The relationships between sociodemographic, psychosocial and clinical variables with personal-stigma in patients diagnosed with schizophrenia.

BACKGROUND: Studies suggest that people with a diagnosis of schizophrenia are one of the most stigmatized groups in society. AIM: To comprehensively analyze personal stigma in patients diagnosed with schizophrenia. METHOD: Data were obtained from 89 patients. Patients were evaluated with the following scales: a sociodemographic and clinical questionnaire, the Discrimination and Stigma Scale, the Self-perception of Stigma Questionnaire for People with Schizophrenia, the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Global Assessment of Functioning Scale, and the Brief Social Functioning Scale. RESULTS: Relations between personal stigma and sociodemographic and psychosocial variables were poor. However, clinical variables correlated with different facets of personal stigma. Personal stigma subscales´ correlations were between experienced stigma, anticipated stigma, and self-stigma to each other. 29.5% of the experienced stigma subscale variance was explained by age of onset and level of depression. 20.1% of the anticipated stigma subscale variance was explained by level of depression and gender. 27.3% of the overcoming stigma subscale variance was explained by level of depression and positive and negative psychotic symptoms. 35.8% of the self-stigma scale variance was explained by the level of depression. CONCLUSIONS: Addressing stigma within treatment seems of crucial importance since all stigma facets seem to be highly related to clinical dimensions, especially depression Therefore, including strategies to reduce stigma in care programs may help patients with schizophrenia to better adjust in life and improve their illness process.

Neuropsychological findings in recent onset schizophrenia and borderline personality disorder: a comparison study.

INTRODUCTION: Neurocognitive impairment is considered an essential symptom of schizophrenia, particularly in its early stages. Nonetheless, the neuropsychological features of borderline personality disorder (BPD) could cast doubt on the specificity of neurocognitive dysfunctions. The aim of this study is to determine whether neurocognitive deficits are specific to schizophrenia-spectrum conditions as compared to a similarly severe psychiatric illness like BPD. METHOD: A battery of neuropsychological tests was used to assess the abilities for attention, verbal memory and executive functions in a group of 34 borderline personality disorder (BPD) patients, 24 patients with first episode of a schizophrenia-spectrum disorder (FEP) and a group of 19 controls. RESULTS: ANOVA for multiple measures with subsequent post-hoc tests demonstrated significant effect sizes between controls and patients for all cognitive domains. However, the effect sizes of comparisons between both groups of patients were not significant. CONCLUSIONS: Results show significant neuropsychological impairment in both disorders when compared with normal controls, but no specific pattern of neurocognitive deficits for schizophrenia-spectrum disorders was found.

Validation of the spanish version of the discrimination and stigma scale (DISC 12).

AIMS: The "Discrimination and Stigma Scale" (DISC) was the first instrument specifically designed to evaluate reported experiences of discrimination by people with mental disorders. This study aims to validate DISC-12 version in Spanish population with Schizophrenia and, as specific objectives, to do the external validation with the Self-Stigma Questionnaire (SSQ) scale and Link PDD scale and to validate their internal consistency, temporal and inter-rater reliability. METHODS: 86 individuals with schizophrenia were interviewed at two time points (between one to two weeks) by two raters. Additionally to assess their sociodemographic and clinical characteristics, following scales were administered: DISC 12, SSQ, PDD, Social Functioning Scale (SFS) and Global Assessment of Function (GAF). RESULTS: Internal consistency as a whole results a Cronbach a between 0.741 and 0.850. Subscales "Unfair treatmen" and "Positive treatment" have a Cronbach a higher than 0.79, but the both subscales "Stopping Self" and "Overcoming stigma" do not have in themselves an adequate consistency. Test-retest reliability shows that four subscales have values higher than 0.67. Inter-rater reliability assessment result that 21 items score values above 0.8, 10 between 0.6-0.8 and one lower than 0.6. DISC-12 was significantly related with the second factor of the PDD (self-stigma) and SSQ. CONCLUSIONS: The Spanish version of the DISC 12 scale is valid, has good internal consistency, is reliable both in terms of test-retest and inter-rater reliability and has good convergent validity with the SSQ and PDD, and the "Unfair treatment" and "Positive Treatment" subscales were the most robust of the four subscales.

Staging of depressive disorders: Relevance of resistance to treatment and residual symptoms.

BACKGROUND: Clinical staging model for depression helps to better define the clinical situation of patients. The objectives of this study are: to correlate the Hetrick's staging model of depression with the severity of depression, associated disability, and resistance to treatment in the established disease stages and to test the modification introduced by our group consisting in the introduction of a substage for recurrence from a previous episode that was stabilized with a complete remission. METHODS: A Cross-sectional study with 133 adult subjects having a current and primary diagnosis of Depressive disorder was developed. Patients were classified according to the model and assessed with: 17-item Hamilton Depression Scale (HAM-D), Clinical Global Impression (CGI); Global Assessment of Function (GAF); Maudsley Staging Method for treatment resistance (MSM) and Sheeham Disability Schedule (SDS). RESULTS: The variable that best contributes to the differentiation between clinical stages, in established Depression, is resistance to treatment evaluated by the MSM. Correlations between MSM and the clinical stages were statistically significant between most pairs of stages. Finally, we showed preliminary data in order to prove that a differential sub-stage for recurrent depression with and without inter-episodic remission in the current heuristic models could be a possible stage for better define depression staging model. CONCLUSIONS: Resistance to treatment should be included in the definition of clinical stages in established depression. Despite the difficulty of establishing a valid model for the staging of depression, it can certainly add great value to diagnosis, therapeutic interventions and clinical research.

Diffusion Tensor Imaging Measures of Brain Connectivity for the Early Diagnosis of Alzheimer's Disease.

The prognostic capacity of the diffusion tensor imaging measures fractional anisotropy (FA) and mean diffusivity (MD) to detect mild cognitive impairment (MCI) progression to Alzheimer's disease (AD) was assessed in 135 MCI patients and 72 healthy subjects over a median follow-up of 40 months. Forty-nine MCI patients (36.3%) developed AD. The factors MD left hippocampus, FA left cingulate, and FA left hippocampus emerged as predictors of progression. Age (hazard ratio [HR] 1.21), delayed text recall (HR 0.89), FA left uncinate (HR 1.90), FA left hippocampus (HR 2.21), and carrying at least one ApoE4 allele (HR 2.86) were associated with a high conversion rate. FA measures revealed the greatest discriminative capacity (Harrell's C = 0.73 versus 0.65 without FA; p = 0.034). The inclusion of FA structural connectivity data in our model improved discrimination between subjects with MCI progressing or not to dementia.