- MeSH
- endofenotypy MeSH
- kognitivní dysfunkce etiologie patofyziologie patologie MeSH
- lidé MeSH
- psychosociální intervence metody MeSH
- schizofrenie * diagnóza patofyziologie patologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- exekutivní funkce MeSH
- kognitivní remediace * metody MeSH
- lidé MeSH
- schizofrenie * patologie rehabilitace terapie MeSH
- software MeSH
- učení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
Úvod. Identifikace jedinců ve vysokém riziku rozvoje psychotického onemocnění může pomoci v prevenci vzniku onemocnění. Cíle. Popsat základní psychometrické vlastnosti české verze dotazníku The Prodromal Questionnaire- Brief Version (PQB) a prevalenci výskytu symptomů rizika rozvoje psychózy u českých adolescentů. Soubor a metody. PQB byl předložen studentům pražských škol (gymnázia, střední odborná učiliště-SOU a střední odborné školy–SOŠ) ve věku 15–20 let. PQB se skládá s 21 otázek. Celkový skór ≥ 8 pozitivních položek byl nastaven jako prahový pro pozitivní screening (PQB+), celkový skór ≥ 8 položek, vyvolávajících signifikantní distres pro PQB distres+ a celkový skór ≥ 24 pro PQB celkový distres +. Statistická analýza. Pro testování psychometrických vlastností PQB byl použit Cronbachův koeficient α, položková analýza a explorační faktorová analýza. Rozdíly v PQB mezi skupinami (pohlaví, typ školy, věk) byly exploračně testovány pomocí Fisherova přesného testu, Mann-Whitneyho testu, Pearsonova chí-kvadrát testu a neparametrického Kruskal-Wallisova testu, dle obvyklých zvyklostí. Výsledky. Analyzována byla data 435 studentů (průměrný věk 17,2 ± 1,0 let). Mezi dotazovanými bylo 249 (54 %) chlapců a 216 (56 %) dívek. Mezi školami byl rozdíl distribuce pohlaví (dívky gymnázium 49 % vs. SOU 87 % vs. SOŠ 31 %; p < 0,001), ale ne v průměrném věku respondentů (p = 0,08). Cronbachovo α pro PQB bylo 0,85. U PQB byla nalezena třífaktorová struktura. Faktor 1 byl sycen 7 položkami (faktorová zátěž 0,444–0,729; Cronbachova α = 0,81), faktor 2 tvořilo 6 položek (faktorová zátěž 0,404–0,721; α = 0,73) a faktor 3 se skládal ze 4 položek (faktorová zátěž 0,313 – 0,618; α = 0,65). Z celkového souboru bylo 204 (44 %) studentů PQB+, 44 (9 %) PQB distres + a 174 (37 %) studentů PQB celkový distres+. Záchyt u dívek byl častější než u chlapců. Omezení studie. Ve studovaném souboru jsou pouze studenti středních škol v Praze, což limituje přenositelnost výsledků na celou Českou republiku.
Background. Identification of individuals at high risk of psychotic disorder can help to prevent onset of the disorder. Objectives. To examine both psychometric characteristics of the Czech version of The Prodromal Questionnaire Brief Version (PQB) and prevalence of risk symptoms for psychosis among Czech adolescents. Sample and methods. The PQB was administered to a sample of students in Prague (grammar and secondary vocational schools-SVS and apprentice training centers-ATC) aged 15–20 years. The PQB consists of 21 items. The cut-off score for positive screening (PQB+) was set as ≥ 8 items, the cut-off score ≥ 8 positive symptoms with significant distress was set for PQB distress + and the cut-off score ≥ 24 for total distress for PQB total distress +. Statistical analysis. Cronbach α, item analysis and exploratory factor analysis were used for reliability estimation of the PQB. Exploratory analyses using Fisher,s exact test, Mann-Whitney test, Pearson chi square test, and Kruskal- Wallis test were used as appropriate for testing between group differences in the PQB scores. Results. Data from 435 students were analyzed (mean age 17.2 ± 1.0 years). Sample consisted of 249 males (54%) and 216 females (46%). Sex distribution among schools differed (female, grammar schools 49% vs. ATC 87% vs. SVS 31%, p<0.001), but age distribution did not (p=0.08). Cronbach α of the PQB was 0.85, and three-dimensional factor structure was found. Factor 1 was made up of 7 (factor load 0.444–0.729; Cronbach α=0.73), factor 2 of 6 (factor load 0.404–0.721; α=0.73), and factor 3 of 4 items (factor load 0.313– –0.618; α=0.65). 204 subjects in the total sample were PQB+ (44%), 44 were PQB distress+ (9%) and 174 were PQB total distress + (37%). Study limitation. Generalization of study results is limited, since only students from Prague high schools were assessed.
Background: Neuroactive steroids (NAS) affect neurotransmitter systems and cognition; thus, they play role in etiopathogenesis of psychiatric disorders. Aims: The primary aim was to examine cognition and effects of NAS on cognitive functioning in first-episode psychosis patients and in their healthy siblings. The secondary aims were to verify whether cognitive deficit is an endophenotype of psychosis and whether higher NAS levels represent a high-risk factor for psychosis. Methods: Studied participants were 1) patients with first episode of psychosis, 2) healthy siblings of the patients, and 3) matching healthy controls. Study procedures included administration of a battery of neuropsychological tests assessing six cognitive domains and examination of NAS plasma levels [cortisol (CORT), 11-deoxycorticosterone (DOC), testosterone (TEST), dehydroepiandrostendione (DHEA), dihydrotestosterone (DHT), and progesterone (PROG)]. Results: A total of 67 subjects were analyzed (16 patients, 22 siblings, and 29 controls). Significant group differences were found in most of the cognitive domains; the patients had the lowest scores. The Kruskal-Wallis test revealed significant group differences in CORT levels (p < 0.01), TEST (p < 0.01), and DHT (p < 0.001); no difference was found in PROG, DHEA, and DOC. All cognitive domains, except for attention, were affected by the NAS levels. CORT levels of patients correlated with speed of processing (r = 0.55) and working memory (r = 0.52), while PROG levels correlated with abstraction (r = -0.63). In siblings, there was a negative correlation between TEST levels and verbal memory (r = -0.51) and PROG with attention (r = -0.47). Conclusions: Our results verified that individual domains of cognitive deficit (abstraction and verbal memory) can be considered as an endophenotype of psychosis. Higher levels of cortisol and testosterone in siblings are consistent with high-risk states for psychosis. Multiple interactions between NAS and cognitive functioning, particularly memory functions, were observed. Study limitations (small sample size and administration of antipsychotic medication) did not allow us to establish unequivocally NAS as an endophenotype.
- Publikační typ
- časopisecké články MeSH
The character of cognitive deficit in schizophrenia is not clear due to the heterogeneity in research results. In heterogeneous conditions, the cluster solution allows the classification of individuals based on profiles. Our aim was to examine the cognitive profiles of first-episode schizophrenia spectrum disorder (FES) subjects based on cluster analysis, and to correlate these profiles with clinical variables and resting state brain connectivity, as measured with magnetic resonance imaging. A total of 67 FES subjects were assessed with a neuropsychological test battery and on clinical variables. The results of the cognitive domains were cluster analyzed. In addition, functional connectivity was calculated using ROI-to-ROI analysis with four groups: Three groups were defined based on the cluster analysis of cognitive performance and a control group with a normal cognitive performance. The connectivity was compared between the patient clusters and controls. We found different cognitive profiles based on three clusters: Cluster 1: decline in the attention, working memory/flexibility, and verbal memory domains. Cluster 2: decline in the verbal memory domain and above average performance in the attention domain. Cluster 3: generalized and severe deficit in all of the cognitive domains. FES diagnoses were distributed among all of the clusters. Cluster comparisons in neural connectivity also showed differences between the groups. Cluster 1 showed both hyperconnectivity between the cerebellum and precentral gyrus, the salience network (SN) (insula cortex), and fronto-parietal network (FPN) as well as between the PreCG and SN (insula cortex) and hypoconnectivity between the default mode network (DMN) and seeds of SN [insula and supramarginal gyrus (SMG)]; Cluster 2 showed hyperconnectivity between the DMN and cerebellum, SN (insula) and precentral gyrus, and FPN and IFG; Cluster 3 showed hypoconnectivity between the DMN and SN (insula) and SN (SMG) and pallidum. The cluster solution confirms the prevalence of a cognitive decline with different patterns of cognitive performance, and different levels of severity in FES. Moreover, separate behavioral cognitive subsets can be linked to patterns of brain functional connectivity.
- Publikační typ
- časopisecké články MeSH
The current evidence of cognitive disturbances and brain alterations in schizophrenia does not provide the plausible explanation of the underlying mechanisms. Neuropsychological studies outlined the cognitive profile of patients with schizophrenia, that embodied the substantial disturbances in perceptual and motor processes, spatial functions, verbal and non-verbal memory, processing speed and executive functioning. Standardized scoring in the majority of the neurocognitive tests renders the index scores or the achievement indicating the severity of the cognitive impairment rather than the actual performance by means of errors. At the same time, the quantitative evaluation may lead to the situation when two patients with the same index score of the particular cognitive test, demonstrate qualitatively different performances. This may support the view why test paradigms that habitually incorporate different cognitive variables associate weakly, reflecting an ambiguity in the interpretation of noted cognitive constructs. With minor exceptions, cognitive functions are not attributed to the localized activity but eventuate from the coordinated activity in the generally dispersed brain networks. Functional neuroimaging has progressively explored the connectivity in the brain networks in the absence of the specific task and during the task processing. The spatio-temporal fluctuations of the activity of the brain areas detected in the resting state and being highly reproducible in numerous studies, resemble the activation and communication patterns during the task performance. Relatedly, the activation in the specific brain regions oftentimes is attributed to a number of cognitive processes. Given the complex organization of the cognitive functions, it becomes crucial to designate the roles of the brain networks in relation to the specific cognitive functions. One possible approach is to identify the commonalities of the deficits across the number of cognitive tests or, common errors in the various tests and identify their common "denominators" in the brain networks. The qualitative characterization of cognitive performance might be beneficial in addressing diffuse cognitive alterations presumably caused by the dysconnectivity of the distributed brain networks. Therefore, in the review, we use this approach in the description of standardized tests in the scope of potential errors in patients with schizophrenia with a subsequent reference to the brain networks.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Schizofrenie je závažným duševním onemocněním, které nejčastěji postihuje osoby v mladém a produktivním věku. Tato nemoc narušuje každodenní fungování nemocných, jejich sociální vztahy, a může vést až k trvalé invaliditě. Ve většině případů se již několik let před nástupem onemocnění rozvíjí prodromální fáze charakteristická prohlubováním neurobiologických změn. Ty se na behaviorální úrovni projevují v myšlení, prožívání, emotivitě či komunikaci. Jedním z přístupů, jak včas zachytit rozvíjející se onemocnění, je vyšetření přítomnosti tzv. bazálních symptomů u osob, které vyhledaly psychiatrickou pomoc. Osoby, u nichž se tyto symptomy vyskytují, vyka-zují vyšší riziko pro rozvoj psychotického onemocnění. Díky včasné detekci těchto symptomů je možné pozitivně ovlivnit další průběh nemoci. Cílem tohoto textu je představit české odborné veřejnosti koncept bazálních symptomů a přispět tak k současné diagnostice psychotických stavů. Dílčím cílem je také představení českého překladu semistrukturovaného rozhovoru Škála tendence ke schizofrenii (Schizophrenia Proneness Instrument), který slouží k vyšetření přítomnosti bazálních symptomů. Detailněji budou popsány dvě jeho části: škála kognitivních a škála percepčních bazálních symptomů.
Schizophrenia is a severe mental disorder that often affects young people of productive age. The illness disrupts daily functioning of patients, their social relationships, and can lead to permanent disability. In most cases, several years before the onset of the disease, a prodromal phase develops, which is characterized by proliferation of neurobiological changes. On a behavioral level these changes manifests themselves in cognition, perception, affect, or communication. One approach to early detection of a developing psychotic disease is examination of “basic symptoms” in people who seek psychiatric help. Individuals with basic symptoms are at higher risk for the development of a psychotic illness. Through early detection of basic symptoms, there is a possibility to influence positively the course of the illness. The aim of our paper is to present to the Czech mental health professionals the concept of basic symptoms and to contribute to diagnosis of psychotic disorders. In addition, we also introduce a Czech translation of a semistructured interview called Schizophrenia Proneness Instrument, which is used to examine the presence of basic symptoms. Two scales of this interview are descri-bed in detail: scale of cognitive and scale of perceptual basic symptoms.
- Klíčová slova
- bazální symptomy, Škála tendence ke schizofrenii,
- MeSH
- behaviorální symptomy diagnostické zobrazování diagnóza klasifikace MeSH
- časná diagnóza MeSH
- kognitivní poruchy MeSH
- lidé MeSH
- percepční poruchy MeSH
- prodromální symptomy * MeSH
- psychiatrické posuzovací škály MeSH
- psychotické poruchy diagnóza MeSH
- schizofrenie * diagnóza patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
