scholarly journals Cognitive Remediation Therapy for People With Schizophrenia Spectrum Disorder: A Rapid Qualitative Review

2021 ◽  
Vol 1 (11) ◽  
Author(s):  
Umair Majid ◽  
Melissa Severn
Keyword(s):  
Social Engagement ◽  
Cognitive Strategies ◽  
Cognitive Remediation ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Cognitive Remediation Therapy ◽  
Schizophrenia Spectrum Disorder ◽  
Qualitative Review ◽  
Schizophrenia Spectrum ◽  
Group Environment

This rapid qualitative review analyzed 8 studies describing the perspectives of people living with schizophrenia spectrum disorder (SSD) who use cognitive remediation therapy (CRT), and their caregivers and clinicians. People living with SSD reported notable improvements in their attention, memory, and problem solving; improvement in their lives when they applied the cognitive strategies acquired from CRT into daily life activities; improvement in communication skills, social engagement, motivation, independence; and a reduction in psychotic symptoms. This review found a common preference among people living with SSD and caregivers to provide personalized delivery and treatment of CRT. People living with SSD cited several ways to introduce personalized CRT: cognitive trainer or clinician’s support and guidance; the content, design, and implementation of CRT; using technology; and group environment and interacting with peers. The constant presence of a polite, friendly, empathetic, and encouraging clinician contributed to beneficial views of CRT. People living with SSD enjoyed the structure of sessions and cognitive tasks, specifically working on tasks at their own pace with gradual increases in difficulty that gave them a sense of accomplishment and mastery. They also enjoyed using technology and playing games to complete tasks; however, some found accessing a computer and a high-quality internet connection difficult. While people living with SSD reported several social benefits to group-based CRT, others found group-based CRT to be unconducive for their learning, especially when the group environment was not supportive or encouraging. Caregivers and clinicians recognized the importance of matching the type of cognitive exercises and structure of sessions to the cognitive needs of people living with SSD.

scholarly journals Acoustic speech markers for schizophrenia-spectrum disorders: a diagnostic and symptom-recognition tool

2021 ◽  
pp. 1-11
Author(s):  
J. N. de Boer ◽  
A. E. Voppel ◽  
S. G. Brederoo ◽  
H. G. Schnack ◽  
K. P. Truong ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Structured Interview ◽  
Diagnostic Value ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum Disorder ◽  
Speech Technology ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

Abstract Background Clinicians routinely use impressions of speech as an element of mental status examination. In schizophrenia-spectrum disorders, descriptions of speech are used to assess the severity of psychotic symptoms. In the current study, we assessed the diagnostic value of acoustic speech parameters in schizophrenia-spectrum disorders, as well as its value in recognizing positive and negative symptoms. Methods Speech was obtained from 142 patients with a schizophrenia-spectrum disorder and 142 matched controls during a semi-structured interview on neutral topics. Patients were categorized as having predominantly positive or negative symptoms using the Positive and Negative Syndrome Scale (PANSS). Acoustic parameters were extracted with OpenSMILE, employing the extended Geneva Acoustic Minimalistic Parameter Set, which includes standardized analyses of pitch (F0), speech quality and pauses. Speech parameters were fed into a random forest algorithm with leave-ten-out cross-validation to assess their value for a schizophrenia-spectrum diagnosis, and PANSS subtype recognition. Results The machine-learning speech classifier attained an accuracy of 86.2% in classifying patients with a schizophrenia-spectrum disorder and controls on speech parameters alone. Patients with predominantly positive v. negative symptoms could be classified with an accuracy of 74.2%. Conclusions Our results show that automatically extracted speech parameters can be used to accurately classify patients with a schizophrenia-spectrum disorder and healthy controls, as well as differentiate between patients with predominantly positive v. negatives symptoms. Thus, the field of speech technology has provided a standardized, powerful tool that has high potential for clinical applications in diagnosis and differentiation, given its ease of comparison and replication across samples.

scholarly journals SU48. A Comparison of Psychotic Symptoms in Subjects With Cocaine or Methamphetamine Dependence vs Schizophrenia Spectrum Disorder

2017 ◽  
Vol 43 (suppl_1) ◽  
pp. S178-S178
Author(s):  
Peter Alexander ◽  
Kristina Gicas ◽  
Taylor Willi ◽  
Clara Kim ◽  
Veronika Boyeva ◽  
...  
Keyword(s):  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorder ◽  
Methamphetamine Dependence ◽  
Schizophrenia Spectrum

scholarly journals Auditory hallucinations, not necessarily a hallmark of psychotic disorder

2017 ◽  
Vol 48 (4) ◽  
pp. 529-536 ◽  
Author(s):  
F. Waters ◽  
J. D. Blom ◽  
R. Jardri ◽  
K. Hugdahl ◽  
I. E. C. Sommer
Keyword(s):  
Psychotic Disorder ◽  
Antipsychotic Medication ◽  
Negative Symptoms ◽  
Spectrum Disorder ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Post Traumatic Stress ◽  
Schizophrenia Spectrum Disorder ◽  
Dsm 5 ◽  
Schizophrenia Spectrum

Auditory hallucinations (AH) are often considered a sign of a psychotic disorder. This is promoted by the DSM-5 category of Other Specified Schizophrenia Spectrum And Other Psychotic Disorder (OSSSOPD), the diagnostic criteria for which are fulfilled with the sole presence of persistent AH, in the absence of any other psychotic symptoms. And yet, persistent AH are not synonymous with having a psychotic disorder, and should therefore not be uncritically treated as such. Many people who seek treatment for persistent AH have no other psychotic symptoms, have preserved reality-testing capacities, and will never develop a schizophrenia spectrum disorder. Instead, hallucinations may be the result of many different causes, including borderline personality disorder, post-traumatic stress disorder (PTSD), hearing loss, sleep disorders or brain lesions, and they may even occur outside the context of any demonstrable pathology. In such cases, the usage of the DSM-5 diagnosis of OSSSOPD would be incorrect, and it may prompt unwarranted treatment with antipsychotic medication. We therefore argue that a DSM-5 diagnosis of Schizophrenia Spectrum Disorder (or any other type of psychotic disorder) characterized by AH should require at least one more symptom listed under the A-criterion (i.e. delusions, disorganized speech, disorganized or catatonic behavior or negative symptoms). Adhering to these more stringent criteria may help to distinguish between individuals with persistent AH which are part of a psychotic disorder, for whom antipsychotic medication may be helpful, and individuals with AH in the absence of such a disorder who may benefit from other approaches (e.g. different pharmacological interventions, improving coping style, trauma-related therapy).

Premorbid cannabis use is associated with more symptoms and poorer functioning in schizophrenia spectrum disorder

2016 ◽  
Vol 46 (15) ◽  
pp. 3127-3136 ◽  
Author(s):  
P. A. Ringen ◽  
R. Nesvåg ◽  
S. Helle ◽  
T. V. Lagerberg ◽  
E. H. Lange ◽  
...  
Keyword(s):  
Substance Use ◽  
Age At Onset ◽  
Cannabis Use ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
Premorbid Functioning ◽  
Spectrum Disorders

BackgroundCannabis use disorder is associated with an earlier age at onset and a more severe outcome of schizophrenia spectrum disorders. The role of cannabis use before the onset of illness (premorbid cannabis use) has not been fully investigated. We here examined how amount and type of premorbid cannabis use was associated with the later course of illness including current substance use, symptoms and level of functioning in schizophrenia spectrum disorder.MethodWe used a naturalistic sample of patients with DSM-IV schizophrenia spectrum disorders with a comprehensive history of illness and substance use. Data on premorbid substance use was obtained from comprehensive self-report. The relationship to outcome was investigated using regression models that included current substance use and premorbid functioning.ResultsPre-schizophrenia cannabis use was significantly associated with more severe psychotic symptoms and impaired functioning. Higher levels of premorbid cannabis use were associated with higher levels of current psychotic symptoms. These associations were independent of current substance use and premorbid functioning. Early use of cannabis (age <17 years) was associated with earlier age at onset of psychosis, independently of potential confounders.ConclusionsPre-psychosis cannabis use affects illness outcome in schizophrenia spectrum disorders, and is associated with lower age at onset of psychosis. These findings of independent negative effects of premorbid cannabis use in schizophrenia suggest that a limitation of the general use of cannabis may have beneficial health effects.

scholarly journals Aberrant connectivity in auditory precision encoding in schizophrenia spectrum disorder and across the continuum of psychotic-like experiences

2019 ◽  
Author(s):  
Kit Melissa Larsen ◽  
Ilvana Dzafic ◽  
Hayley Darke ◽  
Holly Pertile ◽  
Olivia Carter ◽  
...  
Keyword(s):  
Predictive Coding ◽  
Age Distribution ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
Interhemispheric Connectivity ◽  
Statistical Regularities ◽  
Bayesian Mapping ◽  
The Continuum

AbstractBackgroundThe ability to generate a precise internal model of statistical regularities is impaired in schizophrenia. Predictive coding accounts of schizophrenia suggest that psychotic symptoms may be explained by a failure to build precise beliefs or a model of the world. The precision of this model may vary with context. For example, in a noisy environment the model will be more imprecise compared to a model built in an environment with lower noise. However compelling, this idea has not yet been empirically studied in schizophrenia. Methods: In this study, 62 participants engaged in a stochastic mismatch negativity paradigm with high and low precision. We included inpatients with a schizophrenia spectrum disorder (N=20), inpatients with a psychiatric disorder but without psychosis (N=20), and healthy controls (N=22), with comparable sex ratio and age distribution. Bayesian mapping and dynamic causal modelling were employed to investigate the underlying microcircuitry of precision encoding of auditory stimuli. Results: We found strong evidence (exceedance p > 0.99) for differences in the underlying connectivity associated with precision encoding between the three groups as well as on the continuum of psychotic-like experiences assessed across all participants. Critically, we show changes in interhemispheric connectivity between the two inpatient groups, with some connections further aligning on the continuum of psychotic-like experiences. Conclusions: While our results suggest continuity in backward connectivity alterations with psychotic-like experiences regardless of diagnosis, they also point to specificity for the schizophrenia spectrum disorder group in interhemispheric connectivity alterations.

scholarly journals Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis

2010 ◽  
Vol 41 (1) ◽  
pp. 1-6 ◽  
Author(s):  
I. Kelleher ◽  
M. Cannon
Keyword(s):  
Risk Factors ◽  
General Population ◽  
High Risk Group ◽  
Spectrum Disorder ◽  
Psychotic Symptoms ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
Related Risk ◽  
Increased Risk ◽  
Social Environmental

Recent research shows that psychotic symptoms, or psychotic-like experiences (PLEs), are reported not only by psychosis patients but also by healthy members of the general population. Healthy individuals who report these symptoms are considered to represent a non-clinical psychosis phenotype, and have been demonstrated to be at increased risk of schizophrenia-spectrum disorder. Converging research now shows that this non-clinical psychosis phenotype is familial, heritable and covaries with familial schizophrenia-spectrum disorder. A review of the research also shows that the non-clinical phenotype is associated extensively with schizophrenia-related risk factors, including social, environmental, substance use, obstetric, developmental, anatomical, motor, cognitive, linguistic, intellectual and psychopathological risk factors. The criterion and construct validity of the non-clinical psychosis phenotype with schizophrenia demonstrates that it is a valid population in which to study the aetiology of psychosis. Furthermore, it suggests shared genetic variation between the clinical and non-clinical phenotypes. Much remains to be learned about psychosis by broadening the scope of research to include the non-clinical psychosis phenotype.

scholarly journals Psychological treatments for schizophrenia spectrum disorder: What is around the corner?

2017 ◽  
Vol 23 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Douglas Turkington ◽  
Latoyah Lebert
Keyword(s):  
Psychological Treatment ◽  
Cognitive Remediation ◽  
Psychosocial Interventions ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Spectrum Disorder ◽  
Schizophrenia Spectrum Disorder ◽  
Treatment As Usual ◽  
Combination Treatments ◽  
Schizophrenia Spectrum

SummaryThe evidence base for cognitive-behavioural therapy (CBT), family therapy, psychoeducation and cognitive remediation as adjuncts to antipsychotic medication in the treatment of schizophrenia is well established. It is, however, clear that the moderate effect size of the best researched of these treatments (CBT) compared with treatment as usual reduces to small when compared with an active psychological treatment. It would seem that many different psychosocial interventions de liver benefit in schizophrenia. We are now at a stage in their development when new treatments are being energetically piloted and combination treatments tested. This article outlines the most promising of these new interventions and attempts to answer the crucial question as to their differential effects on different psychotic presentations.Learning Objectives• Be aware of the most promising new psychosocial treatments for schizophrenia• Learn the key elements of each intervention• Understand which of these approaches might be best suited to particular presentations of schizophrenia spectrum disorder

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