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Krijnen LJG, Lemmers-Jansen ILJ, Fett AKJ, Krabbendam L. Benefits of Social Contact in Individuals With Psychotic Symptoms: Do Closeness of the Contact and Empathic Skills Make the Difference? Front Psychol 2021; 12:769091. [PMID: 34975658 PMCID: PMC8716939 DOI: 10.3389/fpsyg.2021.769091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/25/2021] [Indexed: 11/14/2022] Open
Abstract
Objectives: Social contact is known to be beneficial for humans’ mental health. Individuals with psychotic symptoms (PS) tend to show poorer social and interpersonal functioning. However, in this patient population, social contact may be crucial for their mental wellbeing and treatment success. Additionally, closeness of social contact (familiar versus less familiar others), rather than only the presence or absence of social contacts, may play an important role. Empathy may heighten the beneficial effects of social/close contact on mental health, facilitating interactions. We investigated the association between social contact and closeness of contact on mental health, defined as positive symptoms, positive affect and negative affect in PS and control participants, with empathy as a moderator. Methods: Participants were 16–30 years old. Information regarding social/close contact and mental health was obtained using the experience sampling method in individuals with PS (n = 29) and healthy controls (n = 28). Empathy was measured using a self-report questionnaire. Results: Social contact was associated with higher positive affect in the total sample. Contact with close as opposed to less close others was related to better mental health: It was associated with lower positive symptoms in the PS group, and with more positive affect in the total sample. Empathy moderated the association between closeness of contact and positive affect in the total sample, in which the combination of higher levels of empathy combined with the presence of close contact was associated with higher positive affect in the total sample. However, the direct association between empathy and positive affect was not significant per group of contact. Conclusion: The results suggest that social contact, but especially contact with a close other is important for mental health outcomes: Contact with close others is beneficial for positive affect in the total sample and for positive symptoms in individuals with PS.
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Affiliation(s)
- Lisa J. G. Krijnen
- Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- *Correspondence: Lisa J. G. Krijnen,
| | - Imke L. J. Lemmers-Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Institute for Brain and Behavior (IBBA), Amsterdam, Netherlands
- CSI Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Anne-Kathrin J. Fett
- CSI Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- Department of Psychology, City University of London, London, United Kingdom
| | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Institute for Brain and Behavior (IBBA), Amsterdam, Netherlands
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2
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Thibaudeau É, Cellard C, Turcotte M, Achim AM. Functional Impairments and Theory of Mind Deficits in Schizophrenia: A Meta-analysis of the Associations. Schizophr Bull 2021; 47:695-711. [PMID: 33433606 PMCID: PMC8084438 DOI: 10.1093/schbul/sbaa182] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Schizophrenia is associated with major functioning difficulties. Theory of mind (ToM), the ability to infer the mental states of others, is an important determinant of functioning. However, the contribution of ToM to each specific domain of functioning remains to be better understood. The objectives of this meta-analysis were to document and compare the magnitude of the associations between ToM and (1) different domains of functioning (social functioning, productive activities, and instrumental activities of daily living), each assessed separately for functional performance and functional outcome and (2) different aspects of functioning (functional performance and functional outcome) in schizophrenia. Fifty-nine studies (N = 4369) published between 1980 and May 2019 targeting patients with schizophrenia or schizoaffective disorder aged between 18 and 65 years old were included. Studies were retrieved from seven databases. Correlations were extracted from the articles, transformed into effect sizes Zr and combined as weighted and unweighted means. The strength of the associations between the domains and aspects of functioning were compared using focused tests. A moderate association was observed between ToM and all domains of functioning, with a stronger association between ToM and productive activities compared with social functioning (only for functional outcome [χ2(2) = 6.43, P = 0.040]). Regarding the different aspects of functioning, a stronger association was observed between ToM and functional performance, compared with functional outcome, for overall functioning (χ2(1) = 13.77, P < 0.001) and social functioning (χ2(1) = 18.21, P < 0.001). The results highlight a stronger association of ToM with productive activities and with functional performance, which should be considered in future studies to improve functional recovery in schizophrenia.
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Affiliation(s)
- Élisabeth Thibaudeau
- École de psychologie, Université Laval, Québec, Québec, Canada,CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada,To whom correspondence should be addressed; Pavillon Félix-Antoine-Savard, 2325 Allée des Bibliothèques, local 1528, Québec, QC G1V 0A6, Canada; tel: 418-656-2131, e-mail:
| | - Caroline Cellard
- École de psychologie, Université Laval, Québec, Québec, Canada,CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada
| | | | - Amélie M Achim
- CERVO Brain Research Center, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Québec, Canada,Département de psychiatrie et neurosciences, Université Laval, Québec, Québec, Canada
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3
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Social Cognition in Autism and Schizophrenia Spectrum Disorders: The Same but Different? J Autism Dev Disord 2020; 50:3046-3059. [PMID: 32642956 DOI: 10.1007/s10803-020-04408-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Social cognition impairment is a core shared phenotype in both schizophrenia spectrum disorders (SSD) and autism spectrum disorders (ASD). This study compares social cognition performance through four different instruments in a sample of 147 individuals with ASD or SSD and in healthy controls. We found that both clinical groups perform similarly to each other and worse than healthy controls in all social cognition tasks. Only performance on the Movie for the Assessment of Social Cognition (MASC) test was independent of age and intelligence. Proportionately, individuals in the control group made significantly more overmentalization errors than both patients group did and made fewer undermentalization errors than patients with SSD did. AUC analyses showed that the MASC was the instrument that best discriminated between the clinical and control groups. Multivariate analysis showed negative symptom severity as a potential mediator of the association between social cognition deficit and poor global functioning.
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4
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Sen MS, Nehra R, Grover S. Social cognition in patients with first episode of psychosis in remission. Indian J Psychiatry 2020; 62:544-554. [PMID: 33678836 PMCID: PMC7909030 DOI: 10.4103/psychiatry.indianjpsychiatry_342_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 11/21/2022] Open
Abstract
AIM The present study aimed to compare the social cognition (SC) deficits in patients with first-episode psychosis (FEP) and healthy controls and evaluate the association of SC deficits with socio-occupational functioning, insight, quality of life, and stigma. METHODS This study included 30 patients with FEP in remission phase and 26 healthy controls matched for age, gender, education, and intelligent quotient. SC was assessed on the domains of theory of mind (ToM), social perception, and attributional bias. RESULTS Compared to healthy controls, patients with FEP had significantly higher deficits in the domains of second-order ToM (unpaired t = 4.447, P < 0.001) and Faux Pas Composite Index (unpaired t = 2.824, P = 0.007). In the correlation analysis, higher age of patients with FEP was significantly associated with more externalizing bias (Pearson's correlation coefficient = 0.38, P = 0.039) and those with lower level of education had more social cognitive deficits in the domains of Faux Pas Composite Index (Pearson's correlation coefficient = 0.43, P = 0.018), Social Perception Index (Pearson's correlation coefficient = 0.38, P = 0.04), and Nonsocial Perception Index (Pearson's correlation coefficient = 0.5, P = 0.005). Duration of untreated psychosis was associated with higher deficits in the first-order ToM (Pearson's correlation coefficient = -0.38, P = 0.04) and Externalizing Bias Index (Pearson's correlation coefficient = -0.49, P = 0.006). Longer duration of treatment was associated with higher impairment in first-order ToM index (Pearson's correlation coefficient = -0.42, P = 0.02). General psychopathology and total Positive and Negative Syndrome Scale total score correlated significantly with externalizing bias, with a higher level of psychopathology associated with more severe deficits in this domain. There was no correlation of SC with the quality of life, cognitive insight, and stigma (except for occasional correlation of stereotype endorsement and externalizing bias). CONCLUSION The present study suggests that compared to healthy controls, patients with FEP have impairment in the domains of second-order ToM and Faux Pas Composite Index. However, social cognitive deficits have only a few correlations with various psychosocial outcomes of FEP.
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Affiliation(s)
- Mahadev Singh Sen
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Nehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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5
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Giralt-López M, Miret S, Soler J, Campanera S, Parellada M, Fañanás L, Fatjó-Vilas M. The role of schizotypal traits and the OXTR gene in theory of mind in schizophrenia: A family-based study. Eur Psychiatry 2020; 63:e15. [PMID: 32093796 PMCID: PMC7315883 DOI: 10.1192/j.eurpsy.2019.17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is consistent evidence that theory of mind (ToM) is impaired in schizophrenia (SZ); however, it remains unclear whether such deficits are trait- or state-dependent. We evaluated ToM in patients with schizophrenia spectrum disorders (SSDs), their healthy first-degree relatives, and controls to test its suitability as an endophenotypic marker. We also studied the modifying effect of markers of clinical and genetic liability to SZ (schizotypy and genetic variability in the oxytocin receptor gene: OXTR) on ToM in healthy individuals. METHODS The sample included 38 stable SSD patients, 80 unaffected first-degree relatives, and 81 controls. ToM was assessed using the Hinting Task (HT) and schizotypy via the Schizotypal Personality Questionnaire-Brief (SPQ-B), which generates interpersonal (SPQ-IP), cognitive-perceptual (SPQ-CP), and disorganization (SPQ-D) scores. The polymorphism rs53576 of OXTR was genotyped. RESULTS Patients presented poorer HT performance than relatives and controls (p = 0.003 and p < 0.001). High SPQ-IP and SPQ-CP scores correlated with poorer ToM performance in relatives (p = 0.010 and p = 0.030), but not in controls. OXTR was not associated with HT scores, but it showed a modifying effect within controls; high SPQ-CP was related to HT poorer performance conditional to GG genotype (p = 0.007). CONCLUSIONS ToM deficits were present in patients but not in unaffected relatives or controls. However, our data indicate the usefulness of clinical and genetic liability markers to characterize differences in ToM abilities within healthy individuals. Then, the observed link between ToM and SZ liability suggests the putative role of ToM as an endophenotypic marker. Nevertheless, new analyses in larger samples are needed.
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Affiliation(s)
- M Giralt-López
- Servei de Psiquiatria, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - S Miret
- Centre de Salut Mental d'Adults de Lleida, Servei de Psiquiatria, Salut Mental i Addiccions, Hospital Universitari Santa Maria, Lleida, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - J Soler
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - S Campanera
- Centre de Salut Mental d'Adults de Lleida, Servei de Psiquiatria, Salut Mental i Addiccions, Hospital Universitari Santa Maria, Lleida, Spain
| | - M Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departamento de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - L Fañanás
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - M Fatjó-Vilas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
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6
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Bisecco A, Altieri M, Santangelo G, Di Nardo F, Docimo R, Caiazzo G, Capuano R, Pappacena S, d'Ambrosio A, Bonavita S, Trojsi F, Cirillo M, Esposito F, Tedeschi G, Gallo A. Resting-State Functional Correlates of Social Cognition in Multiple Sclerosis: An Explorative Study. Front Behav Neurosci 2020; 13:276. [PMID: 32116584 PMCID: PMC7016209 DOI: 10.3389/fnbeh.2019.00276] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022] Open
Abstract
Social cognition includes mental operations essential for functional social interactions, and several studies revealed an impairment of social cognition abilities in patients with Multiple Sclerosis (MS). These deficits have been related to global and focal gray matter atrophy as well as microstructural white matter damage. Although some studies reveal a correlation between social cognition and task-based functional magnetic resonance imaging (MRI), no studies to date have explored the association between brain resting-state functional connectivity (RS-FC) abnormalities and several measures of social cognition in MS. The aim of this explorative study was to assess the contribution of RS-FC abnormalities of major brain networks to social cognition in MS patients. Clinical, neuropsychological, and MRI data were collected from 41 non-depressed and cognitively preserved relapsing-remitting MS patients (mean disease duration = 8.8 ± 8.2 years; median Expanded Disability Status Scale = 1.5, range 0–6.5) and 25 matched healthy controls (HCs). The ToM Pictures Sequencing Task (TMPS) and the Reading the Mind in the Eyes Task were employed to evaluate social cognition. All participants underwent a structural MRI and RS functional MRI 3T protocol. Regional gray matter atrophy was measured, and FCs of the default mode (DMN), right and left fronto-parietal, executive (EN), salience, cerebellar, and limbic (LN) networks were evaluated by independent component analysis (ICA). Differences on TMPS were found between MS patients and HC (MS < HC). In the MS group, associations were found between right middle temporal gyrus FC (in the DMN) and reciprocity subscale of TMPS, posterior cingulate cortex (PCC) FC (in the DMN) and first-order false-belief subscale of TMPS, cingulate gyrus FC (in the EN) and TMPS as well as reciprocity subscale of TMPS, and right superior temporal gyrus (in the LN) and reciprocity subscale of TMPS. All detected RS-FC changes did not co-localize with regional gray matter atrophy. The results suggest an association between social cognition and RS-FC changes of DMN, EN, and LN in MS. Future studies should further explore the possible adaptive or maladaptive mechanisms of these FC abnormalities in MS.
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Affiliation(s)
- Alvino Bisecco
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Manuela Altieri
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy.,Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Federica Di Nardo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Renato Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Giuseppina Caiazzo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Rocco Capuano
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Simona Pappacena
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Alessandro d'Ambrosio
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Simona Bonavita
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Francesca Trojsi
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Mario Cirillo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Fabrizio Esposito
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Antonio Gallo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
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7
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Newton R, Rouleau A, Nylander AG, Loze JY, Resemann HK, Steeves S, Crespo-Facorro B. Diverse definitions of the early course of schizophrenia-a targeted literature review. NPJ SCHIZOPHRENIA 2018; 4:21. [PMID: 30323274 PMCID: PMC6189105 DOI: 10.1038/s41537-018-0063-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 01/07/2023]
Abstract
Schizophrenia is a debilitating psychiatric disorder and patients experience significant comorbidity, especially cognitive and psychosocial deficits, already at the onset of disease. Previous research suggests that treatment during the earlier stages of disease reduces disease burden, and that a longer time of untreated psychosis has a negative impact on treatment outcomes. A targeted literature review was conducted to gain insight into the definitions currently used to describe patients with a recent diagnosis of schizophrenia in the early course of disease ('early' schizophrenia). A total of 483 relevant English-language publications of clinical guidelines and studies were identified for inclusion after searches of MEDLINE, MEDLINE In-Process, relevant clinical trial databases and Google for records published between January 2005 and October 2015. The extracted data revealed a wide variety of terminology and definitions used to describe patients with 'early' or 'recent-onset' schizophrenia, with no apparent consensus. The most commonly used criteria to define patients with early schizophrenia included experience of their first episode of schizophrenia or disease duration of less than 1, 2 or 5 years. These varied definitions likely result in substantial disparities of patient populations between studies and variable population heterogeneity. Better agreement on the definition of early schizophrenia could aid interpretation and comparison of studies in this patient population and consensus on definitions should allow for better identification and management of schizophrenia patients in the early course of their disease.
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Affiliation(s)
- Richard Newton
- Austin Health, University of Melbourne, Melbourne, VIC, Australia.,Peninsula Health, Frankston, VIC, Australia
| | | | | | | | | | | | - Benedicto Crespo-Facorro
- Department of Medicine & Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
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8
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Li M, Deng W, Das T, Li Y, Zhao L, Ma X, Wang Y, Yu H, Li X, Meng YJ, Wang Q, Palaniyappan L, Li T. Neural substrate of unrelenting negative symptoms in schizophrenia: a longitudinal resting-state fMRI study. Eur Arch Psychiatry Clin Neurosci 2018; 268:641-651. [PMID: 29128871 DOI: 10.1007/s00406-017-0851-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 11/02/2017] [Indexed: 02/05/2023]
Abstract
Developing a mechanistic insight into the specific brain processes that underpin improvement in negative symptoms can help us design novel chemical and physical treatments against these unrelenting symptoms. The aim of the present study is to explore the longitudinal changes in the brain's regional functional efficiency that accompany improvement in negative symptoms seen in first-episode patients with schizophrenia when treated with antipsychotic for 1 year. Forty-seven first-episode patients with schizophrenia were scanned at a drug-naive baseline state and followed up for 1 year to identify negative symptom responders (Rn) and non-responders (NRn). Fractional amplitude of low-frequency fluctuations (fALFF) and Granger analysis of effective connectivity (EC) were used to examine the different patterns of regional function and connectivity between Rn and NRn during the 1 year follow-up. Increase of fALFF in the left superior temporal gyrus (STG) and increase of EC from the left STG to the dorsolateral prefrontal cortex (DLPFC) was found in Rn compared to NRn. We further validated that the identified changes in fALFF/EC of STG occur specifically in relation to negative symptoms only (i.e., not pseudo-specific in relation to positive, extrapyramidal or depressive symptoms), and occur irrespective of arbitrary clinical categorization of treatment response. An increase in fALFF in the precuneus and the inferior parietal lobule, and a decrease in EC from the left STG to the occipital cortex, were also found at the 1 year follow-up irrespective of improvement in negative symptoms. Interventions that improve the functional efficiency of left STG and its prefrontal connectivity may show efficacy in alleviating negative symptoms in first-episode schizophrenia.
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Affiliation(s)
- Mingli Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Wei Deng
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Tushar Das
- Robarts Research Institute and The Brain and Mind Institute, University of Western Ontario, London, ON, Canada.,Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Yinfei Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiaohong Ma
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yingcheng Wang
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Hua Yu
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiaojing Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Ya-Jing Meng
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Lena Palaniyappan
- Robarts Research Institute and The Brain and Mind Institute, University of Western Ontario, London, ON, Canada. .,Department of Psychiatry, University of Western Ontario, London, ON, Canada. .,Lawson Health Research Institute, London, ON, Canada. .,Prevention and Early Intervention Program for Psychoses (PEPP), A2-636, LHSC-VH, 800 Commissioners Road, London, ON, N6A 5W9, Canada.
| | - Tao Li
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China. .,West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
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9
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Navarra-Ventura G, Fernandez-Gonzalo S, Turon M, Pousa E, Palao D, Cardoner N, Jodar M. Gender Differences in Social Cognition: A Cross-Sectional Pilot Study of Recently Diagnosed Patients with Schizophrenia and Healthy Subjects. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:538-546. [PMID: 29216439 PMCID: PMC6099750 DOI: 10.1177/0706743717746661] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study had 2 objectives: First, to explore the gender-related differences in emotional processing (EP) and theory of mind-both cognitive (CToM) and affective (AToM)-in patients with schizophrenia and in a control group of healthy subjects; and, second, to examine, from a gender perspective, the possible association between EP and CToM in the AToM performance. METHODS Forty patients with schizophrenia/schizoaffective disorder were recruited and matched by gender, age and years of education with 40 healthy subjects. EP was measured by the pictures of facial affect (POFA) test. CToM was measured using first- and second-order false-belief (FB) stories. AToM was measured by the reading the mind in the eyes test (RMET). Group and gender differences in CToM were analysed using the X2 test, whereas EP and AToM were analysed using the non-parametric Mann-Whitney U Test and a general linear model. Results were adjusted by intelligence quotient and negative symptomatology. RESULTS Patients with schizophrenia underperformed against healthy subjects in the POFA test, second-order FB, and RMET, but not in first-order FB. No significant gender differences were found. However, there was a trend showing that females outperformed males in the POFA ( P = 0.056). Group ( P < 0.001), POFA ( P < 0.001) and second-order FB ( P = 0.022) were the best factors predicting RMET performance (adjusted R2 = 0.584). CONCLUSIONS Our results suggest that the illness is the main factor related to the deficit in social cognition, except for the basic aspects of the CToM that were unimpaired in most patients. Nevertheless, the influence of female gender in EP should not be neglected in any group. Finally, the hierarchal interaction between these domains is discussed.
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Affiliation(s)
- Guillem Navarra-Ventura
- 1 Mental Health Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Corporació Sanitària Parc Taulí, Parc Taulí, Sabadell, Barcelona, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Sol Fernandez-Gonzalo
- 3 Research Department, Fundació Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Parc Taulí, Sabadell, Barcelona, Spain.,4 Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain.,5 Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
| | - Marc Turon
- 3 Research Department, Fundació Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Parc Taulí, Sabadell, Barcelona, Spain.,6 Centro de Investigación Biomédica En Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain
| | - Esther Pousa
- 7 Mental Health Department, Hospital del Mar, Institut de Neuropsiquiatria i Addiccions, Universitat Autònoma de Barcelona, Hospital del Mar, Passeig Marítim, Barcelona, Spain
| | - Diego Palao
- 1 Mental Health Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Corporació Sanitària Parc Taulí, Parc Taulí, Sabadell, Barcelona, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain.,4 Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain
| | - Narcis Cardoner
- 1 Mental Health Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Corporació Sanitària Parc Taulí, Parc Taulí, Sabadell, Barcelona, Spain.,2 Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain.,4 Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain
| | - Merce Jodar
- 4 Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/ Monforte de Lemos, Madrid, Spain.,5 Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain.,8 Neurology Department, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Parc Taulí, Sabadell, Barcelona, Spain
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Javed A, Charles A. The Importance of Social Cognition in Improving Functional Outcomes in Schizophrenia. Front Psychiatry 2018; 9:157. [PMID: 29740360 PMCID: PMC5928350 DOI: 10.3389/fpsyt.2018.00157] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/09/2018] [Indexed: 12/11/2022] Open
Abstract
Social cognition has become recognized as an important driver of functional outcomes and overall recovery in patients with schizophrenia, mediating the relationship between neurocognition and social functioning. Since antipsychotic therapy targeting remission of clinical symptoms has been shown to have a limited impact on social cognition, there has been an increasing drive to develop therapeutic strategies to specifically improve social cognition in schizophrenia. We sought to review current evidence relating to social cognition in schizophrenia and its clinical implications, including interventions designed to target the core domains of social cognition (emotion processing, theory of mind, attributional bias, and social perception) as a means of improving functional outcomes and thereby increasing the likelihood of recovery. Relevant articles were identified by conducting a literature search in PubMed using the search terms "schizophrenia" AND "cognition" AND "social functioning," limited to Title/Abstract, over a time period of the past 10 years. Current evidence demonstrates that schizophrenia is associated with impairments in all four core domains of social cognition, during the pre-first-episode, first-episode, early, and chronic phases of the disease, and that such impairments are important determinants of functional outcome. Interventions targeting the four core domains of social cognition comprise psychosocial approaches (social cognition training programs) and pharmacological therapies. Social cognition training programs targeting multiple and specific core domains of social cognition have shown promise in improving social cognition skills, which, in some cases, has translated into improvements in functional outcomes. Use of some psychosocial interventions has additionally resulted in improvements in clinical symptoms and/or quality of life. Pharmacological therapies, including oxytocin and certain antipsychotics, have yielded more mixed results, due in part to the confounding impact of factors including variation in receptor genetics, bioavailability, pharmacokinetics, and drug-drug interactions, and inconsistencies between study designs and medication dosages. Additional research is required to advance our understanding of the role of social cognition in schizophrenia, and to further establish the utility of targeted interventions in this setting.
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Affiliation(s)
- Afzal Javed
- Jepson House, Coventry and Warwickshire Partnership NHS Trust, Nuneaton, United Kingdom
| | - Asha Charles
- Caludon Centre, Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom
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Social Cognition in Individuals at Ultra-High Risk for Psychosis: A Meta-Analysis. PLoS One 2015; 10:e0141075. [PMID: 26510175 PMCID: PMC4624797 DOI: 10.1371/journal.pone.0141075] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 10/05/2015] [Indexed: 11/29/2022] Open
Abstract
Objective Treatment in the ultra-high risk stage for a psychotic episode is critical to the course of symptoms. Markers for the development of psychosis have been studied, to optimize the detection of people at risk of psychosis. One possible marker for the transition to psychosis is social cognition. To estimate effect sizes for social cognition based on a quantitative integration of the published evidence, we conducted a meta-analysis of social cognitive performance in people at ultra high risk (UHR). Methods A literature search (1970-July 2015) was performed in PubMed, PsychINFO, Medline, Embase, and ISI Web of Science, using the search terms ‘social cognition’, ‘theory of mind’, ‘emotion recognition’, ‘attributional style’, ‘social knowledge’, ‘social perception’, ‘empathy’, ‘at risk mental state’, ‘clinical high risk’, ‘psychosis prodrome’, and ‘ultra high risk’. The pooled effect size (Cohen’s D) and the effect sizes for each domain of social cognition were calculated. A random effects model with 95% confidence intervals was used. Results Seventeen studies were included in the analysis. The overall significant effect was of medium magnitude (d = 0.52, 95% Cl = 0.38–0.65). No moderator effects were found for age, gender and sample size. Sub-analyses demonstrated that individuals in the UHR phase show significant moderate deficits in affect recognition and affect discrimination in faces as well as in voices and in verbal Theory of Mind (TOM). Due to an insufficient amount of studies, we did not calculate an effect size for attributional bias and social perception/ knowledge. A majority of studies did not find a correlation between social cognition deficits and transition to psychosis, which may suggest that social cognition in general is not a useful marker for the development of psychosis. However some studies suggest the possible predictive value of verbal TOM and the recognition of specific emotions in faces for the transition into psychosis. More research is needed on these subjects. Conclusion The published literature indicates consistent general impairments in social cognition in people in the UHR phase, but only very specific impairments seem to predict transition to psychosis.
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