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Cuesta MJ, Sánchez-Torres AM, García de Jalón E, Moreno-Izco L, Gil-Berrozpe GJ, Zarzuela A, Papiol S, Fañanás L, Peralta V. Empirical validity of Leonhard's psychoses: A long-term follow-up study of first-episode psychosis patients. Schizophr Res 2024; 263:237-245. [PMID: 36682995 DOI: 10.1016/j.schres.2022.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/21/2023]
Abstract
The validation of nosological diagnoses in psychiatry remains a conundrum. Leonhard's (1979) nosology seems to be one of the few acceptable alternative categorical models to current DSM/ICD systems. We aimed to empirically validate Leonhard's four classes of psychoses: systematic schizophrenia (SSch), unsystematic (USch), cycloid psychosis (Cyclo), and manic-depressive illness (MDI) using a comprehensive set of explanatory validators. 243 patients with first-episode psychosis were followed between 10 and 31 years. A wide-ranging assessment was carried out by collecting data on antecedent, illness-related, concurrent, response to treatment, neuromotor abnormalities, and cognitive impairment variables. Compared with USch, Cyclo, and MDI, SSch displayed a pattern of impairments significantly larger across the seven blocks of explanatory variables. There were no significant differences between Cyclo and MDI in explanatory variables. Except for the majority of illness-onset features, USch displayed more substantial abnormalities in the explanatory variables than Cyclo and MDI. SSch and MDI showed higher percentages of correctly classified patients than USch and Cyclo in linear discriminant analyses. Partial validation of Leonhard's classification was found. SSch showed differences in explanatory variables with respect to Cyclo and MDI. USch showed also significant differences in explanatory variables regarding Cyclo and MDI, although with a lower strength than SSch. There was strong empirical evidence of the separation between both Leonhard's schizophrenia subtypes; however, the distinction between the Cyclo and MDI groups was not empirically supported. A mild to moderate discriminative ability between Leonhard's subtypes on the basis of explanatory blocks of variables was observed.
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Affiliation(s)
- M J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - A M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - E García de Jalón
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - L Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - G J Gil-Berrozpe
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - A Zarzuela
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - S Papiol
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Spain; Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, 80336, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
| | - L Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Spain
| | - V Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
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Gussmann E, Lindner C, Lucae S, Falkai P, Padberg F, Egli S, Kopf-Beck J. Targeting metacognitive change mechanisms in acute inpatients with psychotic symptoms: feasibility and acceptability of a modularized group intervention. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01690-y. [PMID: 37741946 DOI: 10.1007/s00406-023-01690-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/26/2023] [Indexed: 09/25/2023]
Abstract
Emerging evidence suggests the usefulness of psychological interventions targeting metacognitive change mechanisms in patients experiencing psychosis. Although many of these patients are treated in acute psychiatric contexts, only few studies have adapted such interventions for acute inpatient settings. The present study aimed to assess the feasibility, acceptability, and preliminary clinical outcomes of a novel modularized group intervention focusing on different aspects of metacognitive change mechanisms. In particular, the intervention aims to reduce patients' acute symptoms by enhancing cognitive insight and to relieve distress via cognitive defusion (i.e. coping). A sample of 37 participants with acute psychosis received up to nine sessions of the intervention. Baseline and post-intervention assessments were conducted for general psychopathology, psychotic symptoms, global functioning, and symptom distress. Measures of change mechanisms were assessed before and after the respective treatment module. Participants' experiences were explored in feedback questionnaires and interviews. Recruitment, retention, and attendance rate met the pre-set feasibility benchmark of 80%. The intervention was well received by participants, who emphasised the group's clear structure, positive atmosphere, and helpful contents. Response rates were high and linear mixed models revealed significant medium-to-large time effects on all clinical outcomes. As expected, increase in hypothesised change mechanisms cognitive insight and decrease in cognitive fusion was found. However, the uncontrolled design limits interpreting clinical effects. The study provides evidence that an intervention based on a metacognitive model is feasible and acceptable for acute inpatients with psychosis. Positive results on clinical outcomes and change mechanisms warrant further exploration in a randomized controlled trial.
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Affiliation(s)
- Eva Gussmann
- Max Planck Institute of Psychiatry, Munich, Germany.
| | | | - Susanne Lucae
- Max Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Peter Falkai
- Max Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Samy Egli
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Johannes Kopf-Beck
- Max Planck Institute of Psychiatry, Munich, Germany
- Department of Psychology, LMU Munich, Munich, Germany
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Bassiony MM, Sehlo MG, Ibrahim EF, Zayed AE, Atwa SA. Assessment of compliance and relapse in patients with schizophrenia before and after the onset of COVID-19 pandemic. Int J Psychiatry Clin Pract 2022:1-7. [PMID: 36149774 DOI: 10.1080/13651501.2022.2124175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of this study was to assess the frequency and correlates of relapse among patients with schizophrenia during the COVID-19 pandemic. METHODS This retrospective study included 90 adults who met DSM-IV criteria for schizophrenia. The participants were evaluated using Positive and Negative Syndrome Scale (PANSS), Compliance Rating Scale (CRS) and World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0) before and after the onset of COVID-19 pandemic. RESULTS The mean score of CRS was decreased after the onset of COVID-19 pandemic compared to before COVID 19 ( p < 0.001). The mean total score of PANSS scale and the mean positive subscale (P) score had increased after the onset of COVID-19 pandemic compared to before COVID 19 ( p < 0.001). Following up the news about COVID-19 regularly and decreased level of family support after the pandemic onset were associated with lower CRS scores and higher PANSS scores. In addition, the presence of infection or death with COVID-19 among family members and lower CRS scores were associated with higher scores on PANSS positive subscale. CONCLUSIONS The relapse rate had increased among patients with schizophrenia during COVID-19 pandemic. Non-compliance with medications and lack of family support were the main correlates of relapse in schizophrenia.Key PointsPatients with schizophrenia are at high risk for relapse during Covid-19 pandemic.Non-compliance with medications, lack of family support, COVID-19-related illness or death of family members and following the news of the pandemic are correlates of relapse in patients with schizophrenia.Psychoeducation, availability of medications and mental health services and family support may help to prevent relapse in patients with schizophrenia during pandemics.Prospective studies are needed to confirm the findings of this study.
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Affiliation(s)
- Medhat M Bassiony
- Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohammad G Sehlo
- Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman F Ibrahim
- Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Alaa E Zayed
- Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Samar A Atwa
- Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Dachs I, Irazabal M, García-mieres H, Cacho ND, Usall J, Barajas A, Dolz M, Sánchez B, Baños I, Huerta-ramos E, Marco-garcía S, Carlson J, Coromina M, Ochoa S. Patient’s Determinants of Subjective and Objective Burden in Caregivers of People with First Episode Psychosis. Revista de Psiquiatría y Salud Mental 2022. [DOI: 10.1016/j.rpsm.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Yousef AM, Mohamed AE, Eldeeb SM, Mahdy RS. Prevalence and clinical implication of adverse childhood experiences and their association with substance use disorder among patients with schizophrenia. Egypt J Neurol Psychiatry Neurosurg 2022. [DOI: 10.1186/s41983-021-00441-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Adverse childhood experiences (ACEs) and substance use disorder (SUD) are well-known risk factors for psychosis and dramatically affect schizophrenia. In this research, we aimed to measure the prevalence of adverse childhood experiences and substance use disorder in patients with schizophrenia and assess the effect of ACEs on the clinical presentation and overall functioning and the association between them and SUD in patients with schizophrenia. A cross-sectional study included a random sample of 165 schizophrenic patients who were examined by doing drug screen in urine, structured questionnaire to collect Socioeconomic characteristics, history of schizophrenia, structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders-fifth edition, Positive and Negative Syndrome Scale (PANSS), Adverse Childhood Experiences International Questionnaire (ACE-IQ), World Health Organization Disability Assessment Schedule 2.0, compliance rating scale, addiction severity index fifth edition (ASI) for individuals with positive urine drug screen.
Results
Only 14.4% of the studied patients had no adverse childhood experiences. The prevalence of positive substance abuse screening was 18.2%. There were statistically significant negative correlations between total ACE score and educational level, socioeconomic level, and the onset of schizophrenia. On the other hand, statistically significant positive correlations were found between the total ACE score and PANSS score and ASI score. The first most frequent ACE was significantly associated with female gender, lower education levels, low and middle socioeconomic classes, lifetime substance use, smokers, and positive drug screening. Emotional neglect and contact sexual abuse were significantly associated with positive drug screening. At the same time, Physical abuse was significantly associated with both lifetime substance use and positive drug screening.
Conclusion
The current study’s findings indicate that childhood adverse experiences and substance abuse are prevalent problems in patients with schizophrenia. Given that there is an association between both issues, they may affect the symptomatology of the disorder, the prognosis, and the therapeutic plan. It is advised that a greater emphasis on and identification of childhood trauma and drug use disorder may be a necessary step in assessing patients with schizophrenia.
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Zapata JP, García J, Arroyave CA, Calderón JD, Gómez JM, Buitrago DJ, Aparicio A, Aguirre DC. Validation of the sixth version of the Addiction Severity Index (ASI-6) for patients in a clinical population of Colombia. Biomedica 2019; 39:385-404. [PMID: 31529824 DOI: 10.7705/biomedica.v39i3.4536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Indexed: 06/10/2023]
Abstract
Introduction: The Addiction Severity Index (ASI-6) is recommended for identifying the needs of addicted patients and assessing the effectiveness of a program. Objective: To develop a version of the ASI-6 suitable for Colombia and trans-linguistically and trans-culturally equivalent to the original. Additionally, this study also sought to assess the reliability and construct validity of the resulting version. Materials and methods: The study included Colombian adults with harmful substance use or dependence syndrome who were being treated at drug addiction centers. The original English version underwent a cultural adaptation process. The scale was translated and back-translated to assess its equivalence. Reliability was assessed in terms of internal consistency and interrater and test-retest reliability. The convergent aspect of the construct validity was assessed via the correlation of the instrument with other scales measuring similar underlying constructs. Results: We found an adequate internal consistency for the subscales of the ASI-6 for its Cronbach´s alpha coefficient was above 0.7 with the exception of the social problems subscale (α=0.66). In addition, interrater and test-retest reliability was high, since their intraclass correlation coefficient (ICC) was above 0.7 for all the subscales. Construct validity was demonstrated by a Spearman correlation coefficient ranging from 0.53 to 0.88 between the ASI-6 subscales and other similar scales. Conclusion: The version of the ASI-6 adapted to the Colombian context was found to have good reliability and validity, thus it can be introduced into clinical practice. However, additional studies are needed to evaluate its responsiveness and structural validity.
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Affiliation(s)
- Juan Pablo Zapata
- Grupo Académico de Epidemiología Clínica, GRAEPIC, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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Canal-Rivero M, Lopez-Moriñigo JD, Barrigón ML, Ayesa-Arriola R, Crespo-Facorro B, Ruiz-Veguilla M, Obiols-Llandrich JE. Suicidal Behavior and Personality Traits Contribute to Disability in First-episode Psychosis: A 1-Year Follow-up Study. Suicide Life Threat Behav 2019; 49:798-810. [PMID: 29767457 DOI: 10.1111/sltb.12470] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 02/16/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Disability encompasses impairments, activity limitations, and restrictions on participation. Improvement in functioning has therefore become a crucial outcome of treatment in psychosis. OBJECTIVE The main aim of this study was to analyze the potential relationship between suicidal behavior after first episode of psychosis (FEP) and family disability. The second aim was to find out whether personality traits are associated with disability dimensions. METHOD The study sample was composed of 65 FEP patients. The personal care, occupational, family, and social dimensions of disability were evaluated at 12 months after FEP. Bivariate and multivariate analyses were performed to explore any putative outcome factors associated with dimensions of disability. RESULTS Personal care during the 1-year follow-up was significantly impaired in suicide attempters and significantly associated with sociopathic personality traits. A decline in occupational functioning was significantly associated with schizotypy traits. On the other hand, deterioration in family, social, and global functioning at 1 year after FEP was related to poor premorbid adjustment during late adolescence. CONCLUSIONS Suicidal behavior prevention could improve psychosocial functioning, particularly personal care, in FEP. In addition, sociopathic and schizotypy personality traits as well as poor premorbid adjustment during late adolescence appear to be useful early markers of future disability.
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Affiliation(s)
- Manuel Canal-Rivero
- 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.,Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Javier-David Lopez-Moriñigo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Maria-Luisa Barrigón
- Department of Psychiatry, Hospital Fundación Jiménez Díaz and IIS Fundación Jiménez Díaz, Madrid, Spain.,Universidad Autónoma de Madrid, Madrid, 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
| | - Benedicto Crespo-Facorro
- 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
| | - Miguel Ruiz-Veguilla
- Seville Biomedicine Institute Neurodevelopment and Psychosis Group (IBIS), Virgen del Rocío University Hospital/CSIC/University of Seville UGC Mental Health HVR, Seville, Spain
| | - Jordi E Obiols-Llandrich
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
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8
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García-Cabeza I, Díaz-Caneja CM, Ovejero M, de Portugal E. Adherence, insight and disability in paranoid schizophrenia. Psychiatry Res 2018; 270:274-280. [PMID: 30278408 DOI: 10.1016/j.psychres.2018.09.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/19/2018] [Accepted: 09/12/2018] [Indexed: 12/31/2022]
Abstract
Insight has long been linked to both prognosis and functioning in patients with schizophrenia; likewise, it is key to treatment adherence. This study seeks to assess the association between insight, adherence to pharmacological treatment, and disability in schizophrenia, and to study the potential mediating role of adherence between insight and disability. Insight (SUMD), adherence (CRS), and disability (WHO-DAS) were measured in 80 clinically stable patients with DSM-IV TR paranoid schizophrenia. Psychopathology was assessed with the Positive and Negative Syndrome Scale (PANSS). In a first step, predictors of disability were identified using linear regression to identify variables related to disability and further a mediation analysis was carried out. Negative symptoms, insight, and adherence account for 54.2% of the variance in disability. Negative symptoms act directly on disability, while the effect of insight on disability is partially mediated by adherence. Insight is key in disability in schizophrenia and should be leveraged in treatment programs.
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Affiliation(s)
- I García-Cabeza
- Department of Psychiatry, Gregorio Marañón University Hospital, Complutense University of Madrid, Ibiza, 43, 28009 Madrid, Spain.
| | - C M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense de Madrid, Spain
| | - M Ovejero
- SERMES CRO, Calle de Rufino González, 14, 28037 Madrid, Spain
| | - E de Portugal
- Department of Psychiatry, Gregorio Marañón University Hospital, Complutense University of Madrid, Ibiza, 43, 28009 Madrid, Spain; Ciber del área de Salud Mental (CIBERSAM), Madrid, Spain
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Cuesta MJ, García de Jalón E, Campos MS, Moreno-Izco L, Lorente-Omeñaca R, Sánchez-Torres AM, Peralta V. Motor abnormalities in first-episode psychosis patients and long-term psychosocial functioning. Schizophr Res 2018; 200:97-103. [PMID: 28890132 DOI: 10.1016/j.schres.2017.08.050] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/24/2017] [Accepted: 08/27/2017] [Indexed: 10/18/2022]
Abstract
Motor abnormalities (MAs) are highly prevalent in patients with first-episode psychosis both before any exposure and after treatment with antipsychotic drugs. However, the extent to which these abnormalities have predictive value for long-term psychosocial functioning is unknown. One hundred antipsychotic-naive first-episode psychosis (FEP) patients underwent extensive motor evaluation including catatonic, parkinsonism, dyskinesia, akathisia and neurological soft signs. Patients were assessed at naïve state and 6months later. Patients were followed-up in their naturalistic treatment and settings and their psychosocial functioning was assessed at 6-month, 1year, 5year and 10years from the FEP by collecting all available information. A set of linear mixed models were built to account for the repeated longitudinal assessment of psychosocial functioning during the follow-up regarding to the five domains of MAs (catatonic, parkinsonism, akathisia, dyskinesia and neurologic soft-signs) at index episode at antipsychotic naïve state and after 6months of FEP. Basic epidemiological variables, schizophrenia diagnosis and average of chlorpromazine equivalent doses of antipsychotic drugs were included as covariates. Catatonic signs and dyskinesia at drug-naïve state were significantly associated with poor long-term psychosocial functioning. Moreover, higher scores on parkinsonism, akathisia, neurological soft signs and catatonic signs at 6-month of FEP but not dyskinesia showed significant associations with poor long-term psychosocial functioning. Our results added empirical evidence to motor abnormalities as core manifestations of psychotic illness before and after antipsychotic treatment with high predictive value for poor long-term psychosocial functioning in FEP patients.
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Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Spain; IdiSNa (Instituto de Investigación Sanitaria de Navarra), Spain.
| | - Elena García de Jalón
- Mental Health Department of Servicio Navarro de Salud, Spain; IdiSNa (Instituto de Investigación Sanitaria de Navarra), Spain
| | | | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra, Spain; IdiSNa (Instituto de Investigación Sanitaria de Navarra), Spain
| | - Ruth Lorente-Omeñaca
- Department of Psychiatry, Complejo Hospitalario de Navarra, Spain; IdiSNa (Instituto de Investigación Sanitaria de Navarra), Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Spain; IdiSNa (Instituto de Investigación Sanitaria de Navarra), Spain
| | - Víctor Peralta
- Mental Health Department of Servicio Navarro de Salud, Spain; IdiSNa (Instituto de Investigación Sanitaria de Navarra), Spain
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Sánchez-Torres AM, Elosúa MR, Lorente-Omeñaca R, Moreno-Izco L, Peralta V, Cuesta MJ. The Cognitive Assessment Interview: A comparative study in first episode and chronic patients with psychosis. Schizophr Res 2016; 178:80-85. [PMID: 27617413 DOI: 10.1016/j.schres.2016.08.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 06/29/2016] [Accepted: 08/30/2016] [Indexed: 11/17/2022]
Abstract
The Cognitive Assessment Interview (CAI) is an interview-based instrument to assess cognition considering the impact of cognitive impairment on daily activities. We aimed to explore the associations of the Spanish version of the CAI (CAI-Sp) with a neuropsychological battery and a measure of psychosocial functioning in psychosis. The sample consisted of fifty-six first episode psychosis (FEP) patients and 66 non-FEP patients, who were assessed with a neuropsychological battery, the CAI-Sp and the Short Disability Schedule (DAS-S). Patients also underwent clinical assessment. Additionally, 37 controls were assessed with the neuropsychological battery and CAI-Sp, for normalization purposes. The results showed that CAI-Sp scores were overall correlated with the neuropsychological battery in non-FEP patients. In FEP patients, we found fewer significant correlations. Most associations were maintained after controlling for clinical symptoms. CAI-Sp rater scores contributed to the variance in the DAS-S scores in both groups, as did negative and disorganized symptoms. The CAI-Sp may be a good instrument to assess cognition in non-FEP patients. In FEP patients, it was less effective in capturing cognitive impairments and their functional consequences, probably because cognitive deficits have yet to become evident, due to the recency of illness onset, and no functional disturbances were observed due to these cognitive impairments.
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Affiliation(s)
- Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Department of Basic Psychology I, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - María Rosa Elosúa
- Department of Basic Psychology I, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Ruth Lorente-Omeñaca
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Victor Peralta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
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Rubio-Abadal E, Usall J, Barajas A, Carlson J, Iniesta R, Huerta-Ramos E, Baños I, Dolz M, Sánchez B, Ochoa S. Relationship between menarche and psychosis onset in women with first episode of psychosis. Early Interv Psychiatry 2016; 10:419-25. [PMID: 25263663 DOI: 10.1111/eip.12194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 08/19/2014] [Indexed: 12/17/2022]
Abstract
AIM The aim of this study was to explore the relationship between age at menarche and age at first episode of psychosis, as well as clinical severity and outcome, in a population of women with first-episode psychosis. METHODS Clinical and socio-demographical data, age at menarche and at first-episode psychosis, parental history of psychosis and cannabis-use habits were obtained from 42 subjects with a first episode of psychosis. Positive and Negative Syndrome Scale, Clinical Global Impression, Global Assessment Function, Disability Assessment Schedule, Wechsler Adult Intelligence Scale and Wechsler Intelligence Scale for Children, European Quality of Life, and Lewis and Murray Obstetric Complication Scales were administered. Statistical analysis was performed by means of zero-order correlations and Mann-Whitney U and Kruskal-Wallis tests using SPSS version 17.0. RESULTS We found no significant correlation between age at menarche and age at first-episode psychosis, or with the clinical scores performed. We observed that subjects with earlier age at menarche had more parental history of psychosis. CONCLUSIONS Our negative results do not support the theory of a possible protective role of oestrogen, which seems to be more complex than previously thought. We would suggest that further research is needed to investigate developmental influences of sex steroids on the onset of psychosis and potentially therapeutic benefits based upon oestrogen.
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Affiliation(s)
- Elena Rubio-Abadal
- Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, CIBERSAM. GTRDSM, Spain.
| | - Judith Usall
- Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, CIBERSAM. GTRDSM, Spain
| | - Anna Barajas
- Research Unit, Centre d'Higiene Mental Les Corts, Barcelona, Spain
| | - Janina Carlson
- Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, CIBERSAM. GTRDSM, Spain
| | - Raquel Iniesta
- Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, CIBERSAM. GTRDSM, Spain
| | - Elena Huerta-Ramos
- Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, CIBERSAM. GTRDSM, Spain
| | - Iris Baños
- Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, CIBERSAM. GTRDSM, Spain
| | - Montserrat Dolz
- Psychiatry Department, Hospital Sant Joan de Déu, CIBERSAM, Barcelona, Spain
| | - Bernardo Sánchez
- Psychiatry Department, Hospital Sant Joan de Déu, CIBERSAM, Barcelona, Spain
| | | | - Susana Ochoa
- Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, CIBERSAM. GTRDSM, Spain
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Grau N, Rubio-Abadal E, Usall J, Barajas A, Butjosa A, Dolz M, Baños I, Sánchez B, Rodríguez MJ, Peláez T, Sammut S, Carlson J, Huerta-Ramos E, Ochoa S; GENIPE Group. Influence of cognition, premorbid adjustment and psychotic symptoms on psycho-social functioning in first-episode psychosis. Psychiatry Res 2016; 242:157-62. [PMID: 27280526 DOI: 10.1016/j.psychres.2016.04.121] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 03/22/2016] [Accepted: 04/30/2016] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the relationship between psycho-social functioning and symptoms, cognitive function, and premorbid adjustment, in patients with a first-episode psychosis. METHOD Clinical data were obtained from 90 patients, who were assessed with the Disability Assessment Scale (DAS-sv), the Positive and Negative Syndrome Scale (PANSS), the Premorbid Adjustment Scale (PAS-S) and with a battery of cognitive tests including Trail Making Tests A and B (TMTA- B), Continous Performance Test (CPT), some subscales of the Wechler Adult Intelligence Scale (WAIS), and the Verbal Learning Test España-Complutense (TAVEC). RESULTS The results of the study suggest that psycho-social functioning in first-episode psychosis is significantly related to: positive, negative, excitative, affective and disorganized symptoms, social premorbid adjustment, cognitive flexibility, working memory, short term and long term memory. Of these, those which best explained psycho-social functioning are the positive and excitative symptoms, premorbid adjustment, flexibility and memory. CONCLUSIONS These findings highlight the importance early intervention on cognitive and clinical variables to help provide a better psycho-social functioning in people with a first-episode of psychosis.
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Kästner D, Büchtemann D, Warnke I, Radisch J, Baumgardt J, Giersberg S, Kopke K, Moock J, Kawohl W, Rössler W. Clinical and Functional Outcome of Assertive Outreach for Patients With Schizophrenic Disorder: Results of a Quasi-Experimental Controlled Trial. Eur Psychiatry 2015; 30:736-42. [DOI: 10.1016/j.eurpsy.2015.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 04/12/2015] [Accepted: 04/16/2015] [Indexed: 11/24/2022] Open
Abstract
AbstractBackgroundThe majority of studies support modern assertive health service models. However, the evidence is limited for parts of continental Europe, as well as for the pharmacological adherence outcome parameter.MethodWe conducted a quasi-experimental controlled trial including adult patients with a schizophreniform disorder and a maximum of 60 points on the Global Assessment of Functioning Scale (GAF). Interventions (n = 176) and controls (TAU, n = 142) were assessed every six-month within one year in 17 study practices in rural areas. Mental and functional state were rated using the Brief Psychiatric Rating Scale (BPRS) and the GAF. Functional limitations and pharmacological adherence were patient-rated using the WHO-Disability Assessment Schedule II (WHODAS–II) and the Medication Adherence Report Scale (MARS). We computed multilevel mixed models.ResultsThe GAF and BPRS of both groups improved significantly, yet the increase in the intervention group was significantly higher. In contrast, patient-rated variables – WHODAS–II and MARS – neither showed a stable temporal improvement nor a difference between groups.ConclusionOur findings only partly support the investigated AO intervention, because of conflicting results between clinician- and patient-ratings. Accordingly, the benefits of AO need to be further evaluated.
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Mas-Expósito L, Amador-Campos JA, Gómez-Benito J, Mauri-Mas L, Lalucat-Jo L. Clinical case management for patients with schizophrenia with high care needs. Community Ment Health J 2015; 51:165-70. [PMID: 24972907 DOI: 10.1007/s10597-014-9741-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 06/16/2014] [Indexed: 11/25/2022]
Abstract
The aim of this study is to establish the effectiveness of a clinical case management (CM) programme compared to a standard treatment programme (STP) in patients with schizophrenia. Patients for the CM programme were consecutively selected among patients in the STP with schizophrenia who had poor functioning. Seventy-five patients were admitted to the CM programme and were matched to 75 patients in the STP. Patients were evaluated at baseline and at 1 year follow-up. At baseline, patients in the CM programme showed lower levels of clinical and psychosocial functioning and more care needs than patients in the STP. Both treatment programmes were effective in maintaining contact with services but the CM programme did not show advantages over the STP on outcomes. Differences between groups at baseline may be masking the effects of CM at one year follow-up. A longer follow-up may be required to evaluate the real CM practices effects.
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Affiliation(s)
- Laia Mas-Expósito
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain
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15
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Chiu TY, Yen CF, Chou CH, Lin JD, Hwang AW, Liao HF, Chi WC. Development of traditional Chinese version of World Health Organization disability assessment schedule 2.0 36--item (WHODAS 2.0) in Taiwan: validity and reliability analyses. Res Dev Disabil 2014; 35:2812-2820. [PMID: 25094056 DOI: 10.1016/j.ridd.2014.07.009] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/29/2014] [Accepted: 07/02/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) provided a standardized method for measuring the health and disability and the traditional Chinese version has not been developed. AIMS To describe the process of developing the traditional Chinese version of the WHODAS 2.0 36-item version and to evaluate the concurrent validity and test-retest reliability of this instrument. METHODS The study was conducted in two phases. Phase I was the process of translation of WHODAS 2.0 36-item version. Phase II was a cross-sectional study. The participants were 307 adults who were tested the validity and reliability of draft traditional Chinese version. RESULTS The reliability of Cronbach's α and ICC in the WHODAS 2.0 traditional Chinese version were 0.73-0.99 and 0.8-089, respectively. The content validity was good (r=0.7-0.76), and the concurrent validity was excellent in comparison with the WHOQOL-BREF (p<0.5). The construct validity, the model was explained total variance was 67.26% by the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) illustrated the traditional Chinese version was good to assess disability. There was a valid and reliable measurement scales for evaluating functioning and disability status. CONCLUSION For disability eligibility system of Taiwan government to measure the disability, the traditional Chinese version of the WHODAS 2.0 provided valuable evidence to design the assessment instrument.
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Affiliation(s)
- Tzu-Ying Chiu
- Institute of Medical Science, Tzu Chi University, Hualien, Taiwan
| | - Chia-Feng Yen
- Institute of Medical Science, Tzu Chi University, Hualien, Taiwan; Department of Public Health, Tzu Chi University, Hualien, Taiwan.
| | - Cheng-Hsiu Chou
- Departments of Family Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Jin-Ding Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Ai-Wen Hwang
- College of Medicine, Chang Gung University, Graduate Institute of Early Intervention, Taoyuan, Taiwan
| | - Hua-Fang Liao
- Chinese Association of Early Intervention Profession for Children with Developmental Delays, Taipei, Taiwan
| | - Wen-Chou Chi
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei, Taiwan
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Mas-Expósito L, Amador-Campos JA, Gómez-Benito J, Lalucat-Jo L. Considering variables for the assignment of patients with schizophrenia to a case management programme. Community Ment Health J 2013; 49:831-40. [PMID: 23775241 DOI: 10.1007/s10597-013-9621-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 06/03/2013] [Indexed: 12/16/2022]
Abstract
The elements and intensity of case management (CM) practices should be established according to patients' needs. Therefore, greater understanding of patients' needs in such community-based programmes is essential. This paper addresses this issue by characterizing two groups of patients receiving CM or a standard treatment programme (STP) and identifying the characteristics of patients receiving CM services. We recruited 241 patients with schizophrenia from 10 Adult Mental Health Centres in Barcelona (Catalonia, Spain). We analyzed the profile of new patients included in a clinical, non-intensive CM program against that of patients in a STP. CM patients, compared with STP patients, have a lower educational level and quality of life; greater use of health care services, and higher levels of psychiatric symptoms, disability and unmet needs. Community psychiatric visits, social services, education, physical health and needs were significantly associated with CM services. This study may help in identifying patients' needs and strengthening the CM programme.
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Affiliation(s)
- Laia Mas-Expósito
- Department of Research, Centre d'Higiene Mental Les Corts, c/Numància 103-105 baixos, 08029, Barcelona, Spain
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Barajas A, Usall J, Baños I, Dolz M, Villalta-Gil V, Vilaplana M, Autonell J, Sánchez B, Cervilla JA, Foix A, Obiols JE, Haro JM, Ochoa S. Three-factor model of premorbid adjustment in a sample with chronic schizophrenia and first-episode psychosis. Schizophr Res 2013; 151:252-8. [PMID: 24257516 DOI: 10.1016/j.schres.2013.10.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 09/02/2013] [Accepted: 10/25/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND The dimensionality of premorbid adjustment (PA) has been a debated issue, with attempts to determine whether PA is a unitary construct or composed of several independent domains characterized by a differential deterioration pattern and specific outcome correlates. AIMS This study examines the factorial structure of PA, as well as, the course and correlates of its domains. METHOD Retrospective study of 84 adult patients experiencing first-episode psychosis (FEP) (n=33) and individuals with schizophrenia (SCH) (n=51). All patients were evaluated with a comprehensive battery of instruments including clinical, functioning and neuropsychological variables. A principal component analysis accompanied by a varimax rotation method was used to examine the factor structure of the PAS-S scale. Paired t tests and Wilcoxon rank tests were used to assess the changes in PAS domains over time. Bivariate correlation analyses were performed to analyse the relationship between PAS factors and clinical, social and cognitive variables. RESULTS PA was better explained by three factors (71.65% of the variance): Academic PA, Social PA and Socio-sexual PA. The academic domain showed higher scores of PA from childhood. Social and clinical variables were more strongly related to Social PA and Socio-sexual PA domains, and the Academic PA domain was exclusively associated with cognitive variables. CONCLUSION This study supports previous evidence, emphasizing the validity of dividing PA into its sub-components. A differential deterioration pattern and specific correlates were observed in each PA domains, suggesting that impairments in each PA domain might predispose individuals to develop different expressions of psychotic dimensions.
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Affiliation(s)
- Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain; Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain; Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Esplugues de Llobregat, Barcelona, Spain; Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Esplugues de Llobregat, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.
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Mas-Expósito L, Amador-Campos JA, Gómez-Benito J, Lalucat-Jo L. Validation of the modified DUKE-UNC Functional Social Support Questionnaire in patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2013; 48:1675-85. [PMID: 23229203 DOI: 10.1007/s00127-012-0633-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 11/23/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE The modified DUKE-UNC Functional Social Support Questionnaire (FSSQ) is considered a psychometric instrument to assess the social support in patients with schizophrenia. However, it has not been validated in this patient population. This issue is addressed here by examining the tool's psychometric properties in a clinical sample of patients with schizophrenia. METHODS Two hundred and forty-one patients from ten Adult Mental Health Centres (AMHC) meeting the following inclusion criteria were included: (1) International Classification of Diseases-10 (ICD-10) diagnosis of schizophrenia; (2) Global Assessment of Functioning (GAF) scores ≤50; (3) Illness duration of more than 2 years; and (4) Clinical stability. Patients were evaluated at baseline and at 1-year follow-up for clinical and psychosocial variables. RESULTS The factor analysis revealed two factors that explained 54.15 % of the variance. Internal consistency was excellent for the total FSSQ (0.87 at baseline and 0.88 at 1 year follow-up) and ranged between adequate and excellent for FSSQ domains. Correlations between FSSQ scores and those of global functioning, psychiatric symptoms, disability and quality of life ranged between small and large. There were significant differences between groups of patients with schizophrenia in FSSQ scores. Patients with higher levels of somatic complaints and patients who were disabled scored significantly lower in some or all FSSQ scores. After 1-year follow-up, patients improved in overall functioning and there was a decrease in psychiatric symptoms. There were mainly small significant associations between changes in FSSQ scores from baseline to 1-year follow-up and changes in the rest of the test scores, and AMHC visits between baseline and 1-year follow-up. CONCLUSIONS The FSSQ scores are reliable and valid, which suggests that the instrument is appropriate for the assessment of perceived social support in patients with schizophrenia.
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Affiliation(s)
- Laia Mas-Expósito
- Departament de Docència, Formació, Recerca i Publicacions, Centre d'Higiene Mental Les Corts, c/Numància 103-105 baixos, 08029, Barcelona, Spain,
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Ochoa S, Huerta-Ramos E, Barajas A, Iniesta R, Dolz M, Baños I, Sánchez B, Carlson J, Foix A, Pelaez T, Coromina M, Pardo M, Usall J. Cognitive profiles of three clusters of patients with a first-episode psychosis. Schizophr Res 2013; 150:151-6. [PMID: 23958487 DOI: 10.1016/j.schres.2013.07.054] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 07/05/2013] [Accepted: 07/29/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The primary objective was to identify specific groups of patients with a first-episode psychosis based on family history, obstetric complications, neurological soft signs, and premorbid functioning. The secondary objective was to relate these groups with cognitive variables. METHOD A total of 62 first-episode psychoses were recruited from adult and child and adolescent mental health services. The inclusion criteria were patients between 7 and 65 years old (real range of the samples was 13-35 years old), two or more psychotic symptoms and less than one year from the onset of the symptoms. Premorbid functioning (PAS), soft signs (NES), obstetric complications and a neuropsychological battery (CPT, TMTA/TMTB, TAVEC/TAVECI, Stroop, specific subtest of WAIS-III/WISC-IV) were administered. RESULTS We found three clusters: 1) higher neurodevelopment contribution (N=14), 2) higher genetic contribution (N=30), and 3) lower neurodevelopment contribution (N=18). Statistical differences were found between groups in TMTB, learning curve of the TAVEC, digits of the WAIS and premorbid estimated IQ, the cluster 1 being the most impaired. CONCLUSIONS A cluster approach could differentiate several groups of patients with different cognitive performance. Neuropsychological interventions, as cognitive remediation, should be addressed specifically to patients with more impaired results.
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Affiliation(s)
- Susana Ochoa
- Parc Sanitari Sant Joan de Déu. Sant Boi de Llobregat (Barcelona), CIBERSAM, Spain.
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Barajas A, Ochoa S, Baños I, Dolz M, Villalta-Gil V, Vilaplana M, Autonell J, Sánchez B, Cervilla JA, Foix A, Obiols JE, Haro JM, Usall J; GENIPE group. Spanish validation of the Premorbid Adjustment Scale (PAS-S). Compr Psychiatry 2013; 54:187-94. [PMID: 22995451 DOI: 10.1016/j.comppsych.2012.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 07/06/2012] [Accepted: 07/09/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The Premorbid Adjustment Scale (PAS) has been the most widely used scale to quantify premorbid status in schizophrenia, coming to be regarded as the gold standard of retrospective assessment instruments. AIMS To examine the psychometric properties of the Spanish version of the PAS (PAS-S). METHOD Retrospective study of 140 individuals experiencing a first episode of psychosis (n=77) and individuals who have schizophrenia (n=63), both adult and adolescent patients. Data were collected through a socio-demographic questionnaire and a battery of instruments which includes the following scales: PAS-S, PANSS, LSP, GAF and DAS-sv. The Cronbach's alpha was performed to assess the internal consistency of PAS-S. Pearson's correlations were performed to assess the convergent and discriminant validity. RESULTS The Cronbach's alpha of the PAS-S scale was 0.85. The correlation between social PAS-S and total PAS-S was 0.85 (p<0.001); while for academic PAS-S and total PAS-S it was 0.53 (p<0.001). Significant correlations were observed between all the scores of each age period evaluated across the PAS-S scale, with a significance value less than 0.001. There was a relationship between negative symptoms and social PAS-S (0.20, p<0.05) and total PAS-S (0.22, p<0.05), but not with academic PAS-S. However, there was a correlation between academic PAS-S and general subscale of the PANSS (0.19, p<0.05). Social PAS-S was related to disability measures (DAS-sv); and academic PAS-S showed discriminant validity with most of the variables of social functioning. PAS-S did not show association with the total LSP scale (discriminant validity). CONCLUSION The Spanish version of the Premorbid Adjustment Scale showed appropriate psychometric properties in patients experiencing a first episode of psychosis and who have a chronic evolution of the illness. Moreover, each domain of the PAS-S (social and academic premorbid functioning) showed a differential relationship to other characteristics such as psychotic symptoms, disability or social functioning after onset of illness.
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