ABSTRACT
BACKGROUND: To examine influencing variables of neurocognition in patients with schizophrenia and to predict cognition during antipsychotic treatment. METHODS: Data were obtained from patients with an acute episode of schizophrenia participating in two double-blind and one open label trial comparing the effects of different atypical antipsychotics on cognition. In total, 129 patients were enrolled in this analysis. Cognitive function was assessed at admission, week 4 and 8. Efficacy and tolerability were assessed weekly using the Positive and Negative Syndrome Scale (PANSS) and the Simpson Angus Sale (SAS). Patients were treated with aripirazole, olanzapine, quetiapine and risperidone. Regression analysis including mixed effect models was performed. RESULTS: A significant improvement in all cognitive domains was observed from baseline to week 8. Regarding the antipsychotic treatment applied quetiapine seemed to achieve the most favourable cognitive improvement. Negative and depressive symptoms, the patient's age and the concomitant and antipsychotic treatment applied were observed to significantly influence and predict neurocognition. CONCLUSION: The results may indicate that schizophrenia is a static disorder with trait and state dependent cognitive components especially in the memory domains. The influence of negative and depressive symptoms should be considered in daily clinical routine.
Subject(s)
Antipsychotic Agents/therapeutic use , Cognition Disorders/complications , Cognition/drug effects , Neurons/drug effects , Schizophrenia/complications , Schizophrenia/drug therapy , Acute Disease , Adolescent , Adult , Aged , Aging , Antipsychotic Agents/administration & dosage , Antipsychotic Agents/adverse effects , Cognition Disorders/physiopathology , Diagnostic and Statistical Manual of Mental Disorders , Drug Interactions , Humans , Memory/drug effects , Memory Disorders/complications , Memory Disorders/physiopathology , Middle Aged , Schizophrenia/physiopathology , Schizophrenia/therapy , Severity of Illness Index , Time Factors , Young AdultABSTRACT
BACKGROUND: The aim of this study was to assess the cognitive effects of aripiprazole in inpatients with schizophrenia. METHODS: This was an investigator-initiated, open label eight-week trial evaluating 56 inpatients with the DSM-IV diagnosis of schizophrenia. Efficacy was assessed weekly using the Positive and Negative Syndrome Scale (PANSS) and tolerability was assessed each week using the Udvalg for Klinske Undersogelser side effect rating scale (UKU). Cognitive function was assessed at baseline, week 4 and week 8. RESULTS: Aripiprazole showed significant improvement in PANSS total score and all subscores between baseline and endpoint visit. The substance was very well tolerated. Patients improved significantly in verbal memory, reaction time and reaction quality/attention from baseline to week eight. Furthermore, mean z-values of individual cognitive domains summarized in a global cognitive index improved significantly from baseline to week eight. DISCUSSION: Our results suggest that aripiprazole provides a valuable treatment option for patients with schizophrenia.
Subject(s)
Antipsychotic Agents/therapeutic use , Cognition/drug effects , Piperazines/therapeutic use , Quinolones/therapeutic use , Schizophrenia/drug therapy , Adult , Antipsychotic Agents/adverse effects , Aripiprazole , Attention/drug effects , Humans , Inpatients , Memory/drug effects , Neuropsychological Tests , Piperazines/adverse effects , Psychiatric Status Rating Scales , Quinolones/adverse effects , Reaction Time/drug effects , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: Results in adult attention deficit hyperactivity disorder (ADHD) on structural brain changes and the clinical relevance are contradictory. The aim of this study was to investigate whether in adult patients with ADHD hippocampal or amygdala volumes differs from that in healthy controls and patients with major depression (MD). METHOD: Twenty patients with ADHD, 20 matched patients with MD and 20 healthy controls were studied with high resolution magnetic resonance imaging. RESULTS: Amygdala volumes in patients with ADHD were bilaterally smaller than in patients with MD and healthy controls. In ADHD, more hyperactivity and less inattention were associated with smaller right amygdala volumes, and more symptoms of depression with larger amygdala volumes. CONCLUSION: This study supports findings that the amygdala plays an important role in the systemic brain pathophysiology of ADHD. Whether patients with ADHD and larger amygdala volumes are more vulnerable to affective disorders needs further investigation.