1
|
Cuoco S, Blundo C, Ricci M, Cappiello A, Bisogno R, Carotenuto I, Avallone AR, Erro R, Pellecchia MT, Amboni M, Barone P, Picillo M. Psychometric properties of the Caregiver's inventory neuropsychological diagnosis dementia (CINDD) in mild cognitive impairment and dementia. J Neural Transm (Vienna) 2024; 131:173-180. [PMID: 38200268 PMCID: PMC10791830 DOI: 10.1007/s00702-023-02728-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The Caregiver's Inventory Neuropsychological Diagnosis Dementia (CINDD) is an easy tool designed to quantify cognitive, behavioural and functional deficits of patients with cognitive impairment. Aim of the present study was to analyse the psychometric properties of the CINDD in Mild Cognitive Impairment (MCI) and Dementia (D). DESIGN, SETTING AND PARTICIPANTS The CINDD, composed by 9 sub-domains, was administered to fifty-six caregivers of patients with different types of dementia (D) and 44 caregivers of patients with MCI. All patients underwent an extensive neuropsychological assessment, the Neuropsychiatric Inventory (NPI) and functional autonomy scales. The reliability, convergent construct validity and possible cut-off of CINND were measured by Cronbach's alpha (α), Pearson's correlation and ROC analysis, respectively. RESULTS The D and MCI patients differed only for age (p=0.006). The internal consistency of CINDD was high (α= 0.969). The α-value for each CINDD domain was considered acceptable, except the mood domain (α=0.209). The CINDD total score correlated with cognitive screening tests; each domain of the CINDD correlated with the corresponding score from either tests or NPI (p<0.05), except for visuo-spatial perception skills and apathy. A screening cut-off equal to 59, can be used discriminate D from MCI (Sensitivity=0.70, Specificity=0.57). CONCLUSION The CINDD is a feasible, accurate and reliable tool for the assessment of cognitive and behavioural difficulties in patients with different degree of cognitive impairment. It may be used to quantify and monitor caregiver-reported ecological data in both clinical and research settings.
Collapse
Affiliation(s)
- Sofia Cuoco
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Carlo Blundo
- Department of Neuroscience, Center of Cognitive Disorders and Dementia, San Camillo Hospital, Rome, Italy
| | - Monica Ricci
- Department of Neuroscience, Center of Cognitive Disorders and Dementia, San Camillo Hospital, Rome, Italy
| | - Arianna Cappiello
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Rossella Bisogno
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Immacolata Carotenuto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Anna Rosa Avallone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Maria Teresa Pellecchia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Marianna Amboni
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
- IDC Hermitage-Capodimonte, Naples, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy
| | - Marina Picillo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience section, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Via Allende, Baronissi, 84081, Salerno, Italy.
| |
Collapse
|
2
|
Xu XJ, Liu TL, He L, Pu B. Changes in neurotransmitter levels, brain structural characteristics, and their correlation with PANSS scores in patients with first-episode schizophrenia. World J Clin Cases 2023; 11:5215-5223. [PMID: 37621579 PMCID: PMC10445057 DOI: 10.12998/wjcc.v11.i22.5215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/15/2023] [Accepted: 07/10/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND In patients with schizophrenia, the brain structure and neurotransmitter levels change, which may be related to the occurrence and progression of this disease. AIM To explore the relationships between changes in neurotransmitters, brain structural characteristics, and the scores of the Positive and Negative Symptom Scale (PANSS) in patients with first-episode schizophrenia. METHODS The case group comprised 97 patients with schizophrenia, who were evaluated using the Canadian Neurological Scale and confirmed by laboratory tests at Ningbo Mental Hospital from January 2020 to July 2022. The control group comprised 100 healthy participants. For all participants, brain structural characteristics were explored by measuring brain dopamine (DA), glutamic acid (Glu), and gamma-aminobutyric acid (GABA) levels, with magnetic resonance imaging. The case group was divided into negative and positive symptom subgroups using PANSS scores for hierarchical analysis. Linear correlation analysis was used to analyze the correlations between neurotransmitters, brain structural characteristics, and PANSS scores. RESULTS Patients in the case group had higher levels of DA and lower levels of Glu and GABA, greater vertical and horizontal distances between the corpus callosum and the inferior part of the fornix and larger ventricle area than patients in the control group (P < 0.05). Patients with positive schizophrenia symptoms had significantly higher levels of DA, Glu, and GABA than those with negative symptoms (P < 0.05). In patients with positive schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical and horizontal distances between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05). In patients with negative schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical distance between the corpus callosum and the infrafornix, horizontal distance between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05). CONCLUSION In patients with first-episode schizophrenia, DA levels increased, Glu and GABA levels decreased, the thickness of the corpus callosum increased, and these variables were correlated with PANSS scores.
Collapse
Affiliation(s)
- Xian-Jia Xu
- The Fifth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Tang-Long Liu
- Department of Science and Education, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Liang He
- The Sixteenth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Ben Pu
- The Twelfth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| |
Collapse
|
3
|
Xu XJ, Liu TL, He L, Pu B. Changes in neurotransmitter levels, brain structural characteristics, and their correlation with PANSS scores in patients with first-episode schizophrenia. World J Clin Cases 2023; 11:5209-5217. [DOI: 10.12998/wjcc.v11.i22.5209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/15/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND In patients with schizophrenia, the brain structure and neurotransmitter levels change, which may be related to the occurrence and progression of this disease.
AIM To explore the relationships between changes in neurotransmitters, brain structural characteristics, and the scores of the Positive and Negative Symptom Scale (PANSS) in patients with first-episode schizophrenia.
METHODS The case group comprised 97 patients with schizophrenia, who were evaluated using the Canadian Neurological Scale and confirmed by laboratory tests at Ningbo Mental Hospital from January 2020 to July 2022. The control group comprised 100 healthy participants. For all participants, brain structural characteristics were explored by measuring brain dopamine (DA), glutamic acid (Glu), and gamma-aminobutyric acid (GABA) levels, with magnetic resonance imaging. The case group was divided into negative and positive symptom subgroups using PANSS scores for hierarchical analysis. Linear correlation analysis was used to analyze the correlations between neurotransmitters, brain structural characteristics, and PANSS scores.
RESULTS Patients in the case group had higher levels of DA and lower levels of Glu and GABA, greater vertical and horizontal distances between the corpus callosum and the inferior part of the fornix and larger ventricle area than patients in the control group (P < 0.05). Patients with positive schizophrenia symptoms had significantly higher levels of DA, Glu, and GABA than those with negative symptoms (P < 0.05). In patients with positive schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical and horizontal distances between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05). In patients with negative schizophrenia symptoms, PANSS score was significantly positively correlated with DA, vertical distance between the corpus callosum and the infrafornix, horizontal distance between the corpus callosum and the infrafornix, and ventricular area, and was significantly negatively correlated with Glu and GABA (P < 0.05).
CONCLUSION In patients with first-episode schizophrenia, DA levels increased, Glu and GABA levels decreased, the thickness of the corpus callosum increased, and these variables were correlated with PANSS scores.
Collapse
Affiliation(s)
- Xian-Jia Xu
- The Fifth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Tang-Long Liu
- Department of Science and Education, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Liang He
- The Sixteenth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| | - Ben Pu
- The Twelfth Ward, Ningbo Psychiatric Hospital, Ningbo 315000, Zhejiang Province, China
| |
Collapse
|
4
|
Bucci P, Mucci A, Giordano GM, Caporusso E, Giuliani L, Gibertoni D, Rossi A, Rocca P, Bertolino A, Galderisi S. Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01641-7. [PMID: 37380743 DOI: 10.1007/s00406-023-01641-7] [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: 02/06/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Abstract
The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ (n = 601), the agreement between patients and their informants on CAI ratings, to explore patients' insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet's agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients' and informants' ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative.
Collapse
Affiliation(s)
- Paola Bucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulia M Giordano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Edoardo Caporusso
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Dino Gibertoni
- Research and Innovation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
5
|
Giordano GM, Brando F, Pezzella P, De Angelis M, Mucci A, Galderisi S. Factors influencing the outcome of integrated therapy approach in schizophrenia: A narrative review of the literature. Front Psychiatry 2022; 13:970210. [PMID: 36117655 PMCID: PMC9476599 DOI: 10.3389/fpsyt.2022.970210] [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: 06/15/2022] [Accepted: 08/11/2022] [Indexed: 12/03/2022] Open
Abstract
The integration of pharmacotherapy with psychosocial interventions has an important role to play in the improvement of functional outcome of subjects with schizophrenia (SCZ), in all stages of the disorder. It is essential for the adequate management of unmet therapeutic needs, such as negative symptoms and cognitive dysfunctions which account for most of the functional impairment of subjects with SCZ and do not respond to available antipsychotics. Enhancing the knowledge on factors involved in the effectiveness of integrated treatment plans is an important step forward for SCZ care. This review aims to identify factors that might influence the impact of integrated treatments on functional outcome. Most studies on the impact of psychosocial treatments on functional outcome of subjects with SCZ did not control for the effect of prescribed antipsychotics or concomitant medications. However, several factors relevant to ongoing pharmacological treatment might influence the outcome of integrated therapy, with an impact on the adherence to treatment (e.g., therapeutic alliance and polypharmacotherapy) or on illness-related factors addressed by the psychosocial interventions (e.g., cognitive dysfunctions or motivational deficits). Indirect evidence suggests that treatment integration should consider the possible detrimental effects of different antipsychotics or concomitant medications on cognitive functions, as well as on secondary negative symptoms. Cognitive dysfunctions can interfere with participation to an integrated treatment plan and can be worsened by extrapyramidal or metabolic side effects of antipsychotics, or concomitant treatment with anticholinergics or benzodiazepines. Secondary negative symptoms, due to positive symptoms, sedation, extrapyramidal side effects or untreated depression, might cause early drop-out and poor adherence to treatment. Researchers and clinicians should examine all the above-mentioned factors and implement appropriate and personalized integrated treatments to improve the outcome of SCZ.
Collapse
Affiliation(s)
| | | | | | | | - Armida Mucci
- University of Campania Luigi Vanvitelli, Naples, Italy
| | | |
Collapse
|