1J Intellect Disabil Res 2005 Jul 49: 516-24
PMID15966959
TitleAn exploratory study of assertive community treatment for people with intellectual disability and psychiatric disorders: conceptual, clinical, and service issues.
AbstractAssertive community treatment (ACT) has been applied to a number of disorders in the adult population, such as schizophrenia, with some degree of success; its use in the treatment of people with intellectual disability (ID) and mental illness has received little attention. Despite the high costs of ID in health and social care, there has been very little evidence-based practice for people with ID and mental illness, and it remains a neglected area of research. Aims The aims of this study were an exploratory comparison of the effectiveness of an ACT model for the treatment of mental illness in people with ID (ACT-ID) with a standard community treatment (SCT-ID) approach.
A Randomized controlled trial design was adopted and allocation was made by stratified randomization by an independent statistician. The prognostic factors used in the randomization were gender and psychiatric diagnosis (psychosis vs. affective). Service users were randomly allocated to either ACT-ID or SCT-ID.
There were no statistically significant differences between ACT-ID and SCT-ID in terms of the level of unmet needs, carer burden, functioning and quality of life, but borderline evidence of a difference between treatment groups in quality of life in favour of SCT-ID. Both SCT-ID and ACT-ID groups decreased level of unmet needs and carer burden, and increased functioning. SCT-ID also led to a small increase in quality of life.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
2Psychiatry Res 2006 Jan 141: 15-28
PMID16352347
TitleRelationships of categorization on tests and daily tasks in patients with schizophrenia, post-stroke patients and healthy controls.
AbstractThe purpose of this study was to explore the relationships between performance on formal categorization-sorting tests and daily tasks that require sorting skills among individuals with schizophrenia compared with post-stroke and healthy control groups. Furthermore, the relationships among the performances of patients with schizophrenia on the various tests were studied. The study included 70 participants: 37 patients with schizophrenia treated at a community day center, 18 post-stroke patients, and 15 healthy controls. Subjects were evaluated on four different categorization tests (Wisconsin Card Sorting Test (WCST), Short Category Test (SCT), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and Riska Object Classification (ROC); and five different functional daily tasks that require categorization abilities. Results showed significant differences between the performance of patients and control subjects on both tests and daily tasks. Spearman correlations within the schizophrenic group between test scores showed moderate significant correlations, and between tests and daily tasks showed low to moderate significant correlations. These findings suggest that weaker, yet significant relationships were found between performance on cognitive tests and daily tasks than between cognitive tests tapping the same or similar constructs. This type of difference would be expected; however, further research is needed to clarify the underlying components of categorization tests and their relations to daily task performance of individuals with schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
3Psychiatry Res 2006 Jan 141: 15-28
PMID16352347
TitleRelationships of categorization on tests and daily tasks in patients with schizophrenia, post-stroke patients and healthy controls.
AbstractThe purpose of this study was to explore the relationships between performance on formal categorization-sorting tests and daily tasks that require sorting skills among individuals with schizophrenia compared with post-stroke and healthy control groups. Furthermore, the relationships among the performances of patients with schizophrenia on the various tests were studied. The study included 70 participants: 37 patients with schizophrenia treated at a community day center, 18 post-stroke patients, and 15 healthy controls. Subjects were evaluated on four different categorization tests (Wisconsin Card Sorting Test (WCST), Short Category Test (SCT), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and Riska Object Classification (ROC); and five different functional daily tasks that require categorization abilities. Results showed significant differences between the performance of patients and control subjects on both tests and daily tasks. Spearman correlations within the schizophrenic group between test scores showed moderate significant correlations, and between tests and daily tasks showed low to moderate significant correlations. These findings suggest that weaker, yet significant relationships were found between performance on cognitive tests and daily tasks than between cognitive tests tapping the same or similar constructs. This type of difference would be expected; however, further research is needed to clarify the underlying components of categorization tests and their relations to daily task performance of individuals with schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
4Schizophr. Res. 2012 Aug 139: 53-9
PMID22695257
TitleNeural activity during emotion recognition after combined cognitive plus social cognitive training in schizophrenia.
AbstractCognitive remediation training has been shown to improve both cognitive and social cognitive deficits in people with schizophrenia, but the mechanisms that support this behavioral improvement are largely unknown. One hypothesis is that intensive behavioral training in cognition and/or social cognition restores the underlying neural mechanisms that support targeted skills. However, there is little research on the neural effects of cognitive remediation training. This study investigated whether a 50 h (10-week) remediation intervention which included both cognitive and social cognitive training would influence neural function in regions that support social cognition. Twenty-two stable, outpatient schizophrenia participants were randomized to a treatment condition consisting of auditory-based cognitive training (AT) [Brain Fitness Program/auditory module ~60 min/day] plus social cognition training (SCT) which was focused on emotion recognition [~5-15 min per day] or a placebo condition of non-specific computer games (CG) for an equal amount of time. Pre and post intervention assessments included an fMRI task of positive and negative facial emotion recognition, and standard behavioral assessments of cognition, emotion processing, and functional outcome. There were no significant intervention-related improvements in general cognition or functional outcome. fMRI results showed the predicted group-by-time interaction. Specifically, in comparison to CG, AT+SCT participants had a greater pre-to-post intervention increase in postcentral gyrus activity during emotion recognition of both positive and negative emotions. Furthermore, among all participants, the increase in postcentral gyrus activity predicted behavioral improvement on a standardized test of emotion processing (MSCEIT: Perceiving Emotions). Results indicate that combined cognition and social cognition training impacts neural mechanisms that support social cognition skills.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
5Psychiatry Res 2013 Aug 213: 99-107
PMID23746615
TitleThe influence of combined cognitive plus social-cognitive training on amygdala response during face emotion recognition in schizophrenia.
AbstractBoth cognitive and social-cognitive deficits impact functional outcome in schizophrenia. Cognitive remediation studies indicate that targeted cognitive and/or social-cognitive training improves behavioral performance on trained skills. However, the neural effects of training in schizophrenia and their relation to behavioral gains are largely unknown. This study tested whether a 50-h intervention which included both cognitive and social-cognitive training would influence neural mechanisms that support social ccognition. schizophrenia participants completed a computer-based intervention of either auditory-based cognitive training (AT) plus social-cognition training (SCT) (N=11) or non-specific computer games (CG) (N=11). Assessments included a functional magnetic resonance imaging (fMRI) task of facial emotion recognition, and behavioral measures of cognition, social cognition, and functional outcome. The fMRI results showed the predicted group-by-time interaction. Results were strongest for emotion recognition of happy, surprise and fear: relative to CG participants, AT+SCT participants showed a neural activity increase in bilateral amygdala, right putamen and right medial prefrontal cortex. Across all participants, pre-to-post intervention neural activity increase in these regions predicted behavioral improvement on an independent emotion perception measure (MSCEIT: Perceiving Emotions). Among AT+SCT participants alone, neural activity increase in right amygdala predicted behavioral improvement in emotion perception. The findings indicate that combined cognition and social-cognition training improves neural systems that support social-cognition skills.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
6Clin Schizophr Relat Psychoses 2013 -1 7: 78-86A
PMID23367504
TitleCombining computerized social cognitive training with neuroplasticity-based auditory training in schizophrenia.
AbstractSocial cognitive deficits are an important treatment target in schizophrenia, but it is unclear to what degree they require specialized interventions and which specific components of behavioral interventions are effective. In this pilot study, we explored the effects of a novel computerized neuroplasticity-based auditory training delivered in conjunction with computerized social cognition training (SCT) in patients with schizophrenia.
Nineteen clinically stable schizophrenia subjects performed 50 hours of computerized exercises that place implicit, increasing demands on auditory perception, plus 12 hours of computerized training in emotion identification, social perception, and theory of mind tasks. All subjects were assessed with MATRICS-recommended measures of neurocognition and social cognition, plus a measure of self-referential source memory before and after the computerized training.
Subjects showed significant improvements on multiple measures of neurocognition. Additionally, subjects showed significant gains on measures of social cognition, including the MSCEIT Perceiving Emotions, MSCEIT Managing Emotions, and self-referential source memory, plus a significant decrease in positive symptoms.
Computerized training of auditory processing/verbal learning in schizophrenia results in significant basic neurocognitive gains. Further, addition of computerized social cognition training results in significant gains in several social cognitive outcome measures. Computerized cognitive training that directly targets social cognitive processes can drive improvements in these crucial functions.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
7J Intellect Disabil Res 2015 Oct 59: 902-13
PMID25871427
TitleSocial cognitive training in adolescents with chromosome 22q11.2 deletion syndrome: feasibility and preliminary effects of the intervention.
AbstractChildren with chromosome 22q11.2 deletion syndrome (22q11DS) often have deficits in social cognition and social skills that contribute to poor adaptive functioning. These deficits may be of relevance to the later occurrence of serious psychiatric illnesses such as schizophrenia. Yet, there are no evidence-based interventions to improve social cognitive functioning in children with 22q11DS.
Using a customised social cognitive curriculum, we conducted a pilot small-group-based social cognitive training (SCT) programme in 13 adolescents with 22q11DS, relative to a control group of nine age- and gender-matched adolescents with 22q11DS.
We found the SCT programme to be feasible, with high rates of compliance and satisfaction on the part of the participants and their families. Our preliminary analyses indicated that the intervention group showed significant improvements in an overall social cognitive composite index.
SCT in a small-group format for adolescents with 22q11DS is feasible and results in gains in social cognition. A larger randomised controlled trial would permit assessment of efficacy of this promising novel intervention.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
8Bone Marrow Transplant. 2015 Jan 50: 153-4
PMID25285805
TitleSevere chronic psychosis after allogeneic SCT from a schizophrenic sibling.
Abstract-1
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
9Psychol Med 2015 Nov 45: 3147-57
PMID26062741
TitleCombined social cognitive and neurocognitive rehabilitation strategies in schizophrenia: neuropsychological and psychopathological influences on Theory of Mind improvement.
AbstractNeurocognitive and social cognitive impairments represent important treatment targets in schizophrenia, as they are significant predictors of functional outcome. Different rehabilitative interventions have recently been developed, addressing both cognitive and psychosocial domains. Although promising, results are still heterogeneous and predictors of treatment outcome are not yet identified. In this study we evaluated the efficacy of two newly developed social cognitive interventions, respectively based on the use of videotaped material and comic strips, combined with domain-specific Cognitive Remediation Therapy (CRT). We also analysed possible predictors of training outcome, including basal neurocognitive performance, the degree of cognitive improvement after CRT and psychopathological variables.
Seventy-five patients with schizophrenia treated with CRT, were randomly assigned to: social cognitive training (SCT) group, Theory of Mind Intervention (ToMI) group, and active control group (ACG).
ANOVAs showed that SCT and ToMI groups improved significantly in ToM measures, whereas the ACG did not. We reported no influences of neuropsychological measures and improvement after CRT on changes in ToM. Both paranoid and non-paranoid subjects improved significantly after ToMI and SCT, without differences between groups, despite the better performance in basal ToM found among paranoid patients. In the ACG only non-paranoid patients showed an improvement in non-verbal ToM.
Results showed that both ToMI and SCT are effective in improving ToM in schizophrenia with no influence of neuropsychological domains. Our data also suggest that paranoid symptoms may discriminate between different types of ToM difficulties in schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
10Schizophr Bull 2015 Mar 41: 483-93
PMID24962607
TitleA double-blind randomized controlled trial of oxytocin nasal spray and social cognition training for young people with early psychosis.
AbstractSocial-cognitive deficits contribute to poor functional outcomes in early psychosis; however, no effective pharmacological treatments exist for these problems. This study was the first to investigate the efficacy of an extended treatment of oxytocin nasal spray combined with social cognition training (SCT) to improve social cognition, clinical symptoms, and social functioning in early psychosis. In a double-blind, randomized, placebo-controlled, between-subjects trial, 52 individuals (aged 16-35 years) diagnosed with an early psychosis schizophrenia-spectrum illness were recruited. Participants received oxytocin (24 International Units) or placebo nasal spray twice-daily for 6 weeks, combined with group SCT (2 × 1 hour weekly sessions for 6 weeks). An additional dose of oxytocin was administered before each weekly session. Assessments were conducted at baseline, post-treatment, and at 3-month follow-up. Primary outcomes included the Reading the Mind in the Eyes Test, the Scale for the Assessment of Positive and Negative Symptoms, and the Social Functioning Scale. Secondary outcomes included self-report and behavioral assessments of social cognition, symptom severity, and social functioning. Results showed that on all primary and secondary outcomes, there was no benefit of oxytocin nasal spray treatment in comparison to placebo. Exploratory post hoc analysis suggested that increased use of nasal spray was, however, associated with reductions in negative symptoms in the oxytocin condition only. This study represents the first evaluation of oxytocin treatment for early psychosis. Although results suggest no benefit of oxytocin treatment, results also highlight an urgent need to consider nasal spray delivery and dose-related variables for future clinical trials.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics
11Neuropharmacology 2016 Jun 105: 351-60
PMID26826431
TitleThe effects of a 5-HT5A receptor antagonist in a ketamine-based rat model of cognitive dysfunction and the negative symptoms of schizophrenia.
AbstractSerotonin (5-HT) receptors still represent promising targets for the development of novel multireceptor or stand-alone antipsychotic drugs with a potential to ameliorate cognitive impairments and negative symptoms in schizophrenia. The 5-HT5A receptor, one of the least known members of the serotonin receptor family, has also drawn attention in this regard. Although the antipsychotic efficacy of 5-HT5A antagonists is still equivocal, recent experimental data suggest the cognitive-enhancing activity of this strategy. The aim of the present study was to evaluate pro-cognitive and pro-social efficacies of the 5-HT5A receptor antagonist in a rat pharmacological model of schizophrenia employing the administration of the NMDA receptor antagonist, ketamine. The ability of SB-699551 to reverse ketamine-induced cognitive deficits in the attentional set-shifting task (ASST) and novel object recognition task (NORT) was examined. The compound's efficacy against ketamine-induced social withdrawal was assessed in the social interaction test (SIT) and in the social choice test (SCT). The results demonstrated the efficacy of SB-699551 in ameliorating ketamine-induced impairments on the ASST and NORT. Moreover, the tested compound also enhanced set-shifting performance in cognitively unimpaired control rats and improved object recognition memory in conditions of delay-induced natural forgetting. The pro-social activity of SB-699551 was demonstrated on both employed paradigms, the SIT and SCT. The present study suggests the preclinical efficacy of a strategy based on the blockade of 5-HT5A receptors against schizophrenia-like cognitive deficits and negative symptoms. The utility of this receptor as a target for improvement of cognitive and social dysfunctions warrants further studies.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics