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1.
Schizophr Res ; 270: 459-464, 2024 Jul 11.
Article in English | MEDLINE | ID: mdl-38996523

ABSTRACT

BACKGROUND: Recent operational criteria for treatment-resistant schizophrenia (TRS) recognized positive and negative symptoms. TRS patients may have heterogeneity in negative symptoms, but empirical data were lacking. We aimed to characterize TRS patients based on negative symptoms using cluster analysis, and to examine between-cluster differences in social functioning. METHODS: We administered the Clinical Assessment Interview of Negative symptoms (CAINS), Brief Negative Symptom Scale (BNSS), the Positive and Negative Syndrome Scale (PANSS) and the Social and Occupational Functional Assessment (SOFAS to 126 TRS outpatients. All patients also completed the Temporal Experience of Pleasure Scale (TEPS), the Emotion Expressivity Scale (EES), and the Social Functional Scale (SFS). A two-stage hierarchical cluster analysis was performed with the CAINS, TEPS and EES as clustering variables. We validated the clusters using ANOVAs to compare group differences in the BNSS, PANSS, SOFAS and SFS. RESULTS: Clustering indices supported a 3-cluster solution. Clusters 1 (n = 46) and 3 (n = 16) exhibited higher CAINS scores than Cluster 2 (n = 64), and were negative-symptom TRS subtypes. Cluster 1 reported lower TEPS than Cluster 3; but Cluster 3 reported lower EES than Cluster 1. Upon validation, Clusters 1 and 3 exhibited higher BNSS scores than Cluster 2, but only Cluster 1 exhibited lower SOFAS and higher PANSS general symptoms than Cluster 2. Both Clusters 1 and 3 had higher self-report functioning than Cluster 2. CONCLUSION: We provided evidence for heterogeneity of negative symptoms in TRS. Negative symptoms can characterize TRS patients and predict functional outcome.

2.
J Clin Psychiatry ; 83(2)2022 02 08.
Article in English | MEDLINE | ID: mdl-35143123

ABSTRACT

Background: Prospective memory (PM) impairment is associated with impaired social functioning, but evidence is limited to chronic schizophrenia samples and cross-sectional design. The aim of this study was to utilize network analysis to address the complex interplay between PM, psychopathology, and functional outcome.Methods: This longitudinal study recruited 119 people with first-episode DSM-IV schizophrenia and followed up with them for 2 to 6 years. PM and working memory were assessed at baseline (in 2010-2015) using valid computerized tasks and the Letter-Number Span Test, respectively. Psychopathology and social functioning were assessed at endpoint (in 2016-2017) using the Positive and Negative Syndrome Scale (PANSS) and the Social and Occupational Functioning Assessment Scale (SOFAS), respectively. Network analysis examined the effect of baseline PM on SOFAS while accounting for the effects of psychopathology.Results: The resultant network showed that social functioning, PANSS positive symptoms, and PANSS general symptoms clustered together, whereas time-based and event-based PM and working memory formed another cluster. Time-based PM linked event-based PM and working memory with social functioning. Time-based PM (expected influence [EI] = 0.69), event-based PM (EI = 0.65), and working memory (EI = 0.83) demonstrated high values of expected influence, but social functioning (variance explained = 0.685) and PANSS negative (variance explained = 0.657) and general (variance explained = 0.583) subscales demonstrated high values of predictability.Conclusions: Time-based PM is the central node linking neurocognitive functions with social functioning. PM and working memory are "target" nodes for interventions bringing changes to the network, whereas social functioning and psychopathology are "malleable" nodes. PM and working memory are promising intervention targets for functional recovery in schizophrenia.


Subject(s)
Memory, Episodic , Schizophrenic Psychology , Social Interaction , Adult , Female , Hong Kong , Humans , Longitudinal Studies , Male , Memory, Short-Term , Models, Psychological , Neuropsychological Tests , Pregnancy , Schizophrenia/diagnosis
3.
Early Interv Psychiatry ; 13(5): 1099-1104, 2019 10.
Article in English | MEDLINE | ID: mdl-30175894

ABSTRACT

AIM: The present study aimed to explore the two-year naturalistic trajectory of time- and event-based prospective memory (PM) in patients with first-episode schizophrenia. METHODS: We administered a computer-based dual-task PM paradigm to 57 individuals with first-episode schizophrenia at baseline and after 6 months, 12 months and 24 months. Forty-eight healthy controls were also recruited and completed all the measures at baseline. We compared the trajectories between time-based and event-based PM in first-episode schizophrenia patients using repeated measures ANOVAs, and examined the relationship between PM and clinical symptoms using Spearman's correlation. RESULTS: PM impairments improved significantly after 24 months of follow-up. However, time-based and event-based PM appeared to run different trajectories. After 24 months, first-episode schizophrenia patient performed poorer than healthy controls in time-based but not event-based PM. PM did not appear to be correlated with clinical symptoms, both cross-sectionally and longitudinally. CONCLUSIONS: This is one of the longest follow-up studies investigating PM in first-episode schizophrenia. Our results provide evidence to support that time-based PM is more temporally stable than event-based PM.


Subject(s)
Memory, Episodic , Schizophrenia/diagnosis , Schizophrenic Psychology , Case-Control Studies , Female , Humans , Longitudinal Studies , Male , Neuropsychological Tests , Time Factors , Young Adult
4.
Psychiatry Res ; 236: 22-27, 2016 Feb 28.
Article in English | MEDLINE | ID: mdl-26778631

ABSTRACT

Impairment in facial emotion perception is believed to be associated with aggression. Schizophrenia patients with antisocial features are more impaired in facial emotion perception than their counterparts without these features. However, previous studies did not define the comorbidity of antisocial personality disorder (ASPD) using stringent criteria. We recruited 30 participants with dual diagnoses of ASPD and schizophrenia, 30 participants with schizophrenia and 30 controls. We employed the Facial Emotional Recognition paradigm to measure facial emotion perception, and administered a battery of neurocognitive tests. The Life History of Aggression scale was used. ANOVAs and ANCOVAs were conducted to examine group differences in facial emotion perception, and control for the effect of other neurocognitive dysfunctions on facial emotion perception. Correlational analyses were conducted to examine the association between facial emotion perception and aggression. Patients with dual diagnoses performed worst in facial emotion perception among the three groups. The group differences in facial emotion perception remained significant, even after other neurocognitive impairments were controlled for. Severity of aggression was correlated with impairment in perceiving negative-valenced facial emotions in patients with dual diagnoses. Our findings support the presence of facial emotion perception impairment and its association with aggression in schizophrenia patients with comorbid ASPD.


Subject(s)
Antisocial Personality Disorder/psychology , Emotions/physiology , Facial Expression , Schizophrenia/complications , Schizophrenic Psychology , Social Perception , Aggression/psychology , Antisocial Personality Disorder/complications , Humans , Male , Neuropsychological Tests
5.
J Psychiatr Res ; 61: 141-9, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25479767

ABSTRACT

Prospective memory (PM) is the ability to remember to carry out intended actions in the future. Empirical evidence suggests that PM deficits exist in individuals with chronic schizophrenia. However, it is unclear whether PM deficits in first-episode schizophrenia exist independently from other neuropsychological deficits. Moreover, prior research using patients with first-episode has been limited to small inpatient samples. We aimed to clarify the nature and extent of PM deficits in individuals with first-episode schizophrenia, using a large outpatient sample. Participants were 91 clinically stable outpatients with first-episode schizophrenia and 83 healthy controls. PM was assessed using both a subjective self-reported checklist and a laboratory-based task capturing time- and event-based PM. A battery assessing verbal and visuo-spatial working memory, as well as executive functions was also administered. ANOVA analyses showed that patients with first-episode schizophrenia performed significantly poorer than healthy controls in time- and event-based PM. Stepwise linear regression analyses suggested that cognitive flexibility predicted time- and event-based PM; and working memory predicted event-based PM. Subgroup analyses showed that "cognitive-preserved" patients with first-episode schizophrenia tended to perform poorer in time-based PM deficit than healthy controls who were matched in IQ and other neuropsychological functions. Overall, our results provide substantial evidence to support that time-based PM deficits in first-episode schizophrenia are apparent and not entirely attributable to other neuropsychological deficits. PM may constitute a neuropsychological marker for schizophrenia.


Subject(s)
Memory, Episodic , Schizophrenia , Schizophrenic Psychology , Adolescent , Adult , Analysis of Variance , Case-Control Studies , Cognition , Executive Function , Female , Humans , Linear Models , Male , Neuropsychological Tests , Psychiatric Status Rating Scales , Schizophrenia/diagnosis , Self Report , Time Factors , Verbal Behavior , Visual Perception , Young Adult
6.
Neuropsychologia ; 49(8): 2217-24, 2011 Jul.
Article in English | MEDLINE | ID: mdl-21507327

ABSTRACT

This behavioral study used a dual-task paradigm to compare PM performance in 35 patients with first-onset schizophrenia, 40 non-psychotic siblings and 35 healthy controls. It aimed specifically to examine the effect of schizophrenia group status on PM, the differential effect of group status on PM type, and correlations between PM and other neurocognitive functions and clinical data in first-onset schizophrenia. It also aimed to test the hypothesis that non-psychotic siblings had poorer PM performance than controls. The cohort of first-onset schizophrenia patients had relatively short illness durations (M=1.7 years). The three groups of participants were matched in terms of age, gender and years of education. Results of the study confirmed that first-onset schizophrenia status had a primary effect on PM after controlling for other neurocognitive functions. We also found that first-onset schizophrenia status did not differentially affect two different types of PM. In the first-onset schizophrenia cohort, PM was found to correlate significantly with IQ, executive functions and sustained attention. Finally, contrary to the findings of the previous study, this study did not find siblings of schizophrenia patients to have impaired PM. Taking into account the previous findings of PM in chronic schizophrenia, we concluded that schizophrenia has a primary effect on PM regardless of illness duration.


Subject(s)
Executive Function/physiology , Intention , Memory Disorders/etiology , Schizophrenia/complications , Schizophrenic Psychology , Adult , Female , Humans , Male , Neuropsychological Tests , Siblings/psychology , Young Adult
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