Social and Neurocognitive Deficits in Remitted Patients with Schizophrenia, Schizoaffective and Bipolar Disorder.

This study assesses the empathy level, cognitive performance and emotion recognition skills of remitted patients with schizophrenia, schizoaffective disorder and bipolar disorder, and also explores the relationship between impairments in the mentioned domains. The study was performed on 77 subjects divided into two groups: PAT sample (N = 37) included remitted patients with either schizophrenia, schizoaffective or bipolar disorder who were compared with healthy control subjects from the HC sample (N = 40). Along with sociodemographic and clinical data, empathy levels (using EQ (Empathy Quotient) scale), the ability to recognize another person's emotional state (using RMET (Reading the Mind in the Eyes Test)), and cognitive performance (using MoCA (Montreal Cognitive Assessment) Scale) were investigated. The intensity of the psychiatric symptoms was measured with BPRS-E (Brief Psychiatric Rating Scale-Expanded). The remitted patients had lower EQ (p = 0.02) and RMET (p < 0.0001) scores than the healthy subjects. In the PAT group, RMET scores were positively correlated with MoCA total scores. Both EQ and RMET scores were negatively correlated with BPRS-E total scores. Psychiatric disorder was a significant predictor for deficits in emotion recognition. There were no significant differences in RMET, EQ and MoCA scores between patients with respect to diagnosis, the type of antipsychotic or the associated medication. In both samples, females had higher empathy levels (p = 0.04) and better emotion recognition abilities (p = 0.04) than males. Patients with schizophrenia, schizoaffective or bipolar disorder, currently in remission, displayed lower empathy levels and poorer emotion recognition skills than healthy subjects. Poor emotion recognition skills were associated with symptom severity and impairments in global cognition.

Impairment of the cardiac ejection fraction by blocking dopamine D2 receptors induced by long-acting injectable antipsychotic treatment.

INTRODUCTION: Atypical antipsychotics have numerous benefits compared to conventional ones in respect to the possible adverse effects. However, like the other ones, they may induce direct cardiovascular alterations, probably through the apoptotic effect of dopamine receptor D2 (DRD2) blockade. The main objective of the study was to assess the cardiac ejection fraction (EF) using transthoracic speckle tracking echocardiography (TSTE) in patients treated with long-acting injectable (LAI) atypical antipsychotics. PATIENTS, MATERIALS AND METHODS: This cross-sectional study was conducted on 123 patients with schizophrenia or schizoaffective disorder divided in four samples according to their treatment: Aripiprazole, Olanzapine, Paliperidone and Risperidone. We analyzed socio-demographic data, the intensity of psychiatric symptoms, the duration of psychosis and of LAI treatment, and the cardiac EF measured with TSTE. RESULTS: We found no statistically significant differences between the four antipsychotics regarding the values of the EF. Nevertheless, we observed a trend indicating that patients treated with an antipsychotic associated with a lower affinity for the DRD2, such as Olanzapine, have higher EF values than patients treated with antipsychotics with a stronger binding to the DRD2, such as Paliperidone and Risperidone. Patients receiving Aripiprazole, which has the strongest affinity for the DRD2 from all four antipsychotics but is also a partial DRD2 agonist, display higher EF values than those on Paliperidone and Risperidone. CONCLUSIONS: Antipsychotics with a lower affinity for the DRD2 or a partial agonism for it may be associated with higher EF. Cardiac monitoring should be performed periodically in patients on LAI antipsychotic therapy.