[Poor premorbid adjustment linked to deterioration in theory of mind skills: a study in stabilised schizophrenic patients]. / Ajuste premórbido pobre vinculado al deterioro en habilidades de teoría de la mente: estudio en pacientes esquizofrénicos estabilizados.

INTRODUCTION: Previous studies suggest that there is a deficit in theory of mind (ToM) in stabilised schizophrenic patients. More specifically, it has been claimed that poor premorbid adjustment covaries with the abnormalities in ToM skills detected in such patients. It has also been suggested that this deficit could be a trait marker for schizophrenic disorders. PATIENTS AND METHODS: The aim of this study was to examine the performance in mentalistic skills in 36 stabilised schizophrenic patients in comparison to a standard control group. We also sought to examine the relation between ToM skills and premorbid adjustment in our target sample. Premorbid adjustment was evaluated using the modified Cannon-Spoor premorbid adjustment scale, and ToM measurements were obtained by means of first- and second-order verbal experimental tasks. RESULTS: Schizophrenic patients presented statistically significant poorer performances in first- and second-order ToM tasks, although no differences were observed between these patients and the control sample as regards overall cognitive acuity. Poor premorbid adjustment in areas of social functioning in the patients was also associated with statistically significant poorer performance in both ToM tasks. CONCLUSIONS: Deficient premorbid adjustment in schizophrenia may be linked to a ToM deficit that can be assessed with simple tasks.

Ajuste premórbido pobre vinculado al deterioro en habilidades de teoría de la mente: estudio en pacientes esquizofrénicos estabilizados / Poor premorbid adjustment linked to deterioration in theory of mind skills: A study in stabilised schizophrenic patients

Introducción. Estudios previos indican que existe un déficit en teoría de la mente (ToM) en pacientes esquizofrénicos estabilizados. En particular, se ha señalado que un ajuste premórbido pobre covaría con las anomalías en habilidades ToM detectadas en esos pacientes. Se sugiere que este déficit podría ser un marcador de rasgo para el trastorno esquizofrénico.Pacientes y métodos. El objetivo del presente estudio fue investigar el rendimiento en habilidades mentalísticas en 36 pacientes esquizofrénicos estabilizados comparados con un grupo normativo control, así como explorar la relación entre las aptitudesToM y el ajuste premórbido en la muestra diana. El ajuste premórbido se evaluó mediante la escala de ajuste premórbido modificada de Cannon-Spoor, y las medidas ToM se obtuvieron mediante tareas experimentales verbales de primer y segundo orden. Resultados. Los pacientes esquizofrénicos presentaron peores rendimientos, significativos estadísticamente, enlas tareas ToM de primer y de segundo orden, a pesar de la ausencia de diferencias entre ellos y la muestra control en la agudeza cognitiva global. Un ajuste premórbido desfavorable en áreas de funcionamiento social en los pacientes se asoció, además,a un peor rendimiento, estadísticamente significativo, en ambas tareas ToM. Conclusión. El ajuste premórbido deficiente en la esquizofrenia puede vincularse a un déficit ToM evaluable en tareas sencillas

Introduction. Previous studies suggest that there is a deficit in theory of mind (ToM) in stabilised schizophrenic patients. More specifically, it has been claimed that poor premorbid adjustment covaries with the abnormalities in ToM skills detected in such patients. It has also been suggested that this deficit could be a trait marker for schizophrenic disorders.Patients and methods. The aim of this study was to examine the performance in mentalistic skills in 36 stabilised schizophrenic patients in comparison to a standard control group. We also sought to examine the relation between ToM skills and premorbid adjustment in our target sample. Premorbid adjustment was evaluated using the modified Cannon-Spoor premorbid adjustmentscale, and ToM measurements were obtained by means of first- and second-order verbal experimental tasks. Results. Schizophrenic patients presented statistically significant poorer performances in first- and second-order ToM tasks, although no differences were observed between these patients and the control sample as regards overall cognitive acuity. Poor premorbid adjustmentin areas of social functioning in the patients was also associated with statistically significant poorer performance in both ToM tasks. Conclusions. Deficient premorbid adjustment in schizophrenia may be linked to a ToM deficit that can be assessed with simple tasks

[Spanish adaptation of the Scale to Asses Unawareness of Mental Disorder (SUMD)]. / Adaptación al español de la escala de valoración de la no conciencia de trastorno mental (SUMD).

INTRODUCTION: The aim of this paper is to examine the reliability and external validity of the Spanish adaptation of the Scale to Assess Unawareness of Mental Disorder (SUMD). METHOD: A translation-backtranslation of the original scale was elaborated, and a panel of professionals participated to assess conceptual equivalence and naturality. The scale consists of 3 general items: awareness of mental disorder, awareness of the effects of medication and awareness of the social consequences of the disorder; and of 17 items related to specific symptoms, which make up two subscales: awareness and attribution. Thirty-two patients diagnosed of schizophrenic or schizoaffective disorder following DSM-IV criteria were evaluated. The evaluations were performed using interviews with an observer. Intraclass Correlation Coefficient (ICC) was calculated for the reliability analysis and the Spearman correlation coefficient between the SUMD scores and one independent score of global insight for external validity. RESULTS: The ICC were all over 0.70. Convergent validity with the independent global measurement of insight was found for the general items of awareness of mental disorder and awareness of the effects of medication, and for the subscale on awareness of symptoms. The awareness of the social consequences of the disorder and the subscale on attribution did not correlate significantly with the global measurement of awareness (insight). These results are consistent with the hypothesis that awareness (insight) is a multidimensional phenomenon. CONCLUSION: The Spanish adaptation of the SUMD scale is conceptually equivalent and displays a similar reliability and external validity as the original version.

Adaptación al español de la escala de valoración de la no conciencia de trastorno mental (SUMD) / Spanish adaptation of the scale of unawareness of mental disorder (SUMD)

Introducción. El objetivo del trabajo es examinar la fiabilidad y la validez externa de la versión en español de la Escala de valoración de la no conciencia de enfermedad mental (SUMD). Metodología. Se utilizó un método de traducción-retrotraducción y la participación de un panel de profesionales para valorar equivalencia conceptual y naturalidad. La escala se compone de 3 ítems generales: conciencia de trastorno mental, conciencia de los efectos de la medicación y conciencia de las consecuencias sociales del trastorno, y de 17 ítems destinados a síntomas específicos que conforman dos subescalas: conciencia y atribución. Se valoraron 32 pacientes con trastorno esquizofrénico o esquizoafectivo, según criterios DSM-IV. Las evaluaciones fueron realizadas mediante el sistema de entrevista con observador. Se calculó la fiabilidad a través del coeficiente de correlación intraclase (CCI) y la validez externa mediante el coeficiente de correlación de Spearman entre las puntuaciones de la escala y una medida independiente de conciencia global de trastorno. Resultados. El CCI fue siempre superior a 0,70. Los ítems generales conciencia de trastorno y conciencia de los efectos de la medicación y la subescala conciencia de los síntomas se correlacionaron significativamente con la medida global de conciencia. Contrariamente, el ítem general conciencia de las consecuencias sociales del trastorno y la subescala de atribución no se correlacionaron significativamente, lo que apoyaría la idea de que la conciencia de trastorno es un fenómeno multidimensional. Conclusiones. La versión al español de la escala SUMD es conceptualmente equivalente y presenta una fiabilidad y validez similares a la original (AU)

Introduction. The aim of this paper is to examine the reliability and external validity of the Spanish adaptation of the Scale to Assess Unawareness of Mental Disorder (SUMD).Method. A translation-back translation of the original scale was elaborated, and a panel of professionals participated to assess conceptual equivalence and naturality. The scale consists of 3 general items: awareness of mental disorder, awareness of the effects of medication and awareness of the social consequences of the disorder; and of 17 items related to specific symptoms, which make up two subscales: awareness and attribution. Thirty-two patients diagnosed of schizophrenic or schizoaffective disorder following DSM-IV criteria were evaluated. The evaluations were performed using interviews with an observer. Intraclass Correlation Coefficient (ICC) was calculated for the reliability analysis and the Spearman correlation coefficient between the SUMD scores and one independent score of global insight for external validity. Results. The ICC were all over 0.70. Convergent validity with the independent global measurement of insight was found for the general items of awareness of mental disorder and awareness of the effects of medication, and for the subscale on awareness of symptoms. The awareness of the social consequences of the disorder and the subscale on attribution did not correlate significantly with the global measurement of awareness (insight).These results are consistent with the hypothesis that awareness (insight) is a multidimensional phenomenon. Conclusion. The Spanish adaptation of the SUMD scale is conceptually equivalent and displays a similar reliability and external validity as the original version (AU)

Subjective quality of life in schizophrenic outpatients in a Catalan urban site.

The aim of this cross-sectional study was to assess the subjective quality of life of chronic schizophrenic outpatients living in an urban site in Catalonia (Spain) during a stable phase of the illness. We included 44 patients with a DSM-IV diagnosis of psychotic disorder. Sociodemographic, clinical, and treatment variables were obtained and compared with the subjective quality of life as assessed by the Lehman Quality of Life Interview-short version. The descriptive analysis of the subjective quality of life profile obtained in our sample shows moderate levels of satisfaction in most subscales. Results regarding comparisons showed that sociodemographic, clinical, premorbid adjustment and treatment variables were only related to subjective quality of life in particular life domains and in a nonconclusive way. The need to include other relevant variables such as insight or psychological traits in the study of the quality of life phenomenon in schizophrenia is highlighted.

Catatonía inducida por corticoides. Caso clínico / Corticosteroid-induced catatonia. Case report

Se ha observado que aproximadamente un 5 por ciento de los pacientes1 que siguen tratamiento con corticoides presentan síndromes psiquiátricos secundarios a esta medicación. Mucho más raros son los casos en que estos fármacos provocan catatonía. Cuando ésta se produce, es importante realizar el diagnóstico diferencial con el estupor melancólico y con otras etiologías orgánicas. El tratamiento más efectivo es la terapia electroconvulsiva. Se presenta un caso de catatonía secundaria a glucocorticoides que se trató en nuestro servicio, así como la revisión realizada a propósito del mismo (AU)