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Los déficit neurocognitivos en la esquizofrenia han sido descritos desde las primeras descripciones del trastorno. Su influencia en la funcionalidad y en la calidad de vida ha sido puesta de manifiesto en múltiples estudios. La iniciativa Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) del National Institute of Mental Health (NIMH) de Estados Unidos fue puesta en marcha para impulsar el desarrollo de una batería cognitiva de consenso que pudiera ser empleada en ensayos clínicos de fármacos para mejorar la neurocognición en la esquizofrenia. Aunque en el momento de consensuar los diferentes dominios cognitivos que deberían ser incluidos en dicha batería, la denominada cognición social no cumplía con los requisitos para ser incluida, se decidió finalmente incluir este dominio dada la importante relación con la funcionalidad que presentaba. Estudios posteriores han demostrado el acierto de incluir dicho dominio cognitivo, dada la relevancia que la cognición social ha demostrado en relación a la funcionalidad y calidad de vida de los pacientes con esquizofrenia; bien como variable per se, o bien como variable mediadora entre la neurocognición y la funcionalidad.

Objective To examine emotion processing in euthymic bipolar patients ( EBP) compared to healthy controls. In addition, to determine whether or not there is an association between emotion processing and psychosocial functioning. Material and methods A sample of 60 EBP and 60 healthy controls matched for age, gender, education level, and premorbid intelligence were studied. All subjects were assessed using the MATRICS Consensus Cognitive Battery ( MCCB) and two additional executive function measures: the Trail Making Test-Part B and the Stroop Test. Emotion processing was examined using the Mayer-Salovey-Caruso Emotional Intelligence Test ( MSCEIT). Psychosocial functioning was assessed using the Functional Assessment Short Test ( FAST). Results Euthymic bipolar patients obtained lower scores than controls in all MSCEIT measures except for the using emotions branch. Likewise, EBP obtained a worse performance than healthy controls in all neurocognitive domains. Correlation between MSCEIT strategic area measures and FAST total score was found ( r = −0.311; P < 0.016). Regression analysis showed that residual depressive symptomatology explains a 9.1% of the variance in functional outcome. MSCEIT strategic area score explained an additional 8.6%. Neurocognition did not increase the percentage of the variance explained by emotion processing. Conclusions Euthymic bipolar patients exhibit deficits in emotion processing. Emotion processing is associated with social functioning in these patients. [ABSTRACT FROM AUTHOR]

Background: To assess insight in a large sample of patients with schizophrenia and to study its relationship with set shifting as an executive function. Methods: The insight of a sample of 161 clinically stable, community-dwelling patients with schizophrenia was evaluated by means of the Scale to Assess Unawareness of Mental Disorder (SUMD). Set shifting was measured using the Trail-Making Test time required to complete part B minus the time required to complete part A (TMT B-A). Linear regression analyses were performed to investigate the relationships of TMT B-A with different dimensions of general insight. Results: Regression analyses revealed a significant association between TMT B-A and two of the SUMD general components: 'awareness of mental disorder' and 'awareness of the efficacy of treatment'. The 'awareness of social consequences' component was not significantly associated with set shifting. Conclusions: Our results show a significant relation between set shifting and insight, but not in the same manner for the different components of the SUMD general score. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Negative symptoms and cognitive dysfunction are of crucial functional and prognostic importance in schizophrenia. However, the nature of the relationship between them and the factors that may influence it have not been well established. Aims: To investigate whether the relationship between negative symptoms and executive function changes according to the duration of illness in schizophrenia. Methods: The Positive and Negative Syndrome Scale was used to assess psychopathology and the Wisconsin Card Sorting Test (WCST) to evaluate executive function in a sample of 200 schizophrenic patients who were classified in 3 groups according to their duration of illness: up to 5 years (short duration group), 6-20 years (intermediate duration group) and over 20 years of illness (long duration group). Results: Medium-sized correlations were found between negative symptoms and WCST performance as assessed by the number of completed categories in all 3 groups. However, differences were found according to the duration of schizophrenia. For patients in the short duration group, negative symptoms correlated with WCST nonperseverative errors, but for those in the long duration group the correlation was with perseverative errors. Conclusion: We found a differential relationship between negative and cognitive symptoms in different stages of schizophrenia. Illness duration should be considered when studying the relationship between negative symptoms and cognition. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Introduction: Previous studies have associated a decreased striatal D2 dopamine receptor (DRD2) binding with impaired performance in cognitive tasks. In vivo studies have found a lower DRD2 binding associated with the CC genotype of the C957T single nucleotide polymorphism (SNP) of the DRD2 gene. Objective: The aim of this study was to investigate the relationship between executive functions and the C957T DRD2 SNP. We hypothesized that the CC genotype would be associated with a poorer executive functioning. Methods: Our sample consisted of 83 healthy volunteers (28 males and 55 females; mean age 25.2, SD 1.7 years). To assess executive functions, the Wisconsin Card Sorting Test was used, considering the variables perseverative errors, perseverative responses, and number of categories achieved. The genotype distribution was 13 CC, 41 CT, and29 TT, satisfying Hardy-Weinberg equilibrium. Results: Carriers of the CC genotype, compared with carriers of the CT/TT genotypes, achieved significantly fewer categories (5.00 vs. 5.81; p = 0.004), made a greater number of perseverative errors (13.46 vs. 8.39; p = 0.018), and had a greater number of perseverative responses (14.92 vs. 8.94; p = 0.014). Conclusions: Our results support the hypothesis that the C957T DRD2 SNP may influence cognitive performance through its repercussions on central dopaminergic function. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Introduction. The degree of satisfaction of patients and their relatives with electroconvulsive therapy (ECT) is considered an important treatment goal; however there is no scale in Spanish to quantify it. The aim of the study was to translate and adapt into Spanish the "Patient Satisfaction Survey" (PSS) for its use in patients and their relatives. Methodology. Two translators performed the initial translation and a third translator did the back translation. The research committee obtained a consensus survey; the authors of the original instrument reviewed and accepted this survey. The equivalence between the original instrument with the back translation and the readability of the survey were analyzed. The Spanish version was tested on a sample of patients, relatives and experts in ECT. The same process was carried out for the satisfaction survey of relatives or caregivers. Results. The Spanish surveys were obtained after completing the translation process and identifying the problematic items that were successfully modified. The readability of the surveys was very accessible to the Spanish population. The pilot test carried out on patients, relatives and experts allowed detection and changes of confusing items. The final Spanish surveys were obtained after this pilot test. Conclusions. The adaptation of the PSS for Spanish patients and relatives provide suitable satisfaction scale for its use in Spanish population. [ABSTRACT FROM AUTHOR]

Introduction. Sexual dysfunction is a frequent side effect associated with antipsychotic treatment. It is known to be caused by the hyperprolactinemia that results from the D2 receptor blockade that is characteristic of antipsychotic drugs. The D2 partial dopaminergic agonism of aripiprazole could explain why its use does not usually cause this side effect, and may even revert it when added to another antipsychotic. Case reports. We present the cases of two patients treated with D2 dopaminergic antagonists for a first episode of psychosis, who complained of amenorrhea and erectile dysfunction during follow-up. After the addition of aripiprazole to their previous antipsychotic treatment, these side effects reverted without a negative impact on treatment adherence or therapeutic efficacy. Conclusions. Pharmacological treatments with the potential of reverting sexual dysfunction secondary to antipsychotic treatment can improve compliance and quality of life of our patients, especially in those who are younger and are being treated for a first psychotic episode. In the cases reported here, the use of aripiprazole as an adjunctive treatment resulted in the disappearance of the undesirable effects without affecting the efficacy already achieved with the previous antipsychotic treatment. [ABSTRACT FROM AUTHOR]

The degree of satisfaction of patients and their relatives with electroconvulsive therapy (ECT) is considered an important treatment goal; however there is no scale in Spanish to quantify it. The aim of the study was to translate and adapt into Spanish the &#8220;Patient Satisfaction Survey&#8221; (PSS) for its use in patients and their relatives.

Visual perception in schizophrenia is attracting a broad interest given the deep knowledge that we have about the visual system in healthy populations. One example is the class of effects known collectively as visual surround suppression. For example, the visibility of a grating located in the visual periphery is impaired by the presence of a surrounding grating of the same spatial frequency and orientation. Previous studies have suggested abnormal visual surround suppression in patients with schizophrenia. Given that schizophrenia patients have cortical alterations including hypofunction of NMDA receptors and reduced concentration of GABA neurotransmitter, which affect lateral inhibitory connections, then they should be relatively better than controls at detecting visual stimuli that are usually suppressed. We tested this hypothesis by measuring contrast detection thresholds using a new stimulus configuration. We tested two groups: 21 schizophrenia patients and 24 healthy subjects. Thresholds were obtained using Bayesian staircases in a four-alternative forced-choice detection task where the target was a grating within a 3∘ Butterworth window that appeared in one of four possible positions at 5∘ eccentricity. We compared three conditions, (a) target with no-surround, (b) target embedded within a surrounding grating of 20∘ diameter and 25% contrast with same spatial frequency and orthogonal orientation, and (c) target embedded within a surrounding grating with parallel (same) orientation. Previous results with healthy populations have shown that contrast thresholds are lower for orthogonal and no-surround (NS) conditions than for parallel surround (PS). The log-ratios between parallel and NS thresholds are used as an index quantifying visual surround suppression. Patients performed poorly compared to controls in the NS and orthogonal-surround conditions. However, they performed as well as controls when the surround was parallel, resulting in significantly lower suppression indices in patients. To examine whether the difference in suppression was driven by the lower NS thresholds for controls, we examined a matched subgroup of controls and patients, selected to have similar thresholds in the NS condition. Patients performed significantly better in the PS condition than controls. This analysis therefore indicates that a PS raised contrast thresholds less in patients than in controls. Our results support the hypothesis that inhibitory connections in early visual cortex are impaired in schizophrenia patients.

Introduction: Sexual dysfunction is a frequent side effect associated with antipsychotic treatment. It is known to be caused by the hyperprolactinemia that results from the D2 receptor blockade that is characteristic of antipsychotic drugs. The D2 partial dopaminergic agonism of aripiprazole could explain why its use does not usually cause this side effect, and may even revert it when added to another antipsychotic., Case Reports: We present the cases of two patients treated with D2 dopaminergic antagonists for a first episode of psychosis, who complained of amenorrhea and erectile dysfunction during follow-up. After the addition of aripiprazole to their previous antipsychotic treatment, these side effects reverted without a negative impact on treatment adherence or therapeutic efficacy., Conclusions: Pharmacological treatments with the potential of reverting sexual dysfunction secondary to antipsychotic treatment can improve compliance and quality of life of our patients, especially in those who are younger and are being treated for a first psychotic episode. In the cases reported here, the use of aripiprazole as an adjunctive treatment resulted in the disappearance of the undesirable effects without affecting the efficacy already achieved with the previous antipsychotic treatment.

Cognitive deficits constitute a core symptom in schizophrenia, are difficult to treat, and have special relevance regarding prognosis and functional outcome. The search for pharmacological strategies for improving cognition in schizophrenic patients has been hindered by the lack of a consensus regarding instruments for cognitive assessment. The 'Measurement and Treatment Research to Improve Cognition in Schizophrenia' (MATRICS) initiative of the U.S. National Institute of Mental Health (NIMH) set the development of a consensus cognitive battery as one of its objectives. In a first phase, the seven cognitive domains which have been shown to be impaired in schizophrenia and that were to be assessed were identified: Speed of processing, Attention/Vigilance, Working memory, Verbal learning, Visual learning, Reasoning and problem solving, and Social cognition. In a second phase, the MATRICS Consensus Cognitive Battery (MCCB) was developed. This is a cognitive assessment battery composed of ten instruments, which assess the seven domains in a little over one hour. The MCCB has been standardized in U.S. population, and the Spanish standardization has been recently published.

Comorbidity between a substance use disorder (SUD) and another psychiatric disorder is known as dual diagnosis. It is of great relevance due to its important clinical consequences and costs of care. There are practically no published studies on dual diagnosis prevalence in patients admitted to psychiatric hospitalization units in general hospitals (PHUGH) in our country. The objectives were to estimate the prevalence of dual diagnosis in psychiatric inpatients admitted consecutively to a Psychiatric Hospitalization Unit (Hospital Universitario 12 de Octubre, Madrid, Spain) in one year, to compare clinical and sociodemographic variables between the dual diagnosis group (DD group) and the group with a psychiatric disorder but no SUD (PD group), and to study the types of substances used. This is a retrospective study, based on the review of the clinical charts of the 257 patients admitted to this PHUGH in one year. The results showed that, excluding nicotine dependence, 24.9% of our inpatients had a SUD as well as another psychiatric disorder. A statistically significant predominance of men was found in the DD group, as well as a younger age at the time of the study, at the beginning of their psychiatric attention and on their first psychiatric admission, and they had received diagnoses of schizophrenia or related psychoses more often than the PD group, who had mostly affective disorders. The substances most frequently used in the DD group were alcohol (78.1%), cannabis (62.5%), and cocaine (51.6%). Due to the high prevalence and repercussions of dual diagnosis, it would be advisable to have specialized therapeutic programs for its treatment.