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2.
J Clin Psychiatry ; 83(2)2022 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-35143123

RESUMO

Background: Prospective memory (PM) impairment is associated with impaired social functioning, but evidence is limited to chronic schizophrenia samples and cross-sectional design. The aim of this study was to utilize network analysis to address the complex interplay between PM, psychopathology, and functional outcome.Methods: This longitudinal study recruited 119 people with first-episode DSM-IV schizophrenia and followed up with them for 2 to 6 years. PM and working memory were assessed at baseline (in 2010-2015) using valid computerized tasks and the Letter-Number Span Test, respectively. Psychopathology and social functioning were assessed at endpoint (in 2016-2017) using the Positive and Negative Syndrome Scale (PANSS) and the Social and Occupational Functioning Assessment Scale (SOFAS), respectively. Network analysis examined the effect of baseline PM on SOFAS while accounting for the effects of psychopathology.Results: The resultant network showed that social functioning, PANSS positive symptoms, and PANSS general symptoms clustered together, whereas time-based and event-based PM and working memory formed another cluster. Time-based PM linked event-based PM and working memory with social functioning. Time-based PM (expected influence [EI] = 0.69), event-based PM (EI = 0.65), and working memory (EI = 0.83) demonstrated high values of expected influence, but social functioning (variance explained = 0.685) and PANSS negative (variance explained = 0.657) and general (variance explained = 0.583) subscales demonstrated high values of predictability.Conclusions: Time-based PM is the central node linking neurocognitive functions with social functioning. PM and working memory are "target" nodes for interventions bringing changes to the network, whereas social functioning and psychopathology are "malleable" nodes. PM and working memory are promising intervention targets for functional recovery in schizophrenia.


Assuntos
Memória Episódica , Psicologia do Esquizofrênico , Interação Social , Adulto , Feminino , Hong Kong , Humanos , Estudos Longitudinais , Masculino , Memória de Curto Prazo , Modelos Psicológicos , Testes Neuropsicológicos , Gravidez , Esquizofrenia/diagnóstico
3.
Early Interv Psychiatry ; 13(5): 1099-1104, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30175894

RESUMO

AIM: The present study aimed to explore the two-year naturalistic trajectory of time- and event-based prospective memory (PM) in patients with first-episode schizophrenia. METHODS: We administered a computer-based dual-task PM paradigm to 57 individuals with first-episode schizophrenia at baseline and after 6 months, 12 months and 24 months. Forty-eight healthy controls were also recruited and completed all the measures at baseline. We compared the trajectories between time-based and event-based PM in first-episode schizophrenia patients using repeated measures ANOVAs, and examined the relationship between PM and clinical symptoms using Spearman's correlation. RESULTS: PM impairments improved significantly after 24 months of follow-up. However, time-based and event-based PM appeared to run different trajectories. After 24 months, first-episode schizophrenia patient performed poorer than healthy controls in time-based but not event-based PM. PM did not appear to be correlated with clinical symptoms, both cross-sectionally and longitudinally. CONCLUSIONS: This is one of the longest follow-up studies investigating PM in first-episode schizophrenia. Our results provide evidence to support that time-based PM is more temporally stable than event-based PM.


Assuntos
Memória Episódica , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Estudos de Casos e Controles , Feminino , Humanos , Estudos Longitudinais , Masculino , Testes Neuropsicológicos , Fatores de Tempo , Adulto Jovem
4.
A A Pract ; 11(9): 253-257, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-29851693

RESUMO

Neuroendocrine tumors may rarely present after organ transplantation, including cardiac transplant. Treatment is surgical resection with careful perioperative management to optimize blood pressure and intravascular volume. We present the anesthetic management of a patient who was diagnosed with bilateral neuroendocrine tumors soon after heart-lung transplantation and underwent successful staged bilateral adrenalectomy.


Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia , Anestésicos , Tumores Neuroendócrinos/cirurgia , Feminino , Transplante de Coração-Pulmão , Humanos , Pessoa de Meia-Idade
5.
Clin Teach ; 14(5): 330-335, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28084007

RESUMO

BACKGROUND: The current global trend of growth in medical training is increasing the demand for the teaching and supervision of medical students and junior doctors. If well trained and supported, junior doctors and medical students represent an important teaching resource. Unfortunately, there is limited evidence available on whether Australian medical students are equipped with teaching skills. This study aimed to gain insight into the type and amount of teaching-skills training and peer-to-peer teaching present in Australian medical schools. METHODS: A survey of Australian medical schools was conducted between May and December 2014. An online 22-item questionnaire was sent to all 19 Australian medical schools. RESULTS: The response rate to the questionnaire was 100 per cent. Eleven Australian medical schools reported offering a teaching-skills programme, of which five were described as compulsory formal programmes. Eight schools did not offer such a programme, citing time restraints and other subjects taking higher priority. Formal peer-to-peer teaching opportunities were described by 17 schools, with 13 offering this electively. Two schools reported that they did not offer such opportunities because of time restraints, the belief that the quality of expert teaching is superior and because of a lack of staffing. The demand for the teaching and supervision of medical students and junior doctors is increasing CONCLUSIONS: Despite the increasing number of medical students and subsequently junior doctors in Australia, a minority of Australian medical schools report including a formal, compulsory teaching-skills programme. These results may imply a lost opportunity to use the positive effects of teaching-skills programmes, and are in line with studies from other countries.


Assuntos
Currículo , Educação de Graduação em Medicina , Estudantes de Medicina , Ensino/educação , Austrália , Humanos , Corpo Clínico Hospitalar , Faculdades de Medicina
6.
Psychiatry Res ; 236: 22-27, 2016 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-26778631

RESUMO

Impairment in facial emotion perception is believed to be associated with aggression. Schizophrenia patients with antisocial features are more impaired in facial emotion perception than their counterparts without these features. However, previous studies did not define the comorbidity of antisocial personality disorder (ASPD) using stringent criteria. We recruited 30 participants with dual diagnoses of ASPD and schizophrenia, 30 participants with schizophrenia and 30 controls. We employed the Facial Emotional Recognition paradigm to measure facial emotion perception, and administered a battery of neurocognitive tests. The Life History of Aggression scale was used. ANOVAs and ANCOVAs were conducted to examine group differences in facial emotion perception, and control for the effect of other neurocognitive dysfunctions on facial emotion perception. Correlational analyses were conducted to examine the association between facial emotion perception and aggression. Patients with dual diagnoses performed worst in facial emotion perception among the three groups. The group differences in facial emotion perception remained significant, even after other neurocognitive impairments were controlled for. Severity of aggression was correlated with impairment in perceiving negative-valenced facial emotions in patients with dual diagnoses. Our findings support the presence of facial emotion perception impairment and its association with aggression in schizophrenia patients with comorbid ASPD.


Assuntos
Transtorno da Personalidade Antissocial/psicologia , Emoções/fisiologia , Expressão Facial , Esquizofrenia/complicações , Psicologia do Esquizofrênico , Percepção Social , Agressão/psicologia , Transtorno da Personalidade Antissocial/complicações , Humanos , Masculino , Testes Neuropsicológicos
7.
J Psychiatr Res ; 61: 141-9, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25479767

RESUMO

Prospective memory (PM) is the ability to remember to carry out intended actions in the future. Empirical evidence suggests that PM deficits exist in individuals with chronic schizophrenia. However, it is unclear whether PM deficits in first-episode schizophrenia exist independently from other neuropsychological deficits. Moreover, prior research using patients with first-episode has been limited to small inpatient samples. We aimed to clarify the nature and extent of PM deficits in individuals with first-episode schizophrenia, using a large outpatient sample. Participants were 91 clinically stable outpatients with first-episode schizophrenia and 83 healthy controls. PM was assessed using both a subjective self-reported checklist and a laboratory-based task capturing time- and event-based PM. A battery assessing verbal and visuo-spatial working memory, as well as executive functions was also administered. ANOVA analyses showed that patients with first-episode schizophrenia performed significantly poorer than healthy controls in time- and event-based PM. Stepwise linear regression analyses suggested that cognitive flexibility predicted time- and event-based PM; and working memory predicted event-based PM. Subgroup analyses showed that "cognitive-preserved" patients with first-episode schizophrenia tended to perform poorer in time-based PM deficit than healthy controls who were matched in IQ and other neuropsychological functions. Overall, our results provide substantial evidence to support that time-based PM deficits in first-episode schizophrenia are apparent and not entirely attributable to other neuropsychological deficits. PM may constitute a neuropsychological marker for schizophrenia.


Assuntos
Memória Episódica , Esquizofrenia , Psicologia do Esquizofrênico , Adolescente , Adulto , Análise de Variância , Estudos de Casos e Controles , Cognição , Função Executiva , Feminino , Humanos , Modelos Lineares , Masculino , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Esquizofrenia/diagnóstico , Autorrelato , Fatores de Tempo , Comportamento Verbal , Percepção Visual , Adulto Jovem
8.
Neuropsychologia ; 49(8): 2217-24, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21507327

RESUMO

This behavioral study used a dual-task paradigm to compare PM performance in 35 patients with first-onset schizophrenia, 40 non-psychotic siblings and 35 healthy controls. It aimed specifically to examine the effect of schizophrenia group status on PM, the differential effect of group status on PM type, and correlations between PM and other neurocognitive functions and clinical data in first-onset schizophrenia. It also aimed to test the hypothesis that non-psychotic siblings had poorer PM performance than controls. The cohort of first-onset schizophrenia patients had relatively short illness durations (M=1.7 years). The three groups of participants were matched in terms of age, gender and years of education. Results of the study confirmed that first-onset schizophrenia status had a primary effect on PM after controlling for other neurocognitive functions. We also found that first-onset schizophrenia status did not differentially affect two different types of PM. In the first-onset schizophrenia cohort, PM was found to correlate significantly with IQ, executive functions and sustained attention. Finally, contrary to the findings of the previous study, this study did not find siblings of schizophrenia patients to have impaired PM. Taking into account the previous findings of PM in chronic schizophrenia, we concluded that schizophrenia has a primary effect on PM regardless of illness duration.


Assuntos
Função Executiva/fisiologia , Intenção , Transtornos da Memória/etiologia , Esquizofrenia/complicações , Psicologia do Esquizofrênico , Adulto , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Irmãos/psicologia , Adulto Jovem
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