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1.
J Psychiatr Res ; 138: 607-614, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34004397

RESUMO

Schizophrenia patients exhibit subtle and non-localizing neurological abnormalities, known as neurological soft signs (NSS). Life-span evidence suggests that NSS vary along the course of schizophrenia. An association between NSS and treatment response has been proposed, suggesting that NSS reflect the underlying neuropathology development in schizophrenia. However, few studies have investigated the relationship between NSS and treatment resistance in first-episode schizophrenia patients. We conducted a longitudinal study on 52 first-episode schizophrenia patients, who were assessed at baseline, the sixth month, and the fifth year using the abridged version of the Cambridge Neurological Inventory. The trajectories of NSS between 29 treatment-responsive patients (with full symptomatic remission) and 23 treatment-resistant patients (who received clozapine) were compared using mixed model ANOVA. We also controlled for the effect of age and estimated IQ, using a mixed ANCOVA model. Although the two schizophrenia groups had comparable NSS at the baseline, their trajectories of NSS differed significantly. Compared with their treatment-responsive counterparts, treatment-resistant schizophrenia patients had worsening of NSS over time. Our findings support the potential utility of NSS in identifying treatment resistance in first-episode schizophrenia. Progressive worsening of NSS in treatment-resistant schizophrenia patients may reflect the development of underlying neuropathology. Further studies using large samples of treatment-resistant schizophrenia patients are needed.


Assuntos
Doenças do Sistema Nervoso , Esquizofrenia , Humanos , Estudos Longitudinais , Indução de Remissão , Esquizofrenia/tratamento farmacológico
2.
Eur Arch Psychiatry Clin Neurosci ; 271(8): 1503-1511, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33594521

RESUMO

Prospective memory (PM) refers to the ability to remember to carry out a delayed intention in the future. Evidence suggests that emotionally salient cues can enhance PM functions in healthy population, but whether the benefit exists in schizophrenia and bipolar patients remains unclear. This study aimed to examine and compare the potential enhancement effect of emotional PM cues in schizophrenia patients and bipolar patients. Twenty-eight clinically stable schizophrenia participants, 26 euthymic bipolar participants and 29 controls completed a computerized PM task involving PM cues with different types of valences (i.e., positive, neutral and negative). All the three groups showed better PM performance when negative PM cues were presented compared with positive and neutral PM cues. The sizes of the enhancement effects of negative PM cues were large (all Cohen's d ≥ 1.00) and comparable across three groups. Our findings suggested that patients with schizophrenia and bipolar disorders could benefit from negative PM cues to an extent similar to healthy individuals, thus extended the notion of psychosis continuum to the important area of emotion-cognition interaction.

3.
Schizophr Bull ; 44(suppl_2): S536-S546, 2018 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-29618094

RESUMO

Meehl conceptualized schizotypy as the phenotypic manifestations of a neural integrative defect resulting from a schizophrenia diathesis. The majority of schizotypy studies recruited subjects from the general population and revealed a multidimensional construct. This 2-phase investigation first examined the clustering of schizotypy in 194 unaffected relatives of schizophrenia patients using the Chapman Psychosis Proneness scales and then directly compared the cognitive profiles of negative schizotypal individuals and positive schizotypal individuals with schizophrenia patients and controls. In the first phase, cluster analysis categorized 194 unaffected relatives of schizophrenia patients into positive schizotypy (n = 33), negative schizotypy (n = 66), mixed schizotypy (n = 27), and low schizotypy (n = 64). Positive schizotypal participants showed more self-report pleasure experiences than negative schizotypal participants, replicating earlier cluster analytic findings. In the second phase, 27 negative schizotypal individuals, 18 positive schizotypal individuals, 19 schizophrenia patients, and 29 controls were recruited. Although the groups were matched in terms of age, gender, and IQ, they differed significantly in cognitive profiles. While schizophrenia patients exhibited the broadest cognitive impairments, negative schizotypal participants exhibited visual memory, working memory, and verbal fluency impairments, and positive schizotypal participants exhibited logical memory, visual memory, working memory, and theory-of-mind impairments. Among people with familial risk of schizophrenia, individuals exhibiting positive rather than negative schizotypal features resembled schizophrenia patients in cognitive profiles. Using the psychometric-familial method to identify schizotypy, our findings support the heterogeneity of schizotypy as well as the potential utility of the positive schizotypy dimension in genetically high-risk individuals to predict the risk of developing schizophrenia.


Assuntos
Disfunção Cognitiva/fisiopatologia , Predisposição Genética para Doença , Esquizofrenia/fisiopatologia , Transtorno da Personalidade Esquizotípica/fisiopatologia , Adolescente , Adulto , Disfunção Cognitiva/etiologia , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/complicações , Adulto Jovem
4.
Schizophr Bull ; 44(suppl_2): S547-S555, 2018 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-29471331

RESUMO

The Clinical Assessment Interview for Negative Symptoms (CAINS) was designed in accordance with the recent theory and research in social affective neuroscience and to address the psychometric and conceptual limitations of other instruments assessing negative symptoms. The present study aimed to provide a large-scale validation of the CAINS in China and examine its applicability and validity evidence across the schizophrenia spectrum. Using confirmatory factor analysis, our results replicated the original findings in the US development samples that the CAINS possesses a stable 2-factor structure, namely "motivation/pleasure" and "expression". We also found significant correlations between the CAINS and other negative symptom measures. The CAINS demonstrated good discriminant validity in differentiating negative symptoms in people with schizophrenia, nonpsychotic first-degree relatives and people with social anhedonia. People with schizophrenia exhibited significantly higher CAINS subscale scores than first-degree relatives and healthy controls. In addition, first-degree relatives had higher "motivation/pleasure" scores than healthy controls. The "motivation/pleasure" subscale scores of individuals with social anhedonia were also significantly higher than healthy controls.


Assuntos
Anedonia/fisiologia , Entrevista Psicológica/normas , Escalas de Graduação Psiquiátrica/normas , Psicometria/métodos , Esquizofrenia/diagnóstico , Transtorno da Personalidade Esquizotípica/diagnóstico , Adulto , China , Comparação Transcultural , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Esquizofrenia/fisiopatologia , Transtorno da Personalidade Esquizotípica/fisiopatologia
5.
Psychiatry Res ; 261: 357-360, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29353761

RESUMO

This study examined the change of Theory of Mind (ToM) performances in patients with first-episode schizophrenia over an 18-month period since illness onset. A computerised behavioural task was utilised to assess the affective and cognitive facets of visual-based ToM. Patients' ToM performances were standardised using the norms of gender-stratified, age- and IQ-matched controls. The results showed that schizophrenia patients exhibited poorer second-order affective and cognitive ToM at baseline, but their ToM ability improved after 18 months of follow-up. Our findings do not support a longitudinal dissociation of affective from cognitive ToM in schizophrenia.


Assuntos
Psicologia do Esquizofrênico , Teoria da Mente , Adolescente , Adulto , Afeto , Feminino , Seguimentos , Humanos , Masculino , Testes Neuropsicológicos , Adulto Jovem
6.
Sci Rep ; 5: 11850, 2015 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-26136150

RESUMO

The present study examined different types of neurological signs in patients with first-episode schizophrenia and their relationships with neurocognitive functions. Both cross-sectional and longitudinal designs were adopted with the use of the abridged Cambridge Neurological Inventory which comprises items capturing motor coordination, sensory integration and disinhibition. A total of 157 patients with first-episode schizophrenia were assessed at baseline and 101 of them were re-assessed at six-month interval. A structural equation model (SEM) with invariance model across time was used for data analysis. The model fitted well with the data at baseline assessment, X^2(21) = 21.78, p = 0.413, NFI = 0.95, NNFI = 1.00, CFI = 1.00, IFI = 1.00, RMSEA = 0.015. Subsequent SEM analysis with invariance model at six-month interval also demonstrated the same stable pattern across time and showed strong measurement invariance and structure invariance across time. Our findings suggest that neurological signs capture more or less the same construct captured by conventional neurocognitive tests in patients with schizophrenia. The measurement and structure of these relationships appear to be stable over time.


Assuntos
Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Adolescente , Adulto , Cognição , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Modelos Psicológicos , Modelos Estatísticos , Adulto Jovem
7.
Schizophr Res ; 166(1-3): 1-8, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26049215

RESUMO

BACKGROUND: Theory of mind (ToM) impairment has been consistently demonstrated in patients with schizophrenia, but whether ToM impairments exist in unaffected siblings of patients with schizophrenia remains unclear. Few studies have examined the affective and cognitive components of ToM in schizophrenia. This study aimed to examine whether ToM impairments exist in patients with first-episode schizophrenia and their unaffected siblings, and whether there is any dissociation between the affective and cognitive components of ToM. METHOD: We adopted a family-based case-control design. Participants were 41 patients with first-episode schizophrenia, 43 unaffected siblings, and 42 healthy controls. The Yoni Task which measures the participants' ability to understand first- and second-order affective versus cognitive ToM and the Faux Pas Task which taps into integration of the affective and cognitive components of ToM were administered. Multivariate and univariate ANCOVAs were used to examine the group differences in ToM, while controlling for other neurocognitive functions. RESULTS: Compared with controls, patients with schizophrenia and their unaffected siblings performed poorer on the Faux Pas Task (p<0.001), with siblings having intermediate performance between patients and controls. Patients with schizophrenia performed worse than controls on second-order affective condition of the Yoni Task (p=0.004), but their unaffected siblings did not (p=0.063). We did not find any significant Group-by-Condition interaction in the Yoni Task (p=0.358). CONCLUSION: Patients with first-episode schizophrenia and their unaffected siblings exhibit ToM impairments, but no dissociation between affective and cognitive component of ToM was found. Our findings support the notion that ToM deficit may be a trait marker of schizophrenia.


Assuntos
Transtornos Cognitivos , Psicologia do Esquizofrênico , Irmãos/psicologia , Teoria da Mente , Adulto , Análise de Variância , Estudos de Casos e Controles , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/genética , Endofenótipos , Feminino , Humanos , Masculino , Análise Multivariada , Escalas de Graduação Psiquiátrica , Testes Psicológicos , Esquizofrenia/complicações , Esquizofrenia/genética
8.
Sci Rep ; 5: 11053, 2015 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-26053141

RESUMO

This prospective study examined the course of neurological soft signs (NSS) in patients with first-episode schizophrenia and its relationship with negative symptoms and cognitive functions. One hundred and forty-five patients with first-episode schizophrenia were recruited, 29 were classified as having prominent negative symptoms. NSS and neuropsychological measures were administered to all patients and 62 healthy controls at baseline. Patients were then followed-up prospectively at six-month intervals for up to a year. Patients with prominent negative symptoms exhibited significantly more motor coordination signs and total NSS than patients without prominent negative symptoms. Patients with prominent negative symptoms performed worse than patients without negative symptoms in working memory functions but not other fronto-parietal or fronto-temporal functions. Linear growth model for binary data showed that the prominent negative symptoms were stable over time. Despite general improvement in NSS and neuropsychological functions, the prominent negative symptoms group still exhibited poorer motor coordination and higher levels of NSS, as well as poorer working memory than patients without prominent negative symptoms. Two distinct subtypes of first-episode patients could be distinguished by NSS and prominent negative symptoms.


Assuntos
Testes Neuropsicológicos/estatística & dados numéricos , Desempenho Psicomotor/fisiologia , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Adulto , Cognição/fisiologia , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Prospectivos , Adulto Jovem
9.
Front Psychol ; 6: 7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25698985

RESUMO

The present study aimed to examine the psychometric properties of the Chinese version of the Clinical Assessment Interview for Negative Symptoms (CAINS). We recruited 68 patients with schizophrenia from the Chinese setting. The findings showed a generally consistent two-factor structure with the original version, namely "expression" and "motivation-pleasure." There is a minor cultural variation in perceiving these items in the Chinese culture. However, the present study demonstrated that the Chinese version of the CAINS appears to be a valid and reliable clinical tool for the assessment of negative symptoms in the Chinese setting.

10.
J Atten Disord ; 17(3): 194-202, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22210800

RESUMO

OBJECTIVE: Unlike rating scales that focus on the severity of ADHD symptoms, the Strengths and Weaknesses of ADHD-symptoms and normal-behaviors (SWAN) rating scale is phrased in neutral or positive terms for carers to compare the index child's behaviors with that of their peers. This study explores its psychometric properties when applied to Chinese children in Hong Kong. METHOD: Ratings from the Chinese SWAN scale collected from parents and teachers of a community sample of 3,722 6- to 12-year-old students recruited by stratified random sampling were compared with 247 clinic children with a diagnosis of ADHD. Reliability, validity, factor structure, and cutoff scores were calculated. RESULTS: Favorable psychometrics and a two-factor structure identical to the original were reproduced. Cutoff scores were supported by satisfactory sensitivities and specificities. CONCLUSION: The SWAN scale is a reliable and valid instrument for the assessment of ADHD symptoms in Chinese children in Hong Kong.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Comparação Transcultural , Determinação da Personalidade/estatística & dados numéricos , Inquéritos e Questionários , Atenção , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Cuidadores/psicologia , Criança , Feminino , Hong Kong , Humanos , Masculino , Atividade Motora , Variações Dependentes do Observador , Psicometria/estatística & dados numéricos , Valores de Referência , Reprodutibilidade dos Testes , Tradução
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