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Kalisova L, Michalec J, Dechterenko F, Silhan P, Hyza M, Chlebovcova M, Brenova M, Bezdicek O. Impact of cognitive performance and negative symptoms on psychosocial functioning in Czech schizophrenia patients. Schizophrenia (Heidelb) 2023; 9:43. [PMID: 37460587 DOI: 10.1038/s41537-023-00374-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/05/2023] [Indexed: 07/20/2023]
Abstract
Schizophrenia has a profound influence on the real-life functioning of patients. There are several factors inherent to the disease course affecting the level of psychosocial functioning. Our study focused on the impact of cognitive deficit and severity of negative symptoms (i.e., the experiential domain (avolition, asociality, and anhedonia) and the expressive domain (blunted affect and alogia)) to explore psychosocial functioning in schizophrenia. Schizophrenia patients (n = 211) were tested for the presence of cognitive impairment using the NIMH-MATRICS: Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Cattery (MCCB; MATRICS Consensus Cognitive Battery) and the extent of negative symptoms using the PANSS (PANSS; Positive and Negative Syndrome Scale-selected items). The level of psychosocial functioning was measured with the Personal and Social Performance Scale (PSP). The path analysis using three regression models was used to analyse variables influencing psychosocial functioning (PSP). One of these models analyzed influence of cognitive functioning (MCCB) and negative schizophrenia symptoms (PANSS selected items reflecting expressive and experiential deficits) as predictors and NART/CRT and disease length as confounders. R2 was 0.54. The direct effect of the MCCB (β = 0.09) on the PSP was suppressed by the strong effect of the negative symptoms (β = -0.64). The presence of cognitive deficits and negative symptoms in our sample of schizophrenia patients significantly influences the level of their psychosocial functioning, a key factor in remission and recovery.
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Affiliation(s)
- L Kalisova
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - J Michalec
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic.
| | - F Dechterenko
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | - P Silhan
- Department of Psychiatry, Faculty Hospital, Ostrava, Czech Republic
| | - M Hyza
- Department of Psychiatry, Faculty Hospital, Ostrava, Czech Republic
| | - M Chlebovcova
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - M Brenova
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - O Bezdicek
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
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Hebel T, Langguth B, Schecklmann M, Schoisswohl S, Staudinger S, Schiller A, Ustohal L, Sverak T, Horky M, Kasparek T, Skront T, Hyza M, Poeppl T, Riester M, Schwemmer L, Zimmermann S, Sakreida K. Rationale and study design of a trial to assess rTMS add-on value for the amelioration of negative symptoms of schizophrenia (RADOVAN). Contemp Clin Trials Commun 2022; 26:100891. [PMID: 35128142 PMCID: PMC8804178 DOI: 10.1016/j.conctc.2022.100891] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 11/21/2021] [Accepted: 01/17/2022] [Indexed: 12/16/2022] Open
Abstract
Background Methods Discussion Trial registration number Data dissemination
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Affiliation(s)
- T. Hebel
- Department of Psychiatry and Psychotherapy, Regensburg University Hospital, Universitätsstraße 84, 93053, Regensburg, Germany
- Corresponding author.
| | - B. Langguth
- Department of Psychiatry and Psychotherapy, Regensburg University Hospital, Universitätsstraße 84, 93053, Regensburg, Germany
| | - M. Schecklmann
- Department of Psychiatry and Psychotherapy, Regensburg University Hospital, Universitätsstraße 84, 93053, Regensburg, Germany
| | - S. Schoisswohl
- Department of Psychiatry and Psychotherapy, Regensburg University Hospital, Universitätsstraße 84, 93053, Regensburg, Germany
| | - S. Staudinger
- Department of Psychiatry and Psychotherapy, Regensburg University Hospital, Universitätsstraße 84, 93053, Regensburg, Germany
| | - A. Schiller
- Department of Psychiatry and Psychotherapy, Regensburg University Hospital, Universitätsstraße 84, 93053, Regensburg, Germany
| | - L. Ustohal
- Department of Psychiatry, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic
- Applied Neurosciences Research Group, Central European Institute of Technology, Masaryk University (CEITEC MU), Kamenice 753/5, 625 00, Brno, Czech Republic
| | - T. Sverak
- Department of Psychiatry, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic
| | - M. Horky
- Department of Psychiatry, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic
| | - T. Kasparek
- Department of Psychiatry, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic
| | - T. Skront
- Department of Psychiatry, University Hospital in Ostrava, 17. Listopadu 1790, 708 52, Ostrava, Czech Republic
| | - M. Hyza
- Department of Psychiatry, University Hospital in Ostrava, 17. Listopadu 1790, 708 52, Ostrava, Czech Republic
| | - T.B. Poeppl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52066, Aachen, Germany
| | - M.L. Riester
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52066, Aachen, Germany
| | - L. Schwemmer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52066, Aachen, Germany
| | - S. Zimmermann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52066, Aachen, Germany
| | - K. Sakreida
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52066, Aachen, Germany
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Michalec J, Bezdicek O, Nikolai T, Harsa P, Jech R, Silhan P, Hyza M, Ruzicka E, Shallice T. A Comparative Study of Tower of London Scoring Systems and Normative Data. Arch Clin Neuropsychol 2018; 32:328-338. [PMID: 28096070 DOI: 10.1093/arclin/acw111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 10/27/2015] [Accepted: 12/12/2016] [Indexed: 11/14/2022] Open
Abstract
Objective Tower of London (ToL) is a planning ability task that includes multiple versions. The original ToL was developed by Shallice together with two scoring systems (ToL-SS). Another two ToL-SS were proposed by Anderson et al. and Krikorian et al. The purpose of this study is to provide normative data for four ToL-SS and explore the effects of demographic variables on ToL performance. Furthermore, we aimed to determine the discriminative validity of these ToL-SS in clinical samples. Method Four groups were included in the study: a normative sample of healthy adults (HC; n = 298); patients with Parkinson's disease with mild cognitive impairment (PD-MCI; n = 52) and without cognitive impairment (PD-ND; n = 57); and patients with schizophrenia (SCH; n = 28). The effects of demographic variables on ToL-SS were examined in the HC group. Between-groups comparisons of ToL-SS were conducted using regression analysis with dummy codes. Results All four ToL-SS were not significantly affected by age, whereas the effect of gender and education is not consistent. ToL-SS significantly (p < .05) differentiate HC from PD-MCI and SCH. Cohen's effect size coefficients d range from 0.68 to 1.29. Internal consistency coefficients (Cronbach's α) of ToL-SS range from 0.33 to 0.60. Conclusions Despite poor to questionable internal consistency of ToL-SS, the discriminative validity and clinical utility for assessing planning deficits in PD-MCI and SCH are high. This study provides normative standards for all four ToL-SS on an adult population for use in clinical practice.
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Affiliation(s)
- Jiri Michalec
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Ondrej Bezdicek
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Tomas Nikolai
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Pavel Harsa
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Robert Jech
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Petr Silhan
- Department of Psychiatry, General University Hospital in Ostrava, Ostrava, Czech Republic
| | - Martin Hyza
- Department of Psychiatry, General University Hospital in Ostrava, Ostrava, Czech Republic
| | - Evzen Ruzicka
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Tim Shallice
- Institute of Cognitive Neuroscience, University College London, London, UK
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Silhan P, Urinovska R, Kacirova I, Hyza M, Grundmann M, Ceskova E. What Does Antidepressant Drug level Monitoring Reveal About Outpatient Treatment and Patient Adherence? Pharmacopsychiatry 2018; 52:78-83. [DOI: 10.1055/s-0044-101838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Introduction The evaluation of plasma levels of antidepressants may improve the treatment outcome. The aim was to verify adherence and adequacy of administered doses of antidepressants among patients hospitalized for inadequate outpatient therapeutic response.
Methods Selective serotonin reuptake inhibitors or venlafaxine plasma levels were assessed on the first day of hospitalization and after 3 days of controlled administration. The patients were considered adherent if the plasma level on admission was within the interval of the minimum and maximum plasma level on the fourth day, expanded by 30%. The adequacy of antidepressant doses used during the outpatient treatment was assessed by comparing the plasma level on the fourth day with the therapeutic reference range.
Results Out of 83 patients, 52 (62.7%) were adherent. The plasma levels of antidepressants on the fourth day were found to be within the therapeutic reference range in 35 (43.2%) patients. The same number manifested levels below the therapeutic reference range. In 11 (13.6%) patients, the levels were higher than recommended. No significant difference in rate of adherence was found among individual antidepressants.
Conclusion The results show that antidepressant nonresponders are frequently under-dosed or nonadherent.
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Affiliation(s)
- Petr Silhan
- Psychiatry, University Hospital Ostrava, Czech Republic
- Department of Neurology and Psychiatry, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Romana Urinovska
- Department of Clinical Pharmacology, Department of Laboratory Diagnostics, University Hospital Ostrava, Ostrava, Czech Republic
| | - Ivana Kacirova
- Department of Clinical Pharmacology, Department of Laboratory Diagnostics, University Hospital Ostrava, Ostrava, Czech Republic
- Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Martin Hyza
- Psychiatry, University Hospital Ostrava, Czech Republic
- Department of Neurology and Psychiatry, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Milan Grundmann
- Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Eva Ceskova
- Psychiatry, University Hospital Ostrava, Czech Republic
- Department of Neurology and Psychiatry, Faculty of Medicine, University of Ostrava, Czech Republic
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