Redes neurales de la atencion en pacientes con esquizofrenia y sus familiares no afectados de primer grado: un endofenotipo potencial / Attentional network task in schizophrenic patients and theirs unaffected first degree relatives: a potential endofenotype

Introducción. Existe un notable incremento de reportes sobre déficit atencionales en pacientes con esquizofrenia y sus familiares de primer grado, incluyendo un gran esfuerzo por la búsqueda de endofenotipos para llegar a genes específicos responsables de la enfermedad. Posner y col. Desarrollaron una prueba para explorar las redes neurales de la atención (ANT). Esta provee mediciones por separado para cada una de las tres redes neurales anatómicamente definidas(alerta, orientación y control ejecutivo).Metodología: Investigamos a través de un estudio de asociación familiar el desempeño atencional en 32 pacientes con esquizofrenia, 29 familiares sanos y 29 controles utilizando el ANT. Examinamos segregadamente la eficiencia para las redes del control ejecutivo, la alerta y la orientación, evaluando como los tiempos de reacción eran modificados por la posición de la señal orientadora (“cue”) y la congruencia contextual del estímulo (“flanker”). También exploramos la asociación familiar de estas alteraciones atencionales. Resultados: Un ANOVA reveló un efecto principal del “flanker” y la condición del “cue” y una interacción significativa entre el “flanker” y los grupos estudiados. Los pacientes con esquizofrenia y sus familiares tienen un tiempo de reacción medio superior al grupo control. Los probandos y sus familiares difieren significativamente del grupo control en términos de resolución de conflictos, sin embargo, la alerta aparece conservada. Conclusiones: Nuestros resultados apoyan la tesis de un déficit atencional específico en la esquizofrenia y evidencian la segregación de las tres redes neuro-atencionales. La asociación familiar de estas alteraciones soporta la idea de un endofenotipo potencial en la esquizofrenia (AU)

Introduction. In recent years, reports of attention deficits in schizophrenic patients and in their biological relatives have rapidly increased, including an important effort to search for the endophenotypes in order to link specific genes to this illness. Posner et al. developed a test, the Attention Network Test (ANT), to study the neural networks. This test provides a separate measure for each one of the three anatomically-defined attention networks (alerting, orienting and executive control). Methodology. In this paper, we investigate the attentional performance in 32 schizophrenic patients, 29 unaffected first degree relatives and 29 healthy controls using the ANT through a study of family association. We have studied the efficiency of the segregated executive control, alerting and orienting networks by measuring how response latencies (reaction time) were modified by the cue position and the flanking stimuli. We also studied the familial association of these attentional alterations. Results. The ANOVA revealed main effects of flanker and cue condition and a significant interaction effect between flanker and groups studied. The schizophrenic patients and their relatives had a longer median reaction time than the control group. The probands and their relatives significantly differed from the healthy controls in terms of their conflict resolution; however, the alerting network appeared to be conserved. Conclusions. Our results support the thesis of a specific attentional deficit in schizophrenia and show the segregation of the three attentional networks. The family association of these reported alterations supports the idea of a potential endophenotype in schizophrenia (AU)

Spanish version of the Family Interview for Genetic Studies (FIGS).

INTRODUCTION: The use of the Family Interview for Genetic Studies (FIGS), has made it possible to advance in the performance of family studies for research in genetic psychiatry. This study aimed to adapt this interview into Spanish and develop a validation process of the FIGS in a sample of Cuban families with a family background of schizophrenia. METHODS: The English version of the FIGS was translated into Spanish and was used in this study. The content was validated through the consensus score of several referees. The questionnaire was administered to at least two informants of 146 families of patients diagnosed of schizophrenia. Internal consistency of the items was analyzed, calculating Pearson's correlation coefficients and Cronbach's alpha of the FIGS and reliability. RESULTS: In general the Spanish version of the FIGS interview was found to be useful. Internal consistency of the FIGS as measured by Cronbach's alpha coefficient has been found to be 0.92 for depression, 0.99 for mania; 0.94 for psychosis, 0.94 for alcohol and drugs and 0.97 for personality disorders, which indicates values having satisfactory reliability. In addition, Pearson's correlation coefficient varied from the 0.41 to 0.99 for the different lists of symptoms mentioned above and all were statistically significant (p<0.0001). CONCLUSIONS: This questionnaire is reliable and valid for gathering diagnostic information about relatives of probands and thus suitable for use in genetic studies of Cuban families with a history of schizophrenia.

Spanish version of the Family Interview for Genetic Studies (FIGS)

Introduction. The use of the Family Interview for Genetic Studies (FIGS), has made it possible to advance in the performance of family studies for research in genetic psychiatry. This study aimed to adapt this interview into Spanish and develop a validation process of the FIGS in a sample of Cuban families with a family background of schizophrenia. Methods. The English version of the FIGS was translated into Spanish and was used in this study. The content was validated through the consensus score of several referees. The questionnaire was administered to at least two informants of 146 families of patients diagnosed of schizophrenia. Internal consistency of the items was analyzed, calculating Pearson’s correlation coefficients and Cronbach’s alpha of the FIGS and reliability. Results. In general the Spanish version of the FIGS interview was found to be useful. Internal consistency of the FIGS as measured by Cronbach's alpha coefficient has been found to be 0.92 for depression, 0.99 for mania, 0.94 for psychosis, 0.94 for alcohol and drugs and 0.97 for personality disorders, which indicates values having satisfactory reliability. In addition, Pearson's correlation coefficient varied from the 0.41 to 0.99 for the different lists of symptoms mentioned above and all were statistically significant (p <0.0001).Conclusions. This questionnaire is reliable and valid forgathering diagnostic information about relatives of probands and thus suitable for use in genetic studies of Cuban families with a history of schizophrenia (AU)

Introducción. El uso de la Entrevista Familiar para Estudios Genéticos (FIGS) ha permitido un avance para la realización de los estudios familiares con fines investigativos en psiquiatría genética. El presente trabajo tuvo por objetivo realizar la adaptación al español y desarrollar un proceso de validación de la FIGS en una muestra de familias cubanas con historia familiar de esquizofrenia. Métodos. Se realizó la traducción y cambios lingüísticos al castellano de la versión en inglés de la FIGS y la validación de contenido por el procedimiento de la validez interjueces. El cuestionario fue aplicado al menos a dos informantes a 146 familias de pacientes con diagnóstico de esquizofrenia. Se hizo el análisis de la consistencia interna de los ítems calculando los coeficientes de correlación de Pearson y el coeficiente alfa de Cronbach. Resultados. La adaptación al español de la FIGS resultó ser un instrumento útil. La consistencia interna de la FIGS fue medida con el coeficiente alfa de Cronbach, que fue de 0,92 para la depresión, 0,99 para manía, 0,94 para psicosis, 0,94 para alcohol y drogas y 0,97 para los trastornos de personalidad, lo que indica valores de fiabilidad satisfactorios. Los coeficientes de correlación variaron de0,41 hasta 0,99 para las distintas listas de síntomas y todos fueron estadísticamente significativos (p<0,0001). Conclusiones. La adaptación al español de la FIGS mostró fiabilidad, validez de apariencia y contenido y valores elevados en el análisis de la consistencia interna de los ítems para el estudio genético familiar en familias cubanas con diagnóstico de esquizofrenia (AU)

Scale for assessing perceptual anomalies. Validation of a Spanish version of the SIAPA scale in a sample of Cuban schizophrenic patients.

INTRODUCTION: Perceptual-attentional disorders other than hallucinations in schizophrenic patients have been studied little. In this work, the results of the Spanish version of the SIAPA scale to detect perceptual-attentional anomalies to real stimuli other than hallucinations in a sample of schizophrenic patients in a community study in Cuba are presented. METHODS: 329 subjects were studied: 129 schizophrenic patients and 200 controls. Patients were diagnosed by psychiatrists according to DSM-IV criteria. The SIAPA and PANSS scales were used for the study. Cronbach's alpha coefficient was determined to analyze internal consistency. Reliability, validity of current criterion and structural validity were measured. Comparisons between groups were made using the ANOVA. RESULTS: Schizophrenic patients had more perceptual anomalies than healthy controls. Auditory and visual perceptual anomalies were more frequent. The scale showed high internal consistency (Cronbach's alpha: 0.84). Using a PANSS scale cut-off score of 60, validity had a sensitivity of 56 % and specificity of 79 %. All modalities of SIAPA scales showed good kappa coefficients (0.72-0.85). CONCLUSIONS: This scale showed similar internal validity and test-retest reliability to those reported in the English version. The results showed that this scale can differentiate the presence of perceptual anomalies in schizophrenic patients from healthy controls. Therefore, we suggest that the SIAPA scale may be useful for assessing perceptual anomalies in clinical researching for cognitive impairment evaluations.

Scale for assessing perceptual anomalies: validation of a Spanish version of the SIAPA scale in a sample of Cuban schizophrenic patients

INTRODUCTION: Perceptual-attentional disorders other than hallucinations in schizophrenic patients have been studied little. In this work, the results of the Spanish version of the SIAPA scale to detect perceptual-attentional anomalies to real stimuli other than hallucinations in a sample of schizophrenic patients in a community study in Cuba are presented. METHODS: 329 subjects were studied: 129 schizophrenic patients and 200 controls. Patients were diagnosed by psychiatrists according to DSM-IV criteria. The SIAPA and PANSS scales were used for the study. Cronbach's alpha coefficient was determined to analyze internal consistency. Reliability, validity of current criterion and structural validity were measured. Comparisons between groups were made using the ANOVA. RESULTS: Schizophrenic patients had more perceptual anomalies than healthy controls. Auditory and visual perceptual anomalies were more frequent. The scale showed high internal consistency (Cronbach's alpha: 0.84). Using a PANSS scale cut-off score of 60, validity had a sensitivity of 56 percent and specificity of 79 percent All modalities of SIAPA scales showed good kappa coefficients (0.72-0.85). CONCLUSIONS: This scale showed similar internal validity and test-retest reliability to those reported in the English version. The results showed that this scale can differentiate the presence of perceptual anomalies in schizophrenic patients from healthy controls. Therefore, we suggest that the SIAPA scale may be useful for assessing perceptual anomalies in clinical researching for cognitive impairment evaluations(AU)

Introducción. Las alteraciones perceptuales-atencionalesdiferentes de las alucinaciones en los pacientes esquizofrénicos han sido poco estudiadas. En este trabajo se presentan los resultados de la versión al español de la escala SIAPA para detectar anomalías perceptuales-atencionalesa estímulos reales diferentes de las alucinaciones en una muestra de pacientes esquizofrénicos en unestudio comunitario en Cuba. Métodos. Se estudiaron 329 sujetos: 129 esquizofrénicos y 200 controles. Para el diagnóstico se usaron los criterios diagnósticos del DSM IV. Para el estudio se aplicó la escala SIAPA y la escala PANSS. Se determinó el coeficiente alpha de Cronbach para analizar la consistencia interna. Se determinó la fiabilidad, la validez de criterio concurrente y la validez estructural. La comparación entre los grupos se realizó con el test de análisis de varianza ANOVA. Resultados. Los pacientes presentaron más alteracionesperceptuales-atencionales diferentes de las alucinaciones que los sujetos normales, principalmente en las modalidades auditivas y visuales. La consistencia interna fue de 0,84. Se obtuvo una sensibilidad del 56 por ciento y una especificidad del 79 por ciento. Se obtuvo índices de fiabilidad(Kappa) adecuados (0,72-0,85) en las diferentes subescalas del SIAPA Conclusiones. En este estudio se obtuvieron valores de confiabilidad y validez de la escala similares a los obtenidos con la versión inglesa. Esta escala permite diferenciar la presencia de alteraciones perceptuales atencionales diferentes de las alucinaciones en pacientes esquizofrénicos en comparación con la población general. Esta escala puede ser utilizada en investigaciones clínicasy epidemiológicas para la evaluación de alteraciones perceptuales-atencionales(AU)

Escala de evaluación de las anomalías preceptuales. Validación de la escala SIAPA al español en una muestra de pacientes esquizofrénicos cubanos / Scale for assessing perceptual anomalies. Validation of a Spanish version of the SIAPA scale in a sample of Cuban schizophrenic patients

Introducción. Las alteraciones perceptuales-atencionales diferentes de las alucinaciones en los pacientes esquizofrénicos han sido poco estudiadas. En este trabajo se presentan los resultados de la versión al español de la escala SIAPA para detectar anomalías perceptuales-atencionales a estímulos reales diferentes de las alucinaciones en una muestra de pacientes esquizofrénicos en un estudio comunitario en Cuba. Métodos. Se estudiaron 329 sujetos: 129 esquizofrénicos y 200 controles. Para el diagnóstico se usaron los criterios diagnósticos del DSM IV. Para el estudio se aplicó la escala SIAPA y la escala PANSS. Se determinó el coeficiente alpha de Cronbach para analizar la consistencia interna. Se determinó la fiabilidad, la validez de criterio concurrente y la validez estructural. La comparación entre los grupos se realizó con el test de análisis de varianza ANOVA. Resultados. Los pacientes presentaron más alteraciones perceptuales-atencionales diferentes de las alucinaciones que los sujetos normales, principalmente en las modalidades auditivas y visuales. La consistencia interna fue de 0,84. Se obtuvo una sensibilidad del 56 % y una especificidad del 79 %. Se obtuvo índices de fiabilidad (Kappa) adecuados (0,72-0,85) en las diferentes subescalas del SIAPA. Conclusiones. En este estudio se obtuvieron valores de confiabilidad y validez de la escala similares a los obtenidos con la versión inglesa. Esta escala permite diferenciar la presencia de alteraciones perceptuales-atencionales diferentes de las alucinaciones en pacientes esquizofrénicos en comparación con la población general. Esta escala puede ser utilizada en investigaciones clínicas y epidemiológicas para la evaluación de alteraciones perceptuales-atencionales

Introduction. Perceptual-attentional disorders other than hallucinations in schizophrenic patients have been studied little. In this work, the results of the Spanish version of the SIAPA scale to detect perceptual-attentional anomalies to real stimuli other than hallucinations in a sample of schizophrenic patients in a community study in Cuba are presented. Methods. 329 subjects were studied: 129 schizophrenic patients and 200 controls. Patients were diagnosed by psychiatrists according to DSM-IV criteria. The SIAPA and PANSS scales were used for the study. Cronbach's alpha coefficient was determined to analyze internal consistency. Reliability, validity of current criterion and structural validity were measured. Comparisons between groups were made using the ANOVA. Results. Schizophrenic patients had more perceptual anomalies than healthy controls. Auditory and visual perceptual anomalies were more frequent. The scale showed high internal consistency (Cronbach's alpha: 0.84). Using a PANSS scale cut-off score of 60, validity had a sensitivity of 56 % and specificity of 79 %. All modalities of SIAPA scales showed good kappa coefficients (0.72-0.85). Conclusions. This scale showed similar internal validity and test-retest reliability to those reported in the English version. The results showed that this scale can differentiate the presence of perceptual anomalies in schizophrenic patients from healthy controls. Therefore, we suggest that the SIAPA scale may be useful for assessing perceptual anomalies in clinical researching for cognitive impairment evaluations

[Family transmission of positive and negative symptoms in familial and sporadic schizophrenia]. / Transmisión familiar de los síntomas positivos y negativos en la esquizofrenia familiar y esporádica.

INTRODUCTION: A genetic component is recognized as a cardinal feature in the etiology of schizophrenia that is presently conceived as a complex disease. However, identifying its molecular bases has become a problem, mainly due to the difficulties that the schizophrenic phenotype presents. The aim of this study is to determine whether the positive and negative symptoms are differentiated from each other according to family history in a family study using familial/sporadic strategy. METHODS: 601 subjects were studied (196 schizophrenics, 205 first degree relatives and 200 controls). A SCAN system and the diagnosis criteria of DSM IV were used. For the familial study the FIGS and PANSS scales were applied. Families were grouped into familial or sporadic groups according to family aggregation. Comparisons were made using the ANOVA. RESULTS: The groups of patients and the first degree relatives with familial schizophrenia showed significantly higher scores in the negative sub-scale than did the sporadic schizophrenia subjects. Behavior of the first degree relatives with sporadic schizophrenia was similar to the control group. Positive sub-scale scores and general psychopathology showed no differences in the patients and their relatives according to familiar aggregation. CONCLUSIONS: This study confirms previous results that negative symptoms are more frequent in schizophrenics and their first degree relatives with familial schizophrenia. Therefore, it can be said that negative symptoms are a clinical phenotype more related to the genetic etiology.

Transmisión familiar de los síntomas positivos y negativos en la esquizofrenia familiar y esporádica / Family transmission of positive and negative symptoms in familial and sporadic schizophrenia

Introducción. Se reconoce un componente genético en la etiología de la esquizofrenia concebida en estos momentos como una enfermedad compleja. Identificar las bases moleculares de esta enfermedad se ha convertido en un problema por las dificultades del fenotipo esquizofrénico. El objetivo de esta investigación fue analizar si existen diferencias relacionadas con la presencia de los síntomas positivos y negativos en un estudio familiar utilizando la estrategia familiar/esporádica. Métodos. Se estudiaron 601 sujetos (196 esquizofrénicos, 205 familiares de primer grado y 200 controles). Se utilizó el sistema SCAN y se usaron los criterios diagnósticos del DSM-IV. Para el estudio familiar se aplicó el FIGS y la Escala PANSS. La esquizofrenia se clasificó en familiar o esporádica de acuerdo al número de esquizofrénicos en la familia. La comparación entre los grupos se realizó con el test de análisis de varianza ANOVA. Resultados. La esquizofrenia familiar presentó mayor puntuación en la subescala negativa en los pacientes y sus familiares de primer grado en relación con la esporádica. Los familiares esporádicos se comportaron de forma similar al grupo control. Los grupos familiar y esporádico se comportaron de forma similar en las subescalas positiva y de psicopatología general. Conclusiones. Este estudio confirma resultados previos, donde se ha descrito que los síntomas negativos se presentan más en la esquizofrenia familiar, en los pacientes y en sus familiares. Por tanto pudiéramos decir que los síntomas negativos son un fenotipo clínico más relacionado con la etiología genética (AU)