Disturbed cognitive functioning and clinical symptoms: two independent problem areas in schizophrenia.

BACKGROUND: Research findings on the relationship between cognitive functioning and psychiatric symptoms in schizophrenia have yielded inconsistent results. Although several models were postulated linking cognition and symptoms, the most recent studies point in the direction of cognition and symptoms being relatively independent disease processes. OBJECTIVE: The hypothesis that cognitive decline and psychiatric symptoms are independent disease processes was tested. METHODS: The relationship between cognitive functioning and clinical symptoms was examined in a large sample of 100 schizophrenia patients. RESULTS: The hypothesis was largely confirmed. CONCLUSION: No convincing evidence was found that symptoms and cognition were related.

Does frontal normality exist in schizophrenia? A saccadic eye movement study.

Many observations have supported the general idea of impaired frontal function in schizophrenia. In particular, neuropsychological studies have shown severe frontal deficits. However, other studies found normal cognitive function in a proportion of patients. Since saccadic tasks also provide an index of frontal function, we examined the presence of frontal deficits in patients by means of both neuropsychological and saccadic tasks, and compared the sensitivity of both approaches for frontal impairment. In addition, we examined the relationship between saccadic and neuropsychological measures. Twenty-four schizophrenic patients and twenty healthy controls completed an extensive neuropsychological battery and three saccadic tasks. Based on the neuropsychological battery alone, 42% of the patients showed frontal deficits, whereas combined use of neuropsychological and saccadic tasks resulted in 79% with frontal deficits. The antisaccade task appeared able to detect frontal deficits in patients who were without frontal impairment on the neuropsychological battery. Saccadic deficits were, however, not necessarily accompanied by deficits on frontal neuropsychological measures. This suggests that the saccadic and neuropsychological tasks used in the present study targeted different frontal functions. This view was supported by the lack of correlations between saccadic and frontal neuropsychological measures.

Component structure of the positive and negative syndrome scale (PANSS) in patients with recent-onset schizophrenia and spectrum disorders.

RATIONALE: Earlier studies have examined the symptom dimensions of the PANSS (Positive And Negative Syndrome Scale) in patients with chronic schizophrenia. Results have suggested that three to eight component solutions best explain underlying symptom dimensions. OBJECTIVES: To examine the component structure of the PANSS and the MADRS (Montgomery Asberg Depression Rating Scale) in young patients with recent-onset schizophrenia and related disorders and the correlations between the components of both instruments. METHODS: Symptomatology was measured in 138 patients with recent-onset schizophrenia, by administering the PANSS and the MADRS. RESULTS: Principal component analysis of the PANSS revealed five components: a positive, negative, depression, agitation-excitement and disorganisation component. The MADRS only showed one component. A high correlation was found between the depression component of the PANSS and the overall score of the MADRS (p=0.87, P<0.001). A moderate correlation was found between the PANSS negative component and the overall score of the MADRS (p=0.51, P<0.001). CONCLUSIONS: The data suggest a five component structure of the PANSS. The depression component of the PANSS seems to be a valid way of assessing depression in patients with recent-onset schizophrenia.

Psychopathology and cognition in schizophrenia spectrum disorders: the role of depressive symptoms.

The cognitive correlates of five symptom dimensions based on PANSS ratings were examined in a group of 50 recent onset psychotic patients, using both objective and subjective cognitive measures. We were particularly interested in the depression dimension, since it has not been studied extensively thus far. The depression dimension showed a high number of correlations with both objective and subjective cognitive measures, such as problems with simple and divided attention, psychomotor slowing and subjectively experienced distractibility, overload and diminished attentional control. The other dimensions, including negative symptoms, have less cognitive correlates. It is possible that previous studies based on a three-dimensional model confounded correlates of negative symptoms with correlates of depressive symptoms. The results of this study suggest the need for more research into the mechanisms underlying the relationship between depressive symptoms and cognitive functioning in schizophrenia, and that patients with depressive symptoms are less efficient in information processing, but can compensate by investing more mental effort. Because subjective cognitive measures were related to mental effort in previous research, they can be a useful tool in future research.

Aspectos clinicos do esofago de Barrett. / Clinical aspects of Barrett esophagus

Em 1430 procedimentos endoscopicos to trato digestivo alto, foram encontrados 14 casos de esofago de Barrett. Os sintomas apresentados sao analisados, verificando-se a prevalencia de quadro clinico do tipo "esofagite de refluxo". A patogenese e discutida com alusoes a origem do epitelio sua configuracao histologica, diagnostico e potencial de malignidade

Blastomicose sul-americana palpebral. / Palpebral South-american blastomycosis

Os autores relatam um caso de blastomicose sulamericana, cuja lesao palpebral foi a primeira manifestacao clinica. Sao descritos os achados clinicos e os exames complementares e brevemente comentados oa aspectos de raridade e os achados anatomopatologicos