scholarly journals Decision Making under Risk in Patients Suffering from Schizophrenia or Depression

2021 ◽  
Vol 11 (9) ◽  
pp. 1178
Author(s):  
Theresa Benke ◽  
Josef Marksteiner ◽  
Beatrix Ruepp ◽  
Elisabeth M. Weiss ◽  
Laura Zamarian
Keyword(s):  
Decision Making ◽  
Executive Function ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Neuropsychological Test ◽  
Depressed Patients ◽  
Syndrome Scale ◽  
Patient Groups ◽  
Decision Making Behavior ◽  
Negative Syndrome

Studies have reported difficulties in decision making for patients with schizophrenia or depression. Here, we investigated whether there are differences between schizophrenia patients, depressed patients, and healthy individuals (HC) when decisions are to be made under risk and cognitive flexibility is required. We were also interested in the relationships between decision making, cognitive functioning, and disease severity. Thirty HC, 28 schizophrenia patients, and 28 depressed patients underwent structured clinical assessments and were assessed by the Positive and Negative Syndrome Scale or Hamilton Rating Scale. They performed the Probability-Associated Gambling (PAG) Task and a neuropsychological test battery. Both patient groups obtained lower scores than HC in memory and executive function measures. In the PAG task, relative to HC, depressed patients made slower decisions but showed a comparable number of advantageous decisions or strategy flexibility. Schizophrenia patients were slower, riskier, and less flexible compared to HC. For them, the decision making behavior correlated with the symptom severity. In both groups, decision making scores correlated with memory and executive function scores. Patients with schizophrenia or depression may have difficulties under risk when quick and flexible decisions are required. These difficulties may be more pronounced in patients who have marked cognitive deficits or severe clinical symptoms.

scholarly journals Decision making under ambiguity and risk in adolescent-onset schizophrenia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dandan Li ◽  
Fengyan Zhang ◽  
Lu Wang ◽  
Yifan Zhang ◽  
Tingting Yang ◽  
...  
Keyword(s):  
Decision Making ◽  
Executive Function ◽  
Iowa Gambling Task ◽  
Clinical Symptoms ◽  
Healthy Controls ◽  
Syndrome Scale ◽  
Significant Difference ◽  
Abnormal Pattern ◽  
Negative Syndrome ◽  
The Relationship

Abstract Objective Numerous studies have identified impaired decision making (DM) under both ambiguity and risk in adult patients with schizophrenia. However, the assessment of DM in patients with adolescent-onset schizophrenia (AOS) has been challenging as a result of the instability and heterogeneity of manifestations. The Iowa Gambling Task (IGT) and Game of Dice Task (GDT), which are frequently used to evaluate DM respectively under ambiguity and risk, are sensitive to adolescents and neuropsychiatric patients. Our research intended to examine the performance of DM in a relatively large sample of patients with AOS using the above-mentioned two tasks. We also aimed to take a closer look at the relationship between DM and symptom severity of schizophrenia. Methods We compared the performance of DM in 71 patients with AOS and 53 well-matched healthy controls using IGT for DM under ambiguity and GDT for DM under risk through net scores, total scores and feedback ration. Neuropsychological tests were conducted in all participants. Clinical symptoms were evaluated by using Positive and Negative Syndrome Scale (PANSS) in 71 patients with AOS. Pearson’s correlation revealed the relationship among total score of DM and clinical and neuropsychological data. Results Compared to healthy controls, patients with AOS failed to show learning effect and had a significant difference on the 5th block in IGT and conducted more disadvantageous choices as well as exhibited worse negative feedback rate in GDT. Apart from DM impairment under risk, diminished DM abilities under ambiguity were found related to poor executive function in AOS in the present study. Conclusions Our findings unveiled the abnormal pattern of DM in AOS, mainly reflected under the risky condition, extending the knowledge on the performance of DM under ambiguity and risk in AOS. Inefficient DM under risk may account for the lagging impulse control and the combined effects of developmental disease. In addition, our study demonstrated that the performance on IGT was related to executive function in AOS.

scholarly journals Cognition in Recent Suicide Attempts: Altered Executive Function

2021 ◽  
Vol 12 ◽  
Author(s):  
Jessica Fernández-Sevillano ◽  
Susana Alberich ◽  
Iñaki Zorrilla ◽  
Itxaso González-Ortega ◽  
María Purificación López ◽  
...  
Keyword(s):  
Decision Making ◽  
Risk Factor ◽  
Executive Function ◽  
Neuropsychological Assessment ◽  
Processing Speed ◽  
Suicide Attempts ◽  
Healthy Controls ◽  
Cognitive Domains ◽  
Depressed Patients ◽  
Patient Groups

Background: Neuropsychological alterations can lead to inaccurate perception, interpretation, and response to environmental information, which could be a risk factor for suicide.Methods: Ninety-six subjects were recruited from the Psychiatry Department of the Araba University Hospital—Santiago, including 20 patients with a recent attempt and diagnosis of major depressive disorder (MDD) according to DSM-V, 33 MDD patients with history of attempted suicide, 23 non-attempter MDD patients, and 20 healthy controls. All participants underwent a clinical interview and neuropsychological assessment on the following cognitive domains: working memory, processing speed, decision-making, executive function, and attention. Backward multiple regressions were performed adjusting for significant confounding variables. For group comparisons, ANOVA and Bonferroni post-hoc tests were performed with a p < 0.05 significance level.Results: The patient groups did not differ regarding severity of depression and stressful events in the last 6 months. In comparison to healthy controls, depressed patients with lifetime suicide attempts had more general trauma (p = 0.003), emotional abuse (p = 0.003), emotional negligence (p = 0.006), and physical negligence (p = 0.009), and depressed patients with recent suicide attempts had experienced more child sexual abuse (p = 0.038). Regarding neuropsychological assessment, all patient groups performed significantly worse than did healthy controls in processing speed, decision-making, and attention. Comparisons between patient groups indicated that recent suicide attempters had poorer performance on executive function in comparison to both depressed lifetime attempters and depressed non-attempters (B = 0.296, p = 0.019, and B = 0.301, p = 0.028, respectively). Besides, women with recent attempts had slightly better scores on executive function than males. Regarding the rest of the cognitive domains, there were no significant differences between groups.Conclusion: Executive function performance is altered in recent suicide attempts. As impaired executive function can be risk factor for suicide, preventive interventions on suicide should focus on its assessment and rehabilitation.

scholarly journals Associations of Genetic Polymorphisms and Neuroimmune Markers With Some Parameters of Frontal Lobe Dysfunction in Schizophrenia

2021 ◽  
Vol 12 ◽  
Author(s):  
Anna Morozova ◽  
Yana Zorkina ◽  
Konstantine Pavlov ◽  
Olga Pavlova ◽  
Olga Abramova ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Frontal Lobe Dysfunction ◽  
Reactive Protein ◽  
Frontal Lobe Damage ◽  
Syndrome Scale ◽  
Frontal Lobe Function ◽  
Negative Syndrome ◽  
Control Study

We investigated the associations of DRD3 rs6280, HTR1A rs6295, BDNF rs6265, SCL6A4 rs16965628, and 5HT2A rs7322347 with schizophrenia in a case–control study, and associations of these genetic variants with several clinical features. We also investigated markers of inflammatory response (C-reactive protein, IL-2, IL-6, IL-10), the activity of leukocytic elastase (LE) and α1-proteinase inhibitor (a1-PI), antibodies to S100B and myelin basic protein (MBP) in schizophrenia. Clinical symptoms were assessed on three scales: Positive and Negative Syndrome Scale, The Bush – Francis Catatonia Rating Scale and Frontal Assessment Battery. All SNPs were typed using predesigned TaqMan SNP genotyping assays. The biomarkers related to the immune system were routinely tested using ELISA kits. The association with schizophrenia was found for DRD3 rs6280 (p = 0.05) and HTR2A rs7322347 (p = 0.0013). We found differences between groups by parameters of LE and a1-PI and LE/a1-PI (p < 0.001). And IL-6 was evaluated in the schizophrenia group (p < 0.001). We showed that patients with the TT allele (BDNF rs6265) had more severe impairments in frontal lobe function. a1-PI can serve as a marker for assessing the severity of frontal lobe damage in patients with frontal dementia. We found some biological parameters reflecting the severity of frontal dysfunction in schizophrenia.

scholarly journals Duration of untreated psychosis of first-episode psychotic disorders in Yogyakarta, Indonesia

2019 ◽  
Vol 7 (2) ◽  
pp. 61-64
Author(s):  
Carla R. Marchira ◽  
Irwan Supriyanto
Keyword(s):  
Psychotic Disorders ◽  
Rating Scale ◽  
First Episode ◽  
Medical Facility ◽  
Duration Of Untreated Psychosis ◽  
Global Assessment Of Functioning ◽  
Global Functioning ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
Gaf Scores

Introduction: Duration of untreated psychosis (DUP) is an important predictor for prognosis in first episode of psychotic disorders. Caregivers often seek help from alternative healers first and health professional later. These would delay proper treatments for the patients, resulting in more severe symptoms and lower functioning on their visit to medical facility. The present study aims to find the association between DUP, symptoms severity, and global functioning in patients with first-episode psychotic disorders. Methods: We identified 100 patients with first episode of psychotic disorders and their caregivers. The instruments used were Brief Psychotic Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Premorbid Schizoid-Schizotypal Traits (PSST), and Global Assessment of Functioning (GAF). Results: There were no significant association between BPRS, PANSS, PSST, and GAF scores and DUP in our subjects. Nevertheless, we found that men had significantly longer DUP compared to women. Conclusion: We found significant association between sex and DUP in this study. Longer DUP leads to delayed treatments and poorer prognosis. Further study is required to confirm our finding.

scholarly journals Physician-Specific Maximum Acceptable Risk in Personalized Medicine: Implications for Medical Decision Making

2018 ◽  
Vol 38 (5) ◽  
pp. 593-600
Author(s):  
Marco Boeri ◽  
Alan J. McMichael ◽  
Joseph P. M. Kane ◽  
Francis A. O’Neill ◽  
Frank Kee
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Discrete Choice Experiments ◽  
Medical Decision ◽  
Random Parameters ◽  
Acceptable Risk ◽  
Syndrome Scale ◽  
Unit Increase ◽  
Negative Syndrome

Background. In discrete-choice experiments (DCEs), respondents are presented with a series of scenarios and asked to select their preferred choice. In clinical decision making, DCEs allow one to calculate the maximum acceptable risk (MAR) that a respondent is willing to accept for a one-unit increase in treatment efficacy. Most published studies report the average MAR for the whole sample, without conveying any information about heterogeneity. For a sample of psychiatrists prescribing drugs for a series of hypothetical patients with schizophrenia, this article demonstrates how heterogeneity accounted for in the DCE modeling can be incorporated in the derivation of the MAR. Methods. Psychiatrists were given information about a group of patients’ responses to treatment on the Positive and Negative Syndrome Scale (PANSS) and the weight gain associated with the treatment observed in a series of 26 vignettes. We estimated a random parameters logit (RPL) model with treatment choice as the dependent variable. Results. Results from the RPL were used to compute the MAR for the overall sample. This was found to be equal to 4%, implying that, overall, psychiatrists were willing to accept a 4% increase in the risk of an adverse event to obtain a one-unit improvement of symptoms – measured on the PANSS. Heterogeneity was then incorporated in the MAR calculation, finding that MARs ranged between 0.5 and 9.5 across the sample of psychiatrists. Limitations. We provided psychiatrists with hypothetical scenarios, and their MAR may change when making decisions for actual patients. Conclusions. This analysis aimed to show how it is possible to calculate physician-specific MARs and to discuss how MAR heterogeneity could have implications for medical practice.

Contrasting patterns of deficits in visuospatial memory and executive function in patients with major depression with and without ECT referral

2010 ◽  
Vol 41 (5) ◽  
pp. 983-995 ◽  
Author(s):  
E. Tsaltas ◽  
S. Kalogerakou ◽  
V.-M. Papakosta ◽  
D. Kontis ◽  
E. Theochari ◽  
...  
Keyword(s):  
Executive Function ◽  
Neuropsychological Test ◽  
Visuospatial Memory ◽  
Cognitive Profiles ◽  
Opposite Pattern ◽  
Paired Associates ◽  
Depressed Patients ◽  
Neuropsychological Profile ◽  
Executive Deficits ◽  
State Examination

BackgroundThe pretreatment neuropsychological profile of drug-resistant patients with major depressive disorder (MDD) referred for electroconvulsive therapy (ECT) may differ from that of their drug-respondent MDD counterparts. Such differences could help in identifying distinct MDD subtypes, thus offering insights into the neuropathology underlying differential treatment responses.MethodDepressed patients with ECT referral (ECTs), depressed patients with no ECT referral (NECTs) and non-psychiatric Controls (matched groups,n=15) were assessed with memory and executive function tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB).ResultsECTs scored significantly lower than NECTs in the Mini-Mental State Examination (MMSE;p=0.01). NECTs performed worse than Controls in the Paired Associates Learning (PAL) task (p<0.03; Control/NECTp<0.01) and the Spatial Recognition Memory (SRM) task (p<0.05; Controls/NECTsp<0.05); ECTs performed between Controls and NECTs, not differing from either. In the Intra/Extradimensional (IED) set-shifting task, ECTs performed worse that Controls and NECTS (IED:p<0.01; Controls/ECTsp<0.01), particularly in the shift phases, which suggests reduced attentional flexibility. In Stockings of Cambridge (SOC), ECTs abandoned the test early more often than Controls and NECTs (H=11,p<0.01) but ECTs who completed SOC performed comparably to the other two groups.ConclusionsA double dissociation emerged from the comparison of cognitive profiles of ECT and NECT patients. ECTs showed executive deficits, particularly in attentional flexibility, but mild deficits in tests of visuospatial memory. NECTs presented the opposite pattern. This suggests predominantly frontostriatal involvement in ECTversustemporal involvement in NECT depressives.

Estrogen, menstrual cycle phases, and psychopathology in women suffering from schizophrenia

2007 ◽  
Vol 37 (10) ◽  
pp. 1427-1436 ◽  
Author(s):  
NIELS BERGEMANN ◽  
PETER PARZER ◽  
BENNO RUNNEBAUM ◽  
FRANZ RESCH ◽  
CHRISTOPH MUNDT
Keyword(s):  
Menstrual Cycle ◽  
Rating Scale ◽  
Premenopausal Women ◽  
Psychotic Symptoms ◽  
Cycle Phase ◽  
Syndrome Scale ◽  
Regular Menses ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
Negative Syndrome

ABSTRACTBackgroundEstrogen has been hypothesized to have a protective and antipsychotic-like effect in women at risk for schizophrenia. The aim of the present study was to evaluate the association between menstrual cycle and/or estrogen levels and psychotic symptoms in a sample of women with schizophrenia.MethodOne hundred and twenty-five premenopausal women with schizophrenia and regular menses were examined. The levels of 17β-estradiol and other hormones of the gonadal axis were assessed in the follicular, peri-ovulatory, and luteal phases of the menstrual cycle. The effects of the menstrual cycle phase and/or the estradiol level on the Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS) scores were calculated by means of regression analyses.ResultsSignificant improvement in psychotic, but not depressive, symptoms was observed during the luteal phase, compared with other days of the menstrual cycle.ConclusionsThe present findings indicate that estradiol may have specific antipsychotic-like effects on the symptoms of schizophrenia. Thus further investigation into the therapeutic effect of estrogen may be worthwhile.

Subjective awareness of tardive dyskinesia and insight in schizophrenia

2011 ◽  
Vol 26 (5) ◽  
pp. 293-296 ◽  
Author(s):  
R. Emsley ◽  
D.J.H. Niehaus ◽  
P.P. Oosthuizen ◽  
L. Koen ◽  
B. Chiliza ◽  
...  
Keyword(s):  
Mental Illness ◽  
Tardive Dyskinesia ◽  
Rating Scale ◽  
Subscale Score ◽  
Domain Specific ◽  
Subjective Awareness ◽  
Syndrome Scale ◽  
Mild Impairment ◽  
Negative Syndrome ◽  
Insight Into

AbstractBackgroundLack of awareness of tardive dyskinesia (TD) and poor insight into mental illness are common in schizophrenia, raising the possibility that these phenomena are manifestations of a common underlying dysfunction.MethodsWe investigated relationships between low awareness of TD and poor insight into mental illness in 130 patients with schizophrenia and TD. We also examined selected demographic and clinical correlates of these two phenomena.ResultsSixty-six (51%) patients had no or low awareness of TD and 94 (72%) had at least mild impairment of insight into their mental illness. Low awareness of TD was not significantly correlated with greater impairment of insight into mental illness. Regression analyses indicated that the Positive and Negative Syndrome Scale (PANSS) disorganised factor (β = 0.72, t = 11.88, p < 0.01) accounted for 52% of the variance in insight into mental illness (adjusted R2 = 0.55) (F[2, 127] = 81.00, p < 0.01) and the Extrapyramidal Symptom Rating Scale (ESRS) dyskinesia subscale score (β = 0.47, t = 6.80, p < 0.01), PANSS disorganised factor (β = −0.26, t = −3.73, p < 0.01), and ESRS parkinsonism subscale score (β = 0.31, t = 4.55, p < 0.01) together accounted for 37% of the variance in awareness of TD (adjusted R2 = 0.37) (F[3, 126] = 26.87, p < 0.01).ConclusionThe two phenomena appear to be dissociated, and may be domain-specific.

Influence ofNRGNrs12807809 polymorphism on symptom severity in individuals with schizophrenia in the Han population but not the Zhuang population of south China

2015 ◽  
Vol 27 (4) ◽  
pp. 221-227 ◽  
Author(s):  
Li Su ◽  
Jianxiong Long ◽  
Runde Pan ◽  
Xinfeng Xie ◽  
Xixiang Mao ◽  
...  
Keyword(s):  
South China ◽  
Clinical Symptoms ◽  
Subscale Score ◽  
Assay Method ◽  
Psychotic Symptoms ◽  
Han Population ◽  
Syndrome Scale ◽  
General Activation ◽  
Negative Syndrome ◽  
Pooled Samples

BackgroundNRGNis one of the most promising candidate genes for schizophrenia based on function and position. Therefore, this study aimed to examine the genetic association of this polymorphism with schizophrenia in the Zhuang and Han populations of south China.Subjects and methodsA total of 282 patients (188 Han and 94 Zhuang) and 282 healthy subjects (188 Han and 94 Zhuang) were recruited. Of these, 246 schizophrenia patients underwent an assessment of psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS). A TaqMan genotyping assay method was used to determine the genotypes.ResultsWe did not find a significant association of rs12807809 polymorphism with schizophrenia in the total pooled samples, or in the separate ethnic groups. However, in Han schizophrenia patients, quantitative data analyses showed that the CC genotype of the rs12807809 polymorphism was associated with PANSS aggression subscale score and activation subscale score. Furthermore, carriers of the C allele of rs12807809 polymorphism among Han schizophrenia patients had higher scores of general, activation, depression, aggression, and global symptoms than the T allele carriers.ConclusionIn conclusion rs12807809 polymorphism may not contribute to the risk of schizophrenia but influence the clinical symptoms of schizophrenia in the Han population.

scholarly journals Nicotine dependence and illness severity in schizophrenia

2012 ◽  
Vol 201 (4) ◽  
pp. 306-312 ◽  
Author(s):  
Rajeev Krishnadas ◽  
Sameer Jauhar ◽  
Susan Telfer ◽  
Somashekara Shivashankar ◽  
Robin G. McCreadie
Keyword(s):  
Nicotine Dependence ◽  
Social Adjustment ◽  
Symptom Severity ◽  
Clinical Symptoms ◽  
Cross Sectional ◽  
Syndrome Scale ◽  
Never Smokers ◽  
Negative Syndrome ◽  
The Relationship ◽  
Higher Doses

BackgroundReasons for the increased prevalence of cigarette smoking in schizophrenia are unclear. Studies assessing clinical symptoms have sampled heterogeneous populations, with discrepant findings.AimsTo examine the relationship between clinical features, social adjustment and nicotine dependence in a geographically defined population of people with schizophrenia.MethodCross-sectional clinical study of 131 people with schizophrenia in Nithsdale, Scotland.ResultsSmokers were younger, mostly males and three times more likely to be unemployed. Those with severe nicotine dependence had greater scores on the positive subscale of the Positive and Negative Syndrome Scale (PANSS), and were prescribed higher doses of antipsychotic. Those with mild–moderate dependence had greater scores on the PANSS negative subscale. Greater symptom severity was associated with poorer social adjustment. Psychopathology and social adjustment were similar in quitters and never-smokers.ConclusionsOur findings indicate an association between nicotine dependence, clinical symptoms and social adjustment in schizophrenia. Although causal links cannot be inferred, identifying the relationship between nicotine dependence and psychopathology may have some value in the management of smoking in schizophrenia. Further longitudinal studies are required to explore this relationship.

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