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Objective:To ulteriorly explore the differences of psychotic symptoms and neurocognitive between patients with first-episode deficit subtype of schizophrenia (FDS) and patients with first-episode nondeficit subtype of schizophrenia (FNDS).Methods:From January 2021 to September 2021, a total of 88 first-episode treatment-naive schizophrenia were recruited from the Mental Health Center of West China Hospital and divided into FDS group( n=44) and FNDS group( n=44) according to the schedule for the deficit syndrome (SDS), and 44 healthy subjects were included as healthy control group (HC group, n=44). Positive and negative syndrome scale (PANSS) was used to assess psychotic symptoms of patients and Wechsler adult intelligence scale, trail making test and logic memory test were used to evaluate intelligence quotient and neurocognitive function of all subjects.SPSS 22.0 was used for statistical analysis, and independent samples t-test and one-way analysis of variance (ANOVA) were used to compare variables that met normal distribution, while the Mann-Whitney U test and Kruskal-Wallis H test were used to compare variables that did not meet normal distribution. Results:(1) There were significant differences in psychotic symptoms between the FDS group and the FNDS group.Compared with the FNDS group, the FDS group had higher total score of PANSS ((95.95±16.82) vs (88.39±16.29)), negative symptoms ((27.57±7.52) vs (16.57±5.76)) and anergastic reaction ((13.43±3.82) vs (7.00(5.00, 9.00)), and lower positive symptoms scores ((21.95±6.88) vs (25.41±6.07)), activation ((8.00(5.00, 9.00) vs (9.27±3.47)), depression ((5.50(4.00, 9.00) vs (8.00(6.00, 12.00)) and supplementary item ((13.60±4.17) vs (17.30±5.39))(all P<0.05). (2) There were differences in neurocognitive functions between FDS group and FNDS group, and which in FDS and FNDS group were worse than that in HC group.Spatial memory (block design test: (23.70±11.05) vs (31.72±11.49)) and information processing speed (digit symbol test: (38.38±15.85) vs (47.97±14.99)) of FDS group were significantly lower than those of FNDS group(both P<0.05). Intelligence quotient, information processing speed and spatial memory of FDS group and FNDS group were lower than those of HC group(all P<0.05). Conclusion:FDS patients has more severe negative symptoms and anergastic reaction, and exit worse information processing speed and spatial memory dysfunction than FNDS patients.This unique pattern of impairment suggests that information processing speed and spatial memory may be important classification indicators for differentiating the deficit subtype of schizophrenia in the early stage.
ABSTRACT
The primary and enduring presence of negative symptoms observed in a relatively homogeneous subgroup of patients with schizophrenia led to the concept of deficit syndrome (DS). Until date, it is considered that 20–25% of schizophrenia cohorts have DS. The aim of this meta-analysis was to determine the current prevalence of DS, including international and most recent studies. Thirteen observational studies met the inclusion criteria, comprising 2092 patients from eight countries. Pooled proportion of the DS subgroup was 32.64%, higher than previously reported. Based on our outcomes, up to one-third of patients with schizophrenia might have idiopathic and stable negative symptoms. This significant proportion of patients should be well represented in clinical trial's samples.
Subject(s)
Humans , Cohort Studies , Prevalence , SchizophreniaABSTRACT
OBJECTIVES: Deficit schizophrenia (DS) constitutes a disease separate from non-deficit schizophrenia (NDS). The aim of the current study was to compare the quantitative EEG and low resolution electromagnetic tomography (LORETA) imaging between DS and NDS. METHODS: This study was performed by 32 channels EEG for 42 schizophrenia patients who we categorized into DS and NDS using proxy instrument deficit syndrome (PDS). We performed the absolute power spectral analyses for delta, theta, alpha, low beta and high beta activities. We compared power spectrum between two groups using Independent t-test. Partial correlation test was performed with clinical parameters. Standardized LORETA (sLORETA) was used for comparison of cortical activity, and statistical nonparametric mapping (SnPM) was applied for the statistical analysis. RESULTS: DS showed significantly increased delta and theta absolute power in fontal and parietal region compared with NDS (p<0.05). Power spectrum showed significant correlation with 'anergia' and 'hostility/suspiciousness' subscale of brief psychiatric rating scale (BPRS)(p<0.05). sLORETA found out the source region (anterior cingulate cortex/limbic part) that delta activity was significantly increased in DS (p=0.042). CONCLUSIONS: DS showed different cortical activity compared with NDS. Our results may suggest QEEG and LORETA could be the marker in differentiating between DS and NDS.
Subject(s)
Humans , Brief Psychiatric Rating Scale , Electroencephalography , Magnets , Naphthalenesulfonates , Proxy , SchizophreniaABSTRACT
El objetivo de la presente revisión es analizar varios factores relacionados con la cafeína, sus efectos sobre determinados aspectos sobre la salud y de los procesos cognoscitivos. La cafeína es una sustancia ergogénica, que interactúa principalmente con esta sustancia, la adenosina, con sus diferentes subtipos de receptores y las acciones diversas que median cada uno de éstos, así como la distribución de estos receptores en el organismo; se destacaron algunos de los efectos positivos y negativos sobre la salud. Se examinan los aspectos neurobioquímicos de la cafeína, su relación con algunas patologías como el cáncer, el Parkinson y el Alzheimer. Adicionalmente se revisaron los efectos de la cafeína sobre la atención, base fundamental de otros procesos cognoscitivos más complejos como el aprendizaje, la memoria, el lenguaje y el pensamiento, y teniendo en cuenta la alta incidencia del déficit atencional con y sin hiperactividad, se presentan algunas investigaciones relacionadas con esta problemática, sus síntomas, formas de evaluación y de tratamiento, en las que se involucraran a la familia y los profesores.
The objective of this review is to analyze some aspects related with caffeine, its effects on health and cognitive processes. Caffeine is a ergogénica substance, interact with the interaction with Adenosine, different subtypes of receptors and its actions, as well as the distribution of these receptors in the body: later on, some positive and negative effects on health were noticed. The Neuro biochemical aspects of caffeine were examined and its relation with some pathology such as cancer, Parkinson and Alzheimer. After, the effects of caffeine on attention were reviewed, as fundamental base of other more complex cognitive processes such as learning, memory, language and thought; considering the high incidence of attention deficit with or without hyperactivity, some investigation related with it is presented, its symptoms, associated problems with this syndrome, ways to assess and treatment, in with the family and the teachers are involved.
Subject(s)
Adult , Adenosine , Caffeine , Coffee , Cognition , MemoryABSTRACT
OBJECTIVES: Primary, enduring negative symptoms have been used to define the deficit syndrome of schizophrenia, and the diagnostic validity of the deficit syndrome has been demonstrated by clinical, biological and neuropsychological studies. This study aims at evaluating the long-term stability of the diagnostic category of deficit syndrome using direct patient assessments. METHODS: The subjects were thirty-two patients with schizophrenia who were categorized into deficit or non-deficit subgroup using the Schedule for the Deficit Syndrome (SDS) in their remission or partial remission state maintained by long-term treatments with antipsychotics (mostly atypical drugs). These patients were re-assessed based on the same deficit syndrome criteria an average of 5.6 years after having been initially categorized. Lifetime presence of clinical symptoms were evaluated using the Krawiecka Scale. RESULTS: The majority (87.5%) of the patients who were classified as non-deficit at the initial assessment continued to remain non-deficit during the follow-through period. However, only 37.5% of the patients classified as deficit at the initial assessment remain classified as showing deficit syndrome. Compared to the non-deficit group, patients of the deficit group at the final assessment showed significantly higher scores of positive symptoms at their previous psychotic states. Among the individual items of SDS, 'poverty of speech' was the most predictable of the long-lasting deficit syndrome. CONCLUSION: This study showed insufficient long-term stability of the deficit syndrome categorized by SDS criteria. This could be explained by low validity of SDS criteria for the identification of the trait-dependent deficit syndrome. It might also suggest that deficit symptoms could be improved by optimal long-term treatment with atypical antipsychotics.
Subject(s)
Humans , Antipsychotic Agents , Appointments and Schedules , Diagnosis , Follow-Up Studies , SchizophreniaABSTRACT
Objective: To develop a Chinese version of the Schedule for the Deficit Syndrome(SDS) and examine its reliability and validity. Methods: 123 schizophrenic patients finished the Chinese version of SDS and were subtyped into deficit (n=30) and nondeficit(n=93) groups. In addition, all patients completed BPRS, SANS and SAPS. The reliability analysis of SDS included Cronbach's ?琢 coefficients and mean inter-item correlations and the inter-rater reliability; while the validity analysis included construct validity and criteria validity. Results: The Cronbach's ?琢 coefficient and the mean interitem correlation coefficients of the negative symptoms severity subscale of SDS were 0.8441 and 0.4818, respectively. The inter-rater reliability for categorization was 0.8777. The correlation coefficients of the six negative symptom items with the total score ranged from 0.685 to 0.875,and that among the six negative symptom items ranged from 0.437 to 0.794. The negative symptom items and the total score of SDS were significantly correlated with the anergia factor score from the BPRS and the total score and several subscale scores of SANS, while none of them was correlated with subscale scores and total score of SAPS. Conclusion: The Chinese version of SDS was a reliable and valid measure for the diagnostic classification of deficit and nondeficit schizophrenia.
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OBJECTIVES: Previous studies of cognitive impairment in schizophrenia suggest that negative syndrome can be characterized by specific impairments in visual information-processing. We examined the possibility of such cognitive impairments as a a trait marker of 'deficit' syndrome group characterized by persistent primary negative symptoms or schizophrenic patients as a whole. METHODS: The subjects were 35 schizophrenic patients in partial or full remission state and the controls were 25 volunteers screened for major mental illnesses in their 2nd degree relatives. The patients were divided into deficit & nondeficit groups based on Schedule for the Deficit Syndrome and they showed positive, depressive or extrapyramidal symptoms of minimal to mild degree. Performance on various cognitive tasks associated with visual information-processing was examined. RESULTS: Deficit and nondeficit groups showed no significant difference in age of onset, duration of illness, the severity of positive and depressive symptoms and dose of antipsychotics. Deficit group performed significantly less well than normal control group on Continuous Attention Test. Significant difference was found between the patients groups and normal control group on Vigilance Test, Signal-Detection Test, and in decision time of Reaction Unit Tests. There were no significant differences among three groups on the tasks of visual immediate memory, visual analysis, motor reaction, and fine motor control. No cognitive variable was correlated to duration of illness, the severity of positive and depressive symptoms, general psychopathology, and dose of antipsychotics. CONCLUSIONS: The results suggest that deficit syndrome might be characterized by the impairment of continuous attention to simple visual stimuli. Impaired vigilance to infrequent visual stimuli, selective auention to visual stimuli and delayed decision time in simple information-processing tasks which were not related to various clinical variables were suggested to be cognitive markers of schizophrenia.