The European Journal of Psychiatry

Neurocognition, social cognition and functional outcome in schizophrenia

Background and Objectives: A relationship has been found between cognition and functioning in patients with schizophrenia. Our objective was to study the relationship between the cognitive domains assessed by the MATRICS Consensus Cognitive Battery (MCCB), and functioning as evaluated using the functioning subscale of the Global Assessment of Functioning scale (GAF-f). Methods: A sample of 83 clinically stable outpatients diagnosed with schizophrenia according to DSM-IV criteria were assessed using the MCCB and the GAF-f. Pearson correlations and stepwise linear regression analyses were performed. Results: Correlation analysis between the GAF-f and the cognitive domains of the MCCB showed a significant relationship between functioning and all of the cognitive domains. Regression yielded a statistically significant model (F2,74 = 20.4, p < 0.001) in which functioning was related to Speed of processing (standardized β = 0.369, p = 0.001) and to Social cognition (standardized β = 0.325, p = 0.003). Together, these two variables explained 33.8% of the variance of functioning. Conclusions: Both speed of processing and social cognition have an important association with functioning in patients with schizophrenia.

Lower risk of prostate cancer in schizophrenia: fact or artifact?

Background and Objectives: Reduced risk for prostate cancer in persons diagnosed with schizophrenia has been reported repeatedly. While genetic factors and antipsychotic medications were imputed, a methodological hypothesis could be raised: given the reported disparities of health services with regard to service users with schizophrenia these persons may be screened less often compared to schizophrenia-free counterparts resulting in undetected prostate tumors. The study objective was to compare the rates of performance of the prostate specific antigen (PSA) screening test among persons diagnosed with schizophrenia to matched-comparison subjects. Methods: A prospective historical epidemiological study which included service users with and without a diagnosis of schizophrenia (N = 52,131). Linkage was conducted between databases of the nation-wide psychiatric register and Israels largest health maintenance organization. Annual performance of PSA tests was recorded between the years 2002-2009. Results: Service users with schizophrenia performed the PSA test 23% less than the comparison subjects. However, among service users who were diagnosed with prostate cancer only 44% performed the PSA test during the year prior to diagnosis. Conclusions: In line with our hypothesis, lower rates of PSA screening tests were conducted among service users with schizophrenia. However, the relatively low rate of this test prior to prostate cancer diagnosis ought to be noted.

A prospective study of natural recovery from cannabis use in early psychosis

Background and Objectives: Cannabis use is common in early psychosis and has been linked to adverse outcomes. However, factors that influence and maintain change in cannabis use in this population are poorly understood. An existing prospective dataset was used to predict abstinence from cannabis use over the 6 months following inpatient admission for early psychosis. Methods: Participants were 67 inpatients with early psychosis who had used cannabis in the 6 weeks prior to admission. Current diagnoses of psychotic and substance use disorders were confirmed using a clinical checklist and structured diagnostic interview. Measures of clinical, substance use and social and occupational functioning were administered at baseline and at least fortnightly over the 6-month follow up. Results: No substance use or clinical variables were associated with 6-months’ of cannabis abstinence. Only Caucasian ethnicity, living in private accommodation and receiving an income before the admission were predictive. Only private accommodation and receiving an income were significant predictors of abstinence when these variables were entered into a multivariate analysis. Conclusions: While the observed relationships do not necessarily imply causation, they suggest that more optimal substance use outcomes could be achieved by addressing the accommodation and employment needs of patients.

Suicide risk in a Portuguese non-clinical sample of adults

Background and Objectives: This exploratory study simultaneously tests the contribution of socio-demographic, clinical, distress, and personality variables for identifying suicide risk in a non-clinical sample. Methods: A convenience sample of 810 adults ranging in age from 19 to 67 years (M = 36.34, SD = 12.46) and living in various Portuguese regions participated. Their education varied from 6 to 21 years of schooling (M = 11.74, SD = 5.14). Participants responded to socio-demographic questions, the Depressive Experiences Questionnaire, the Center for the Epidemiological Studies of Depression Scale, and the Suicide Behaviors Questionnaire-Revised. Results: In the present sample, 4.3% of participants indicated past suicide attempts, 27.9% reported some lifetime suicide ideation, and 6.4% indicated a past suicide plan. Depressive symptoms, having seen a psychologist or psychiatrist, self-criticism, and education discriminated between participants who had attempted suicide (n = 35) and those who had not attempted to die by suicide (n = 775). Depressive symptoms, having seen a psychologist or psychiatrist, self-criticism, psychiatric disease and age discriminated between participants who scored below (n = 650) and who scored equal to or above (n = 160) the cut-off score for the Suicide Behaviors Questionnaire-Revised. Conclusions: Results have implications for the assessment of suicide risk.

Psychometric properties of the Swedish version of the Outcome Questionnaire-45 as administered by automated technique in a large sample of mental ill-health patients in Primary Health Care

Background and Objectives: Mental health problems are common in Primary Health care and clinicians require valid and reliable instruments to make good treatment plans for these patients. The Outcome Questionnaire-45 (OQ-45) was developed by Lambert and colleagues in order to help improve outcomes of treatment. The aims of this study were to examine the psychometric properties of the Swedish version of OQ-45 when administered by an automated technique and to evaluate if the OQ-45 uniquely could contribute to the description of the patients’ difficulties and needs beyond demographic characteristics and other instruments. Methods: The study comprised 816 patients with mental ill-health taking part in a large randomized controlled trial, Regassa. The OQ-45 data were collected by Interactive Voice Response IVR, a computerized, automated telephone technique. The OQ-45 consists of 45 items summarized in a total score and in three subscales; Symptoms of distress, SD, Interpersonal relations, IR, and Social role functioning, SR. Depression was measured by MADRS and health-related quality of life by EQ-5D. Results: The OQ-45 total score showed good psychometric properties, but there was little support for its three factor structure. The OQ-45 significantly predicted level of depression and health-related quality of life in patients. Conclusions: The OQ-45 contributed uniquely to the description of the patients´ problems. The results indicate that the total score of the Swedish version of OQ-45 can be valuable to use for clinicians in the field.

A preliminary analysis of association between plasma microRNA expression alteration and symptomatology improvement in Major Depressive Disorder (MDD) patients before and after antidepressant treatment

Background and Objectives: Currently, there is a serious need to find practical biomarker(s) for Major Depressive Disorder (MDD) therapeutic target(s). This study aimed to investigate the association between microRNA (miRNA, miR) expression level in Peripheral Blood Mononuclear Cells (PBMCs) and symptomatology improvement in MDD patients before and after six-week antidepressant treatment. Methods: By using an Affymetrix array that covers 723 human miRNAs, 26 miRNAs were identified with significantly altered expression in PBMCs in MDD patients, of which 10 miRNAs were selected for quantitative real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR) study. Twenty out of all the 81 MDD patients were selected for miRNA expression levels testing and symptomatology assessments before and after six-week treatment. Results: Compared with the control group, the expression levels of miR-26b, miR-4743, miR-4498, miR-4485 and miR-1972 of the MDD group were significantly higher (P < 0.05); the changes of expression levels of miR-4743, miR-4498, miR-4485 and miR-1972 were positively related to retardation improvement (P < 0.05), and the change of expression level of miR-26b negatively to the improvement of day and night change (P < 0.05); regression analysis result demonstrated that the alteration of miR-4485 expression accounted for 28.8% of retardation improvement (P < 0.05). Conclusions: These five miRNAs (miR-4743, miR-4498, miR-4485, miR-1972 and miR-26b) may serve as biomarker for MDD diagnosis and therapeutic targets for MDD treatment.