Cultural adaptation to Spanish of the “Patient Satisfaction Survey” to assess satisfaction with electroconvulsive therapy (ECT).

The degree of satisfaction of patients and their relatives with electroconvulsive therapy (ECT) is considered an important treatment goal; however there is no scale in Spanish to quantify it. The aim of the study was to translate and adapt into Spanish the “Patient Satisfaction Survey” (PSS) for its use in patients and their relatives.

Adaptación cultural al español de laencuesta “Patient Satisfaction Survey”para valorar la satisfacción con laterapia electroconvulsiva (TEC) / Cultural adaptation to spanish of the “patient satisfaction survey” to assess satisfaction with electroconvulsive therapy (ECT)

Introducción. El grado de satisfacción de pacientes y familiares con la terapia electroconvulsiva (TEC) es un resultado importante del tratamiento, pero no existe ningún instrumento en español que lo cuantifique. El objetivo del estudio es traducir y adaptar culturalmente al español el instrumento “Patient Satisfaction Survey” (PSS)1 para pacientes y familiares. Metodología. La traducción inicial la realizaron dos traductores y la retrotraducción un tercer traductor. Se obtuvouna encuesta de consenso adaptada por el comité investigador y revisada por los autores del instrumento original. Para la adaptación cultural se valoró la equivalencia entre el instrumento original y la retrotraducción, la legibilidad de la encuesta y se ensayó la versión española en una muestra de pacientes, de familiares y de expertos en TEC. Se realizó el mismo proceso para la encuesta de satisfacción de los familiares o cuidadores. Resultados. Las encuestas finales en español se obtuvieron de forma consensuada tras completarse el proceso de traducción e identificarse ítems problemáticos que se modificaron satisfactoriamente. La legibilidad de las encuestas fue muy accesible a la población española. La prueba piloto realizada en pacientes, familiares y expertos permitió detectar y modificar ítems confusos. Con los comentarios y los cambios realizados en esta prueba piloto se obtuvo la versión final de la traducción adaptada al español. Conclusiones. La traducción y adaptación realizada de la PSS para pacientes y familiares o cuidadores podría proporcionar unas escalas adecuadas de satisfacción con la TEC para su uso en español.(AU)

Introduction. The degree of satisfaction of patients and their relatives with electroconvulsive therapy (ECT) is considered an important treatment goal; however there is no scale in Spanish to quantify it. The aim of the study was to translate and adapt into Spanish the “Patient Satisfaction Survey” (PSS) for its use in patients and their relatives. Methodology. Two translators performed the initial translation and a third translator did the back translation. The research committee obtained a consensus survey; the authors of the original instrument reviewed and accepted this survey. The equivalence between the original instrument with the back translation and the readability of the survey were analyzed. The Spanish version was tested on a sample of patients, relatives and experts in ECT. The same process was carried out for the satisfaction survey of relatives or caregivers. Results. The Spanish surveys were obtained after completing the translation process and identifying the problematic items that were successfully modified. The readability of the surveys was very accessible to the Spanish population. The pilot test carried out on patients, relatives and experts allowed detection and changes of confusing items. The final Spanish surveys were obtained after this pilot test. Conclusions. The adaptation of the PSS for Spanish patients and relatives provide suitable satisfaction scale for its use in Spanish population.(AU)

Are negative symptoms really related to cognition in schizophrenia?

Previous studies have generally found a relationship between negative and cognitive symptoms in schizophrenia. The present study investigated the relationship between the 5 PANSS factors of a recent consensus model developed by NIMH researchers, and cognitive performance as assessed with the MATRICS Consensus Cognitive Battery (MCCB) in 80 patients with schizophrenia using correlation and regression analyses. The PANSS Cognitive factor showed a small to moderate significant association with MCCB Speed of processing, Working memory, Verbal learning, the Neurocognitive composite score, and the Overall composite score. Notably, however, no relationship was found between the PANSS Negative factor and any of the MCCB scores. The Positive, Excited and Depressed factors also did not show associations with the MCCB. These results highlight the need for refined assessment instruments and support the relative independence of cognition from other domains of psychopathology, including negative symptoms, in patients with schizophrenia.

Retinal nerve fiber layer and macular thickness in patients with schizophrenia: Influence of recent illness episodes.

Optical coherence tomography (OCT) has been recently used to investigate neuropsychiatric disorders. We aimed to study retinal OCT measures of patients with schizophrenia with respect to healthy controls, and to evaluate possible differences between recent illness episode (RIE) and non-recent illness episode (NRIE) patients. Thirty schizophrenia patients were classified as RIE (n=10) or NRIE (n=20), and compared with 30 matched controls. Statistical analyses included linear mixed-effects models to study the association between OCT measures and group membership. Multivariate models were used to control for potential confounders. In the adjusted linear mixed-effects regression model, patients had a significantly thinner retinal nerve fiber layer (RNFL) in overall measurements, and in the nasal, superior and inferior quadrants. Macular inner ring thickness and macular volume were also significantly smaller in patients than controls. Compared with controls, in the adjusted model only NRIE (but not RIE) patients had significantly reduced RNFL overall measures, superior RNFL, nasal RNFL, macular volume, and macular inner ring thickness. No significant correlation was found between illness duration and retinal measurements after controlling for age. In conclusion, retinal parameters observed using OCT in schizophrenia patients could be related to clinical status and merit attention as potential state biomarkers of the disorder.

Utilidad clínica e implicaciones económicas de la terapia electroconvulsiva de continuación/mantenimiento en un hospital público del Sistema Nacional de Salud español: serie de casos / Clinical usefulness and economic implications of continuation/maintenance electroconvulsive therapy in a Spanish National Health System public hospital: A case series

Introducción: La terapia electroconvulsiva de continuación/mantenimiento ha demostrado su eficacia en la prevención de recaídas tanto en cuadros afectivos como psicóticos. Sin embargo, existen pocos estudios sobre variables de gestión clínica, costes asociados y calidad percibida. Material y métodos: Se presenta una serie de 8 casos incluidos en el Programa de terapia electroconvulsiva de Continuación/Mantenimiento del Servicio de Psiquiatría del Hospital Universitario 12 de Octubre durante los primeros 18 meses de su funcionamiento. Para cada paciente se compararon variables clínicas (Escala de Impresión Clínica Global-Mejoría Global, días de ingreso, visitas a Urgencias, ingresos urgentes) antes y después de su inclusión en el programa, así como costes asociados y calidad percibida. Resultados: Tras su inclusión en el programa, el 50,0% de los pacientes refirió encontrarse «mucho mejor», y el 37,5% «moderadamente mejor» en la Escala de Impresión Clínica Global-Mejoría Global. Además, una vez incluidos en el programa de terapia electroconvulsiva de continuación/mantenimiento, los pacientes tuvieron un total de 349 días de ingreso, 3 visitas a Urgencias y 2 ingresos urgentes, frente a los 690 días de ingreso (p = 0,012), 26 visitas a Urgencias (p = 0,011) y 22 ingresos urgentes (p = 0,010) en el mismo periodo, antes de su inclusión en el programa. Los costes directos asociados por estancia/día tras su inclusión en el programa se redujeron al 50,6% del coste previo, y los costes asociados a visitas a Urgencias disminuyeron al 11,5% del coste previo. Respecto a la calidad percibida, un 87,5% de los pacientes evaluaron la atención y tratamiento recibido como «muy satisfactorio», y un 12,5% como «satisfactorio». Conclusiones: El programa de terapia electroconvulsiva de continuación/mantenimiento estudiado ha demostrado utilidad clínica, repercusión económica favorable, así como una elevada calidad percibida (AU)

Introduction: Continuation/maintenance electroconvulsive therapy has been shown to be effective for prevention of relapse in affective and psychotic disorders. However, there is a limited nubber of studies that investigate clinical management, associated costs, and perceived quality variables. Material and methods: A series of 8 cases included during the first 18 months of the Continuation/Maintenance Electroconvulsive Therapy Program of the Psychiatry Department at 12 de Octubre University Hospital is presented. Clinical variables (Clinical Global Impression-Improvement Scale, length of hospitalization, number of Emergency Department visits, number of urgent admissions) before and after inclusion in the continuation/maintenance electroconvulsive therapy program were compared for each patient, as well as associated costs and perceived quality. Results: After inclusion in the program, 50.0% of patients reported feeling «much better» and 37.5% «moderately better» in the Clinical Global Impression-Improvement Scale. In addition, after inclusion in the continuation/maintenance electroconvulsive therapy program, patients were hospitalized for a total of 349 days, visited the Emergency Department on 3 occasions, and had 2 urgent admissions, compared to 690 days of hospitalization (P = .012), 26 Emergency Department visits (P = .011) and 22 urgent admissions (P = .010) during the same period before inclusion in the program. Associated direct costs per day of admission were reduced to 50.6% of the previous costs, and costs associated with Emergency Department visits were reduced to 11.5% of the previous costs. As regards perceived quality, 87.5% of patients assessed the care and treatment received as being «very satisfactory», and 12.5% as «satisfactory». Conclusions: This continuation/maintenance electroconvulsive therapy program has shown to be clinically useful and to have a favourable economic impact, as well as high perceived quality (AU)

Clinical usefulness and economic implications of continuation/maintenance electroconvulsive therapy in a Spanish National Health System public hospital: A case series.

INTRODUCTION: Continuation/maintenance electroconvulsive therapy has been shown to be effective for prevention of relapse in affective and psychotic disorders. However, there is a limited nubber of studies that investigate clinical management, associated costs, and perceived quality variables. MATERIAL AND METHODS: A series of 8 cases included during the first 18 months of the Continuation/Maintenance Electroconvulsive Therapy Program of the Psychiatry Department at 12 de Octubre University Hospital is presented. Clinical variables (Clinical Global Impression-Improvement Scale, length of hospitalization, number of Emergency Department visits, number of urgent admissions) before and after inclusion in the continuation/maintenance electroconvulsive therapy program were compared for each patient, as well as associated costs and perceived quality. RESULTS: After inclusion in the program, 50.0% of patients reported feeling « much better ¼ and 37.5% « moderately better ¼ in the Clinical Global Impression-Improvement Scale. In addition, after inclusion in the continuation/maintenance electroconvulsive therapy program, patients were hospitalized for a total of 349 days, visited the Emergency Department on 3 occasions, and had 2 urgent admissions, compared to 690 days of hospitalization (P = .012), 26 Emergency Department visits (P = .011) and 22 urgent admissions (P = .010) during the same period before inclusion in the program. Associated direct costs per day of admission were reduced to 50.6% of the previous costs, and costs associated with Emergency Department visits were reduced to 11.5% of the previous costs. As regards perceived quality, 87.5% of patients assessed the care and treatment received as being « very satisfactory ¼, and 12.5% as « satisfactory ¼. CONCLUSIONS: This continuation/maintenance electroconvulsive therapy program has shown to be clinically useful and to have a favourable economic impact, as well as high perceived quality.

Is it possible to combine different psychotic symptom scales in bipolar disorder?

It has been suggested that data on positive and negative psychotic symptoms in patients with schizophrenia as assessed using different scales may be combined. For the first time, we assessed correlations between the positive syndrome subscale of the Positive and Negative Syndrome Scale (PANSS-P) and the Scale for the Assessment of Positive Symptoms (SAPS), and between the negative syndrome subscale of the Positive and Negative Syndrome Scale (PANSS-N) and the Scale for the Assessment of Negative Symptoms (SANS) in patients with bipolar disorder. We also aimed to confirm these correlations in patients with schizophrenia. This cross-sectional study was conducted with a group of 94 patients (40 diagnosed with bipolar disorder, 54 with schizophrenia). Assessments were carried out using the PANSS, SAPS and SANS. Large significant correlations were found between the PANSS-P and SAPS, and between the PANSS-N and SANS, in both the bipolar disorder group and the schizophrenia group. These results confirm previous findings regarding correlations between these scales in schizophrenia, and support the hypothesis that similar correlations exist in bipolar disorder. Therefore, our data support the potential usefulness in collaborative research of combining results from different scales for the assessment of psychotic symptoms in patients with bipolar disorder.

Reduced visual surround suppression in schizophrenia shown by measuring contrast detection thresholds.

Visual perception in schizophrenia is attracting a broad interest given the deep knowledge that we have about the visual system in healthy populations. One example is the class of effects known collectively as visual surround suppression. For example, the visibility of a grating located in the visual periphery is impaired by the presence of a surrounding grating of the same spatial frequency and orientation. Previous studies have suggested abnormal visual surround suppression in patients with schizophrenia. Given that schizophrenia patients have cortical alterations including hypofunction of NMDA receptors and reduced concentration of GABA neurotransmitter, which affect lateral inhibitory connections, then they should be relatively better than controls at detecting visual stimuli that are usually suppressed. We tested this hypothesis by measuring contrast detection thresholds using a new stimulus configuration. We tested two groups: 21 schizophrenia patients and 24 healthy subjects. Thresholds were obtained using Bayesian staircases in a four-alternative forced-choice detection task where the target was a grating within a 3∘ Butterworth window that appeared in one of four possible positions at 5∘ eccentricity. We compared three conditions, (a) target with no-surround, (b) target embedded within a surrounding grating of 20∘ diameter and 25% contrast with same spatial frequency and orthogonal orientation, and (c) target embedded within a surrounding grating with parallel (same) orientation. Previous results with healthy populations have shown that contrast thresholds are lower for orthogonal and no-surround (NS) conditions than for parallel surround (PS). The log-ratios between parallel and NS thresholds are used as an index quantifying visual surround suppression. Patients performed poorly compared to controls in the NS and orthogonal-surround conditions. However, they performed as well as controls when the surround was parallel, resulting in significantly lower suppression indices in patients. To examine whether the difference in suppression was driven by the lower NS thresholds for controls, we examined a matched subgroup of controls and patients, selected to have similar thresholds in the NS condition. Patients performed significantly better in the PS condition than controls. This analysis therefore indicates that a PS raised contrast thresholds less in patients than in controls. Our results support the hypothesis that inhibitory connections in early visual cortex are impaired in schizophrenia patients.

Cognición y calidad de vida en pacientes con esquizofrenia: utilidad de la MATRICS Consensus Cognitive Battery / Cognition and quality of life in patients with schizophrenia: usefullness of the MATRICS Consensus Cognitive Battery

El déficit cognitivo es un síntoma nuclear de la esquizofrenia. La iniciativa Measurement And Treatment Research to Improve Cognition in Schizophrenia (MATRICS) del National Institute of Mental Health (NIMH) de Estados Unidos se planteó como objetivo desarrollar una batería cognitiva de consenso para evaluar en un contexto clínico los diferentes dominios cognitivos afectados en estos pacientes. El resultado de ese trabajo fue el desarrollo de la MATRICS Consensus Cognitive Battery (MCCB). La estandarización y obtención de datos normativos en nuestro medio ha sido realizada recientemente. Los objetivos del presente trabajo fueron: a) estudiar el funcionamiento cognitivo medido con la MCCB en una muestra de pacientes con esquizofrenia y comparar los resultados con un grupo control, y b) estudiar la relación entre los diferentes dominios cognitivos y la calidad de vida en el grupo de pacientes con esquizofrenia. Se realizó el estudio con un grupo de 40 pacientes con diagnóstico de esquizofrenia según los criterios de la cuarta edición del Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), y un grupo control de 40 sujetos pareados por sexo y edad. Los resultados mostraron un déficit cognitivo de los pacientes con esquizofrenia en todos los dominios cognitivos evaluados por la MCCB, así como la utilidad de la MCCB en el estudio de la función cognitiva en nuestro medio. Además, se encontraron correlaciones significativas entre la calidad de vida y algunos dominios cognitivos: velocidad de proceso (0,398; p = 0,011), aprendizaje y memoria verbal (0,456; p = 0,003), y razonamiento y solución de problemas (0,496; p = 0,001) (AU)

Cognitive dysfunction is a nuclear symptom of schizophrenia. The Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative of the U.S. National Institute of Mental Health (NIMH) set as one of its objectives the development of a consensus cognitive battery for the clinical assessment of the different cognitive domains that are impaired in these patients. The result of this was the MATRICS Consensus Cognitive Battery (MCCB). The standardization and obtention of normative data of the battery in our milieu was recently carried out. The objectives of the present investigation were a) to study the cognitive performance of a sample of schizophrenic patients as assessed by the MCCB and to compare the results with a control group; b) to study the relationship between the different cognitive domains and quality of life in the sample of schizophrenic patients. The study was carried out with a group of 40 patients diagnosed with schizophrenia according to DSM-IV criteria, and a control group of 40 subjects who were matched by age and gender. Results show cognitive deficits in the patient group across all the cognitive domains assessed by the MCCB, as well as the usefulness of the MCCB in the study of cognitive function in our milieu. In addition, significant correlations were found between quality of life and some of the cognitive domains: speed of processing (0.398; p = 0.011), verbal learning and memory (0.456; p = 0.003), and reasoning and problem solving (0.496; p = 0.001) (AU)

Neurocognition, social cognition and functional outcome in schizophrenia

Background and Objectives: A relationship has been found between cognition and functioning in patients with schizophrenia. Our objective was to study the relationship between the cognitive domains assessed by the MATRICS Consensus Cognitive Battery (MCCB), and functioning as evaluated using the functioning subscale of the Global Assessment of Functioning scale (GAF-f). Methods: A sample of 83 clinically stable outpatients diagnosed with schizophrenia according to DSM-IV criteria were assessed using the MCCB and the GAF-f. Pearson correlations and stepwise linear regression analyses were performed. Results: Correlation analysis between the GAF-f and the cognitive domains of the MCCB showed a significant relationship between functioning and all of the cognitive domains. Regression yielded a statistically significant model (F2,74 = 20.4, p < 0.001) in which functioning was related to Speed of processing (standardized â = 0.369, p = 0.001) and to Social cognition (standardized â = 0.325, p = 0.003). Together, these two variables explained33.8% of the variance of functioning. Conclusions: Both speed of processing and social cognition have an important association with functioning in patients with schizophrenia (AU)

Psicosis por déficit de vitamina B12 en un paciente de edad avanzada / Psychosis due to vitamin B12 deficiency in an elderly patient

No disponible

A five-year follow-up study of neurocognitive functioning in bipolar disorder.

OBJECTIVES: Cognitive dysfunction in bipolar disorder has been well-established in cross-sectional studies; however, there are few data regarding the longitudinal course of cognitive performance in bipolar disorder. The aim of this study was to examine the course of cognitive function in a sample of euthymic patients with bipolar disorder during a five-year follow-up period. METHODS: Eighty euthymic outpatients with a DSM-IV diagnosis of bipolar disorder and 40 healthy control comparison subjects were neuropsychologically assessed at baseline (T1) and then at follow-up of five years (T2). A neurocognitive battery including the main cognitive domains of speed of processing, working memory, attention, verbal memory, visual memory, and executive function was used to evaluate cognitive performance. RESULTS: Repeated-measures multivariate analyses showed that progression of cognitive dysfunction in patients was not different to that of control subjects in any of the six cognitive domains examined. Only a measure from the verbal memory domain, delayed free recall, worsened more in patients with bipolar disorder. Additionally, it was found that clinical course during the follow-up period did not influence the course of cognitive dysfunction. CONCLUSIONS: Cognitive dysfunction that is characteristic of bipolar disorder is persistent and stable over time. Only dysfunction in verbal recall was found to show a progressive course that cannot be explained by clinical or treatment variables.

Dopamine partial agonism in antipsychotic-induced sexual dysfunction.

INTRODUCTION: Sexual dysfunction is a frequent side effect associated with antipsychotic treatment. It is known to be caused by the hyperprolactinemia that results from the D2 receptor blockade that is characteristic of antipsychotic drugs. The D2 partial dopaminergic agonism of aripiprazole could explain why its use does not usually cause this side effect, and may even revert it when added to another antipsychotic. CASE REPORTS: We present the cases of two patients treated with D2 dopaminergic antagonists for a first episode of psychosis, who complained of amenorrhea and erectile dysfunction during follow-up. After the addition of aripiprazole to their previous antipsychotic treatment, these side effects reverted without a negative impact on treatment adherence or therapeutic efficacy. CONCLUSIONS: Pharmacological treatments with the potential of reverting sexual dysfunction secondary to antipsychotic treatment can improve compliance and quality of life of our patients, especially in those who are younger and are being treated for a first psychotic episode. In the cases reported here, the use of aripiprazole as an adjunctive treatment resulted in the disappearance of the undesirable effects without affecting the efficacy already achieved with the previous antipsychotic treatment.

Agonismo parcial dopaminérgico en la disfunción sexual secundaria a antipsicóticos / Dopamine partial agonism in antipsychoticinduced sexual dysfunction

Introducción. La disfunción sexual es un efecto secundario frecuente de los antipsicóticos. Ha sido relacionada con la hiperprolactinemia producida por el antagonismo dopaminérgico D2 propio de los fármacos antipsicóticos. El agonismo parcial dopaminérgico D2 del aripiprazol podría explicar por qué su utilización no suele producir ese efecto secundario y que incluso lo revierta al añadirse aripiprazol al tratamiento con otros antipsicóticos. Casos clínicos. Se presentan dos casos clínicos con un primer episodio psicótico en tratamiento con antagonistas dopaminérgicos D2, que desarrollan amenorrea y disfunción eréctil respectivamente. Tras añadir aripiprazol a su tratamiento antipsicótico previo remiten estos efectos secundarios manteniendo adherencia y eficacia terapéutica. Conclusiones. Los fármacos que pueden disminuir los efectos secundarios en la esfera sexual pueden mejorar la aceptación al tratamiento y la calidad de vida, especialmente en pacientes jóvenes con primeros episodios psicóticos. En los casos presentados, el uso de aripiprazol como fármaco adyuvante, se tradujo en una mejoría en los efectos secundarios de la esfera sexual, sin comprometer la eficacia terapéutica (AU)

Introduction. Sexual dysfunction is a frequent side effect associated with antipsychotic treatment. It is known to be caused by the hyperprolactinemia that results from the D2 receptor blockade that is characteristic of antipsychotic drugs. The D2 partial dopaminergic agonism of aripiprazole could explain why its use does not usually cause this side effect, and may even revert it when added to another antipsychotic. Case reports. We present the cases of two patients treated with D2 dopaminergic antagonists for a first episode of psychosis, who complained of amenorrhea and erectile dysfunction during follow-up. After the addition of aripiprazole to their previous antipsychotic treatment, these side effects reverted without a negative impact on treatment adherence or therapeutic efficacy. Conclusions. Pharmacological treatments with the potential of reverting sexual dysfunction secondary to antipsychotic treatment can improve compliance and quality of life of our patients, especially in those who are younger and are being treated for a first psychotic episode. In the cases reported here, the use of aripiprazole as an adjunctive treatment resulted in the disappearance of the undesirable effects without affecting the efficacy already achieved with the previous antipsychotic treatment (AU)

Cognition and the five-factor model of the positive and negative syndrome scale in schizophrenia.

Different exploratory and confirmatory factorial analyses of the Positive and Negative Syndrome Scale (PANSS) have found a number of factors other than the original positive, negative, and general psychopathology. Based on a review of previous studies and using confirmatory factor analyses (CFA), Wallwork et al. (Schizophr Res 2012; 137: 246-250) have recently proposed a consensus five-factor structure of the PANSS. This solution includes a cognitive factor which could be a useful measure of cognition in schizophrenia. Our objectives were 1) to study the psychometric properties (factorial structure and reliability) of this consensus five-factor model of the PANSS, and 2) to study the relationship between executive performance assessed using the Wisconsin Card Sorting Test (WCST) and the proposed PANSS consensus cognitive factor (composed by items P2-N5-G11). This cross-sectional study included a final sample of 201 Spanish outpatients diagnosed with schizophrenia. For our first objective, CFA was performed and Cronbach's alphas of the five factors were calculated; for the second objective, sequential linear regression analyses were used. The results of the CFA showed acceptable fit indices (NNFI=0.94, CFI=0.95, RMSEA=0.08). Cronbach's alphas of the five factors were adequate. Regression analyses showed that this five-factor model of the PANSS explained more of the WCST variance than the classical three-factor model. Moreover, higher cognitive factor scores were associated with worse WCST performance. These results supporting its factorial structure and reliability provide robustness to this consensus PANSS five-factor model, and indicate some usefulness of the cognitive factor in the clinical assessment of schizophrenic patients.

Negative symptoms and executive function in schizophrenia: does their relationship change with illness duration?

BACKGROUND: Negative symptoms and cognitive dysfunction are of crucial functional and prognostic importance in schizophrenia. However, the nature of the relationship between them and the factors that may influence it have not been well established. AIMS: To investigate whether the relationship between negative symptoms and executive function changes according to the duration of illness in schizophrenia. METHODS: The Positive and Negative Syndrome Scale was used to assess psychopathology and the Wisconsin Card Sorting Test (WCST) to evaluate executive function in a sample of 200 schizophrenic patients who were classified in 3 groups according to their duration of illness: up to 5 years (short duration group), 6-20 years (intermediate duration group) and over 20 years of illness (long duration group). RESULTS: Medium-sized correlations were found between negative symptoms and WCST performance as assessed by the number of completed categories in all 3 groups. However, differences were found according to the duration of schizophrenia. For patients in the short duration group, negative symptoms correlated with WCST nonperseverative errors, but for those in the long duration group the correlation was with perseverative errors. CONCLUSION: We found a differential relationship between negative and cognitive symptoms in different stages of schizophrenia. Illness duration should be considered when studying the relationship between negative symptoms and cognition.

[Cognitive deficit in schizophrenia: MATRICS Consensus Cognitive Battery]. / Déficit cognitivo en la esquizofrenia: MATRICS Consensus Cognitive Battery.

Cognitive deficits constitute a core symptom in schizophrenia, are difficult to treat, and have special relevance regarding prognosis and functional outcome. The search for pharmacological strategies for improving cognition in schizophrenic patients has been hindered by the lack of a consensus regarding instruments for cognitive assessment. The 'Measurement and Treatment Research to Improve Cognition in Schizophrenia' (MATRICS) initiative of the U.S. National Institute of Mental Health (NIMH) set the development of a consensus cognitive battery as one of its objectives. In a first phase, the seven cognitive domains which have been shown to be impaired in schizophrenia and that were to be assessed were identified: Speed of processing, Attention/Vigilance, Working memory, Verbal learning, Visual learning, Reasoning and problem solving, and Social cognition. In a second phase, the MATRICS Consensus Cognitive Battery (MCCB) was developed. This is a cognitive assessment battery composed of ten instruments, which assess the seven domains in a little over one hour. The MCCB has been standardized in U.S. population, and the Spanish standardization has been recently published.

Déficit cognitivo en la esquizofrenia: MATRICS Consensus Cognitive Battery / Cognitive deficit in schizophrenia: MATRICS Consensus Cognitive Battery

El déficit cognitivo en la esquizofrenia es un síntoma nuclear, de difícil tratamiento en la actualidad, y que tiene especial relevancia en el pronóstico y capacidad funcional de los pacientes. La búsqueda de estrategias farmacológicas que demuestren eficacia en la mejoría cognitiva de pacientes con esquizofrenia ha presentado como una importante barrera la ausencia de instrumentos de evaluación cognitiva consensuados y utilizados de manera generalizada. La iniciativa Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) del National Institute of Mental Health (NIMH) de Estados Unidos ha tenido como uno de sus objetivos el desarrollo de una batería cognitiva de consenso. En una primera fase estableció los siete dominios cognitivos afectados en la esquizofrenia que habían de evaluarse: velocidad de proceso, atención/vigilancia, memoria de trabajo, aprendizaje y memoria verbal, aprendizaje y memoria visual, razonamiento y solución de problemas y, por último, cognición social. Posteriormente se desarrolló la MATRICS Consensus Cognitive Battery, una batería de evaluación cognitiva formada por 10 instrumentos con los que en algo más de una hora se evalúan los siete dominios cognitivos. Este instrumento se ha estandarizado en población estadounidense y recientemente se ha publicado la estandarización en España (AU)

Cognitive deficits constitute a core symptom in schizophrenia, are difficult to treat, and have special relevanceregarding prognosis and functional outcome. The search for pharmacological strategies for improving cognition in schizophrenic patients has been hindered by the lack of a consensus regarding instruments for cognitive assessment. The ‘Measurement and Treatment Research to Improve Cognition in Schizophrenia’ (MATRICS) initiative of the U.S. National Institute of Mental Health (NIMH) set the development of a consensus cognitive battery as one of its objectives. In a first phase, the seven cognitive domains which have been shown to be impaired in schizophrenia and that were to be assessed were identified: Speed of processing, Attention/Vigilance, Working memory, Verbal learning, Visual learning, Reasoning and problem solving, and Social cognition. In a second phase, the MATRICS Consensus Cognitive Battery (MCCB) was developed. This is a cognitive assessment battery composed of ten instruments, which assess the seven domains in a little over one hour. The MCCB has been standardized in U.S. population, and the Spanish standardization has been recently published (AU)