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Background and Aims:Cognition has been proposed as a determinant of insight in schizophrenia, but results have been mixed. The MATRICS Consensus Cognitive Battery (MCCB) was developed to provide a cognitive assessment tool to help overcome the heterogeneity of existing instruments (Nuechterlein et al. 2008; Rodriguez-Jimenez et al. 2012; Rodriguez-Jimenez et al. 2015). The aim of the present study was to study the relationship between cognitive domains and insight in a sample of patients with schizophrenia.Methods:A cross-sectional study was conducted in a sample of 103 patients (31.1 % female). The mean age was 41.5 years (SD 8.5). Cognition was measured with the MCCB, and insight with the three general u00edtems of the SUMD (awareness of mental disorder, awareness of need for treatment, and of social consequences of the disorder), and the total awareness and attribution items (Amador & Strauss 1990). Pearson correlation coefficients were calculated.Results:Awareness of having a mental disorder showed a significant correlation with processing speed (-0.257;p=.009) and working memory (-0.257;p=.005). Awareness of need for treatment and total awareness showed no significant relationships with cognition. Working memory showed a significant correlation with awareness of consequences (-0.266;p=.007), and with total attribution (-0.216; p=.028). Processing speed (-0.263;p=.007), attention (-0.240;p=.015), and visual learning (-0.282;p=.004) showed relationship with awareness of social consequences.Conclusions:Insight is a multidimensional construct holding specific associations with different cognitive domains, such as working memory, attention, and processing speed. Further studies are required to understand the complex linkages between cognition and insight, while the study of individual relationships seem necessary.

Background and Aims:Electroconvulsive therapy (ECT) was first applied in Italy in 1938 for the treatment of psychosis. The following years the ECT had a variable and often controversial use. Recent studies show that ECT, combined with antipsychotics, may be a therapeutic option for patients with schizophrenia, specially when an immediate recovery is required, or when show limited response to medication (Tharyan P & Adams CE, 2005). Despite this findings, the ECT use in schizophrenia remains controversial. The aim of the present study was to analyse patients with schizophrenia who received ECT treatment at the 12 de Octubre Hospital in Madrid.Methods:A naturalistic study was conducted by analysing a one year period of activity. Included patients and their characteristics are described below. Included patients were refractory to pharmacological treatment, with various and severe psycotic episodes with, in not few cases, high suicide risk. Results:A total of twelve patients with a diagnosis of schizophrenia received treatment with ECT on the year 2017. Patients mean age was 41.5 years (SD 12.5) and 33% of patients were female. Of these, 8 patients received acute ECT, while four were included in the continuation/maintenance (C/M) ECT Program. Three of those who were on the C/M ECT treatment received the treatment on ambulatory basis, while the other required previos day admission.Conclusions:For the last decade, ECT administration has been sistematized and its risks lessened. It is a technique with virtually no contraindication for its administration, and it is nowadays a safe and effective treatment for certain patients with schizophrenia.

Background and Aims:Partial or total unawareness is present in 50-80% of patients with schizophrenia. Poor insight is associated with worse treatment compliance, more hospital admissions, poorer functional outcome, and a higher severity of illness. While gender differences on age of onset, prevalence, and outcomes have been widely studied on schizophrenia, scarce and mixed data exists on gender differences on insight (Pruu03b2 et al. 2012; Parellada et al. 2013). The Scale to Assess Unawareness of Mental Disorder (SUMD) is a widely accepted and validated scale that evaluates several insight domains (Amador et al. 1993). The aim of the present study was to study gender differences on insight in a sample of patients with schizophrenia.Methods:A cross-sectional study was conducted in a sample of 109 patients (31.2 % female). The mean age was 41.3 years (SD 8.4). Average age of disease onset was 24.2 (SD 6.7), with a mean of 17.1 years (SD 9.1) of duration of disease. Insight was measured with the three general u00edtems of the Scale to Assess Unawareness of Mental Disorder (SUMD): awareness of having a mental disorder, awareness of need for treatment, and awareness of the social consequences of the disorder. T-student tests were performed with SPSS version 23. Results:By gender groups, women scored 2.91 (SD 1.24) on awareness of having a mental disorder, while men scored 2.23 (SD 1.23). This difference was statistically significant (t=-2.770; p=.007). No significant differences were observed on awareness of the effects of treatment, or on awareness of social consequences. Conclusions:On our sample, gender differences on one general insight domain were observed: awareness of having a mental disorder. While further studies are necessary, our results might help the development of gender-specific insight interventions.

ackground and Aims:Important efforts are being made to provide an early and specialized care to first-episode psychosis patients. A successful development of this programs require an adequate understanding of the patients they are aiming at. Thus, we intend to analyse the characteristics of first-episode psychosis patients admitted to our psychiatry unit, and to evaluate the change on severity of symptoms.Methods:A retrospective study was conducted on the 31 first-episode patients admitted during 2017. The mean age was 25.3 years (SD 4.3). 39% were female. A t-test for related samples was conducted to analyse the change on severity of symptoms measured with the Clinical General Impression Scale, severity subscale (CGI-s). Patients older than 40 years were excluded.Results:Duration of untreated psychosis (DUP) was 7.3 months (SD 9.1). 45% of patients (n=14) had previous contact with a mental health professional. Of these, 4 had received an ADHD diagnosis, while 4 had recent contacts in mental health services related to anxiety and/or depressive symptoms. Only 5 patients (16%) had previous mental health contacts related to psychotic symptoms. At admission 58% (n=18) had cannabis use disorder, and 32% (n=10) alcohol use disorder. The mean CGI-s score at admission was 5.2 (SD 0.8), while at discharge was 2.9 (SD 0.8). The change on CGI was statistically significant (t=10.5; p=.00). Conclusions:First-episode patients require interdisciplinary and individualized intervention plans, including those aimed at decreasing drug abuse and favouring early diagnosis. In our hospital, a mean of three first episode patients were admitted per month, and substance abuse was frequent.

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., Psilogos, v. 11, n. 1 (2013)