Clinical evaluation of functional capacity in treatment resistant schizophrenia patients: Comparison and differences with non-resistant schizophrenia patients

Iasevoli, Felice; D’Ambrosio, Luigi; Francesco, Danilo Notar; Razzino, Eugenio; Buonaguro, Elisabetta Filomena; Giordano, S.; Patterson, Thomas L.; Bartolomeis, Andrea de

doi:10.1016/j.schres.2018.06.030

Cited by 17 publications

(23 citation statements)

References 66 publications

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“…In line with previous findings, PANNS negative scores and medication use explained significant variance in UPSA scores. Previous studies suggest negative symptoms are the strongest symptomatic contributor to poor functional capacity in FEP 5,6 and schizophrenia 58 . Likewise, in the present study negative symptoms emerged as a significant predictor of UPSA scores and underscores the importance of addressing negative symptoms as a treatment goal so as to promote better functioning in FEP.…”

Section: Discussionmentioning

confidence: 95%

Brain structural correlates of functional capacity in first-episode psychosis

Alkan

Davies

Greenwood

et al. 2020

Sci Rep

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Impaired functional capacity is a core feature of schizophrenia and presents even in first-episode psychosis (FEP) patients. Impairments in daily functioning tend to persist despite antipsychotic therapy but their neural basis is less clear. Previous studies suggest that volume loss in frontal cortex might be an important contributor, but findings are inconsistent. We aimed to comprehensively investigate the brain structural correlates of functional capacity in FEP using MRI and a reliable objective measure of functioning [University of California, San Diego Performance-Based Skills Assessment (UPSA)]. In a sample of FEP (n = 39) and a well-matched control group (n = 21), we measured cortical thickness, gray matter volume, and white matter tract integrity (fractional anisotropy, FA) within brain regions implicated by previous work. The FEP group had thinner cortex in various frontal regions and fusiform, and reduced FA in inferior longitudinal fasciculus (ILF). In FEP, poorer functional capacity correlated with reduced superior frontal volume and lower FA in left ILF. Importantly, frontal brain volumes and integrity of the ILF were identified as the structural correlates of functional capacity in FEP, controlling for other relevant factors. These findings enhance mechanistic understanding of functional capacity deficits in schizophrenia by specifying the underlying neural correlates. In future, this could help inform intervention strategies.

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Section: Discussionmentioning

confidence: 95%

Brain structural correlates of functional capacity in first-episode psychosis

Alkan

Davies

Greenwood

et al. 2020

Sci Rep

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“…This post-hoc analysis used data from a previous cross-sectional naturalistic study ( 6 ). Patients' recruitment continued after the above-mentioned report, and therefore the present study includes data from an expanded sample compared to that earlier one.…”

Section: Methodsmentioning

confidence: 99%

“…A preliminary screening procedure was carried out for identifying non-schizophrenia psychotic disorders, pseudo-TRS, non-TRS, and TRS patients. This procedure has been described elsewhere ( 6 ). For all patients, the following set of clinical-demographic data were recorded: age; gender; education years; age at disease onset (AaO); duration of illness (DoI); age at first psychiatric evaluation; history of substance, alcohol, or drug abuse; everyday living functional milestones ( 4 ).…”

Section: Methodsmentioning

confidence: 99%

“…TRS is defined as the lack of response to a number of antipsychotic agents, which causes the patients to be actively symptomatic and to not gain symptom remission and functional recovery ( 3 ). Accordingly, TRS has been associated to more severe social disability ( 4 ), whose determinants appear to strongly diverge from that in responder schizophrenia patients (i.e., non-TRS) ( 5 , 6 ). Also, TRS may represent a categorically distinct subtype of schizophrenia ( 7 ), as also suggested by clinical data showing higher severity of neurological soft signs (NSS) in these patients ( 8 ), a marker of aberrant brain development ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

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Disease Severity in Treatment Resistant Schizophrenia Patients Is Mainly Affected by Negative Symptoms, Which Mediate the Effects of Cognitive Dysfunctions and Neurological Soft Signs

et al. 2018

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This post-hoc study was aimed at assessing whether disease severity was higher in a sample of Treatment Resistant Schizophrenia patients (TRS) compared to schizophrenia patients responsive to antipsychotics (non-TRS). Determinants of disease severity were also investigated in these groups. Eligible patients were screened by standardized diagnostic algorithm to categorize them as TRS or non-TRS. All patients underwent the following assessments: CGI-S; PANSS; DAI; NES; a battery of cognitive tests. Socio-demographic and clinical variables were also recorded. TRS patients exhibited significantly higher disease severity and psychotic symptoms, either as PANSS total score or subscales' scores. A preliminary correlation analysis ruled out clinical and cognitive variables not associated with disease severity in the two groups. Hierarchical linear regression showed that negative symptoms were the clinical variable explaining the highest part of variation in disease severity in TRS, while in non-TRS patients PANSS-General Psychopathology was the variable explaining the highest variation. Mediation analysis showed that negative symptoms mediate the effects of verbal fluency dysfunctions and high-level neurological soft signs (NSS) on TRS' disease severity. These results show that determinants of disease severity sharply differ in TRS and non-TRS patients, and let hypothesize that TRS may stem from cognitive disfunctions and putatively neurodevelopmental aberrations.

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“…Os pacientes com ERT mostram desempenhos cognitivos mais comprometidos, como também maior comprometimento nos marcos funcionais da vida cotidiana em comparação aos pacientes que respondem ao tratamento. Notavelmente, os pacientes com ERT sofrem de sintomas negativos mais graves do que os pacientes não ERT, como também, correm maior risco de desemprego, falta de moradia, agressão, prisão, abuso de substâncias, violência e suicídio, representando um imenso desafio para o paciente, seus familiares e cuidadores (Iasevoli et al, 2018).…”

Section: Resistência Ao Tratamento Antipsicótico Habitual (Esquizofrenia Resistente Ao Tratamento -Ert) E Clozapinaunclassified

Sobrecarga dos cuidadores na esquizofrenia: relação com a sintomatologia, funcionamento social do paciente e satisfação com o tratamento medicamentoso

Sarno¹,

Scapaticio²

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Clinical evaluation of functional capacity in treatment resistant schizophrenia patients: Comparison and differences with non-resistant schizophrenia patients

Cited by 17 publications

References 66 publications

Brain structural correlates of functional capacity in first-episode psychosis

Brain structural correlates of functional capacity in first-episode psychosis

Disease Severity in Treatment Resistant Schizophrenia Patients Is Mainly Affected by Negative Symptoms, Which Mediate the Effects of Cognitive Dysfunctions and Neurological Soft Signs

Sobrecarga dos cuidadores na esquizofrenia: relação com a sintomatologia, funcionamento social do paciente e satisfação com o tratamento medicamentoso

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