Schizophrenia Research-Cognition最新文献

Background

The category Fluency Test (CFT) is included in the MATRICS consensus cognitive battery for schizophrenia (MCCB). This test has several components that allow the exploration of other cognitive functions and could be related to different symptom profiles.

Methods

a sample of 98 Mexican adolescents was evaluated with the CFT and the following components were analyzed: total words, errors, clusters, switching, related words, and categories. Demographic and clinical differences among them and correlations with other MCCB tests and with Positive and Negative Syndrome Scale (PANSS) factors were explored.

Results

The CFT components showed significant correlations with each other and with other MCCB tests, particularly with those related to verbal learning, working memory, and speed of processing. In addition, they showed moderate correlations with the total PANSS score and with the negative, positive, and cognitive PANSS factors.

Conclusions

The analysis of CFT components allows clinicians and investigators to obtain information regarding other cognitive functions and symptom profiles in adolescents with schizophrenia.

Schizophrenia (SCZ) is a psychiatric disorder that alters both general and social cognition. However, the exact mechanisms that are altered remain to be elucidated. In this study, we investigated associative learning (AL) and facial expression recognition (FER) in the same patients, using emotional expressions and abstract images. Our main aim was to investigate how these cognitive abilities are affected by SCZ and to assess the role of mere social presence, a factor that has not been considered before. The study compared the behavioral performance of 60 treated outpatients with SCZ and 103 demographically matched healthy volunteers. In the AL task, participants had to associate abstract images or facial expressions with key presses, guided by feedback on each trial. In the FER task, they had to report whether two successively presented facial expressions were the same or different. All participants performed the two tasks under two social context conditions: alone or in the presence of a passive but attentive audience. The results showed a severe learning impairment in patients compared to controls, with a slight advantage for facial expressions compared to abstract images, and a gender-dependent effect of social presence. In contrast, facial expression recognition was partially spared in patients and facilitated by social presence. We conclude that cognitive abilities are impaired in patients with SCZ, but their investigation needs to take into account the social context in which they are assessed.

People with schizophrenia have difficulty understanding figurative expressions, such as metaphors, humor or irony. The present study investigated the specificity of figurative language impairment in schizophrenia and its relation with cognitive and psychotic symptoms. It included 54 schizophrenia and 54 age and sex-matched healthy subjects who performed a cognitive screening (ACE-III) and figurative language comprehension task consisting of 60 short stories with three types of endings: a figurative one and its literal and an absurd (meaningless) counterparts. Each figurative domain – metaphor, humor, irony - was split into two sub-domains, i.e., conventional and novel metaphors, intended-to-be-funny and social-norm-violation jokes, simple irony and critical sarcasm, respectively. The main findings are: i) in schizophrenia, figurative language deficit manifests itself in each domain; ii) the most pronounced subdomain-specific impairment has been found for novel vs conventional metaphors and irony vs sarcasm; iii) altered figurative language comprehension was related to diminished cognitive abilities but not to psychopathology symptoms (PANSS) or other clinical characteristics. This may suggest that figurative language impairment, as a specific part of communication deficit, may be regarded as an essential characteristic of schizophrenia, related to primary cognitive deficits but independent of psychopathology.

Background

Although executive functioning is often measured using performance-based measures, these measures have their limits, and self-report measures may provide added value. Especially since these two types of measures often do not correlate with one another. It thus has been proposed they might measure different aspects of the same construct. To explore the differences between a performance-based measure of executive functioning and a self-report measure, we examined their associations in patients with a psychotic disorder with the following: other neurocognitive measures; psychotic symptoms; anxiety and depression symptoms, and daily-life outcome measures.

Method

This cross-sectional study consisted of baseline measures collected as part of a cohort study of people with a psychotic disorder (the UP'S study; n = 301). The Behavioral Rating Inventory of Executive Functioning Adult version (BRIEF-A) was used to assess self-rated executive functioning, and the Tower of London (TOL) to assess performance-based executive functioning. Generalized linear models (GLM) were used with the appropriate distribution and link function to study the associations between TOL and BRIEF-A, and the other variables, including the Brief Assessment of Cognition in Schizophrenia (BACS), the Positive and Negative Symptoms Scale-Remission (PANSS-R), the General Anxiety Disorder – 7 (GAD-7), the Patient Health Questionnaire – 9 (PHQ-9) and the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Model selection was based on the Wald test.

Results

The TOL was associated with other neurocognitive measures, such as verbal list learning (β = 0.24), digit sequencing (β = 0.35); token motor task (β = 0.20); verbal fluency (β = 0.24); symbol coding (β = 0.43); and a screener for intelligence (β = 2.02). It was not associated with PANNS-R or WHO-DAS scores. In contrast, the BRIEF-A was associated not with other neurocognitive measures, but with the PANSS-R (β = 0.32); PHQ-9 (β = 0.52); and GAD-7 (β = 0.55); and with all the WHODAS domains: cognition domain (β = 0.54), mobility domain (β = 0.30) and selfcare domain (β = 0.22).

Conclusion

Performance-based and self-report measures of executive functioning measure different aspects of executive functioning. Both have different associations with neurocognition, symptomatology and daily functioning measures. The difference between the two instruments is probably due to differences in the underlying construct assessed.

Schizophrenia is characterized by memory impairments, yet the relationships between its distinct symptom clusters (i.e., positive, negative, disorganized) and specific aspects of memory dysfunction remain poorly characterized. In the present study, we compiled a large analog sample (N = 795) to test whether positive symptoms, versus negative and disorganized symptoms, were uniquely and differentially related to false alarm versus miss errors during recognition memory. Mixed-effects beta regression analyses revealed that both positive schizotypy and paranoia were more strongly associated with false alarms than misses. Disorganized schizotypy showed a similar pattern, though to a lesser extent; negative schizotypy showed a significant relationship with neither false alarm nor miss errors. We suggest that those higher in positive schizotypy are especially prone to misattribute signal to noise stimuli during recognition memory – characteristic of an “intrusive-like” profile of memory impairment, wherein context-irrelevant stimuli trigger spurious retrieval events – and speculate on the neural processes that might give rise to this asymmetry.

Objective

To explore the correlation between insomnia and language ability in patients with schizophrenia.

Methods

120 patients with schizophrenia admitted to our hospital from June 2020 to January 2022 were enrolled as the research objects. According to the total score of the Pittsburgh Sleep Index (PSQI), they were divided into the insomnia group (PSQI total score > 10 points) and the non-insomnia group (PSQI total score ≤ 10 points). To compare the difference in verbal fluency scale between insomnia and non-insomnia groups and to understand the correlation between insomnia symptoms and language ability in patients with schizophrenia.

Results

There were no significant differences in age, gender, and years of education between the insomnia group and the non-insomnia group (P > 0.05). The total score of the verbal fluency test (VFT) in the insomnia group was significantly different from that in the non-insomnia group (P < 0.01). The total score of the insomnia group was lower than that of the non-insomnia group, and the factors (fluency animal, fluency fruit and vegetable, speech fluency, motor fluency) were lower than that of the non-insomnia group. Logistic regression analysis showed that the total verbal fluency score in schizophrenia patients was negatively correlated with insomnia symptoms (P < 0.05). Schizophrenia patients with insomnia symptoms had worse language ability than those without.

Conclusion

There is a significant difference in language ability between schizophrenia patients with insomnia and those without insomnia symptoms. This suggests that schizophrenia patients with insomnia have a greater probability of language ability disorder.

Background

In a previous meta-analysis, the use of serotonin_1A(5-HT_1A) receptor partial agonists of the azapirone class as an add-on therapy was associated with beneficial effects on positive symptoms and attention/processing speed in schizophrenia patients. This meta-analysis builds on that study by examining the effects of adjunctive treatment with 5-HT_1A partial agonists in improving other domains of neurocognitive function in schizophrenia patients.

Methods

A literature search was performed from 1987 to May 2023 to identify randomized controlled trials. The standardized mean difference (SMD) with 95 % confidence intervals (CI) was calculated when there were two or more studies. Four studies, involving 313 patients, met the inclusion criteria and were used in the analysis.

Results

5-HT_1A partial agonists (buspirone or tandospirone) did not have a significant effect on verbal learning (SMD = 0.08, 95 % CI = −0.31 to 0.47) or working memory (SMD = 0.15, 95 % CI = −0.09 to 0.39). Regarding executive functions (Wisconsin Card Sorting Test), positive but non-significant results were seen with the category number (SMD = 0.26, 95 % CI = −0.81 to 1.32), while non-significant effects were noted for percent preservation errors (SMD = −0.10, 95 % CI = −0.53 to 0.33).

Conclusions

The absence of any significant benefits in the cognitive domains studied here may have been due to the variance in the concomitant medication (typical vs atypical antipsychotic drugs), the level of cognition at baseline, or other factors. Further studies with various types of 5-HT_1A agonists are warranted to examine the potential cognitive efficacy of stimulating these receptors.

Objective

Cognitive impairment is an essential feature of schizophrenia, and it involves a broad array of nonsocial and social cognitive domains. This study aimed to examine whether there are the same or different social cognition profiles between two cognitive subtypes of schizophrenia.

Method

There were one hundred and two chronic and institutionalized patients with schizophrenia from two referral tracks. One group is “Cognitively Normal Range” (CNR) (N = 52), and another group is “Below Normal Range” (BNR) (N = 50). We assessed or collected their apathy, emotional perception judgment, facial expression judgment, and empathy by the Apathy Evaluation Scale, the International Affective Picture System, the Japanese and Caucasian Facial Expression of Emotion, and the Interpersonal Reactivity Index, respectively.

Results

We found different impairment profiles depending on the cognitive subtypes of the patient with schizophrenia. Surprisingly, the CNR presented impairments in apathy, emotional perception judgment, facial expression judgment, and empathy and feature impairment in empathy and affective apathy. In contrast, even though the BNR had significant neurocognition impairments, they had almost intact empathy with significantly impaired cognitive apathy. Both groups' global deficit scores (GDSs) were comparable, and all reached at least a mild impairment level.

Conclusions

The CNR and the BNR had similar abilities in emotional perception judgment and facial emotion recognition. They also had differentiable deficits in apathy and empathy. Our findings provide important clinical implications for neuropsychological pathology and treatment in schizophrenia.

Background

The role of loneliness and social exclusion in the development of paranoia is largely unexplored. Negative affect may mediate potential associations between these factors. We investigated the temporal relationships of daily-life loneliness, felt social exclusion, negative affect, and paranoia across the psychosis continuum.

Method

Seventy-five participants, including 29 individuals with a diagnosis of non-affective psychosis, 20 first-degree relatives, and 26 controls used an Experience Sampling Method (ESM) app to capture the fluctuations in loneliness, feelings of social exclusion, paranoia, and negative affect across a 1-week period. Data were analysed with multilevel regression analyses.

Results

In all groups, loneliness and feelings of social exclusion were independent predictors of paranoia over time (b = 0.05, p < .001 and b = 0.04, p < .05, respectively). Negative affect predicted paranoia (b = 0.17, p < .001) and partially mediated the associations between loneliness, social exclusion, and paranoia. It also predicted loneliness (b = 0.15, p < .0001), but not social exclusion (b = 0.04, p = .21) over time. Paranoia predicted social exclusion over time, with more pronounced effects in controls (b = 0.43) than patients (b = 0.19; relatives: b = 0.17); but not loneliness (b = 0.08, p = .16).

Conclusion

Paranoia and negative affect worsen in all groups following feelings of loneliness and social exclusion. This highlights the importance of a sense of belonging and being included for mental well-being. Loneliness, feeling socially excluded, and negative affect were independent predictors of paranoid thinking, suggesting they represent useful targets in its treatment.

People with schizophrenia have difficulties recognizing other people's expressions, emotional states, and intentions; however, much less is known about their ability to perceive and understand social interactions. We used scenes depicting social situations to compare responses from 90 volunteers (healthy controls [HC], schizophrenia [SZ], and bipolar disorder [BD] outpatients from the Hospital del Salvador in Valparaíso, Chile) to the question: “What do you think is happening in the scene?” Independent blind raters assigned a score of 0 (absent), 1 (partial), or 2 (present) for each item based on whether the description identifies a) the context, b) the people, and c) the interaction depicted in the scenes. Regarding the context of the scenes, the SZ and BD groups scored significantly lower than the HC group, with no significant difference between the SZ and BD groups. Regarding the identification of the people and the interactions, the SZ group scored lower than the HC and BD groups, with no significant difference between the HC and BD groups. An ANCOVA was used to examine the relationship between diagnosis, cognitive performance, and the results of the social perception test. The diagnosis had an effect on context (p = .001) and people (p = .0001) but not on interactions (p = .08). Cognitive performance had a significant effect on interactions (p = .008) but not on context (p = .88) or people (p = .62). Our main result is that people with schizophrenia may have significant difficulties perceiving and understanding social encounters between other people.