Emotion recognition through Spanish prosody in people with schizophrenia.

People with schizophrenia have deficits in the ability to identify emotions. An area of important dysfunction is the understanding of affective prosody, which can limit communication and social functionality. The objective of this study is to compare emotional recognition through prosody between a group of people with schizophrenia versus a control group without pathology, through the Reading the Mind in the Voice - Spanish Version scale (RMV-SV).

Reconocimiento de las emociones a través de la prosodia en español en personas con esquizofrenia / Emotion recognition through Spanish prosody in people with schizophrenia

Introducción: Las personas con esquizofrenia presentan déficits en lahabilidad para identificar emociones. Un área de importante disfunción es la comprensión de la prosodia afectiva, que puede limitar la comunicación y la funcionalidad social. Elobjetivo de este estudio es comparar el reconocimiento emocional a través de la prosodia entre un grupo de personas con esquizofrenia frente a un grupo control sin patología, através de la escala Reading the Mind in the Voice – SpanishVersion (RMV-SV).Metodología:Se reclutó un grupo de personas con esquizofrenia otrastorno esquizo-afectivo, clínicamente estables (n = 62).Se compararon con un grupo control (n = 63) en las características sociodemográficas, clínicas, el coeficiente intelectualy el rendimiento en la escala RMV-SV.Resultados:El grupo de casos presentó puntuaciones más bajas enla RMV-SV, con diferencias estadísticamente significativas (p< ,001) frente a los controles. En 17/22 ítems de respuestaserróneas, los enunciados contenían emociones negativas. Lacorrelación fue positiva entre RMV-SV y CI. Se correlacionó de forma inversa el RMV-SV y PANSS, principalmente lasubescala negativa, y la edad.Conclusiones:La escala RMV-SV, validada en autismo, permite detectarlas alteraciones del reconocimiento prosódico en español enla esquizofrenia, postulándose como una herramienta evaluadora de este dominio de la cognición social. (AU)

Introduction: People with schizophrenia have deficits in the ability toidentify emotions. An area of important dysfunction is theunderstanding of affective prosody, which can limit communication and social functionality. The objective of this studyis to compare emotional recognition through prosody between a group of people with schizophrenia versus a controlgroup without pathology, through the Reading the Mind inthe Voice - Spanish Version scale (RMV-SV).MethodA group of people with clinically stable schizophrenia orschizoaffective disorder was recruited (n = 62). They werecompared with a control group (n = 63) in sociodemographic, clinical characteristics, intelligence quotient, and performance on RMV-SV scale. ResultsThe case group presented lower scores on the RMV-SV,with statistically significant differences (p < .001) comparedto controls. In 17/22 items of wrong answers, the statementscontained negative emotions. The correlation was positivebetween RMV-SV and IQ. RMV-SV and PANSS, mainly thenegative subscale, and age were inversely correlated.ConclusionsThe RMV-SV scale, validated in autism, allows detectingthe alterations of prosodic recognition in Spanish in schizophrenia, postulating itself as an evaluating tool of this domain of social cognition. (AU)

Voices 2: Improving Prosodic Recognition in Schizophrenia With an Online Rehabilitation Program.

Introduction: Emotion recognition of voices may play an important role in interpersonal communication and patients with schizophrenia present alterations in this regard. Several on-line rehabilitation tools have been developed for treatment in this area. Voices is an on-line prosodic recognition program consisting of identifying different emotional tones in neutral phrases, in different sessions of gradually increasing difficulty. This training tool has previously reported benefits, and a new version has been created called Voices 2. The main aim of this study is to test the capacity of the Voices 2 program to improve emotion recognition through prosody for adults with schizophrenia. Secondly, it seeks to observe durability effects 1 month after intervention. Method: A randomized, single-blind, multicenter clinical trial was conducted with 44 outpatients diagnosed with schizophrenia or schizoaffective disorder. The intervention group (also called Voices) was treated with Voices 2, whereas the control group was treated with auditory training that was not related to emotions. Sociodemographic and clinical data, clinical state (PANSS), Intelligence Quotient and prosodic recognition (RMV-SV) were measured at baseline. After intervention, RMV-SV and PANSS were assessed. One month later, the RMV-SV measure was repeated. Results: The control group (n = 19) and the Voices group (n = 22) did not differ on χ2, t or U tests in sociodemographic, clinical and psychometric variables at baseline or post-intervention (all p-values > 0.05). In the Voices group, statistically significant differences were observed in the RMV-SV scale applied post-intervention vs. that applied pre-intervention (Z = 2.47, p = 0.013). Similar results were observed in the 1-month follow-up RMV-SV vs. the pre-intervention RMV-SV (Z = 1.97, p = 0.049). PANSS scale was also assessed with no significant differences between pre vs. post measures in both groups. Lastly, Voices 2 was rated relatively higher, based on its ease of understanding, entertainment value, usefulness and the appropriateness of use of its emotional glossary. Discussion: Improvements were observed in prosodic recognition following intervention with Voices 2 in the Voices group. Although these results are similar to other clinical trial rehabilitation programs, specific research on the matter remains scarce. Certain aspects, such as the durability of effects or adherence should be thoroughly studied and clarified. Clinical Trial Registration: [https://doi.org/10.17605/OSF.IO/G95C4].

La importancia de descartar patología orgánica en la psiquiatría de urgencias / The importance of ruling out organic pathology in emergency psychiatry

OBJETIVO: La clínica psiquiátrica puede ser expresión de múltiples patologías somáticas. Es necesario valorar la importancia de la historia clínica y de las pruebas complementarias pertinentes para realizar un abordaje adecuado. CASO CLÍNICO: Varón de 53 años que acude al Servicio de Urgencias con clínica abrupta consistente en fobias de impulsión, irritabilidad y agresividad verbal. La impresión diagnóstica es de trastorno adaptativo y rasgos anancásticos de personalidad. Al día siguiente acude de nuevo, con clínica confuso-delirante y hemiplejía izquierda. Se realiza TAC cerebral con el hallazgo de un infarto subagudo parietotemporal. RESULTADOS: Los «accidentes cerebrovasculares no obvios» o «infartos camaleón» se definen como ictus con principal expresión clínica psiquiátrica. Su aparición aguda es escasa y presentan un mayor error diagnóstico. CONCLUSIONES: Este caso presenta un proceso neurológico de forma atípica. Consideramos relevante la reflexión sobre la importancia de la etiología de la «descompensación psicopatológica aguda» en el servicio de urgencias

OBJECTIVE: On some occasions, diverse somatic pathologies can present relevant psychiatric clinical features. However, the etiology of the disease may not be due to psychiatric disorder, but both to organic and neurological causes. Thus, for proper diagnosis of the disease, evaluation of the importance of the clinical history, as well as supplementary tests, is required. CLINICAL CASE: A 53-years-old man is admitted to the Emergency Room, presenting abrupt psychiatric clinical features: impulsive phobias, irritability, and verbal aggression. The patient is diagnosed with adjustment disorder with obsessive personality traits. The next day, the patient returns to the Emergency Room. He is diagnosed with confused-delusional clinic and left hemiplegia, and underwent a CT scan. Sub-acute parietal-temporal stroke was found. RESULTS: The term "non-obvious cerebrovascular accident" or "stroke chameleon" has been coined to the stroke with a main clinical psychiatric expression. Literature about this type of acute onset stroke is scarce and they could present a major misdiagnosis. CONCLUSIONS: This case report highlights a neurological process with an atypical form. Great importance of the reflection of the etiology of "acute psychopathological decompensation" should be given

Improving emotion recognition in schizophrenia with "VOICES": An on-line prosodic self-training.

INTRODUCTION: Emotion recognition (ER) deficits have been extensively demonstrated in schizophrenia. These deficiencies are not only restricted to facial emotion recognition but also include emotional prosody (tone of the voice) recognition deficits. They have been significantly associated with symptom severity and poor social functioning. The aim of this study was to test the efficacy, in real clinical conditions, of an online self-training prosodic game included in the Social Cognition rehabilitation program e-Motional Training. METHOD: A randomized, single-blind multicenter clinical trial was conducted with 50 outpatients with schizophrenia or schizoaffective disorder. The control group was treated with Treatment-as-usual (TAU), based on drug therapy, case management and individual and group psychotherapy (not focused on Social Cognition). The intervention group was treated with TAU plus the employment of Voices, an online self-training program devised for prosodic rehabilitation. STATISTICAL ANALYSIS: Linear regression was used to evaluate the effectiveness of the intervention in emotion recognition measured with the Reading the Mind in the Voice-Spanish Version (RMV-SV). RESULTS: There were statistically significant differences between the intervention and control group measured with RMV-SV (ß = 3,6[IC 95%], p<0.001), with a response variable in RMV post R2 = 0,617. DISCUSSION: Voices, a prosodic rehabilitation game included in e-Motional Training, seems to be a promising tool for improving emotional voice recognition deficits in schizophrenia, filling the need for such interventions.