basically different. We performed magnetic resonance spectroscopy (MRS) to study metabolite differences between the two diseases in vivo. The subjects were 31 patients with SIVD and 99 with AD. Additionally, 45 elderly subjects were recruited as controls. We measured N-acetylaspartate (NAA), glutamine and glutamate (Glx), and myoinositol (mIns) concentration quantitatively using a 1.5-T MR scanner. N-acetylaspartate and Glx concentrations decreased in the hippocampus and cingulate/precuneal cortices (PCC) in both AD and SIVD patients, and the NAA decrease in the hippocampus was more prominent in AD than in SIVD. Interestingly, the pattern of mIns concentration changes differed between the two disorders; mIns was increased in AD but not increased in SIVD. If one differentiates between AD and SIVD by the mIns concentration in the hippocampus, the area under the receiver operating characteristic curve was 0.95, suggesting a high potential for discrimination. Our results suggest that proton MRS can provide useful information to differentiate between AD and SIVD. The difference of mIns concentrations in the hippocampus and PCC seems to reflect the different neurodegenerative mechanisms of the two disorders.

Clinical Psychopathology of Negative Symptoms: A Phenomenological Perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. S14-S14
Author(s):  
A. Raballo
Keyword(s):  
Negative Symptoms ◽  
Clinical Decision Making ◽  
Personal Autonomy ◽  
Social Withdrawal ◽  
Clinical Decision ◽  
Phenotypic Characterization ◽  
Subjective Experiences ◽  
Substantial Impact ◽  
Phenomenological Perspective ◽  
Competing Interest

Negative symptoms encompass a broad constellation of psycho-behavioral phenomena, including affective flattening, poverty of speech, alogia, avolition, social withdrawal, apathy and anhedonia. These phenomena obviously exert a substantial impact on personal autonomy, quality of life and broad functional outcomes, ultimately being an important challenge for clinical decision-making and therapeutic support. In recent years, the attention to negative symptoms in schizophrenia has revamped, boosting the development of new rating tools as well as a broader conceptualization of derivative constructs (e.g. apathy, amotivation, anhedonia). However, despite its behavioral expressivity, the in-depth phenotypic characterization of negative symptoms remains partly unaddressed. Similarly, their clinical intertwining with other non-productive clinical features (e.g. anomalous subjective experiences, cognitive-perceptual basic symptoms and schizotypal features) is generally overlooked. Therefore, the current presentation specifically offers a stratified overview of the phenomenology of negative symptoms filtered through lens of clinical psychopathology.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Signs and symptoms in the pre-psychotic phase: description and implications for diagnostic trajectories

2008 ◽  
Vol 38 (8) ◽  
pp. 1147-1156 ◽  
Author(s):  
S. N. Iyer ◽  
L. Boekestyn ◽  
C. M. Cassidy ◽  
S. King ◽  
R. Joober ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Signs And Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Related Factors ◽  
Affective Psychosis ◽  
Duration Of Untreated Illness ◽  
Early Signs

BackgroundFew studies have examined the underlying factor structure of signs and symptoms occurring before the first psychotic episode. Our objective was to determine whether factors derived from early signs and symptoms are differentially associated with non-affective versus affective psychosis.MethodA principal components factor analysis was performed on early signs and symptoms reported by 128 individuals with first-episode psychosis. Factor scores were examined for their associations with duration of untreated illness, drug abuse prior to onset of psychosis, and diagnosis (schizophrenia versus affective psychosis).ResultsOf the 27 early signs and symptoms reported by patients, depression and anxiety were the most frequent. Five factors were identified based on these early signs and symptoms: depression, disorganization/mania, positive symptoms, negative symptoms and social withdrawal. Longer duration of untreated illness was associated with higher levels of depression and social withdrawal. Individuals with a history of drug abuse prior to the onset of psychosis scored higher on pre-psychotic depression and negative symptoms. The two mood-related factors, depression and disorganization/mania, distinguished the eventual first-episode diagnosis of affective psychosis from schizophrenia. Individuals with affective psychosis were also more likely to have a ‘mood-related’ sign and symptom as their first psychiatric change than individuals later diagnosed with schizophrenia.ConclusionsFactors derived from early signs and symptoms reported by a full diagnostic spectrum sample of psychosis can have implications for future diagnostic trajectories. The findings are a step forward in the process of understanding and characterizing clinically important phenomena to be observed prior to the onset of psychosis.

Hypofrontality in Schizophrenia: A Review of the Evidence*

1987 ◽  
Vol 32 (5) ◽  
pp. 399-404 ◽  
Author(s):  
Peter Williamson
Keyword(s):  
Frontal Lobe ◽  
Negative Symptoms ◽  
Axial Tomography ◽  
Cat Scan ◽  
Positron Emission ◽  
Frontal Lobe Function ◽  
Schizophrenic Patients ◽  
Computerized Axial Tomography ◽  
Magnetic Resonance Imaging Mri ◽  
Pet Scans

This paper reviews the possible role of frontal lobe dysfunction in the pathophysiology of schizophrenia. Pathological, computerized axial tomography (CAT) scan and magnetic resonance imaging (MRI) studies have indicated that a substantial number of schizophrenic patients show structural abnormalities in the frontal lobe areas and other parts of the brain. In some cases, these changes can be correlated with negative symptoms. Attempts to study frontal lobe function with neuropsychological tests, topographic EEG, cerebral blood flow (CBF) and positron emission tomography (PET) scans have also indicated that a substantial number of schizophrenics show abnormalities compared to normal controls. However, these abnormalities can be seen to some degree in other conditions. As well, patients early in the course of their illness tend not to show frontal lobe functional abnormalities. The implications of these findings for current theories of schizophrenia are discussed.

scholarly journals Matching drug transcriptional signatures to rare losses disrupting synaptic gene networks identifies known and novel candidate drugs for schizophrenia

2018 ◽  
Author(s):  
Daniele Merico ◽  
Xiao Wang ◽  
Ryan K. C. Yuen ◽  
Stephen W. Scherer ◽  
Anne S. Bassett
Keyword(s):  
Drug Development ◽  
Gene Networks ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Global Gene Expression ◽  
Recent Analysis ◽  
P Value ◽  
Copy Number Loss ◽  
Wide Range ◽  
Psychoactive Effects

ABSTRACTSchizophrenia is a complex neuropsychiatric disorder. The etiology is not fully understood, but genetics plays an important role. Pathway analysis of genetic variants have suggested a central role for neuronal synaptic processes. Currently available antipsychotic medications successfully control positive symptoms (hallucinations and delusions) largely by inhibiting the dopamine D2 receptors; however, these drugs have more limited impact on negative symptoms (social withdrawal, flat affections, anhedonia) and cognitive deterioration. Drug development efforts have focused on a wide range of neurotransmitter systems and other agents, with conflicting or inconclusive results. New drug development paradigms are needed. A recent analysis, using common variant association results to match drugs based on their transcriptional perturbation signature, found drugs enriched in known antipsychotics plus novel candidates.We followed a similar approach, but started our analysis from a synaptic gene network implicated by rare copy number loss variants. We found that a significant number of antipsychotics (p-value = 0.0002) and other psychoactive drugs (p-value = 0.0004) upregulate synaptic network genes. Based on global gene expression similarity, active drugs formed two main clusters: one with many known antipsychotics and antidepressants, the other with various drug categories including two nootropics. We specifically recommend further examination of nootropics with limited side effects (meclofenoxate, piracetam and vinpocetine) for combination therapy with antipsychotics to improve cognitive performance. Detailed experimental follow-up is required to further evaluate other candidate drugs lacking an official nervous system indication, although, for at least a few of these, psychoactive effects have been reported in the literature.

scholarly journals Cognitive ability and motor performances in the elderly

2020 ◽  
pp. 143-143
Author(s):  
Stevan Jovanovic ◽  
Biljana Stojanovic-Jovanovic ◽  
Aleksandra Pavlovic ◽  
Radovan Milosevic ◽  
Dragan Pavlovic
Keyword(s):  
Physical Fitness ◽  
Executive Functions ◽  
Cognitive Abilities ◽  
Dynamic Balance ◽  
The Elderly ◽  
Upper Body ◽  
Elderly Subjects ◽  
Physical Strength ◽  
Speed Test ◽  
Wide Range

Background/Aim. Ageing entails a wide range of cognitive processes that are not independent of one another. It leads to changes in physical-motor characteristics and sometimes to disability. The aim was to examine the association between multiple cognitive performances in elderly subjects and their physical-motor abilities measured by a variety of tests. Methods: In total, 98 elderly (60+) participants (16 males and 82 females), took part in the study. Cognitive abilities were assessed by the Montreal Cognitive Assessment (MoCA)/Serbian version and physical measures were assessed by the Senior Fitness Test with its five subtests, supplemented by the Walking Speed Test. Results: Several MoCA items demonstrated relatively low variability, i.e. they proved to be too easy for most of the participants. The participants exhibited the lowest performance on the memory relating to other domains, followed by executive functions, visuospatial skills, attention, concentration, and working memory domains, with the highest performance on temporal and spatial orientation relating to other domains. Executive functions and language correlated most significantly with physical strength. Agility and dynamic balance, lower- and upper-body strength, and aerobic endurance correlated moderately and positively. Conclusions: This study underlines the positive correlation between physical fitness and cognitive level in the elderly and emphasizes the importance of physical fitness for cognitive functions, especially those of executive type in elderly subjects. Clinicians should consider the association between cognitive function and physical-motor performances when dealing with functioning improvement in the elderly. The importance of designing the most efficient exercise programs to achieve maximal somatic and cognitive effects.

scholarly journals The effectiveness of long-term aripiprazole injections to a patient with paranoid schizophrenia: a case report

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anna Maria Szota ◽  
Aleksander Araszkiewicz
Keyword(s):  
Case Report ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Paranoid Schizophrenia ◽  
Psychotic Symptoms ◽  
Suicidal Thoughts ◽  
Duration Of Hospitalization ◽  
History Of ◽  
Long Acting

AbstractParanoid schizophrenia is a chronic, psychotic disorder which can be treated with long-acting injectable (LAI) antipsychotic drugs. There are risperidone (Risperdal Consta®), olanzapine (Zypadhera®), paliperidone (Xepilon®) and aripiprazole (Abilify Maintena®) currently available.The aim of this study was to present a case history of the patient to whom monthly injections of aripiprazole effectively prevented both relapses of psychotic symptoms and hospitalizations.Case report: A 55-year-old male patient with a 13-year history of paranoid schizophrenia has been effectively treated with aripiprazole (LAI) (400mg, every 4 weeks). During the last 8 years of treatment his mental state has been stabilized, without any acute psychotic symptoms and without any anxiety, or violent behaviours. Moreover, there have been no psychotic symptoms, or suicidal thoughts, or tendencies recordered. Therefore, no hospitalization has been required. However, despite the treatment, negative symptoms such as blunted affect, cognitive dysfunction and social withdrawal have been sustained.Discussion: The available articles on aripiprazole (LAI) treatment indicate that it was effective in reducing the positive and negative symptoms of schizophrenia, as well as reducing the frequency and duration of hospitalization. However, the case report of a patient who has not had relapses of psychotic symptoms and suicidal thoughts and has not been hospitalized during 8 years of treatment with aripiprazole (LAI) has not yet been reported.Conclusions: Regular, long-term injections of aripiprazole (LAI) are very effective at preventing positive symptoms of schizophrenia development and preventing both suicidal thoughts and hospitalizations. Therefore, treatment with this drug in everyday practice should be increased.

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