ABSTRACT
BACKGROUND: While pragmatic deficits are well documented in patients with schizophrenia (SCZ) and right hemisphere damage (RHD), there is a paucity of research comparing the pragmatic deficits of these two groups. Do they experience similar cognitive dysfunction or is there a dissociation between the two patient groups? AIMS: To investigate the nature of pragmatic deficits in these two groups and to gain an understanding of the underlying cognitive mechanisms that might be associated with these deficits to further future investigations. METHODS & PROCEDURES: A total of 60 participants (15 patients with SCZ; 15 with RHD; 30 (15 + 15) healthy controls (HC) were administered the Bengali Audio-Visual Test-Battery for Assessment of Pragmatic Skills. OUTCOMES & RESULTS: Both SCZ and RHD patients were found to have significant pragmatic deficits compared with their matched controls. SCZ patients were found to score significantly better than the RHD group in six out of the 10 pragmatic skills when controlled for age and education. Discriminant function analysis was performed and 86.7% of the cases (HC = 100%, SCZ = 73.3% and RHD = 86.7%) were correctly reclassified into their original categories using the test scores. CONCLUSIONS & IMPLICATIONS: The study suggests that there is heterogeneity in the nature of the pragmatic breakdown within and across patient groups. Therefore, individualized restorative measures targeting the disrupted cognitive mechanism(s) might help elevate pragmatic competence and enhance the social functioning of patients with pragmatic deficits. WHAT THIS PAPER ADDS: What is already known on the subject Pragmatic deficits are common in adults with cognitive impairments of different etiologies. However, few studies have explored pragmatic deficits across clinical populations. Consequently, very little is known about the nature of pragmatic deficits in patients with schizophrenia and right hemisphere damage. What this paper adds to existing knowledge This work offers preliminary data on pragmatic difficulties in patients with schizophrenia and right hemisphere damage. This study overrides the boundaries of traditional classifications and evaluates pragmatic difficulties in these two clinical populations with reference to the underlying cognitive mechanisms, which might be disrupted. What are the potential or actual clinical implications of this work? The study adds a transdiagnostic perspective suggesting that there might be heterogeneity in pragmatic deficits, both within and across patient groups, and stresses the need for individualized therapy.
Subject(s)
Cognitive Dysfunction , Schizophrenia , Adult , Humans , Schizophrenia/complications , Schizophrenia/diagnosis , Pilot Projects , Educational StatusABSTRACT
Background: As India reduced maternal mortality by 50% in the last decade, the mental health of mothers has slowly started catching our attention. Increased participation of women in the economic sector and awareness of women's rights has added to this process. Perinatal depression has been associated with negative birth outcomes and poor child development. The paucity of research from eastern India poses challenges for physicians and hinders effective medical interventions. Aim: To investigate the effect of antenatal and postnatal depression on child development at 12 months of age. Method: In total, 174 mothers were administered Bengali Edinburgh Postnatal Depression Scale (EPDS-B) for assessment of antenatal and postnatal depression. Developmental Assessment Scale in Indian Infants (DASII) was administered to assess the motor and cognitive development of their children (n = 153) at 12 months. Result: The prevalence of antenatal and postnatal depression was 28.7% and 16.7%, respectively. Antenatal depression predicted postnatal depression (b = 0.631). Mothers with AD scored significantly low on family support measures (P = 0.012). Children of mothers with AD had low motor and cognitive attainment at the age of 12 months (P = 0.022). Conclusion: Screening and treatment of mental health need to be included in the antenatal care routine to facilitate appropriate child development.
ABSTRACT
BACKGROUND: Social cognition deficits are common in clinical populations but there is a dearth of standardized social cognition assessment tools in India. Theory of mind (ToM) is an important aspect of social cognition which is often assessed with the revised reading the mind in eyes test (RMET-R). However, we do not have a statistically validated version of the test for the Indian population. AIM: This study aims to assess the acceptability, reliability, and validity of the Bengali version of the RMET-R. MATERIALS AND METHODS: We administered the RMET-R to 23 patients with chronic schizophrenia (SCZ), 22 patients with bipolar disorder, and 104 healthy controls (HCs) to evaluate the reliability and validity of the instrument in the Indian (Bengali) population. RESULTS: We obtained moderate internal consistency (Cronbach's alpha = 0.6) and test-retest reliability (intraclass correlation coefficient = 0.64, P < 0.001). Positive correlations were found between RMET-R and Wechsler picture arrangement (r = 0.60, P < 0.001), picture completion (r = 0.54, P < 0.001), and comprehension subtests (r = 0.48, P < 0.001). Patients with SCZ (M = 49.7, standard deviation [SD] = 16.5) scored significantly lower than HCs (M = 68.9, SD = 13.8) (P = 0.008; Cohen's d = 1.3) on the RMET-R. Thus this tool could discriminate patients who are reported to have Theory of Mind deficits from healthy controls. CONCLUSION: The Bengali version of the RMET-R is a reliable and valid tool for assessing first-order ToM insofar as the original RMET-R measures this construct.
ABSTRACT
The association of hyperglycaemia and weight gain with the use of atypical antipsychotics has been documented. However, there is still not enough data from India. The fact that Indian patients usually have a lower body weight compared to European and American counterparts makes it difficult to extrapolate available data to the Indian context. The purpose of this study is: (a) To compare the prevalence of hyperglycaemia in schizophrenic patients taking olanzapine with those taking typical antipsychotics, and (b) to follow-up non-diabetic, non-obese schizophrenics on a stable regimen of antipsychotic monotherapy and determine the proportion of patients who develop weight gain, diabetes or impaired glucose tolerance; comparing the effects of olanzapine versus typical antipsychotics. Fifty-five schizophrenic patients attending psychiatry outpatients' department and on stable antipsychotic monotherapy for at least 6 weeks were included in the study. Those with a family or personal history of diabetes were excluded. There were 28 cases on olanzapine and 27 on either haloperidol or trifluoperazine. Fasting blood glucose estimation and body-mass Index (BMI) were recorded at baseline, at 6 weeks, and at 12 weeks. The two groups were comparable with respect to age, genderwise composition, and duration of illness. There was no significant difference in baseline glycaemic status or BMI. At the end of 12 weeks, olanzapine was not associated with any significant change in body weight, BMI or plasma fasting glucose. Duration of use of antipsychotic emerged as the only statistically significant risk factor for developing hyperglycaemia across both groups.
