Psychometric properties of the Spanish version of the measure of insight into cognition-self-report in psychosis-risk and non-clinical Mexican young adults.

AIM: Cognitive disturbances typically precede the onset of overt psychotic symptoms and represent a neurobiological marker for psychosis risk that is also associated with poor functional outcomes. The Measure of Insight into Cognition-Self Report (MIC-SR) is a widely used 12-item questionnaire that assesses the perceived frequency of cognitive impairment in the domains of executing functioning, attention, and memory. However, the MIC-SR is not available in Spanish, one of the most widely spoken languages worldwide. The present study aimed to provide a Spanish version of the MIC-SR and examine its psychometric properties in psychosis-risk and non-clinical Mexican young adults. METHODS: The sample comprised 621 participants who completed a battery of self-report measures via an online survey. Of the participants, 478 were non-clinical, and 143 met the screening criteria for a clinical high-risk for psychosis (CHR-positive). RESULTS: Confirmatory Factor Analyses supported a one-factor model, consistent with the findings for the original MIC-SR. The results showed adequate fit indices for the general model and the independent models for both groups, with high Cronbach's alpha coefficients. Furthermore, the CHR-positive group showed more frequent subjective cognitive problems on each of the 12 items, higher total scores, and higher average frequency than the non-clinical group. CONCLUSION: To our knowledge, this is the first translation of the MIC-SR into Spanish. Using the MIC-SR at the CHR stage may contribute to our understanding of cognitive processes associated with the onset of a psychotic disorder and provide valuable information in the context of detection and early intervention efforts.

Follow-up of cognitive impairment and inflammatory profile in individuals with mild COVID-19.

Individuals who experience mild COVID-19 can suffer from long-lasting cognitive symptoms. Notably, 26% of these individuals experience difficulties with visuospatial abilities six months after infection. However, among those who initially exhibited visuoconstructive impairments, 66% showed improvement or complete reversal over time. Additionally, changes in cytokine levels, particularly CCL11, HGF, and CXCL10, were observed. These results suggest a potential link between ongoing cognitive issues and elevated levels of pro-inflammatory cytokines, which merits further investigation.

Impaired Decision-Making Capacity in the Elderly King David (c. 1040-970 BCE): Was Hypothyroidism the Underlying Cause?

It has been suggested in the medical literature that in the last period of his life King David (c. 1040-970 BCE) suffered from dementia, osteoporosis, hyperparathyroidism, Parkinson's disease, autonomic neuropathy, major depression, and malignancy. The goal of this study was to identify, based on the "Succession Narrative (SN)," a historically objective section of the Old Testament, the clinical syndrome presented by King David and to determine whether an impaired decision making capacity may have been manipulated by his courtiers to influence his succession's politics. The "SN" indicates that besides forgetfulness and trouble in thinking, King David suffered from marked cold intolerance and sexual dysfunction. The symptom triad consisting of cognitive impairment, cold intolerance, and sexual dysfunction is more strongly suggestive of hypothyroidism than of any other diagnoses proposed in the medical literature so far. We hypothesized that hypothyroidism was the underlying cause of the elderly King David's clinical picture and that his sometimes troubled thinking was successfully manipulated by the courtiers to favor his son Solomon's accession to the throne, with profound historical consequences.

BDNF as a Biomarker of Cognition in Schizophrenia/Psychosis: An Updated Review.

Brain Derived Neurotrophic Factor (BDNF) has been linked to cognitive symptoms of schizophrenia, which has been documented in previous reviews by several authors. However, a trend has recently emerged in this field moving from studying schizophrenia as a disease to studying psychosis as a group. This review article focuses on recent BDNF studies in relation to cognition in human subjects during different stages of the psychotic process, including subjects at high risk of developing psychosis, patients at their first episode of psychosis, and patients with chronic schizophrenia. We aim to provide an update of BDNF as a biomarker of cognitive function on human subjects with schizophrenia or earlier stages of psychosis, covering new trends, controversies, current research gaps, and suggest potential future developments in the field. We found that most of current research regarding BDNF and cognitive symptoms in psychosis is done around schizophrenia as a disease. Therefore, it is necessary to expand the study of the relationship between BDNF and cognitive symptoms to psychotic illnesses of different stages and origins.

Altruistic behaviour, but not volunteering, has been associated with cognitive performance in community-dwelling older persons.

AIM: Studies have indicated that altruistic behaviour may be associated with better health. Nevertheless, it has not been determined if volunteering acts as a protective factor against cognitive decline or if a person's altruistic character does so. This study aims to evaluate whether altruistic behaviour and volunteering are associated with better cognitive function in active community-dwelling older persons. METHODS: This was a cross-sectional study in healthy older persons. Sociodemographics, altruistic behaviour (self-report altruism scale), volunteering (days volunteered), cognitive state (cognitive assessment battery), and factors associated with cognition (e.g. depression, social support, functional status, and religiosity) were evaluated. Adjusted and non-adjusted models were created in order to understand the relationship of altruistic behaviour and volunteering with cognitive performance. RESULTS: A total of 312 older adults were evaluated; 89.4% were women, and the mean age was 69.6 years. In the linear regression models, greater altruistic behaviour was associated with higher scores on the Mini-Mental State Examination (ß = 0.148, P < 0.05) and the verbal fluency test (ß = 0.219, P < 0.001), even after adjustments. In contrast, volunteering was not associated with any of the cognitive tests used. CONCLUSION: Altruistic behaviour seems to have a role in older persons' cognition, with more altruistic people tending to have greater cognitive performance. These findings can assist in developing mechanisms that can help keep older people more cognitively active and serve as the foundation for future interventions and studies in this area.

An ethnographic study of the effects of cognitive symptoms in patients with major depressive disorder: the IMPACT study.

BACKGROUND: The manifestation of major depressive disorder (MDD) may include cognitive symptoms that can precede the onset of MDD and persist beyond the resolution of acute depressive episodes. However, little is known about how cognitive symptoms are experienced by MDD patients and the people around them. METHODS: In this international (Brazil, Canada, China, France, and Germany) ethnographic study, we conducted semi-structured interviews and observations of remitted as well as symptomatic MDD patients (all patients self-reported being diagnosed by an HCP and self-reported being on an antidepressant) aged 18-60 years with self-reported cognitive symptoms (N = 34). In addition, participating depressed patients' close family or friends (N = 31) were interviewed. Separately recruited from depressed participants, work colleagues (N = 21) and healthcare providers (HCPs; N = 13) of depressed individuals were interviewed. RESULTS: Key insights were that: (1) patients were generally unaware that their cognitive symptoms were linked to their depression and, instead, attributed these symptoms to negative aspects of their person (e.g., age, separate disease, laziness, exhaustion); (2) cognitive symptoms in MDD appeared to negatively impact patients' social relationships and patients' ability to handle daily tasks at work and at home; (3) patients' cognitive symptoms also impacted relationships with family members and coworkers; (4) patients' cognitive symptoms increased stress and feelings of failure, which in turn seemed to worsen the cognitive symptoms, thereby creating a destructive cycle; and (5) although HCPs recommended that patients re-engage in everyday activities to help overcome their depression, cognitive symptoms seemed to impede such functional recovery. CONCLUSIONS: Taken together, these findings highlight a negative impact of patients' cognitive symptoms on their social functioning, work performance, and quality of life on the people close to them, and consequently on the degree of functional recovery after depression.

Executive dysfunction, obsessive-compulsive symptoms, and attention deficit and hyperactivity disorder in Systemic Lupus Erythematosus: Evidence for basal ganglia dysfunction?

INTRODUCTION: Chorea is well described in a group of patients with Systemic Lupus Erythematosus (SLE). There is less information, however, on other movement disorders as well as non-motor neuropsychiatric features such as obsessive-compulsive symptoms (OCS), executive dysfunction and attention deficit and hyperactivity disorder (ADHD) in subjects with SLE. METHODS: Fifty-four subjects with SLE underwent a battery of neuropsychiatric tests that included the Mini Mental State Examination, the Montreal Cognitive Assessment, the Frontal Assessment Battery (FAB), the FAS verbal and the categorical (animals) semantic fluency tests, the Obsessive and Compulsive Inventory - Revised, the Yale-Brown Obsessive and Compulsive Scale and Beck's Anxiety and Depression Scales. ADHD was diagnosed according to DSM-IV criteria. SLE disease activity and cumulative damage were evaluated according to the modified SLE Disease Activity Index 2000 (mSLEDAI-2K) and the SLICC/ACR, respectively. RESULTS: Six (11.1%) and 33 (61.1%) patients had cognitive impairment according to the MMSE and MoCA, respectively. Eleven (20.4%) had abnormal FAB scores, and 5 (9.3%) had lower semantic fluency scores than expected. The overall frequency of cognitive dysfunction was 72.2% (39 patients) and of neuropsychiatric SLE was 77.8% (42 patients). Two patients (3.7%) had movement disorders. Fifteen (27.8%) had OCS and 17 (31.5%) met diagnostic criteria for ADHD. ADHD and OCS correlated with higher disease activity, p=0.003 and 0.006, respectively. Higher cumulative damage correlated with lower FAB scores (p 0.026). CONCLUSIONS: Executive dysfunction, ADHD, OCS, and movement disorders are common in SLE. Our finding suggests that there is frequent basal ganglia dysfunction in SLE.

Gender differences and disabilities of perceived depression in the workplace.

BACKGROUND: Few studies have investigated gender difference and associated disability among workers. Comprehensive investigations concerning the occurrence and consequences of depression in workplace are scarce. The study aims to evaluate how workers perceive depression in workplace, as well as to examine depression-related disabilities by gender. METHODS: This is a cross-sectional web-based survey of 1000 Brazilian workers recruited from Internet sources. Participants answered an online questionnaire about depressive symptoms and related consequences in the workplace. RESULTS: Common symptoms attributable to depression were crying, loss of interest, and sadness. Almost one in five (18.9%) participants reported had ever been "labeled" by a health professional as suffering from depression. However, the majority of ever-depressed workers (73.5%) remained working. Performance-related impairments were reported by around 60% of depressed workers who continued working. Over half of them also complained about cognitive symptoms (concentration difficulties, indecisiveness, forgetfulness), with men reporting more cognitive dysfunctions than women. One in three workers had taken off work due to depression (mean 65.7 out-of-role days), with these periods being lengthier for men than women. LIMITATIONS: Some depressive events might have occurred before working age, since the participants have self-reported the diagnosis of health professionals in past timeframe. The representativeness of recruited workers was reliant upon the availability of Internet service. CONCLUSIONS: The findings suggest that identification and management of symptoms of depression should be set as a priority in worker׳s health care. General and gender-related strategies to handle depression in the workplace are recommended.

School performance as a marker of cognitive decline prior to diagnosis of multiple sclerosis.

BACKGROUND: For many years, cognitive impairment has been established as a well-known symptom of multiple sclerosis. Moreover, we know that it was present even at the beginning of the disease. OBJECTIVE: In this case-control study, we decided to evaluate whether there is an impairment of cognitive functions even before onset in those patients who will eventually suffer from multiple sclerosis. METHODS: We evaluated the overall school performance, and particularly school performance in math and language in a group of patients who would later develop the disease and we compared our findings with a control group. RESULTS: We found that school performance was poorer in subjects who were to become patients. And we found that the later the start of the first symptom, the better the qualifications. CONCLUSION: Testing a premorbid cognitive deficit by a validated indirect evaluation method allowed us to verify that there was evidence of neurological compromise even before a clinical diagnosis or the completion of the first magnetic resonance imaging in patients who would then suffer from multiple sclerosis.

Relação entre qualidade do sono e funções cognitivas em pacientes com doença de Parkinson / Relación entre la calidad del sueño y función cognitiva en pacientes con la enfermedad de Parkinson / Relationship between quality of sleep and cognitive function in patients with Parkinsons disease

Descrever as características clínicas e demográficas de pacientes com Doença de Parkinson, bem como verificar a relação entre a qualidade do sono e as funções cognitivas. Trata-se de um estudo descritivo-analítico de corte transversal em que foram avaliados episódios de depressão, ansiedade, estado geral e progressão da doença, sonolência, qualidade do sono e funções cognitivas de 24 pacientes com Doença de Parkinson sem demência. Analisando os resultados do teste de memória tardia e a as alterações do sono, encontrou-se correlação do tipo inversa e moderada. O componente latência do sono teve uma correlação inversa e moderada com a memória, e também com a função visuoespacial. Outras relações também foram observadas como entre a qualidade subjetiva do sono e a função visuoespacial, a latência do sono e o resultado global do SCOPA-COG, e entre a duração do sono e a atenção. Todas essas correlações foram inversas e de caráter fraco. Esse estudo sugere que os déficits cognitivos leves, na ausência de demência, foram relacionados com qualidade ruim do sono.

Describir las características clínicas de pacientes con la enfermedad de Parkinson, así como la relación entre la calidad del sueño y las funciones cognitivas. Se realizó un estudio descriptivo-analítico de corte transversal que evaluó: los episodios de depresión, ansiedad, estado de salud general, progresión de la enfermedad, sueño, calidad del sueño y funciones cognitivas de 24 pacientes con enfermedad de Parkinson sin demencia. Se observó una relación inversa de tipo moderada entre la memoria tardía y trastornos del sueño. El componente de la latencia del sueño tuvo una correlación inversa moderada con la memoria, y con la función visuoespacial. También se observaron otras relaciones entre la calidad subjetiva del sueño y la función visuoespacial, la latencia del sueño y el resultado global de la SCOPA-COG, y entre la duración del sueño y la atención. Se observó que estas correlaciones fueron inversas y de carácter débil. Este estudio sugiere que los déficits cognitivos leves en ausencia de demencia se relacionaron con la mala calidad del sueño.

Here, we describe the clinical characteristics of patients with Parkinson's disease, as well as study the relationship between sleep quality and cognitive functions. This is a descriptive-analytical cross-sectional study in which we evaluate episodes of depression and anxiety, as well as the state of general health, disease progression, sleepiness, sleep quality and cognitive functions of 24 patients with Parkinson's disease without dementia. We found a moderate inverse correlation between memory and sleep disturbances, and a moderate inverse correlation of memory and visuospatial function. We also observed other associations between subjective sleep quality and visuospatial function, sleep latency and the overall result of the SCOPA-COG, and between sleep duration and attention; all of these correlations were inverse and weak. This study suggests that mild cognitive deficits in the absence of dementia are associated with poor sleep quality.

Revisión de dos instrumentos de simulación neurocognitiva y su utilidad en el contexto forense / Review of the neurocognitive malingering instrument and its useful in a forensic contex

Gran parte de la precisión de la evaluación neuropsicológica, depende que los instrumentos que utiliza, sean medidas estandarizadas, válidas y confiables. Sin embargo, la simulación, la exageración y el bajo esfuerzo son aspectos que pueden interferir en los resultados de los test. El objetivo de esta revisión pretende describir y analizar dos instrumentos en el contexto de la Neuropsicología Forense que evalúan simulación de síntomas cognitivos: el Test of Memory Malingering (TOMM) y el Victoria Symptoms Validity Test (VSVT). Se realizó una búsqueda dirigida no exhaustiva, en diversas bases de datos y libros afines. El criterio de inclusión fue la utilización o revisión de los test. Se seleccionaron 68 trabajos publicados. Cada uno de los cuales fue analizado en base a las características técnicas de los instrumentos. La revisión ha demostrado que el TOMM y el VSVT son instrumentos pertinentes para valorar simulación y exageración de sintomatología cognitiva. Estos instrumentos cuentan con un cúmulo de investigaciones que avalan sus propiedades, pero también las limitaciones y restricciones de su utilización.

Most of the accuracy in neuropsychological assessment depends that the instruments used are standardized, valid and reliable measures. However, malingering, exaggeration and poor effort are aspects that can interfere with the interpretation of the results. The aim of this review was to describe and analyze two instruments in the context of forensic neuropsychology that assess malingering of cognitive symptoms: Test of Memory Malingering (TOMM) and Victoria Symptoms ValidityTest (VSVT). Several scientific databases and related books were searched non-exhaustively. The criterion for inclusion in this review was the use of test. We selected 68 documents, each one was analyzed based on the technical characteristics of the instruments. Review showed that the TOMM and VSVT are relevant instruments for assessing malingering and exaggeration of cognitive symptoms. These instruments have several evidence that support their psychometric properties but also limitations and restrictions on their use.

Norms for the mini-mental state examination: adjustment of the cut-off point in population-based studies (evidences from the Bambuí health aging study) / Normas para o uso do mini-exame do estado mental: adequação do ponto de corte em estudos populacionais (evidências do Projeto Bambuí)

OBJECTIVE: To estimate the prevalence of cognitive impairment in an elderly population-based cohort, using several Mini-Mental State Examination (MMSE) cut-off points recommended by Brazilian authors and to examine the percentile distribution of MMSE scores in the study population. METHOD: A total of 1558 subjects aged >60 years (89.4 percent of the total), living in the city of Bambuí, MG, completed the MMSE and were included in the present study. RESULTS: The estimated prevalences of cognitive impairment varied from 13.2 percent to 27.0 percent depending on the cut-off point and agreement varied widely between them (kappa range: 0.38 to 0.88). Cut-off point 13/14 corresponded to the 5th percentile and 21/22 corresponded to the lower quartile of the MMSE score distribution. CONCLUSION: In the absence of comparable cut-off points, percentile distributions are more adequate for population-based studies of elderly with low schooling level.

OBJETIVO: Estimar a prevalência de déficit cognitivo em uma base populacional de idosos, utilizando-se os diferentes pontos de corte do Mini-Exame do Estado Mental (MEEM) recomendados por autores brasileiros e verificar a distribuição em percentis da pontuação do MEEM na população estudada. MÉTODO: Participaram do estudo 1558 (89,4 por cento do total) indivíduos com idade >60 anos residentes na cidade de Bambuí, MG, que foram submetidos ao MEEM. RESULTADOS: A prevalência estimada de déficit cognitivo variou de 13,2 por cento a 27,0 por cento, dependendo do ponto de corte utilizado, observando-se grande variação na sua concordância (índices de kappa entre 0,38 e 0,88). O ponto de corte de 13/14 correspondeu ao 5º percentil e o de 21/22, ao quartil inferior da distribuição dos escores do MEEM. CONCLUSÃO: Na ausência de pontos de corte comparáveis, a distribuição em percentis é mais adequada para estudos de base populacional de idosos com baixa escolaridade.

Revisión actualizada de la relación BDNF, cognición y esquizofrenia/psicosis / BDNF, cognition and schizophrenia/psychosis: an updated review

El Factor Neurotrófico Derivado del Cerebro (BDNF) se ha relacionado con los síntomas cognitivos de la esquizofrenia, lo que se ha documentado en revisiones previas. Sin embargo, recientemente el foco de la investigación neurobiológica ha pasado de estudiar la esquizofrenia como enfermedad a estudiar las psicosis como grupo. El objetivo de esta investigación fue realizar una revisión actualizada de las publicaciones de los últimos cinco años (2013 a 2018) respecto a BDNF y síntomas cognitivos, tanto en esquizofrenia como en psicosis en general. Para esto se revisaron en PubMed los artículos con las palabras clave BDNF, cognitive y schizophrenia, y luego se repitió este proceso con la palabra psychosis. Como resultado, en el desarrollo del artículo se describe la manera en que distintos estudios, tanto en seres humanos como en modelos animales, dan cuenta de la relación entre BDNF y cognición, y de cómo influyen en ella elementos importantes como por ejemplo el género o el ejercicio. Sin embargo, se constata que aún la mayor parte de la investigación respecto a BDNF y síntomas cognitivos en psicosis se realiza en torno a la esquizofrenia como enfermedad. Por lo tanto, es necesario ampliar el estudio de la relación entre BDNF y síntomas cognitivos a cuadros psicóticos de distintos estadios y orígenes

Brain Derived Neurotrophic Factor (BDNF) has been linked to cognitive symptoms of schizophrenia, which has been documented in previous reviews. However, recently the focus of neurobiological research has moved from studying schizophrenia as a disease to studying psychosis as a group. The main aim of this research was to carry out an updated review of all relevant publications in the last 5 years (2013 to 2018) regarding BDNF and cognitive symptoms, both in schizophrenia and in psychosis. In order to achieve this, the keywords BDNF, cognitive and schizophrenia were reviewed in PubMed, and then this process was repeated with the word psychosis. As a result, in this article we describe the way in which different studies, both in human beings and in animal models, account for the relation between BDNF and cognition, and for the way in which important elements such as gender or exercise influence it. However, we found that still most of the research regarding BDNF and cognitive symptoms in psychosis is done around schizophrenia as a disease. Therefore, it is necessary to expand the study of the relationship between BDNF and cognitive symptoms to psychotic illnesses of different stages and origins