Males and females with first episode psychosis present distinct profiles of social cognition and metacognition.

Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive, and metacognitive assessment. Subsequent latent profile analysis split by sex yielded two clusters common to both sexes (a Homogeneous group, 53% and 79.3%, and an Indecisive group, 18.3% and 8.6% of males and females, respectively), a specific male profile characterized by presenting jumping to conclusions (28.7%) and a specific female profile characterized by cognitive biases (12.1%). Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had lower self-esteem. These results suggest that males and females may benefit from specific targeted treatment and highlights the need to consider sex when planning interventions.

Persons with first episode psychosis have distinct profiles of social cognition and metacognition.

Subjects with first-episode psychosis experience substantial deficits in social cognition and metacognition. Although previous studies have investigated the role of profiles of individuals in social cognition and metacognition in chronic schizophrenia, profiling subjects with first-episode psychosis in both domains remains to be investigated. We used latent profile analysis to derive profiles of the abilities in 174 persons with first-episode psychosis using the Beck's Cognitive Insight Scale, the Faces Test, the Hinting Task, the Internal, Personal and Situational Attributions Questionnaire, and the Beads Task. Participants received a clinical assessment and a neuropsychological assessment. The best-fitting model was selected according to the Bayesian information criterion (BIC). We assessed the importance of the variables via a classification tree (CART). We derived three clusters with distinct profiles. The first profile (33.3%) comprised individuals with low social cognition. The second profile (60.9%) comprised individuals that had more proneness to present jumping to conclusions. The third profile (5.7%) presented a heterogeneous profile of metacognitive deficits. Persons with lower social cognition presented worse clinical and neuropsychological features than cluster 2 and cluster 3. Cluster 3 presented significantly worst functioning. Our results suggest that individuals with FEP present distinct profiles that concur with specific clinical, neuropsychological, and functional challenges. Each subgroup may benefit from different interventions.

Facial emotion recognition in neurological disorders: a narrative review. / Reconocimiento facial de emociones en trastornos neurologicos: una revision narrativa.

Facial emotion recognition refers to a person's interpretation of facial features of another to identify a particular emotional state. It is essential in human evolution and encompasses distinct neural networks. Facial emotion recognition is altered in most neurodegenerative diseases, but literature just focus on single neurological pathologies or limited comparison with psychiatric pathologies. It is unknown if a common pattern of affection through pathologies exists or if facial emotion recognition changes according to the underlying pathology. This review discusses its development in healthy population, synthesizes facial emotion recognition studies regarding most common neurological diseases, as well as most relevant findings in neuroimaging and current treatments. Facial emotion recognition, especially negative emotions, is altered in all described neurodegenerative diseases and could constitutes an early marker of cognitive deterioration.

TITLE: Reconocimiento facial de emociones en trastornos neurologicos: una revision narrativa.El reconocimiento facial de emociones hace referencia a la interpretacion de una persona sobre los rasgos faciales de otra para identificar un determinado estado emocional. Es esencial en la evolucion humana y abarca distintas redes neuronales. A pesar de que el reconocimiento facial de emociones se ve alterado en la mayoria de las enfermedades neurodegenerativas, la bibliografia solo se centra en patologias neurologicas individuales o en limitadas comparaciones con patologias psiquiatricas. Se desconoce si existe un patron comun de alteracion entre las patologias o si el reconocimiento facial de emociones cambia segun el trastorno subyacente. Esta revision describe su desarrollo en poblacion sana y sintetiza los estudios de reconocimiento facial de emociones en relacion con las enfermedades neurologicas mas comunes, asi como los hallazgos mas relevantes de neuroimagen y los tratamientos actuales. El reconocimiento facial de emociones, especialmente en emociones negativas, esta alterado en todas las enfermedades neurodegenerativas descritas y podria constituir en algunos casos un marcador temprano de deterioro cognitivo.

Birth weight and obstetric complications determine age at onset in first episode of psychosis.

BACKGROUND: Earlier age at onset of psychosis (AOP) has been associated with poor social adjustment and clinical outcome. Genetic and environmental factors such as obstetric complications, parental history of psychosis, advanced paternal age at time of birth, low birth weight and gestational age, and use of drugs have been described as bringing AOP forward. This study aims to evaluate the relationship between AOP and these factors in a sample of first episode of psychosis (FEP) patients. METHODS: Clinical and sociodemographic data, age at FEP, age of parents at birth, parental history of psychosis, drug-use habits of the mother during pregnancy and of the patient before psychotic onset, and Lewis and Murray obstetric complication scale were obtained from 90 patients with FEP. Statistical analysis was performed by means of Pearson correlations, Chi-square tests, Student T-test analyses and a linear regression model using SPSS version 22. RESULTS: Pre-eclampsia, need for incubator at birth, use of forceps, parental history of psychosis, and low birth weight were associated with an earlier AOP. Use of forceps and birth weight are the variables which best predict AOP in FEP. Stimulant drugs, which were mostly used together with cannabis and cocaine, were the only substances associated with an earlier AOP. CONCLUSIONS: Our findings are consistent with previous study results and underline the role of the prenatal period in the development of psychosis and the importance of careful monitoring of pregnancy and delivery, especially in cases with familial history.

Decreased processing speed might account for working memory span deficit in schizophrenia, and might mediate the associations between working memory span and clinical symptoms.

OBJECTIVE: Verbal working memory span is decreased in patients with schizophrenia, and this might contribute to impairment in higher cognitive functions as well as to the formation of certain clinical symptoms. Processing speed has been identified as a crucial factor in cognitive efficiency in this population. We tested the hypothesis that decreased processing speed underlies the verbal working memory deficit in patients and mediates the associations between working memory span and clinical symptoms. METHOD: Forty-nine schizophrenia inpatients recruited from units for chronic and acute patients, and forty-five healthy participants, were involved in the study. Verbal working memory span was assessed by means of the letter-number span. The Digit Copy test was used to assess motor speed, and the Digit Symbol Substitution Test to assess cognitive speed. RESULTS: The working memory span was significantly impaired in patients (F(1,90)=4.6, P<0.05). However, the group difference was eliminated when either the motor or the cognitive speed measure was controlled (F(1,89)=0.03, P=0.86, and F(1,89)=0.03, P=0.88). In the patient group, working memory span was significantly correlated with negative symptoms (r=-0.52, P<0.0001) and thought disorganisation (r=-0.34, P<0.025) scores. Regression analyses showed that the association with negative symptoms was no longer significant when the motor speed measure was controlled (ß=-0.12, P=0.20), while the association with thought disorganisation was no longer significant when the cognitive speed measure was controlled (ß=-0.10, P=0.26). CONCLUSIONS: Decrement in motor and cognitive speed plays a significant role in both the verbal working memory impairment observed in patients and the associations between verbal working memory impairment and clinical symptoms.