Randomized control trial to assess the efficacy of metacognitive training compared with a psycho-educational group in people with a recent-onset psychosis.

BACKGROUND: Aims were to assess the efficacy of metacognitive training (MCT) in people with a recent onset of psychosis in terms of symptoms as a primary outcome and metacognitive variables as a secondary outcome. METHOD: A multicenter, randomized, controlled clinical trial was performed. A total of 126 patients were randomized to an MCT or a psycho-educational intervention with cognitive-behavioral elements. The sample was composed of people with a recent onset of psychosis, recruited from nine public centers in Spain. The treatment consisted of eight weekly sessions for both groups. Patients were assessed at three time-points: baseline, post-treatment, and at 6 months follow-up. The evaluator was blinded to the condition of the patient. Symptoms were assessed with the PANSS and metacognition was assessed with a battery of questionnaires of cognitive biases and social cognition. RESULTS: Both MCT and psycho-educational groups had improved symptoms post-treatment and at follow-up, with greater improvements in the MCT group. The MCT group was superior to the psycho-educational group on the Beck Cognitive Insight Scale (BCIS) total (p = 0.026) and self-certainty (p = 0.035) and dependence self-subscale of irrational beliefs, comparing baseline and post-treatment. Moreover, comparing baseline and follow-up, the MCT group was better than the psycho-educational group in self-reflectiveness on the BCIS (p = 0.047), total BCIS (p = 0.045), and intolerance to frustration (p = 0.014). Jumping to Conclusions (JTC) improved more in the MCT group than the psycho-educational group (p = 0.021). Regarding the comparison within each group, Theory of Mind (ToM), Personalizing Bias, and other subscales of irrational beliefs improved in the MCT group but not the psycho-educational group (p < 0.001-0.032). CONCLUSIONS: MCT could be an effective psychological intervention for people with recent onset of psychosis in order to improve cognitive insight, JTC, and tolerance to frustration. It seems that MCT could be useful to improve symptoms, ToM, and personalizing bias.

[Genetic factors in the development of language]. / Factores genéticos en el desarrollo del lenguaje.

AIM: To review selectively the status of the genetic research in the field of speech and language disorders. DEVELOPMENT: Major contributions to the field are selected, presented, and discussed. Twin and family studies have demonstrated that most cognitive traits including language are moderately to highly heritable. Rare mutations affecting the FOXP2 transcription factor cause a monogenic speech and language disorder. The results of association studies of FOXP2 with several language disorders are controversial, probably due to the problem of phenotype definition. CONCLUSIONS: Common forms of disorders of speech and language are mostly likely associated with variability in the function of multiple genes. Longitudinal studies looking at gene environmental interaction might be important in order to understand the mechanism of language development.

Prevalencia y significación pronóstica del síndrome del enfermo eutiroideo en patología crítica / Prevalence and prognostic meaning of euthyroid sick syndrome in critical diseases

Hemos estudiado la prevalencia y significación pronóstica del síndrome del enfermo eutiroideo (SEE) en 91 pacientes ingresados en la Unidad de Cuidados Intensivos (UCI) mediante la determinación de hormonas tiroideas libres (FT3 y FT4), T3 inversa (rT3) y hormona tiroestimulante (TSH). La prevalencia del SEE es menor de la esperada, siendo la del SEE tipo I mayor que la del tipo II. La cardiopatía isquémica aguda presenta menor prevalencia de SEE que el resto de patologías estudiadas. Los pacientes críticos que desarrollan el tipo II presentan mayor mortalidad (AU)

[Prevalence and prognosis significance of euthyroid sick syndrome in critical illness]. / Prevalencia y significación pronóstica del síndrome del enfermo eutiroideo en patología crítica.

The prevalence and prognosis of the sick euthyroid syndrome (SES) was studied in 91 patients admitted to the ICU by determining free thyroid hormones (FT3 and FT4), T3 reverse (rT3) and thyrotropin (TSH). The prevalence of SES was lower than expected, type I being higher that type II. The acute coronary syndrome had a lower prevalence of SES than other clinical conditions. Patients who developed type II SES had a higher mortality rate.