RESUMO
BACKGROUND: Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. METHODS: We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. RESULTS: Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. CONCLUSIONS: Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
Assuntos
Esquizofrenia , Humanos , América Latina/epidemiologia , Esquizofrenia/epidemiologia , Esquizofrenia/diagnóstico , Classe Social , Fatores Socioeconômicos , CogniçãoAssuntos
Esquizofrenia , Humanos , América Latina/epidemiologia , Classe Social , Fatores Socioeconômicos , CogniçãoRESUMO
Background: Cognitive alterations have been reported in early stages of psychosis including people with First Episode Psychosis (FEP), Clinical High-Risk Mental State (CHR), and Psychotic-Like Experience (PLE). This study aimed to compare the cognitive function in early stages of psychosis using the Montreal Cognitive Assessment (MoCA), a low-cost and brief assessment tool of cognitive functions. Methods: A total of 154 individuals, including 35 with FEP, 38 CHR, 44 PLE, and 37 healthy controls (HC), were evaluated with the MoCA in Santiago, Chile. We calculated the mean total score of the MoCA and the standard deviation of the mean. Groups were assessed for a trend to lower scores in a pre-determined sequence (HC > PLE > CHR > FEP) using the Jonckheere-Terpstra test (TJT). Results: The mean total MoCA scores were 24.8 ± 3.3 in FEP, 26.4 ± 2.4 in CHR, 26.4 ± 2.3 in PLE, and 27.2 ± 1.8 in HC. The analyses revealed a significant trend (p < 0.05) toward lower MoCA individual domain scores and MoCA total scores in the following order: HC > PLE > CHR > FEP. The mean total scores of all groups were above the cut-off for cognitive impairment (22 points). Conclusions: The MoCA describes lower scores in cognition across early stages of psychosis and may be a useful low-cost assessment instrument in early intervention centers of poorly resourced settings.
RESUMO
Currently, the diagnosis of schizophrenia is made solely based on interviews and behavioral observations by a trained psychiatrist. Technologies such as electroencephalography (EEG) are used for differential diagnosis and not to support the psychiatrist's positive diagnosis. Here, we show the potential of EEG recordings as biomarkers of the schizophrenia syndrome. We recorded EEG while schizophrenia patients freely viewed natural scenes, and we analyzed the average EEG activity locked to the image onset. We found significant differences between patients and healthy controls in occipital areas approximately 500 ms after image onset. These differences were used to train a classifier to discriminate the schizophrenia patients from the controls. The best classifier had 81% sensitivity for the detection of patients and specificity of 59% for the detection of controls, with an overall accuracy of 71%. These results indicate that EEG signals from a free-viewing paradigm discriminate patients from healthy controls and have the potential to become a tool for the psychiatrist to support the positive diagnosis of schizophrenia.
Assuntos
Eletroencefalografia/classificação , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Adulto , Biomarcadores , Potenciais Evocados , Feminino , Voluntários Saudáveis , Humanos , Masculino , Lobo Occipital/fisiopatologia , Estimulação Luminosa , Projetos Piloto , Reprodutibilidade dos Testes , Esquizofrenia/classificação , Processamento de Sinais Assistido por Computador , Máquina de Vetores de Suporte , Adulto JovemRESUMO
El presente estudio tiene como objetivo validar un conjunto de imágenes del International Affective Picture System (IAPS) de Lang, Bradley y Cuthbert, 2005 -un instrumento ampliamente utilizado en investigación afectiva- en una muestra chilena, así como comparar sus resultados con aquellos obtenidos en el estudio estadounidense, en vistas a contribuir a su validación intercultural. Se utilizó una muestra de 135 estudiantes universitarios, quienes evaluaron 188 imágenes en las dimensiones de valencia y arousal, de acuerdo con instrucciones estándar. Los resultados muestran la organización esperada de la afectividad, con variaciones entre sexos en la valoración de valencia, y diferencias entre países en la dimensión de arousal. Se concluye que la adaptación chilena del IAPS es consistente con los estudios previos, lo cual añade evidencia a favor de su validez intercultural.
The present study aimed to obtain a valid set of images of the International Affective Picture System (Lang, Bradley & Cuthbert, 2005) a widely used instrumentation in emotion research- in a Chilean sample, as well as comparing these results with those obtained from the US study in order to con tribute to its cross-cultural validation. A sample of 135 college students assessed 188 pictures according to standard instructions in valence and arousal dimensions. The results showed the expected organization of affectivity, with variations between sex in valence judgments, and differences between countries in the arousal dimension. It is concluded that the Chilean adaptation of the IAPS is consistent with the previous evidence, adding support to it cross-cultural validity.