Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 93
Filtrar
1.
Brain Inform ; 11(1): 14, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38833014

RESUMO

Depression is a serious mental illness that affects millions worldwide and consequently has attracted considerable research interest in recent years. Within the field of automated depression estimation, most researchers focus on neural network architectures while ignoring other research directions. Within this paper, we explore an alternate approach and study the impact of input representations on the learning ability of the models. In particular, we work with graph-based representations to highlight different aspects of input transcripts, both at the interview and corpus levels. We use sentence similarity graphs and keyword correlation graphs to exemplify the advantages of graphical representations over sequential models for binary classification problems within depression estimation. Additionally, we design multi-view architectures that split interview transcripts into question and answer views in order to take into account dialogue structure. Our experiments show the benefits of multi-view based graphical input encodings over sequential models and provide new state-of-the-art results for binary classification on the gold standard DAIC-WOZ dataset. Further analysis establishes our method as a means for generating meaningful insights and visual summaries of interview transcripts that can be used by medical professionals.

2.
AIMS Neurosci ; 11(1): 25-38, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38617038

RESUMO

Auditory verbal hallucinations (AVHs) are among the most common and disabling symptoms of schizophrenia. They involve the superior temporal sulcus (STS), which is associated with language processing; specific STS patterns may reflect vulnerability to auditory hallucinations in schizophrenia. STS sulcal pits are the deepest points of the folds in this region and were investigated here as an anatomical landmark of AVHs. This study included 53 patients diagnosed with schizophrenia and past or present AVHs, as well as 100 healthy control volunteers. All participants underwent a 3-T magnetic resonance imaging T1 brain scan, and sulcal pit differences were compared between the two groups. Compared with controls, patients with AVHs had a significantly different distributions for the number of sulcal pits in the left STS, indicating a less complex morphological pattern. The association of STS sulcal morphology with AVH suggests an early neurodevelopmental process in the pathophysiology of schizophrenia with AVHs.

3.
J Clin Med ; 13(6)2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38541934

RESUMO

Background: The transnosographic nature of negative symptoms (NS) makes them fruitful for detecting psychiatric symptoms. The main objective of this study was to determine whether NS can be useful in screening for ultra-high risk of psychosis (UHR) or depressive symptoms in the no-help-seeking student population. The most prevalent NS and their relationship with cannabis use were also researched. Methods: From an online survey sent to students, 2128 filled out the Self-evaluation of Negative Symptoms (SNS), Prodromal Questionnaire 16 (PQ-16), Beck Depression Inventory (BDI), and Cannabis Abuse Screening Test (CAST). Results: 367 students (17.2%, 95% CI [15.6-18.9]) were considered to have UHR (PQ-16 distress score ≥ 9) and/or depression (BDI ≥ 16). The receiver operation characteristic curve showed that a threshold of 13 for the SNS score discriminated this subgroup of students with a sensitivity and specificity of 79.8% and 70.6%, respectively. The motivational dimension was overrepresented and linked to cannabis use. Conclusions: The early detection of NS in the no-help-seeking student population is relevant for detecting depressive and prodromal symptoms. This will enable early intervention to limit the progression to chronic mental disorders. The predominance of NS linked to the amotivational dimension was observed and related to cannabis use.

4.
Schizophr Res ; 267: 19-23, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38513330

RESUMO

BACKGROUND: A scale for self-assessment of auditory verbal hallucinations (SAVH) was developed for patients, and this study aimed to validate the scale by investigating its psychometric properties. METHODS: Forty one patients with schizophrenia or schizoaffective disorders (DSM-5) self-assessed their hallucinations using nine SAVH questions. Each question was scored from 0 to 5, indicating the severity of the symptoms. Patients were also evaluated with the Brief Psychiatric Rating Scale (BPRS), Auditory Hallucination Rating Scale (AHRS), and Birchwood Insight Scale (BIS). The psychometric properties of the SAVH were assessed by the face, internal consistency, construct, convergent and discriminant validities. RESULTS: SAVH scores were used to examine the psychometric properties. Cronbach's α and Guttman's Lambda-6 were 0.67 and 0.73 respectively. Significant correlations were observed between SAVH and AHRS total scores, as well as BPRS hallucinatory behavior subscores. No significant correlations were found between total SAVH scores and (i) levels of insight or (ii) negative BPRS subscores. Factor analysis on SAVH revealed three factors accounting for 59.3 % of the variance. Most patients found the questions clear, appropriate, and of adequate length. CONCLUSIONS: SAVH demonstrated good psychometric properties, suggesting its utility in assessing auditory verbal hallucinations (AVH). This self-assessment could be valuable in evaluating AVH treatment efficacy, monitoring AVH, and empowering patients.


Assuntos
Alucinações , Psicometria , Transtornos Psicóticos , Esquizofrenia , Humanos , Alucinações/diagnóstico , Alucinações/etiologia , Alucinações/fisiopatologia , Masculino , Feminino , Esquizofrenia/complicações , Esquizofrenia/fisiopatologia , Adulto , Psicometria/normas , Transtornos Psicóticos/fisiopatologia , Transtornos Psicóticos/complicações , Transtornos Psicóticos/diagnóstico , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Autoavaliação (Psicologia) , Escalas de Graduação Psiquiátrica/normas , Psicologia do Esquizofrênico , Adulto Jovem , Autoavaliação Diagnóstica , Análise Fatorial
5.
Schizophr Res ; 264: 188-190, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38154361

RESUMO

Auditory verbal hallucinations (AVH) are experienced by approximately 70 % of patients with schizophrenia and are frequently associated with high levels of distress. Therefore, alleviating hallucinations is an important therapeutic challenge. However, for prescribing a personalized treatment adapted to the patient, an accurate and detailed assessment of AVH is necessary. Until now, there have been no self-evaluations; instead, only scales based on observer ratings have been used to assess AVH. Nevertheless, self-assessments may enhance patient symptom awareness and increase their insight and involvement in the treatment, promoting empowerment (Eisen et al., 2000). In this context, a mobile app called MIMO was devised in order to monitor AVHs assessed by the patients themselves. This app, including the Self-assessment of Auditory verbal Hallucinations (SAVH-https://sns-dollfus.com/), was devised as an ecological momentary assessment tool. The present study aimed to demonstrate the feasibility and acceptability of this app.


Assuntos
Aplicativos Móveis , Esquizofrenia , Humanos , Esquizofrenia/complicações , Autoavaliação (Psicologia) , Alucinações/etiologia , Alucinações/complicações
6.
J Clin Med ; 12(3)2023 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-36769548

RESUMO

(1) Background: Schizophrenia is a severe mental disorder characterized by various symptom groups that tremendously affect health-related quality of life (HRQoL). We aimed to specify whether negative symptoms and cognitive deficits of schizophrenia correlate and can predict HRQoL. (2) Methods: Patients diagnosed with paranoid schizophrenia were invited to participate in the study. Participants were evaluated using the Montreal Cognitive Assessment (MoCA) and the Brief Psychiatric Rating Scale (BPRS) and were asked to fill out the Self-evaluation of Negative Symptoms scale (SNS) and the Medical Outcomes Short Form Survey (SF-36). Pearson's and Spearman's correlations were used to calculate the correlations between cognitive deficits and negative symptoms. We performed the receiver operating characteristic (ROC) analysis for the variables correlated with SF-36 scores. (3) Results: HRQoL correlated significantly with the negative symptoms; however, it did not correlate with cognitive deficits. ROC analysis showed that the abulia subscore of the SNS showed the most significant predictive potential of HRQoL. (4) Conclusions: Negative symptoms correlate more significantly with the HRQoL than cognitive symptoms. The SNS offers the possibility of predicting the HRQoL of patients with schizophrenia and is useful as a screening tool in clinical practice.

7.
Psychol Med ; 53(2): 342-350, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-33902760

RESUMO

BACKGROUND: Patients with psychiatric disorders are exposed to high risk of COVID-19 and increased mortality. In this study, we set out to assess the clinical features and outcomes of patients with current psychiatric disorders exposed to COVID-19. METHODS: This multi-center prospective study was conducted in 22 psychiatric wards dedicated to COVID-19 inpatients between 28 February and 30 May 2020. The main outcomes were the number of patients transferred to somatic care units, the number of deaths, and the number of patients developing a confusional state. The risk factors of confusional state and transfer to somatic care units were assessed by a multivariate logistic model. The risk of death was analyzed by a univariate analysis. RESULTS: In total, 350 patients were included in the study. Overall, 24 (7%) were transferred to medicine units, 7 (2%) died, and 51 (15%) patients presented a confusional state. Severe respiratory symptoms predicted the transfer to a medicine unit [odds ratio (OR) 17.1; confidence interval (CI) 4.9-59.3]. Older age, an organic mental disorder, a confusional state, and severe respiratory symptoms predicted mortality in univariate analysis. Age >55 (OR 4.9; CI 2.1-11.4), an affective disorder (OR 4.1; CI 1.6-10.9), and severe respiratory symptoms (OR 4.6; CI 2.2-9.7) predicted a higher risk, whereas smoking (OR 0.3; CI 0.1-0.9) predicted a lower risk of a confusional state. CONCLUSION: COVID-19 patients with severe psychiatric disorders have multiple somatic comorbidities and have a risk of developing a confusional state. These data underline the need for extreme caution given the risks of COVID-19 in patients hospitalized for psychiatric disorders.


Assuntos
COVID-19 , Transtornos Mentais , Humanos , Estudos Prospectivos , Transtornos Mentais/epidemiologia , Transtornos Mentais/diagnóstico , Comorbidade , Confusão
8.
Psychol Med ; 53(5): 2060-2071, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-34579796

RESUMO

BACKGROUND: Electroconvulsive therapy (ECT) is one of the most effective treatments for treatment-resistant depression (TRD). However, due to response delay and cognitive impairment, ECT remains an imperfect treatment. Compared to ECT, repetitive transcranial magnetic stimulation (rTMS) is less effective at treating severe depression, but has the advantage of being quick, easy to use, and producing almost no side effects. In this study, our objective was to assess the priming effect of rTMS sessions before ECT on clinical response in patients with TRD. METHODS: In this multicenter, randomized, double-blind, sham-controlled trial, 56 patients with TRD were assigned to active or sham rTMS before ECT treatment. Five sessions of active/sham neuronavigated rTMS were administered over the left dorsolateral prefrontal cortex (20 Hz, 90% resting motor threshold, 20 2 s trains with 60-s intervals, 800 pulses/session) before ECT (which was active for all patients) started. Any relative improvements were then compared between both groups after five ECT sessions, in order to assess the early response to treatment. RESULTS: After ECT, the active rTMS group exhibited a significantly greater relative improvement than the sham group [43.4% (28.6%) v. 25.4% (17.2%)]. The responder rate in the active group was at least three times higher. Cognitive complaints, which were assessed using the Cognitive Failures Questionnaire, were higher in the sham rTMS group compared to the active rTMS group, but this difference was not corroborated by cognitive tests. CONCLUSIONS: rTMS could be used to enhance the efficacy of ECT in patients with TRD. ClinicalTrials.gov: NCT02830399.


Assuntos
Transtorno Depressivo Resistente a Tratamento , Eletroconvulsoterapia , Humanos , Estimulação Magnética Transcraniana , Depressão/terapia , Transtorno Depressivo Resistente a Tratamento/terapia , Método Duplo-Cego , Resultado do Tratamento , Córtex Pré-Frontal/fisiologia
10.
Front Psychiatry ; 13: 826465, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35173641

RESUMO

BACKGROUND: Negative symptoms are usually evaluated with scales based on observer ratings and up to now self-assessments have been overlooked. The aim of this paper was to validate the Self-evaluation of Negative Symptoms (SNS) in a large European sample coming from 12 countries. We wanted to demonstrate: (1) good convergent and divergent validities; (2) relationships between SNS scores and patients' functional outcome; (3) the capacity of the SNS compared to the Brief Negative Symptom Scale (BNSS) to detect negative symptoms; and (4) a five-domain construct in relation to the 5 consensus domains (social withdrawal, anhedonia, alogia, avolition, blunted affect) as the best latent structure of SNS. METHODS: Two hundred forty-five subjects with a DSM-IV diagnosis of schizophrenia completed the SNS, the Positive and Negative Syndrome Scale (PANSS), the BNSS, the Calgary Depression Scale for Schizophrenia (CDSS), and the Personal and Social Performance (PSP) scale. Spearman's Rho correlations, confirmatory factor analysis investigating 4 models of the latent structure of SNS and stepwise multiple regression were performed. RESULTS: Significant positive correlations were observed between the total score of the SNS and the total scores of the PANSS negative subscale (r = 0.37; P < 0.0001) and the BNSS (r = 0.43; p < 0.0001). SNS scores did not correlate with the level of insight, parkinsonism, or the total score of the PANSS positive subscale. A positive correlation was found between SNS and CDSS (r = 0.35; p < 0.0001). Among the 5 SNS subscores, only avolition subscores entered the regression equation explaining a lower functional outcome. The 1-factor and 2-factor models provided poor fit, while the 5-factor model and the hierarchical model provided the best fit, with a small advantage of the 5-factor model. The frequency of each negative dimension was systematically higher using the BNSS and the SNS vs. the PANSS and was higher for alogia and avolition using SNS vs. BNSS. CONCLUSION: In a large European multicentric sample, this study demonstrated that the SNS has: (1) good psychometric properties with good convergent and divergent validities; (2) a five-factor latent structure; (3) an association with patients' functional outcome; and (4) the capacity to identify subjects with negative symptoms that is close to the BNSS and superior to the PANSS negative subscale.

11.
Trials ; 22(1): 964, 2021 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-34963486

RESUMO

BACKGROUND: One out of three patients with schizophrenia failed to respond adequately to antipsychotics and continue to experience debilitating symptoms such as auditory hallucinations and negative symptoms. The development of additional therapeutic approaches for these persistent symptoms constitutes a major goal for patients. Here, we develop a randomized-controlled trial testing the efficacy of high-frequency transcranial random noise stimulation (hf-tRNS) for the treatment of resistant/persistent symptoms of schizophrenia in patients with various profiles of symptoms, cognitive deficits and illness duration. We also aim to investigate the biological and cognitive effects of hf-tRNS and to identify the predictors of clinical response. METHODS: In a randomized, double-blind, 2-arm parallel-group, controlled, multicentre study, 144 patients with schizophrenia and persistent symptoms despite the prescription of at least one antipsychotic treatment will be randomly allocated to receive either active (n = 72) or sham (n = 72) hf-tRNS. hf-tRNS (100-500 Hz) will be delivered for 20 min with a current intensity of 2 mA and a 1-mA offset twice a day on 5 consecutive weekdays. The anode will be placed over the left dorsolateral prefrontal cortex and the cathode over the left temporoparietal junction. Patients' symptoms will be assessed prior to hf-tRNS (baseline), after the 10 sessions, and at 1-, 3- and 6-month follow-up. The primary outcome will be the number of responders defined as a reduction of at least 25% from the baseline scores on the Positive and Negative Syndrome Scale (PANSS) after the 10 sessions. Secondary outcomes will include brain activity and connectivity, source monitoring performances, social cognition, other clinical (including auditory hallucinations) and biological variables, and attitude toward treatment. DISCUSSION: The results of this trial will constitute a first step toward establishing the usefulness of hf-tRNS in schizophrenia whatever the stage of the illness and the level of treatment resistance. We hypothesize a long-lasting effect of active hf-tRNS on the severity of schizophrenia symptoms as compared to sham. This trial will also have implications for the use of hf-tRNS as a preventive intervention of relapse in patients with schizophrenia. TRIAL REGISTRATION: ClinicalTrials.gov NCT02744989. Prospectively registered on 20 April 2016.


Assuntos
Esquizofrenia , Estimulação Transcraniana por Corrente Contínua , Córtex Pré-Frontal Dorsolateral , Método Duplo-Cego , Alucinações/diagnóstico , Alucinações/terapia , Humanos , Estudos Multicêntricos como Assunto , Recidiva Local de Neoplasia , Ensaios Clínicos Controlados Aleatórios como Assunto , Esquizofrenia/diagnóstico , Esquizofrenia/tratamento farmacológico , Resultado do Tratamento
12.
BMC Psychiatry ; 21(1): 516, 2021 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-34666744

RESUMO

AIM: The Self-evaluation of Negative Symptoms (SNS) has been developed to allow schizophrenia patients to evaluate themselves in five dimensions of negative symptoms. The present study aimed to examine psychometric properties of the Persian version of SNS. METHODS: A group of 50 patients with schizophrenia and a group of 50 healthy controls received the Persian-SNS. Severity of negative symptoms were evaluated by the Scale for Assessment of Negative symptoms (SANS) and the Brief Psychiatric Rating Scale (BPRS). RESULTS: The results showed that the Cronbach's alpha for the Persian SNS was 0.95. The Persian-SNS and its subscales showed significant positive correlations with the total SANS score and SANS subscales as well as BPRS negative subscale, thus confirming the validity of the scale. Finally, the Persian-SNS showed the ability to discriminate patients with schizophrenia from healthy controls. CONCLUSION: The acceptable properties of the Persian version of SNS demonstrated that it is a practical tool for screening negative symptoms in Persian-speaking schizophrenia patients.


Assuntos
Autoavaliação Diagnóstica , Esquizofrenia , Humanos , Irã (Geográfico) , Psicometria , Reprodutibilidade dos Testes , Esquizofrenia/diagnóstico , Autoavaliação (Psicologia) , Inquéritos e Questionários
13.
Rev Prat ; 71(1): 36-41, 2021 Jan.
Artigo em Francês | MEDLINE | ID: mdl-34160935

RESUMO

"Early detection Of schizophrenia, why and who to contact? Schizophrenia usually occurs in late adolescence or early adulthood but is generally preceded by a prodromal phase or by a "high risk mental state" which corresponds to the onset of the disease. Early detection of symptoms and rapid specialized intervention begin at this stage. Medical intervention at this stage aims to influence the course of the disease and to limit the transition to a first-episode psychosis (FEP). Patients with FEP will require initiation of antipsychotic treatment. A long delay before antipsychotic treatment initiation will negatively impact the short and long term outcomes: more severe symptoms, worse treatment response and less global functioning. Early detection of schizophrenia involves general practitioners who will be firstly solicited by patients and their families. Patient should then be addressed without any delay to specialized psychiatric teams."


"Détection précoce de la schizophrénie, pourquoi et à qui s'adresser ? La schizophrénie survient généralement vers la fin de l'adolescence ou au début de l'âge adulte, mais est souvent précédée d'une phase prodromique ou « état mental à risque ¼ où se manifestent les premiers symptômes de la maladie. La détection précoce des premiers symptômes et l'intervention spécialisée débutent dès cette phase de prodromes. L'intervention à ce stade a pour objectif d'infléchir la trajectoire de la maladie et de limiter le risque de faire un premier épisode psychotique. Pour les patients qui font un tel épisode, un traitement antipsychotique doit être instauré sans délai. Le retard à l'instauration du traitement antipsychotique et à l'adressage des patients en psychiatrie impacte négativement leur pronostic à court, moyen et long terme : symptômes plus graves, moins bonne réponse au traitement et moins bon fonctionnement global. L'adressage rapide passe par une détection précoce qui implique en première ligne les médecins généralistes, qui sont souvent sollicités en première intention par les patients et leur famille."


Assuntos
Antipsicóticos , Transtornos Psicóticos , Esquizofrenia , Adolescente , Adulto , Antipsicóticos/uso terapêutico , Diagnóstico Precoce , Humanos , Transtornos Psicóticos/tratamento farmacológico , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Esquizofrenia/terapia
14.
Pharmacogenomics ; 22(7): 389-399, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33858192

RESUMO

Aim: Explore the possible association between clinical factors and genetic variants of the dopamine pathways and negative symptoms. Materials & methods: Negative symptoms were assessed in 206 patients with schizophrenia using the Arabic version of the self-evaluation of negative symptoms scale and the Positive and Negative Syndrome Scale. Genotyping for COMT, DRD2, MTHFR and OPRM1 genes was performed. Results: Multivariable analysis showed that higher self-evaluation of negative symptoms scale scores were significantly associated with higher age, higher chlorpromazine-equivalent daily dose for typical antipsychotics and in married patients. Higher negative Positive and Negative Syndrome Scale scores were significantly associated with women and having the CT genotype for MTHFR c.677C>T (ß = 4.25; p = 0.008) compared with CC patients. Conclusion: Understanding both clinical/genetic factors could help improve the treatment of patients.


Assuntos
Esquizofrenia/genética , Psicologia do Esquizofrênico , Antipsicóticos/uso terapêutico , Catecol O-Metiltransferase/genética , Clorpromazina/uso terapêutico , Feminino , Frequência do Gene/genética , Técnicas de Genotipagem , Humanos , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genética , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Receptores Opioides mu/genética , Esquizofrenia/tratamento farmacológico , Resultado do Tratamento
15.
Nord J Psychiatry ; 75(5): 351-355, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33356749

RESUMO

PURPOSE: To validate the Lithuanian version of the Self-Evaluation Negative Symptoms Scale (Lith-SNS). MATERIALS AND METHODS: A double translation from French to Lithuanian and back was performed. We included patients from in-patient and out-patient settings that had a diagnosis of paranoid schizophrenia according to ICD-10 criteria and were screened as free from acute psychotic symptoms using the Mini International Neuropsychiatric Interview (MINI). Participants were evaluated using the Brief Psychiatric Rating Scale (BRPS) and completed the Lith-SNS scale. We measured internal consistency, convergent validity, and discriminant validity of Lith - SNS comparing its scores with BPRS negative and positive symptom subscores. RESULTS: A total of 67 participants were evaluated. Cronbach's alpha (α) for all 20 items of Lith-SNS (α = 0.82), and for the five subscores (α = 0.76) showed good internal consistency. Factor analysis showed a 2-factor solution which accounted for 70.12% of the variance with the first factor accounting for 53.3% and the second factor accounting for 16.8% of the variance. Lith-SNS total scores and all five subscores significantly correlated with BPRS negative symptoms subscores showing good convergent validity. There was a correlation between the Positive subscore of BPRS and the alogia subscore of Lith-SNS (r = 0.39, p = 0.001), but no correlations with other subscores or the total Lith-SNS score showing adequate discriminant validity. CONCLUSIONS: Lithuanian version of SNS is a valuable tool to evaluate negative symptoms of schizophrenia with good internal consistency, convergent, and discriminant validity.


Assuntos
Autoavaliação Diagnóstica , Esquizofrenia , Humanos , Escalas de Graduação Psiquiátrica , Psicometria , Reprodutibilidade dos Testes
16.
Eur Arch Psychiatry Clin Neurosci ; 271(2): 325-337, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32458107

RESUMO

Patients with schizophrenia (SZ) have a high level of cardiovascular morbidity and some clinical symptoms of illness remain resistant to pharmacological approaches. A large number of studies support the effectiveness of physical activity (PA) in SZ. The aims of this trial is to assess the effects of a remote, web-based adapted PA program (e-APA) compared to a health education program (e-HE) on brain plasticity in SZ and healthy volunteers (HV) and on psychiatric, neurocognitive, circadian and physical variables. The study is an interventional, multicenter, randomized open-label trial. Forty-two SZ will be randomized to either the active group (e-APA, N = 21) or nonactive group (e-HE, N = 21), and 21 HV will be matched to SZ according to age, gender, and level of PA in both e-APA and e-HE groups. Interventions will consist of 32 sessions (2 × 60 min/week, for 16 weeks) via supervised home-based videoconferencing. Cerebral magnetic resonance imaging, psychiatric symptoms, neurocognitive and circadian rhythms assessments as well as physical tests and biological analyses will be assessed at baseline and 16 weeks after the intervention. To our knowledge, this is the first study aiming to evaluate the efficacy of APA delivered by supervised home-based videoconferencing in SZ. Moreover, using multimodal MRI, this study could clarify the pathophysiological mechanisms underlying the efficacy of APA. Finally, this innovative approach might also increase participation in long-term PA since PA-based programs are known to have low adherence and early dropout. Trial registration: ClinicalTrials.gov identifier: NCT03261817. Registered on 16 August 2017.


Assuntos
Encéfalo , Terapia por Exercício , Intervenção Baseada em Internet , Educação de Pacientes como Assunto , Reabilitação Psiquiátrica , Esquizofrenia/reabilitação , Telerreabilitação , Adolescente , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Encéfalo/patologia , Encéfalo/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Plasticidade Neuronal/fisiologia , Avaliação de Resultados em Cuidados de Saúde , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/metabolismo , Esquizofrenia/fisiopatologia , Comunicação por Videoconferência , Adulto Jovem
17.
Schizophr Res ; 228: 519-528, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33298334

RESUMO

Whether the etiology of schizophrenia remains unknown, its multifactorial aspect is conversely now well admitted. However, most preclinical models of the disease still rely on a mono-factorial construction and do not allow discover unequivocal treatments, particularly for negative and cognitive symptoms. The main interaction factors that have been implicated in schizophrenia are a genetic predisposition and unfavorable environmental factors. Here we propose a new animal model combining a genetic predisposition (1st hit: partial deletion of MAP-6 (microtubule-associated protein)) with an early postnatal stress (2nd hit: 24 h maternal separation at post-natal day 9), and a late cannabinoid exposure during adolescence (3rd hit: tetrahydrocannabinol THC from post-natal day 32 to 52; 8 mg/kg/day). The 2-hit mice displayed spatial memory deficits, decreased cortical thickness and fractional anisotropy of callosal fibers. The 3-hit mice were more severely affected as attested by supplementary deficits such a decrease in spontaneous activity, sociability-related behavior, working memory performances, an increase in anxiety-like behavior, a decrease in hippocampus volume together with impaired integrity of corpus callosum fibers (less axons, less myelin). Taken together, these results show that the new 3-hit model displays several landmarks mimicking negative and cognitive symptoms of schizophrenia, conferring a high relevance for research of new treatments. Moreover, this 3-hit model possesses a strong construct validity, which fits with gene x environment interactions hypothesis of schizophrenia. The 2-hit model, which associates maternal separation with THC exposure in wild-type mice gives a less severe phenotype, and could be useful for research on other forms of psychiatric diseases.


Assuntos
Esquizofrenia , Animais , Modelos Animais de Doenças , Interação Gene-Ambiente , Hipocampo , Privação Materna , Camundongos , Esquizofrenia/genética
18.
Can J Psychiatry ; 66(8): 683-700, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33131322

RESUMO

OBJECTIF: L'objectif de cette revue est d'identifier les corrélats anatomo-fonctionnels cérébraux lors d'un traitement par clozapine (CLZ) ainsi que les marqueurs anatomo-fonctionnels prédictifs de la réponse à la CLZ. MÉTHODES: Nous avons réalisé une revue systématique de la littérature avec les bases de données MEDLINE et Web of Science afin d'identifier et d'examiner toutes les études longitudinales en neuroimagerie investiguant l'impact cérébral de la CLZ. RÉSULTATS: 30 études ont été incluses et analysées. La CLZ induit une diminution du volume et de la perfusion dans les noyaux gris centraux chez les patients répondeurs. Un plus grand volume de substance grise et perfusion dans ces structures avant l'instauration de la CLZ étaient associés à une meilleure réponse au traitement. La diminution de volume et de perfusion au niveau du cortex préfrontal (CPF) est observée malgré l'instauration de CLZ mais de façon moins importante chez les patients sous CLZ que chez les patients sous antipsychotiques typiques. Un plus grand volume au niveau du CPF avant l'instauration de la CLZ est associé à une meilleure réponse clinique dans la majorité des études. Enfin, la CLZ semble induire une réduction des altérations au niveau de la substance blanche. CONCLUSION: Les corrélats anatomo-fonctionnels de la CLZ différent de ceux des autres antipsychotiques avec une action spécifique de la CLZ au niveau des ganglions de la base et du CPF pouvant participer à sa supériorité en termes de réponse clinique. Plusieurs données cliniques et d'imagerie conduisent à l'hypothèse d'un meilleur pronostic associé à une instauration plus rapide de la CLZ.


Assuntos
Clozapina , Esquizofrenia/tratamento farmacológico , Clozapina/efeitos adversos , Clozapina/uso terapêutico , Humanos
19.
Brain Sci ; 10(6)2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32481756

RESUMO

Visual scenes are processed in terms of spatial frequencies. Low spatial frequencies (LSF) carry coarse information, whereas high spatial frequencies (HSF) subsequently carry information about fine details. The present magnetic resonance imaging study investigated how cortical thickness covaried with LSF/HSF processing abilities in ten-year-old children and adults. Participants indicated whether natural scenes that were filtered in either LSF or HSF represented outdoor or indoor scenes, while reaction times (RTs) and accuracy measures were recorded. In adults, faster RTs for LSF and HSF images were consistently associated with a thicker cortex (parahippocampal cortex, middle frontal gyrus, and precentral and insula regions for LSF; parahippocampal cortex and fronto-marginal and supramarginal gyri for HSF). On the other hand, in children, faster RTs for HSF were associated with a thicker cortex (posterior cingulate, supramarginal and calcarine cortical regions), whereas faster RTs for LSF were associated with a thinner cortex (subcallosal and insula regions). Increased cortical thickness in adults and children could correspond to an expansion mechanism linked to visual scene processing efficiency. In contrast, lower cortical thickness associated with LSF efficiency in children could correspond to a pruning mechanism reflecting an ongoing maturational process, in agreement with the view that LSF efficiency continues to be refined during childhood. This differing pattern between children and adults appeared to be particularly significant in anterior regions of the brain, in line with the proposed existence of a postero-anterior gradient of brain development. Taken together, our results highlight the dynamic brain processes that allow children and adults to perceive a visual natural scene in a coherent way.

20.
BMC Psychiatry ; 20(1): 240, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32408876

RESUMO

BACKGROUND: The self-evaluation of negative symptoms scale (SNS) is a new easy-to-use self-administered questionnaire allowing clinicians to understand the clinical and genetic factors affecting the negative symptoms in patients with schizophrenia. There was a need to translate and validate this scale in Arabic so that Arab-speaking patients benefit from it. Therefore, the aim of our study was to validate the Arabic version of the SNS in a sample of Lebanese patients with schizophrenia. METHODS: The Arabic SNS was used to quantify the disability associated with negative symptoms in patients with schizophrenia (n = 206). Six weeks after completing the SNS, the participants were interviewed again to assess test-retest reproducibility. The validity was confirmed by factor analyses using the principal component analysis technique with a varimax rotation. The Positive and Negative Syndrome Scale (PANSS) was also assessed. RESULTS: None of the items of the SNS scale were removed; all items converged over a solution of five factors that had an eigenvalue > 1, explaining a total of 66.01% of the variance (Cronbach's alpha = 0.879; test part). The mean total SNS score was 17.33 ± 8.43 for the "test", and 16.35 ± 7.50 for the "retest". The correlation coefficients between the SNS total score and the PANSS scale and subscales were as follows: total PANSS (r = 0.044; p = 0.530), positive PANSS score (r = - 0.106; p = 0.131), negative PANSS score (r = 0.204; p = 0.003), and general psychopathological PANSS score (r = 0.03; p = 0.530). CONCLUSION: This study is the first to validate the Arabic version of the SNS in patients with schizophrenia. Using this scale would help improve treatment by correctly assessing negative symptoms, thus optimizing treatment options.


Assuntos
Autoavaliação Diagnóstica , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Tradução , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA