MICEmi: A method to identify cognitive endophenotypes of mental illnesses.

BACKGROUND: Characterizing neurocognitive endophenotypes of mental illnesses (MIs) could be useful for identifying at-risk individuals, increasing early diagnosis, improving disease subtyping, and proposing therapeutic strategies to reduce the negative effects of the symptoms, in addition to serving as a scientific basis to unravel the physiopathology of the disease. However, a standardized algorithm to determine cognitive endophenotypes has not yet been developed. The main objective of this study was to present a method for the identification of endophenotypes in MI research. METHODS: For this purpose, a 14-expert working group used a scoping review methodology and designed a method that includes a scoring template with five criteria and indicators, a strategy for their verification, and a decision tree. CONCLUSIONS: This work is ongoing since it is necessary to obtain external validation of the applicability of the method in future research.

Brain activity changes with emotional words in different stages of psychosis.

BACKGROUND: To date, a large number of functional magnetic resonance imaging (fMRI) studies have been conducted on psychosis. However, little is known about changes in brain functioning in psychotic patients using an emotional auditory paradigm at different stages of the disease. Such knowledge is important for advancing our understanding of the disorder and thus creating more targeted interventions. This study aimed to investigate whether individuals with first-episode psychosis (FEP) and chronic schizophrenia show abnormal brain responses to emotional auditory processing and to compare the responses between FEP and chronic schizophrenia. METHODS: Patients with FEP (n = 31) or chronic schizophrenia (n = 23) and healthy controls (HCs, n = 31) underwent an fMRI scan while presented with both emotional and nonemotional words. RESULTS: Using HC as a reference, patients with FEP showed decreased right temporal activation, while patients with chronic schizophrenia showed increased bilateral temporal activation. When comparing the patient groups, individuals with FEP showed lower frontal lobe activation. CONCLUSION: To the best of our knowledge, this is the first study with an emotional auditory paradigm used in psychotic patients at different stages of the disease. Our results suggested that the temporal lobe might be a key issue in the physiopathology of psychosis, although abnormal activation could also be derived from a connectivity problem. There is lower activation in the early stage and evolution to greater activation when patients become chronic. This study highlights the relevance of using emotional paradigms to better understand brain activation at different stages of psychosis.

Public stigma profile toward mental disorders across different university degrees in the University of Valencia (Spain).

Background: A large proportion of studies carried out in recent years in different populations have shown that stigma toward mental disorders is highly prevalent. In the present study we conducted a comprehensive assessment of stigma to describe and compare stigma toward mental disorders in students enrolled in five different university degrees. Methods: Three hundred and twenty-five students from the University of Valencia (Spain), attending the second term of their first-degree courses in the faculties of medicine, psychology, teaching, economics, and data science participated in this cross-sectional study. Stigma was measured using: the Reported and Intended Behavior Scale (RIBS), the Scale of Community Attitudes toward Mental Illness (CAMI), the Attribution Questionnaire (AQ-27), and the Knowledge about Mental Illness test (KMI). Results: We found different patterns of stigma according to gender, the fact of knowing or living with a person with mental disorders and the university degree studied. Overall, women show fewer stigmatizing attitudes than men but similar stereotypes and prejudice toward people with mental disorders. However, the pattern of results across degrees is more complex. Overall, students of medicine, psychology and teaching showed fewer stigmatizing attitudes than students of economics and data science but differences between degrees were more subtle in stereotypes and prejudice toward people with mental disorders. Conclusion: Our study suggests the existence of different profiles of stigma in relation to mental disorders in university students. These profiles varied in relation with the degree being studied, gender and already knowing or living with a person with mental disorders.

Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies.

INTRODUCTION: The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP. METHODS: Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines. RESULTS: Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum. CONCLUSIONS: While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation.

Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies / Hipoactivación precúnea e insular durante el procesamiento cognitivo en el primer episodio psicótico: revisión sistemática y metaanálisis de estudios de fMRI

Introduction: The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP.Methods: Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines.Results: Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum.Conclusions: While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation. (AU)

Introducción:Los correlatos neurales de la disfunción cognitiva en el primer episodio psicótico (PEP) aún no están claros. Esta revisión y este metaanálisis proporcionan una actualización de la localización de las anormalidades en la respuesta cerebral medida por fMRI a los procesos cognitivos en individuos con PEP.Métodos: Revisión sistemática y metaanálisis basado en vóxeles de estudios cros-seccionales de fMRI que comparen respuestas neuronales a tareas cognitivas entre individuos con PEP y controles sanos de acuerdo con las guías PRISMA.Resultados: Se incluyeron 26 estudios, que comprendían 598 individuos con PEP y 567 controles sanos. Los estudios individuales reportaban hipoactivación estadísticamente significativa en la corteza prefrontal dorsolateral (6 estudios), el lóbulo frontal (8 estudios), el cíngulo (6 estudios) y la ínsula (5 estudios). El metaanálisis mostró hipoactivación estadísticamente significativa en la ínsula anterior izquierda, el precúneo y el cuerpo estriado bilateral.Conclusiones: Si bien los estudios tienden a resaltar la hipoactivación frontal durante las tareas cognitivas en PEP, nuestros resultados metaanalíticos muestran que el precúneo izquierdo y la ínsula presentan principalmente una activación aberrante en PEP que puede estar asociada con la atribución de saliencia a estímulos externos y relacionada con déficits en la percepción y la regulación. (AU)

Forma corta de cuatro subtest de la WAIS-IV para la evaluación de pacientes con diagnóstico de esquizofrenia / Four-subtest short-form of the WAIS-IV for assessment of patients diagnosed with schizophrenia

Introducción: El objetivo de este estudio ha sido obtener una forma corta de la versión española de la WAIS-IV para pacientes con diagnóstico de esquizofrenia que necesite entorno a media hora para ser administrada. Una forma abreviada puede ser muy útil en contextos clínicos y de investigación cuando se necesite una estimación del cociente intelectual de pacientes con diagnóstico de esquizofrenia para su adscripción a programas de intervención o para la descripción de la muestra.Materiales y métodosParticipó en el estudio una muestra de 143 pacientes. Noventa y uno formaron el grupo de test, y los otros 52 se utilizaron en un análisis de validación cruzada. Para aumentar la validez de contenido, se tomó la decisión de crear una forma corta compuesta por un subtest de cada uno de los 4 dominios cognitivos que mide la escala.ResultadosVarios análisis mostraron que la mejor combinación era la compuesta por los subtest: Información, Cubos, Aritmética y Búsqueda de Símbolos. Se calcularon 9 criterios diferentes para evaluar la calidad de esta forma corta.ConclusionesLos datos mostraron muy buenos resultados en los criterios basados en las correlaciones, las diferencias de medias y la validación cruzada, y resultados satisfactorios en los criterios de acuerdos en la categoría, margen de error, precisión clínica y fiabilidad. (AU)

Introduction: The present study aimed to obtain a short form of the Spanish version of the WAIS-IV for patients diagnosed with schizophrenia that requires about half an hour to be administered. The reduced test can be very useful in clinical and research settings when an estimation of the intelligence quotient is required to decide about intervention programmes or to describe the sample.Materials and methodsA sample of 143 patients participated in the study, 91 out of them were the test group, and the other 52 were used for a cross-validation analysis. To increase the content validity, the decision was made to create a short form composed of a subtest of each of the four cognitive domains that the scale measures.ResultsSeveral analyses showed that the best combination was composed of the Information, Block Design, Arithmetic, and Symbol Search subtests. Nine different criteria were calculated to evaluate the quality of the short form.ConclusionsThe data showed very good results for the criteria: correlations, difference of means, and cross-validation. The results were satisfactory for: category agreement, band of error, clinical accuracy, and reliability. (AU)

Four-subtest short-form of the WAIS-IV for assessment of patients diagnosed with schizophrenia.

INTRODUCTION: The present study aimed to obtain a short form of the Spanish version of the WAIS-IV for patients diagnosed with schizophrenia that requires about half an hour to be administered. The reduced test can be very useful in clinical and research settings when an estimation of the intelligence quotient (IQ) is required to decide about intervention programs or to describe the sample. MATERIALS AND METHODS: A sample of 143 patients participated in the study, 91 out of them were the test group, and the other 52 were used for a cross-validation analysis. To increase the content validity, the decision was made to create a short form composed of a subtest of each of the four cognitive domains that the scale measures. RESULTS: Several analyses showed that the best combination was composed of the Information, Block Design, Arithmetic, and Symbol Search subtests. Nine different criteria were calculated to evaluate the quality of the short form. CONCLUSIONS: The data showed very good results for the criteria: correlations, difference of means, and cross-validation. The results were satisfactory for: category agreement, band of error, clinical accuracy, and reliability.

Precuneus and insular hypoactivation during cognitive processing in first-episode psychosis: Systematic review and meta-analysis of fMRI studies.

INTRODUCTION: The neural correlates of the cognitive dysfunction in first-episode psychosis (FEP) are still unclear. The present review and meta-analysis provide an update of the location of the abnormalities in the fMRI-measured brain response to cognitive processes in individuals with FEP. METHODS: Systematic review and voxel-based meta-analysis of cross-sectional fMRI studies comparing neural responses to cognitive tasks between individuals with FEP and healthy controls (HC) according to PRISMA guidelines. RESULTS: Twenty-six studies were included, comprising 598 individuals with FEP and 567 HC. Individual studies reported statistically significant hypoactivation in the dorsolateral prefrontal cortex (6 studies), frontal lobe (8 studies), cingulate (6 studies) and insula (5 studies). The meta-analysis showed statistically significant hypoactivation in the left anterior insula, precuneus and bilateral striatum. CONCLUSIONS: While the studies tend to highlight frontal hypoactivation during cognitive tasks in FEP, our meta-analytic results show that the left precuneus and insula primarily display aberrant activation in FEP that may be associated with salience attribution to external stimuli and related to deficits in perception and regulation.

Clozapine-related drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: a systematic review.

INTRODUCTION: The Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe, multiorganic, and potentially life-threatening drug-induced hypersensitivity reaction, linked to several common drugs, including antiepileptics, antibiotics, and several psychotropic drugs, including clozapine. Due to the importance of clozapine in the management of treatment-resistant schizophrenia, a systematic review and characterization of clozapine-related DRESS syndrome is long overdue. AREAS COVERED: This systematic review was conducted following PRISMA guidelines. PubMed, Embase, PsychINFO, and the Cochrane Library databases were independently reviewed up to 1 November 2019 for articles reporting clozapine-related DRESS syndrome cases. The RegiSCAR score system was applied to systematically characterize the clinical presentations of selected studies. EXPERT OPINION: Clozapine-related DRESS syndrome was reported in six patients from four articles. Five patients received polypharmacy. Skin rash and liver involvement with elevated liver enzymes were very common. No fatal cases were found. Treatment mainly included clozapine discontinuation and immunosuppression. The mismatch between incidences of DRESS with other responsible drugs, the common misdiagnosis of this syndrome, and the fact that an extensive literature search only identified six cases suggests that clozapine-related DRESS may be overlooked. It is, therefore, necessary to optimize diagnostic strategies to identify immune-related side effects of clozapine.

Visual memory dysfunction as a neurocognitive endophenotype in bipolar disorder patients and their unaffected relatives. Evidence from a 5-year follow-up Valencia study.

BACKGROUND: Scarce research has focused on Visual Memory (VM) deficits as a possible neurocognitive endophenotype of bipolar disorder (BD). The main aim of this longitudinal, family study with healthy controls was to explore whether VM dysfunction represents a neurocognitive endophenotype of BD. METHODS: Assessment of VM by Rey-Osterrieth Complex Figure Test (ROCF) was carried out on a sample of 317 subjects, including 140 patients with BD, 60 unaffected first-degree relatives (BD-Rel), and 117 genetically-unrelated healthy controls (HC), on three occasions over a 5-year period (T1, T2, and T3). BD-Rel group scores were analyzed only at T1 and T2. RESULTS: Performance of BD patients was significantly worse than the HC group (p < 0.01). Performance of BD-Rel was also significantly different from HC scores at T1 (p < 0.01) and T2 (p = 0.05), and showed an intermediate profile between the BD and HC groups. Only among BD patients, there were significant differences according to sex, with females performing worse than males (p = 0.03). Regarding other variables, education represented significant differences only in average scores of BD-Rel group (p = 0.01). LIMITATIONS: Important attrition in BD-Rel group over time was detected, which precluded analysis at T3. CONCLUSIONS: BD patients show significant deficits in VM that remain stable over time, even after controlling sociodemographic and clinical variables. Unaffected relatives also show stable deficits in VM. Accordingly, the deficit in VM could be considered a potential endophenotype of BD, which in turn may be useful as a predictor of the evolution of the disease. Further studies are needed to confirm these findings.

WAIS-IV Performance in Patients With Schizophrenia.

Wechsler Adult Intelligence Scale (WAIS) is one of the most widely used instruments to measure cognitive functioning. The aims of this study were 1) to obtain the cognitive profile of Spanish patients with schizophrenia on the WAIS-IV; 2) to compare their profile to the profile of a healthy control group; and 3) to compare the cognitive profile of patients with schizophrenia to the performance observed in two separate previous studies in Canada and China. A sample of 99 outpatients and 99 healthy control participants, matched on age, sex, and educational level, were measured using the WAIS-IV, including 10 core subtests, 4 indices, and 2 general intelligence scores, to obtain their cognitive profile. Results showed that only the performance on the Verbal Comprehension Index and its subtests was similar in the patient and control groups. This pattern of cognitive impairment was similar to the pattern reported in the Canadian and Chinese studies.

Efficacy of functional remediation in bipolar disorder: a multicenter randomized controlled study.

OBJECTIVE The authors sought to assess the efficacy of functional remediation, a novel intervention program, on functional improvement in a sample of euthymic patients with bipolar disorder. METHOD In a multicenter, randomized, rater-blind clinical trial involving 239 outpatients with DSM-IV bipolar disorder, functional remediation (N=77) was compared with psychoeducation (N=82) and treatment as usual (N=80) over 21 weeks. Pharmacological treatment was kept stable in all three groups. The primary outcome measure was improvement in global psychosocial functioning, measured blindly as the mean change in score on the Functioning Assessment Short Test from baseline to endpoint. RESULTS At the end of the study, 183 patients completed the treatment phase. Repeated-measures analysis revealed significant functional improvement from baseline to endpoint over the 21 weeks of treatment (last observation carried forward), suggesting an interaction between treatment assignment and time. Tukey's post hoc tests revealed that functional remediation differed significantly from treatment as usual, but not from psychoeducation. CONCLUSIONS Functional remediation, a novel group intervention, showed efficacy in improving the functional outcome of a sample of euthymic bipolar patients as compared with treatment as usual.

[Short form of the WAIS-III for use with patients with schizophrenia]. / Versión abreviada del WAIS-III para su uso en la evaluación de pacientes con diagnóstico de esquizofrenia.

The aim of this study is to obtain a sufficiently guaranteed, abridged, Spanish version of the WAIS-III and thereby reduce the time needed to administer the complete scale. Although the samples used were based both on normal individuals (41 participants with no known history of mental illness) as well as individuals diagnosed with schizophrenia (41 participants), the real focus of the study was the clinical group because this is where the greatest advantages can be obtained by shortening the time to administer the scale. The data demonstrates that the best combination of tests was: Similarities, Picture Completion, Digit Span and Digit Symbol-coding because, with this reduced form, it was possible to obtain a linear correlation between the IQ of the complete scale and that of the abridged form of .91 in the clinical and .86 in the control group. For both groups, the differences between the real IQ averages and the estimated ones were nonsignificant.

Versión abreviada del WAIS-III para su uso en la evaluación de pacientes con diagnóstico de esquizofrenia / Short form of the WAIS-III for use with patients with schizophrenia

El presente trabajo tiene como objetivo obtener una forma abreviada de la versión española del WAISIII que permita, con las garantías suficientes, reducir el tiempo de aplicación de la escala completa. Aunque se utilizaron muestras procedentes tanto de población normal (41 participantes sin patología mental conocida) como de población con diagnóstico de esquizofrenia (41 participantes), realmente el interés estaba centrado en el grupo clínico, ya que en el mismo es donde mayores ventajas se pueden obtener al acortar el tiempo de aplicación de la escala. Los datos mostraron que la mejor combinación de tests fue la de Semejanzas, Figuras Incompletas, Dígitos y Clave de números, ya que con esta forma reducida se obtiene una correlación lineal entre el CI Total de la escala completa y el de la forma abreviada de 0,91 en el grupo clínico y de 0,86 en el control. Para ambos grupos las diferencias entre los CI medios reales y los estimados no fueron significativas(AU)

The aim of this study is to obtain a sufficiently guaranteed, abridged, Spanish version of the WAIS-III and thereby reduce the time needed to administer the complete scale. Although the samples used were based both on normal individuals (41 participants with no known history of mental illness) as well as individuals diagnosed with schizophrenia (41 participants), the real focus of the study was the clinical group because this is where the greatest advantages can be obtained by shortening the time to administer the scale. The data demonstrates that the best combination of tests was: Similarities, Picture Completion, Digit Span and Digit Symbol-coding because, with this reduced form, it was possible to obtain a linear correlation between the IQ of the complete scale and that of the abridged form of .91 in the clinical and .86 in the control group. For both groups, the differences between the real IQ averages and the estimated ones were nonsignificant(AU)

La relevancia de la cognición social en la esquizofrenia / The relevance of social cognition in schizophrenia

La investigación realizada en los últimos años ha mostrado la existencia de unacorrelación entre los déficits cognitivos y el funcionamiento social en esquizofrenia.Mientras que los déficits en la atención, la memoria y el funcionamiento ejecutivo hansido ampliamente estudiados, se ha puesto menos atención a la investigación en cogniciónsocial. Sin embargo, la cognición social se está convirtiendo en el foco de interésporque la evidencia empírica está mostrando su relevancia funcional como variablemediadora entre neurocognición y el nivel de funcionamiento social del paciente conesquizofrenia. En consecuencia, se han desarrollado nuevas intervenciones centradas enlos componentes clave de la cognición social que están deteriorados en la esquizofrenia(procesamiento emocional, percepción social, teoría de la mente, esquemas sociales/conocimientosocial y estilo atribucional), con el objetivo de mejorar el funcionamientocognitivo social. Los objetivos de este trabajo son: sintetizar cuál es la concepto actualde cognición social, indicar cuáles son los componentes que incluye, presentar algunosde los instrumentos disponibles para evaluar la cognición social y revisar los programasde intervención más destacados que están dirigidos a mejorar la cognición social en laspersonas con esquizofrenia

Research conducted in recent years has shown correlations between neurocognitive deficits and functional outcome in schizophrenia. Whereas deficits such as attention, memory and executive functioning have been widely studied, less attention has been paid to social cognition. However social cognition is moving into the focus of interest because empirical evidence is showing the functional significance of social cognition as a mediating variable between neurocognition and the social level of functioning in schizophrenic patients. Consequently, new interventions have been developed focusing on the key domains of social cognition that are impaired in schizophrenia (emotion perception, social perception, theory of main, social schemata, and attributional style), with the goal of improving social cognitive functioning. The purpose of this present work is: to summarize the current conceptualisation of social cognition and the domains included under this concept; to present some of the instruments available to evaluate social cognition; and to review the main intervention programs devoted to improving social cognition in schizophrenia