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6. The clinical characterization of the patient with primary psychosis aimed at personalization of management

Author

Maj, M. (Mario), van Os, J. (Jim), De Hert, M. (Marc), Gaebel, W. (Wolfgang), Galderisi, S. (Silvana), Green, M. F. (Michael F.), Guloksuz, S. (Sinan), Harvey, P. D. (Philip D.), Jones, P. B. (Peter B.), Malaspina, D. (Dolores), McGorry, P. (Patrick), Miettunen, J. (Jouko), Murray, R. M. (Robin M.), Nuechterlein, K. H. (Keith H.), Peralta, V. (Victor), Thornicroft, G. (Graham), van Winkel, R. (Ruud), Ventura, J. (Joseph), Maj, M. (Mario), van Os, J. (Jim), De Hert, M. (Marc), Gaebel, W. (Wolfgang), Galderisi, S. (Silvana), Green, M. F. (Michael F.), Guloksuz, S. (Sinan), Harvey, P. D. (Philip D.), Jones, P. B. (Peter B.), Malaspina, D. (Dolores), McGorry, P. (Patrick), Miettunen, J. (Jouko), Murray, R. M. (Robin M.), Nuechterlein, K. H. (Keith H.), Peralta, V. (Victor), Thornicroft, G. (Graham), van Winkel, R. (Ruud), and Ventura, J. (Joseph)

Abstract

The current management of patients with primary psychosis worldwide is often remarkably stereotyped. In almost all cases an antipsychotic medica­tion is prescribed, with second-generation antipsychotics usually preferred to first-generation ones. Cognitive behavioral therapy is rarely used in the vast majority of countries, although there is evidence to support its efficacy. Psychosocial interventions are often provided, especially in chronic cases, but those applied are frequently not validated by research. Evidence-based family interventions and supported employment programs are seldom implemented in ordinary practice. Although the notion that patients with primary psychosis are at increased risk for cardiovascular diseases and diabetes mellitus is widely shared, it is not frequent that appropriate measures be implemented to address this problem. The view that the management of the patient with primary psychosis should be personalized is endorsed by the vast majority of clinicians, but this personalization is lacking or inadequate in most clinical contexts. Although many mental health services would declare themselves “recovery-oriented”, it is not common that a focus on empowerment, identity, meaning and resilience is ensured in ordinary practice. The present paper aims to address this situation. It describes systematically the salient domains that should be considered in the characterization of the individual patient with primary psychosis aimed at personalization of management. These include positive and negative symptom dimensions, other psychopathological components, onset and course, neurocognition and social cognition, neurodevelopmental indicators; social functioning, quality of life and unmet needs; clinical staging, antecedent and concomitant psychiatric conditions, physical comorbidities, family history, history of obstetric complications, early and recent environmental exposures, protective factors and resilience, and internalized stigma. For

Published
2021

10. Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample o outpatients with schizophrenia and their unaffected relatives

Author

Mucci A., Galderisi S., Green M. F., Nuechterlein K., Rucci P., Gibertoni D., Rossi A., Rocca P., Bertolino A., Bucci P., Hellemann G., Spisto M., Palumbo D., Aguglia E., Amodeo G., Amore M., Bellomo A., Brugnoli R., Carpiniello B., Dell'osso L., Di Fabio F., Di Giannantonio M., Di Lorenzo G., Marchesi C., Monteleone P., Montemagni C., Oldani L., Romano R., Roncone R., Stratta P., Tenconi E., Vita A., Zeppegno P., Maj M., Piegari G., Vignapiano A., Caputo F., Plescia G., Montefusco V., Mancini M., Attrotto M. T., Paladini V., Atti A. R., Barlati S., Galluzzo A., Mussoni C., Pinna F., Sanna L., Primavera D., Signorelli M. S., Minutolo G., Cannavo D., Acciavatti T., Santacroce R., Corbo M., Altamura M., La Montagna M., Carnevale R., Pizziconi G., Rossi R., Santarelli V., Giusti L., Malavolta M., Salza A., Murri M. B., Calcagno P., Bugliani M., Serati M., Orsenigo G., Gramaglia C., Gattoni E., Cattaneo C., Campagnola N., Ferronato L., Piovan C., Tonna M., Bettini E., Ossola P., Gesi C., Landi P., Rutigliano G., Biondi M., Girardi P., Buzzanca A., Zocconali M., Comparelli A., Mancinelli I., Niolu C., Ribolsi M., Siracusano A., Corrivetti G., Bartoli L., Diasco F., Bolognesi S., Goracci A., Fagiolini A., Bellino S., Cardillo S., Bracale N., Mucci, A., Galderisi, S., Green, M. F., Nuechterlein, K., Rucci, P., Gibertoni, D., Rossi, A., Rocca, P., Bertolino, A., Bucci, P., Hellemann, G., Spisto, M., Palumbo, D., Aguglia, E., Amodeo, G., Amore, M., Bellomo, A., Brugnoli, R., Carpiniello, B., Dell'Osso, L., Di Fabio, F., Di Giannantonio, M., Di Lorenzo, G., Marchesi, C., Monteleone, P., Montemagni, C., Oldani, L., Romano, R., Roncone, R., Stratta, P., Tenconi, E., Vita, A., Zeppegno, P., Maj, M., Piegari, G., Vignapiano, A., Caputo, F., Plescia, G., Montefusco, V., Mancini, M., Attrotto, M. T., Paladini, V., Atti, A. R., Barlati, S., Galluzzo, A., Mussoni, C., Pinna, F., Sanna, L., Primavera, D., Signorelli, M. S., Minutolo, G., Cannavo, D., Acciavatti, T., Santacroce, R., Corbo, M., Altamura, M., La Montagna, M., Carnevale, R., Pizziconi, G., Rossi, R., Santarelli, V., Giusti, L., Malavolta, M., Salza, A., Murri, M. B., Calcagno, P., Bugliani, M., Serati, M., Orsenigo, G., Gramaglia, C., Gattoni, E., Cattaneo, C., Campagnola, N., Ferronato, L., Piovan, C., Tonna, M., Bettini, E., Ossola, P., Gesi, C., Landi, P., Rutigliano, G., Biondi, M., Girardi, P., Buzzanca, A., Zocconali, M., Comparelli, A., Mancinelli, I., Niolu, C., Ribolsi, M., Siracusano, A., Corrivetti, G., Bartoli, L., Diasco, F., Bolognesi, S., Goracci, A., Fagiolini, A., Bellino, S., Cardillo, S., Bracale, N., and di Giannantonio, M.

Subjects
Attention, MCCB Italian standardization, reasoning and problem solving, social cognition, verbal learning, working memory, Proband, Adult, Male, Consensus, Psychometrics, Context (language use), social cognition, Verbal learning, working memory, 03 medical and health sciences, Attention, MCCB Italian standardization, reasoning and problem solving, verbal learning, Aged, Cognition, Cognitive Dysfunction, Family, Female, Humans, Middle Aged, Outpatients, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, 0302 clinical medicine, Social cognition, medicine, Applied Psychology, Psychiatry and Mental Health, Family aggregation, medicine.disease, 030227 psychiatry, Settore MED/25, Psychology, MATRICS, Neurocognitive, 030217 neurology & neurosurgery, Clinical psychology
Abstract

BackgroundThe increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative–control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands’ scores.MethodsMultivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands’ MCCB scores predicted REL neurocognitive performance.ResultsSCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning.ConclusionsIn a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.

Published
2018

20. Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample of outpatients with schizophrenia and their unaffected relatives.

Author

Italian Network for Research on Psychoses, Mucci, A., Galderisi, S., Bucci, P., Spisto, M., Palumbo, D., Maj, M., Amodeo, G., Amore, M., Bellomo, A., Brugnoli, R., Carpiniello, B., Dell'Osso, L., Di Fabio, F., di Giannantonio, M., Di Lorenzo, G., Marchesi, C., Hellemann, G., Green, M. F., and Nuechterlein, K.

Subjects
COGNITION disorders, ANALYSIS of variance, COGNITION, CONSENSUS (Social sciences), LEARNING, MULTIVARIATE analysis, REGRESSION analysis, SCHIZOPHRENIA, EXTENDED families, INDEPENDENT living, GENETICS
Abstract

Background: The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative–control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands’ scores. Methods: Multivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands’ MCCB scores predicted REL neurocognitive performance. Results: SCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning. Conclusions: In a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors. [ABSTRACT FROM AUTHOR]

Published
2018
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23. Comparison of the Heritability of Schizophrenia and Endophenotypes in the COGS-1 Family Study

Author

Light, G., primary, Greenwood, T. A., additional, Swerdlow, N. R., additional, Calkins, M. E., additional, Freedman, R., additional, Green, M. F., additional, Gur, R. E., additional, Gur, R. C., additional, Lazzeroni, L. C., additional, Nuechterlein, K. H., additional, Olincy, A., additional, Radant, A. D., additional, Seidman, L. J., additional, Siever, L. J., additional, Silverman, J. M., additional, Sprock, J., additional, Stone, W. S., additional, Sugar, C. A., additional, Tsuang, D. W., additional, Tsuang, M. T., additional, Turetsky, B. I., additional, and Braff, D. L., additional

Published
2014
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28. Selecting Paradigms From Cognitive Neuroscience for Translation into Use in Clinical Trials: Proceedings of the Third CNTRICS Meeting

Author

Barch, D. M., primary, Carter, C. S., additional, Arnsten, A., additional, Buchanan, R. W., additional, Cohen, J. D., additional, Geyer, M., additional, Green, M. F., additional, Krystal, J. H., additional, Nuechterlein, K., additional, Robbins, T., additional, Silverstein, S., additional, Smith, E. E., additional, Strauss, M., additional, Wykes, T., additional, and Heinssen, R., additional

Published
2009
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32. The Consortium on the Genetics of Endophenotypes in Schizophrenia: Model Recruitment, Assessment, and Endophenotyping Methods for a Multisite Collaboration

Author

Calkins, M. E., primary, Dobie, D. J., additional, Cadenhead, K. S., additional, Olincy, A., additional, Freedman, R., additional, Green, M. F., additional, Greenwood, T. A., additional, Gur, R. E., additional, Gur, R. C., additional, Light, G. A., additional, Mintz, J., additional, Nuechterlein, K. H., additional, Radant, A. D., additional, Schork, N. J., additional, Seidman, L. J., additional, Siever, L. J., additional, Silverman, J. M., additional, Stone, W. S., additional, Swerdlow, N. R., additional, Tsuang, D. W., additional, Tsuang, M. T., additional, Turetsky, B. I., additional, and Braff, D. L., additional

Published
2006
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