Evaluación del control inhibitorio verbal con el test de Stroop en primeros episodios de psicosis con experiencia de trauma en la infancia / Evaluation of verbal inhibitory control with the Stroop Test in early episodes of psychosis with the experience of traumatic events in infancy

Introducción. Los datos aportados por la experiencia clínica evidencian la elevada prevalencia de experiencias traumáticas en sujetos que desarrollan psicosis. No obstante, queda mucho por examinar sobre el efecto de las experiencias traumáticas en su desarrollo y gravedad. El test de Stroop mide la inhibición cognitiva verbal, una función ejecutiva que permite frenar una respuesta automatizada y posibilita la inhibición de comportamientos alternativos a los ya aprendidos, en función de las demandas. Objetivo. Examinar la relación entre la experiencia subjetiva de trauma, el control inhibitorio verbal medido con el test de Stroop y la gravedad del diagnóstico a los seis meses desde el inicio de la enfermedad en sujetos con un primer episodio psicótico. Pacientes y métodos. La muestra estuvo formada por 119 pacientes del «Programa Asistencial para Fases Iniciales de Psicosis» del Hospital Universitario Marqués de Valdecilla. Las variables de interés fueron el test de Stroop y el Childhood Trauma Questionnaire como parte del protocolo de evaluación neuropsicológica de dicho programa. Resultados. Se obtuvieron diferencias estadísticamente significativas en control inhibitorio verbal y se encontró un mayor número de sujetos con alto control inhibitorio cuando el trauma referido fue de baja intensidad. Conclusiones. Estos datos confirman la relación entre intensidad de la experiencia traumática en la infancia y alteración del control inhibitorio verbal en personas con primer episodio psicótico, aunque no permiten concluir una mayor gravedad del diagnóstico a los seis meses del inicio de la psicosis en personas con experiencias traumáticas de mayor intensidad

Introduction. Data from clinical experience highlight the high prevalence of traumatic experiences in subjects with schizophrenia spectrum disorder. However, much is left to examine about the effect of traumatic experiences in the development and severity of psychosis. The Stroop Test assess the verbal response inhibition, an executive function which allows to stop an automatic response and makes possible the inhibition of new behaviours, depending on the situation. Aim. To examine the relationship between subjective experience of trauma, verbal response inhibition in the Stroop Test, and severity of the diagnosis at six months from the onset of the disease, in patients with first episode psychosis. Patients and methods. Data were obtained from a longitudinal intervention program of first-episode of psychosis (PAFIP) conducted at the University Hospital Marqués de Valdecilla, Spain. The variables of interest in the present study were the Stroop Test and the Childhood Trauma Questionnaire as part of the neuropsychological assessment of PAFIP. Results. Statistically significant differences were obtained in verbal response inhibition, being more subjects with high response inhibition when the said trauma was of low intensity. Conclusions. These data support the relationship between intensity of the traumatic experience in childhood and response inhibition dysfunction in people with first episode psychosis, although we cannot conclude a more severe diagnosis at six months from the onset of psychosis in people with traumatic experiences more intense

Targeting recovery in first episode psychosis: The importance of neurocognition and premorbid adjustment in a 3-year longitudinal study.

INTRODUCTION: Recovery in psychotic disorders remains a major challenge across mental health. Identifying predictors of recovery in first psychotic episodes is a priority in order to increase knowledge on underlying mechanisms of the illness and to obtain objective severity markers at initial phases. In this study we gathered sociodemographic, clinical and cognitive data to explore predictive variables of recovery after three years follow-up in a sample of 399 patients with a first episode of psychosis (FEP). MATERIAL AND METHOD: This is a longitudinal study including patients with a FEP. A dichotomic variable of recovery was created according to symptomatic and functional outcome after 3years follow-up. Significant variables in univariate analysis were entered into a binary logistic regression to obtain a multivariate prediction model of recovery. RESULTS: The predictive model was statistically significant and classified an overall of 76% of patients correctly, specifically 86.7% of patients that would not recover and 55% of the patients that would recover. From all the variables that where significantly different between recovered and not recovered patients, only speed of processing, executive functions and premorbid adjustment were found to be significant predictors of recovery. DISCUSSION: This study provides evidence that the degree of basal impairment in cognitive functions related to the Prefrontal Cortex and a worst premorbid adaptation predict in a significant way which patients are less likely to recover three years after a FEP.