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Journal Cover Schizophrenia Research : Cognition
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  This is an Open Access Journal Open Access journal
     ISSN (Print) 2215-0013
     Published by Elsevier Homepage  [2575 journals]
  • Consensus five factor PANSS for evaluation of clinical remission: effects
           on functioning and cognitive performances

    • Abstract: Publication date: December 2014
      Source:Schizophrenia Research: Cognition, Volume 1, Issue 4
      Author(s): Federica Pinna , Marta Bosia , Roberto Cavallaro , Bernardo Carpiniello
      Criteria developed by the Remission in Schizophrenia Working Group (RSWG), based upon 8 core symptoms of PANSS, are generally used for evaluation of Remission. However, some concerns have arisen as regard to the ability of the RSWG criteria to detect truly remitted cases. This study aims to compare the severity criteria of remission defined by the RSWG (RSWG-cr) with more restrictive criteria, based upon the use of PANSS factor model. Methods 112 chronic psychotic outpatients were examined. Symptomatic remission according to RSWGcr was compared with remission according to criteria based on the 20-items of PANSS considered in the consensus five factor model (PANSS-FCTcr), in relation to functional and neurocognitive outcomes. Results Data from the study demonstrated the superiority of PANSS-FCTcr in identifying patients with higher functional and cognitive outcomes. Conclusion PANSS-FCTcr seems to be suitable for use in both common clinical practice and research setting, being associated with improved identification of truly remitted patients.


      PubDate: 2014-12-11T08:24:11Z
       
  • The effect of cognitive training on evoked potentials in schizophrenia

    • Abstract: Publication date: December 2014
      Source:Schizophrenia Research: Cognition, Volume 1, Issue 4
      Author(s): Daniela Kariofillis , Gudrun Sartory , Christian Kärgel , Bernhard W. Müller
      Electrophysiological indices are sensitive to cognitive dysfunction in schizophrenia but have rarely been used to assess benefits of cognitive remediation. Our aim was to evaluate the effect of specific cognitive training approaches on event-related potentials. Forty-six patients with schizophrenia underwent either auditory (AUD) or visuo-spatial (VIS) cognitive training or treatment-as-usual (TAU). Cognitive training was computer-assisted and administered for 10 sessions within two weeks. Event-related potentials during an active odd-ball paradigm together with clinical and neuropsychological variables were assessed before and after training and again at a two-month follow-up. Compared to the TAU group both the AUD and VIS training groups showed decreased P2 latency following training. At follow-up, the P2-latency reduction was stable in the VIS group but the AUD group experienced a relapse. Training resulted in improved digit-span backward among neuropsychological variables. Increased P2 amplitude was related to more positive symptoms and lower social-occupational functioning and longer P2 latency was associated with greater severity of stereotyped thinking. The more general visuo-spatial training appears to have a longer-lasting effect on P2 latency than the specific auditory training. Alternatively, there may be specific auditory discrimination deficits in schizophrenia requiring more extensive training for a stable change.


      PubDate: 2014-12-11T08:24:11Z
       
  • Positive and negative subclinical symptoms and MCCB performance in
           non-psychiatric controls

    • Abstract: Publication date: December 2014
      Source:Schizophrenia Research: Cognition, Volume 1, Issue 4
      Author(s): Cole Korponay , George C. Nitzburg , Anil K. Malhotra , Pamela DeRosse
      Considerable data support the phenomenological and temporal continuity between subclinical psychosis and psychotic disorders. In recent years, neurocognitive deficits have increasingly been recognized as a core feature of psychotic illness but there are few data seeking to elucidate the relationship between subclinical psychosis and neurocogntive deficits in non-clinical samples. The goal of the present study was to examine the relationship between subclinical positive and negative symptoms, as measured by the Community Assessment of Psychic Experiences (CAPE) and performance on the MATRICS Consensus Cognitive Battery (MCCB) in a large (n=303) and demographically diverse non-clinical sample. We found that compared to participants with low levels of subclinical positive symptoms, participants with high levels of subclinical positive symptoms performed significantly better in the domains of working memory (p<.001), verbal learning (p=.007) and visual learning (p=.014). Although comparison of participants with high and low levels of subclinical negative symptoms revealed no differences in MCCB performance, we found that individuals with high levels of subclinical negative symptoms performed significantly better on a measure of estimated IQ (WRAT-3 Reading subtest; p=.02) than those with low levels of subclinical negative symptoms. These results are at odds with prior reports that have generally shown a negative relationship between neurocognitive functioning and severity of subclinical psychotic symptoms, and suggest some potential discontinuities between clinically significant psychotic symptoms and sub-syndromal manifestations of psychosis.


      PubDate: 2014-12-11T08:24:11Z
       
  • Social cognition and social judgment in schizophrenia

    • Abstract: Publication date: December 2014
      Source:Schizophrenia Research: Cognition, Volume 1, Issue 4
      Author(s): Robyn Langdon , Michael H. Connors , Emily Connaughton
      Schizophrenia typically involves poor social functioning. This may be due, in part, to deficits in theory-of-mind, the cognitive ability to reason flexibly about the mental states of others. Patients also have deficits in social knowledge. It is currently unclear how these two impairments interrelate in schizophrenia. To address this issue, 43 patients with schizophrenia and 25 healthy controls completed two theory-of-mind tests and a novel test of social judgment. This latter measure required participants to judge whether various social behaviors were normal or reasonable in the context in which the behaviors occurred. Whereas patients demonstrated clear deficits in theory-of-mind, they performed similarly to controls when judging socially appropriate behaviors and violations of social norms. Patients, however, were less likely than controls to judge social behavior as reasonable when the behavior was impolite but understandable if the characters’ thoughts were taken into account. This latter difficulty correlated with patients’ performance deficits on the theory-of-mind tasks. Overall, findings suggest that basic social knowledge is intact in schizophrenia, though judgments of social behavior are affected by patients’ theory-of-mind deficits.


      PubDate: 2014-12-11T08:24:11Z
       
  • Overconfidence in incorrect perceptual judgments in patients with
           schizophrenia

    • Abstract: Publication date: December 2014
      Source:Schizophrenia Research: Cognition, Volume 1, Issue 4
      Author(s): Steffen Moritz , Nora Ramdani , Helena Klass , Christina Andreou , David Jungclaussen , Sarah Eifler , Susanne Englisch , Frederike Schirmbeck , Mathias Zink
      Background Patients with schizophrenia show overconfidence in memory and social cognition errors. The present investigation examined whether this cognitive distortion also manifests in perceptual tasks. Methods A total of 55 individuals with schizophrenia, 58 with obsessive–compulsive disorder (OCD) as well as 45 non-clinical controls were presented 24 blurry black and white pictures, half of which contained a hidden object; the other half contained (“snowy”) visual noise. Participants had to judge whether the pictures depicted an object or not and how confident they were in this judgment. Results Participants with schizophrenia showed overconfidence in errors and an enhanced knowledge corruption index (i.e. rate of high-confident errors on all high-confident responses) relative to both control groups. In contrast, accuracy scores did not differ between clinical groups. Metacognitive parameters were correlated with self-rated levels of current paranoia. Discussion To the best of our knowledge, this is the first study to demonstrate overconfidence in errors among individuals with psychosis using a visual perception task. Speaking to the specificity of this abnormality for schizophrenia and its pathogenetic relevance, overconfidence in errors and knowledge corruption were elevated in patients with schizophrenia relative to both control groups and were correlated with paranoia.


      PubDate: 2014-12-11T08:24:11Z
       
  • Supported employment among veterans with serious mental illness: the role
           of cognition and social cognition on work outcome

    • Abstract: Publication date: Available online 12 October 2014
      Source:Schizophrenia Research: Cognition
      Author(s): L. Felice Reddy , Robert S. Kern
      Unemployment is a primary functional deficit for the majority of adults with schizophrenia. Research indicates that over two-thirds of adults living in the community with schizophrenia are unemployed. Despite effective programs to assist with job identification and placement, the ability to attain and maintain employment remains a pressing concern. Neurocognitive functioning is widely acknowledged to be a determinant of work outcome; however, effect sizes tend to be in the small to medium range. The present study sought to further understand the determinants of work outcome among a sample of 104 veterans with schizophrenia enrolled in a supported employment program. A small percentage of veterans in the study got competitive jobs; 53% who secured jobs maintained employment for longer than 6months. Cognition, social cognition, and symptoms were unrelated to job attainment. However, speed of processing and social cognition were significant predictors of work outcomes such as wages and tenure. These findings suggest that cognitive abilities including processing speed and the ability to accurately interpret and respond to social cues are significant determinants of whether individuals with schizophrenia remain employed. The results are discussed in light of current available treatment options and domains to target in synergy with work rehabilitation efforts.


      PubDate: 2014-10-17T05:19:48Z
       
  • Cognitive functioning among patients with schizophrenia in a Nigerian
           hospital: a comparison with mood disorder

    • Abstract: Publication date: Available online 12 October 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Adeniran Olubunmi Okewole , Abiodun Olugbenga Adewuya , Roger Olatokunbo Aderibigbe Makanjuola
      Objective The study aimed to investigate correlates of cognition among patients with schizophrenia. Methods Over a three month period, in-patients diagnosed with schizophrenia (n=50) and mood disorders (n=50) were recruited into the study. Both groups of patients were assessed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), the Annett Hand Preference Questionnaire (AHPQ) and the Global Assessment of Function Scale (GAF). Patients with schizophrenia were further assessed using the Positive and Negative Syndromes Scale, PANSS and the Clinical Global impression (CGI). The cognitive screen section of SCAN (comprising Verbal Trails Test and Mini Mental State examination, MMSE) and the cognitive factor of PANSS were used to assess cognitive function. Results No differences were found in the cognitive profile of patients with schizophrenia and mood disorder. Among patients with schizophrenia, poor verbal performance was associated with the negative or mixed syndrome (p=0.004), left or mixed handedness (p=0.013), greater illness severity (p=0.030) and lower GAF scores (p=0.039). Poor performance on MMSE correlated with higher total PANSS score (p=0.022) and was also associated with the negative or mixed syndrome (p=0.003) and lack of clinical improvement (p=0.035). Conclusion Patients with the negative or mixed schizophrenia syndrome may suffer more cognitive deficit. Poor verbal performance among patients with schizophrenia may be associated with left or mixed handedness, more severe illness and poor functioning.


      PubDate: 2014-10-17T05:19:48Z
       
  • Working memory impairment as an endophenotypic marker of a schizophrenia
           diathesis

    • Abstract: Publication date: Available online 12 October 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Sohee Park , Diane C. Gooding
      This review focuses on the viability of working memory impairment as an endophenotypic marker of a schizophrenia diathesis. It begins with an introduction of the construct of working memory. It follows with a consideration of the operational criteria for defining an endophenotype. Research findings regarding the working memory performance of schizophrenia and schizophrenia-spectrum patients, first-degree relatives of schizophrenia patients and healthy controls, are reviewed in terms of the criteria for being considered an endophenotypic marker. Special attention is paid to specific components of the working memory deficit (namely, encoding, maintenance, and manipulation), in terms of which aspects are likely to be the best candidates for endophenotypes. We examine the extant literature regarding working memory performance in bipolar disorder and major depression in order to address the issue of relative specificity to schizophrenia. Despite some unresolved issues, it appears that working memory impairment is a very promising candidate for an endophenotypic marker of a schizophrenia diathesis but not for mood disorders. Throughout this review, we identify future directions for research in this exciting and dynamic area of research and evaluate the contribution of working memory research to our understanding of schizophrenia.


      PubDate: 2014-10-17T05:19:48Z
       
  • Utility of the UCSD Performance-based Skills Assessment-Brief Japanese
           version: discriminative ability and relation to neurocognition

    • Abstract: Publication date: Available online 12 October 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Chika Sumiyoshi , Manbu Takaki , Yuko Okahisa , Thomas L. Patterson , Philip D. Harvey , Tomiki Sumiyoshi
      The UCSD Performance-based Skills Assessment Brief (the UPSA-B) has been widely used for evaluating functional capacity in patients with schizophrenia. The utility of the battery in a wide range of cultural contexts has been of concern among developers. The current study investigated the validity of the Japanese version of the UPSA-B as a measure of functional capacity and as a co-primary for neurocognion. Sixty-four Japanese patients with schizophrenia and 83 healthy adults entered the study. The Japanese version of the UPSA-B (UPSA-B Japanese version) and the MATRICS Cognitive Consensus Battery Japanese version (MCCB Japanese version) were administered. Normal controls performed significantly better than patients, with large effect sizes for the Total and the subscale scores of the UPSA-B. Receiver Operating Characteristic (ROC) curve analysis revealed that the optimal cut-off point for the UPSA-B Total score was estimated at around 80. The UPSA-B Total score was significantly correlated with the MCCB Composite score and several domain scores, indicating the relationship between this co-primary measure and overall cognitive functioning in Japanese patients with schizophrenia. The results obtained here suggest that the UPSA-B Japanese version is an effective tool for evaluating disturbances of daily-living skills linked to cognitive functioning in schizophrenia, providing an identifiable cut-off point and relationships to neurocognition. Further research is warranted to evaluate the psychometrical properties and response to treatment of the Japanese version of the UPSA-B.


      PubDate: 2014-10-17T05:19:48Z
       
  • Brief report: The impact of alcohol and cannabis misuse on cognition among
           individuals with schizophrenia

    • Abstract: Publication date: Available online 6 October 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Amber L. Bahorik , Jack R. Cornelius , Srihari S. Bangalore , Christina E. Newhill , Matcheri S. Keshavan , Shaun M. Eack



      PubDate: 2014-10-07T02:13:30Z
       
  • Enhanced vulnerability to distraction does not account for working memory
           capacity reduction in people with schizophrenia

    • Abstract: Publication date: Available online 6 October 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Molly Erickson , Britta Hahn , Carly Leonard , Benjamin Robinson , Steven Luck , James Gold
      Although working memory impairment has been well-documented among people with schizophrenia (PSZ), the underlying mechanism of this impairment remains unknown. The present study was conducted in a large sample of PSZ and healthy control subjects (HCS) to test the hypothesis that one putative mechanism – vulnerability to distraction from task-irrelevant stimuli – (1) can account for working memory impairment among PSZ, and (2) is associated with other neurocognitive and clinical variables that are highly predictive of functional outcome in schizophrenia. Participants (127 PSZ and 124 HCS) completed a visual change detection task in which a distractor stimulus (mask) was presented on half of the trials during the delay period between sample and test array. PSZ lost proportionately more information from working memory than did HCS, but this effect was small (Cohen’s d =0.36–0.38), and large differences between groups in working memory capacity remained when differences in distractibility were factored out. Furthermore, vulnerability to distraction was not strongly associated with any clinical or cognitive variables of interest. These results suggest that, although PSZ may be somewhat more susceptible to distraction than HCS, this impairment is unlikely to be a significant factor accounting for the robust capacity deficits observed in this population.


      PubDate: 2014-10-07T02:13:30Z
       
  • Facial emotion recognition impairment is related to disorganisation in
           multi-episode schizophrenia

    • Abstract: Publication date: Available online 30 August 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Anna Comparelli , Antonella De Carolis , Valentina Corigliano , Giada Trovini , Julia Dehning , Simone Di Pietro , Eleonora De Pisa , Silvana Galderisi , Paolo Girardi
      The present investigation explores the relationship between facial emotion recognition (FER) and symptom domains in three groups of schizophrenia spectrum patients (43 ultra-high-risk, 50 first episode and 44 multi-episode patients) in which the existence of FER impairment has already been demonstrated. Regression analysis showed that symptoms and FER impairment are related in multi-episode patients, regardless of the illness duration. We suggest that the link between symptoms and FER impairment is involved in the progression of the disease.


      PubDate: 2014-09-03T01:39:58Z
       
  • Cognitive predictors of violence in schizophrenia: a meta-analytic review

    • Abstract: Publication date: Available online 29 August 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Jonathan Reinharth , Graham Reynolds , Charles Dill , Mark Serper
      Background Aggression committed by patients with schizophrenia and other serious and persistent mental illnesses represents a major public health concern affecting patients, their families, treating clinicians as well as the community at large. Cortical dysfunction has been implicated as an anatomical correlate of acts of aggression as well as a fundamental feature associated with individuals with schizophrenia (SZ). As a result, examination of neurocognitive deficits may serves as a natural experiment to explore the relationship between cognition and aggression committed by SZ patients. Past studies, however, have yielded inconsistent and complex results regarding the relevance of cognitive impairment to aggressive behavior. Objective Despite a fair number of studies in the literature, there have been no statistical reviews conducted to date examining the association between cognitive deficits and aggression in SZ. The present meta-analytic study examined the relationship between cognitive impairment and SZ acts of aggression. Methods Electronic databases were searched up to April 2013 using the words and word stems “aggress*, psychotic, risk, cognit*, neurocognit*, and neurobiological.” The search resulted in 29 studies with independent samples. Information was extracted regarding study sample and methodological characteristics in addition to aggression prediction, and comprehensive meta-analytic procedures were performed. Inter-rater reliability for coding was good to excellent. Results The meta-analysis (4764 participants) demonstrated heterogeneous results, leading to follow-up comparisons. Results revealed that SZ cognitive impairment exerted a significant risk for aggression, across studies with differing methodologies. Global cognitive impairment and lack of insight emerged as significant risk indicators for aggression, accounting for 2% of the variance. Conclusions It was concluded that measurement of patients’ global cognitive ability adds incremental variance in the comprehensive assessment and prediction of SZ violence risk.


      PubDate: 2014-09-03T01:39:58Z
       
  • The relationship between IQ and performance on the MATRICS consensus
           cognitive battery

    • Abstract: Publication date: Available online 27 August 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Christine Mohn , Kjetil Sundet , Bjørn Rishovd Rund
      The associations between IQ and individual tests of neurocognitive function are well studied. However, there is a lack of information as to how IQ relates to performance on neuropsychological test batteries as a whole and in the same individuals. In this study, 250 healthy participants aged 20-69 years were tested with the Wechsler Abbreviated Scale of Intelligence (WASI) and the MATRICS Consensus Cognitive Battery (MCCB). In correlation analyses, IQ was significantly related to all MCCB scores, except the Social Cognition domain. Hierarchical regression analyses including gender, age, and education confirmed this association. For overall cognitive function, 50% of the variance was explained by IQ and demographic characteristics. For the domains Speed of Processing, Working Memory, Visual and Verbal Learning, IQ explained a larger proportion of the variance than the demographic factors did. The implication is that these domains may provide information of a person’s intelligence level.


      PubDate: 2014-09-03T01:39:58Z
       
  • Physical performance and disability in schizophrenia

    • Abstract: Publication date: Available online 27 August 2014
      Source:Schizophrenia Research: Cognition
      Author(s): M. Strassnig , J. Signorile , C. Gonzalez , P.D. Harvey
      Despite 50years of pharmacological and psychosocial interventions, schizophrenia remains one of the leading causes of disability. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. The end result is a considerably reduced lifespan that is marred by reduced levels of independence, with few novel treatment options available. Disability is a multidimensional construct that results from different, and often interacting, factors associated with specific types and levels of impairment. In schizophrenia, the most poignant and well characterized determinants of disability are symptoms, cognitive and related skills deficits, but there is limited understanding of other relevant factors that contribute to disability. Here we conceptualize how reduced physical performance interacts with aging, neurobiological, treatment-emergent, and cognitive and skills deficits to exacerbate ADL disability and worsen physical health. We argue that clearly defined physical performance components represent underappreciated variables that, as in mentally healthy people, offer accessible targets for exercise interventions to improve ADLs in schizophrenia, alone or in combination with improvements in cognition and health. And, finally, due to the accelerated aging pattern inherent in this disease – lifespans are reduced by 25years on average – we present a training model based on proven training interventions successfully used in older persons. This model is designed to target the physical and psychological declines associated with decreased independence, coupled with the cardiovascular risk factors and components of the metabolic syndrome seen in schizophrenia due to their excess prevalence of obesity and low fitness levels.


      PubDate: 2014-09-03T01:39:58Z
       
  • The evolution of illness phases in schizophrenia: A non-parametric item
           response analysis of the Positive and Negative Syndrome Scale

    • Abstract: Publication date: Available online 24 April 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Anzalee Khan , Jean Pierre Lindenmayer , Mark Opler , Mary E. Kelley , Leonard White , Michael Compton , Zimeng Gao , Philip D. Harvey
      Background The Positive and Negative Syndrome Scale (PANSS) assesses multiple domains of schizophrenia. Evaluation of each of these domains was conducted to assess differences in the characteristics of psychopathology and their relative predominance in sub-populations. Method Subjects (N=1,832) with DSM-IV schizophrenia were represented in three sub-populations: First Episodes, n=305, Chronic Inpatients, n=694, and Ambulatory Outpatients, n=833. Nonparametric Item Response Analysis (IRT) was performed with Option Characteristic Curves (OCC), Item Characteristic Curves (ICC), slopes and item biserial correlation. Items were characterized as Very Good, Good, or Weak based on specified operational criteria for item selection. Results First episode patients were represented by negative, disorganized hostility and anxiety. Some negative domain items (Poor Rapport, Passive/Apathetic Social Withdrawal) and most positive domain items were scored as Weak. For chronic inpatients, all items of the anxiety domain and some items of the positive domain (Suspiciousness/Persecution, Stereotyped Thinking, Somatic Concerns) were Weak; for all other domains, items were Very Good or Good. For ambulatory outpatients, most items in the anxiety and hostility domain were scored as Weak. The majority of PANSS items were either Very Good or Good at assessing the overall illness severity: chronic inpatients (73.33%, 22 items), first episodes (60.00%, 18 items), and only 46.67% (14 items) in the ambulatory group. Conclusion Findings confirm differences in symptom presentation and predominance of particular domains in subpopulations of schizophrenia. Identifying symptom domains characteristic of subpopulations may be more useful in assessing efficacy endpoints than total or subscale scores.


      PubDate: 2014-04-28T21:18:53Z
       
  • A longitudinal examination of the moderating effects of symptoms on the
           relationship between functional competence and real world functional
           performance in Schizophrenia

    • Abstract: Publication date: Available online 26 April 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Michael W. Best , Maya Gupta , Christopher R. Bowie , Philip D. Harvey
      Background Many individuals with schizophrenia experience remission of prominent positive symptoms but continue to experience impairments in real world functioning. Residual negative and depressive symptoms may have a direct impact on functioning and impair patients' ability to use the cognitive and functional skills that they possess (competence) in the real world (functional performance). Methods One hundred thirty-six individuals (100 men, 36 women) with schizophrenia were classified as having primarily positive symptoms, primarily negative symptoms, primarily depressive symptoms, or undifferentiated symptom profiles. Performance based measures of cognition and adaptive and interpersonal functional competence were used, along with ratings of real world behavior by high contact clinicians. Assessments were performed at baseline and at an 18-month follow-up. Results The relationships between neurocognition and capacity/performance were not moderated by symptom group ps>.091; neurocognition predicted capacity and performance for all groups ps<.001. The relationship between adaptive competence and adaptive performance was moderated by symptom group, ps<.01, such that baseline competence only predicted future performance ratings for participants with primarily positive or undifferentiated symptoms, and not for individuals with primarily negative or depressive symptoms. This same moderation effect was found on the relationship between interpersonal competence and interpersonal performance, ps<.002. Conclusions Residual negative and depressive symptoms are distinct constructs that impede the use of functional skills in the real world. Depressive symptoms are often overlooked in schizophrenia but appear to be an important factor that limits the use of functional ability in real world environments.


      PubDate: 2014-04-28T21:18:53Z
       
  • The course and correlates of everyday functioning in schizophrenia

    • Abstract: Publication date: Available online 26 March 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Abraham Reichenberg , Concetta Feo , Davide Prestia , Christopher R. Bowie , Thomas L. Patterson , Philip D. Harvey
      Previously institutionalized older patients with schizophrenia show changes in cognitive and functional capacity over time. This study examined changes in real-world functioning in a sample of people with schizophrenia who varied in their history of long-term institutionalization and related changes in real world functioning to changes in cognition and functional capacity over the follow-up period. Older patients with schizophrenia (n=111) were examined with assessments of cognitive functioning, functional capacity, clinical symptoms, and everyday functioning. They were then followed up to 45 months and examined up to two times. Mixed-model regression was used to examine changes in real-world functioning in social, everyday living, and vocational domains over the follow-up period and identify potential predictors of change. Everyday functioning worsened over time in all three domains. Although length of longest hospitalization predicted worsening, this influence was eliminated when the course of functional capacity was used to predict the course of everyday functioning. For both vocational and everyday living domains, as well as the composite score on functional status, worsening in performance based measures of everyday functioning and social competence predicted worsening in real world functioning. Changes in negative symptoms further predicted worsening in the everyday living domain. Worsening in everyday functioning is found in people with schizophrenia and those with a history of greater chronicity and severity of illness seem more affected. These influences seem to be expressed through worsening in the ability to perform everyday functional skills. Potential causes of these changes and implications for reducing these impairments are discussed.


      PubDate: 2014-04-01T06:15:02Z
       
  • Qualitative analysis of interviews of future non-affective psychotic
           disorder patients and non-psychiatric controls: preliminary results

    • Abstract: Publication date: Available online 20 March 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Katya Rubinstein , Rivka Tuval-Mashiach , Ortal Bhuknik-Atzil , Suzanne Fund , Abraham Reichenberg , Eyal Fruchter , Mark Weiser
      Background Previous research has shown that people with psychotic disorders have impaired functioning prior to the onset of the illness. The goal of this study is to obtain a detailed, in depth, analysis of the characteristics of premorbid impairment. Methods In this study we examined summaries of interviews with 20 male adolescents who were later diagnosed with non-affective psychotic disorders and compared them to interviews conducted with 20 matched controls without psychiatric disorders. The current study applied a qualitative analysis, performed in the following stages: each interview was read thoroughly by two blinded raters with no a-priori hypothesis, and then key themes and statements were identified and organized into meaningful domains. Afterwards, the frequency of each item was calculated and comparisons between the groups were performed. Results Future non-affective psychotic disorder patients were more likely to be described as strange or different, be involved in violent behavior, experience difficulties in educational functioning and peer integration, deal with problems in everyday functioning and have an avoidant interpersonal conflict resolution style in comparison with matched controls without psychiatric disorders. In addition, future patients experienced more stressful life events and dealt with these stressors more poorly in comparison with controls. Conclusions The findings of this unique historical-prospective qualitative analysis of interviews performed before the onset of psychosis, confirmed previous findings of premorbid abnormality of future non-affective psychosis patients. Using qualitative analysis enabled obtaining a more in-depth understanding of the real-life experience of the premorbid period among patients with non-affective psychotic disorders.


      PubDate: 2014-04-01T06:15:02Z
       
  • Cognition in schizophrenia: Past, present, and future

    • Abstract: Publication date: Available online 20 March 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Michael F. Green , Philip D. Harvey
      Schizophrenia Research: Cognition will serve an important function – a place where interests converge and investigators can learn about the recent developments in this area. This new journal will provide rapid dissemination of information to people who will make good use of it. In this initial article, we comment globally on the study of cognition in schizophrenia: how we got here, where we are, and where we are going. The goal of this first article is to place the study of cognition in schizophrenia within a historical and scientific context. In a field as richly textured as ours it is impossible to hit all the important areas, and we hope the reader will forgive our omissions. Phrased in cognitive terms, our limited presentation of the past is a matter of selective memory, the present is a matter of selective attention, and the future is a matter of selective prospection. This broad introduction emphasizes that cognition in schizophrenia provides clues to pathophysiology, treatment, and outcome. In fact, the study of cognitive impairment in schizophrenia has become wholly intertwined with the study of schizophrenia itself.


      PubDate: 2014-04-01T06:15:02Z
       
  • A novel, online social cognitive training program for young adults with
           schizophrenia: A pilot study

    • Abstract: Publication date: Available online 12 March 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Mor Nahum , Melissa Fisher , Rachel Loewy , Gina Poelke , Joseph Ventura , Keith H. Nuechterlein , Christine I. Hooker , Michael F. Green , Michael M. Merzenich , Sophia Vinogradov
      Background Pervasive social cognition deficits are evident early in the course of schizophrenia and are directly linked to functional outcome, making them an important target for intervention. Here, we tested the feasibility of use, and initiated the evaluation of efficacy, of a novel, neuroplasticity-based online training program (SocialVille) in young adults with schizophrenia. Methods Schizophrenia patients (n=17) completed 24 hours of online SocialVille game play either from home or at a clinic, over a 6–10 week period. We examined training feasibility, gains on the SocialVille exercises relative to matched healthy controls (n=17), and changes on measures of social cognition, social functioning, global functioning and motivation. Results Subjects adhered to training requirements, and rated SocialVille in the medium to high range in satisfaction, enjoyment, and ease of use. Subjects demonstrated significant, large improvements on the speeded SocialVille tasks, and small to moderate improvements on the working memory tasks. Post-training performance on the SocialVille tasks were similar to initial performance of the healthy controls. Subjects also showed improvements on standard measures of social cognition, social functioning, and motivation. No improvements were recorded for emotion recognition indices of the MSCEIT, or on quality of life scales. Conclusion This study provides an initial proof of concept for online social cognition training in schizophrenia. This form of training demonstrated feasibility and resulted in within-subject gains in social functioning and motivation. This pilot study represents a first step towards validating this training approach; randomized controlled trials, now underway, are designed to confirm and extend these findings.


      PubDate: 2014-04-01T06:15:02Z
       
  • Virtual reality functional capacity assessment in schizophrenia:
           Preliminary data regarding feasibility and correlations with cognitive and
           functional capacity performance

    • Abstract: Publication date: Available online 12 March 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Stacy A. Ruse , Philip D. Harvey , Vicki G. Davis , Alexandra S. Atkins , Kolleen H. Fox , Richard S.E. Keefe
      Introduction Assessment of functional capacity is an intrinsic part of determining the functional relevance of response to treatment of cognitive impairment in schizophrenia. Existing methods are highly and consistently correlated with performance on neuropsychological tests, but most current assessments of functional capacity are still paper and pencil simulations. We developed a computerized virtual reality assessment that contains all of the components of a shopping trip. Methods We administered the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) to 54 healthy controls and to 51 people with schizophrenia to test its feasibility. Dependent variables for the VRFCAT included time to completion and errors on 12 objectives and the number of times that an individual failed to complete an objective. The MATRICS Consensus Cognitive Battery (MCCB) and a standard functional capacity measure, the UCSD Performance-Based Skills Assessment-Brief (UPSA-B), were administered to the patients with schizophrenia. Results Patients with schizophrenia performed more poorly than healthy controls on 10/11 of the time variables, as well as 2/12 error scores and 2/12 failed objectives. Pearson correlations for 7 of 15 VRFCAT variables with MCCB composite scores were statistically significant. Conclusion These results provide support for the possibility of computerized functional capacity assessment, but more substantial studies are required.


      PubDate: 2014-04-01T06:15:02Z
       
  • Economic considerations of cognition and functional outcomes in patients
           with schizophrenia: A systematic literature review

    • Abstract: Publication date: Available online 18 February 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Nicolas Furiak , Amy Duhig , Julie Myers , Amber Pitts , Steven Hass , Robert Klein
      Background The primary focus of research in schizophrenia has been on the positive symptoms, with findings that clearly establish their economic burden. More recently, research has expanded to focus on another core symptom of schizophrenia, namely cognitive impairments. While this work has established the adverse impact of cognitive impairments associated with schizophrenia (CIAS) on functional outcomes, their relationship to the economic impact of schizophrenia has not been systematically evaluated. Objective The aim of this research was to perform a systematic literature review identifying evidence that evaluates: 1) the economic impact of CIAS and its treatments, including health-state utilities, and 2) the economic evidence associated with improvements in the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery and the University of California Performance Skills Assessment (UPSA). Method A systematic search of articles published from January 1999–April 2013 was conducted. Studies reporting direct costs, indirect costs, and quality of life impacts of CIAS and costs of CIAS interventions were reviewed. Results Forty-three studies met inclusion criteria. Twenty-four focused on indirect costs (work-related outcomes) associated with cognitive impairments and 14 studies included residential status outcomes. Four studies concentrated on the direct cost of cognitive remediation therapy. Three studies reported quality of life outcomes, but none used health-state utilities. Eight studies focused on the UPSA and its relationship to community outcomes. Only two studies were cost-effectiveness analyses. Conclusions Despite the growing scientific literature relating CIAS to adverse outcomes, the translation of outcomes into economic outcomes is seldom reported. Should novel pharmacotherapies and/or psychosocial treatments require reimbursement from health authorities and/or other payers, many gaps warrant attention in order to demonstrate the economic value of these therapies.


      PubDate: 2014-04-01T06:15:02Z
       
  • The course of vocational functioning in patients with schizophrenia:
           Re-examining social drift

    • Abstract: Publication date: Available online 12 February 2014
      Source:Schizophrenia Research: Cognition
      Author(s): Gabriela Vargas , Martin Strassnig , Samir Sabbag , Felicia Gould , Dante Durand , Laura Stone , Thomas L. Patterson , Philip D. Harvey
      Vocational functioning is markedly impaired in people with schizophrenia. In addition to low rates of employment, people with schizophrenia have been reported to be underachieved compared to other family members. Among the causes of this vocational impairment may be cognitive deficits and other skills deficits, as well as social factors impacting on opportunities for employment. In this study, we examined two separate samples of people with schizophrenia who differed in their educational and social backgrounds. We compared personal and maternal education in people with schizophrenia attending an outpatient rehabilitation facility (n = 57) or receiving outpatient services at a VA medical center (n = 39). The sample as a whole showed evidence of decline in vocational status from their best job to their most recent job. Patients attending a rehabilitation facility had completed less education than their mothers, while the VA patients completed more. Differences between personal and maternal education predicted the difference in status between best and latest jobs in the sample as a whole. VA patients were more likely to be living independently and performed better on a measure of functional capacity than the rehabilitation sample. These data implicate vocational decline in schizophrenia and also suggest that this decline may originate prior to the formal onset of the illness. At the same time, vocational outcomes appear to be related to social opportunities.


      PubDate: 2014-04-01T06:15:02Z
       
 
 
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