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Abbreviations CC: Completed categories; CPT: Continuous performance test; CT: Correct trials; PANSS: Positive and negative syndrome scale; PE: Perseverative errors; RE: Random errors; RT: Reaction time; SCWT: Stroop color-word test; TE: Total number of errors; TMT: Trail making test; TT: Total trials; WCST: Wisconsin card sorting test
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Background
This study aimed to explore differences in links between negative symptoms and neurocognitive deficits in adolescent and adult patients with first-episode schizophrenia. Schizophrenia is a mental disorder often characterized by positive and negative symptoms, reduced emotional expression, excitatory status, and poor cognitive ability. Th...
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Background:
Schizophrenia is a heterogeneous disorder characterized by various symptom dimensions and neurocognitive deficits. Impairment of insight is a core clinical symptom of the disorder. There has been an increasing focus on neurocognition and insight in schizophrenia; although, many studies fail to control for premorbid cognitive status.
M...
Purpose: The aim of this study is to examine the relationship between thyroid hormone levels and positive, negative, general, and cognitive symptoms in euthyroid patients with psychosis.
Materials and Methods: Thirty-three schizophrenia patients were included in this cross-sectional study. Sociodemographic and clinical data of the participants, pos...
Purpose: The aim of this study is to examine the relationship between thyroid hormone levels and positive, negative, general, and cognitive symptoms in euthyroid patients with psychosis. Materials and Methods: Thirty-three schizophrenia patients were included in this cross-sectional study. Sociodemographic and clinical data of the participants, pos...
Background
The high smoking rate among patients with schizophrenia is an important public health problem, and researchers have been studying how to change the status quo.
Objective
We investigated the effects of high frequency (10Hz) repetitive transcranial magnetic stimulation on the amount of cigarette smoking in patients with schizophrenia.
Me...
Objective: Dysregulation of biological rhythm is associated with reduced executive functioning and potentiating psychosis, which are essential for the Theory of Mind (ToM) among patients with schizophrenia. However, the association between cognitive dysfunction, emotional information and disruption of biological rhythm remains uncertain.
Methods: F...
Citations
... Consistent with the observation related to negative symptom domains, word production showed higher correlations (especially total words written). These findings may not be surprising given that negative symptoms (including those pertaining to speech production, such as alogia and aprosody) are known to be associated with neurocognitive deficits (including those pertaining to verbal performance, such as verbal working memory) (Ebrahimi et al., 2021;Huang et al., 2016;Voruganti et al., 1997). ...
Straightforward linguistic measures may be indicators of reduced language production and lexical diversity among individuals with schizophrenia with negative symptoms and neurocognitive impairments. We compared 98 patients with schizophrenia to 101 unaffected controls on six language variables (e.g., number of relationships between objects, use of complex transitions in the narrative structure), number of words produced, and lexical diversity computed as the moving average type-token ratio from both speaking and writing tasks. Patients differed from controls on nearly all of the linguistic measures; number of words produced had the strongest effect, with an average Cohen's d of 0.68; values pertaining to lexical diversity were 0.50 and 0.32, respectively, for the speaking tasks and the writing tasks. Most measures were correlated with alogia and other domains of negative symptoms (including avolition-apathy and anhedonia-asociality), as well as with diverse neurocognitive domains, especially those pertaining to working memory, verbal learning, and verbal category fluency. Further work is needed to understand longitudinal changes in these linguistic variables, as well as their utility as measures of alogia.
... Frontal cortical dysfunction can be reliably assessed with the Wisconsin Card Sort Test [56] and capture frontal lobe dysfunction in schizophrenia [57][58][59]. Both adolescent and adult schizophrenia are associated with frontal cortex dysfunction, as measured with the Wisconsin Card Sorting Task (WCST) [60,61]. This implies that psychosis in juvenile schizophrenia is also driven by frontal-cortical demand, and inadequate frontal-cortical response. ...
Introduction:
Schizophrenia usually begins with prodromal symptoms in adolescence. In 39% of patients onset of psychotic symptoms occurs prior to age 19. Advances in the treatment of psychosis with medications over the last decade are reviewed this paper.
Areas covered:
Understanding how to prescribe antipsychotics early in schizophrenia requires understanding of the pathophysiology of the disease. The current structure of the dopamine hypothesis is reviewed. Risperidone, paliperidone, olanzapine, quetiapine, and aripiprazole have become established treatments prior to 2012. Since 2012, lurasidone (2017) and brexpiprazole (2022) have also been approved. Lurasidone was approved based on placebo-controlled studies, but brexpiprazole has been approved on the bases of open safety trials. In comparative trials, aripiprazole was better tolerated and less likely to cause hyperprolactinemia and metabolic abnormalities.
Expert opinion:
Antipsychotics can induce adaptive changes in the brain that predispose patients to future problems such as tardive dyskinesia and supersensitivity psychosis. When pathophysiology of schizophrenia, and a clear understanding of the pharmacology of existing antipsychotics are included in the evidence-based analysis, use of partial agonists, that are less likely to induce adaptive changes in the brain, and less likely to induce metabolic and prolactin side effects, become the preferred agents.
... Schizophrenia is a debilitating psychiatric disorder that affects around 1% of the population. In addition to so-called positive and negative symptoms, 'cognitive deficits' are a core feature of schizophrenia, a debilitating psychiatric disorder (Huang et al., 2016). At present, pharmacological strategies mainly target the positive and negative symptoms. ...
Background
Schizophrenia is a complex psychiatric disorder that includes positive and negative symptoms but also debilitating cognitive deficits. Current pharmacological interventions do not target these deficits. Recent evidence suggests a connection between some inflammatory markers (including C-reactive protein) and cognitive impairment, but did not address other inflammatory markers. In the current study, we try to fill the gap by focusing on the association of Interleukin-6 (IL-6), IL-1β, Tumor Necrosis Factor-α and CRP with cognitive dysfunction.
Methods
PUBMED and Web of Science databases were searched for all studies published until July 2022. A total of 25 studies were included in an analysis of the association between cognitive performance and variation in IL-6, IL-1β, TNF-α and CRP.
Results
A total of 2398 patients were included in this study. Meta-analyses results showed a significant inverse relationship between performance in five cognitive domains (attention-processing speed, executive function, working memory, verbal and visual learning and memory) and systemic IL-6, IL-1β, TNF-α and CRP plasma levels in patients with schizophrenia. The meta-analyses results showed a significant decline in the cognitive performances with the evaluated inflammatory markers with effect sizes ranging from −0.136 to −0.181 for IL-6, −0.188 to −0.38 for TNF-α -0.372 to −0.476 for IL-1β and − 0.168 to −0.311 for CRP.
Conclusion
Findings from the current study shows that cognitive deficits are reflective of elevated proinflammatory biomarkers (IL-6, IL-1β, TNF-α and CRP) levels. The results obtained indicate relatedness between inflammation and cognitive decline in patients with schizophrenia. Understanding the underlying pathways between them could have a significant impact on the disease progression and quality of life in schizophrenia patients.
... In turn, negative symptoms appeared to be significantly associated with cognitive performance at 12 months. Negative symptoms and cognitive impairment strongly interrelate and may represent different patterns of the same pathological process [54,55]. In our sample, contrary to psychotic and anxiety symptoms, the severity of negative symptoms among FEP cannabis users has not significantly reduced during the follow-up. ...
Aim
Cannabis use is common in people with psychotic disorders. However, the effect of cannabis on cognition in psychosis remains unclear. Our study investigates relationships between the history of cannabis use and cognitive performance in patients with first-episode psychosis (FEP) during a one-year follow-up.
Methods
The present study included FEP (N = 91) and control (N = 61) groups. Cannabis use was evaluated with a self-report questionnaire, clinical assessment, and medical records during a lifetime and 12 months prior to the treatment onset (recent). Symptoms of psychosis and anxiety were evaluated on the brief psychiatric rating scale. Negative symptoms were assessed using the scale for the assessment of negative symptoms. Cognitive tests were used to evaluate neurocognition (summarized in the g factor) and social cognition. Crude regression analyses for the g factor included variables of cannabis use as independent variables. Full regression models were controlled for gender, education, and clinical symptoms.
Results
In the FEP group, men used cannabis more frequently than women. In the crude regression model for FEP patients, never having used cannabis was associated with a better neurocognitive profile at 12 months. In the full model, more severe anxiety symptoms were associated with better neurocognition at two months, and less severe negative symptoms were associated with better neurocognition at 12 months. Cannabis use was not associated with social cognition. No associations between cognitive performance and cannabis use emerged in the controls.
Conclusion
Negative and affective symptom severity in FEP was associated with cognitive performance to a greater degree than a lifetime history of cannabis use.
... Cognitive performance is usually impaired in the psychiatric population ( Millan et al., 2012 ) and could be negatively affected by other variables such as the presence or exacerbations of psychopathological symptoms ( Ganguli et al., 2006 ;Huang et al., 2016 ;Talreja et al., 2013 ). Therefore, situations such as the current one are very prone to cause changes in psychiatric symptoms. ...
Lockdown caused by COVID-19 pandemic has a negative impact on mental health. The aim was to assess self-reported neurocognitive symptoms during the lockdown and identify associated vulnerable and protective factors in a sample of psychiatric patients in a Spanish population. These results are part of the Barcelona ResIlience Survey for Mental Health COVID-19 (BRIS-MHC) project. Neurocognitive symptoms were assessed through an online survey considering the five items that represented self-reported neurocognitive complaints. We split the sample into two groups based on the severity of the self-reported neurocognitive complaints: intact cognitive function/mild cognitive impairment (CI-) and moderate/severe cognitive impairment (CI+). Univariate analyses were used to compare both groups in terms of sociodemographic and clinical variables. Multiple logistic regression models were carried out to identify clinical variables and coping strategies associated with neurocognitive symptoms. 198 patients with different psychiatric diagnoses were included in this study. One hundred seventeen patients were classified in the CI- group and 81 in the CI+ group. Depressive symptoms and negative psychotic-like symptoms were vulnerable factors for neurocognitive impairment. Coping strategies of performing physical activity, carrying out relaxing activities and maintaining a routine were protective factors against cognitive impairment. Lockdown situation negatively impact on neurocognitive function. Psychopathological symptoms and coping strategies were associated with neurocognitive symptoms during lockdown in subjects with psychiatric illness. The early treatment of psychopathological symptoms in psychiatric patients and promoting coping strategies during lockdown should be considered an intervention strategy against cognitive impairment.
... The NH group showed a significantly higher rate of omissions than the HC group but a comparable rate to that of the AVH group. Previous reports showed an association of cognitive deficits with negative symptoms (Basso et al., 1998;Galaverna et al., 2014;Huang et al., 2016). However, the level of negative symptoms as assessed by PANSS (Kay et al., 1987) did not differ between the NH and AVH patients; thus, the higher rate of omissions could not be attributed to the higher severities of negative symptoms. ...
Patients with schizophrenia present with various symptoms related to different domains. Abnormalities of auditory and visual perception are parts of a more general problem. Nevertheless, the relationship between the lifetime history of auditory verbal hallucination (AVH), one of the most prevalent symptoms in schizophrenia, and visuospatial deficits remains unclear. This study aimed to investigate differences in hemispheric involvement and visuospatial processing between healthy controls (HCs) and schizophrenia patients with and without AVHs. HCs (N=20), schizophrenia patients with AVH (AVH group, N=16), and schizophrenia patients without hallucinations (NH group, N=10) participated in a 4-choice reaction task with lateralized stimuli. An event-related potential (ERP)-microstate approach was used to analyze ERP differences between the conditions and groups. The schizophrenia patients without hallucinations had slower responses than the HCs. An early visual N1 contralateral to stimulation side was prominent in all groups of participants but with decreased amplitude in the patients with schizophrenia, especially in the AVH group over the right hemisphere. The amplitude of P3b, a cognitive evaluation component, was also decreased in schizophrenia. Compared to AVH and HC groups, the patients in the NH group had altered microstate patterns: P3b was replaced by a novelty component, P3a. Although the difference between both patient groups was only based on the presence of AVHs, our findings indicated that patients had specific visuospatial deficits associated with a lifetime history of hallucinations: patients with AVHs showed early visual component alterations in the right hemisphere, and those without AVHs had more prominent visuospatial impairment.
... INTRODUCTION Schizophrenia (SCZ) is a severe, chronic, and heritable mental disorder that affects about 1% population. SCZ is characterized by negative symptoms (reduced emotional expression, increased cognitive deficits, and social isolation, et al.) and positive symptoms (excitatory status, delusions, and hallucinations et al.) (1)(2)(3). While the causes of SCZ are widely investigated, evidence demonstrates the etiology is multifactorial and prompts interaction between genetic factors and environmental contributors (1,4). ...
Background
Schizophrenia (SCZ) is a severe psychiatric disease affected by genetic factors and environmental contributors, and premorbid abnormality of glucose metabolism is one of the SCZ characteristics supposed to contribute to the disease’s pathological process. Transmembrane protein 108 (Tmem108) is a susceptible gene associated with multiple psychiatric diseases, including SCZ. Moreover, Tmem108 mutant mice exhibit SCZ-like behaviors in the measurement of sensorimotor gating. However, it is unknown whether Tmem108 regulates glucose metabolism homeostasis while it involves SCZ pathophysiological process.
Results
In this research, we found that Tmem108 mutant mice exhibited glucose intolerance, insulin resistance, and disturbed metabolic homeostasis. Food and oxygen consumption decreased, and urine production increased, accompanied by weak fatigue resistance in the mutant mice. Simultaneously, the glucose metabolic pathway was enhanced, and lipid metabolism decreased in the mutant mice, consistent with the elevated respiratory exchange ratio (RER). Furthermore, metformin attenuated plasma glucose levels and improved sensorimotor gating in Tmem108 mutant mice.
Conclusions
Hyperglycemia occurs more often in SCZ patients than in control, implying that these two diseases share common biological mechanisms, here we demonstrate that the Tmem108 mutant may represent such a comorbid mechanism.
... attention (ATT), processing speed (PS), reasoning and problem solving (RaPS), verbal learning and memory (VerbL), visual learning and memory (VisL), and working memory (WM)]. There are also a number of individual studies that have found significant associations between negative symptoms and cognitive function in SSD (Couture, Granholm, & Fish, 2011;Dibben, Rice, Laws, & McKenna, 2009;Gonzalez-Ortega et al., 2013;Huang et al., 2016;Tanaka et al., 2012). ...
Objective
There is ongoing debate regarding the relationship between clinical symptoms and cognition in schizophrenia spectrum disorders (SSD). The present study aimed to explore the potential relationships between symptoms, with an emphasis on negative symptoms, and social and non-social cognition.
Method
Hierarchical cluster analysis with k -means optimisation was conducted to characterise clinical subgroups using the Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms in n = 130 SSD participants. Emergent clusters were compared on the MATRICS Consensus Cognitive Battery, which measures non-social cognition and emotion management as well as demographic and clinical variables. Spearman’s correlations were then used to investigate potential relationships between specific negative symptoms and emotion management and non-social cognition.
Results
Four distinct clinical subgroups were identified: 1. high hallucinations, 2. mixed symptoms, 3. high negative symptoms, and 4. relatively asymptomatic. The high negative symptom subgroup was found to have significantly poorer emotion management than the high hallucination and relatively asymptomatic subgroups. No further differences between subgroups were observed. Correlation analyses revealed avolition-apathy and anhedonia-asociality were negatively correlated with emotion management, but not non-social cognition. Affective flattening and alogia were not associated with either emotion management or non-social cognition.
Conclusions
The present study identified associations between negative symptoms and emotion management within social cognition, but no domains of non-social cognition. This relationship may be specific to motivation, anhedonia and apathy, but not expressive deficits. This suggests that targeted interventions for social cognition may also result in parallel improvement in some specific negative symptoms.
... Thus, grid measures might be preferable for research in personcentered approaches to psychosis (García-Mieres et al. 2019, under review) and as evaluative measures for case conceptualization in clinical practice. 26 Psychological models of negative symptoms emphasize the role of neurocognitive factors such as low premorbid intelligence and poor executive functioning, 27,28 social cognition related factors such as limited theory of mind (ToM), 29,30 and metacognitive aspects such as poor self-reflectivity or reduced ability to think about one's mental state. [31][32][33] Negative symptoms are characterized by the diminishment of a set of essential human capacities, including emotional experience, and a loss of volition and impoverishment of internal experiences. ...
... Third, we performed 2 separate correlation analyses for positive and negative symptoms. The inclusion criteria of psychological factors associated with these symptoms were drawn from previous research, 20,21,27,29,31 as described in the background. For positive symptoms, we introduced self-reflectivity, selfcertainty, and depressive symptoms. ...
Abstract
Background
People with psychosis experience disruptions in personal identity that affect positive and negative symptoms, but the complexity of these phenomena needs to be addressed in an in-depth manner. Using the Personal Construct Theory, we examined whether distinct dimensions of personal identity, as measured with the Repertory Grid Technique along with other cognitive factors, might influence psychotic symptomatology.
Method
Eighty-five outpatients with schizophrenia-spectrum disorders completed a repertory grid, an observed-rated interview of psychotic symptoms, and measures of cognitive insight, depressive symptoms, neurocognition, and theory of mind.
Results
Structural equation models revealed that interpersonal dichotomous thinking directly affected positive symptoms. Self-discrepancies influenced positive symptoms by mediation of depressive symptoms. Interpersonal cognitive differentiation and interpersonal cognitive richness mediated the impact of self-reflectivity and neurocognitive deficits in negative symptomatology.
Conclusions
This study is the first of its kind to examine the structure of personal identity in relation to positive and negative symptoms of psychosis. Results suggest interventions targeted to improving interpersonal dichotomous thinking, self-discrepancies, interpersonal cognitive differentiation, and interpersonal cognitive richness may be useful in improving psychotic symptoms.
... Each item can be rated from 1 ("absent") to 7 ("extreme"). In the present study, we used the Italian version of the PANSS [36], which has been widely used to assess psychotic symptoms in adolescents, showing good psychometric properties [38]. ...
The clinical significance and the prognostic value of clinical high risk (CHR) for psychosis, while substantially corroborated in adults, remains less firmly established in children and early adolescents. This follow-up study, developed within the Reggio Emilia At Risk Mental States project, is meant to contribute to the reduction of such lacuna, and has two main aims: (1) to characterize the clinical profile of help seekers [stratified in non-CHR, CHR and first episode psychosis (FEP)] referred to child–adolescent mental health services; and (2) to monitor the cumulative transition rate from CHR to FEP in adolescents at the follow-up of 12 and 24 months. 112 adolescents (aged 13–18 years) were assessed with the Comprehensive Assessment of At-Risk Mental States and the Schizophrenia Proneness Instrument, Child and Youth version. 51 subjects met CHR criteria (45.5% of the sample) and 33 subjects met FEP criteria (29.5%) at baseline. The criterial transition rate from CHR to FEP was 7% over 12 months and 13% over 24 months; higher rates of cumulative transition were detected when also functional transition (indexed by the consensual introduction of antipsychotic medication by the treating clinical staff) was considered. The identification of CHR for psychosis in help-seeking adolescents is feasible and clinically relevant. Studies conducted in real world, publicly funded components of the national health system, should take into consideration not only criterial, psychometric transition, but also functional equivalents of transition.
