The relationships between sociodemographic, psychosocial and clinical variables with personal-stigma in patients diagnosed with schizophrenia.

BACKGROUND: Studies suggest that people with a diagnosis of schizophrenia are one of the most stigmatized groups in society. AIM: To comprehensively analyze personal stigma in patients diagnosed with schizophrenia. METHOD: Data were obtained from 89 patients. Patients were evaluated with the following scales: a sociodemographic and clinical questionnaire, the Discrimination and Stigma Scale, the Self-perception of Stigma Questionnaire for People with Schizophrenia, the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Global Assessment of Functioning Scale, and the Brief Social Functioning Scale. RESULTS: Relations between personal stigma and sociodemographic and psychosocial variables were poor. However, clinical variables correlated with different facets of personal stigma. Personal stigma subscales´ correlations were between experienced stigma, anticipated stigma, and self-stigma to each other. 29.5% of the experienced stigma subscale variance was explained by age of onset and level of depression. 20.1% of the anticipated stigma subscale variance was explained by level of depression and gender. 27.3% of the overcoming stigma subscale variance was explained by level of depression and positive and negative psychotic symptoms. 35.8% of the self-stigma scale variance was explained by the level of depression. CONCLUSIONS: Addressing stigma within treatment seems of crucial importance since all stigma facets seem to be highly related to clinical dimensions, especially depression Therefore, including strategies to reduce stigma in care programs may help patients with schizophrenia to better adjust in life and improve their illness process.

Staging of depressive disorders: Relevance of resistance to treatment and residual symptoms.

BACKGROUND: Clinical staging model for depression helps to better define the clinical situation of patients. The objectives of this study are: to correlate the Hetrick's staging model of depression with the severity of depression, associated disability, and resistance to treatment in the established disease stages and to test the modification introduced by our group consisting in the introduction of a substage for recurrence from a previous episode that was stabilized with a complete remission. METHODS: A Cross-sectional study with 133 adult subjects having a current and primary diagnosis of Depressive disorder was developed. Patients were classified according to the model and assessed with: 17-item Hamilton Depression Scale (HAM-D), Clinical Global Impression (CGI); Global Assessment of Function (GAF); Maudsley Staging Method for treatment resistance (MSM) and Sheeham Disability Schedule (SDS). RESULTS: The variable that best contributes to the differentiation between clinical stages, in established Depression, is resistance to treatment evaluated by the MSM. Correlations between MSM and the clinical stages were statistically significant between most pairs of stages. Finally, we showed preliminary data in order to prove that a differential sub-stage for recurrent depression with and without inter-episodic remission in the current heuristic models could be a possible stage for better define depression staging model. CONCLUSIONS: Resistance to treatment should be included in the definition of clinical stages in established depression. Despite the difficulty of establishing a valid model for the staging of depression, it can certainly add great value to diagnosis, therapeutic interventions and clinical research.

Relación entre variables sociodemográficas, psicosociales y clínicas y el estigma personal en pacientes con diagnóstico de esquizofrenia / The relationships between sociodemographic, psychosocial and clinical variables

ANTECEDENTES: Estudios previos sugieren que las personas con esquizofrenia son uno de los grupos más estigmatizados de la sociedad. OBJETIVO: analizar ampliamente el estigma personal en pacientes con esquizofrenia. MÉTODO: Se obtuvieron datos de 89 pacientes. Éstos fueron evaluados con los siguientes instrumentos: características sociodemográficas y clínicas, Escala de Discriminación y Estigma, Cuestionario de Autopercepción del Estigma, Escala de Síndromes positivos y negativos, Escala de depresión de Calgary, Escala de Evaluación de la Actividad Global y Escala Breve de Funcionamiento Social. RESULTADOS: las relaciones entre el estigma personal y las variables sociodemográficas y psicosociales resultaron escasamente significativas. Sin embargo, las variables clínicas correlacionaron significativamente con diferentes facetas del estigma personal. Las correlaciones de las subescalas de estigma personal fueron entre estigma experimentado, estigma anticipado y autoestigma entre sí. El 29,5% de la variación de la subescala "trato injusto" se explicó por la edad de inicio y el nivel de depresión. El 20,1% de la variación de la subescala "autolimitación" se explicó por el nivel de depresión y el género. El 27,3% de la subescala "superación del estigma" se explica por el nivel de depresión y los síntomas psicóticos positivos y negativos. El 35,8% de la variación de la escala de autoestigma se explicó por el nivel de depresión. CONCLUSIONES: Abordar el estigma dentro del tratamiento parece de crucial importancia ya que todas las facetas del estigma están altamente relacionadas con las dimensiones clínicas, especialmente la depresión. Por lo tanto, incluir estrategias para reducir el estigma en los programas de atención puede ayudar a los pacientes con esquizofrenia a una mejor adaptación funcional y proceso evolutivo

BACKGROUND: Studies suggest that people with a diagnosis of schizophrenia are one of the most stigmatized groups in society. AIM: To comprehensively analyze personal stigma in patients diagnosed with schizophrenia. METHOD: Data were obtained from 89 patients. Patients were evaluated with the following scales: a sociodemographic and clinical questionnaire, the Discrimination and Stigma Scale, the Self-perception of Stigma Questionnaire for People with Schizophrenia, the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Global Assessment of Functioning Scale, and the Brief Social Functioning Scale. RESULTS: Relations between personal stigma and socio-demographic and psychosocial variables were poor. However, clinical variables correlated with different facets of personal stigma. Personal stigma subscales ́ correlations were between experienced stigma, anticipated stigma, and self-stigma to each other. 29.5% of the experienced stigma subscale variance was explained by age of onset and level of depression. 20.1% of the anticipated stigma subscale variance was explained by level of depression and gender. 27.3% of the overcoming stigma subscale variance was explained by level of depression and positive and negative psychotic symptoms. 35.8% of the self-stigma scale variance was explained by the level of depression

Validation of the spanish version of the discrimination and stigma scale (DISC 12).

AIMS: The "Discrimination and Stigma Scale" (DISC) was the first instrument specifically designed to evaluate reported experiences of discrimination by people with mental disorders. This study aims to validate DISC-12 version in Spanish population with Schizophrenia and, as specific objectives, to do the external validation with the Self-Stigma Questionnaire (SSQ) scale and Link PDD scale and to validate their internal consistency, temporal and inter-rater reliability. METHODS: 86 individuals with schizophrenia were interviewed at two time points (between one to two weeks) by two raters. Additionally to assess their sociodemographic and clinical characteristics, following scales were administered: DISC 12, SSQ, PDD, Social Functioning Scale (SFS) and Global Assessment of Function (GAF). RESULTS: Internal consistency as a whole results a Cronbach a between 0.741 and 0.850. Subscales "Unfair treatmen" and "Positive treatment" have a Cronbach a higher than 0.79, but the both subscales "Stopping Self" and "Overcoming stigma" do not have in themselves an adequate consistency. Test-retest reliability shows that four subscales have values higher than 0.67. Inter-rater reliability assessment result that 21 items score values above 0.8, 10 between 0.6-0.8 and one lower than 0.6. DISC-12 was significantly related with the second factor of the PDD (self-stigma) and SSQ. CONCLUSIONS: The Spanish version of the DISC 12 scale is valid, has good internal consistency, is reliable both in terms of test-retest and inter-rater reliability and has good convergent validity with the SSQ and PDD, and the "Unfair treatment" and "Positive Treatment" subscales were the most robust of the four subscales.

Validación de la versión española de la escala de discriminación y estigma (DISC 12) / Validation of the spanish version of the discrimination and stigma scale (DISC 12)

Objetivos. La "Escala de Discriminación y Estigma" (DISC) fue el primer instrumento diseñado para evaluar experiencias de discriminación referidas por pacientes con trastornos mentales. El objetivo principal de este estudio es validar la versión española de la escala DISC 12 en población con esquizofrenia y, como objetivos específicos, realizar la validación externa con el Cuestionario de Autoestigma (SSQ) y la Escala de Link (PDD) y validar su consistencia interna y la fiabilidad temporal y entre observadores. Métodos. 86 individuos con esquizofrenia fueron entrevistados en dos tiempos (entre una y dos semanas) por dos evaluadores. Se estudiaron sus características sociodemo-gráficas y clínicas y se aplicaron las escalas: DISC-12, SSQ, PDD, Escala de Funcionamiento Social (SFS) y Evaluación del Funcionamiento (GAF). Resultados. La consistencia interna resultó un a Cronbach entre 0,741 y 0,850. Las subescalas "Trato injusto" y "Trato positivo" tuvieron a Cronbach superior a 0,79, pero las subscalas "Anticipación de la discriminación" y "Superación del estigma" no tuvieron adecuada consistencia. La fiabilidad test-retest de las cuatro subescalas fue superior a 0,67. La fiabilidad entre evaluadores mostró que 21 ítems tuvieron puntuación superior a 0,8, 10 entre 0,6-0,8 y uno, menos de 0,6. DISC-12 se relacionó significativamente con el Segundo factor de PDD (self-stigma) y con SSQ. Conclusiones. La versión española de la escala DISC 12 es válida, tiene una buena consistencia interna, buena fiabilidad test-retest y entre evaluadores y tiene una buena validez convergente con la SSQ y PDD. Las subescalas "Trato injusto" y "Trato positivo" son las más robustas"

Aims. The "Discrimination and Stigma Scale" (DISC) was the first instrument specifically designed to evaluate reported experiences of discrimination by people with mental dis-orders. This study aims to validate DISC-12 version in Spanish population with Schizophrenia and, as specific objectives, to do the external validation with the Self-Stigma Questionnaire (SSQ) scale and Link PDD scale and to validate their internal consistency, temporal and inter-rater reliability. Methods. 86 individuals with schizophrenia were interviewed at two time points (between one to two weeks) by two raters. Additionally to assess their sociodemographic and clinical characteristics, following scales were administered: DISC 12, SSQ, PDD, Social Functioning Scale (SFS) and Global Assessment of Function (GAF).Results. Internal consistency as a whole results a Cronbach a between 0.741 and 0.850. Subscales "Unfair treatment" and "Positive treatment" have a Cronbach a higher than 0.79, but the both subscales "Stopping Self" and "Over-coming stigma" do not have in themselves an adequate consistency. Test-retest reliability shows that four subscales have values higher than 0.67. Inter-rater reliability assessment result that 21 items score values above 0.8, 10 be-tween 0.6-0.8 and one lower than 0.6. DISC-12 was significantly related with the second factor of the PDD (self-stigma) and SSQ. Conclusions. The Spanish version of the DISC 12 scale is valid, has good internal consistency, is reliable both in terms of test-retest and inter-rater reliability and has good convergent validity with the SSQ and PDD, and the "Unfair treatment" and "Positive Treatment" subscales were the most robust of the four subscales

Diffusion Tensor Imaging Measures of Brain Connectivity for the Early Diagnosis of Alzheimer's Disease.

The prognostic capacity of the diffusion tensor imaging measures fractional anisotropy (FA) and mean diffusivity (MD) to detect mild cognitive impairment (MCI) progression to Alzheimer's disease (AD) was assessed in 135 MCI patients and 72 healthy subjects over a median follow-up of 40 months. Forty-nine MCI patients (36.3%) developed AD. The factors MD left hippocampus, FA left cingulate, and FA left hippocampus emerged as predictors of progression. Age (hazard ratio [HR] 1.21), delayed text recall (HR 0.89), FA left uncinate (HR 1.90), FA left hippocampus (HR 2.21), and carrying at least one ApoE4 allele (HR 2.86) were associated with a high conversion rate. FA measures revealed the greatest discriminative capacity (Harrell's C = 0.73 versus 0.65 without FA; p = 0.034). The inclusion of FA structural connectivity data in our model improved discrimination between subjects with MCI progressing or not to dementia.

Neuropsychological findings in recent onset schizophrenia and borderline personality disorder: a comparison study.

INTRODUCTION: Neurocognitive impairment is considered an essential symptom of schizophrenia, particularly in its early stages. Nonetheless, the neuropsychological features of borderline personality disorder (BPD) could cast doubt on the specificity of neurocognitive dysfunctions. The aim of this study is to determine whether neurocognitive deficits are specific to schizophrenia-spectrum conditions as compared to a similarly severe psychiatric illness like BPD. METHOD: A battery of neuropsychological tests was used to assess the abilities for attention, verbal memory and executive functions in a group of 34 borderline personality disorder (BPD) patients, 24 patients with first episode of a schizophrenia-spectrum disorder (FEP) and a group of 19 controls. RESULTS: ANOVA for multiple measures with subsequent post-hoc tests demonstrated significant effect sizes between controls and patients for all cognitive domains. However, the effect sizes of comparisons between both groups of patients were not significant. CONCLUSIONS: Results show significant neuropsychological impairment in both disorders when compared with normal controls, but no specific pattern of neurocognitive deficits for schizophrenia-spectrum disorders was found.

Perfil neuropsicológico en primeros episodios de esquizofrenia y trastorno límite de la personalidad: un estudio comparativo / Neuropsychological findings in recent onset schizophrenia and borderline personality disorder: a comparison study

Introducción. El deterioro neurocognitivo es considerado un síntoma esencial de la esquizofrenia, especialmente en sus fases iniciales. Sin embargo, las características neuropsicológicas del trastorno límite de la personalidad (TLP) podrían poner en duda la especificidad de estas disfunciones cognitivas. El objetivo de este estudio es determinar si los déficits cognitivos son específicos del espectro de la esquizofrenia comparado con trastornos igualmente graves como el TLP. Metodología. Se administró una batería de pruebas neuropsicológicas para evaluar atención, memoria verbal y funciones ejecutivas a un grupo de 34 pacientes con TLP, 24 pacientes con primeros episodios psicóticos (PEP) y 19 controles. Resultados. Las pruebas ANOVA realizadas con sus correspondientes pruebas mostraron diferencias significativas entre controles y pacientes en todos los aspectos. Sin embargo, las diferencias entre los dos grupos de pacientes no fueron significativas. Conclusiones. Los resultados muestran un deterioro neuropsicológico significativo en ambos trastornos en comparación con los controles, pero no indican un patrón de déficit neurocognitivo específico para los trastornos del espectro de la esquizofrenia

Introduction. Neurocognitive impairment is considered an essential symptom of schizophrenia, particularly in its early stages. Nonetheless, the neuropsychological features of borderline personality disorder (BPD) could cast doubt on the specificity of neurocognitive dysfunctions. The aim of this study is to determine whether neurocognitive deficits are specific to schizophrenia-spectrum conditions as compared to a similarly severe psychiatric illness like BPD. Method. A battery of neuropsychological tests was used to assess the abilities for attention, verbal memory and executive functions in a group of 34 borderline personality disorder (BPD) patients, 24 patients with first episode of a schizophrenia-spectrum disorder (FEP) and a group of 19 controls. Results. ANOVA for multiple measures with subsequent post-hoc tests demonstrated significant effect sizes between controls and patients for all cognitive domains. However, the effect sizes of comparisons between both groups of patients were not significant. Conclusions. Results show significant neuropsychological impairment in both disorders when compared with normal controls, but no specific pattern of neurocognitive deficits for schizophrenia-spectrum disorders was found