ABSTRACT
Negative symptoms and cognitive deficits play a major role in psychosis and significantly influence the functional outcomes of patients, particularly those with a first episode of psychosis (FEP). However, limited research has explored the predictive capacity of cognitive deficits during FEP for subsequent negative symptomatology. Drawing from the Athens FEP research study, we conducted a retrospective longitudinal study in 80 individuals with FEP. All patients were drug naive at admission. Cognitive tests were administered at 1-month and 1-year post-admission, while negative symptomatology was assessed at the same time points using PANSS by trained raters. We considered confounding factors such as age, gender, duration of untreated psychosis (DUP), treatment received, premorbid social adjustment, and premorbid IQ. Univariate regression analysis identified cognitive domains that correlated with negative symptomatology. These, along with the confounders, were incorporated into a multiple regression, with the 1-year PANSS negative scale serving as the dependent variable. Employing the backward elimination technique, we found a statistically significant inverse relationship between the categories completed in the Wisconsin card sorting test (WCST) and the 1-year PANNS negative scale (p = 0.01), beyond the associations with DUP and the 1-month PANSS negative scale. Our results suggest that cognitive flexibility, a key component of executive functions, predicts negative symptom severity one year after FEP.
ABSTRACT
The present study attempts to examine the mental health locus of control (LOC) of refugees with clinically diagnosed psychopathology and to examine the possible association of LOC with the presentation of the psychopathology. LOC refers to the degree to which a person attributes what happens in their life to themselves or to external factors. It draws its theoretical background from Rotter's theory of social learning. External LOC has been linked to psychopathology in anxiety disorders (AD), depression and post-traumatic stress disorder (PTSD), of which migrants are primarily at risk in comparison to the indigenous population. This is a descriptive cross-sectional study. The study involved 40 refugees who were referred to the psychiatric office, by the psychologists of a non-governmental organization, due to clinically established psychopathology. In the first session, the Patient Health Questionnaire-9 (PHQ-9) and the Harvard Trauma Questionnaire-5 (HTQ5) were administered, according to the score of which the psychologists' referral diagnoses were confirmed. To assess the LOC the Multidimensional Health Locus of Control Questionnaire (MHLC) was administered, which measures LOC in self, significant others, and luck. The questionnaires were administered in English, Farsi, and Lingala. We translated the MHLC questionnaire to Lingala for the needs of the present study and the validity of the translation was ensured using back-translation, from English to Lingala and from Lingala back to English by different translators to control the identification of the English texts. Refugees scored lower on self and higher on significant others and chance. Correlations between LOC and the presentation of psychopathology were sought. A negative correlation was found between the severity of depression and the score on self on the MHLC, a finding that has also been demonstrated in other studies. The intensity of depression was positively correlated with the score of MHLC on luck. There was also a positive correlation between the intensity of the symptoms of PTSD and the score of MHLC to luck, in our sample. The present study highlights the Multidimensional Health Locus of Control Questionnaire as a remarkable and useful tool in the assessment of refugees with psychopathology in Greece.