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1.
Front Aging Neurosci ; 15: 1100057, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36993909

RESUMEN

Introduction: Age-related decline in episodic memory performance in otherwise healthy older adults is indisputably evident. Yet, it has been shown that under certain conditions episodic memory performance in healthy older adults' barely deviates from those seen in young adults. Here we report on the quality of object encoding in an ecologically valid, virtual-reality based memory assessment in a sample of healthy older and younger adults with comparable memory performance. Methods: We analyzed encoding by establishing both a serial and semantic clustering index and an object memory association network. Results: As expected, semantic clustering was superior in older adults without need for additional allocation of executive resources whereas young adults tended more to rely on serial strategies. The association networks suggested a plethora of obvious but also less obvious memory organization principles, some of which indicated converging approaches between the groups as suggested by a subgraph analysis and some of which indicated diverging approaches as suggested by the respective network interconnectivity. A higher interconnectivity was observed in the older adults' association networks. Discussion: We interpreted this as a consequence of superior semantic memory organization (extent to which effective semantic strategies diverged within the group). In conclusion, these results might indicate a diminished need for compensatory cognitive effort in healthy older adults when encoding and recalling everyday objects under ecologically valid conditions. Due to an enhanced and multimodal encoding model, superior crystallized abilities might be sufficient to counteract an age-related decline in various other and specific cognitive domains. This approach might potentially elucidate age-related changes in memory performance in both healthy and pathological aging.

2.
Disabil Rehabil ; 45(26): 4457-4470, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36523117

RESUMEN

PURPOSE: Insurers often commission psychiatric experts to evaluate the eligibility of workers with mental disorders for disability benefits, by estimating their residual work capacity (RWC). We investigated the validity of a standardized, computer-based battery of established diagnostic instruments, for evaluating the personality, cognition, performance, symptom burden, and symptom validity of claimants. METHODS: One hundred and fifty-three claimants for benefits were assessed by the assembled test battery, which was applied in addition to a conventional clinical work disability evaluation. RESULTS: A principal component analysis of the test and questionnaire battery data revealed six factors (Negative Affectivity, Self-Perceived Work Ability, Behavioral Dysfunction, Working Memory, Cognitive Processing Speed, and Excessive Work Commitment). Claimants with low, medium, and high RWC exclusively varied in the factor Negative Affectivity. Importantly, this factor also showed a strong association to psychiatric ratings of capacity limitations in psychosocial functioning. CONCLUSIONS: The findings demonstrate that the used test battery allows a substantiation of RWC estimates and of psychiatric ratings by objective and standardized data. If routinely incorporated in work disability evaluations, the test battery could increase their transparency for all stakeholders (insurers, claimants, medical experts, expert case-coordinators, and legal practitioners) and would open new avenues for research in the field of insurance medicine.Implications for rehabilitationThe residual work capacity (RWC) estimation by medical experts is internationally good practice, but plagued by a relatively low interrater agreement.The current study shows that psychiatric RWC estimates and capacity limitation ratings can be substantiated by data from objective, standardized psychometric instruments.Systematically using such instruments might help to improve the poor interrater agreement for RWC estimates in work disability evaluations.Such data could also be used for adopting vocational trainings and return-to-work programs to the individual needs of workers with mental health problems.


Asunto(s)
Personas con Discapacidad , Seguro por Discapacidad , Medicina , Humanos , Psicometría , Evaluación de Capacidad de Trabajo , Evaluación de la Discapacidad , Personas con Discapacidad/psicología
3.
Sex Abuse ; 33(5): 579-605, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32543329

RESUMEN

The present study aimed to differentiate pedophilic child sex offenders (CSOs) from nonoffending controls (CTLs), as well as contact from noncontact CSOs. For this purpose, we investigated 21 contact CSOs, 20 noncontact CSOs (child pornography offenders), as well as 21 CTLs on neuropsychological test measures and indirect test measures of sexual interest. Multiple logistic regression models showed that three parameters of indirect tests and two neuropsychological test parameters allowed the differentiation of CSOs from CTLs with a maximum accuracy of 87%. The profile of contact and noncontact CSOs was remarkably similar and the optimal model for this group differentiation had a maximum accuracy of 66%, with slightly increased levels of risk-taking behavior and greater susceptibility for perceptual interference in contact CSOs than in noncontact CSOs. The findings suggest that standardized, objective methods can support the assessment of sexual offenders against children in forensic psychiatry and legal psychology.


Asunto(s)
Criminales , Pedofilia , Delitos Sexuales , Niño , Literatura Erótica , Humanos , Conducta Sexual
4.
J Child Sex Abus ; 28(8): 990-1006, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31225780

RESUMEN

Personality traits are considered as an important aspect in the assessment of child sex offenders (CSOs). The current study sought to elucidate the association between neuroticism, psychopathy, and abusive behavior in low risk CSOs. 43 pedophilic CSOs and 21 controls (CTLs) completed the NEO-Personality Inventory-Revised (NEO-PI-R), Psychopathy Checklist: Screening Version (PCL:SV), and Multiphasic Sex Inventory (MSI). Our results revealed small differences in PCL scores between CSOs and CTLs, with comparatively low levels of psychopathy in both groups. Higher levels of neuroticism were associated with higher PCL scores, in both CSOs and CTLs. However, higher PCL scores in CSOs did not correlate with higher MSI total scores on the subscale child molest. These findings suggest an ambiguous role of psychopathy in CSOs: higher levels of psychopathy co-occur with higher levels of neuroticism, but psychopathy does apparently not modulate abusive behavior, at least not in low risk offenders, as currently investigated.


Asunto(s)
Trastorno de Personalidad Antisocial/psicología , Abuso Sexual Infantil/psicología , Neuroticismo , Personalidad , Adulto , Estudios de Casos y Controles , Niño , Psiquiatría Forense , Humanos , Masculino , Inventario de Personalidad/normas
5.
Neuropsychology ; 32(6): 680-689, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29878838

RESUMEN

OBJECTIVES: Since the advent of imaging techniques, the role of the neuropsychological assessment has changed. Questions concerning everyday functionality became primarily important and, thus, ecologically valid neuropsychological assessments are mandatory. Virtual reality (VR) environments might provide a way of implementing immersive cognitive assessments with a higher degree of everyday-life-related cognitive demands. METHOD: We report on a VR-based episodic memory examination in N = 30 young and N = 18 healthy older adults (HOA) using a kitchen scene. The test procedure was designed to be structurally comparable to clinically used California Verbal Learning Test (CVLT) in terms of repeated learning trials as well as short and long delayed recall measures. RESULTS: The results showed that age-related learning and performance decrements were mainly evident in the CVLT but not in the VR-memory examination. CONCLUSIONS: The ecologically valid VR-memory examination might provide a more accurate "age-fair" estimation of everyday-life-related memory demands in HOA than the frequently and clinically used CVLT. We concluded this from our finding of context-related automatic and effortless activations of deeply experience based encoding and retrieval strategies with regard to everyday-life-related objects in the HOA, which might not be paralleled by learning arbitrary word associations. (PsycINFO Database Record


Asunto(s)
Envejecimiento/fisiología , Trastornos de la Memoria/fisiopatología , Memoria Episódica , Pruebas Neuropsicológicas/normas , Aprendizaje Verbal/fisiología , Realidad Virtual , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
6.
Psychol Res Behav Manag ; 11: 157-168, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29785144

RESUMEN

BACKGROUND: Episodic memory encoding and working memory (WM) deficits are among the first cognitive signs and symptoms in the course of schizophrenia spectrum disorders. However, it is not clear whether the deficit pattern is generalized or specific in nature. We hypothesized that encoding deficits at an early stage of the disease might be due to the more fundamental WM deficits. METHODS: We examined episodic memory encoding and WM by administering the California Verbal Learning Test, a 2-back task, and the Wisconsin Card Sorting Test in 90 first-episode psychosis (FE) patients and 116 individuals with an at-risk mental state for psychosis (ARMS) compared to 57 healthy subjects. RESULTS: Learning progress, but not span of apprehension, was diminished to a similar extent in both the ARMS and the FE. We showed that this was due to WM impairment by applying a structural equation approach. CONCLUSION: Thus, we conclude that verbal memory encoding deficits are secondary to primary WM impairment in emerging psychosis.

7.
Neuroimage ; 167: 354-365, 2018 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-29175611

RESUMEN

While much is known about immediate brain activity changes induced by the confrontation with emotional stimuli, the subsequent temporal unfolding of emotions has yet to be explored. To investigate whether exposure to emotionally aversive pictures affects subsequent resting-state networks differently from exposure to neutral pictures, a resting-state fMRI study implementing a two-group repeated-measures design in healthy young adults (N = 34) was conducted. We focused on investigating (i) patterns of amygdala whole-brain and hippocampus connectivity in both a seed-to-voxel and seed-to-seed approach, (ii) whole-brain resting-state networks with an independent component analysis coupled with dual regression, and (iii) the amygdala's fractional amplitude of low frequency fluctuations, all while EEG recording potential fluctuations in vigilance. In spite of the successful emotion induction, as demonstrated by stimuli rating and a memory-facilitating effect of negative emotionality, none of the resting-state measures was differentially affected by picture valence. In conclusion, resting-state networks connectivity as well as the amygdala's low frequency oscillations appear to be unaffected by preceding exposure to widely used emotionally aversive visual stimuli in healthy young adults.


Asunto(s)
Amígdala del Cerebelo/fisiología , Nivel de Alerta/fisiología , Conectoma/métodos , Electroencefalografía/métodos , Emociones/fisiología , Red Nerviosa/fisiología , Reconocimiento Visual de Modelos/fisiología , Adolescente , Adulto , Amígdala del Cerebelo/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Red Nerviosa/diagnóstico por imagen , Adulto Joven
8.
Int J Law Psychiatry ; 54: 83-89, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28595809

RESUMEN

Studies in child sex offenders (CSO) often report deviant personality characteristics. In our study, we investigated neuroticism in CSO and tested the hypothesis that CSO with high neuroticism show more serious abuse behavior and are more likely to exhibit sexual dysfunction and cognitive distortions, as compared to CSO with low neuroticism. A sample of 40 CSO (both child sexual abusers and child sexual material users) was split into two subsamples based on their neuroticism scores, obtained by the NEO-Personality Inventory-Revised (NEO-PI-R) questionnaire. Subsequently, we compared their scores in the Multiphasic Sex Inventory (MSI) questionnaire and Symptom Checklist-90-Revised (SCL-90-R). Our results show that CSO exhibited higher levels of neuroticism than controls, but were still in the normal range. In CSO, neuroticism was associated with sexual dysfunction and cognitive distortions, rather than with more severe abuse behavior. Moreover, neuroticism in this group was linked to a broad range of psychological problems and psychopathological symptoms, such as somatization or anxiety. Our findings suggest that neuroticism even below the level of personality disorder is associated with a broader range of psychological problems in CSO, which should be addressed in therapy.


Asunto(s)
Abuso Sexual Infantil/psicología , Disfunción Cognitiva/complicaciones , Disfunción Cognitiva/psicología , Neuroticismo , Disfunciones Sexuales Fisiológicas/psicología , Disfunciones Sexuales Psicológicas/complicaciones , Adolescente , Adulto , Estudios de Casos y Controles , Comorbilidad , Psiquiatría Forense , Humanos , Masculino , Persona de Mediana Edad , Trastornos de la Personalidad/complicaciones , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/psicología , Inventario de Personalidad , Disfunciones Sexuales Fisiológicas/complicaciones , Suiza , Adulto Joven
9.
Child Abuse Negl ; 68: 44-54, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28395194

RESUMEN

Findings on the relationship of experienced sexual abuse and abuse behavior in adulthood are ambiguous. However, associations between experienced abuse and neuroticism as well as between neuroticism and active child abuse have been reported repeatedly. In our study, we compared pedosexual child abusers with consumers of internet child pornography and control subjects with adult-sexual preference with regard to traumatic childhood experience (Childhood Trauma Questionnaire, CTQ), personality traits (NEO - Personality Inventory - Revised, NEO-PI-R), and sexual abnormalities (Multiphasic Sex Inventory, MSI). In an initial analysis, sexual abuse experienced in childhood was not directly linked to sexual abuse behavior in adulthood. However, this relationship was mediated by neuroticism. In a second step, the CTQ scales were conflated and, using a structural equation model, direct links between the overall level of abuse experienced in childhood (generally high CTQ levels) and sexual abuse behavior in adulthood revealed again the mediation by neurotic personality. We conclude that the overall level of abuse experienced in childhood in general, and less sexual abuse experience in particular, modulates the tendency for child sexual abuse behavior in adulthood. Data suggest that, depending on the resilience of an individual, abuse experience during childhood increases the likelihood of developing neurotic personality traits in later life, which are in turn considered to increase the risk of child sexual abuse in child sex offenders.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Abuso Sexual Infantil/psicología , Neuroticismo , Adolescente , Adulto , Niño , Literatura Erótica , Femenino , Humanos , Internet , Masculino , Persona de Mediana Edad , Personalidad , Inventario de Personalidad , Factores de Riesgo , Encuestas y Cuestionarios , Adulto Joven
10.
Fortschr Neurol Psychiatr ; 85(1): 17-33, 2017 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-28114691

RESUMEN

High prevalence rates of non-authentic complaints identified by experts in the field of insurance medicine draw attention to the risk of services, which are of limited availability and financially compensated, being used in ways that are not goal-oriented. Therefore, symptom validity testing has become a growing issue to prevent non-targeted monetary compensations. This paper outlines the best-evaluated methods and instruments. Based on the data currently available, their validity, in particular in the context of medico-legal assessment, is assessed. It is concluded that symptom validity assessment allows inferences about the degree of certainty of clinical judgements on the authenticity of reported symptoms. Thus, the application of the suggested instruments enhances significantly the quality of medical and psychological expertise. However, the integration of the additional results into the overall assessment is challenging and needs to be further clarified.


Asunto(s)
Evaluación de la Discapacidad , Testimonio de Experto , Seguro por Discapacidad , Simulación de Enfermedad/diagnóstico , Compensación y Reparación/legislación & jurisprudencia , Diagnóstico Diferencial , Testimonio de Experto/legislación & jurisprudencia , Alemania , Humanos , Seguro por Discapacidad/legislación & jurisprudencia
11.
PLoS One ; 10(11): e0143293, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26576055

RESUMEN

BACKGROUND & AIMS: Sleep disturbance is associated with the development of obesity, diabetes and hepatic steatosis in murine models. Hepatic triglyceride accumulation oscillates in a circadian rhythm regulated by clock genes, light-dark cycle and feeding time in mice. The role of the sleep-wake cycle in the pathogenesis of human non-alcoholic fatty liver disease (NAFLD) is indeterminate. We sought to detail sleep characteristics, daytime sleepiness and meal times in relation to disease severity in patients with NAFLD. METHODS: Basic Sleep duration and latency, daytime sleepiness (Epworth sleepiness scale), Pittsburgh sleep quality index, positive and negative affect scale, Munich Chronotype Questionnaire and an eating habit questionnaire were assessed in 46 patients with biopsy-proven NAFLD and 22 healthy controls, and correlated with biochemical and histological parameters. RESULTS: In NAFLD compared to healthy controls, time to fall asleep was vastly prolonged (26.9 vs. 9.8 min., p = 0.0176) and sleep duration was shortened (6.3 vs. 7.2 hours, p = 0.0149). Sleep quality was poor (Pittsburgh sleep quality index 8.2 vs. 4.7, p = 0.0074) and correlated with changes in affect. Meal frequency was shifted towards night-times (p = 0.001). In NAFLD but not controls, daytime sleepiness significantly correlated with liver enzymes (ALAT [r = 0.44, p = 0.0029], ASAT [r = 0.46, p = 0.0017]) and insulin resistance (HOMA-IR [r = 0.5, p = 0.0009]) independent of cirrhosis. In patients with fibrosis, daytime sleepiness correlated with the degree of fibrosis (r = 0.364, p = 0.019). CONCLUSIONS: In NAFLD sleep duration was shortened, sleep onset was delayed and sleep quality poor. Food-intake was shifted towards the night. Daytime sleepiness was positively linked to biochemical and histologic surrogates of disease severity. The data may indicate a role for sleep-wake cycle regulation and timing of food-intake in the pathogenesis of human NAFLD as suggested from murine models.


Asunto(s)
Resistencia a la Insulina , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Índice de Severidad de la Enfermedad , Trastornos del Sueño-Vigilia/complicaciones , Trastornos del Sueño-Vigilia/fisiopatología , Sueño , Estudios de Casos y Controles , Conducta Alimentaria , Humanos , Hígado/enzimología , Hígado/patología , Cirrosis Hepática/complicaciones , Persona de Mediana Edad , Factores de Tiempo
12.
BMC Psychol ; 3(1): 22, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26146558

RESUMEN

BACKGROUND: Under stressful conditions such as in an emergency situation, efficient information processing is essential for reasonable responses. PURPOSE OF THE STUDY: Virtual Reality (VR) technology is used to induce stress and to test three main cognitive functions for decision making in stressful situations. METHODS: A VR task was developed to induce stress following the Trier Social Stress Test (TSST) protocol and two VR cognitive performance tests to measure learning aptitude, spatial orientation and cognitive flexibility. Participants (N = 31) gave a public speech in front of a virtual audience (TSST) and later had to find their way out of different VR labyrinths. The first exercise tested spatial orientation and learning aptitude where participants had to learn aspects of the ground layout and geometric icons had to be identified as correct in order to be able to exit. The second labyrinth tested cognitive flexibility on the background of the Wisconsin Card Sorting Test. STATISTICAL TESTS: Correlations were analyzed using Kendall Tau Correlation (One-tailed tests with p set to 0.05 for all analyses). Heart rate (HR) was calculated from the RR time values and averaged across the TSST- speech and the post-stress period. Autonomic nervous system reactivity was defined as the deviation of HR during TSST- speech condition from post-stress baseline measurement. A repeated-measures t-test was used to analyze differences. RESULTS: The newly developed virtual stress test was successfully adapted from the original TSST. Participants perceived the task as stressful and scored an average of 5.7 points on a 1-8 Likert Scale. As a physiological stress parameter, increased heart rates of the participants showed that they were more stressed during the TSST procedure compared to the post-stress period. Also, the subjective stress perception, has a strong correlation with the results of the cognitive tasks performed after the stress induction. CONCLUSIONS: The more a participant experienced the TSST as stressful, the lower their learning aptitude and spatial orientation were found to be at the end of the study. On the other hand, if someone perceived the virtual TSST as "unexpected", as an indicator for a mild stress response, their cognitive flexibility was improved. Potential Implications: The findings indicate that both, the VR stress induction scenario using TSST, as well as the VR cognitive tests, are a first successful step towards a better ecological validity in neuropsychological testing.

13.
BMC Psychiatry ; 15: 62, 2015 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-25885691

RESUMEN

BACKGROUND: Psychiatric expert opinions are supposed to assess the accused individual's risk of reoffending based on a valid scientific foundation. In contrast to specific recidivism, general recidivism has only been poorly considered in Continental Europe; we therefore aimed to develop a valid instrument for assessing the risk of general criminal recidivism of mentally ill offenders. METHOD: Data of 259 mentally ill offenders with a median time at risk of 107 months were analyzed and combined with the individuals' criminal records. We derived risk factors for general criminal recidivism and classified re-offences by using a random forest approach. RESULTS: In our sample of mentally ill offenders, 51% were reconvicted. The most important predictive factors for general criminal recidivism were: number of prior convictions, age, type of index offence, diversity of criminal history, and substance abuse. With our statistical approach we were able to correctly identify 58-95% of all reoffenders and 65-97% of all committed offences (AUC = .90). CONCLUSIONS: Our study presents a new statistical approach to forensic-psychiatric risk-assessment, allowing experts to evaluate general risk of reoffending in mentally disordered individuals, with a special focus on high-risk groups. This approach might serve not only for expert opinions in court, but also for risk management strategies and therapeutic interventions.


Asunto(s)
Crimen/estadística & datos numéricos , Trastornos Mentales/psicología , Adulto , Área Bajo la Curva , Crimen/psicología , Criminales/psicología , Criminales/estadística & datos numéricos , Femenino , Psiquiatría Forense/métodos , Humanos , Masculino , Recurrencia , Medición de Riesgo , Factores de Riesgo , Trastornos Relacionados con Sustancias/psicología , Suiza
14.
Schizophr Res ; 145(1-3): 43-9, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23394743

RESUMEN

BACKGROUND: Studies examining the influence of duration of untreated psychosis (DUP) or duration of untreated illness (DUI) on cognition vary with regard to results and methods. This study is the first in this field to include an at risk mental state with later transition to psychosis (ARMS-T) sample and to analyse how the DUI relates to their cognitive functioning. Because methodological operationalization of cognitive functioning in previous studies is highly heterogeneous, we aimed to compare different approaches. METHOD: 60 first episode psychosis (FEP) patients and 24 ARMS-T patients were examined. Associations between DUP, DUI and neurocognitive performance were tested by three different operationalizations of cognition: as the raw outcome measure of different neuropsychological tests, as outcome scores which were normed on a sample of 75 healthy participants, and as the deterioration index (DI). RESULTS: There were no significant correlations between DUP or DUI and outcome of neuropsychological tests in both normed and raw scores. When adjusted for covariates, DUP and DUI also did not significantly predict any cognitive performance. There was no significant relationship between DUP or DUI and the DI index. However, longer DUP and DUI were significantly associated with stronger negative symptoms. CONCLUSIONS: This study could not confirm an association between duration of untreated psychosis or duration of untreated illness and neurocognitive performance in the ARMS-T and FEP samples. This could be because schizophrenic psychoses are neurodevelopmental disorders in which most cognitive deficits exist long before the onset of psychiatric symptoms.


Asunto(s)
Trastornos del Conocimiento/etiología , Trastornos Psicóticos/complicaciones , Adolescente , Adulto , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Evaluación de Resultado en la Atención de Salud , Escalas de Valoración Psiquiátrica , Factores Sexuales , Estadísticas no Paramétricas , Factores de Tiempo , Adulto Joven
15.
Soc Psychiatry Psychiatr Epidemiol ; 48(7): 1033-43, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23266662

RESUMEN

PURPOSE: Delay in the treatment of a first psychotic episode can have a negative influence on the future course of the disease. In this context, it is important to examine pathways to care to understand factors contributing to delay in access to adequate care. METHODS: Using the Basel Interview for Psychosis, we examined the help-seeking behaviour of 61 individuals with an at-risk mental state for psychosis and 37 patients with a first episode of psychosis in a low threshold health care system as part of the Basel early detection of psychosis study. RESULTS: The median duration of untreated illness was 3.4 years, of untreated psychosis 12 months. Eighty-six percent of all individuals sought help of some kind before reaching our specialised early detection outpatient clinic, with a mean number of help-seeking contacts of 1.5 prior to referral. The most frequent first help-seeking contacts were family members or relatives n = 24 (26.7 %), close friends n = 17 (17.9 %), psychiatrists in private practice n = 13 (14.4 %) or general practitioners n = 11 (12.2 %). Most patients consulted other health professionals in the early course of the illness before reaching our specialised service; help-seeking with non-medical institutions was rare. Women had more help-seeking contacts than men before contact with our early detection clinic. CONCLUSIONS: Family, close friends and medical professionals play an important role in help-seeking leading to specialised psychiatric care. Men seek help less often; specific strategies for encouraging young, at-risk men to seek help should be developed.


Asunto(s)
Accesibilidad a los Servicios de Salud , Servicios de Salud Mental , Aceptación de la Atención de Salud , Trastornos Psicóticos/terapia , Adulto , Diagnóstico Tardío , Diagnóstico Precoz , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Entrevista Psicológica , Masculino , Servicios de Salud Mental/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Síntomas Prodrómicos , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Suiza , Adulto Joven
16.
Early Interv Psychiatry ; 7(4): 381-90, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23164358

RESUMEN

AIM: Many studies have provided evidence of cognitive deficits in individuals in an 'At Risk Mental State' (ARMS) for psychosis, which makes neuropsychology potentially useful in the early detection of psychosis. As depression is an important differential diagnosis in prodromal states of psychosis, the specificity of neurocognitive deficits in ARMS individuals as compared with non-psychotic depressive disorders is investigated. METHODS: Neurocognitive performance of four groups was analysed: 22 ARMS individuals with later transition to psychosis (ARMS-T), 25 ARMS individuals without later transition to psychosis (ARMS-NT), 34 controls with depressive disorders and 76 healthy controls. The subjects were assessed with a neurocognitive test battery covering the domains' intelligence, executive function and attention/ working memory. MANOVAs, ANOVAs and Tukey's tests were applied after adjustment for confounding factors. RESULTS: ARMS-T showed significant cognitive deficits in working memory and in certain executive function tasks compared with healthy controls as well as with controls with depression. Controls with depression were only impaired in time per move in the tower of Hanoi test when compared with healthy controls. CONCLUSIONS: The psychosis prodrome seems to be associated with cognitive deficits in the domains of working memory and executive function. In contrast, depressive patients showed no cognitive deficits, but slowing in one executive function task. Neurocognitive testing might therefore contribute to the differential diagnosis between prodromal psychosis and depressive disorders.


Asunto(s)
Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/psicología , Trastorno Depresivo/diagnóstico , Valor Predictivo de las Pruebas , Síntomas Prodrómicos , Trastornos Psicóticos/diagnóstico , Adulto , Estudios de Casos y Controles , Trastorno Depresivo/complicaciones , Trastorno Depresivo/psicología , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Trastornos Psicóticos/complicaciones , Trastornos Psicóticos/psicología
17.
Early Interv Psychiatry ; 6(4): 455-9, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22390396

RESUMEN

AIM: To investigate differences between the early symptoms of schizophrenia and depressive disorders. METHODS: Sixty-one individuals with an at-risk mental state (ARMS), 17 of whom later made the transition to psychosis, 37 patients with a first episode of psychosis and 16 controls with depressive disorders were interviewed about first self-perceived signs and symptoms. RESULTS: In ARMS and first episode of psychosis, on average, first self-perceived signs or symptoms had occurred about 5-6 years before the interview. In ARMS, including transition to psychosis, 'loss of energy' and 'difficulties concentrating' were the most frequently recalled first signs. There was much overlap for the four most frequently mentioned symptoms in the three groups. As compared with ARMS, controls with depressive disorders significantly more often recalled 'depression' and 'social isolation' as the very first signs of disease. CONCLUSIONS: Clinicians should consider the development of self-recalled first signs over time carefully when assessing suspected early prodromal stages of schizophrenia and beginning depressive disorder.


Asunto(s)
Trastorno Depresivo/psicología , Trastornos Psicóticos/psicología , Autoimagen , Adulto , Trastorno Depresivo/diagnóstico , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Trastornos Psicóticos/diagnóstico
18.
Schizophr Res ; 125(1): 41-8, 2011 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21074369

RESUMEN

BACKGROUND: Morphologic abnormalities of the pituitary gland volume (PV) have been reported in schizophrenia, but at what point in time they occur remains unclear. This study determines PV across different stages of emerging psychotic disorders compared to healthy controls. METHODS: We compared PV of 36 individuals with an at-risk mental state (ARMS) for psychosis, 23 patients with a first episode psychosis (FEP) and 20 healthy controls (HC). Transition to psychosis was monitored using the BPRS transition criteria according to Yung et al. (Yung, A.R. et al., 1998. Prediction of psychosis. A step towards indicated prevention of schizophrenia. Br. J. Psychiatry Suppl. 172 (33), 14-20). Applying these transition criteria, 16 of the 36 ARMS individuals made the transition to psychosis (ARMS-T) and 20 did not (ARMS-NT). We traced PV manually on 1mm slices of magnetic resonance images in three dimensions (coronal, sagittal and axial) blind to group status. We used univariate analysis of covariance (ANCOVA) with PV as dependent variable, group and sex as between-subject factors and whole brain volume as covariate. RESULTS: PV increased from HC to ARMS-NT to ARMS-T/FEP. ANCOVA revealed a significant effect of group (F(3,78)=3.0; p=.036) and a sex × group interaction (F(3,78)=6.5; p=.001). Over all groups, women had considerably larger PV than men (F(1,78)=9.8; p=.003). CONCLUSIONS: Our findings provide further evidence that PV is increased in emerging psychotic disorders, and suggest that this is due to a stress-associated activation of the pituitary gland.


Asunto(s)
Hipófisis/patología , Trastornos Psicóticos/patología , Adulto , Análisis de Varianza , Femenino , Estudios de Seguimiento , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Escalas de Valoración Psiquiátrica , Estudios Retrospectivos , Adulto Joven
19.
Schizophr Res ; 123(2-3): 208-16, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20850950

RESUMEN

INTRODUCTION: EEG power in the delta, theta and beta1 bands has been shown to be positively correlated with negative symptoms in first episode psychotic patients. The present study investigates this correlation in an "at risk mental state for psychosis" (ARMS) with the aim to improve prediction of transition to psychosis. METHODS: Thirteen ARMS patients with later transition to psychosis (ARMS-T) and fifteen without (follow-up period of at least 4 years) (ARMS-NT) were investigated using spectral resting EEG data (of 8 electrodes over the fronto-central scalp area placed according to the 10-20 system) and summary score of the Scale for the Assessment of Negative Symptoms (SANS). Linear regressions were used to evaluate the correlation of SANS and EEG power in seven bands (delta, theta, alpha1, alpha2, beta1, beta2, beta3) in both ARMS groups and logistic regressions were used to predict transition to psychosis. Potentially confounding factors were controlled. RESULTS: ARMS-T and ARMS-NT showed differential correlations of EEG power and SANS in delta, theta, and beta1 bands (p<.05): ARMS-T showed positive and ARMS-NT negative correlations. Logistic regressions showed that neither SANS score nor EEG spectral power alone predicted transition to psychosis. However, SANS score in combination with power in the delta, theta, beta1, and beta2 bands, respectively, predicted transition significantly (p<.03). CONCLUSIONS: ARMS-T and ARMS-NT show differential correlations of SANS summary score and EEG power in delta, theta, and beta bands. Prediction of transition to psychosis is possible using combined information from a negative symptom scale and EEG spectral data.


Asunto(s)
Encéfalo/fisiopatología , Electroencefalografía , Trastornos Psicóticos/fisiopatología , Trastornos Psicóticos/psicología , Adolescente , Adulto , Ritmo alfa , Ritmo beta , Mapeo Encefálico/métodos , Factores de Confusión Epidemiológicos , Ritmo Delta , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Diagnóstico Precoz , Electroencefalografía/métodos , Femenino , Estudios de Seguimiento , Humanos , Modelos Lineales , Masculino , Valor Predictivo de las Pruebas , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/epidemiología , Reproducibilidad de los Resultados , Medición de Riesgo/métodos , Suiza/epidemiología , Ritmo Teta , Adulto Joven
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