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Roux P, Faivre N, Urbach M, Aouizerate B, Brunel L, Capdevielle D, Chereau I, Dubertret C, Dubreucq J, Fond G, Lançon C, Leignier S, Mallet J, Misdrahi D, Pires S, Schneider P, Schurhoff F, Yazbek H, Zinetti-Bertschy A, Passerieux C, Brunet-Gouet E. Relationships between neuropsychological performance, insight, medication adherence, and social metacognition in schizophrenia. Schizophr Res 2023; 252:48-55. [PMID: 36623435 DOI: 10.1016/j.schres.2022.12.037] [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: 09/29/2021] [Revised: 08/24/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Social metacognition is still poorly understood in schizophrenia, particularly its neuropsychological basis and its impact on insight and medication adherence. We therefore quantified social metacognition as the agreement between objective and subjective mentalization and assessed its correlates in a sample of individuals with schizophrenia spectrum disorders. METHODS Participants consisted of 143 patients with schizophrenia or schizoaffective disorders who underwent a metacognitive version of a mentalization task, an extensive neuropsychological battery, and a clinical evaluation to assess their insight into illness and medication adherence. We studied potential interactions between confidence judgments and several neuropsychological and clinical variables on mentalization accuracy with mixed-effects multiple logistic regressions. RESULTS Confidence judgments were closely associated with mentalization accuracy, indicative of good social metacognition in this task. Working memory, visual memory, and reasoning and problem-solving were the three neuropsychological dimensions positively associated with metacognition. By contrast, the two measures of medication adherence were associated with poorer metacognition, whereas no association was found between metacognition and clinical insight. The multiple regression model showed a significant positive impact of better working memory, older age at onset, longer duration of hospitalization, and worse medication adherence on social metacognition. CONCLUSIONS We discuss possible mechanisms underlying the apparent association between social metacognition and working memory. Adherence should be monitored when remediating social metacognition, and psychoeducation should be given to patients with a high level of awareness of their capacity to mentalize.
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Affiliation(s)
- Paul Roux
- Fondation Fondamental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay, France; Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, INSERM UMR1018, 94807 Villejuif, France.
| | - Nathan Faivre
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | - Mathieu Urbach
- Fondation Fondamental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay, France; Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, INSERM UMR1018, 94807 Villejuif, France
| | - Bruno Aouizerate
- Fondation Fondamental, Créteil, France; Department of Adult Psychiatry, Charles Perrens Hospital, F-33076 Bordeaux, France; Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), University of Bordeaux, France
| | - Lore Brunel
- Fondation Fondamental, Créteil, France; INSERM U955, Translational Psychiatry Team, AP-HP Mondor University Hospital, DHU Pe-PSY, Schizophrenia Expert Center, 40 rue de Mesly, 94000 Creteil, France
| | - Delphine Capdevielle
- Fondation Fondamental, Créteil, France; University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France; INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; University of Montpellier, Montpellier, France
| | - Isabelle Chereau
- Fondation Fondamental, Créteil, France; CHU Clermont-Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Caroline Dubertret
- Fondation Fondamental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Inserm UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris Descartes University, France; Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, France
| | - Julien Dubreucq
- Fondation Fondamental, Créteil, France; Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Guillaume Fond
- Fondation Fondamental, Créteil, France; La Conception Hospital, AP-HM, Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Christophe Lançon
- Fondation Fondamental, Créteil, France; Ste Marguerite Hospital, AP-HM, Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Sylvain Leignier
- Fondation Fondamental, Créteil, France; Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Jasmina Mallet
- Fondation Fondamental, Créteil, France; University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France
| | - David Misdrahi
- Fondation Fondamental, Créteil, France; Department of Adult Psychiatry, Charles Perrens Hospital, F-33076 Bordeaux, France; University of Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Sylvie Pires
- Fondation Fondamental, Créteil, France; CHU Clermont-Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Priscille Schneider
- Fondation Fondamental, Créteil, France; University Hospital of Strasbourg, Department of Psychiatry, University of Strasbourg, Strasbourg, France; Inserm U1114, Strasbourg, France
| | - Franck Schurhoff
- Fondation Fondamental, Créteil, France; INSERM U955, Translational Psychiatry Team, AP-HP Mondor University Hospital, DHU Pe-PSY, Schizophrenia Expert Center, 40 rue de Mesly, 94000 Creteil, France
| | - Hanan Yazbek
- Fondation Fondamental, Créteil, France; University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France; INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; University of Montpellier, Montpellier, France
| | - Anna Zinetti-Bertschy
- Fondation Fondamental, Créteil, France; University Hospital of Strasbourg, Department of Psychiatry, University of Strasbourg, Strasbourg, France; Inserm U1114, Strasbourg, France
| | - Christine Passerieux
- Fondation Fondamental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay, France; Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, INSERM UMR1018, 94807 Villejuif, France
| | - Eric Brunet-Gouet
- Fondation Fondamental, Créteil, France; Centre Hospitalier de Versailles, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Le Chesnay, France; Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, DisAP-DevPsy-CESP, INSERM UMR1018, 94807 Villejuif, France
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Chauvin V, Villarino RTH, Bernard P, Yazbek H, Kern L, Hokayem M, Mattar L, Kotbagi G, Rizk M, Morvan Y, Baillot A, Romain AJ. Impacts of social restrictions on mental health and health behaviours of individuals with multimorbidity during Covid-19 pandemic. J Multimorb Comorb 2023; 13:26335565231221609. [PMID: 38106621 PMCID: PMC10725145 DOI: 10.1177/26335565231221609] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 11/29/2023] [Indexed: 12/19/2023]
Abstract
Background Social restrictions and their possible impact on lifestyle make people with multimorbidity (≥2 co-existing chronic conditions) more vulnerable to poor perceived mental health and health behaviours modifications during the COVID-19 pandemic. Objective To understand the mental health status and health behaviour modifications among individuals with multimorbidity during different levels of COVID-19 social restrictions. Methods Longitudinal multinational cohort study consisting of two online questionnaires with its first wave taken place while social restrictions were imposed (May 2020), and its second wave with less social restrictions in place (November 2020). Including 559 participants (wave 1) and 147 participants from wave 1 (wave 2) with an average age of 34.30±12.35 and 36.21±13.07 years old. Mostly females living in Canada, France, India and Lebanon. Results The prevalence of multimorbidity was 27.68% (wave 1) and 35.37% (wave 2). While social restrictions were imposed, people with multimorbidity were 2 to 3 times more likely to experience psychological distress, depressive symptoms, increased stress or isolation than those without multimorbidity. Health behaviours were also modified during this period with people with multimorbidity being more likely to reduce their physical activity and increased their fruit and vegetable consumption. In wave 2, regardless of multimorbidity status, sexual desire continuously decreased while stress and psychological distress increased. Conclusion Mental health and health behaviours modifications occurred while social restrictions were imposed and people with multimorbidity were more severely impacted than those without multimorbidity, indicating a need for a more adapted approach of care during socially restrictive periods for this population.
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Affiliation(s)
- Valérie Chauvin
- Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
| | | | - Paquito Bernard
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- Université du Québec à Montréal, Montréal, QC, Canada
| | - Hanan Yazbek
- Centre local de services communautaires, Montréal, QC, Canada
| | | | - Marie Hokayem
- Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | | | | | - Melissa Rizk
- Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | | | - Aurélie Baillot
- Université du Québec en Outaouais, Gatineau, QC, Canada
- Institut du Savoir Monfort, Ottawa, ON, Canada
| | - Ahmed Jérôme Romain
- Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
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Brunet-Gouet E, Decaix-Tisserand C, Urbach M, Bazin N, Aouizerate B, Brunel L, Capdevielle D, Chereau I, Dubertret C, Dubreucq J, Fond G, Lançon C, Leignier S, Mallet J, Misdrahi D, Pires S, Schneider P, Schurhoff F, Yazbek H, Zinetti-Bertschy A, Passerieux C, Roux P. Outcome prediction with a social cognitive battery: a multicenter longitudinal study. NPJ Schizophr 2021; 7:30. [PMID: 34039999 PMCID: PMC8155046 DOI: 10.1038/s41537-021-00160-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/29/2021] [Indexed: 11/08/2022]
Abstract
The interest in social cognition in schizophrenia is justified by the relationship between deficits in these skills and negative functional outcomes. Although assessment batteries have already been described, there is no consensus about which measures are useful in predicting patient functioning or quality of life (QoL). We investigated a set of five measures of recognition of facial emotions, theory of mind (ToM), and empathy in a cohort of 143 patients with schizophrenia or schizoaffective disorder at inclusion and, amongst whom 79 were reassessed 1 year later. The distribution was satisfactory for the TREF (Facial Emotion Recognition Task), V-SIR (Versailles-Situational Intention Reading), and QCAE (Questionnaire of Cognitive and Affective Empathy). Internal consistency was satisfactory for the TREF, V-SIR, V-Comics (Versailles Intention Attribution Task), and QCAE. Sensitivity to change was acceptable for the TREF. The TREF and V-SIR showed a cross-sectional relationship with functioning beyond the clinical symptoms of schizophrenia but not beyond neurocognition. Moreover, the TREF and V-SIR at inclusion could not predict functioning one year later, whereas most neurocognitive and clinical dimensions at inclusion could. Finally, only affective QCAE showed a significant cross-sectional, but not longitudinal, association with QoL. In conclusion, the TREF had satisfactory psychometric properties and showed a cross-sectional, but not longitudinal, association with objective outcome measures, thus appearing to be reliable in clinical practice and research. The V-SIR also showed promising psychometric properties, despite a possible weakness to detect change. However, these measures should be interpreted within the context of the good predictive power of the neurocognitive and clinical status on the outcome.
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Affiliation(s)
- Eric Brunet-Gouet
- FondaMental Foundation, Créteil, France.
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France.
| | - Capucine Decaix-Tisserand
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
| | - Mathieu Urbach
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
| | - Nadine Bazin
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
| | - Bruno Aouizerate
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
- Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), University of Bordeaux, Bordeaux, France
| | - Lore Brunel
- FondaMental Foundation, Créteil, France
- INSERM U955, Translational Psychiatry Team, Creteil, France
- Departement Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Federation Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), AP-HP, HU Henri Mondor, Creteil, France
| | - Delphine Capdevielle
- FondaMental Foundation, Créteil, France
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, Montpellier, France
- INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Isabelle Chereau
- FondaMental Foundation, Créteil, France
- CHU Clermont-Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Caroline Dubertret
- FondaMental Foundation, Créteil, France
- AP-HP; Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Inserm UMR1266, Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, Paris, France
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - Julien Dubreucq
- FondaMental Foundation, Créteil, France
- Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Guillaume Fond
- FondaMental Foundation, Créteil, France
- La Conception Hospital, AP-HM, Aix-Marseille Univ., School of Medicine-La Timone Medical Campus, EA 3279: CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - Christophe Lançon
- FondaMental Foundation, Créteil, France
- Ste Marguerite Hospital, AP-HM, Aix-Marseille Univ., School of Medicine-La Timone Medical Campus, EA 3279: CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - Sylvain Leignier
- FondaMental Foundation, Créteil, France
- Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Jasmina Mallet
- FondaMental Foundation, Créteil, France
- AP-HP; Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Inserm UMR1266, Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, Paris, France
- Sorbonne Paris Cité, Faculté de Médecine, Université Paris Diderot, Paris, France
| | - David Misdrahi
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
| | - Sylvie Pires
- FondaMental Foundation, Créteil, France
- CHU Clermont-Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Priscille Schneider
- FondaMental Foundation, Créteil, France
- Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
- Inserm U1114, Strasbourg, France
| | - Franck Schurhoff
- FondaMental Foundation, Créteil, France
- INSERM U955, Translational Psychiatry Team, Creteil, France
- Departement Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Federation Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), AP-HP, HU Henri Mondor, Creteil, France
| | - Hanan Yazbek
- FondaMental Foundation, Créteil, France
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, Montpellier, France
- INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Anna Zinetti-Bertschy
- FondaMental Foundation, Créteil, France
- Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
- Inserm U1114, Strasbourg, France
| | - Christine Passerieux
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
| | - Paul Roux
- FondaMental Foundation, Créteil, France
- Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France
- DisAP, DevPsy, CESP, Inserm 1018, University Paris Saclay, INSERM, Villejuif, France
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Brunet-Gouet E, Urbach M, Ramos V, Ehrminger M, Aouizerate B, Brunel L, Capdevielle D, Chereau I, Dubertret C, Dubreucq J, Fond G, Lançon C, Leignier S, Mallet J, Misdrahi D, Pires S, Schneider P, Schürhoff F, Yazbek H, Zinetti-Bertschy A, Bazin N, Passerieux C, Roux P. Assessing metacognitive and help-seeking strategies in schizophrenia: design and psychometric validation of the Versailles Metacognitive Strategies Evaluation Questionnaire. Clin Rehabil 2019; 34:263-275. [PMID: 31795759 DOI: 10.1177/0269215519888784] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study is to design a questionnaire, the Versailles Metacognitive Strategies Evaluation Questionnaire, for assessing the use of metacognitive and help-seeking strategies in three key-domains of impaired daily functioning in schizophrenia. To evaluate its psychometric properties (internal consistency, factor structure, convergent and divergent validity, and stability). DESIGN Development of a questionnaire and psychometric validation procedure in patients with schizophrenia compared with healthy controls. Stability over one year was assessed in the patient group. SETTING Schizophrenia Centers of Expertise (French FondaMental Network). SUBJECTS A total of 141 patients with schizophrenia, among whom 77 participated in the second evaluation; 97 healthy subjects. MAIN MEASURES The Versailles Metacognitive Strategies Evaluation Questionnaire, Positive and Negative Symptoms Scale, Personal and Social Performance Scale, Evaluation of Cognitive Processes involved in Disability in Schizophrenia Scale, Schizophrenia Quality of Life Questionnaire, and Stages of Recovery Instrument. RESULTS From the 36-items version, stepwise exploratory factor analysis (oblimin) produced a 25-items scale which had a 3-factors structure (hygiene concern, social relationships, and hygiene help-seeking). Cronbach's were respectively equal to 0.91, 0.82, and 0.78. One-year stability was good (intra-class correlation coefficient = 0.7). The three factors showed good convergent validity with measures of quality of life (rho = 0.34, P ⩽ 0.001). The first two factors correlated with recovery (N = 34, rho = 0.53, P ⩽ 0.001). On the contrary, the factors exhibited divergent validity, with no significant correlation, with symptoms and cognitive and psychosocial functioning (P > 0.05). Factor structure in healthy controls did not match with that of patients, all items but one were found significantly different among groups. CONCLUSION The Versailles Metacognitive Strategies Evaluation Questionnaire provides a simple and valid means to assess metacognitive strategies in individuals with schizophrenia.
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Affiliation(s)
- Eric Brunet-Gouet
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Mathieu Urbach
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Veronica Ramos
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Mickael Ehrminger
- HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France.,University of Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Lore Brunel
- Fondation FondaMental, Créteil, France.,Translational Psychiatry Team, INSERM U955, Creteil, France.,AP-HP Mondor University Hospital, DHU Pe-PSY, Schizophrenia Expert Center, Creteil, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France.,Inserm U1061, Service Universitaire de Psychiatrie adulte, Hôpital la Colombière, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Isabelle Chereau
- Fondation FondaMental, Créteil, France.,CHU Clermont-Ferrand, Service de psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France.,Inserm U894, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, Paris, France
| | - Julien Dubreucq
- Fondation FondaMental, Créteil, France.,Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Guillaume Fond
- Fondation FondaMental, Créteil, France.,Hopital de la conception, AMU CEReSS u 3729, Marseille, France
| | - Christophe Lançon
- Fondation FondaMental, Créteil, France.,Hopital Sainte-Marguerite, Marseille, France
| | - Sylvain Leignier
- Fondation FondaMental, Créteil, France.,Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France.,Inserm U894, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, Paris, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France.,University of Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Sylvie Pires
- Fondation FondaMental, Créteil, France.,CHU Clermont-Ferrand, Service de psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Priscille Schneider
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France.,University of Strasbourg, Strasbourg, France.,Inserm U1114, Strasbourg, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France.,Translational Psychiatry Team, INSERM U955, Creteil, France.,AP-HP Mondor University Hospital, DHU Pe-PSY, Schizophrenia Expert Center, Creteil, France
| | - Hanan Yazbek
- Fondation FondaMental, Créteil, France.,Inserm U1061, Service Universitaire de Psychiatrie adulte, Hôpital la Colombière, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Anna Zinetti-Bertschy
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France.,University of Strasbourg, Strasbourg, France.,Inserm U1114, Strasbourg, France
| | - Nadine Bazin
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Paul Roux
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
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Raffard S, Bortolon C, Yazbek H, Lançon C, Benoit M, Norton J, Capdevielle D. The cognitive, affective motivational and clinical longitudinal determinants of apathy in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2019; 269:911-920. [PMID: 29948250 DOI: 10.1007/s00406-018-0907-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 01/10/2018] [Accepted: 05/22/2018] [Indexed: 11/28/2022]
Abstract
Apathy is a frequent and debilitating condition with few treatment options available in schizophrenia patients. Despite evidence of its multidimensional structure, most of past studies have explored apathy through a categorical approach. The main objective of this study was to identify the cognitive, emotional, motivational, and clinical factors at baseline that best predicted the three subtypes of apathy dimensions at follow-up. In a longitudinal study, 137 participants diagnosed with schizophrenia underwent different assessments including clinical, motivational, affective and cognitive measurements, at 1-month (referred to as baseline) and 12-month follow-ups. Data were analyzed using partial least squares variance-based structural equation modeling. Three latent variables representing the three previously described domains of apathy reaching consensus in the literature were extracted from the Lille Apathy Rating Scale. Results showed that in addition to baseline apathy, positive symptoms, anticipatory pleasure and sensibility to punishment at baseline predicted cognitive apathy at follow-up. Likewise, both baseline apathy and sensibility to punishment predicted emotional apathy at follow-up. Finally, baseline anhedonia and episodic memory were the main variables the predicted behavioral apathy at follow-up. This is the first study to show specific associations between apathy subtypes and clinical and cognitive motivational dysfunction in individual with schizophrenia, indicating possible distinct underlying mechanisms to these demotivational symptoms. Treatment for apathy should address both types of processes. Importantly, our results demonstrate the interest of multidimensional approaches in the understanding of apathy in schizophrenia.
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Affiliation(s)
- Stéphane Raffard
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHU Montpellier, Montpellier, France. .,Epsylon Laboratory EA 4556, Université Paul Valéry Montpellier 3, Université Montpellier, Montpellier, France.
| | - Catherine Bortolon
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHU Montpellier, Montpellier, France.,Epsylon Laboratory EA 4556, Université Paul Valéry Montpellier 3, Université Montpellier, Montpellier, France
| | - Hanan Yazbek
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHU Montpellier, Montpellier, France.,Epsylon Laboratory EA 4556, Université Paul Valéry Montpellier 3, Université Montpellier, Montpellier, France
| | - Christophe Lançon
- Aix-Marseille Univ., EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, 13005, Marseille, France
| | - Michel Benoit
- Psychiatry-Clinical Neuroscience Department, Pasteur Hospital, University of Nice Sophia-Antipolis, Nice, France
| | - Joanna Norton
- INSERM U1061, Montpellier, France.,University of Montpellier, Montpellier, France
| | - Delphine Capdevielle
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHU Montpellier, Montpellier, France.,INSERM U1061, Montpellier, France.,University of Montpellier, Montpellier, France
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6
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Bortolon C, Yazbek H, Norton J, Capdevielle D, Raffard S. The contribution of optimism and hallucinations to grandiose delusions in individuals with schizophrenia. Schizophr Res 2019; 210:203-206. [PMID: 30639163 DOI: 10.1016/j.schres.2018.12.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 06/29/2018] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 01/08/2023]
Abstract
Grandiose delusions (GDs) are defined as false beliefs about having an inflated worth, power, or a special identity which are firmly sustained despite undeniable evidence to the contrary. Although it is the second most commonly encountered delusional beliefs, GDs have received little attention. Thus, in this study, we explored the role of future expectations and sensitivity to reward in GDs in schizophrenia (SZ) disorder. In total, 115 SZ patients completed measures of positive and negative symptoms, sensitivity to reward, depression, and a task in which individuals were asked to estimate the probability that positive, negative and neutral events will occur in the future. Correlation and Linear Regression analyses were performed in order to determine whether sensitivity to reward and future expectations are associated with GDs. Regressions showed that hallucinations and future positive expectations were significantly associated with GDs. In conclusion, the present study showed that higher optimism regarding the future might be important psychological processes associated with the maintenance of GDs in SZ patients. Moreover, it is possible that patients experiencing hallucinations may interpret this phenomenon as a kind of special ability or power, resulting in turn in GDs maintenance. Implications of these findings and directions for future research are discussed.
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Affiliation(s)
- Catherine Bortolon
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France; Université Grenoble Alpes - Laboratoire Inter-universitaire de Psychologie: Personnalité, Cognition et Changement Social, Grenoble, France.
| | - Hanan Yazbek
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France
| | - Joanna Norton
- INSERM U1061, Montpellier, France; University of Montpellier, Montpellier, France
| | - Delphine Capdevielle
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France; INSERM U1061, Montpellier, France; University of Montpellier, Montpellier, France
| | - Stéphane Raffard
- University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France; Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, F34000, Montpellier, France
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7
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Brunet-Gouet E, Myszkowski N, Ehrminger M, Urbach M, Aouizerate B, Brunel L, Capdevielle D, Chereau I, Dubertret C, Dubreucq J, Fond G, Lançon C, Leignier S, Mallet J, Misdrahi D, Pires S, Schneider P, Schurhoff F, Yazbek H, Zinetti-Bertschy A, Bazin N, Passerieux C, Zenasni F, Roux P. Confirmation of a Two-Factor Solution to the Questionnaire of Cognitive and Affective Empathy in a French Population of Patients With Schizophrenia Spectrum Disorders. Front Psychiatry 2019; 10:751. [PMID: 31708814 PMCID: PMC6823714 DOI: 10.3389/fpsyt.2019.00751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/18/2019] [Indexed: 11/13/2022] Open
Abstract
The Questionnaire of Cognitive and Affective Empathy (QCAE) is a tool for self-assessing the cognitive and emotional components of empathy. A study showed that a two-factor model fits the data of patients with schizophrenia, whereas other reports on healthy subjects have suggested a five-factor decomposition. We aimed to replicate the model of Horan et al. in a French population with schizophrenia spectrum disorders (i.e., schizophrenia and schizoaffective disorders) participating in the EVACO Study (NCT02901015). In total, 133 patients were assessed with the QCAE, the Positive and Negative Symptom Scale (PANSS), the Personal and Social Performance Scale (PSP), and the Self rating Quality of Life Scale (S-QoL). The two-factor model demonstrated an adequate fit with the data, comparable to that reported by Horan et al. Males scored higher on the Affective subscore than females. After correction for multiple tests, psychopathology (PANSS) and functioning (PSP) did not correlate significantly with the QCAE subscores. However, quality of life (S-QoL) correlated positively with the Emotional Contagion subscore. Thus, the variability of empathetic disposition in schizophrenia may be considered through the cognitive versus affective dichotomy and properly investigated with the QCAE. The results support further investigation of the relationship between QCAE scores and subjective outcome measurements, such as quality of life, and emphasize the importance of cross-cultural comparisons.
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Affiliation(s)
- Eric Brunet-Gouet
- FondaMental Foundation, Créteil, France.,Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Nils Myszkowski
- Department of Psychology, Pace University, New York, NY, United States.,Laboratoire Adaptations Travail-Individu, Université Paris Descartes, Université Sorbonne Paris Cité, Boulogne-Billancourt, France
| | - Mickael Ehrminger
- HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Mathieu Urbach
- FondaMental Foundation, Créteil, France.,Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Bruno Aouizerate
- FondaMental Foundation, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, F-33076 Bordeaux, France; Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), University of Bordeaux, France
| | - Lore Brunel
- FondaMental Foundation, Créteil, France.,INSERM U955, Translational Psychiatry Team; AP-HP Mondor University Hospital, DHU Pe-PSY, Schizophrenia Expert Center, Creteil, France
| | - Delphine Capdevielle
- FondaMental Foundation, Créteil, France.,University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France; INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; University of Montpellier, Montpellier, France
| | - Isabelle Chereau
- FondaMental Foundation, Créteil, France.,CHU Clermont-Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Caroline Dubertret
- FondaMental Foundation, Créteil, France.,AP-HP; Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Inserm UMR1266, Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, France; Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, France
| | - Julien Dubreucq
- FondaMental Foundation, Créteil, France.,Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Guillaume Fond
- FondaMental Foundation, Créteil, France.,La Conception Hospital, AP-HM, Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Christophe Lançon
- FondaMental Foundation, Créteil, France.,Ste Marguerite Hospital, AP-HM, Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - Sylvain Leignier
- FondaMental Foundation, Créteil, France.,Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Jasmina Mallet
- FondaMental Foundation, Créteil, France.,University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France; INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; University of Montpellier, Montpellier, France
| | - David Misdrahi
- FondaMental Foundation, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, F-33076 Bordeaux; University of Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Sylvie Pires
- FondaMental Foundation, Créteil, France.,CHU Clermont-Ferrand, Service de Psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Priscille Schneider
- FondaMental Foundation, Créteil, France.,University Hospital of Strasbourg, Department of Psychiatry, Strasbourg, France; University of Strasbourg, Strasbourg, France; Inserm U1114, Strasbourg, France
| | - Franck Schurhoff
- FondaMental Foundation, Créteil, France.,INSERM U955, Translational Psychiatry Team; AP-HP Mondor University Hospital, DHU Pe-PSY, Schizophrenia Expert Center, Creteil, France
| | - Hanan Yazbek
- FondaMental Foundation, Créteil, France.,University Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, France; INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; University of Montpellier, Montpellier, France
| | - Anna Zinetti-Bertschy
- FondaMental Foundation, Créteil, France.,University Hospital of Strasbourg, Department of Psychiatry, Strasbourg, France; University of Strasbourg, Strasbourg, France; Inserm U1114, Strasbourg, France
| | - Nadine Bazin
- FondaMental Foundation, Créteil, France.,Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Christine Passerieux
- FondaMental Foundation, Créteil, France.,Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Franck Zenasni
- Laboratoire Adaptations Travail-Individu, Université Paris Descartes, Université Sorbonne Paris Cité, Boulogne-Billancourt, France
| | - Paul Roux
- HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France.,Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,FondaMental Foundation, Créteil, France
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8
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Roux P, Urbach M, Fonteneau S, Berna F, Brunel L, Capdevielle D, Chereau I, Dubreucq J, Faget-Agius C, Fond G, Leignier S, Perier CC, Richieri R, Schneider P, Schürhoff F, Tronche AM, Yazbek H, Zinetti-Bertschy A, Passerieux C, Brunet-Gouet E. Psychiatric disability as mediator of the neurocognition-functioning link in schizophrenia spectrum disorders: SEM analysis using the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale. Schizophr Res 2018; 201:196-203. [PMID: 29941294 DOI: 10.1016/j.schres.2018.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 01/23/2018] [Revised: 06/05/2018] [Accepted: 06/09/2018] [Indexed: 11/17/2022]
Abstract
The functional outcome in schizophrenia spectrum disorders is affected by multiple factors such as cognitive performance and clinical symptoms. Psychiatric disability may be another important determinant of functional outcome. The purpose of this study was to test whether schizophrenia symptoms and psychiatric disability mediated the association between cognition and functioning. Between April 2013 and July 2017, we included 108 community-dwelling adults with stable schizophrenia spectrum disorder in a multicenter study. Psychiatric disability was assessed with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale by relatives of patients. ECPDS focused on the broad array of motivational, neurocognitive, sociocognitive, and metacognitive impairments that result in activity restrictions. We used a battery of tests to assess seven cognition domains (processing speed, attention/vigilance, working, verbal and visual memory, reasoning and problem solving, and executive functioning) and cross-sectional structural equation modeling (SEM) for the mediation analyses. We estimated the one-year temporal stability of ECPDS scores in 45 participants. The model provided showed good fit and explained 43.9% of the variance in functioning. The effect of neurocognition on functioning was fully mediated by symptoms (proportion mediated: 36.5%) and psychiatric disability (proportion mediated: 31.3%). The ECPDS score had acceptable one-year temporal stability. The ECPDS scale has satisfactory psychometric properties, and shows significant convergence with neurocognition and functioning, suggesting a role for this tool in the routine evaluation of cognitive remediation needs. Our model validates psychiatric disability as a crucial step from cognitive impairment to restricted participation in life situations.
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Affiliation(s)
- Paul Roux
- Fondation FondaMental, Créteil, France; Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France; HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France.
| | - Mathieu Urbach
- Fondation FondaMental, Créteil, France; Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France; HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Sandrine Fonteneau
- Fondation FondaMental, Créteil, France; Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France; HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Fabrice Berna
- Fondation FondaMental, Créteil, France; Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, Strasbourg, France
| | - Lore Brunel
- Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry team, Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY, Department of Adult Psychiatry, University Hospitals H Mondor, Créteil, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France; Academic Department of Adult Psychiatry, La Colombière Hospital, CHU Montpellier, University of Montpellier 1, INSERM 1061, Montpellier, France
| | - Isabelle Chereau
- Fondation FondaMental, Créteil, France; CMP B, Clermont-Ferrand University Hospital, EA 7280, Faculty of Medicine, Auvergne University, Clermont-Ferrand, France
| | - Julien Dubreucq
- Fondation FondaMental, Créteil, France; Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Catherine Faget-Agius
- Fondation FondaMental, Créteil, France; Academic Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | | | - Sylvain Leignier
- Fondation FondaMental, Créteil, France; Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Claire-Cécile Perier
- Fondation FondaMental, Créteil, France; Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Raphaëlle Richieri
- Fondation FondaMental, Créteil, France; Academic Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | - Priscille Schneider
- Fondation FondaMental, Créteil, France; Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, Strasbourg, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry team, Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY, Department of Adult Psychiatry, University Hospitals H Mondor, Créteil, France
| | - Anne-Marie Tronche
- Fondation FondaMental, Créteil, France; CMP B, Clermont-Ferrand University Hospital, EA 7280, Faculty of Medicine, Auvergne University, Clermont-Ferrand, France
| | - Hanan Yazbek
- Fondation FondaMental, Créteil, France; Academic Department of Adult Psychiatry, La Colombière Hospital, CHU Montpellier, University of Montpellier 1, INSERM 1061, Montpellier, France
| | - Anna Zinetti-Bertschy
- Fondation FondaMental, Créteil, France; Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, Strasbourg, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France; Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France; HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Eric Brunet-Gouet
- Fondation FondaMental, Créteil, France; Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France; HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
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9
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Roux P, Urbach M, Fonteneau S, Berna F, Brunel L, Capdevielle D, Chereau I, Dubreucq J, Faget-Agius C, Fond G, Leignier S, Perier CC, Richieri R, Schneider P, Schürhoff F, Tronche AM, Yazbek H, Zinetti-Bertschy A, Passerieux C, Brunet-Gouet E. Screening for cognitive deficits with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale. Clin Rehabil 2018; 33:113-119. [PMID: 30012064 DOI: 10.1177/0269215518787324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE: This study aimed to evaluate the validity of the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale (ECPDS) to discriminate for cognitive impairment in schizophrenia. DESIGN: This multicentre cross-sectional study used a validation design with receiver operating characteristic (ROC) curve analysis. SETTINGS: The study was undertaken in a French network of seven outward referral centres. SUBJECTS: We recruited individuals with clinically stable schizophrenia diagnosed based on the Structured Clinical Interview for assessing Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; DSM-IV-R) criteria. MAIN MEASURES: The index test for cognitive impairment was ECPDS (independent variable), a 13-item scale completed by a relative of the participant. The reference standard was a standardized test battery that evaluated seven cognitive domains. Cognitive impairment was the dependent variable and was defined as an average z-score more than 1 SD below the normative mean in two or more cognitive domains. RESULTS: Overall, 97 patients were included (67 with schizophrenia, 28 with schizoaffective disorder, and 2 with schizophreniform disorder). The mean age was 30.2 (SD 7.7) years, and there were 75 men (77.3%). There were 59 (60.8%) patients with cognitive impairment on the neuropsychological battery, and the mean ECPDS score was 27.3 (SD 7.3). The ROC curve analysis showed that the optimal ECPDS cut-off was 29.5. The area under the curve was 0.77, with 76.3% specificity and 71.1% sensitivity to discriminate against cognitive impairment. CONCLUSION: The ECPDS is a valid triage tool for detecting cognitive impairment in schizophrenia, before using an extensive neuropsychological battery, and holds promise for use in everyday clinical practice.
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Affiliation(s)
- Paul Roux
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Mathieu Urbach
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Sandrine Fonteneau
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Fabrice Berna
- 1 Fondation FondaMental, Créteil, France.,4 Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, University of Strasbourg, Strasbourg, France
| | - Lore Brunel
- 1 Fondation FondaMental, Créteil, France.,5 INSERM U955, Translational Psychiatry Team, Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY, Department of Adult Psychiatry, Henri Mondor University Hospitals, Créteil, France
| | - Delphine Capdevielle
- 1 Fondation FondaMental, Créteil, France.,6 University Department of Adult Psychiatry, La Colombière Hospital, CHU Montpellier, University of Montpellier 1, INSERM 1061, Montpellier, France
| | - Isabelle Chereau
- 1 Fondation FondaMental, Créteil, France.,7 CMP B, Clermont-Ferrand University Hospital, EA 7280, Faculty of Medicine, Auvergne University, Clermont-Ferrand Cedex 1, France
| | - Julien Dubreucq
- 1 Fondation FondaMental, Créteil, France.,8 Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Catherine Faget-Agius
- 1 Fondation FondaMental, Créteil, France.,9 Academic Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | | | - Sylvain Leignier
- 1 Fondation FondaMental, Créteil, France.,8 Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Claire-Cécile Perier
- 1 Fondation FondaMental, Créteil, France.,8 Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Raphaëlle Richieri
- 1 Fondation FondaMental, Créteil, France.,9 Academic Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | - Priscille Schneider
- 1 Fondation FondaMental, Créteil, France.,4 Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, University of Strasbourg, Strasbourg, France
| | - Franck Schürhoff
- 1 Fondation FondaMental, Créteil, France.,5 INSERM U955, Translational Psychiatry Team, Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY, Department of Adult Psychiatry, Henri Mondor University Hospitals, Créteil, France
| | - Anne Marie Tronche
- 1 Fondation FondaMental, Créteil, France.,7 CMP B, Clermont-Ferrand University Hospital, EA 7280, Faculty of Medicine, Auvergne University, Clermont-Ferrand Cedex 1, France
| | - Hanan Yazbek
- 1 Fondation FondaMental, Créteil, France.,6 University Department of Adult Psychiatry, La Colombière Hospital, CHU Montpellier, University of Montpellier 1, INSERM 1061, Montpellier, France
| | - Anna Zinetti-Bertschy
- 1 Fondation FondaMental, Créteil, France.,4 Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, University of Strasbourg, Strasbourg, France
| | | | - Christine Passerieux
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Eric Brunet-Gouet
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
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10
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Fond G, Boyer L, Leboyer M, Godin O, Llorca PM, Andrianarisoa M, Berna F, Brunel L, Aouizerate B, Capdevielle D, Chereau I, D'Amato T, Dubertret C, Dubreucq J, Faget C, Gabayet F, Mallet J, Misdrahi D, Rey R, Lancon C, Passerieux C, Roux P, Vidailhet P, Yazbek H, Schürhoff F, Bulzacka E, Aouizerate B, Berna F, Blanc O, Brunel L, Bulzacka E, Capdevielle D, Chereau-Boudet I, Chesnoy-Servanin G, Danion J, D'Amato T, Deloge A, Delorme C, Denizot H, Dorey J, Dubertret C, Dubreucq J, Faget C, Fluttaz C, Fond G, Fonteneau S, Gabayet F, Giraud-Baro E, Hardy-Bayle M, Lacelle D, Lançon C, Laouamri H, Leboyer M, Le Gloahec T, Le Strat Y, Llorca, Mallet J, Metairie E, Misdrahi D, Offerlin-Meyer I, Passerieux C, Peri P, Pires S, Portalier C, Rey R, Roman C, Sebilleau M, Schandrin A, Schurhoff F, Tessier A, Tronche A, Urbach M, Vaillant F, Vehier A, Vidailhet P, Vilà E, Yazbek H, Zinetti-Bertschy A. Influence of Venus and Mars in the cognitive sky of schizophrenia. Results from the first-step national FACE-SZ cohort. Schizophr Res 2018; 195:357-365. [PMID: 28974404 DOI: 10.1016/j.schres.2017.09.027] [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: 03/25/2017] [Revised: 09/20/2017] [Accepted: 09/21/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Sex differences can yield important clues regarding illness pathophysiology and its treatment. Schizophrenia (SZ) has a lower incidence rate, and a better prognosis, in women versus men. The present study investigated the cognitive profiles of both sexes in a large multi-centre sample of community-dwelling SZ patients. METHOD 544 community-dwelling stable SZ subjects (141 women and 403 men; mean age 34.5±12.1 and 31.6±8.7years, respectively) were tested with a comprehensive battery of neuropsychological tests. RESULTS Although community-dwelling SZ men had more risk factors for impaired cognition (including first-generation antipsychotics administration and comorbid addictive disorders), women had lower scores on a wide range of cognitive functions, including current and premorbid intellectual functioning, working memory, semantic memory, non-verbal abstract thinking and aspects of visual exploration. However, women scored higher in tests of processing speed and verbal learning, as well as having a lower verbal learning bias. No sex difference were evident for visuospatial learning abilities, cued verbal recall, sustained attention and tests of executive functions, including cognitive flexibility, verbal abstract thinking, verbal fluency and planning abilities. CONCLUSION Sex differences are evident in the cognitive profiles of SZ patients. The impact on daily functioning and prognosis, as well as longitudinal trajectory, should be further investigated in the FACE-SZ follow-up study. Sex differences in cognition have implications for precision-medicine determined therapeutic strategies. LIMITS Given the restricted age range of the sample, future research will have to determine cognitive profiles across gender in late onset SZ.
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Affiliation(s)
- G Fond
- Fondation FondaMental, Créteil, France.
| | - L Boyer
- Fondation FondaMental, Créteil, France; Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, F-13274 Marseille cedex 09, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
| | - O Godin
- Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - M Andrianarisoa
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
| | - F Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - L Brunel
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est BP 300 39 - 95 bd Pinel, 69678 Bron Cedex, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France
| | - F Gabayet
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - J Mallet
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; CNRS UMR 5287-INCIA, France
| | - R Rey
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est BP 300 39 - 95 bd Pinel, 69678 Bron Cedex, France
| | - C Lancon
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Roux
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Vidailhet
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - H Yazbek
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, 1061, Montpellier, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
| | - E Bulzacka
- Fondation FondaMental, Créteil, France; INSERM U955, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Translational Psychiatry Team, Créteil, France
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11
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Fond G, Berna F, Boyer L, Godin O, Brunel L, Andrianarisoa M, Aouizerate B, Capdevielle D, Chereau I, Danion JM, Dubertret C, Dubreucq J, Faget C, Gabayet F, Le Gloahec T, Llorca PM, Mallet J, Misdrahi D, Rey R, Richieri R, Passerieux C, Portalier C, Roux P, Vehier A, Yazbek H, Schürhoff F, Bulzacka E. Benzodiazepine long-term administration is associated with impaired attention/working memory in schizophrenia: results from the national multicentre FACE-SZ data set. Eur Arch Psychiatry Clin Neurosci 2018; 268:17-26. [PMID: 28349247 DOI: 10.1007/s00406-017-0787-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 06/04/2016] [Accepted: 03/13/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The effect of benzodiazepine long-term administration (BLTA) in cognitive functioning of subjects with schizophrenia (SZ) has been partially explored to date. The objective was to assess BLTA-associated cognitive impairment with a comprehensive cognitive battery in a non-selected multicentric/national community-dwelling sample of stabilized SZ subjects. METHOD 407 community-dwelling stabilized SZ subjects were consecutively included in the FondaMental Academic Centers of Expertise for Schizophrenia Cohort (FACE-SZ). Patients taking daily benzodiazepine were defined as BLTA+ as all patients examined by the Expert Center were clinically stabilized and under stable dose of treatment for at least 3 months. Each patient has been administered a 1-day long comprehensive cognitive battery (including The National Adult Reading Test, the Wechsler Adult Intelligence Scale, the Trail Making Test, the California Verbal Learning Test, the Doors test, and The Continuous Performance Test-Identical Pairs). RESULTS In the multivariate analyses, results showed that BLTA was associated with impaired attention/working memory (OR 0.60, 95% confidence interval 0.42-0.86; p = 0.005) independently of socio-demographic variables and illness characteristics. Verbal and performance current IQ-[respectively, OR 0.98, 95% CI (0.96;0.99), p = 0.016 and 0.98, 95% CI(0.97;0.99), p = 0.034] but not premorbid IQ-(p > 0.05) have been associated with BLTA in a multivariate model including the same confounding variables. CONCLUSION BLTA is associated with impaired attention/working memory in schizophrenia. The BLTA benefit/risk ratio should be regularly reevaluated. Alternative pharmacological and non-pharmacological strategies for comorbid anxiety disorders and sleep disorders should be preferred when possible. It seems reasonable to withdraw BLTA before the start of cognitive remediation therapy, as soon as possible, to improve the effectiveness of this therapy. Limits: the delay between the last benzodiazepine intake and testing, as well as the specific class of benzodiazepines (long half-life vs. short half-life), and the number of benzodiazepine daily intakes have not been recorded in the present study. The precise motive for BLTA prescription and sleep disturbances have not been reported, which is a limit for the interpretation of the present results.
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Affiliation(s)
- Guillaume Fond
- Fondation FondaMental, Créteil, France. .,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France. .,Clinique Jeanne d'arc-Hôpital Privé Parisien, 55 rue du commandant Mouchotte, 94160, Saint-Mandé, France. .,CHU Carémeau, 30000, Nîmes, France.
| | - F Berna
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - L Boyer
- Fondation FondaMental, Créteil, France.,Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, 13274, Marseille cedex 09, France
| | - O Godin
- Fondation FondaMental, Créteil, France.,Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France
| | - L Brunel
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
| | - M Andrianarisoa
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, Université de Bordeaux, 33076, Bordeaux, France.,Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, 33000, Bordeaux, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - J M Danion
- Fondation FondaMental, Créteil, France.,Hôpitaux Universitaires de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Inserm U894, Sorbonne Paris Cité, Faculté de médecine, Louis Mourier Hospital, Université Paris Diderot, Colombes, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - F Gabayet
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - T Le Gloahec
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France
| | - J Mallet
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Inserm U894, Sorbonne Paris Cité, Faculté de médecine, Louis Mourier Hospital, Université Paris Diderot, Colombes, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, Université de Bordeaux, 33076, Bordeaux, France.,CNRS UMR 5287-INCIA, Bordeaux, France
| | - R Rey
- Fondation FondaMental, Créteil, France.,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est, 95 bd Pinel, BP 300 39, 69678, BRON Cedex, France
| | - R Richieri
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France.,Service de Psychiatrie d'Adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - C Portalier
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Inserm U894, Sorbonne Paris Cité, Faculté de médecine, Louis Mourier Hospital, Université Paris Diderot, Colombes, France
| | - P Roux
- Fondation FondaMental, Créteil, France.,Service de Psychiatrie d'Adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - A Vehier
- Fondation FondaMental, Créteil, France.,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est, 95 bd Pinel, BP 300 39, 69678, BRON Cedex, France
| | - H Yazbek
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
| | - E Bulzacka
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor,, Paris Est University, 40 rue de Mesly, 94000, Créteil, France
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12
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Bulzacka E, Boyer L, Schürhoff F, Godin O, Berna F, Brunel L, Andrianarisoa M, Aouizerate B, Capdevielle D, Chéreau-Boudet I, Chesnoy-Servanin G, Danion JM, Dubertret C, Dubreucq J, Faget C, Gabayet F, Le Gloahec T, Llorca PM, Mallet J, Misdrahi D, Rey R, Richieri R, Passerieux C, Roux P, Yazbek H, Leboyer M, Fond G. Chronic Peripheral Inflammation is Associated With Cognitive Impairment in Schizophrenia: Results From the Multicentric FACE-SZ Dataset. Schizophr Bull 2016; 42:1290-302. [PMID: 27143795 PMCID: PMC4988740 DOI: 10.1093/schbul/sbw029] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [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: 12/13/2022]
Abstract
OBJECTIVES Inflammation, measured by abnormal blood C-reactive protein (CRP) level, has been described in schizophrenia (SZ), being inconsistently related to impaired cognitive functions. The aim of the present study is to investigate cognitive impairment associated with abnormal CRP levels in a large multi-centric sample of community-dwelling SZ patients, using a comprehensive neuropsychological battery. METHOD Three hundred sixty-nine community-dwelling stable SZ subjects (76.2% men, mean age 32.7 y) were included and tested with a comprehensive battery of neuropsychological tests. Abnormal CRP level was defined as >3mg/L. RESULTS Multiple factor analysis revealed that abnormal CRP levels, found in 104 patients (28.2%), were associated with impaired General Intellectual Ability and Abstract Reasoning (aOR = 0.56, 95% CI 0.35-0.90, P = .014), independently of age, sex, education level, psychotic symptomatology, treatments, and addiction comorbidities. Abnormal CRP levels were also associated with the decline of all components of working memory (respectively effect size [ES] = 0.25, P = .033; ES = 0.27, P = .04; ES = 0.33, P = .006; and ES = 0.38, P = .004) and a wide range of other impaired cognitive functions, including memory (ES = 0.26, P = .026), learning abilities (ES = 0.28, P = .035), semantic memory (ES = 0.26, P = .026), mental flexibility (ES = 0.26, P = .044), visual attention (ES = 0.23, P = .004) and speed of processing (ES = 0.23, P = .043). CONCLUSION Our results suggest that abnormal CRP level is associated with cognitive impairment in SZ. Evaluating the effectiveness of neuroprotective anti-inflammatory strategies is needed in order to prevent cognitive impairment in SZ.
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Affiliation(s)
- Ewa Bulzacka
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Laurent Boyer
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Pôle psychiatrie universitaire, CHU Sainte-Marguerite, F-13274 Marseille cedex 09, France
| | - Franck Schürhoff
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,CMP B, CHU, EA 7280 Faculté de Médecine, Université d’Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - Ophélia Godin
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F-75013, Paris, France, INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - Fabrice Berna
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Lore Brunel
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Méja Andrianarisoa
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Bruno Aouizerate
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France;,Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France
| | - Delphine Capdevielle
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chéreau-Boudet
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,CMP B, CHU, EA 7280 Faculté de Médecine, Université d’Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - Gabrielle Chesnoy-Servanin
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39—95 bd Pinel—69678 BRON Cedex, France
| | - Jean-Marie Danion
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Caroline Dubertret
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - Julien Dubreucq
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Catherine Faget
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Franck Gabayet
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Tifenn Le Gloahec
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,CMP B, CHU, EA 7280 Faculté de Médecine, Université d’Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - Jasmina Mallet
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - David Misdrahi
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France;,CNRS UMR 5287 - Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Bordeaux, France
| | - Romain Rey
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39—95 bd Pinel—69678 BRON Cedex, France
| | - Raphaëlle Richieri
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Christine Passerieux
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Service de psychiatrie d’adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Paul Roux
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Service de psychiatrie d’adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Hanan Yazbek
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Marion Leboyer
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Guillaume Fond
- Fondation FondaMental, RTRS santé mentale, Créteil, France; INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France;
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13
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Raffard S, Gutierrez LA, Yazbek H, Larue A, Boulenger JP, Lançon C, Benoit M, Faget C, Norton J, Capdevielle D. Working Memory Deficit as a Risk Factor for Severe Apathy in Schizophrenia: A 1-Year Longitudinal Study. Schizophr Bull 2016; 42:642-51. [PMID: 26834026 PMCID: PMC4838112 DOI: 10.1093/schbul/sbw002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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] [Indexed: 11/13/2022]
Abstract
Apathy, described as impaired motivation and goal-directed behavior, is a common yet often overlooked multidimensional psychopathological state in schizophrenia. Its underlying cognitive processes remain largely unexplored. Data was drawn from a longitudinal hospital study of patients with a DSM-IV diagnosis of schizophrenia; 137 (82.5%) participated at the 1-month follow-up and 81 (59.1%) at the 1-year follow-up. Apathy was assessed with the Lille Apathy Rating Scale, validated in French and in schizophrenia. Severe apathy, overall (total score > -13) and on 4 previously identified distinct dimensions, was considered. Episodic verbal learning was assessed with the California Verbal Learning Test, executive functioning with the Trail Making Test, the Six Element Test and the Stop Signal Paradigm and working memory with the Letter-Number Sequencing Test. After controlling for confounding variables, only episodic verbal learning was associated with severe overall apathy in the cross-sectional study. At 1 year, working memory was associated with an increased risk of severe overall apathy, adjusting for baseline apathy. Using a dimensional approach to apathy, specific types of cognition were found to be associated with specific dimensions of apathy. Our findings confirm the need for a multidimensional approach of negative symptoms in schizophrenia. Moreover, cognitive functioning could be a risk factor for developing severe apathy. Cognitive remediation may thus be a useful non-pharmacological intervention for treating apathy in schizophrenia patients.
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Affiliation(s)
- Stéphane Raffard
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHRU Montpellier, Montpellier, France; Epsylon Laboratory Dynamic of Human Abilities & Health Behaviors, University of Montpellier 3, Montpellier, France;
| | - Laure-Anne Gutierrez
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHRU Montpellier, Montpellier, France; U1061: Neuropsychiatry: Epidemiological and Clinical Research, INSERM U1061, Montpellier, France; U1061: Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France
| | - Hanan Yazbek
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHRU Montpellier, Montpellier, France; Epsylon Laboratory Dynamic of Human Abilities & Health Behaviors, University of Montpellier 3, Montpellier, France
| | - Aurore Larue
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHRU Montpellier, Montpellier, France
| | - Jean-Philippe Boulenger
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHRU Montpellier, Montpellier, France
| | - Christophe Lançon
- Aix-Marseille University, EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, Marseille, France
| | - Michel Benoit
- Psychiatry-Clinical Neuroscience Department, Pasteur Hospital, University of Nice Sophia-Antipolis, Nice, France
| | - Catherine Faget
- Aix-Marseille University, EA 3279-Public Health, Chronic Diseases and Quality of Life-Research Unit, Marseille, France
| | - Joanna Norton
- U1061: Neuropsychiatry: Epidemiological and Clinical Research, INSERM U1061, Montpellier, France; U1061: Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France
| | - Delphine Capdevielle
- University Department of Adult Psychiatry, Hôpital de la Colombière, CHRU Montpellier, Montpellier, France; U1061: Neuropsychiatry: Epidemiological and Clinical Research, INSERM U1061, Montpellier, France; U1061: Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, Montpellier, France
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14
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Roux P, Urbach M, Fonteneau S, Aouizerate B, Berna F, Brunel L, Capdevielle D, Chereau I, Danion J, Dorey J, Dubertret C, Dubreucq J, Faget C, Gabayet F, Llorca P, Mallet J, Misdrahi D, Rey R, Richieri R, Schürhoff F, Yazbek H, Passerieux C, Brunet-Gouet E. The EVACO Project: A new battery for assessing social cognition disorders and related psychiatric disability in schizophrenia. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The relation of social cognitive disorders and schizophrenic symptoms are well-established. Yet, assessment methods have not reached a consensus. In addition, causal paths between neurocognition, social cognition, symptoms and functional expression are not clearly understood. During the past few years, some authoritative accounts proposed specialized batteries of tests and emphasized theory of mind, emotion recognition, and interpretation bias constructs:– NIMH's “Social cognition psychometric evaluation” battery (Pinkham AE, Penn DL, Green MF, Harvey PD. Schizophrenia Bulletin, 2015);– “Social cognition and functioning in schizophrenia” (Green MF, Lee J, Ochsner KN. Schizophrenia Bulletin, 2013).Interestingly, these accounts stemming either from expert consensus and psychometric considerations or from neuroscience knowledge recognized some difficulties in providing a fully usable set of instruments. The project described here (EVACO protocol, funded by the Programme Hospitalier de Recherche Clinique national) follows an alternative approach and aims at providing a psychometrically validated battery. Based on a cognitive neuropsychology view on schizophrenic functional disability, several tests were gathered and are assessed in a 12-months multi-center follow-up of 160 individuals with schizophrenia. The FondaMental foundation network of Expert Centers is involved in recruiting patients from eight centers (Clermont-Ferrand, Colombes, Créteil, Grenoble, Marseille, Montpellier, Strasbourg, Versailles). To-date, the first evaluation of the population has been achieved. Experience reports and inclusions follow-up demonstrate the good acceptability of this battery both on the patients and the evaluator's side. We emphasize the usefulness of this project to meet the clinicians’ needs of validated social cognition tools, by describing different scenarios of use.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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15
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Berna F, Misdrahi D, Boyer L, Aouizerate B, Brunel L, Capdevielle D, Chereau I, Danion JM, Dorey JM, Dubertret C, Dubreucq J, Faget C, Gabayet F, Lancon C, Mallet J, Rey R, Passerieux C, Schandrin A, Schurhoff F, Tronche AM, Urbach M, Vidailhet P, Llorca PM, Fond G, Berna F, Blanc O, Brunel L, Bulzacka E, Capdevielle D, Chereau-Boudet I, Chesnoy-Servanin G, Danion J, D'Amato T, Deloge A, Delorme C, Denizot H, De Pradier M, Dorey J, Dubertret C, Dubreucq J, Faget C, Fluttaz C, Fond G, Fonteneau S, Gabayet F, Giraud-Baro E, Hardy-Bayle M, Lacelle D, Lançon C, Laouamri H, Leboyer M, Le Gloahec T, Le Strat Y, Llorca P, Mallet J, Metairie E, Misdrahi D, Offerlin-Meyer I, Passerieux C, Peri P, Pires S, Portalier C, Rey R, Roman C, Sebilleau M, Schandrin A, Schurhoff F, Tessier A, Tronche A, Urbach M, Vaillant F, Vehier A, Vidailhet P, Vilain J, Vilà E, Yazbek H, Zinetti-Bertschy A. Akathisia: prevalence and risk factors in a community-dwelling sample of patients with schizophrenia. Results from the FACE-SZ dataset. Schizophr Res 2015; 169:255-261. [PMID: 26589388 DOI: 10.1016/j.schres.2015.10.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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: 04/20/2015] [Revised: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 11/16/2022]
Abstract
The main objective of this study was to determine the prevalence of akathisia in a community-dwelling sample of patients with schizophrenia, and to determine the effects of treatments and the clinical variables associated with akathisia. 372 patients with schizophrenia or schizoaffective disorder were systematically included in the network of FondaMental Expert Center for Schizophrenia and assessed with validated scales. Akathisia was measured with the Barnes Akathisia Scale (BAS). Ongoing psychotropic treatment was recorded. The global prevalence of akathisia (as defined by a score of 2 or more on the global akathisia subscale of the BAS) in our sample was 18.5%. Patients who received antipsychotic polytherapy were at higher risk of akathisia and this result remained significant (adjusted odd ratio=2.04, p=.025) after controlling the influence of age, gender, level of education, level of psychotic symptoms, substance use comorbidities, current administration of antidepressant, anticholinergic drugs, benzodiazepines, and daily-administered antipsychotic dose. The combination of second-generation antipsychotics was associated with a 3-fold risk of akathisia compared to second-generation antipsychotics used in monotherapy. Our results indicate that antipsychotic polytherapy should be at best avoided and suggest that monotherapy should be recommended in cases of akathisia. Long-term administration of benzodiazepines or anticholinergic drugs does not seem to be advisable in cases of akathisia, given the potential side effects of these medications.
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Affiliation(s)
- F Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France.
| | - D Misdrahi
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France; Université de Bordeaux; CNRS UMR 5287-INCIA
| | - L Boyer
- Fondation FondaMental, Créteil, France; Pôle psychiatrie universitaire, CHU Sainte-Marguerite, F-13274, Marseille cedex 09, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France; Université de Bordeaux; Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France
| | - L Brunel
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - J M Danion
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - J M Dorey
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39 - 95 bd Pinel - 69678 BRON Cedex, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - F Gabayet
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Lancon
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - J Mallet
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - R Rey
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39 - 95 bd Pinel - 69678 BRON Cedex, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - A Schandrin
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - F Schurhoff
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - A M Tronche
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - M Urbach
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Vidailhet
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - G Fond
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
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16
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Godin O, Leboyer M, Gaman A, Aouizerate B, Berna F, Brunel L, Capdevielle D, Chereau I, Dorey JM, Dubertret C, Dubreucq J, Faget C, Gabayet F, Le Strat Y, Llorca PM, Misdrahi D, Rey R, Richieri R, Passerieux C, Schandrin A, Schürhoff F, Urbach M, Vidalhet P, Girerd N, Fond G, Berna F, Blanc O, Brunel L, Bulzacka E, Capdevielle D, Chereau-Boudet I, Chesnoy-Servanin G, Danion J, D'Amato T, Deloge A, Delorme C, Denizot H, Depradier M, Dorey J, Dubertret C, Dubreucq J, Faget C, Fluttaz C, Fond G, Fonteneau S, Gabayet F, Giraud-Baro E, Hardy-Bayle M, Lacelle D, Lançon C, Laouamri H, Leboyer M, Le Gloahec T, Le Strat Y, Llorca P, Metairie E, Misdrahi D, Offerlin-Meyer I, Passerieux C, Peri P, Pires S, Portalier C, Rey R, Roman C, Sebilleau M, Schandrin A, Schürhoff F, Tessier A, Tronche A, Urbach M, Vaillant F, Vehier A, Vidailhet P, Vilà E, Yazbek H, Zinetti-Bertschy A. Metabolic syndrome, abdominal obesity and hyperuricemia in schizophrenia: Results from the FACE-SZ cohort. Schizophr Res 2015; 168:388-94. [PMID: 26255568 DOI: 10.1016/j.schres.2015.07.047] [Citation(s) in RCA: 47] [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: 03/07/2015] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Abdominal obesity was suggested to be a better predictor than Metabolic Syndrome (MetS) for cardiovascular mortality, however this is has not been extensively studied in schizophrenia. Hyperuricemia (HU) was also suggested to be both an independent risk factor for greater somatic comorbidity and a global metabolic stress marker in patients with schizophrenia. The aim of this study was to estimate the prevalence of MetS, abdominal obesity and HU, to examine the association between metabolic parameters with HU in a cohort of French patients with schizophrenia or schizo-affective disorder (SZ), and to estimate the prevalence rates of treatment of cardio-vascular risk factors. METHOD 240 SZ patients (age=31.4years, male gender 74.3%) were systematically included. Metabolic syndrome was defined according to the International Diabetes Federation and HU if serum uric acid level was above 360μmol/L. RESULTS MetS, abdominal obesity and HU were found respectively in 24.2%, 21.3% and 19.6% of patients. In terms of risk factors, multiple logistic regression showed that after taking into account the potential confounders, the risk for HU was higher in males (OR=5.9, IC95 [1.7-21.4]) and in subjects with high waist circumference (OR=3.1, IC95 [1.1-8.3]) or hypertriglyceridemia (OR=4.9, IC95 [1.9-13]). No association with hypertension, low HDL cholesterol or high fasting glucose was observed. Only 10% of patients with hypertension received a specific treatment, 18% for high fasting glucose and 8% for dyslipidemia. CONCLUSIONS The prevalence of MetS, abdominal obesity and hyperuricemia is elevated in French patients with schizophrenia, all of which are considerably under-diagnosed and undertreated. HU is strongly associated with abdominal obesity but not with psychiatric symptomatology.
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Affiliation(s)
- O Godin
- Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Génétique et psychopathologie, DHU Pe-PSY, Université Paris Est-Créteil, Créteil, France
| | - A Gaman
- Fondation FondaMental, Créteil, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France; Université de Bordeaux, France; Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France
| | - F Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - L Brunel
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Génétique et psychopathologie, DHU Pe-PSY, Université Paris Est-Créteil, Créteil, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - J M Dorey
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est BP 300 39-95 bd Pinel-69678 BRON Cedex, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle Universitaire de Psychiatrie, Marseille, France
| | - F Gabayet
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Y Le Strat
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France; Université de Bordeaux, France; CNRS UMR 5287-INCIA, France
| | - R Rey
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est BP 300 39-95 bd Pinel-69678 BRON Cedex, France
| | - R Richieri
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle Universitaire de Psychiatrie, Marseille, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - A Schandrin
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Génétique et psychopathologie, DHU Pe-PSY, Université Paris Est-Créteil, Créteil, France
| | - M Urbach
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Vidalhet
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - N Girerd
- Inserm, centre d'investigations cliniques 9501 & U1116, université de Lorraine, Institut Lorrain du cœur et des vaisseaux Louis-Mathieu, CHU de Nancy, 4, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - G Fond
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Génétique et psychopathologie, DHU Pe-PSY, Université Paris Est-Créteil, Créteil, France.
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Bortolon C, Larøi F, Stephan Y, Capdevielle D, Yazbek H, Boulenger JP, Gely-Nargeot MC, Raffard S. Further insight into the role of metacognitive beliefs in schizophrenia and OCD patients: testing a mediation model. Psychiatry Res 2014; 220:698-701. [PMID: 25150921 DOI: 10.1016/j.psychres.2014.07.081] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 02/05/2014] [Revised: 07/26/2014] [Accepted: 07/31/2014] [Indexed: 11/28/2022]
Abstract
This study explored the mediation effect of metacognitive beliefs on the relationship between intrusive thoughts and emotional distress in schizophrenia (N=49) and obsessive-compulsive disorder (OCD) (N=35). Intrusive thoughts impact on anxiety and depression through beliefs about uncontrollability and danger of thoughts in schizophrenia. Negative beliefs in general mediated the effect of intrusive thoughts on anxiety in obsessive-compulsive disorder. The results suggest that metacognitive beliefs may be a vulnerability factor for emotional and psychological disorder.
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Affiliation(s)
- Catherine Bortolon
- Epsylon Laboratory, EA 4556, Montpellier, France; University Department of Adult Psychiatry, CHU Montpellier, 39 Avenue Charles Flahault, 34295 Montpellier Cedex 5, France.
| | - Frank Larøi
- Department of Psychology, FAPSE, University of Liège, 4000 Liège, Belgium
| | | | - Delphine Capdevielle
- University Department of Adult Psychiatry, CHU Montpellier, 39 Avenue Charles Flahault, 34295 Montpellier Cedex 5, France; French National Institute of Health and Medical Research (INSERM), U1061Pathologies of the Nervous System: Epidemiological and Clinical Research, La Colombiere Hospital, 34093 Montpellier Cedex 5, France
| | - Hanan Yazbek
- University Department of Adult Psychiatry, CHU Montpellier, 39 Avenue Charles Flahault, 34295 Montpellier Cedex 5, France
| | - Jean-Philippe Boulenger
- University Department of Adult Psychiatry, CHU Montpellier, 39 Avenue Charles Flahault, 34295 Montpellier Cedex 5, France; French National Institute of Health and Medical Research (INSERM), U1061Pathologies of the Nervous System: Epidemiological and Clinical Research, La Colombiere Hospital, 34093 Montpellier Cedex 5, France
| | | | - Stéphane Raffard
- Epsylon Laboratory, EA 4556, Montpellier, France; University Department of Adult Psychiatry, CHU Montpellier, 39 Avenue Charles Flahault, 34295 Montpellier Cedex 5, France
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Yazbek H, Norton J, Capdevielle D, Larue A, Boulenger JP, Gély-Nargeot MC, Raffard S. The Lille Apathy Rating Scale (LARS): exploring its psychometric properties in schizophrenia. Schizophr Res 2014; 157:278-84. [PMID: 24875172 DOI: 10.1016/j.schres.2014.04.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 10/21/2013] [Revised: 03/28/2014] [Accepted: 04/22/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Apathy in schizophrenia patients is linked to marked functional impairments and can be defined as a quantitative reduction of voluntary, goal-directed behaviors. If there are now convincing arguments to consider apathy as a multidimensional psychopathological state (cognitive, emotional, and behavioral), there is a lack of validated and standardized instruments for detecting apathy and assessing its multidimensional aspects in schizophrenia. The Lille Apathy Rating Scale (LARS) is a semi-structured interview, yielding a global score and composite subscores for the different domains of apathy and has been validated in several different contexts but not in schizophrenia patients. OBJECTIVE The aim of this study is to examine the psychometric properties of the LARS and identify the distinct components of apathy in a sample of schizophrenia patients. METHODS One hundred-and-twelve schizophrenia patients were included and they completed the LARS, The Calgary Depression Scale in Schizophrenia, the Positive and the Negative Syndrome Scale and the Scale for the Assessment of Negative Symptoms. The patient group was compared to 51 healthy control subjects. RESULTS Principal component analysis showed that the LARS proved a single construct which forms the root of an oblique factor structure reflecting four dimensions: novelty and social life, behavioral involvement, emotional involvement, and judgment skills. The main psychometric properties of the LARS were satisfactory. CONCLUSIONS Our findings show that the LARS has satisfactory psychometric properties when used in a different setting than the original version. The LARS is a promising instrument to examine apathy in schizophrenia through a multidimensional framework.
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Affiliation(s)
- Hanan Yazbek
- Epsylon EA 4556 Laboratory of Dynamics of Human Abilities & Health Behaviors, University of Montpellier, France; University Department of Adult Psychiatry, Hospital La Colombière, CHRU Montpellier, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France.
| | - Joanna Norton
- University Department of Adult Psychiatry, Hospital La Colombière, CHRU Montpellier, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France
| | - Delphine Capdevielle
- INSERM U-1061, France; University Department of Adult Psychiatry, Hospital La Colombière, CHRU Montpellier, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France
| | - Aurore Larue
- University Department of Adult Psychiatry, Hospital La Colombière, CHRU Montpellier, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France
| | - Jean-Philippe Boulenger
- INSERM U-1061, France; University Department of Adult Psychiatry, Hospital La Colombière, CHRU Montpellier, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France
| | | | - Stéphane Raffard
- Epsylon EA 4556 Laboratory of Dynamics of Human Abilities & Health Behaviors, University of Montpellier, France; University Department of Adult Psychiatry, Hospital La Colombière, CHRU Montpellier, 39 avenue Charles Flahault, 34295 Montpellier Cedex 5, France
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Larue A, Yazbek H, Raffard S, Norton J, Boulenger JP, Capdevielle D. Existe-t-il une association entre Motivation et Apathie dans la Schizophrénie ? Eur Psychiatry 2013. [DOI: 10.1016/j.eurpsy.2013.09.134] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Les symptômes négatifs dans la schizophrénie, le plus souvent chroniques et prédictifs du fonctionnement actuel et futur des patients, restent actuellement difficiles à traiter tant sur le plan médicamenteux que psychothérapique. Or, il s’agit d’un groupe de symptômes vaste et hétérogène qu’il est difficile d’étudier dans son ensemble. C’est pourquoi, nous avons choisi de nous intéresser à l’un d’entre eux : l’apathie à la fois symptôme cardinal dans les descriptions précoces de la schizophrénie et symptôme transnosographique. Dans la schizophrénie, il est également admis qu’il existe des troubles de la motivation qui entrent dans la description des symptômes négatifs. Les données de la littérature suggèrent qu’il existerait uniquement sur un plan conceptuel un lien entre motivation et apathie. L’objectif principal de cette étude transversale est de rechercher s’il existe une association entre motivation et apathie chez des patients souffrant de schizophrénie. Soixante-quinze patients hospitalisés ayant un diagnostic de schizophrénie selon les critères du DSM IV, âgés de 18 à 60 ans ont été inclus. Les critères de jugement principaux sont :– l’Apathie évaluée par deux échelles dont la « Lille Apathy Rating Scale » (LARS) ;– la Motivation explorée par la BIRT Motivation Questionnaire (BMQ), par une échelle de sensibilité à la punition et à la récompense et par une tâche d’apprentissage par renforcement.Les résultats montrent que les patients apathiques sont significativement moins motivés et plus sensibles à la punition que les patients non apathiques, et présentent une corrélation positive significative entre les scores obtenus à la LARS et à la BIRT (p < 0,001). Il existe donc une association entre motivation et apathie chez des patients souffrant de schizophrénie montrant que plus les patients sont apathiques, moins ils sont motivés. Une meilleure compréhension de cette symptomatologie négative doit permettre le développement de stratégies thérapeutiques spécifiques.
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Yazbek H, Raffard S, Del-Monte J, Pupier F, Larue A, Boulenger JP, Gély-Nargeot MC, Capdevielle D. [The clinic of apathy in schizophrenia: a critical review of the issue]. Encephale 2013; 40:231-9. [PMID: 23958346 DOI: 10.1016/j.encep.2013.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 05/13/2013] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Today the concept of apathy is subject to many questions. This psychological state is present and predominant in different disorders such as neurodegenerative and psychiatric diseases or neurological acquired disorders. Apathy is a part of the clinical vocabulary, however, we can note that in the literature there remains confusion in its definition, and we can find an amalgam with other clinical symptoms. OBJECTIVES The aim of this review is to provide a clarification of the concept of apathy in clinical practice in schizophrenia as well as to highlight the gaps that exist. LITERATURE FINDINGS Apathy belongs to the negative symptoms of schizophrenia. For its understanding, it is necessary to define apathy as a multidimensional syndrome (cognitive, emotional, and behavioral) manifesting as a quantitative reduction of voluntary behaviors directed toward one or several goals. However, at present, we are witnessing a reductionist and simplistic conception of the syndrome of apathy and this especially in the Anglo-Saxon literature. Several authors reduce apathy to its behavioral component, so in other words, to avolition/amotivation. Avolition refers to a loss of self-initiated and spontaneous behaviors. In this definition only observable behavior is taken into account and not the underlying mechanisms (cognitive and emotional). In order to understand the syndrome of apathy, it is necessary to have a holistic and multidimensional outlook. Some authors have proposed diagnostic criteria for apathy by taking into account the different dimensions of apathy. Moreover not only is apathy confused with avolition, but it is also still difficult to distinguish it from depression. Apathy and depression share common clinical signs (i.e. loss of interest), but they also have distinct clinical signs (lack of motivation for apathy, and suicidal ideation for depression). Authors have shown that the presence of one symptom (apathy or depression) does not predict the presence of the other. An apathetic patient does not have to be necessarily in a depressive state and vice versa. However, to our knowledge, there is no data capable of distinguishing depression from apathy in schizophrenia, and knowing what is the part of one and the other when the patient has both symptoms. In addition, we can see that the confusion that persists between those two symptoms also stems from assessment tools. Indeed, some assessment tools such as the Montgomery and Asberg Depression Rating Scale (MARDS) have an apathy subscale. Therefore, this scale does not only evaluate depression. Regarding the assessment of apathy in schizophrenia, there are specific and nonspecific tools. Nonspecific tools define apathy differently. For this reason, authors have proposed to measure apathy by using analytic factors of negative symptoms. In this case, apathy is going to be assessed by the factor "motivation/pleasure" including anhedonia, asociality and avolition. This factor will provide the possibility of a better assessment of apathy. Concerning specific scales (like AES), there are gaps such as a lack of standardization in the execution and the quotation. Furthermore, no scale takes into account the factors causing apathy. CONCLUSION Knowing the reasons for apathy is necessary because this syndrome is frequent in schizophrenia, and it is found in the different phases of this disease (prodromal, first episode psychosis, and chronic). In addition, apathy has significant functional consequences on the patient's quality of life, as well as on his or her global functioning. Indeed, apathy impacts on his or her social and professional life. Patients with schizophrenia have a loss of autonomy, less employment and social withdrawal. Consequently, interest in its drug or treatment it is obvious. However, drug and non-drug treatments are not specific to apathy and therefore little effective on this syndrome. Implications to stimulate future research are presented.
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Affiliation(s)
- H Yazbek
- EA4556 dynamique des capacités humaines et des conduites de santé, UFR médecine, psychologie, STAPS, laboratoire Epsylon, université Montpellier-I, Montpellier III, 34000 Saint-Étienne, France; Service universitaire de psychiatrie adulte, hôpital de la Colombière, centre hospitalier universitaire de Montpellier, 39, avenue Charles-Flahault, 34295 Montpellier cedex 5, France.
| | - S Raffard
- EA4556 dynamique des capacités humaines et des conduites de santé, UFR médecine, psychologie, STAPS, laboratoire Epsylon, université Montpellier-I, Montpellier III, 34000 Saint-Étienne, France; Service universitaire de psychiatrie adulte, hôpital de la Colombière, centre hospitalier universitaire de Montpellier, 39, avenue Charles-Flahault, 34295 Montpellier cedex 5, France
| | - J Del-Monte
- EA4556 dynamique des capacités humaines et des conduites de santé, UFR médecine, psychologie, STAPS, laboratoire Epsylon, université Montpellier-I, Montpellier III, 34000 Saint-Étienne, France
| | - F Pupier
- Service universitaire de psychiatrie adulte, hôpital de la Colombière, centre hospitalier universitaire de Montpellier, 39, avenue Charles-Flahault, 34295 Montpellier cedex 5, France
| | - A Larue
- Service universitaire de psychiatrie adulte, hôpital de la Colombière, centre hospitalier universitaire de Montpellier, 39, avenue Charles-Flahault, 34295 Montpellier cedex 5, France
| | - J-P Boulenger
- Inserm U-1061, 34000 Montpellier, France; Service universitaire de psychiatrie adulte, hôpital de la Colombière, centre hospitalier universitaire de Montpellier, 39, avenue Charles-Flahault, 34295 Montpellier cedex 5, France
| | - M-C Gély-Nargeot
- EA4556 dynamique des capacités humaines et des conduites de santé, UFR médecine, psychologie, STAPS, laboratoire Epsylon, université Montpellier-I, Montpellier III, 34000 Saint-Étienne, France
| | - D Capdevielle
- Inserm U-1061, 34000 Montpellier, France; Service universitaire de psychiatrie adulte, hôpital de la Colombière, centre hospitalier universitaire de Montpellier, 39, avenue Charles-Flahault, 34295 Montpellier cedex 5, France
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Del-Monte J, Capdevielle D, Gély-Nargeot MC, Yazbek H, Pupier F, Boulenger JP, Raffard S. Évolution du concept d’apathie : nécessité d’une approche multifactorielle dans la schizophrénie. Encephale 2013; 39 Suppl 1:S57-63. [DOI: 10.1016/j.encep.2012.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 08/27/2012] [Indexed: 11/16/2022]
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