General and domain-specific neurocognitive impairments in deficit and non-deficit schizophrenia.

Earlier studies suggested more severe overall cognitive impairments in deficit versus non-deficit schizophrenia; however, the specific contribution of different cognitive domains to this overall cognitive impairment remains unclear. The purpose of this study was to compare the two subtypes in general cognitive functioning as well as in individual cognitive domains using the composite score approach. One hundred and forty-three patients fulfilling the criteria for the deficit syndrome were compared with 123 patients diagnosed with non-deficit schizophrenia. Neurocognitive functioning was assessed by a neuropsychological test battery measuring the domains of sustained vigilance/attention, working memory, short-term memory, verbal memory, cognitive flexibility, and ideation fluency. Using the raw neuropsychological measures, we calculated a global index of cognitive impairment and domain-specific composite z-scores. Association between these composite scores and the deficit syndrome was examined by logistic regression analysis. After adjusting for relevant covariates including sex, age, education, smoking, and antipsychotic dose, results indicated a significant increase in the likelihood of deficit syndrome as a function of global (OR = 5.40; 95% CI 3.02-9.65) as well as domain-specific impairments (OR > 2 for all individual domains except for short-term memory). Cognitive flexibility was an independent predictor (OR = 2.92; 95% CI 1.47-5.80), whereas other cognitive domains demonstrated no unique contribution to the general cognitive impairment. Patients with deficit schizophrenia suffer from a more severe degree of neurocognitive impairment, which is qualitatively similar to the dysfunction seen in non-deficit schizophrenia. However, our results indicate that cognitive flexibility is specifically impaired in deficit versus non-deficit patients and may therefore represent a core feature of this subtype.

Spectroscopic characterization of tablet properties in a continuous powder blending and tableting process.

By the advent of continuous pharmaceutical manufacturing, fast and accurate characterization of product quality has become of a major interest. Although it also promotes the real-time release testing approach, so far mainly content uniformity studies were performed by near-infrared (NIR) spectroscopy. This paper proposes the simultaneous application of NIR and Raman spectroscopy to nondestructively analyze the critical quality attributes of continuously produced tablets in a real-time release testing procedure. A face-centered composite design was applied to determine the impact of lubrication and compression force on the properties of a tablet formulation containing caffeine, glucose-monohydrate and magnesium stearate and to provide a systematic comparison of the applicability of spectroscopic methods. Quantitative methods were developed to evaluate different lubrication approaches in a continuous blending and tableting line. The simultaneous application of NIR and Raman spectroscopy revealed that NIR spectroscopy is more suitable to follow the changes of compression force, while Raman spectroscopy could be successfully applied for the detection of overlubrication. The presented approach can be a part of a comprehensive real-time release strategy, where NIR and Raman spectroscopy provide complementary information about multiple critical quality attributes, such as content uniformity, tablet hardness, friability and dissolution.

[Monitoring of quality of life--review]. / Az életminoség vizsgálata--áttekinto tanulmány.

Over the past few years, the study of the Quality of Life (QOL) has become a focus of clinical research, with respect to its importance in the assessment of functioning. In many chronic illnesses, a linear relationship cannot be found between the alleviation of symptoms and long-term functioning. Therefore, the efficacy of therapy cannot be estimated only by symptom scales. In addition, monitoring of the Quality of Life can be used to assess subjective satisfaction with therapy and to estimate its cost-effectiveness. Quality of Life scales have two basic subtypes: general and illness-specific questionnaires, which have been produced in huge numbers. In view of the fact that quality of life depends on culture, validated versions of these questionnaires have made in many countries. The topic has a fairly broad scope; therefore, in the present review, we offer a brief survey of the QOL-literature published during the last six years on the basis of four important journals which have a high impact factor and deal with general topics (American Journal of Psychiatry, Archives of General Psychiatry, Journal of Clinical Psychiatry, and British Journal of Psychiatry). In the first part we introduce the scales that are used most often, while in the second part we present the results of the illness-specific research studies. We hope that our review will be a good map to the labyrinth of this topic and will provide help for selecting the most suitable scale for everyone.