ABSTRACT
The aim of this study was to explore the capacity of acutely ill patients with psychosis (N = 40) to self-report their symptoms by comparing self-assessment and objective measures. Positive, negative, and depressive symptoms were rated using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Calgary Depression Scale. Insight level was measured using the Scale to Assess Unawareness of Mental Disorder. Patients were asked to self-report positive, negative, and depressive symptoms using the Community Assessment of Psychic Experience. Patients presenting with acute psychotic disorders are able to assess fairly their positive, negative, and depressive symptoms. Significant associations were found between self-reported and objective measures of positive, negative, and depressive symptoms independently of insight level. Individual positive and negative symptoms were correctly self-assessed, except for persecutory delusion and alogia, respectively. These results suggest that self-report questionnaires can be used in educational programs to favor the patient's therapeutic adherence.
Subject(s)
Awareness , Personality Inventory/statistics & numerical data , Psychiatric Status Rating Scales/statistics & numerical data , Psychotic Disorders/diagnosis , Acute Disease , Adolescent , Adult , Affective Disorders, Psychotic/diagnosis , Affective Disorders, Psychotic/psychology , Female , Humans , Male , Middle Aged , Psychometrics , Psychotic Disorders/psychology , Schizophrenia/diagnosis , Schizophrenia, Paranoid/diagnosis , Schizophrenia, Paranoid/psychology , Schizophrenic Psychology , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To explore the links between Schneiderian first-rank symptoms (FRS), handedness and speech disorder in subjects with psychosis. METHODS: A Schneiderian score was calculated by summing seven items of the Scale for the Assessment of Positive Symptoms (SAPS) exploring first-rank symptoms in 33 hospitalized patients presenting with psychotic symptoms. Speech disorder was rated using the Scale for the Assessment of Thought, Language and Communication Disorders (TLC). Handedness was assessed using the Edinburgh Handedness Inventory. RESULTS: Higher Schneiderian score was independently predicted by reduced right-hand preference and by lower TLC score. The associations between Schneiderian score and lateralisation or speech disorder were independent from level of psychotic and depressive symptoms, and from categorical diagnosis. CONCLUSION: The present study adds further support to the hypothesis that loss of normal cerebral asymmetry may be implicated in the emergence of FRS.
Subject(s)
Functional Laterality , Psychotic Disorders/complications , Schizophrenic Psychology , Speech Disorders/etiology , Adolescent , Adult , Communication Disorders/diagnosis , Communication Disorders/etiology , Depression , Female , Humans , Language , Male , Middle Aged , Neuropsychological Tests , Prospective Studies , Psychiatric Status Rating Scales , Psychometrics , Psychotic Disorders/diagnosis , Speech Disorders/diagnosisABSTRACT
OBJECTIVE: To explore whether baseline memory and executive deficits predicted poor social and clinical outcome over the 2 years following a first admission for psychosis, regardless of categorical diagnosis. METHOD: Cognitive functioning was assessed in first-admitted subjects with psychosis (n=35) with a neuropsychological battery of tests measuring executive, language and memory functions. Social and clinical outcome were assessed at 6-monthly intervals over a two-year follow-up using multiple sources of information. RESULTS: A dose-response relationship was found between visual and verbal memory performance at first admission and clinical outcome over the 2-year follow-up: the poorer the memory performance, the more likely the risk of presenting with psychotic symptoms and rehospitalization. Poor baseline performance on the WCST executive function predicted better medication adherence. No association was found between cognitive performance and occupational or residential outcome. CONCLUSION: Cognitive performance was a better predictor of clinical than social outcome in this sample of first-episode patients. The association between cognitive deficits and poor social outcome may be more marked in subjects with chronic psychosis than in first-episode subjects. The finding that cognitive deficits predict better medication adherence is in need of further exploration.
