Sex-specific cognitive abnormalities in early-onset psychosis.

OBJECTIVES:: Brain maturation differs depending on the area of the brain and sex. Girls show an earlier peak in maturation of the prefrontal cortex. Although differences between adult females and males with schizophrenia have been widely studied, there has been less research in girls and boys with psychosis. The purpose of this study was to examine differences in verbal and visual memory, verbal working memory, auditory attention, processing speed, and cognitive flexibility between boys and girls. METHODS:: We compared a group of 80 boys and girls with first-episode psychosis to a group of controls. RESULTS:: We found interactions between group and sex in verbal working memory (p = 0.04) and auditory attention (p = 0.01). The female controls showed better working memory (p = 0.01) and auditory attention (p = 0.001) than males. However, we did not find any sex differences in working memory (p = 0.91) or auditory attention (p = 0.93) in the psychosis group. CONCLUSIONS:: These results are consistent with the presence of sex-modulated cognitive profiles at first presentation of early-onset psychosis.

Sex-specific cognitive abnormalities in early-onset psychosis

Objectives: Brain maturation differs depending on the area of the brain and sex. Girls show an earlier peak in maturation of the prefrontal cortex. Although differences between adult females and males with schizophrenia have been widely studied, there has been less research in girls and boys with psychosis. The purpose of this study was to examine differences in verbal and visual memory, verbal working memory, auditory attention, processing speed, and cognitive flexibility between boys and girls. Methods: We compared a group of 80 boys and girls with first-episode psychosis to a group of controls. Results: We found interactions between group and sex in verbal working memory (p = 0.04) and auditory attention (p = 0.01). The female controls showed better working memory (p = 0.01) and auditory attention (p = 0.001) than males. However, we did not find any sex differences in working memory (p = 0.91) or auditory attention (p = 0.93) in the psychosis group. Conclusions: These results are consistent with the presence of sex-modulated cognitive profiles at first presentation of early-onset psychosis.

Childhood trauma as a risk factor for psychosis: A sib-pair study.

BACKGROUND: Childhood trauma, cannabis use and certain personality traits have been related to the development of psychosis. This study uses a sib-pair design to examine the association between childhood trauma and psychosis controlling for cannabis use and neuroticism. METHODS: We evaluated 60 patient-sibling pairs, conformed by patients with functional psychosis in the first five years of their illness matched with a non-psychotic sibling. In univariate analyses, patients and siblings were compared with McNemar tests and paired-sample t tests. A conditional logistic regression model of the risk of developing psychosis was built. The dependent variable of this model was the patient-sibling status (patient = 1, sibling = 0). RESULTS: After controlling for cannabis use and neuroticism, the odds of suffering psychosis for subjects who experienced a childhood trauma were 7.3 times higher than the odds for subjects who did not experience a childhood trauma [95% CI, (1.06-50.01); P = 0.04]. Also, after controlling for experiencing childhood trauma and neuroticism, subjects who were heavy cannabis users had odds of suffering psychosis that were 6.4 times higher than the odds of the remaining subjects [95% CI, (1.2-35.2); P = 0.03]. CONCLUSION: Both childhood trauma and cannabis use were significantly associated with an increased risk of suffering functional psychosis. A neurotic personality also contributed independently to this risk. These findings might help improve the prevention of psychosis and the development of specific treatment strategies on this specific population.

Evaluación neuropsicológica de la memoria en un grupo de niños y adolescentes con un primer episodio de psicosis: consumo de Cannabis y «efecto paradójico» / Neuropsychological assessment of memory in child and adolescent first episode psychosis: cannabis and «the paradox effect»

Introducción. La importancia que se otorga al funcionamiento neuropsicológico durante el primer episodio de psicosis (PEP) ha dado lugar a la publicación de un número creciente de artículos de investigación sobre este aspecto en poblaciones de pacientes. El objetivo del presente estudio fue triple: por un lado, examinar la memoria verbal y visual de una muestra de niños y adolescentes con un PEP; en segundo lugar, evaluar el efecto de otros dominios cognitivos sobre la memoria verbal y visual y, en tercer lugar, analizar la relación entre el rendimiento cognitivo en memoria y el consumo de Cannabis. Método. La muestra incluyó a 41 pacientes con PEP y a 39 individuos de control sanos. Las variables analizadas fueron la memoria verbal y visual, atención, memoria de trabajo, velocidad de procesamiento, flexibilidad mental, fluidez verbal, coordinación motora, capacidad de planificación e inteligencia. Resultados. En pacientes con un PEP, comparado con el grupo de individuos sanos que sirvieron como control, se encontraron alteraciones en los dominios de memoria verbal a corto y largo plazo y de la memoria visual a corto plazo; además, también identificamos una influencia de la inteligencia y la coordinación motora en la memoria visual. Por último, entre los pacientes consumidores de Cannabis, detectamos un «efecto paradójico» del consumo, puesto que ejecutaron mejor el test que mide la memoria visual en comparación con los que no consumieron dicha sustancia. Conclusiones. En primer lugar, en pacientes con un PEP se identifican alteraciones en la memoria verbal a corto y largo plazo y en la reproducción visual a corto plazo. En segundo lugar, la coordinación motora y la inteligencia son 2 dimensiones cognitivas que influyen en la memoria visual a corto plazo de los pacientes. Y, por último, en la muestra del presente estudio de pacientes con PEP, el consumo de Cannabis se asoció a un mejor rendimiento en el test que evalúa la memoria visual a corto plazo, determinado mediante el tiempo requerido para la ejecución del test, es decir, la eficiencia en su ejecución. No obstante, la precisión en la ejecución de la tarea de memoria visual no fue mejor que la observada entre individuos sanos del grupo de control (AU)

Introduction. The importance of neuropsychological functioning in First-Episode Psychosis (FEP) has led to the publication of a growing number of studies in this area of research. The present study pursued three goals: First, to examine verbal and visual memory in a sample of Child and Adolescent FEP, second, to evaluate the effect of other cognitive domains on verbal and visual memory, and finally, to examine the relationship between performance in this cognitive dimension and the use of cannabis at this age. Method. A sample of 41 FEPs and 39 healthy subjects were evaluated. The variables assessed were verbal and visual memory, attention, working memory, processing speed, mental flexibility, verbal fluency, motor coordination, planning ability and intelligence. Results. Our results found impairment of short and long-term recall of verbal memory, and short-term visual memory in early psychosis. They also found relationships between cognitive dimensions, such as visual memory and intelligence and motor coordination. Finally, a «paradoxical» effect was found in patients who used cannabis, as the FEP consumers performed the visual memory test better than those who had not used it. Conclusions. Patients showed impairment of short and long-term recall of verbal information and short-term visual reproduction. In the second place, motor coordination and intelligence influenced short-term visual memory in patients in the early stages of the illness. Third, use of cannabis in patients with FEP was associated with better performance in the test that evaluated the short-term visual memory, as measured by task completion time, that is, efficiency in performing the test.However, when measured by task execution accuracy, their visual memory was no better than the controls (AU)

Neuropsychological assessment of memory in child and adolescent first episode psychosis: cannabis and «the paradox effect¼.

INTRODUCTION: The importance of neuropsychological functioning in First-Episode Psychosis (FEP) has led to the publication of a growing number of studies in this area of research. The present study pursued three goals: First, to examine verbal and visual memory in a sample of Child and Adolescent FEP, second, to evaluate the effect of other cognitive domains on verbal and visual memory, and finally, to examine the relationship between performance in this cognitive dimension and the use of cannabis at this age. METHOD: A sample of 41 FEPs and 39 healthy subjects were evaluated. The variables assessed were verbal and visual memory, attention, working memory, processing speed, mental flexibility, verbal fluency, motor coordination, planning ability and intelligence. RESULTS: Our results found impairment of short and long-term recall of verbal memory, and short-term visual memory in early psychosis. They also found relationships between cognitive dimensions, such as visual memory and intelligence and motor coordination. Finally, a «paradoxical¼ effect was found in patients who used cannabis, as the FEP consumers performed the visual memory test better than those who had not used it. CONCLUSIONS: Patients showed impairment of short and long-term recall of verbal information and short-term visual reproduction. In the second place, motor coordination and intelligence influenced short-term visual memory in patients in the early stages of the illness. Third, use of cannabis in patients with FEP was associated with better performance in the test that evaluated the short-term visual memory, as measured by task completion time, that is, efficiency in performing the test. However, when measured by task execution accuracy, their visual memory was no better than the controls.

The duration of untreated psychosis is associated with social support and temperament.

The duration of untreated psychosis (DUP) has been suggested to be a modifiable factor influencing psychosis outcome. There are many studies on the factors that predict DUP, although with contradictory findings. Although temperament has been associated with seeking help in other pathologies, studies about how temperament influences DUP are lacking. This study explored the role of temperament (measured by the Eysenck Personality Inventory Questionnaire) on DUP and tested the hypothesis that social support modifies the effects of neuroticism and extraversion on DUP. We evaluated 97 first-episode psychosis patients. The effect of temperament, affective diagnosis and social support (measured by the Social Support Index) on DUP was explored through a multivariate analysis using Cox regression model. Once psychotic symptoms had started, a patient with affective psychosis was 76% more likely to start antipsychotic medications than a patient with non-affective psychosis of comparable time without treatment (adjusted hazard ratio, HR, 1.76; 95% CI, (1.07, 2.9)). There was a significant interaction between diffuse social support and neuroticism (p=0.04). Among patients who had a good diffuse social support, a patient with a high neuroticism score was 45% less likely to start antipsychotic medication than a time-comparable patient with a low neuroticism (HR, 0.55 (0.32, 0.95)). Among patients who had a low neuroticism score, a patient with poor diffuse social support was 56% less likely to start antipsychotic medication than a comparable patient with good support (HR, 0.44 (0.23, 0.86)). In conclusion, patients with affective psychosis had significantly shorter DUPs. In patients with a good diffuse social support, low neuroticism scores were significantly associated with decreased DUP. In patients with low neuroticism scores, a poor diffuse social support was associated with a significant increase in DUP.