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Biomedical subjects

E Daneluzzo

Publications and source records attributed to E Daneluzzo.

At least 19 recordsLinked to original sources

PANSS factors and scores in schizophrenic and bipolar disorders during an index acute episode: a further analysis of the cognitive component.

To investigate the factor structure of psychotic symptoms, we compared the clinical characteristics of manic patients with those of schizophrenic patients evaluated with positive and negative syndrome scale (PANSS). The clinical symptoms of 148 bipolar patients and 86 schizophrenic patients hospitalized for an index psychotic episode were assessed. Schizophrenic patients showed more positive and cognitive symptoms than bipolars. The factor analysis of the two PANSS scores showed a three-factor solution with 'positive', 'negative' and 'mixed' depressive-activated factors for bipolars and 'positive', 'negative' and 'depressive' factors for schizophrenics. In both groups, the 'cognitive cluster' loaded on the first 'positive' factor while the 'lack of insight' (LOI) has a different meaning in the two groups, more related to the positive symptoms in the bipolar patients and more related to the negative symptoms in the schizophrenic patients. This finding suggests that LOI could be a non-unitary phenomenon in psychoses and it should be further explored to better elucidate differences in symptom structures between schizophrenic and bipolar disorders.

Acute Disease↗

Educational level and age influence spatial working memory and Wisconsin Card Sorting Test performance differently: a controlled study in schizophrenic patients.

The influence of educational level and age on executive function, as evaluated by the Wisconsin Card Sorting Test (WCST), and 'working memory,' as evaluated by means of a visual-manual delayed-response task, has been investigated in 25 schizophrenic patients and 35 healthy controls matched for age. Different patterns of correlations between educational level, age and cognitive variables were seen for the 'working memory' task but not for the WCST. No significant correlations between the WCST and the 'working memory' task indexes have been observed. Based on multivariate analyses, poor performance of schizophrenic patients on working memory and executive function tasks was observed; after covarying for the educational level, group differences were no longer significant for executive functions, but the difference in 'working memory' performance persisted. The implications of sociodemographic variables as well as the role of statistical manipulation are evaluated and their differential impact on 'working memory' and executive functions is proposed in further support of these neurocognitive constructs that may be dissociable.

Adolescent↗

A factor analysis of signs and symptoms of the manic episode with Bech-Rafaelsen Mania and Melancholia Scales.

BACKGROUND: Several factor analyses of signs and symptoms of mania have been reported using different rating scales. We propose here that the use of two instruments well known in the European literature may be useful in detecting the structure of manic episodes. METHOD: We investigated the pattern of symptoms in a group of 124 bipolar inpatients hospitalised for a manic episode. We conducted a factor analysis of the broad range of psychiatric symptoms covered by the Bech-Rafaelsen Mania Scale (BRMaS) and Melancholia Scale (BRMeS). RESULTS: Five eigen values were greater than unity, which determined the number of factors computed. The five factors captured 66.7% of the total variance. Following rotation, five factors were clinically relevant. CONCLUSION: This suggests that both euphoric activation and depression are prominent in this sample.

Bipolar Disorder↗

Behavioral neurodevelopment abnormalities and schizophrenic disorder: a retrospective evaluation with the Childhood Behavior Checklist (CBCL).

This study is a retrospective report of childhood and adolescence neurobehavioral assessment in patients with schizophrenia and their healthy siblings using the Childhood Behavior Checklist (CBCL). The CBCL ratings were obtained from retrospective maternal reports, for five age periods (birth to 3years, 4-7years, 8-11years, 12-15years and 16-18years) in a sample of 32 patients with schizophrenia. The patients showed a variety of childhood and adolescence behavioral problems when compared with their siblings, and the various types of problems differed in the developmental course of the disease. Cluster analysis was conducted on the childhood premorbid behavior ratings for the schizophrenic patients, and two subgroups emerged: a cluster with an initially low level of behavioral abnormalities (B.A. ) that increased over the years, and a cluster with a high level of B.A. that remain relatively stable until early adulthood. The latter group showed more severe current negative symptoms.

Adolescent↗

Processing of context information in schizophrenia: relation to clinical symptoms and WCST performance.

Failure in contextual information processing has been hypothesized as being the single function responsible for several impairments in cognitive tasks and symptoms, through an involvement of the prefrontal cortex, in patients with schizophrenia. A variant of the Continuous Performance Test (CPT) designed specifically to elicit deficits in the processing of contextual information has been administered to 20 schizophrenic patients and 20 healthy controls. The relation to Wisconsin Card Sorting Test (WCST), relatively specific to prefrontal damage and executive dysfunctioning, and clinical status by using scales for the assessment of positive, negative symptoms and outcome has been investigated. The data show that multi-episode schizophrenic patients manifest inability to use contextual information to inhibit habitual response to an ambiguous stimulus and to maintain information across delay, without a general attention deficit. We also found a relationship between contextual reasoning and WCST unique errors, hallucinations, formal thought disorders, and outcome evaluation. Our results further support the hypothesis that the deficit of contextual reasoning could account for cognitive impairments and symptoms of patients with schizophrenia.

Adult↗

Cognitive symptoms of mania in pure and mixed episodes evaluated with the Positive and Negative Syndrome Scale.

To investigate the clinical specificity of mixed affective patients, we compared the clinical characteristics of pure manic patients with those of mixed manic patients. The clinical symptoms of 146 bipolar inpatients hospitalized for a manic episode were assessed by means of the Positive and Negative Syndrome Scale. Mixed patients showed more positive and cognitive symptoms and among these the lack of judgement and insight was prominent. Further studies are needed to clarify the specificity of lack of insight of the mixed bipolar patients.

Adult↗

Awareness of illness and outcome in schizophrenia.

The purpose of the present study was to investigate whether awareness of illness affects specific measures of outcome in schizophrenia. Patient awareness was evaluated using a shortened version of the Scale to Assess Unawareness of Mental Disorder (SUMD). Patient outcome was assessed by means of the Strauss-Carpenter scale. Our findings indicate that lack of awareness of "negative symptoms" has a considerable impact on outcome: in fact "Social Contacts" highly correlated with Blunt Affect, Anhedonia and Asociality items on the SUMD. Lack of awareness seems then to be a powerful predictor of poor outcome.

Adult↗

Neuromorphological abnormalities in schizophrenic patients with good and poor outcome.

OBJECTIVE: The present study was designed specifically to assess the relationship between brain morphology and outcome in schizophrenia. METHOD: Fifty-six schizophrenic patients and a matched group of 32 healthy subjects were studied with magnetic resonance (MR) imaging scans. Clinical assessment included the Krawiecka-Manchester Scale (K-MS) and the Outcome scale by Strauss and Carpenter. RESULTS: Along several neuromorphological measures the patients differed from controls only for right and left ventricular volumes. The 'poor outcome' patients had a left and right ventricular enlargement when compared to the 'good outcome' patients and healthy controls. A regression analysis showed that right ventricle volume, left temporal lobe volume and left hippocampal volume entered into the regression equation, accounting for a 27% of the outcome measure. CONCLUSION: The outcome does not seem to be predicted by one particular morphological site but involves different brain regions; however, the ventricular enlargement identifies a subgroup of patients with poor outcome.

Adult↗

The cognitive bias task (CBT) in healthy controls: a replication study.

Contextual processing is the selection and bringing "on-line" of internal representations of a task that can be used in planning and mediating goal-appropriate behavioral responses and is a relevant issue that probably is involved in many neurological and psychiatric conditions. The Cognitive Bias Task is a measure of context-dependent responding, is sensitive to quadrant-lesion effects, and interacts with gender. The goal of this study was to replicate and detail more completely the method of context-dependent processing for healthy control patients on the Cognitive Bias Task. The results show the presence of three different cognitive patterns that could biases the response of control patients: context-independent, context-dependent, and mixed. Gender, but not handedness, significantly influences contextual processing, with more females than males producing a context-independent pattern of responding. Test results and the relation of contextual processing in psychiatric disorders were discussed.

Adult↗

Spatial working memory assessment by a visual-manual delayed response task: a controlled study in schizophrenia.

'Working memory' dysfunction has been proposed as a central cognitive feature in schizophrenia. To further explore this issue we developed a computerized easy and fast to administer test using the standard keyboard as visual-manual subject-computer interface along a delayed-response paradigm. The test has been administered to 25 patients who met the DSM-III-R criteria for schizophrenia and 25 healthy control subjects matched as possible for sex. The data confirm the visuo-spatial 'working memory' dysfunction in schizophrenic patients. The test maintains the discriminative capacity of similar previously devised tasks with the advantages of being usable on almost every standard computer and shorter and more acceptable for severely disabled patients also. The test can be considered an useful tool to study the 'working memory' impairment in the cognitive deficit of schizophrenia.

Adult↗

Schizophrenic patients use context-independent reasoning more often than context-dependent reasoning as measured by the cognitive bias task (CBT): a controlled study.

The processing of context is a relevant issue that is probably involved in many neurological and psychiatric conditions. Contextual reasoning is conceived as selection and bringing 'on line' internal representations of the tasks that can be used to mediate goal-appropriate behavioral responses. Impairment in contextual reasoning is thought to play a key role in the pathophysiology and symptom formation of schizophrenia. The Cognitive Bias Task (CBT) has recently been designed and is thought to activate contextual reasoning. A study for applying this method to schizophrenic patients and healthy control subjects has been carried out. The data show that a large percentage of the schizophrenic subjects (87.5%) do not use a context-dependent procedure for reasoning. There was a gender difference in CBT performance in the healthy control group, with more females than males using a context-independent procedure, but not in patients. These findings appear to be in agreement with the body of literature supporting the hypothesis that schizophrenic patients utilize a more uneconomic data-driven information-processing procedure. The study of contextual reasoning seems to allow the identification of a fundamental cognitive process and/or crucial regions or circuits that further research could demonstrate parsimoniously account for large parts of the heterogeneous cognitive deficits of schizophrenia.

Adult↗

No implication of apolipoprotein E polymorphism in Italian schizophrenic patients.

Numerous studies have provided evidence for a genetic association of the Apolipoprotein E (ApoE) epsilon4 allele and late onset familial and sporadic Alzheimer's disease (AD). Clinical observations show that a proportion of schizophrenic patients may suffer from severe cognitive impairment. That could reflect a particular clinical aspect of this mental disorder or a common, yet unknown, neurodegenerative mechanism. We analysed the ApoE gene polymorphism in a sample of 69 Italian patients with schizophrenia, 140 AD patients and 121 controls. In schizophrenic patients, the distribution of ApoE genotypes does not significantly differ from that of controls. No effect of the ApoE genotype on age of onset was found. The frequency of ApoE alleles in Italian schizophrenic patients is comparable with control values, suggesting that ApoE polymorphism does not represent a risk factor for schizophrenia.

Age of Onset↗

Association between striatal reduction and poor Wisconsin card sorting test performance in patients with schizophrenia.

Several findings support the hypothesis that the striatum is implicated in executive functions and in the modulation of goal-directed behavior, and could play a key role in the pathophysiology and in the production of symptoms and signs in schizophrenia. We have studied the relationship between the objective measures of the striatal structures, as evaluated by magnetic resonance imaging (MRI), and the Wisconsin Card Sorting Test (WCST) performance in a schizophrenic sample. Thirty-five schizophrenic patients underwent MRI scans of striatal structure and neuropsychological evaluation of executive functions by WCST. Poor WCST performers had a reduction of the left caudate nucleus and putamen, and right total striatum when compared to 24 healthy controls. Significant correlation coefficients were also observed between neuropsychological indexes and left striatal measures. The findings suggest the existence of a relationship between abnormalities of striatal structure and abnormal executive-type or organizational cognitive functions.

Adult↗

Is Wisconsin Card Sorting Test performance related to 'working memory' capacity?

The Wisconsin Card Sorting Test (WCST) is a multifactorial and complex test, and it involves so many different kinds of functions that it is difficult to understand why patients fail. Capacity of 'working memory' is possibly involved in the WCST performance and is considered a relevant factor responsible for the schizophrenics' poor performance. The present study was specifically designed to assess the relationship between 'working memory' measurements and WCST performances of schizophrenics. Furthermore, we investigated the relationship between the cognitive dysfunction and the clinical symptomatology. The following tests were administered to 30 schizophrenics and 25 healthy subjects: WCST, Digit Span Test (Backward and Forward), Digit Symbol Substitution Test and Visuo-Spatial 'working memory' Test, a card test appropriately devised. Clinical assessment included the Italian version of the scale of Krawiecka Manchester Scale (K-MS) and the Outcome scale by Strauss and Carpenter (1972). The 30 patients differed significantly in all the neuropsychological variables from the controls. WCST indexes did not correlate significantly with any of the 'working memory' measures (visuo-spatial and verbal) in the samples studied. No relationship was seen between the neuropsychological performances and clinical symptomatology as evaluated by the K-MS scale. WCST indexes and DSST significantly correlated with the outcome measure. The results do not support the hypothesis that executive dysfunction as evaluated by WCST is attributed to 'working memory' impairment, rather they could suggest that these two neuropsychological functions identify different neurocognitive constructs.

Adult↗

No deficit in Wisconsin Card Sorting Test performance of schizophrenic patients' first-degree relatives.

The Wisconsin Card Sorting Test (WCST) was administered to 92 schizophrenic patients, 25 first-degree relatives and 60 normal subjects in order to investigate whether this task could be considered a trait marker of vulnerability to schizophrenia. The schizophrenic patients performed significantly worse than either their relatives or normal subjects, but unaffected relatives did not differ from controls. Our results suggest that WCST performance is more likely a feature inherent to the disease process rather than an index of the genetic susceptibility to the illness.

Adult↗

Wisconsin card sorting test and Stroop test performance in schizophrenia: a shared construct.

The Wisconsin card sorting test (WCST) and Stroop test were administered to 25 schizophrenic patients in order to better identify and understand more specific processing mechanisms involved in executive dysfunctions and to investigate their hypothetical involvement in symptom formation. Data show that for as much as the two tests employed measured executive functions in terms of mental control and cognitive flexibility, our findings seemed to indicate shared or interconnected mechanisms. No correlations were seen between the psychopathological evaluation and any of the neuropsychological indexes. The use of the Stroop task could provide a more readily cognitive analysis in terms of specific processing mechanisms, at the basis of WCST impairment in schizophrenia.

Adult↗