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Amoretti S, Anmella G, Bernardo M, Alfonso M, Hernandez C, García-Portilla MP, González-Blanco L, Safont G, Garrido I, Sanchez-Autet M, Arranz B. Impact of cognitive reserve in clinical, neurocognitive and lifestyle factors in chronic schizophrenia and early stages of schizophrenia. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00010-3. [PMID: 38218376 DOI: 10.1016/j.sjpmh.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/20/2023] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Although there is evidence that higher cognitive reserve (CR) is a protective factor and it has been related to better prognosis, there have been no studies to date that have explored the CR level and its impact in clinical, neurocognitive and lifestyle outcomes according to the stage of the disease: early stage of psychosis (ESP) or chronic schizophrenia (SCZ). MATERIAL AND METHODS A total of 60 patients in the ESP and 225 patients with SCZ were enrolled in the study. To test the predictive capacity of CR for each diagnostic group, a logistic regression analysis was conducted. Hierarchical linear regression analyses were performed to explore the associations between CR and different outcomes. The mediation analyses were performed according to the principles of Baron and Kenny. RESULTS Patients with SCZ showed lower CR than those in the ESP (p<0.001). CR correctly classified 79.6% of the cases (p<0.001; Exp(B)=1.062). In ESP group, CR was related to working memory (p=0.030) and negative symptoms (p=0.027). CR (t=3.925, p<0.001) and cannabis use (t=2.023, p=0.048) explained 26.7% of the variance on functioning (p=0.003). In patients with SCZ, CR predicted all cognitive domains, negative symptoms (R2=0.091, p=0.001) and functioning (R2=0.074, p=0.005). In both ESP and SCZ groups, higher CR was associated with lower body mass index and circumference. In ESP group, the effect of adherence to Mediterranean diet on functioning (p=0.037) was mediated by CR level (p=0.003). CONCLUSIONS The implications of CR depend on the stage of the disease (ESP vs. SCZ), with a greater effect on neurocognition and negative symptoms in patients with chronic SCZ.
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Affiliation(s)
- Silvia Amoretti
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Biomedical Research Networking Center for Mental Health Network (CIBERSAM), ISCIII, Barcelona, Catalonia, Spain; Departament de Medicina, Institut de Neurociències (UBNeuro), Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Universitat de Barcelona (UB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Gerard Anmella
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institute of Neurosciences (UBNeuro), Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Universitat de Barcelona (UB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Miquel Bernardo
- Departament de Medicina, Institut de Neurociències (UBNeuro), Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Institut de Neurociències (UBNeuro), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain.
| | - Miqueu Alfonso
- Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain
| | | | - María Paz García-Portilla
- Department of Psychiatry, Universidad de Oviedo, Spain; CIBERSAM, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Leticia González-Blanco
- Department of Psychiatry, Universidad de Oviedo, Spain; CIBERSAM, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Gemma Safont
- Hospital Universitari Mútua Terrassa, CIBERSAM, Spain
| | | | | | - Belén Arranz
- Parc Sanitari Sant Joan de Deu, CIBERSAM, Barcelona, Spain
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Tor J, Baeza I, Sintes-Estevez A, De la Serna E, Puig O, Muñoz-Samons D, Álvarez-Subiela J, Sugranyes G, Dolz M. Cognitive predictors of transition and remission of psychosis risk syndrome in a child and adolescent sample: longitudinal findings from the CAPRIS study. Eur Child Adolesc Psychiatry 2024; 33:89-104. [PMID: 36598585 DOI: 10.1007/s00787-022-02137-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023]
Abstract
Cognitive impairments are proposed as predictors in the differentiation between subjects with psychosis risk syndrome (PRS) who will develop a psychotic disorder (PRS-P) and those who will not (PRS-NP). More in-depth study of the PRS-NP group could contribute to defining the role of cognitive alterations in psychosis. This study aims to analyze cognition of children and adolescents with PRS in terms of their clinical outcome at 18-month follow-up (psychosis, remission, and non-remission) and of determinate predictors of transition to psychosis and remission of PRS. The method is two-site, naturalistic, longitudinal study design, with 98 help-seeking adolescents with PRS and 64 healthy controls (HC). PRS-P (n = 24) and PRS-NP (n = 74) participants were clinically and cognitively assessed at baseline, and when full-blown psychotic disorder had developed or at 18-month follow-up. PRS-P subjects showed lower scores at baseline in processing speed, visuospatial memory, attention, and executive function (cognitive flexibility/processing speed) compared to HC. PRS-NP subjects showed lower baseline scores in verbal working memory and verbal fluency compared to HC. This deficit is also observed in the PRS group of participants still presenting attenuated psychotic symptoms at 18-month follow-up, while PRS subjects in remission showed a similar cognitive profile to HC subjects. Baseline score on processing speed, measured with a coding task, appeared to be a predictive variable for the development of a psychotic disorder. Performance in verbal working memory was predictive of remission in the PRS-NP. Post hoc comparisons indicate the need for careful interpretation of cognitive markers as predictors of psychosis. Cognitive impairments are present in both PRS-P and PRS-NP. Those individuals who recover from PRS show baseline cognitive performance comparable to the HC group. Together with sociodemographic variables, this observation could help in the differentiation of a variety of PRS trajectories in children and adolescents.
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Affiliation(s)
- Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain.
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain.
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, (2017SGR881), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Health Sciences Division, Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Anna Sintes-Estevez
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Elena De la Serna
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, (2017SGR881), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Olga Puig
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, (2017SGR881), Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
| | - Daniel Muñoz-Samons
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Javier Álvarez-Subiela
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, (2017SGR881), Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
| | - Montserrat Dolz
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Ponsoni A, Branco LD, Cotrena C, Shansis FM, Fonseca RP. A longitudinal study of cognition, functional outcome and quality of life in bipolar disorder and major depression. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:757-763. [PMID: 34597199 DOI: 10.1080/23279095.2021.1979551] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Cognitive impairments are known to be a frequent cause of disability in bipolar disorder (BD) and major depression (MDD). Yet there is no consensus regarding the particular cognitive functions whose impairments can lead to disability in each domain of functioning. The aim of this study was to perform a longitudinal evaluation of working memory, inhibition, cognitive flexibility and attention in BD and MDD, investigate the relationship of these cognitive functions to disability and quality of life, and evaluate the impact of variables related to cognitive reserve (education and daily cognitive stimulation) on cognitive performance. METHOD 31 participants (MDD = 12; BD = 19) were evaluated at baseline and after an average time of 2 years. RESULTS the BD group showed improvements in attention while patients with MDD improved on measures of attention and working memory. In BD working memory performance was associated with the cognition and mobility domains of functioning, and with physical and environmental quality of life. In MDD, cognitive flexibility was related to social relationships and environmental quality of life. CONCLUSION working memory and cognitive flexibility may be an interesting target for interventions aiming to improve everyday functioning and quality of life in BD and MDD.
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Affiliation(s)
- André Ponsoni
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Laura Damiani Branco
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Charles Cotrena
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Flávio Milman Shansis
- Medical Sciences Post Graduate Program, University of Vale do Taquari (Univates), Lajeado, Brazil
| | - Rochele Paz Fonseca
- Department of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Magdaleno Herrero R, Ortiz-García de la Foz V, Murillo-García N, Vázquez-Bourgon J, Setién-Suero E, Crespo-Facorro B, Ayesa-Arriola R. Sex differences in cognitive reserve among first episode of psychosis patients. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:143-150. [PMID: 38520113 DOI: 10.1016/j.rpsm.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/09/2021] [Accepted: 11/27/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cognitive reserve (CR) has recently been considered a key factor in the onset of a first episode of psychosis (FEP). However, the differences in CR in FEP patients according to sex have not yet been investigated. MATERIAL AND METHODS CR was estimated among 443 FEP patients (246 men and 197 women) and 156 healthy controls (96 men and 60 women) by using the proxies premorbid IQ, years of education and employment status. A neuropsychological battery was administrated to measure neurocognitive specific domains. Analyses of variance were used to make comparisons between groups. RESULTS FEP women had greater CR than FEP men. This circumstance was not observed in healthy controls. Among the group of patients with low CR, FEP women outperformed FEP men in the cognitive domains verbal memory and processing speed. Meanwhile, among the FEP patients with high CR, men showed better performance in attention than women. CONCLUSIONS Differences in CR observed between FEP men and women could be related to a number of specific factors, such as, age at illness onset, education level, and variability in performance in verbal memory, processing speed, and attention domains. These results provide background information about CR in FEP patients that will be useful in the design of sex specific cognitive remediation interventions.
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Affiliation(s)
- Rebeca Magdaleno Herrero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Nancy Murillo-García
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Esther Setién-Suero
- Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain; Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain; Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain; Instituto de Investigación Sanitaria de Sevilla, IBiS, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain.
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de la Serna E, Montejo L, Solé B, Castro-Fornieles J, Camprodon-Boadas P, Sugranyes G, Rosa-Justicia M, Martinez-Aran A, Vieta E, Vicent-Gil M, Serra-Blasco M, Cardoner N, Torrent C. Effectiveness of enhancing cognitive reserve in children, adolescents and young adults at genetic risk for psychosis: Study protocol for a randomized controlled trial. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:184-191. [PMID: 33631372 DOI: 10.1016/j.rpsm.2021.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/01/2021] [Accepted: 02/13/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Offspring of patients diagnosed with bipolar disorder and schizophrenia (Off-BDSZ) have a high genetic risk of developing a mental illness. The aim of this project is to develop and investigate the efficacy of an intervention aimed at this population, based on the concept of cognitive reserve. METHODS This is a multicenter randomized trial with an experimental test-retest design study with control group. Two groups will be included: a community comparison group (CC) and a Off-BDSZ group. A total of 108 Off-BDSZ and 65 CC aged between 6 and 25 years will be recruited. Off-BDSZ participants will be randomized to receive either Cognitive Reserve EnhAncement ThErapy (CREATE) (n=54), or a supportive approach (n=54). The CC group will be assessed at baseline. The duration of the intervention will be 3 months, with 12 weekly group sessions. The primary outcome will be the improvement in CR measured according to change in the Cognitive Reserve Assessment Scale in Health (CRASH) and Cognitive Reserve scale for Adolescents (CORE-A). All participants will be blindly evaluated using clinical, cognitive and neuroimaging measures at baseline, at three months (after the psychological intervention), and at twelve-month follow-up after treatment completion. DISCUSSION The results will provide insight into whether the CREATE-Offspring version may enhance cognitive reserve (CR) in child, adolescent and young adult Off-BDSZ as well as advance knowledge about changes in clinical manifestations, neuropsychological performance and brain structure and function associated with improving CR. This novel and cost-effective intervention represents an advance in the framework of preventive interventions in mental health. TRIAL REGISTRATION Clinicaltrials.gov, NCT03722082. Registered on 26 October 2018.
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Affiliation(s)
- Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Laura Montejo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Brisa Solé
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain.
| | - Patricia Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Mireia Rosa-Justicia
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Anabel Martinez-Aran
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain.
| | - Muriel Vicent-Gil
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Depression and Anxiety Program, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Maria Serra-Blasco
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Depression and Anxiety Program, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Narcís Cardoner
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Depression and Anxiety Program, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Carla Torrent
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
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Segura AG, Mezquida G, Martínez-Pinteño A, Gassó P, Rodriguez N, Moreno-Izco L, Amoretti S, Bioque M, Lobo A, González-Pinto A, García-Alcon A, Roldán-Bejarano A, Vieta E, de la Serna E, Toll A, Cuesta MJ, Mas S, Bernardo M. Link between cognitive polygenic risk scores and clinical progression after a first-psychotic episode. Psychol Med 2023; 53:4634-4647. [PMID: 35678455 PMCID: PMC10388335 DOI: 10.1017/s0033291722001544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Clinical intervention in early stages of psychotic disorders is crucial for the prevention of severe symptomatology trajectories and poor outcomes. Genetic variability is studied as a promising modulator of prognosis, thus novel approaches considering the polygenic nature of these complex phenotypes are required to unravel the mechanisms underlying the early progression of the disorder. METHODS The sample comprised of 233 first-episode psychosis (FEP) subjects with clinical and cognitive data assessed periodically for a 2-year period and 150 matched controls. Polygenic risk scores (PRSs) for schizophrenia, bipolar disorder, depression, education attainment and cognitive performance were used to assess the genetic risk of FEP and to characterize their association with premorbid, baseline and progression of clinical and cognitive status. RESULTS Schizophrenia, bipolar disorder and cognitive performance PRSs were associated with an increased risk of FEP [false discovery rate (FDR) ⩽ 0.027]. In FEP patients, increased cognitive PRSs were found for FEP patients with more cognitive reserve (FDR ⩽ 0.037). PRSs reflecting a genetic liability for improved cognition were associated with a better course of symptoms, functionality and working memory (FDR ⩽ 0.039). Moreover, the PRS of depression was associated with a worse trajectory of the executive function and the general cognitive status (FDR ⩽ 0.001). CONCLUSIONS Our study provides novel evidence of the polygenic bases of psychosis and its clinical manifestation in its first stage. The consistent effect of cognitive PRSs on the early clinical progression suggests that the mechanisms underlying the psychotic episode and its severity could be partially independent.
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Affiliation(s)
- Alex G. Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Gisela Mezquida
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Albert Martínez-Pinteño
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Patricia Gassó
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Natalia Rodriguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Silvia Amoretti
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Miquel Bioque
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitario de Alava, Vitoria-Gasteiz, Spain
- Instituto de Investigación Sanitaria Bioaraba, Vitoria-Gasteiz, Spain
- University of the Basque Country, Vizcaya, Spain
| | - Alicia García-Alcon
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Alexandra Roldán-Bejarano
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Psychiatry Department, Institut d'Investigació Biomèdica-SantPau (IIB-SANTPAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Alba Toll
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Manuel J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - PEPs Group
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
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Magdaleno Herrero R, Murillo-García N, Yorca-Ruiz Á, Neergaard K, Crespo-Facorro B, Ayesa-Arriola R. Biomarkers as proxies for cognitive reserve: The role of high density lipoprotein cholesterol in first episode of psychosis. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2023:S1888-9891(23)00012-5. [PMID: 37852878 DOI: 10.1016/j.rpsm.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/19/2023] [Accepted: 03/06/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION The proxies used to compose cognitive reserve (CR) for patients of a first episode of psychosis (FEP) have varied in the literature. The development of FEP is linked to peripheral pathways of the central nervous system, yet despite this knowledge, no research has considered the introduction of biomarkers as proxies for CR. Meanwhile, schizophrenia has been linked to the metabolic system, indicating that alterations in the levels of biological parameters, in particular high-density lipoproteins (HDL), cause worse global functioning and cognitive impairment. For these reasons, the present study aimed to create a quantifiable and objective CR index that adjusts for the multifactorial nature of FEP. MATERIALS AND METHODS We included 668 FEP patients and 217 healthy controls. Participants were assessed for sociodemographic information, years of education, employment status, premorbid IQ and biological parameters: waist circumference, hypertension, and levels of HDL, triglycerides, and glucose. RESULTS The findings suggest that the years of education proxy showed correlational and higher relationship with HDL levels for both FEP patients (r=0.23, b=0.185) and controls (r=0.31, b=0.342). We found that the CR index composed of years of education and HDL levels showed a higher explanatory power for the phenomenon than the classic CR index composed of years of education, employment status and premorbid IQ. CONCLUSIONS This article proposes an objective and quantifiable method to measure CR that is more the multifactorial nature of FEP.
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Affiliation(s)
- Rebeca Magdaleno Herrero
- Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Doctoral School University of Cantabria (EDUC), Santander, Spain
| | - Nancy Murillo-García
- Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Doctoral School University of Cantabria (EDUC), Santander, Spain
| | - Ángel Yorca-Ruiz
- Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Doctoral School University of Cantabria (EDUC), Santander, Spain
| | - Karl Neergaard
- Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Benedicto Crespo-Facorro
- Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain; Instituto de Investigación Sanitaria de Sevilla, IBiS, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Rosa Ayesa-Arriola
- Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
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8
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Sayed SE, Gomaa S, Alhazmi A, ElKalla I, Khalil D. Metabolic profile in first episode drug naïve patients with psychosis and its relation to cognitive functions and social cognition: a case control study. Sci Rep 2023; 13:5435. [PMID: 37012300 PMCID: PMC10070352 DOI: 10.1038/s41598-023-31829-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/17/2023] [Indexed: 04/05/2023] Open
Abstract
1st episode drug naïve patients with psychosis might be at higher risk for cardiometabolic disturbances which could affect the different cognitive, and executive functions and domains of social cognition. This study aimed to study the metabolic parameters in 1st episode drug naïve patients with psychosis, to evaluate the relation of these cardiometabolic domains to the cognitive, executive functions, and social cognition. Socio-demographic characteristics of 150 first episode drug naïve patients with psychosis and 120 matched healthy control groups were collected. The current study also assessed the cardiometabolic profile and cognitive functions in both groups. Social cognition was examined by Edinburgh Social Cognition Test. The study revealed a statistically significant difference in parameters of metabolic profile among the studied groups (p < 0.001*), the scores of cognitive and executive tests were statistically significantly different (p < 0.001*). In addition, the patient's group has lowered scores of domains of social cognition (p < 0.001*). Also, the mean affective theory of mind was negatively correlated with the conflict cost of the Flanker test (r = -.185* p value = .023). The total cholesterol level (r = - 0.241**, p value = .003) and level of triglycerides (r = - 0.241**, p value = 0.003) were negatively correlated with the interpersonal domain of social cognition, the total cholesterol level is positively correlated to the total score of social cognition (r = 0.202*, p value = 0.013). Patients with 1st episode drug naïve psychosis showed disturbed cardiometabolic parameters which have deleterious effects on cognitive functions and social cognition.
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Affiliation(s)
- Samir El Sayed
- Department of Psychiatry, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
- , Riyadh City, Riyadh, Kingdom of Saudi Arabia.
| | - Sarah Gomaa
- Mansoura University Students' Hospital, Mansoura University, Mansoura, Egypt
- , Riyadh City, Riyadh, Kingdom of Saudi Arabia
| | - Alaa Alhazmi
- Department of Psychiatry, Hayat National Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | - Dalia Khalil
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
- , Riyadh City, Riyadh, Kingdom of Saudi Arabia
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9
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Ayesa-Arriola R, de la Foz VOG, Murillo-García N, Vázquez-Bourgon J, Juncal-Ruiz M, Gómez-Revuelta M, Suárez-Pinilla P, Setién-Suero E, Crespo-Facorro B. Cognitive reserve as a moderator of outcomes in five clusters of first episode psychosis patients: a 10-year follow-up study of the PAFIP cohort. Psychol Med 2023; 53:1891-1905. [PMID: 37310335 DOI: 10.1017/s0033291721003536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive reserve (CR) has been associated with the development and prognosis of psychosis. Different proxies have been used to estimate CR among individuals. A composite score of these proxies could elucidate the role of CR at illness onset on the variability of clinical and neurocognitive outcomes. METHODS Premorbid intelligence quotient (IQ), years of education and premorbid adjustment were explored as proxies of CR in a large sample (N = 424) of first-episode psychosis (FEP) non-affective patients. Clusters of patients were identified and compared based on premorbid, clinical and neurocognitive variables at baseline. Additionally, the clusters were compared at 3-year (N = 362) and 10-year (N = 150) follow-ups. RESULTS The FEP patients were grouped into five CR clusters: C1 (low premorbid IQ, low education and poor premorbid) 14%; C2 (low premorbid IQ, low education and good premorbid adjustment) 29%; C3 (normal premorbid IQ, low education and poor premorbid adjustment) 17%; C4 (normal premorbid IQ, medium education and good premorbid adjustment) 25%; and C5 (normal premorbid IQ, higher education and good premorbid adjustment) 15%. In general, positive and negative symptoms were more severe in the FEP patients with the lowest CR at baseline and follow-up assessments, while those with high CR presented and maintained higher levels of cognitive functioning. CONCLUSIONS CR could be considered a key factor at illness onset and a moderator of outcomes in FEP patients. A high CR could function as a protective factor against cognitive impairment and severe symptomatology. Clinical interventions focused on increasing CR and documenting long-term benefits are interesting and desirable.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Nancy Murillo-García
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - María Juncal-Ruiz
- Department of Psychiatry, Sierrallana Hospital, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Marcos Gómez-Revuelta
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Paula Suárez-Pinilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Esther Setién-Suero
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
- Instituto de Investigación Sanitaria de Sevilla, IBiS, Sevilla, Spain
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10
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Xie XM, Sha S, Smith RD, Liang S, Ungvari GS, Amoretti S, Wang G, Xiang YT, Vieta E. Cognitive reserve in patients with mood disorders: Validation study of the Chinese version of the cognitive reserve assessment scale in health. J Affect Disord 2023; 325:480-486. [PMID: 36621675 DOI: 10.1016/j.jad.2022.12.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cognitive reserve (CR) is closely associated with cognitive and functional outcome, disease severity, progression and prognosis in psychiatric patients; however, it has not been extensively tested in mood disorders. This study examined the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH) in mood disorder patients. METHODS Altogether 166 subjects were recruited, 44 with major depressive disorder (MDD), 64 with bipolar disorder (BD), and 58 healthy controls. CR was assessed using the CRASH and the Cognitive Reserve Questionnaire (CRQ). RESULTS Internal consistency (Cronbach's alpha) was 0.779 for the CRASH. The Receiver Operating Characteristic (ROC) curve analysis revealed an area under the ROC curve (AUC) value of 0.73 (95 % CI: 0.647-0.809). The optimal cut-off score of 51 generated the best combination of sensitivity (0.78) and specificity (0.43) for discriminating between patients with mood disorders and healthy controls. The CRASH score was highly correlated with the CRQ score in both mood disorder patients (rs = 0.586, P < 0.001) and healthy controls (rs = 0.627, P < 0.001), indicating acceptable convergent validity for the CRASH. Within the mood disorder sample, the CRASH score was associated with functional outcomes (FAST: rs = -0.243, P = 0.011). CONCLUSIONS The CRASH is a useful tool to measure CR in mood disorder with acceptable psychometric properties and could be used in both research and clinical practice.
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Affiliation(s)
- Xiao-Meng Xie
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Robert D Smith
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Sixiang Liang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, Australia
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, 170 Villarroel St, 08036 Barcelona, Catalonia, Spain
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, 170 Villarroel St, 08036 Barcelona, Catalonia, Spain.
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11
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Murillo-García N, Ortíz-García de la Foz V, Miguel-Corredera M, Vázquez-Bourgon J, Setién-Suero E, Neergaard K, Moya-Higueras J, Crespo-Facorro B, Ayesa-Arriola R. Intelligence quotient changes over 10 years: Diversity of cognitive profiles in first episode of psychosis and healthy controls. Schizophr Res 2023; 254:163-172. [PMID: 36905766 DOI: 10.1016/j.schres.2023.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 11/24/2022] [Accepted: 02/23/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE This study aimed to analyse whether intelligence quotient (IQ) improves, declines, or remains stable over 10 years among FEP patients and healthy subjects. METHODS A group of FEP patients enrolled in a Program of First Episode Psychosis in Spain called PAFIP, and a sample of Healthy Controls (HC) completed the same neuropsychological battery at baseline and approximately 10 years later, which included the WAIS vocabulary subtest to estimate premorbid IQ and 10-year IQ. Cluster analysis was performed separately in the patient group and the HC group to determine their profiles of intellectual change. RESULTS One hundred and thirty-seven FEP patients were grouped into five clusters: "Improved low IQ" (9.49 % of patients), "Improved average IQ" (14.6 %), "Preserved low IQ" (17.52 %), "Preserved average IQ" (43.06 %), and "Preserved high IQ" (15.33 %). Ninety HC were grouped into three clusters: "Preserved low IQ" (32.22 % of the HC), "Preserved average IQ" (44.44 %), and "Preserved high IQ" (23.33 %). The first two clusters of FEP patients, characterized by a low IQ, earlier age at illness onset, and lower educational attainment, showed a substantial cognitive improvement. The remaining clusters demonstrated cognitive stability. CONCLUSIONS The FEP patients showed intellectual improvement or stability, but no decline post-onset of psychosis. However, their profiles of intellectual change are more heterogeneous than that of HC over 10 years. Particularly, there is a subgroup of FEP patients with a significant potential for long-term cognitive enhancement.
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Affiliation(s)
- Nancy Murillo-García
- Research Group on Mental Illnesses, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain
| | - Víctor Ortíz-García de la Foz
- Research Group on Mental Illnesses, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Center for Biomedical Research Network on Mental Health (CIBERSAM), Spain
| | | | - Javier Vázquez-Bourgon
- Center for Biomedical Research Network on Mental Health (CIBERSAM), Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla, Santander, Spain
| | - Esther Setién-Suero
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Karl Neergaard
- Research Group on Mental Illnesses, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | | | - Benedicto Crespo-Facorro
- Center for Biomedical Research Network on Mental Health (CIBERSAM), Spain; Department of Psychiatry, University Hospital Virgen del Rocío, University of Seville, Seville, Spain
| | - Rosa Ayesa-Arriola
- Research Group on Mental Illnesses, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain; Center for Biomedical Research Network on Mental Health (CIBERSAM), Spain.
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12
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Sánchez-Torres AM, Amoretti S, Enguita-Germán M, Mezquida G, Moreno-Izco L, Panadero-Gómez R, Rementería L, Toll A, Rodriguez-Jimenez R, Roldán A, Pomarol-Clotet E, Ibáñez Á, Usall J, Contreras F, Vieta E, López-Ilundain JM, Merchán-Naranjo J, González-Pinto A, Berrocoso E, Bernardo M, Cuesta MJ. Relapse, cognitive reserve, and their relationship with cognition in first episode schizophrenia: a 3-year follow-up study. Eur Neuropsychopharmacol 2023; 67:53-65. [PMID: 36495858 DOI: 10.1016/j.euroneuro.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/18/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022]
Abstract
Schizophrenia is frequently characterized by the presence of multiple relapses. Cognitive impairments are core features of schizophrenia. Cognitive reserve (CR) is the ability of the brain to compensate for damage caused by pathologies such as psychotic illness. As cognition is related to CR, the study of the relationship between relapse, cognition and CR may broaden our understanding of the course of the disease. We aimed to determine whether relapse was associated with cognitive impairment, controlling for the effects of CR. Ninety-nine patients with a remitted first episode of schizophrenia or schizophreniform disorder were administered a set of neuropsychological tests to assess premorbid IQ, attention, processing speed, working memory, verbal and visual memory, executive functions and social cognition. They were followed up for 3 years (n=53) or until they relapsed (n=46). Personal and familial CR was estimated from a principal component analysis of the premorbid information gathered. Linear mixed-effects models were applied to analyse the effect of time and relapse on cognitive function, with CR as covariate. Patients who relapsed and had higher personal CR showed less deterioration in attention, whereas those with higher CR (personal and familial CR) who did not relapse showed better performance in processing speed and visual memory. Taken together, CR seems to ameliorate the negative effects of relapse on attention performance and shows a positive effect on processing speed and visual memory in those patients who did not relapse. Our results add evidence for the protective effect of CR over the course of the illness.
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Affiliation(s)
- Ana M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR); Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Mónica Enguita-Germán
- Navarra Institute of Health Research (IdiSNA), Pamplona, Spain; Unidad de Metodología. Navarrabiomed-CHN -UPNA. Pamplona
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Rocío Panadero-Gómez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Lide Rementería
- BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Alba Toll
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital del Mar Medical Research Institute (IMIM)
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12); Universidad Complutense de Madrid (UCM), Plaza Ramón y Cajal, s/n, 28040 Madrid, Spain
| | - Alexandra Roldán
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Ángela Ibáñez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat
| | - Fernando Contreras
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychiatric Department. Bellvitge Universitary Hospital. IDIBELL
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jose M López-Ilundain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Jessica Merchán-Naranjo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Esther Berrocoso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychology, University of Cadiz, Spain, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain.
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13
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Ayesa-Arriola R, Miguel-Corredera M, de la Foz VOG, Neergaard KD, Correa-Ghisays P, Setién-Suero E, Crespo-Facorro B. Education and long-term outcomes in first episode psychosis: 10-year follow-up study of the PAFIP cohort. Psychol Med 2023; 53:66-77. [PMID: 33952364 DOI: 10.1017/s0033291721001112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Lower levels of education have been associated with the development of psychosis. Investigating educational achievement in the first episode of psychosis (FEP) patients may shed light on the origins of the alterations and on the variability of outcomes in psychotic disorders. METHODS Education achievement was explored in a large sample (n = 659) of FEP patients enrolled in programa de atención a fases iniciales de psicosis (PAFIP), a research and assistance program conducted in Spain. Patients were stratified according to the Spanish educational system according to their attendance in primary (low), secondary (medium) or university studies (high). The three groups were compared on available premorbid, clinical and neuropsychological variables. A subgroup of patients (n = 209), comprising the 10-year follow-up PAFIP cohort, were again compared. RESULTS Overall, 49% and 37% of FEP patients had low and medium levels of education, respectively. In total, 13% of the patients with a higher level of education were more frequently women (64%) and older at illness onset (36 years old), reported better premorbid adjustment, presented less severe positive symptoms and better functioning; and showed higher premorbid intelligence quotient and better performance on all the explored cognitive domains. Ten years later the FEP patients in the medium- and high-education groups had good global functioning and a neurocognitive performance within the normal limits. CONCLUSIONS Higher education is associated with better initial conditions and more favourable outcomes after an FEP. Sharing this information with the world's educational systems is essential to targeting resources and designing innovative programs or strategies to compensate for student difficulties.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Margarita Miguel-Corredera
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | | | - Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Psychology and TMAP, Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Valencia, Spain
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Instituto de Investigacion Sanitaria de Sevilla, IBiS, Sevilla, Spain
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14
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Cognitive reserve profiles are associated with outcome in schizophrenia. J Neurol Sci 2022; 443:120496. [PMID: 36410188 DOI: 10.1016/j.jns.2022.120496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/17/2022] [Accepted: 11/12/2022] [Indexed: 11/17/2022]
Abstract
Cognitive reserve (CR), the brain's ability to cope with brain pathology to minimize symptoms, could explain the heterogeneity of outcomes in neuropsychiatric disorders, however it is still rarely investigated in schizophrenia. Indeed, this study aims to classify CR in this disorder and evaluate its impact on neurocognitive and socio-cognitive performance and daily functioning. A group of 106 patients diagnosed with schizophrenia was enrolled and assessed in these aereas: neurocognition, Theory of Mind (ToM) and daily functioning. A composite CR score was determined through an integration of the intelligence quotient and education and leisure activities. CR profiles were classified with a two-step cluster analysis and differences among clusters were determined with an analysis of variance (ANOVA). The cluster analysis was identified with three CR profiles characterized, respectively, by high, medium and low CR. ANOVA analysis showed significant differences on neurocognition, ToM and daily functioning between the clusters: people with higher CR reached significantly superior scores. This study suggests that greater general cognitive resources could act as a buffer against the effect of brain pathology, allowing patients to have a better cognitive performance, social outcome and quality of life.
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15
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Segura ÀG, Prohens L, Mezquida G, Amoretti S, Bioque M, Ribeiro M, Gurriarán-Bas X, Rementería L, Berge D, Rodriguez-Jimenez R, Roldán A, Pomarol-Clotet E, Ibáñez A, Usall J, García-Portilla MP, Cuesta MJ, Parellada M, González-Pinto A, Berrocoso E, Bernardo M, Mas S, González-Díaz JM, Arbelo N, González-Peñas J, Pina-Camacho L, Diestre A, Selma J, Zorrilla I, López P, Trabsa A, Monserrat C, Sanchez-Pastor L, Nuñez-Doyle A, Fatjó-Vilas M, Sarró S, Butjosa A, Pardo M, López-Ilundain JM, Sánchez Torres AM, Saiz-Ruiz J, Ochoa-Mangado E, RIevero O, De-la-Cámara C, Echevarría RS, González-Blanco L. Epigenetic clocks in relapse after a first episode of schizophrenia. SCHIZOPHRENIA 2022; 8:61. [PMID: 35869075 PMCID: PMC9307769 DOI: 10.1038/s41537-022-00268-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022]
Abstract
The main objective of the present study was to investigate the association between several epigenetic clocks, covering different aspects of aging, with schizophrenia relapse evaluated over a 3-year follow-up period in a cohort of ninety-one first-episode schizophrenia patients. Genome-wide DNA methylation was profiled and four epigenetic clocks, including epigenetic clocks of chronological age, mortality and telomere length were calculated. Patients that relapsed during the follow-up showed epigenetic acceleration of the telomere length clock (p = 0.030). Shorter telomere length was associated with cognitive performance (working memory, r = 0.31 p = 0.015; verbal fluency, r = 0.28 p = 0.028), but no direct effect of cognitive function or symptom severity on relapse was detected. The results of the present study suggest that epigenetic age acceleration could be involved in the clinical course of schizophrenia and could be a useful marker of relapse when measured in remission stages.
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16
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Seitz-Holland J, Wojcik JD, Cetin-Karayumak S, Lyall AE, Pasternak O, Rathi Y, Vangel M, Pearlson G, Tamminga C, Sweeney JA, Clementz BA, Schretlen DA, Viher PV, Stegmayer K, Walther S, Lee J, Crow T, James A, Voineskos A, Buchanan RW, Szeszko PR, Malhotra AK, Kelly S, Shenton ME, Keshavan MS, Mesholam-Gately RI, Kubicki M. Cognitive deficits, clinical variables, and white matter microstructure in schizophrenia: a multisite harmonization study. Mol Psychiatry 2022; 27:3719-3730. [PMID: 35982257 PMCID: PMC10538303 DOI: 10.1038/s41380-022-01731-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 02/08/2023]
Abstract
Cognitive deficits are among the best predictors of real-world functioning in schizophrenia. However, our understanding of how cognitive deficits relate to neuropathology and clinical presentation over the disease lifespan is limited. Here, we combine multi-site, harmonized cognitive, imaging, demographic, and clinical data from over 900 individuals to characterize a) cognitive deficits across the schizophrenia lifespan and b) the association between cognitive deficits, clinical presentation, and white matter (WM) microstructure. Multimodal harmonization was accomplished using T-scores for cognitive data, previously reported standardization methods for demographic and clinical data, and an established harmonization method for imaging data. We applied t-tests and correlation analysis to describe cognitive deficits in individuals with schizophrenia. We then calculated whole-brain WM fractional anisotropy (FA) and utilized regression-mediation analyses to model the association between diagnosis, FA, and cognitive deficits. We observed pronounced cognitive deficits in individuals with schizophrenia (p < 0.006), associated with more positive symptoms and medication dosage. Regression-mediation analyses showed that WM microstructure mediated the association between schizophrenia and language/processing speed/working memory/non-verbal memory. In addition, processing speed mediated the influence of diagnosis and WM microstructure on the other cognitive domains. Our study highlights the critical role of cognitive deficits in schizophrenia. We further show that WM is crucial when trying to understand the role of cognitive deficits, given that it explains the association between schizophrenia and cognitive deficits (directly and via processing speed).
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Affiliation(s)
- Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Joanne D Wojcik
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Suheyla Cetin-Karayumak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Amanda E Lyall
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Carol Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brett A Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA, USA
| | - David A Schretlen
- Department of Psychiatry and Behavioral Sciences, Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Petra Verena Viher
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jungsun Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Tim Crow
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Anthony James
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Aristotle Voineskos
- Center for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, NY, USA
| | - Anil K Malhotra
- The Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Sinead Kelly
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Raquelle I Mesholam-Gately
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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17
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Bernardo M, Anmella G, Verdolini N, Saiz-Masvidal C, Casals S, Contreras F, Garrido I, Pérez F, Safont G, Mas S, Rodriguez N, Meseguer A, Pons-Cabrera MT, Vieta E, Amoretti S. Assessing cognitive reserve outcomes and biomarkers in first episode of psychosis: rationale, objectives, protocol and preliminary results of the CRASH Project. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022. [DOI: 10.1016/j.rpsm.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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18
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Wojtalik JA, Flores AT, Keshavan MS, Eack SM. Premorbid Sociality Moderates Social Adjustment Change during Cognitive Enhancement Therapy for Adults with Early Schizophrenia. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:312-322. [PMID: 35044886 PMCID: PMC9177526 DOI: 10.1080/15374416.2022.2025599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Cognitive remediation approaches for early course schizophrenia are promising interventions for improving social adjustment. Premorbid sociality is a potentially important moderator of social adjustment response to cognitive remediation and may serve to personalize such interventions. METHOD Eighty-eight early course schizophrenia outpatients with premorbid sociality scores were included in this preliminary investigation. Secondary data came from a recent 18-month multi-site confirmatory trial of Cognitive Enhancement Therapy (CET) compared to Enriched Supportive Therapy (EST). Intent-to-treat mixed effects models examined the moderating effect of premorbid sociality assessed at baseline on differential social adjustment change between CET and EST assessed at baseline, 9, and 18 months. RESULTS Premorbid sociality significantly moderated the differential effect of CET vs. EST on overall social adjustment change at 18 months, such that CET was particularly effective for patients with high premorbid sociality and EST for low premorbid sociality. This significant group x time x premorbid sociality interaction was also observed for 18-month change in interpersonal anguish, self-care, and sexual relations. Again, CET was largely favorable for higher premorbid sociality patients and EST for lower premorbid sociality for these sub-scales. CONCLUSIONS The results provide initial evidence that premorbid sociality moderates differential social adjustment change during cognitive remediation in early course schizophrenia. In many, but not all cases, better social functioning prior to the development of schizophrenia was associated with a significantly better social adjustment response to CET. Data on social functioning during childhood and adolescence is possibly useful for personalizing treatment planning in the early course of schizophrenia.
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Affiliation(s)
- Jessica A. Wojtalik
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
- Correspondence: Jessica A. Wojtalik, PhD, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106,
| | - Ana T. Flores
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Shaun M. Eack
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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19
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Amoretti S, Verdolini N, Varo C, Mezquida G, Sánchez-Torres AM, Vieta E, Garcia-Rizo C, Lobo A, González-Pinto A, Abregú-Crespo R, Corripio I, Serra M, de la Serna E, Mané A, Ramos-Quiroga JA, Ribases M, Cuesta MJ, Bernardo M. Is the effect of cognitive reserve in longitudinal outcomes in first-episode psychoses dependent on the use of cannabis? J Affect Disord 2022; 302:83-93. [PMID: 35066012 DOI: 10.1016/j.jad.2022.01.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cognitive reserve (CR) is a protective factor against cognitive and functional impairment in first-episode psychosis (FEP). The aim of this study was to evaluate the differences in clinical presentation according to the use of cannabis (cannabis users vs non-users) among patients presenting a FEP (non-affective vs affective psychosis), to investigate the impact of CR and cannabis use on several outcomes and to explore the potentially mediatory role played by CR in the relationship between cognitive domains or clinical status and functionality, depending on the use of cannabis. METHODS Linear regression analysis models were carried out to assess the predictive value of CR on clinical, functional and cognitive variables at baseline and at two-year follow-up. The mediation analyzes were performed according to the principles of Baron and Kenny. RESULTS CR was associated with better cognitive performance, regardless of cannabis consumption or diagnosis. In both diagnoses, CR was associated with better clinical and functional outcomes in those patients who did not use cannabis. In terms of mediation procedure, CR mediates the relationship between some cognitive domains and functioning at follow-up only in patients without cannabis use. LIMITATIONS The small sample size of the affective group. CONCLUSIONS CR plays a differential role in the outcome of psychoses according to whether patients are cannabis users or not. Both in affective and non-affective groups CR exerted a greater effect in patients without cannabis use. Our results suggest that the deleterious effect of cannabis use on functioning in FEP surpasses the protective effect of CR.
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Affiliation(s)
- Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain
| | - Norma Verdolini
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain
| | - Cristina Varo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain.
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Medicine and Psychiatry, Zaragoza University. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Araba University Hospital, Bioaraba Research Institute, Spain; University of the Basque Country (UPV-EHU), Spain
| | - Renzo Abregú-Crespo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Serra
- Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, SGR2017881, Institut Clinic de Neurociències, Hospital Clínic Universitari, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Anna Mané
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Hospital del Mar Medical research Institute (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J Antoni Ramos-Quiroga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Catalonia, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Barcelona, Spain
| | - Marta Ribases
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, SGR2017881, Institut Clinic de Neurociències, Hospital Clínic Universitari, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
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20
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Rodriguez M, Knížková K, Keřková B, Siroňová A, Šustová P, Jonáš J, Španiel F. The relationships between cognitive reserve, cognitive functioning and quality of life in first-episode schizophrenia spectrum disorders. Psychiatry Res 2022; 310:114479. [PMID: 35231876 DOI: 10.1016/j.psychres.2022.114479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/17/2022]
Abstract
Cognitive reserve (CR) has been conceptualized as an individual's ability to optimize or maximize performance through differential recruitment of brain networks. As such, CR may contribute to the heterogeneity of cognitive deficits observed in schizophrenia. This study aimed to assess the relationships between CR, cognition and quality of life in first-episode (FES) patients. A total of 137 patients with either ICD-10 schizophrenia or "acute and transient psychotic disorders" diagnosis, and 62 healthy controls had completed a comprehensive assessment of six cognitive domains: speed of processing, attention, working memory/flexibility, verbal memory, visual memory, and abstraction/executive functioning. CR was calculated from the participants' education, premorbid IQ, and socioeconomic status. The results suggested that in patients, CR was positively related to cognitive performance in all domains, explaining 42.6% of the variance observed in cognition overall. Effects of CR in the control group were limited to three domains: speed of processing, abstraction/executive function and working memory/flexibility. These results suggest that CR largely contributes to cognitive variations present in FES patients. In addition, CR was negatively related to the social construct of patients' quality of life, and positively to symptom severity and general functioning.
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Affiliation(s)
- Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychology, Faculty of Arts, Charles University in Prague, Czech Republic
| | - Karolína Knížková
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
| | - Barbora Keřková
- National Institute of Mental Health, Klecany, Czech Republic
| | - Aneta Siroňová
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Petra Šustová
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychology, Faculty of Arts, Charles University in Prague, Czech Republic
| | - Juraj Jonáš
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychology, Faculty of Arts, Charles University in Prague, Czech Republic
| | - Filip Španiel
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University in Prague, Czech Republic
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21
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Cognitive reserve and its correlates in child and adolescent offspring of patients diagnosed with schizophrenia or bipolar disorder. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-01957-0. [PMID: 35175425 DOI: 10.1007/s00787-022-01957-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 02/06/2022] [Indexed: 11/03/2022]
Abstract
AIM To analyze cognitive reserve (CR) in child and adolescent offspring of patients diagnosed with schizophrenia (SZ-off) or bipolar disorder (BD-off) and compare them with a group of community controls (CC-off). We also aimed to investigate whether there was an association between CR and clinical and neuropsychological variables according to group. METHODS The study included 46 SZ-off, 105 BD-off and 102 CC-off. All participants completed assessments regarding CR and clinical, neuropsychological and psychosocial functioning. CR was measured with a proxy based on premorbid intelligence, parental occupational level, educational attainment, developmental milestones and sociability. The clinical assessment included the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime, the Semi-structured Interview for Prodromal Syndromes, and the Global Assessment Functioning scale. The neuropsychological assessment included measures of executive functioning, attention, verbal memory, working memory and processing speed. RESULTS SZ-off showed a lower level of CR compared to BD-off and CC-off, while BD-off showed an intermediate level of CR between SZ-off and CC-off. Moreover, an association between higher CR and less lifetime psychopathology, fewer prodromal psychotic symptoms, higher psychosocial functioning, and a higher working memory score was observed in all groups, but it was stronger in SZ-off. CONCLUSIONS CR seemed to be associated with psychopathology, clinical symptoms, psychosocial functioning, and some cognitive functions. SZ-off appeared to benefit more from a higher CR, therefore it could be considered a protective factor against the development of clinical symptomatology and cognitive impairment.
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22
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Camprodon-Boadas P, la Serna ED, Baeza I, Ilzarbe D, Puig O, Andrés-Perpiñá S, Sugranyes G, Castro-Fornieles J. Psychometric Properties of the Cognitive Reserve Questionnaire for Adolescents (CoRe-A). REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022. [DOI: 10.1016/j.rpsm.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Amoretti S, Rosa AR, Mezquida G, Cabrera B, Ribeiro M, Molina M, Bioque M, Lobo A, González-Pinto A, Fraguas D, Corripio I, Vieta E, de la Serna E, Morro L, Garriga M, Torrent C, Cuesta MJ, Bernardo M. The impact of cognitive reserve, cognition and clinical symptoms on psychosocial functioning in first-episode psychoses. Psychol Med 2022; 52:526-537. [PMID: 32900395 DOI: 10.1017/s0033291720002226] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Functional impairment is a defining feature of psychotic disorders. A range of factors has been shown to influence functioning, including negative symptoms, cognitive performance and cognitive reserve (CR). However, it is not clear how these variables may affect functioning in first-episode psychosis (FEP) patients. This 2-year follow-up study aimed to explore the possible mediating effects of CR on the relationship between cognitive performance or specific clinical symptoms and functional outcome. METHODS A prospective study of non-affective FEP patients was performed (211 at baseline and 139 at follow-up). CR was entered in a path analysis model as potential mediators between cognitive domains or clinical symptoms and functioning. RESULTS At baseline, the relationship between clinical variables or cognitive performance and functioning was not mediated by CR. At follow-up, the effect of attention (p = 0.003) and negative symptoms (p = 0.012) assessed at baseline on functioning was partially mediated by CR (p = 0.032 and 0.016), whereas the relationship between verbal memory (p = 0.057) and functioning was mediated by CR (p = 0.014). Verbal memory and positive and total subscales of PANSS assessed at follow-up were partially mediated by CR and the effect of working memory on functioning was totally mediated by CR. CONCLUSIONS Our results showed the influence of CR in mediating the relationship between cognitive domains or clinical symptoms and functioning in FEP. In particular, CR partially mediated the relationship between some cognitive domains or clinical symptoms and functioning at follow-up. Therefore, CR could improve our understanding of the long-term functioning of patients with a non-affective FEP.
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Affiliation(s)
- Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Adriane R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Postgraduate Program: Psychiatry and Behavioral Science, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Pharmacology and Postgraduate Program: Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - María Ribeiro
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Mariola Molina
- Instituto de Investigación Sanitaria Gregorio Marañón. School of Psychology, Complutense University, Madrid, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Medicine and Psychiatry. Zaragoza University. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Psychiatry, Hospital Universitario de Álava (Sede Santiago), University of the Basque Country (UPV-EHU), Bioaraba Research Institute, Spain
| | - David Fraguas
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Institute of Psychiatry and Mental Health, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute of Neurosciences, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Laura Morro
- Hospital del Mar, Department of Psychiatry, Barcelona, Spain
| | - Marina Garriga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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Serra-Navarro M, Amoretti S, Verdolini N, Forte MF, Sánchez-Torres AM, Vieta E, Clougher D, Lobo A, González-Pinto A, Panadero R, Roldán A, Carvalho AF, de la Serna E, Toll A, Ramos-Quiroga JA, Torrent C, Cuesta MJ, Bernardo M. Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: Differences between males and females. Front Psychiatry 2022; 13:982583. [PMID: 36339856 PMCID: PMC9632657 DOI: 10.3389/fpsyt.2022.982583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/28/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Deficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset. MATERIALS AND METHODS The initial sample comprised 588 individuals. However, only adults with non-affective FEP (n = 247, 161 males and 86 females) and healthy controls (n = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up. RESULTS FEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, p = 0.003) and worse premorbid adjustment (β = 0.256, p = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, p = 0.003), executive function (β = 0.299, p = 0.020) and CR (β = -0.307, p = 0.012) were significantly associated with functioning. CONCLUSION Our data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended.
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Affiliation(s)
- Maria Serra-Navarro
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Perugia, Italy
| | - María Florencia Forte
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Derek Clougher
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Medicine and Psychiatry, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza University, Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain.,Department of Psychiatry, University of the Basque Country (UPV-EHU), Vitoria-Gasteiz, Spain
| | - Rocío Panadero
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Institute of Psychiatry and Mental Health, Universidad Complutense, IiSGM, Madrid, Spain
| | - Alexandra Roldán
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - André F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT), School of Medicine, Barwon Health, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institut Clínic de Neurociències, Hospital Clínic Universitari, CIBERSAM, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Alba Toll
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J A Ramos-Quiroga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
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25
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The onset of falls and its effects on perceived social exclusion and loneliness. Evidence from a nationally representative longitudinal study. Arch Gerontol Geriatr 2022; 100:104622. [DOI: 10.1016/j.archger.2022.104622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/19/2021] [Accepted: 01/15/2022] [Indexed: 12/11/2022]
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26
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Camprodon-Boadas P, de la Serna E, Baeza I, Puig O, Ilzarbe D, Sugranyes G, Borras R, Castro-Fornieles J. Cognitive reserve in patients with first-episode psychosis as outcome predictor at 5-year follow-up. Eur Child Adolesc Psychiatry 2021; 30:1959-1967. [PMID: 33113026 DOI: 10.1007/s00787-020-01668-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 10/18/2020] [Indexed: 12/13/2022]
Abstract
Cognitive reserve (CR) is the premorbid brain capacity to cope with neural damage. People with good CR can tolerate higher levels of pathological brain injuries before displaying clinical symptoms than others. This study aimed to analyze CR in a sample of patients diagnosed with first-episode psychosis (FEP) during childhood or adolescence, comparing them to a community control group (CC) and assessing the predictive value of CR regarding psychosocial functioning, clinical symptoms and neuropsychological variables at the 5-year follow-up. 57 patients diagnosed with FEP during childhood or adolescence and 37 controls completed clinical, neuropsychological, and psychosocial functioning assessments at baseline and 5-year follow-up. CR was assessed in both groups at baseline. The FEP group showed lower CR scores than the CC group. Higher CR in the FEP group was associated with fewer psychotic negative symptoms, total psychotic symptoms and depressive symptoms, higher psychosocial functioning, and less impaired memory and attention at the 5-year follow-up. CR is associated with long-term clinical, neuropsychological and psychosocial functioning outcomes in patients diagnosed with FEP during childhood or adolescence.
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Affiliation(s)
- Patricia Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Fundació Clínic Per a La Recerca Biomèdica, Barcelona, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Olga Puig
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Daniel Ilzarbe
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain
| | - Roger Borras
- Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. .,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain. .,Department of Medicine, University of Barcelona, Barcelona, Spain.
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27
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Amoretti S, Rabelo-da-Ponte FD, Rosa AR, Mezquida G, Sánchez-Torres AM, Fraguas D, Cabrera B, Lobo A, González-Pinto A, Pina-Camacho L, Corripio I, Vieta E, Torrent C, de la Serna E, Bergé D, Bioque M, Garriga M, Serra M, Cuesta MJ, Bernardo M. Cognitive clusters in first-episode psychosis. Schizophr Res 2021; 237:31-39. [PMID: 34481203 DOI: 10.1016/j.schres.2021.08.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 07/15/2021] [Accepted: 08/22/2021] [Indexed: 02/08/2023]
Abstract
Impairments in a broad range of cognitive domains have been consistently reported in some individuals with first-episode psychosis (FEP). Cognitive deficits can be observed during the prodromal stage. However, the course of cognitive deficits is still unclear. The aim of this study was to identify cognitive subgroups over time and to compare their sociodemographic, clinical and functional profiles. A total of 114 patients with Schizophrenia Spectrum Disorders were included in the present study. We assessed subjects through psychiatric scales and eight neuropsychological tests at baseline and at two-year follow-up visit. We performed the Partition Around Medoids algorithm with all cognitive variables. Furthermore, we performed a logistic regression to identify the predictors related to the different cognitive clusters at follow-up. Two distinct subgroups were found: the first cluster characterized by cognitive impairment and a second cluster had relatively intact cognition in comparison with norms. Up to 54.7% of patients with cognitive deficits at baseline tended to improve during the first two years of treatment. Patients with intact cognition at follow-up had a higher socioeconomic status, later age of onset, lower negative symptoms and a higher cognitive reserve (CR) at baseline. CR and age of onset were the baseline variables that predicted cognitive impairment. This research allows us to obtain a better understanding of the heterogeneous profile of psychotic disorders. Identifying the characteristics of patients who will present a cognitive impairment could improve early detection and intervention. These results suggest that enhancing CR could contribute to improving the course of the illness.
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Affiliation(s)
- Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | | | - Adriane Ribeiro Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil; Department of Pharmacology, Postgraduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, Porto Alegre, RS, Brazil
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - David Fraguas
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, School of Medicine, Universidad Complutense de Madrid, Spain
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Antonio Lobo
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Medicine and Psychiatry, Zaragoza University, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Department of Neurociences, University of the Basque Country, Vitoria, Spain
| | - Laura Pina-Camacho
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, School of Medicine, Universidad Complutense de Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Elena de la Serna
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Department of Medicine, University of Barcelona, Spain
| | - Daniel Bergé
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Autonomous Universitiy of Barcelona (UAB), Barcelona, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Marina Garriga
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Maria Serra
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain.
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Kharawala S, Hastedt C, Podhorna J, Shukla H, Kappelhoff B, Harvey PD. The relationship between cognition and functioning in schizophrenia: A semi-systematic review. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 27:100217. [PMID: 34631435 PMCID: PMC8488595 DOI: 10.1016/j.scog.2021.100217] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022]
Abstract
In schizophrenia, impairments in neurocognition (NC) and social cognition (SC) are associated with reduced functional capacity (FC) and poor real-world functioning (RWF). In this semi-systematic review, we examined this association across a range of research questions. We conducted a systematic search in Embase and MEDLINE from 2005 to 2019, and conducted additional pragmatic searches. After screening of titles, abstracts and full-texts, we included 564 citations, of which 44 (26 primary studies, 15 systematic reviews and 3 narrative reviews) were prioritized for reporting. Both NC and SC were significantly associated with functioning, with slightly stronger association for SC. Effect sizes were generally larger for FC than for RWF. NC showed stronger associations with occupational functioning and independent living, and SC with social functioning. Baseline cognition predicted long-term RWF up to 20 years of follow-up, though long-term data were limited for SC. Cognitive remediation improved RWF functioning, especially when it was combined with psychosocial rehabilitation. SC mediated the relationship of NC with functioning. Negative symptoms appeared to mediate and moderate the association of cognition with functioning. Other factors involved included severity of cognitive dysfunction, metacognition, depression and choice of RWF instrument. We discuss potential implications for studies of pharmacological cognitive interventions in schizophrenia – the relevance of both NC and SC, the advantage of adjunctive psychosocial rehabilitation, the role of relevant moderating and mediating variables, and the challenges with RWF instrument selection. Successful cognitive interventions could allow patients with schizophrenia to improve their potential for community functioning.
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Affiliation(s)
- Saifuddin Kharawala
- Bridge Medical Consulting Ltd., 2 Marsault Court, 11 Kew Foot Road, Richmond TW9 2SS, United Kingdom
| | - Claudia Hastedt
- Boehringer Ingelheim International GmbH, Binger Strasse 173, 55216 Ingelheim, Germany
| | - Jana Podhorna
- Boehringer Ingelheim International GmbH, Binger Strasse 173, 55216 Ingelheim, Germany
| | - Hemlata Shukla
- Bridge Medical Consulting Ltd., 2 Marsault Court, 11 Kew Foot Road, Richmond TW9 2SS, United Kingdom
| | - Bregt Kappelhoff
- Boehringer Ingelheim bv, De Boelelaan 32, 1083 HJ Amsterdam, the Netherlands
| | - Philip D Harvey
- University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1450, Miami, FL, United States of America
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Seitz-Holland J, Cetin-Karayumak S, Wojcik JD, Lyall A, Levitt J, Shenton ME, Pasternak O, Westin CF, Baxi M, Kelly S, Mesholam-Gately R, Vangel M, Pearlson G, Tamminga CA, Sweeney JA, Clementz BA, Schretlen D, Viher PV, Stegmayer K, Walther S, Lee J, Crow T, James A, Voineskos A, Buchanan RW, Szeszko PR, Malhotra AK, Rathi Y, Keshavan M, Kubicki M. Elucidating the relationship between white matter structure, demographic, and clinical variables in schizophrenia-a multicenter harmonized diffusion tensor imaging study. Mol Psychiatry 2021; 26:5357-5370. [PMID: 33483689 PMCID: PMC8329919 DOI: 10.1038/s41380-021-01018-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/24/2020] [Accepted: 01/05/2021] [Indexed: 01/30/2023]
Abstract
White matter (WM) abnormalities are repeatedly demonstrated across the schizophrenia time-course. However, our understanding of how demographic and clinical variables interact, influence, or are dependent on WM pathologies is limited. The most well-known barriers to progress are heterogeneous findings due to small sample sizes and the confounding influence of age on WM. The present study leverages access to the harmonized diffusion magnetic-resonance-imaging data and standardized clinical data from 13 international sites (597 schizophrenia patients (SCZ)). Fractional anisotropy (FA) values for all major WM structures in patients were predicted based on FA models estimated from a healthy population (n = 492). We utilized the deviations between predicted and real FA values to answer three essential questions. (1) "Which clinical variables explain WM abnormalities?". (2) "Does the degree of WM abnormalities predict symptom severity?". (3) "Does sex influence any of those relationships?". Regression and mediator analyses revealed that a longer duration-of-illness is associated with more severe WM abnormalities in several tracts. In addition, they demonstrated that a higher antipsychotic medication dose is related to more severe corpus callosum abnormalities. A structural equation model revealed that patients with more WM abnormalities display higher symptom severity. Last, the results exhibited sex-specificity. Males showed a stronger association between duration-of-illness and WM abnormalities. Females presented a stronger association between WM abnormalities and symptom severity, with IQ impacting this relationship. Our findings provide clear evidence for the interaction of demographic, clinical, and behavioral variables with WM pathology in SCZ. Our results also point to the need for longitudinal studies, directly investigating the casualty and sex-specificity of these relationships, as well as the impact of cognitive resiliency on structure-function relationships.
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Affiliation(s)
- Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Suheyla Cetin-Karayumak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Joanne D Wojcik
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Amanda Lyall
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - James Levitt
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Brockton, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Brockton, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carl-Fredrik Westin
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Madhura Baxi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Graduate Program of Neuroscience, Boston University, Boston, MA, USA
| | - Sinead Kelly
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Raquelle Mesholam-Gately
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Brett A Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA, USA
| | - David Schretlen
- Department of Psychiatry and Behavioral Sciences, Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Petra Verena Viher
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jungsun Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Tim Crow
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Anthony James
- Department of Psychiatry, SANE POWIC, Warneford Hospital, University of Oxford, Oxford, UK
| | - Aristotle Voineskos
- Center for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Philip R Szeszko
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, NY, USA
| | - Anil K Malhotra
- The Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Ballesteros A, Sánchez Torres AM, López-Ilundáin J, Mezquida G, Lobo A, González-Pinto A, Pina-Camacho L, Corripio I, Vieta E, de la Serna E, Mané A, Bioque M, Moreno-Izco L, Espliego A, Lorente-Omeñaca R, Amoretti S, Bernardo M, Cuesta MJ. The longitudinal effect of antipsychotic burden on psychosocial functioning in first-episode psychosis patients: the role of verbal memory. Psychol Med 2021; 51:2044-2053. [PMID: 32326991 DOI: 10.1017/s003329172000080x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous literature supports antipsychotics' (AP) efficacy in acute first-episode psychosis (FEP) in terms of symptomatology and functioning but also a cognitive detrimental effect. However, regarding functional recovery in stabilised patients, these effects are not clear. Therefore, the main aim of this study is to investigate dopaminergic/anticholinergic burden of (AP) on psychosocial functioning in FEP. We also examined whether cognitive impairment may mediate these effects on functioning. METHODS A total of 157 FEP participants were assessed at study entry, and at 2 months and 2 years after remission of the acute episode. The primary outcomes were social functioning as measured by the functioning assessment short test (FAST). Cognitive domains were assessed as potential mediators. Dopaminergic and anticholinergic AP burden on 2-year psychosocial functioning [measured with chlorpromazine (CPZ) and drug burden index] were independent variables. Secondary outcomes were clinical and socio-demographic variables. RESULTS Mediation analysis found a statistical but not meaningful contribution of dopaminergic receptor blockade burden to worse functioning mediated by cognition (for every 600 CPZ equivalent points, 2-year FAST score increased 1.38 points). Regarding verbal memory and attention, there was an indirect effect of CPZ burden on FAST (b = 0.0045, 95% CI 0.0011-0.0091) and (b = 0.0026, 95% CI 0.0001-0.0006) respectively. However, only verbal memory post hoc analyses showed a significant indirect effect (b = 0.009, 95% CI 0.033-0.0151) adding premorbid IQ as covariate. We did not find significant results for anticholinergic burden. CONCLUSION CPZ dose effect over functioning is mediated by verbal memory but this association appears barely relevant.
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Affiliation(s)
- Alejandro Ballesteros
- Red de Salud Mental de Navarra, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Ana M Sánchez Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Jose López-Ilundáin
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Zaragoza University, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- BIOARABA Health Research Institute, OSI Araba, University Hospital, University of the Basque Country, Vitoria, Spain
| | - Laura Pina-Camacho
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IISGM, CIBERSAM, Madrid, Spain
| | - Iluminada Corripio
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Unidad de Trastornos bipolares y depresivos, Hospital Clínic, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, Spain
| | - Anna Mané
- Hospital del Mar Medical Research Institute (IMIM), CIBERSAM, Autonomous University of Barcelona, Barcelona, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Ana Espliego
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IISGM, CIBERSAM, Madrid, Spain
| | - Ruth Lorente-Omeñaca
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
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31
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Bernardo M, Amoretti S, Cuesta MJ, Parellada M, Mezquida G, González-Pinto A, Bergé D, Lobo A, Aguilar EJ, Usall J, Corripio I, Bobes J, Rodríguez-Jiménez R, Sarró S, Contreras F, Ibáñez Á, Gutiérrez M, Micó JA. The prevention of relapses in first episodes of schizophrenia: The 2EPs Project, background, rationale and study design. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:164-176. [PMID: 34456031 DOI: 10.1016/j.rpsmen.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/15/2020] [Indexed: 12/16/2022]
Abstract
Up to 80% of first-episode psychosis patients suffer a relapse within five years of the remission. Relapse should be an important focus of prevention given the potential harm to the patient and family. It threatens to disrupt their psychosocial recovery, increases the risk of resistance to treatment and has been associated with greater direct and indirect costs for society. Based on a previous project entitled "Genotype-phenotype and environment. Application to a predictive model in first psychotic episodes" (PEPs Project), the project "Clinical and neurobiological determinants of second episodes of schizophrenia. Longitudinal study of first episode of psychosis" was designed, also known as the 2EPs Project. It aimed to identify and characterize those factors that predict a relapse within the years immediately following a first episode. This project has focused on following the clinical course, with neuropsychological assessments, biological and neuroanatomical measures, genetic adherence and physical health monitoring in order to compare a subgroup of patients with a second episode to another group of patients which remains in remission. The main objective of the present article is to describe the rationale of the 2EPs Project, explaining the measurement approach adopted and providing an overview of the selected clinical and functional measures. 2EPs Project is a multicenter, coordinated, naturalistic, longitudinal follow-up study over three years in a Spanish sample of patients in remission after a first-psychotic episode of schizophrenia. It is closely monitoring the clinical course of the cases recruited to compare the subgroup of patients with a second episode to that which remains in remission. The sample is composed of 223 subjects recruited from 15 clinical centres in Spain with experience of the preceding PEPs Study project, albeit 2EPs being an expanded version with new basic groups in biological research. From the total sample recruited, 63 patients presented a relapse (44%). 2EPs arose to characterize first episodes in an exhaustive, novel and multimodal way, thus contributing towards the development of a predictive model of relapse. Identifying the characteristics of patients who relapse could improve early detection and intervention.
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Affiliation(s)
- Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Manuel Jesús Cuesta
- Departamento de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Mara Parellada
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón (IiSGM), Facultad de Medicina, Universidad Complutense, CIBERSAM, Madrid, España
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Ana González-Pinto
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Department of Neurociences, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Daniel Bergé
- Department of Neurosciences and Psychiatry, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry. Universidad de Zaragoza. Instituto de Investigación Aragón, CIBERSAM, Zaragoza, Spain
| | - Eduardo J Aguilar
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, CIBERSAM, Valencia, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Santa Creu and Sant Pau Hospital; Autonomous University of Barcelona (UAB), CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Área de Psiquiatría, Universidad de Oviedo, Servicio de Salud del Principado de Asturias, Instituto de Neurociencias del Principado de Asturias (INEUROPA), CIBERSAM, Oviedo, Asturias, Spain
| | - Roberto Rodríguez-Jiménez
- Departamento de Psiquiatría, Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), CogPsy-Group, Universidad Complutense de Madrid (UCM), CIBERSAM, Madrid, Spain
| | - Salvador Sarró
- FIDMAG Research Foundation Germanes Hospitalàries, CIBERSAM, Barcelona, Spain
| | - Fernando Contreras
- Psychiatry Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ángela Ibáñez
- Departamento de Psiquiatría, Hospital Ramon y Cajal, Universidad de Alcalá, IRYCIS, CIBERSAM, Madrid, Spain
| | - Miguel Gutiérrez
- Department of Psychiatry, Hospital Santiago Apóstol, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Juan Antonio Micó
- Grupo de Investigación en Neuropsicofarmacología y Psicobiología, Departamento de Neurociencias, Universidad de Cádiz, Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, CIBERSAM, Cádiz, Spain
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Prat G, Marquez-Arrico JE, Río-Martínez L, Navarro JF, Adan A. Premorbid functioning in schizophrenia spectrum disorders with comorbid substance use: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110310. [PMID: 33775743 DOI: 10.1016/j.pnpbp.2021.110310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/03/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022]
Abstract
Premorbid functioning has been related with several clinical features and prognosis of schizophrenia spectrum disorders. Comorbidity with substance use is highly prevalent and usually hinders clinical improvement in this kind of psychiatric disorders. This systematic review analyzes the differences in the premorbid functioning of subjects with a schizophrenia spectrum disorder with substance use (SSD+, dual psychosis) or without it (SSD-). A systematic review (PRISMA guidelines), including search in electronic databases (MEDLINE, Web of Science, and Cochrane Library), was performed. 118 published works were considered of which only 20 met our inclusion criteria. Although there is a great variability in methodologies, diagnoses included, and substances used, studies using the Premorbid Functioning Scale to assess the academic and/or social domains found that SSD+ subjects had a poorer academic but better social premorbid functioning than those with SSD-. Current evidence is not conclusive, so additional studies are required to integrate intervening factors in order to clarify the clinical implications of premorbid functioning to improve the course and therapeutic response of patients.
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Affiliation(s)
- Gemma Prat
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Julia E Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Laura Río-Martínez
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - José Francisco Navarro
- Department of Psychobiology, School of Psychology, University of Málaga, Campus Teatinos s/n, 29071 Málaga, Spain
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain.
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Amoretti S, Ramos-Quiroga JA. Cognitive reserve in mental disorders. Eur Neuropsychopharmacol 2021; 49:113-115. [PMID: 33965891 DOI: 10.1016/j.euroneuro.2021.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/15/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Silvia Amoretti
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Pg.de la Vall d'Hebron, 119-129, 08035 Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain.
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Pg.de la Vall d'Hebron, 119-129, 08035 Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
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34
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Verdolini N, Amoretti S, Mezquida G, Cuesta MJ, Pina-Camacho L, García-Rizo C, Lobo A, González-Pinto A, Merchán-Naranjo J, Corripio I, Salagre E, Baeza I, Bergé D, Garriga M, Bioque M, Vallespir C, Serra M, Vieta E, Bernardo M. The effect of family environment and psychiatric family history on psychosocial functioning in first-episode psychosis at baseline and after 2 years. Eur Neuropsychopharmacol 2021; 49:54-68. [PMID: 33857739 DOI: 10.1016/j.euroneuro.2021.03.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 01/13/2023]
Abstract
The aim of the present study was to evaluate the contribution of family environment styles and psychiatric family history on functioning of patients presenting first-episode psychosis (FEP). Patients with FEP and healthy controls (HC) were assessed at baseline and after 2 years. The Functional Assessment Short Test (FAST) was used to assess functional outcome and the Family Environment Scale (FES) to evaluate family environment. Linear regressions evaluated the effect that family environment exerts on functioning at baseline and at 2-year follow-up, when FEP patients were diagnosed according to non-affective (NA-PSYCH) or affective psychoses (A-PSYCH). The influence of a positive parents' psychiatric history on functioning was evaluated through one-way between-groups analysis of covariance (ANCOVA) models, after controlling for family environmental styles. At baseline, FEP patients presented moderate functioning impairment, significantly worse than HC (28.65±16.17 versus 3.25±7.92; p<0.001, g = 1.91). At 2-year follow-up, the functioning of NA-PSYCH patients was significantly worse than in A-PSYCH (19.92±14.83 versus 12.46±14.86; p = 0.020, g = 0.50). No specific family environment style was associated with functioning in FEP patients and HC. On the contrary, a positive psychiatric father's history influenced functioning of FEP patients. After 2 years, worse functioning in NA-PSYCH patients was associated with lower rates of active-recreational and achievement orientated family environment and with higher rates of moral-religious emphasis and control. In A-PSYCH, worse functioning was associated with higher rates of conflict in the family. Both family environment and psychiatric history influence psychosocial functioning, with important implications for early interventions, that should involve both patients and caregivers.
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Affiliation(s)
- Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Laura Pina-Camacho
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry. Universidad de Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Hospital Universitario de Alava, UPV/EHU, BIOARABA, CIBERSAM, Vitoria, Spain
| | - Jessica Merchán-Naranjo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Estela Salagre
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Immaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain
| | - Daniel Bergé
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Spain; Autonomous University of Barcelona (UAB), Spain
| | - Marina Garriga
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Catalina Vallespir
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Maria Serra
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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Prakash J, Chatterjee K, Srivastava K, Chauhan VS. First-episode psychosis: How long does it last? A review of evolution and trajectory. Ind Psychiatry J 2021; 30:198-206. [PMID: 35017801 PMCID: PMC8709526 DOI: 10.4103/ipj.ipj_38_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/13/2021] [Accepted: 03/16/2021] [Indexed: 11/12/2022] Open
Abstract
Study of first-episode psychosis (FEP), an episode of psychotic nature which manifests for the first time in an individual in the longitudinal continuum of his/her illness, has been study matter of research interest in recent years. A comprehensive review of the literature will help us understand the evolution and trajectory of this concept better. A literature review of available articles addressing the concept, phenomenology, evolution, identification, course, and outcome of FEP was done; the same was subsequently divided into broad topics for better clarity and analyzed. FEP constituted a clinical psychotic phenomenon with underlying significant heterogeneity in diagnosis, stability, course, and outcome. The study has attempted to view FEP both as horizontal spectrum across various diagnoses and longitudinally ranging from asymptomatic individual with unknown risk status to attenuated psychosis to multiple relapses/unremitting illness. Many risk and protective factors have been brought out with varying certainty ranging bio-psycho-social spectrum. Efforts have been made to calculate polygenic risk score based on genes involvement/sharing between various psychotic spectrum disorders; as well as biomarker panels to identify people at risk. FEP may prove to be an important concept to understand psychosis in general; without putting things into the diagnostic rubric. It may help understand multiple risk and protective factors for the course and outcome of psychotic illness and may clear the cloud to sharpen the evidence toward commonality and distinctiveness between various psychotic diagnoses in vogue for more comprehensive concept.
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Affiliation(s)
- Jyoti Prakash
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - K. Chatterjee
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - K. Srivastava
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - V. S. Chauhan
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
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36
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Molina-García M, Fraguas D, del Rey-Mejías Á, Mezquida G, Sánchez-Torres AM, Amoretti S, Lobo A, González-Pinto A, Andreu-Bernabeu Á, Corripio I, Vieta E, Baeza I, Mané A, Cuesta M, de la Serna E, Payá B, Zorrilla I, Arango C, Bernardo M, Rapado-Castro M, Parellada M. The Role of Premorbid IQ and Age of Onset as Useful Predictors of Clinical, Functional Outcomes, and Recovery of Individuals with a First Episode of Psychosis. J Clin Med 2021; 10:2474. [PMID: 34199653 PMCID: PMC8199787 DOI: 10.3390/jcm10112474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. METHODS we characterized 255 individuals who have experienced a first episode of psychosis in four a priori defined subgroups based on pIQ (low pIQ < 85; average pIQ ≥ 85) and age of onset (early onset < 18 years; adult onset ≥ 18 years). We conducted clinical and functional assessments at baseline and at two-year follow-up. We calculated symptom remission and recovery rates using the Positive and Negative Symptoms of Schizophrenia Schedule (PANSS) and the Global Assessment Functioning (GAF or Children-GAF). We examined clinical and functional changes with pair-wise comparisons and two-way mixed ANOVA. We built hierarchical lineal and logistic regression models to estimate the predictive value of the independent variables over functioning or recovery rates. RESULTS early-onset patients had more severe positive symptoms and poorer functioning than adult-onset patients. At two-year follow-up, only early-onset with low pIQ and adult-onset with average pIQ subgroups differed consistently, with the former having more negative symptoms (d = 0.59), poorer functioning (d = 0.82), lower remission (61% vs. 81.1%), and clinical recovery (34.1% vs. 62.2%). CONCLUSIONS early-onset individuals with low pIQ may present persistent negative symptoms, lower functioning, and less recovery likelihood at two-year follow-up. Intensive cognitive and functional programs for these individuals merit testing to improve long-term recovery rates in this subgroup.
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Affiliation(s)
- Mariola Molina-García
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
| | - David Fraguas
- Institute of Psychiatry and Mental Health, Hospital Clínico San Carlos (IdISSC), Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28040 Madrid, Spain;
| | - Ángel del Rey-Mejías
- Data Science Unit, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, School of Psychology, Complutense University of Madrid (UCM), 28223 Madrid, Spain;
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain; (G.M.); (S.A.); (M.B.)
| | - Ana M. Sánchez-Torres
- Department of Psychiatry, Navarra Institute for Health Research (IdiSNA), Complejo Hospitalario de Navarra, 31008 Pamplona, Spain; (A.M.S.-T.); (M.C.)
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain; (G.M.); (S.A.); (M.B.)
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain;
| | - Ana González-Pinto
- Department of Psychiatry, Bioaraba Health Research Institute, Hospital Universitario de Álava, Research Networking Center for Mental Health Network (CIBERSAM), University of the Basque Country (UPV/EHU), 01009 Vitoria, Spain; (A.G.-P.); (I.Z.)
| | - Álvaro Andreu-Bernabeu
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
| | - Iluminada Corripio
- Department of Psychiatry, Institut d’Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Research Networking Center for Mental Health Network (CIBERSAM), Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain;
| | - Eduard Vieta
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Institute of Neurosciences, Hospital Clinic, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain;
| | - Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, SGR-881, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clínic de Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), Universitat de Barcelona, 08036 Barcelona, Spain;
| | - Anna Mané
- Hospital del Mar Medical Research Institute, Research Networking Center for Mental Health Network (CIBERSAM), Autonomous University of Barcelona, 08003 Barcelona, Spain;
| | - Manuel Cuesta
- Department of Psychiatry, Navarra Institute for Health Research (IdiSNA), Complejo Hospitalario de Navarra, 31008 Pamplona, Spain; (A.M.S.-T.); (M.C.)
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), 08036 Barcelona, Spain;
| | - Beatriz Payá
- IDIVAL, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
| | - Iñaki Zorrilla
- Department of Psychiatry, Bioaraba Health Research Institute, Hospital Universitario de Álava, Research Networking Center for Mental Health Network (CIBERSAM), University of the Basque Country (UPV/EHU), 01009 Vitoria, Spain; (A.G.-P.); (I.Z.)
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain; (G.M.); (S.A.); (M.B.)
| | - Marta Rapado-Castro
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
- Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC 3053, Australia
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
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Amoretti S, Mezquida G, Rosa AR, Bioque M, Cuesta MJ, Pina-Camacho L, Garcia-Rizo C, Barcones F, González-Pinto A, Merchán-Naranjo J, Corripio I, Vieta E, Baeza I, Cortizo R, Bonnín CM, Torrent C, Bernardo M. The functioning assessment short test (FAST) applied to first-episode psychosis: Psychometric properties and severity thresholds. Eur Neuropsychopharmacol 2021; 47:98-111. [PMID: 33658165 DOI: 10.1016/j.euroneuro.2021.02.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/11/2021] [Indexed: 02/07/2023]
Abstract
Functional impairment is a defining feature of psychotic disorders. The Functional Assessment Short Test (FAST) is one of the most widely used instruments to measure psychosocial functioning. However, cut-offs of impairment have been well-established for bipolar disorders, but not for other clinical populations. This study aims to analyse psychometric properties of the FAST and establish their corresponding cut-off values for the different severity gradations in a first-episode of non-affective psychosis (FEP) patients. Global Assessment Functioning (GAF) and FAST ratings from 212 non-affective FEP and 204 healthy controls were analyzed. The psychometric properties of FAST (internal consistency, concurrent validity, discriminant validity, factorial analyses and sensitivity to change) were analyzed. The severity gradations of the FAST were defined by the congruence between two grading methods: linear regression analysis (LRA) and percentiles. The FAST showed strong psychometric properties. LRA with the GAF scores yielded the following equation: GAFscore= 80.83 - 0.639*FASTscore. The FAST ranges in non-affective FEP patients derived from LRA and percentiles, were as follows: 0-9 (No impairment); 10-19 (Minimal impairment); 20-34 (Mild impairment); 35-45 (Moderate impairment); 46-72 (Severe impairment). Patients with no functional impairment had a higher socioeconomic status, fewer depressive and negative symptoms, lower severity of illness and higher cognitive reserve level than the others groups. In conclusion, the FAST shows optimal psychometric properties which corroborate its applicability in FEP populations. It is a well-demonstrated valid instrument and the present cut-off scores could be implemented in clinical and research practice to assess properly the psychosocial functional outcome of non-affective FEP populations.
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Affiliation(s)
- Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain.; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain.; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Adriane R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.; Pharmacology Department and Postgraduate Program: Psychiatry and Behavioral Science, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain.; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Laura Pina-Camacho
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain.; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Fe Barcones
- Department of Family Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain.; Department of Medicine and Psychiatry. Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Department of Neurociences, University of the Basque Country, Vitoria, Spain
| | - Jessica Merchán-Naranjo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eduard Vieta
- Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain..
| | - Inmaculada Baeza
- Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.; Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, Barcelona, Spain
| | - Romina Cortizo
- Instituto de Neuropsiquiatria y Adicciones (INAD), Barcelona, Spain
| | - C Mar Bonnín
- Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
| | - Carla Torrent
- Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain.; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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38
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Amoretti S, Verdolini N, Mezquida G, Rabelo-da-Ponte FD, Cuesta MJ, Pina-Camacho L, Gomez-Ramiro M, De-la-Cámara C, González-Pinto A, Díaz-Caneja CM, Corripio I, Vieta E, de la Serna E, Mané A, Solé B, Carvalho AF, Serra M, Bernardo M. Identifying clinical clusters with distinct trajectories in first-episode psychosis through an unsupervised machine learning technique. Eur Neuropsychopharmacol 2021; 47:112-129. [PMID: 33531261 DOI: 10.1016/j.euroneuro.2021.01.095] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/04/2021] [Accepted: 01/18/2021] [Indexed: 12/22/2022]
Abstract
The extreme variability in symptom presentation reveals that individuals diagnosed with a first-episode psychosis (FEP) may encompass different sub-populations with potentially different illness courses and, hence, different treatment needs. Previous studies have shown that sociodemographic and family environment factors are associated with more unfavorable symptom trajectories. The aim of this study was to examine the dimensional structure of symptoms and to identify individuals' trajectories at early stage of illness and potential risk factors associated with poor outcomes at follow-up in non-affective FEP. One hundred and forty-four non-affective FEP patients were assessed at baseline and at 2-year follow-up. A Principal component analysis has been conducted to identify dimensions, then an unsupervised machine learning technique (fuzzy clustering) was performed to identify clinical subgroups of patients. Six symptom factors were extracted (positive, negative, depressive, anxiety, disorganization and somatic/cognitive). Three distinct clinical clusters were determined at baseline: mild; negative and moderate; and positive and severe symptoms, and five at follow-up: minimal; mild; moderate; negative and depressive; and severe symptoms. Receiving a low-dose antipsychotic, having a more severe depressive symptomatology and a positive family history for psychiatric disorders were risk factors for poor recovery, whilst having a high cognitive reserve and better premorbid adjustment may confer a better prognosis. The current study provided a better understanding of the heterogeneous profile of FEP. Early identification of patients who could likely present poor outcomes may be an initial step for the development of targeted interventions to improve illness trajectories and preserve psychosocial functioning.
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Affiliation(s)
- Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Neuroscience Institute, University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Norma Verdolini
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Neuroscience Institute, University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain
| | | | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Laura Pina-Camacho
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Marta Gomez-Ramiro
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Neuroscience Institute, University of Barcelona, Spain
| | - Concepción De-la-Cámara
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Neuroscience Institute, University of Barcelona, Spain; Hospital Clínico Universitario and Instituto de Investigación Sanitaria (IIS), Department of Medicine and Psychiatry. Universidad de Zaragoza, Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Department of Neurociences, University of the Basque Country, Vitoria, Spain
| | - Covadonga M Díaz-Caneja
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain.
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Anna Mané
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Brisa Solé
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - André F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Maria Serra
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Neuroscience Institute, University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain
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39
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Verdolini N, Vieta E. Resilience, prevention and positive psychiatry. Acta Psychiatr Scand 2021; 143:281-283. [PMID: 33720387 DOI: 10.1111/acps.13288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Norma Verdolini
- Hospital Clinic, Institute of Neurosciences, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Hospital Clinic, Institute of Neurosciences, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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Evermann U, Gaser C, Besteher B, Langbein K, Nenadić I. Cortical Gyrification, Psychotic-Like Experiences, and Cognitive Performance in Nonclinical Subjects. Schizophr Bull 2020; 46:1524-1534. [PMID: 32691058 PMCID: PMC7707080 DOI: 10.1093/schbul/sbaa068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Psychotic-like experiences (PLE) are present in nonclinical populations, yet their association with brain structural variation, especially markers of early neurodevelopment, is poorly understood. We tested the hypothesis that cortical surface gyrification, a putative marker of early brain development, is associated with PLE in healthy subjects. METHODS We analyzed gyrification from 3 Tesla MRI scans (using CAT12 software) and PLE (positive, negative, and depressive symptom dimensions derived from the Community Assessment of Psychic Experiences, CAPE) in 103 healthy participants (49 females, mean age 29.13 ± 9.37 years). A subsample of 63 individuals completed tasks from the Wechsler Adult Intelligence Scale and Controlled Oral Word Association Test. Estimated IQ and a composite neuropsychological score were used to explore mediation pathways via cognition. RESULTS Positive PLE distress was negatively associated with gyrification of the left precuneus. PLE depression dimension showed a negative association with gyrification in the right supramarginal and temporal region. There was no significant mediating effect of cognition on these associations. CONCLUSION Our results support a neurobiological psychosis spectrum, for the first time linking an early developmental imaging marker (rather than volume) to dimensional subclinical psychotic symptoms. While schizophrenia risk, neurodevelopment, and cognitive function might share genetic risk factors, additional mediation analyses did not confirm a mediating effect of cognition on the gyrification-psychopathology correlation.
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Affiliation(s)
- Ulrika Evermann
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Igor Nenadić
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
- Marburg University Hospital – UKGM, Marburg, Germany
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González-Ortega I, González-Pinto A, Alberich S, Echeburúa E, Bernardo M, Cabrera B, Amoretti S, Lobo A, Arango C, Corripio I, Vieta E, de la Serna E, Rodriguez-Jimenez R, Segarra R, López-Ilundain JM, Sánchez-Torres AM, Cuesta MJ, Zorrilla I, López P, Bioque M, Mezquida G, Barcones F, De-la-Cámara C, Parellada M, Espliego A, Alonso-Solís A, Grasa EM, Varo C, Montejo L, Castro-Fornieles J, Baeza I, Dompablo M, Torio I, Zabala A, Eguiluz JI, Moreno-Izco L, Sanjuan J, Guirado R, Cáceres I, Garnier P, Contreras F, Bobes J, Al-Halabí S, Usall J, Butjosa A, Sarró S, Landin-Romero R, Ibáñez A, Selva G. Influence of social cognition as a mediator between cognitive reserve and psychosocial functioning in patients with first episode psychosis. Psychol Med 2020; 50:2702-2710. [PMID: 31637990 DOI: 10.1017/s0033291719002794] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years. METHODS The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis. RESULTS At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (-10.215 to -0.337) and (-4.731 to -0.605) respectively). CONCLUSIONS Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.
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Affiliation(s)
- I González-Ortega
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
- The National Distance Education University (UNED), Vitoria, Spain
| | - A González-Pinto
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
| | - S Alberich
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
- The National Distance Education University (UNED), Vitoria, Spain
| | - E Echeburúa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Personality, Assessment and Psychological Treatment, University of the Basque Country, San Sebastián, Spain
| | - M Bernardo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - B Cabrera
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - S Amoretti
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - A Lobo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Medicine and Psychiatry, University of Zaragoza, Aragon Institute for Health Sciences (IIS Aragón), Zaragoza, Spain
| | - C Arango
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, Gregorio Marañón General University Hospital, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - I Corripio
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - E Vieta
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - E de la Serna
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Service, Hospital Clinic of Barcelona, Barcelona, Spain
| | - R Rodriguez-Jimenez
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- 12 de Octubre Hospital Research Institute (i+12), Madrid, Spain
| | - R Segarra
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Neurosciences, University of the Basque Country, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - J M López-Ilundain
- Department of Psychiatry, Navarre Hospital Complex, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - A M Sánchez-Torres
- Department of Psychiatry, Navarre Hospital Complex, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - M J Cuesta
- Department of Psychiatry, Navarre Hospital Complex, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - I Zorrilla
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
| | - P López
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain
- Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
| | - M Bioque
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - G Mezquida
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - F Barcones
- Department of Medicine and Psychiatry, University of Zaragoza, Aragon Institute for Health Sciences (IIS Aragón), Zaragoza, Spain
- Department of Family Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - C De-la-Cámara
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Medicine and Psychiatry, University of Zaragoza, Aragon Institute for Health Sciences (IIS Aragón), Zaragoza, Spain
| | - M Parellada
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, Gregorio Marañón General University Hospital, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - A Espliego
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, Gregorio Marañón General University Hospital, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - A Alonso-Solís
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - E M Grasa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - C Varo
- Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - L Montejo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - J Castro-Fornieles
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Service, Hospital Clinic of Barcelona, Barcelona, Spain
| | - I Baeza
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Service, Hospital Clinic of Barcelona, Barcelona, Spain
| | - M Dompablo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- 12 de Octubre Hospital Research Institute (i+12), Madrid, Spain
| | - I Torio
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- 12 de Octubre Hospital Research Institute (i+12), Madrid, Spain
| | - A Zabala
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Neurosciences, University of the Basque Country, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - J I Eguiluz
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Neurosciences, University of the Basque Country, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - L Moreno-Izco
- Department of Psychiatry, Navarre Hospital Complex, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - J Sanjuan
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- INCLIVA, University of Valencia, Hospital Clinico Universitario of Valencia, Spain
| | - R Guirado
- Neurobiology Unit, Department of Cell Biology, Interdisciplinary Research Structure for Biotechnology and Biomedicine (BIOTECMED), University of Valencia, Valencia, Spain
| | - I Cáceres
- Department of Psychiatry, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - P Garnier
- Department of Psychiatry, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - F Contreras
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Psychiatry Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Bobes
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Psychiatry Department, University of Oviedo, Oviedo, Spain
| | - S Al-Halabí
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Psychiatry Department, University of Oviedo, Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias, INEUROPA, Oviedo, Spain
| | - J Usall
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona (UB), Sant Boi de Llobregat, Barcelona, Spain
| | - A Butjosa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Research Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona (UB), Sant Boi de Llobregat, Barcelona, Spain
| | - S Sarró
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- FIDMAG Hermanas Hospitalarias Research Foundation, Barcelona, Spain
| | - R Landin-Romero
- FIDMAG Hermanas Hospitalarias Research Foundation, Barcelona, Spain
| | - A Ibáñez
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Psychiatry Department, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRyCIS), University of Alcalá, Madrid, Spain
| | - G Selva
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Valencia, Spain
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Bernardo M, Amoretti S, Cuesta MJ, Parellada M, Mezquida G, González-Pinto A, Bergé D, Lobo A, Aguilar EJ, Usall J, Corripio I, Bobes J, Rodríguez-Jiménez R, Sarró S, Contreras F, Ibáñez Á, Gutiérrez M, Micó JA. The prevention of relapses in first episodes of schizophrenia: The 2EPs Project, background, rationale and study design. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020. [PMID: 33020032 DOI: 10.1016/j.rpsm.2020.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Up to 80% of first-episode psychosis patients suffer a relapse within five years of the remission. Relapse should be an important focus of prevention given the potential harm to the patient and family. It threatens to disrupt their psychosocial recovery, increases the risk of resistance to treatment and has been associated with greater direct and indirect costs for society. Based on a previous project entitled "Genotype-phenotype and environment. Application to a predictive model in first psychotic episodes" (PEPs Project), the project "Clinical and neurobiological determinants of second episodes of schizophrenia. Longitudinal study of first episode of psychosis" was designed, also known as the 2EPs Project. It aimed to identify and characterize those factors that predict a relapse within the years immediately following a first episode. This project has focused on following the clinical course, with neuropsychological assessments, biological and neuroanatomical measures, genetic adherence and physical health monitoring in order to compare a subgroup of patients with a second episode to another group of patients which remains in remission. The main objective of the present article is to describe the rationale of the 2EPs Project, explaining the measurement approach adopted and providing an overview of the selected clinical and functional measures. 2EPs Project is a multicenter, coordinated, naturalistic, longitudinal follow-up study over three years in a Spanish sample of patients in remission after a first-psychotic episode of schizophrenia. It is closely monitoring the clinical course of the cases recruited to compare the subgroup of patients with a second episode to that which remains in remission. The sample is composed of 223 subjects recruited from 15 clinical centres in Spain with experience of the preceding PEPs Study project, albeit 2EPs being an expanded version with new basic groups in biological research. From the total sample recruited, 63 patients presented a relapse (44%). 2EPs arose to characterize first episodes in an exhaustive, novel and multimodal way, thus contributing towards the development of a predictive model of relapse. Identifying the characteristics of patients who relapse could improve early detection and intervention.
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Affiliation(s)
- Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Manuel Jesús Cuesta
- Departamento de Psiquiatría, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Mara Parellada
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón (IiSGM), Facultad de Medicina, Universidad Complutense, CIBERSAM, Madrid, España
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Departament de Medicina, Institut de Neurociències, Universitat de Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | | | | | - Ana González-Pinto
- Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Department of Neurociences, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Daniel Bergé
- Department of Neurosciences and Psychiatry, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry. Universidad de Zaragoza. Instituto de Investigación Aragón, CIBERSAM, Zaragoza, Spain
| | - Eduardo J Aguilar
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, CIBERSAM, Valencia, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Santa Creu and Sant Pau Hospital; Autonomous University of Barcelona (UAB), CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Área de Psiquiatría, Universidad de Oviedo, Servicio de Salud del Principado de Asturias, Instituto de Neurociencias del Principado de Asturias (INEUROPA), CIBERSAM, Oviedo, Asturias, Spain
| | - Roberto Rodríguez-Jiménez
- Departamento de Psiquiatría, Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), CogPsy-Group, Universidad Complutense de Madrid (UCM), CIBERSAM, Madrid, Spain
| | - Salvador Sarró
- FIDMAG Research Foundation Germanes Hospitalàries, CIBERSAM, Barcelona, Spain
| | - Fernando Contreras
- Psychiatry Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ángela Ibáñez
- Departamento de Psiquiatría, Hospital Ramon y Cajal, Universidad de Alcalá, IRYCIS, CIBERSAM, Madrid, Spain
| | - Miguel Gutiérrez
- Department of Psychiatry, Hospital Santiago Apóstol, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Juan Antonio Micó
- Grupo de Investigación en Neuropsicofarmacología y Psicobiología, Departamento de Neurociencias, Universidad de Cádiz, Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, CIBERSAM, Cádiz, Spain
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Kilciksiz CM, Keefe R, Benoit J, Öngür D, Torous J. Verbal memory measurement towards digital perspectives in first-episode psychosis: A review. Schizophr Res Cogn 2020; 21:100177. [PMID: 32322540 PMCID: PMC7163058 DOI: 10.1016/j.scog.2020.100177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/20/2020] [Accepted: 03/21/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Even in the early phases of psychotic spectrum illnesses such as schizophrenia, patients can experience cognitive decline or deficits prior to the onset of psychotic symptoms such as delusions and hallucinations. In this systematic review, we assessed which verbal memory assessments are most widely used in first-episode psychosis and may be applied via digital technologies (smartphone applications, etc.) for use in early detection. METHODS In November 2019, we searched for studies measuring verbal memory in first episode psychosis or schizophrenia over the past 10 years on PubMed and PsycINFO. We screened abstracts of these studies and excluded review studies. Full-texts of included studies were used to identify the verbal memory measurement tests, follow-up frequencies, and sample sizes. RESULTS We screened 233 reports and found that 120 original research studies measured verbal memory in first episode psychosis over the past 10 years. Four of these studies specified using a computer, 24 (20%) used a paper-pen format, 1(1%) used both, and 91 (76%) studies did not specify their administration tools or suggest there were offered in digital formats. Thirty-five (30%) studies had follow-up measurements of verbal memory, while 85 (70%) had only a single verbal memory measurement. DISCUSSION While many scales are commonly used to measure verbal memory in first episode psychosis, they are not often administered via digital technology. There is an emerging opportunity to administer these and other tests via digital technologies for expanding access to early detection of cognitive decline in clinical high risk and first-episode psychosis.
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Affiliation(s)
- Can Mişel Kilciksiz
- Digital Psychiatry Division, Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Richard Keefe
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States of America
| | - James Benoit
- Digital Psychiatry Division, Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Dost Öngür
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States of America
| | - John Torous
- Digital Psychiatry Division, Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
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The effects of cognitive reserve and depressive symptoms on cognitive performance in major depression and bipolar disorder. J Affect Disord 2020; 274:813-818. [PMID: 32664019 DOI: 10.1016/j.jad.2020.05.143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Significant heterogeneity is observed in the cognitive profiles of bipolar disorder (BD) and major depression (MDD), characterized in part by differences in individual and clinical variables such as cognitive reserve (CR) and depression severity. However, no other study evaluated how this variables may interact regarding neurocognitive functioning. The aim of the present exploratory study was to evaluate the interaction between different depressive symptoms severity, CR and diagnosis with neurocognitive functioning. METHOD 202 participants (MDD=91; BD=111) classified either as euthymic, with mild depression or moderate to severe depression, and low or high CR completed a neuropsychological evaluation of verbal fluency, working memory (WM), inhibitory control (IC), cognitive flexibility (CF) and attention (Att). RESULTS Neuroprotective effects of CR were observed in patients with BD within a major depressive episode in WM, IC, FC and Att. In MDD, CR acted as a neuroprotective factor during euthymia and moderate to severe depression in the same cognitive functions. CR and depression severity differentiated the cognitive profiles of individuals with BD and MDD. LIMITATIONS Some variables related to neurocognitive performance like medication use, number of mood episodes, illness duration or previous hospitalizations were not controlled. CONCLUSION CR may be protective against cognitive impairment in both BD and MDD, and these effects were observed in euthymia and during depressive episodes of varying severity. These findings highlight the importance of investigating such variables in the neuropsychological evaluation of mood disorders, which may help to understand the cognitive heterogeneity within these populations.
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Clinical and cognitive correlates of childhood attention-deficit/hyperactivity disorder in first-episode psychosis: A controlled study. Eur Neuropsychopharmacol 2020; 36:90-99. [PMID: 32540207 DOI: 10.1016/j.euroneuro.2020.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/15/2020] [Accepted: 05/24/2020] [Indexed: 11/23/2022]
Abstract
The relationship between childhood attention-deficit/hyperactivity disorder (c-ADHD) and psychosis has been understudied. Cognitive dysfunction is a core feature of both disorders, but no previous study has investigated whether first-episode psychosis (FEP) with c-ADHD (FEP-ADHD+) presents a different cognitive profile than FEP without c-ADHD (FEP-ADHD-). One hundred and thirty-three FEP outpatients were screened for c-ADHD through a diagnostic interview and underwent a comprehensive clinical and cognitive assessment with the MATRICS Consensus Cognitive Battery (MCCB). Cognitive differences among FEP groups, and a group of 65 healthy controls (HCs) were analysed by multivariate analysis of covariance. Nearly 25% of FEP fulfilled criteria for c-ADHD. Both FEP groups performed worse than HCs in speed processing, executive function and social cognition, but only the FEP-ADHD+group was significantly more impaired than the HC group in attention (F = 4.35; p = 0.04). Only the Trail Making Test A (TMT-A) (F = 6.99; p = 0.01) within the domain of processing speed and the Neuropsychological Assessment Battery (NAB) (F = 6.46; p = 0.01) within the domain of executive function reliably differentiated the two clinical groups. The FEP groups did not differ in the severity of psychopathology, but the FEP-ADHD+reported fewer years of education than the FEP-ADHD- and were more likely to use tobacco and cannabis and to require higher doses of antipsychotics to achieve a clinical response. In conclusion, we found a gradient of severity in cognitive performance between groups, with FEP-ADHD+ having the greatest cognitive impairment. Our results suggest that FEP-ADHD+ represents a subgroup with a worse prognosis than FEP-ADHD-.
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García-Mieres H, Usall J, Feixas G, Ochoa S. Placing Cognitive Rigidity in Interpersonal Context in Psychosis: Relationship With Low Cognitive Reserve and High Self-Certainty. Front Psychiatry 2020; 11:594840. [PMID: 33324260 PMCID: PMC7725761 DOI: 10.3389/fpsyt.2020.594840] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/29/2020] [Indexed: 01/28/2023] Open
Abstract
Introduction: People with psychosis show impairments in cognitive flexibility, a phenomenon that is still poorly understood. In this study, we tested if there were differences in cognitive and metacognitive processes related to rigidity in patients with psychosis. We compared individuals with dichotomous interpersonal thinking and those with flexible interpersonal thinking. Methods: We performed a secondary analysis using two groups with psychosis, one with low levels of dichotomous interpersonal thinking (n = 42) and the other with high levels of dichotomous interpersonal thinking (n = 43). The patients were classified by splitting interpersonal dichotomous thinking (measured using the repertory grid technique) to the median. The groups were administered a sociodemographic questionnaire, a semi-structured interview to assess psychotic symptoms [Positive and Negative Syndrome Scale (PANSS)], a self-report of cognitive insight [Beck Cognitive Insight Scale (BCIS)], neurocognitive tasks [Wisconsin Card Sorting Test (WCST) and Wechsler Adult Intelligence Scale (WAIS)], and the repertory grid technique. We used a logistic regression model to test which factors best differentiate the two groups. Results: The group with high dichotomous interpersonal thinking had earlier age at onset of the psychotic disorder, higher self-certainty, impaired executive functioning, affected abstract thinking, and lower estimated cognitive reserve than the group with flexible thinking. According to the logistic regression model, estimated cognitive reserve and self-certainty were the variables that better differentiated between the two groups. Conclusion: Cognitive rigidity may be a generalized bias that affects not only neurocognitive and metacognitive processes but also the sense of self and significant others. Patients with more dichotomous interpersonal thinking might benefit from interventions that target this cognitive bias on an integrative way and that is adapted to their general level of cognitive abilities.
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Affiliation(s)
- Helena García-Mieres
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain.,Mental Health Networking Biomedical Research Center, CIBERSAM, Madrid, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain.,Mental Health Networking Biomedical Research Center, CIBERSAM, Madrid, Spain
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.,The Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain.,Mental Health Networking Biomedical Research Center, CIBERSAM, Madrid, Spain
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Influence of cognitive reserve in schizophrenia: A systematic review. Neurosci Biobehav Rev 2020; 108:149-159. [DOI: 10.1016/j.neubiorev.2019.10.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/10/2019] [Accepted: 10/26/2019] [Indexed: 01/08/2023]
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Lin X, Lu D, Zhu Y, Luo X, Huang Z, Chen W. The effects of cognitive reserve on predicting and moderating the cognitive and psychosocial functioning of patients with bipolar disorder. J Affect Disord 2020; 260:222-231. [PMID: 31505400 DOI: 10.1016/j.jad.2019.09.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/28/2019] [Accepted: 09/02/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cognitive reserve (CR) reflects the resilience of the brain to cope with neuropathological changes and minimize clinical manifestations. In the present study, we explore the association between CR and cognitive and psychosocial functioning, and examined the potential moderating role of CR in patients with bipolar disorder (BD). METHODS One hundred and twenty-five outpatients with BD type I and sixty healthy individuals were recruited. All participants were assessed with a neuropsychological battery examining attention and processing speed, working memory, visual memory and executive functioning, the Global Assessment of Functioning scale and the Cognitive Complaints in Bipolar Disorder Rating Assessment. Proxies for cognitive reserve included premorbid intelligence and educational level. RESULTS Patients with bipolar disorder presented with worse cognitive performance and psychosocial functioning than healthy controls. Multiple regression models revealed that educational level negatively associated with all assessed domain-specific cognition scores and premorbid intelligence predicted attention and processing speed and psychosocial functioning. Notably, premorbid intelligence significantly moderated the associations between the number of episodes (total, hypo/manic and depressed) and neurocognitive functioning, and the educational level also moderated the relationships between the numbers of hypo/manic and total episodes and subjective cognitive functioning. CONCLUSIONS Cognitive reserve contributes to functional outcomes in patients with BD and may emerge as a key factor contributing to the course and prognosis of patients with BD. In the future, cognitive reserve must be considered in both research and clinical interventions related to bipolar disorder.
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Affiliation(s)
- Xiaoling Lin
- School of Nursing, Sun Yat-sen University, Guangzhou 510089, China.
| | - Dali Lu
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, China
| | - Yinghua Zhu
- School of Nursing, Sun Yat-sen University, Guangzhou 510089, China
| | - Xia Luo
- School of Nursing, Sun Yat-sen University, Guangzhou 510089, China
| | - Zhixin Huang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou 510317, China
| | - Wen Chen
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, China
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Thomas EC, Snethen G, McCormick B, Salzer MS. An exploration of linear and curvilinear relationships between community participation and neurocognition among those with serious mental illnesses. Psychiatr Rehabil J 2019; 42:358-365. [PMID: 30945919 PMCID: PMC6776709 DOI: 10.1037/prj0000364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Longitudinal research supports an effect of participation in aspects of community life (e.g., leisure activity, employment) on neurocognition in the general population. This study examined the extent and nature of the relationship between community participation and neurocognition among people with serious mental illnesses. METHOD Participants included 168 adults with schizophrenia spectrum or affective disorder diagnoses who completed the Temple University Community Participation Measure and Brief Assessment of Cognition in Schizophrenia. Hierarchical multiple regression analyses explored linear and curvilinear effects of the amount and breadth of community participation on neurocognition. RESULTS Significant linear relationships existed between amount of community participation and overall neurocognitive functioning, motor speed, verbal fluency, and attention/processing speed, and between breadth of participation and verbal fluency. Significant curvilinear effects were noted between amount of community participation and verbal memory, and between breadth of community participation and overall neurocognitive functioning and motor speed. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Findings suggest that enhanced community participation may contribute to improved neurocognitive functioning, further supporting the importance of this rehabilitation target. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Elizabeth C Thomas
- Department of Rehabilitation Sciences, College of Public Health, Temple University
| | - Gretchen Snethen
- Department of Rehabilitation Sciences, College of Public Health, Temple University
| | - Bryan McCormick
- Department of Rehabilitation Sciences, College of Public Health, Temple University
| | - Mark S Salzer
- Department of Rehabilitation Sciences, College of Public Health, Temple University
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Luperdi SC, Tabarés-Seisdedos R, Livianos L, Vieta E, Cuesta MJ, Balanzá-Martínez V. Neurocognitive endophenotypes in schizophrenia and bipolar disorder: A systematic review of longitudinal family studies. Schizophr Res 2019; 210:21-29. [PMID: 31272906 DOI: 10.1016/j.schres.2019.06.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/16/2019] [Accepted: 06/17/2019] [Indexed: 01/28/2023]
Abstract
Although there is substantial evidence supporting the existence of neurocognitive impairment in patients diagnosed with schizophrenia (SZ) and bipolar disorder (BD), few studies have explored the field from an endophenotypic perspective. The present systematic review sought to identify longitudinal family studies exploring suitable neurocognitive endophenotypes in unaffected relatives of patients with SZ and/or BD. Following the PRISMA statement, only five follow-up studies met the inclusion criteria, comprising 79 SZ patients, 159 SZ unaffected relatives of SZ, 131 BD patients, 77 unaffected relatives of BD, and 248 controls. Verbal memory, auditory attention, face memory and emotion processing were found as putative endophenotypic candidates for SZ, whereas this strategy identified none for BD. Substantial heterogeneity and lack of standardization in global neurocognitive assessment within this area should be pointed out; nevertheless, several candidate endophenotypes were identified for SZ, except for executive impairment.
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Affiliation(s)
- Sussy C Luperdi
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; PhD Program in Medicine. University of Valencia, Spain
| | - Rafael Tabarés-Seisdedos
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; INCLIVA Health Research Institute, Valencia, Spain
| | - Lorenzo Livianos
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Public Health (CIBERESP-Grupo 17), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Vicent Balanzá-Martínez
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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