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Background People suffering from schizophrenia cannot easily access employment in European countries. Different types of vocational programs coexist in France: supported employment, sheltered employment (ShE), and hybrid vocational programs. It is now acknowledged that the frequent cognitive impairments constitute a major obstacle to employment for people with schizophrenia. However, cognitive remediation (CR) is an evidence-based nonpharmacological treatment for these neurocognitive deficits. Methods RemedRehab was a multicentric randomized comparative open trial in parallel groups conducted in eight centers in France between 2013 and 2018. Participants were recruited into ShE firms before their insertion in employment (preparation phase). They were randomly assigned to cognitive training Cognitive Remediation for Schizophrenia (RECOS) or Treatment As Usual (TAU). The aim of the study was to compare with the benefits of the RECOS program on access to employment and work attendance for people with schizophrenia, measured by the ratio: number of hours worked on number of hours stipulated in the contract. Results Seventy-nine patients were included in the study between October 2018 and September 2019. Fifty-three patients completed the study. Hours worked / planned hours equal to 1 or greater than 1 were significantly higher in the RECOS group than in the TAU group. Conclusions Participants benefited from a RECOS individualized CR program allows a better rate of work attendance in ShE, compared to the ones benefited from TAU. Traditional vocational rehabilitation enhanced with individualized CR in a population of patients with schizophrenia is efficient on work attendance during the first months of work integration.

Interactions between social cognition and symptoms of schizophrenia have been investigated, but mostly component by component. Here we tested the assumption that two categories of deficits exist depending on clinical profiles, one corresponding to a defect in social cognition – “under-social cognition” – and one corresponding to excessive attributions leading to social cognitive impairments – “over-social cognition”. To conduct the investigation, we performed a Hierarchical Clustering Analysis using positive and negative symptoms in seventy patients with schizophrenia and we compared the clusters obtained to a group of healthy controls on social cognitive measures. We distinguished two social cognitive profiles based on prevailing symptoms for emotion processes and Theory of Mind. Actually, patients with negative symptoms showed lower performances in emotion recognition task than both those with positive symptoms and controls. Concerning Theory of Mind, patients with positive symptoms had a significant tendency to make over interpretative errors than both patients with negative symptoms and controls. For other processes assessed, further explorations are needed. Actually, concerning social perception and knowledge both patients' groups presented significant impairments compared to controls. Assessment of attribution bias showed that patients in the positive group presented a significant hostility bias and a higher intentionality score compared to healthy controls. These results favor the existence of different categories of impairments depending more on the clinical characteristics of patients than on nosographical categories, but further investigations are now necessary to specify these profiles. It nevertheless showed the importance of assessing symptoms in relationship with cognitive functioning. Keywords: Social cognition, Schizophrenia, Symptoms, Emotion, Theory of mind, Attribution style

Background Auditory verbal hallucinations (AVH) in schizophrenia may arise because of aberrant speech perception. We used an electroencephalography method to examine the neural processes underlying speech perception in schizophrenic patients with hallucinations. Methods Cortical event-related potentials (ERPs) were analyzed topographically (scalp potential and scalp current density (SCD) mapping) in response to the vowel /a/ using a passive paradigm in 26 patients with schizophrenia. Results From the SCD distribution of the P1 peak, we showed that, whereas the hallucination score (PSYRATS) was negatively correlated with the amplitude of the frontal currents, the PANSS negative symptom score was negatively correlated with the amplitude of the temporal currents in patients with schizophrenia. Conclusions These results provide evidence that AVH and negative symptoms are associated with abnormal early processing of speech. Whereas AVH are related to decreased early frontal activation, negative symptoms are associated with a reduced early temporal response.

International audience; Cognitive deficits are well documented in psychiatric disorders, particularly in schizophrenia and depression. Cognitive activity roots in perceptions. However, research on sensorial alterations in psychiatric conditions has mainly focused on visual or auditory processes and less on olfaction. Here, we examine data on olfactory deficits in psychiatric patients using a systematic review of recent publications. Schizophrenic patients are mainly characterized by no reliable change in odour sensitivity and by a deficit in odour identification, recognition and discrimination. Depressed patients principally exhibit a deficit in the hedonic aspects of this perception, even if, in some case, alterations in sensitivity or identification are also found. Changes in odour perception are also found in dementia and in some neurodegenerative disease, but in this case alterations concern all aspects of the sensorial experience (detection threshold, identification and recognition). Taken together, these data indicate that olfactory abnormalities might be a marker of psychiatric conditions, with a specific pattern for each disease.

It is not clear whether self-stimuli are processed by the brain as highly familiar overlearned stimuli or as self-specific stimuli. This study examined the neural processes underlying discrimination of one’s own voice (OV) compared with a familiar voice (FV) using electrophysiological methods. Event-related potentials were recorded while healthy subjects (n = 15) listened passively to oddball sequences composed of recordings of the French vowel /a/ pronounced either by the participant her/himself, or by a familiar person or an unknown person. The results indicated that, although mismatch negativity displayed similar peak latency and amplitude in both conditions, the amplitude of the subsequent P3a was significantly smaller in response to OV compared with a FV. This study therefore indicated that fewer pre-attentional processes are involved in the discrimination of one’s OV than in the discrimination of FVs.

We report the case of a 78-year-old patient admitted to the hospital for behavioral and psychological disorders consisting in impressions of presence of a stranger located behind the bathroom mirror, who strikingly shared the patient's appearance but was considered a different person, yet. We discuss how this case can be interpreted as an atypical Capgras syndrome for his mirror image and how it suggests an adjustment of the classical dual-route model that sustains face recognition between covert (or affective) and overt neural pathways.

This study examined the neural processes underlying own voice discrimination using electrophysiological methods. Event-related potentials were recorded while healthy subjects (n = 17) heard passively three oddball sequences composed of recordings of the French vowel/a/pronounced either by the participant her/himself or by two unknown persons. The results indicated that, although the mismatch negativity (MMN) displayed similar peak latency and amplitude in both conditions, the subsequent P3a clearly distinguished the two conditions since its amplitude was significantly smaller for own voice discrimination than for that of unknown voices. Moreover, the own voice discriminative response was associated with an early pre-MMN response. This early response involved a left inferior frontal component, the activity of which lasted throughout the time course of the discriminative response, which included both MMN and P3a.

International audience; Henri Ey suggested that all hallucinations occur against the background of depersonalization, which is an alteration in experience that people find hard to describe, where the subject feels a strangeness pervading the world and her/his own body, emotions and thoughts. Embracing Ey's proposal, this paper draws a comparison between depersonalization in hallucinations and depersonalization in some delusional states (especially the Capgras and the Cotard syndromes), which by the most recent models used in cognitive neuroscience is considered to be a disruption in so-called 'affective familiarity'. Sensory information regarding the world is divided into the 'overt pathway' of perceptual inputs and the 'covert pathway' of 'atmospheric cues'. In hallucinating subjects, we suggest that a breakdown of the grasping of atmospheric qualities in the environment triggers a compensatory process consisting of the production of hypotheses that make sense of the world perceived. Finally, we report on a case that illustrates our proposal.