[Cognitive remediation therapy in schizophrenia]

Despite progress in chemo-therapeutics, schizophrenia remains a chronic disease with occurrence of residual symptoms and drug resistance in 60%of the cases. Besides, cognitive impairment is frequent and highly con-elated to social dysfunction seen in patients with schizophrenia. Several cognitive remediation programs have been elaborated. Rehacom [R] is one of such programs. Aim of the study is to evaluate through a case control the efficiency of Rehacom [R] towards cognitive functions. This program has been administered to a patient suffering from undifferentiated schizophrenia which was ameliorated after drug therapy considering positive symptoms but still was complaining from cognitive deficits causing social withdrawal. After following the remediation program, the patient was ameliorated considering its negative symptoms as attested by an amelioration of the PANSS negative score and considering its cognitive performances on memory, attention and executive functions. We have also noticed an improvement in his self-esteem and his quality of life. This first trial of a cognitive remediation program among our patients suffering from schizophrenia using Rehacom [R] was encouraging. Enlarging its use and designing controlled studies will be the next step of our study

[Evaluation of correlations between cognitive performances ans clinical dimensions of schizophrenia]

Schizophrenia is characterised by positive and negative symptoms as well as thought disorders and disorganised behaviour. Multiple cognitive deficits within the areas of memory, attention and executive functions are also associated with schizophrenia. Aim of the study was to proceed to a study of correlations between clinical dimensions of schizophrenia and cognitive functions. The authors recruited 105 patients suffering from schizophrenia spectrum disorders [DSM IV criteria]. The patients were clinically stabilised, showing no depressive state at the time of the study, with no organic brain disorders and no history of drug intake. They were clinically evaluated using the PANSS and the Calgary Depression Scale. A cognitive battery was also administered. Positive dimension of schizophrenia was shown to be independent from any cognitive function. Disorganisation was negatively correlated to attention, working memory, long-term verbal memory and executive functions. Negative dimension was negatively correlated with working memory and executive functions. Cognition wasn't correlated to the positive dimension of schizophrenia whereas it was currelated to the negative and to the disorganisation dimension of the disease. This is probably due to overlapping of conceptsand to the disorganisation dimension of the disease. This is probably due to overlapping of concepts

[Tunisian of "Hopkins verbal learning test" form1]

Memory impairment and verbal learning are the most common cognitive deficits associated with schizophrenia. Hopkins Verbal Learning Test [HVLT] is considered to be the most reliable test to asses memory and verbal learning in this mental illness. To create one form of the HVLT which would suit our linguistic and cultural context and to study the characteristics of this test in a group of healthy subjects. The HVLT consists of a list of 12 words belonging to 3 semantic categories and which are read orally to the subject with an immediate and differed recall. The first part of this work was to select words from a lexical database in order to create the list of the HVLT. The test was then administered to 103 subjects aged from 17 to 45V years-.old [mean 27, 4; SD=7, 3] and having between 1 and 20 years of education mean=12, 2; SD=5, 3]. No statistical difference was found within performances of the HVLT across gender and sex. Whereas, years of education was found to have an impact on performances. Although statistically difference was found across level of education. Our study permitted us to create one form of the HVLT which well suits our Tunisian context and which we could use to evaluate memory functions among people suffering from schizophrenia

[ tunisian cognitive battery for patients with schizophrenia]

Cognitive disorders are common and severe in schizophrenia. They are also correlated with the functional outcome of the disease. Cognition can not he assessed during a standard clinical interview hut needs to be evaluated by means of specific cognitive tasks. Aim of the study is to construct a battery of cognitive tests which is adapted to the Tunisian cultural and linguistic context and to collect normative data in Tunisian Arabic speaking healthy subjects. We have selected and adapted cognitive tests to our socio cultural context. Then we have proceeded to the administration of these tests within a group of healthy subjects. The cognitive battery is composed of 7 tests: the Hopkins Verbal Learning Test, the Token test, the Zazzo test, phonemic fluency, semantic fluency, visual working memory test and number working memory test. These tests are presented with their manual of utilisation and their normative data. The Tunisian cognitive battery is believed to permit a better cognitive assessment of patients suffering from schizophrenia. Improvement of cognitive impairments in schizophrenia is associated with a better social and professional integration of these patients

[ concept of attention]

Attention is a complex function which matches environment's information to the needs of the organism. Describe the different variety of attention, the attenti000el tests and attentional disorders in the psychiatric pathology. Review of literature on PUBMED. There are several types of attention such as selective attention, sustained attention and the divided attentions. Besides these different varieties of attention, we find the pre attentive phenomena: alertness and orientation which leads to preparing the attention. The investigation of attention requires different tools of measures such as the Stroop test, the Continuous performance test or the "test de Barrage de zazzo" and a few years ago the visual detection task of Posner and the attentional network test that explores the three attentional networks independently. In psychiatric illness, the attentional disorders are not specific although certain abnormalities are more suggestive of some pathology like the disengagement deficit in schizophrenia and the attention deficit and hyperactivity of children. There are several types of attention and pre attentive phenomena which investigation require specific cognitive tests