scholarly journals Aberrant Learned Irrelevance in Patients with First-Episode Schizophrenia-Spectrum Disorder

2021 ◽  
Vol 11 (11) ◽  
pp. 1370
Author(s):  
Ryan Sai-Ting Chu ◽  
Chung-Mun Ng ◽  
Kwun-Nam Chan ◽  
Kit-Wa Chan ◽  
Ho-Ming Lee ◽  
...  
Keyword(s):  
Selective Attention ◽  
Psychotic Symptom ◽  
Attention Deficit ◽  
Positive Symptom ◽  
First Episode ◽  
Positive Symptoms ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
Learned Irrelevance ◽  
First Episode Schizophrenia

Emerging evidence has indicated disrupted learned irrelevance (LIrr), a form of selective attention deficit that may contribute to psychotic symptom formation, in schizophrenia. However, previous research mostly focused on chronic patients. There is a paucity of studies on LIrr in first-episode schizophrenia-spectrum disorder (i.e., schizophrenia and schizophreniform disorder; FES), which were limited by small sample size and have produced mixed results. The current study examined a LIrr effect and its relationship with positive symptom severity in 40 briefly-medicated FES patients and 42 demographically-matched healthy controls using a well-validated computerized LIrr paradigm which has been applied in chronic schizophrenia sample. Positive symptoms were assessed by Positive and Negative Syndrome Scale (PANSS) and Psychotic Symptom Rating Scales (PSYRATS). Our results showed that controls demonstrated intact LIrr, with significantly faster learning about previously predictive (relevant) than previously non-predictive (irrelevant) cues. Lack of such normal attention bias towards predictive over non-predictive cues was observed in FES patients, indicating their failure to distinguish between relevant and irrelevant stimuli. Nonetheless, we failed to reveal any significant correlations between learning scores, in particular learning scores for non-predictive cues, and positive symptom measures in FES patients. Learning scores were also not associated with other symptom dimensions, cognitive functions and antipsychotic dose. In conclusion, our findings indicate aberrant LIrr with impaired allocation of attention to relevant versus irrelevant stimuli in briefly-medicated FES patients. Further prospective research is warranted to clarify the longitudinal trajectory of such selective attention deficit and its association with positive symptoms and treatment response in the early course of illness.

scholarly journals Predictors of Remission and Recovery in a First-Episode Schizophrenia Spectrum Disorder Sample: 2-Year Follow-up of the OPUS Trial

2008 ◽  
Vol 53 (10) ◽  
pp. 660-670 ◽  
Author(s):  
Lone Petersen ◽  
Anne Thorup ◽  
Johan Øqhlenschlæger ◽  
Torben Øqstergaard Christensen ◽  
Pia Jeppesen ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Negative Symptoms ◽  
Spectrum Disorder ◽  
First Episode ◽  
Schizophrenia Spectrum Disorder ◽  
Adherence To Medication ◽  
Premorbid Adjustment ◽  
Schizophrenia Spectrum ◽  
First Episode Schizophrenia

Objective: To examine the frequency and predictors of good outcome for patients with first-episode schizophrenia spectrum disorder (SSD). Method: We conducted a 2-year follow-up of a cohort of patients ( n = 547) with first-episode SSD. We evaluated the patients on demographic variables, diagnosis, duration of untreated psychosis (DUP), premorbid functioning, psychotic and negative symptoms, substance abuse, adherence to medication, and service use. ORs were calculated with logistic regression analyses. Results: A total of 369 patients (67%) participated in the follow-up interview. After 2 years, 36% remitted and 17% were considered fully recovered. Full recovery was associated with shorter DUP, better premorbid adjustment, fewer negative symptoms at baseline, no substance abuse at baseline, and adherence to medication and OPUS treatment. Conclusions: Several predictive factors were identified, and focus should be on potentially malleable predictors of outcome, for example, reducing DUP and paying special attention to patients who are unlikely to achieve good outcome, for example, patients with a substance abuse problem and poor premorbid adjustment.

The Significance of Family History in First-Episode Schizophrenia Spectrum Disorder

2007 ◽  
Vol 195 (10) ◽  
pp. 846-852 ◽  
Author(s):  
Ross M. G. Norman ◽  
Rahul Manchanda ◽  
Ashok K. Malla ◽  
Raj Harricharan ◽  
Sandra Northcott
Keyword(s):  
Family History ◽  
Spectrum Disorder ◽  
First Episode ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
First Episode Schizophrenia

scholarly journals Latent Iron Deficiency as a Marker of Negative Symptoms in Patients with First-Episode Schizophrenia Spectrum Disorder

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1707 ◽  
Author(s):  
Sung-Wan Kim ◽  
Robert Stewart ◽  
Woo-Young Park ◽  
Min Jhon ◽  
Ju-Yeon Lee ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Negative Symptoms ◽  
Early Stage ◽  
Spectrum Disorder ◽  
First Episode ◽  
Duration Of Treatment ◽  
Schizophrenia Spectrum Disorder ◽  
Dsm 5 ◽  
Schizophrenia Spectrum ◽  
First Episode Schizophrenia

Iron deficiency may alter dopaminergic transmission in the brain. This study investigated whether iron metabolism is associated with negative symptoms in patients with first-episode psychosis. The study enrolled 121 patients with first-episode schizophrenia spectrum disorder, whose duration of treatment was 2 months or less. Negative symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) and Clinician-Rated Dimensions of Psychosis Symptom Severity (Dimensional) scale of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Prominent negative symptoms were defined as moderate or severe negative symptoms on the Dimensional scale of the DSM-5. Iron deficiency was defined as a serum ferritin ≤ 20 ng/mL. Patients with iron deficiency were significantly more likely to have prominent negative symptoms (45.2 vs. 22.2%; p = 0.014) and a higher PANSS negative symptoms score (p = 0.046) than those with normal ferritin levels. Patients with prominent negative symptoms had significantly lower ferritin levels (p = 0.025). The significance of these results remained after controlling for the duration of illness and other confounding variables. Our finding of an independent association between iron deficiency and negative symptoms in patients at the very early stage of illness implies that iron dysregulation has an effect on negative symptoms in patients with schizophrenia. The possibility of therapeutic intervention with iron should be further investigated.

scholarly journals T86. RELEVANCE OF CANNABIS USE AS A PREDICTOR OF CLINICAL OUTCOME IN FIRST-EPISODE SCHIZOPHRENIA SPECTRUM DISORDER PATIENTS OVER 24 MONTHS OF TREATMENT

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S264-S264
Author(s):  
Frederika Scheffler ◽  
Hilmar Luckhoff ◽  
Stefan du Plessis ◽  
Lebogang Phahladira ◽  
Laila Asmal ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Cannabis Use ◽  
Spectrum Disorder ◽  
Self Report ◽  
Study Entry ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
First Episode Schizophrenia

Abstract Background Cannabis use is generally associated with an unfavourable course of illness in first-episode schizophrenia, including non-remission of psychopathology symptoms, higher rates of relapse and re-hospitalization, and poorer functioning. The aim of this study was to explore the influence of cannabis use on clinical and treatment outcomes in first-episode schizophrenia spectrum disorder patients over 24 months of assured antipsychotic treatment. Methods The present longitudinal study included 123 minimally treated or antipsychotic-naive first-episode patients assessed over 24 months of treatment with flupenthixol decanoate according to a standardized regimen. Time to relapse, rates of symptomatic and functional remission, as well as recovery were compared between cannabis users (n=41) and non-users (n=82) stratified based on a combination of self-report and urine toxicology results over the course of treatment. In addition, visit-wise changes in psychopathology severity and overall functioning were compared between these two study groups. We hypothesized that 1) ongoing cannabis use would present with more severe psychopathology and poorer overall level of functioning, and 2) rates of remission and recovery would be lower in cannabis users compared to their non-using counterparts. Results At study entry, cannabis-using patients were younger, more likely to be male and to use methamphetamine, and scored lower in social and occupational functioning. Moreover, while cannabis users were more likely to relapse at any point over 24 months of treatment, cannabis non-users were more likely to achieve remission within the first six months, although this effect was not statistically significant. However, our most important finding was the interaction between cannabis use and time for total psychopathology as well as for the PANSS positive factor. While differences were not evident at either study entry or endpoint, cannabis users recovered at a slower rate than non-users. Discussion These results suggest a poorer treatment response in cannabis users compared to non-users in the context of assured adherence to antipsychotic medication. Therefore, regardless of the neurobiological impact of cannabis use in schizophrenia, the behaviour of substance use itself needs to be targeted as part of first-line treatment in order to improve the treatment outcomes of substance-using patients.

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