Search

La pair-aidance repose sur l'apport de personnes ayant expérimenté le rétablissement de troubles psychiques à d'autres personnes qui font face à de tels troubles. L'adhésion renvoie aux facteurs psychosociaux qui interviennent sur l'observance, c'est-à-dire le suivi d'un traitement prescrit, des conseils et des règles hygiénodiététiques. Quel impact l'intervention des pair-aidants a-t-elle sur l'observance médicamenteuse ? Cette étude répond à cette question à travers une description des pratiques professionnelles des pair-aidants dans ce domaine. Une enquête a été diffusée aux personnes exerçant la pair-aidance en santé mentale en France, quels que soient leur mode d'exercice ou leur formation. Elle a porté sur leur pratique en matière de traitements psychopharmacologiques et d'adhésion médicamenteuse, sur leur formation de pair-aidant, leurs conditions d'exercice et leurs missions, ainsi que sur leur vécu personnel en termes de prise de médicaments psychopharmacologiques et d'effets indésirables. Cent quarante-deux sujets ont participé à l'enquête, dont 47,9 % ont suivi une formation dans le passé, 28,2 % en suivent actuellement une et 23,9 % n'en ont pas suivi. Parmi ceux qui ont suivi une formation, 55,9 % ont obtenu le diplôme universitaire de pair-aidance de l'université Lyon 1 et 32,4 % la licence parcours médiateur de santé pair de l'université Paris 13. L'adhésion médicamenteuse a été abordée dans la formation de 36,8 % des participants. Parmi les 142 participants, 54,9 % estimaient avoir des connaissances sur le sujet et 81 % souhaitaient s'y former. Dans leur pratique professionnelle, 69 % des participants considéraient la question du traitement psychopharmacologique ; parmi eux, 48,2 % abordaient celle de l'adhésion médicamenteuse. Aborder les médicaments est lié au statut de la formation, c'est-à-dire que le fait d'avoir bénéficié d'une formation de pair-aidant facilite les échanges en matière d'adhésion médicamenteuse et de connaissances générales portant sur ce domaine. Le métier de pair-aidant se professionnalise depuis peu et les savoirs expérientiels sont maintenant reconnus et valorisés. Les pair-aidants sont envisagés comme des acteurs complémentaires de la prise en charge psychopharmacologique, notamment concernant l'amélioration de l'adhésion au traitement médicamenteux. Il est nécessaire de clarifier leur cadre d'intervention et leurs missions, ainsi que leur formation initiale et continue. Peer support is defined as the contribution of people who have themselves recovered from psychological disorders given to others coping with similar disorders. Adherence refers to the psychosocial factors involved in compliance, i.e., following a prescribed treatment and the associated advice on health and dietary rules. What impact does the intervention of peer helpers have on medication adherence? This study answers this question by describing the professional practices of peer helpers in this field. A survey was sent to people working as peer helpers in mental health in France, regardless of their mode of practice or training. It focused on their practice in terms of psychopharmacological treatments and medication adherence, their training as peer helpers, the conditions of their practice and their missions, as well as their personal experience in terms of taking psychopharmacological medications and any adverse side effects. One hundred and forty-two participants responded to the survey, of whom 47.9% had taken a training course in the past, 28.2% were currently taking one and 23.9% had not. Of those who had received training, 55.9% had obtained a university diploma in peer support from the University of Lyon 1, and 32.4% a bachelor's degree in peer health mediation from the University of Paris 13. Medication adherence was addressed in the training of 36.8% of the participants. Of the 142 participants, 54.9% felt they knew something about the subject, and 81% wanted to learn more. In their professional practice, 69% of the participants considered the question of psychopharmacological treatment; of these, 48.2% addressed the issue of medication adherence. Addressing medication is linked to their training status, i.e., having benefited from peer-helper training facilitates exchanges on medication adherence and general knowledge in this area. The peer-support profession has just recently become professionalized, and experiential knowledge is now recognized and valued. Peer helpers are complementary players in psychopharmacological care, particularly with regard to improving adherence to medication. We need to clarify the scope of their intervention and missions, as well as their initial and ongoing training. [ABSTRACT FROM AUTHOR]

A first Assessment and Orientation Center (CAdEO) was created in Lyon at the beginning of June 2020 in order to facilitate access to mental health care. This structure allows any person who requests it to access a psychiatric assessment within a few days. It does not implement a follow-up, but it allows the person to be quickly directed towards the structure or the professional, public or private, who will be able to provide the care he or she needs. The CAdEO relies on a multidisciplinary team, which includes psychiatrists, psychologists and nurses (including an advanced practice nurse), in order to provide a adjusted assessment and orientation. It opens from Monday to Friday. The CAdEO, which is located in the city center, works in close partnership with the general practitioners in its health territory, as well as with all the health, medico-social and social services involved in the field of mental health. Among its consultants, about 4 out of 5 people are referred to private practice or associations. One person out of five is referred to other services in the general psychiatric sector, of which the CAdEO is the entry point. [ABSTRACT FROM AUTHOR]

Background: Mental health and well-being were seriously impacted by the COVID-19 lockdown especially among young people and people with psychiatric disorders. This study aimed to identify factors associated with well-being in young people with psychiatric disorders, during early phase of COVID-19 lockdown in France. Methods: A national cross-sectional online study started on the 8th day of COVID-19 lockdown in France (during March 25–30, 2020). We included young people aged from 16 to 29 who responded to the questionnaire, living and being confined in France, with past or current psychiatric treatment. The questionnaire was accessible online and explored demographics and clinical factors, well-being, stress, situation during lockdown. Well-being was measured by the Warwick-Edinburg Mental Well-Being Scale (WEMWBS). Simple and multiple linear regression analyses were carried out. Results: 439 individuals were included with 262 (59.7%) previously treated and 177 (40.3%) currently treated. WEMWBS total score were 42.48 (9.05). Feeling of useful was the most affected dimension. Well-being was positively correlated with: currently working on site, physical activity, abilities to cope with difficulties, family and social supports (p<0.05). It was negatively correlated with: elevated stress level, anxious ruminations, dissatisfaction with information, difficulties to sleep or reorganize daily life, feeling supported by medicines (p<0.05). No individual factor was correlated with well-being. The stepwise linear multivariate model had simple R2 coefficient of determination of 0.535. Conclusion: In the specific population of young people with psychiatric disorders, factors associated with well-being at early stage of lockdown were mainly psychosocial and related to brutal disorganisation of daily life. [ABSTRACT FROM AUTHOR]

While Republican states have been criticized for their limited efforts to contain the spread of COVID-19, it is important to consider that political orientation can modify human behaviour via complex effects that are still poorly understood. During the first period of the pandemic, we found that the association of Republican partisanship with US citizens' mobility varied depending on the nature of the exposure being considered. First, Republican partisanship was associated with increased mobility when the stringency of anti-COVID measures increased. Second, Republican partisanship was associated with decreased mobility when COVID-related deaths increased. Third, Republican partisanship was associated with increased mobility over time, i.e. as time went by, citizens living in Republican states were more mobile than those in Democratic states. These findings raise caution on any over-interpretation of the impact of polarization in US politics on COVID-related behaviour. They prompt consideration of persuasive tools that emphasize risk perception to promote social distancing in Republican states, rather than relying heavily on stringent anti-COVID interventions. [ABSTRACT FROM AUTHOR]

En renforçant le pouvoir de décision et d'action, les outils thérapeutiques de la réhabilitation psychosociale (psychoéducation, remédiation cognitive, thérapie cognitive et entraînement des compétences sociales) sont favorables au rétablissement des personnes ayant des troubles psychiques. La posture soignante adoptée doit être propice à l'autodétermination. Le plan de soin de réhabilitation psychosociale est construit selon les besoins et les objectifs propres à la personne accompagnée. Il s'appuie sur une évaluation multidisciplinaire destinée à mettre en évidence les capacités, les limitations et les éventuels obstacles à la réussite du projet. Afin de pouvoir instaurer une relation thérapeutique positive et de pouvoir recourir à la nécessaire technicité, les professionnels de santé mentale qui mettent en œuvre la réhabilitation psychosociale ont été spécifiquement formés. Ils doivent faire des liens entre le contenu des séances de réhabilitation psychosociale et les situations concrètes auxquelles la personne concernée est confrontée pour que les bénéfices de la prise en charge puissent se transférer dans son quotidien et se généraliser. Psychosocial rehabilitation empowers people to make decisions and take action. This effect favors the self-determination of people with mental disorders and, consequently, their recovery. To do so, it relies on specific therapeutic tools and a specific caregiving posture. Cognitive remediation, psychoeducation, social skills training and/or behavioral and cognitive therapy can be proposed according to the needs and objectives of the person, after a multidisciplinary integrative evaluation that has highlighted his or her capacities, limitations and possible obstacles to the success of his or her own project. Each therapeutic action gives the person new possibilities to overcome these obstacles. The caregivers implementing psychosocial rehabilitation must be committed and trained, which is a guarantee of a positive therapeutic relationship and a necessary technicality. They support the construction of the person's recovery plan, by co-constructing the person's personalized psychosocial rehabilitation project. They establish links between the content of the therapeutic sessions and the person's daily life, in order to promote the generalization and transfer of benefits. [ABSTRACT FROM AUTHOR]

In high-functioning autism, deficits in emotional processing and theory of mind are relevant to understanding the particularities of social functioning. Here we used a multiple baseline and ABA single-case design to assess the efficacy of an individualized social cognitive training program using both pen-and-paper and computerized materials for an 18-year old patient. After the treatment phase, we found significant improvement in both emotional processes and theory of mind. These results provide further significant data showing that therapeutic tools based on digital relational simulation are a promising way for helping people with autism to compensate for their impaired social functioning. [ABSTRACT FROM AUTHOR]

Phenomenologists have provided a detailed description of the disorders of the subjective experience associated with minimal‐self disorders in patients with schizophrenia. Those patients report a range of distortions of their conscious experiences, including a sense of inner void, confusion between self and others, and, sometimes, a disruption of the sense of time. These reports have been interpreted as distortion of the first‐person perspective and a lack of immersion in the world, associated with a breakdown of the temporal structure of consciousness, and especially a disruption of the sense of time continuity. Further, it has been proposed that these disruptions are based on a difficulty to retain past information and to predict future information, that is, the mechanisms that help to relate events with one another and to reach a sense of time continuity. Experimental psychology results seem to converge to similar conclusions, inasmuch as some results in patients with schizophrenia suggest a deficient ability to predict sequences of events at the millisecond level. Several studies have underlined this convergence. Here we reflect on the limits of both the phenomenological and experimental psychology approaches, and of the convergence of their hypotheses. We think that this reflection is necessary to avoid premature conclusions on the mechanisms underlying the impairments in patients, but also to enrich our understanding of schizophrenia. [ABSTRACT FROM AUTHOR]

Abstract: Context: cognitive remediation involves either intensive training of impaired functions or implementing strategies to compensate for these impairments. In cases of schizophrenia, both methods have demonstrated benefits in terms of behavior and cerebral activity. However, despite the major differences between these two approaches, their impact has not yet been compared. Method: We searched the PsychInfo, Pubmed, and ScienceDirect databases using the key words “cognitive remediation,” “schizophrenia,” “cerebral activity,” and “magnetic resonance imaging,” in order to select studies investigating the effects of cognitive remediation on patients with schizophrenia. The studies selected had to present their approach in detail and measure its impact in terms of both cerebral activity and cognitive function, both before and after therapy. We divided the studies into two groups, those using the strategy method and those using the training method. Results: Eight studies were included in the review, four for the strategy method (88 patients, 44 of whom underwent remediation) and 4 for the training method (87 patients, 43 of whom underwent remediation). The analysis of the results of this study indicates that the training method is capable of activating more the targeted brain areas than the strategy method. However, the latter appears to encourage more extensive activation of the cerebral networks. Discussion: The studies used for this review vary widely in terms of the imaging methods and protocol. However, differences were found between the two methods and lead us to suggest that further studies, with proper bias control, should be conducted to systematically compare the two approaches. [ABSTRACT FROM AUTHOR]

Background: The "opioid crisis" has been responsible for hundreds of thousands deaths in the US, and is at risk of dissemination worldwide. Within-country studies have demonstrated that the rise of opioid use disorders (OUD) is linked to increased access to opioid prescriptions and to so-called "diseases of despair". Both have been related to the emergence of globalization policies since the 1980s. First, globalized countries have seen a reorganization of healthcare practices towards quick and easy answers to complex needs, including increased opioid prescriptions. Second, despair has gained those suffering from the mutations of socio-economic systems and working conditions that have accompanied globalization policies (e.g. delocalization, deindustrialization, and the decline of social services). Here, using data with high quality ratings from the Global Burden of Disease database, we evaluated the country-based association between four levels of globalization and the burden of OUD 2019. Results: The sample included 87 countries. Taking into account potential country-level confounders, we found that countries with the highest level of globalization were associated with a 31% increase in the burden of OUD 2019 compared to those with the lowest level of globalization (mean log difference: 0.31; 95%CI, 0.04–0.57; p = 0.02). Additional analyses showed a significant effect for low back pain (mean log difference: 0.07; 95%CI, 0.02–0.12; p = 0.007). In contrast, despite sharing some of the risk factors of OUD, other mental and substance use disorders did not show any significant relationship with globalization. Finally, socio-cultural de jure globalization, which compiles indicators related to gender equality, human capital and civil rights, was specifically associated with the burden of OUD (mean log difference: 0.49; 95%CI: 0.23,0.75; p < 0.001). Conclusions: These findings suggest that OUD may have inherent underpinnings linked to globalization, and more particularly socio-cultural aspects of globalization. Key factors may be increased rights to access prescriptions, as well as increased feelings of despair related to the erosion of local cultures and widening educational gaps. [ABSTRACT FROM AUTHOR]

The different dimensions of recovery (clinical, social, functional) allows us to better understand its definitions and thus to identify obstacles or, conversely, determinants of the recovery process. The study of recovery factors leads to consider several principles that can guide the practices of health professionals: self-determination is the common thread. Practices known as "psychosocial rehabilitation" seem able to support the recovery process, in particular by their willingness and ability to restore, at least in part, the power to act and to choose of the user suffering from severe psychic disorders. Cognitive remediation, a tool that comes from the field of psychosocial rehabilitation, appears to support the recovery of people with cognitive deficits with significant functional impacts. But beyond the creation of innovative practices, it is a territorial organization of these care practices that we need if we are actually aiming at the development of recovery. It is in particular the goal of the Resource Center for Psychosocial Rehabilitation (CRR) to disseminate, train and structure practices and knowledge oriented towards the recovery of the person. [ABSTRACT FROM AUTHOR]

The 22q11.2 deletion syndrome (22q11.2DS) is one of the most common microdeletion syndromes, with a widely underestimated prevalence between 1 per 2000 and 1 per 6000. Since childhood, patients with 22q11.2DS are described as having difficulties to initiate and maintain peer relationships. This lack of social skills has been linked to attention deficits/hyperactivity disorder, anxiety and depression. A high incidence of psychosis and positive symptoms is observed in patients with 22q11.2DS and remains correlated with poor social functioning, anxiety and depressive symptoms. Because 22q11.2DS and schizophrenia share several major clinical features, 22q11.2DS is sometimes considered as a genetic model for schizophrenia. Surprisingly, almost no study suggests the use of cognitive and behavioral therapy (CBT) in this indication. We reviewed what should be learned from schizophrenia to develop specific intervention for 22q11.2DS. In our opinion, the first step of CBT approach in 22q11.2DS with psychotic symptoms is to identify precisely which tools can be used among the already available ones. Cognitive behavioral therapy (CBT) targets integrated disorders, i.e. reasoning biases and behavior disorders. In 22q11.2DS, CBT-targeted behavior disorders may take the form of social avoidance and withdrawal or, in the contrary, a more unusual disinhibition and aggressiveness. In our experience, other negative symptoms observed in 22q11.2DS, such as motivation deficit or anhedonia, may also be reduced by CBT. Controlled trials have been studying the benefits of CBT in schizophrenia and several meta-analyses proved its effectiveness. Therefore, it is legitimate to propose this tool in 22q11.2DS, considering symptoms similarities. Overall, CBT is the most effective psychosocial intervention on psychotic symptoms and remains a relevant complement to pharmacological treatments such as antipsychotics. [ABSTRACT FROM AUTHOR]

Organizing the management of severe mental disorders at the national level is a major challenge given the complexity of the disorders and the diversity of responses needed to address all the needs. A founding principle for the creation or development of measures consists in structuring care programs around functional and personal recovery, and not only clinical recovery. The fact that the French psychiatric field is currently being modernized by its missions being redefined within territorial mental health projects gives the opportunity to generalize these principles. This article illustrates how the creation of a hierarchical organization of psychosocial rehabilitation can (a) give more coherence to the part of the French mental health system, (b) improve the quality of care, and (c) promote social inclusion and recovery of people with severe mental disorders. [ABSTRACT FROM AUTHOR]

Résumé Malgré leur absence de spécificité diagnostique, les troubles cognitifs constituent l’une des caractéristiques centrales des troubles du spectre schizophrénique, du fait de leur fréquence et de leur retentissement. De ce fait, tout patient souffrant de tels troubles devrait pouvoir bénéficier d’une évaluation fonctionnelle pluridisciplinaire comprenant un bilan neuropsychologique. Ce bilan, réalisé en période de stabilité clinique et thérapeutique, permet de décrire le profil cognitif qui est propre à chaque patient et qui peut comprendre des atteintes de la neurocognition (fonctions exécutives, attentionnelles et mnésiques), de la cognition sociale et de la métacognition. Alors que les traitements médicamenteux et psychothérapiques influencent peu les troubles cognitifs primaires, la remédiation cognitive a montré, à travers de nombreux essais contrôlés et plusieurs méta-analyses, son efficacité dans la réduction de ceux-ci, ainsi que de leurs impacts. Différents programmes ciblant certains processus cognitifs spécifiques sont disponibles en langue française. Ces outils de soins non médicamenteux s’appuient sur des tâches rééducatives permettant de renforcer des capacités atteintes ou de compenser leurs altérations par le renforcement des capacités préservées, tout en visant l’impact fonctionnel des déficits cognitifs. La remédiation cognitive vient ainsi compléter l’action des médicaments et de la psychothérapie et apparaît comme un nouvel outil de soin permettant de favoriser le rétablissement des personnes. Cognitive impairments represent a core deficit of schizophrenia spectrum disorders. Cognition is severely impaired in patients with schizophrenia and compromises the recovery process. All patients should have an initial baseline assessment including neuropsychological and medical evaluation. After the initial treatment and stabilization of patients, neuropsychological profile of schizophrenia spectrum disorders regularly shows neurocognitive (attention, memory and cognitive function), social cognitive and metacognitive deficits. While antipsychotic medications and psychotherapy appear to have little effect on primary cognitive impairments, cognitive remediation has shown its effectiveness in reducing the cognitive deficits and their impacts in many controlled trials and meta-analyses. Many programs targeting specific components of cognition are available in French. These non-drug approaches are behavioral training based intervention that aims to improve cognitive processes and functional outcome. Cognitive remediation does not replace medical treatments or certain types of psychotherapy, but complements their effects for promoting people's recovery. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 65-year-old man who was referred due to atypical esophageal neoplastic lesion where a gastroscopy detected a polyp in the mid-esophagus.

Abstract: Background: This study assesses the benefits of an individualized therapy (RECOS program) compared with the more general cognitive remediation therapy (CRT). Methods: 138 participants took part with 65 randomized to CRT and 73 to RECOS. In the RECOS group, participants were directed towards one of five training modules (verbal memory, visuo-spatial memory and attention, working memory, selective attention or reasoning) corresponding to their key cognitive concern whereas the CRT group received a standard program. The main outcome was the total score on BADS (Behavioural Assessment of Dysexecutive Syndrome) and the secondary outcomes were: cognition (executive functions; selective attention; visuospatial memory and attention; verbal memory; working memory) and clinical measures (symptoms; insight; neurocognitive complaints; self-esteem). All outcomes were assessed at baseline (T1), week 12 (posttherapy, T2), and follow-up (week 36, i.e., 6months posttherapy, T3). Results: No difference was shown for the main outcome. A significant improvement was found for BADS' profile score for RECOS at T2 and T3, and for CRT at T3. Change in BADS in the RECOS and CRT arms were not significantly different between T1 and T2 (+0.86, p=0.108), or between T1 and T3 (+0.36, p=0.540). Significant improvements were found in several secondary outcomes including cognition (executive functions, selective attention, verbal memory, and visuospatial abilities) and clinician measures (symptoms and awareness to be hampered by cognitive deficits in everyday) in both treatment arms following treatment. Self-esteem improved only in RECOS arm at T3, and working memory improved only in CRT arm at T2 and T3, but there were no differences in changes between arms. Conclusions: RECOS (specific remediation) and CRT (general remediation) globally showed similar efficacy in the present trial. [Copyright &y& Elsevier]

Abstract: In the context of desinstitutionalisation of the psychiatric care system, the question of the possibility and the limits of the reinsertion of people with severe mental disease has risen. If cognitive science actually contributes, in a functional perspective, to a better understanding of crucial aspects of reinsertion by the identification and treatment of cognitive dysfunctions, others factors can also contribute to a better understanding of reinsertion. Among them, several subjective factors can take place. They can be approached under two ways. The first is rehabilitation: through, for example, aspects as metacognition, insight, self-stigma or motivation. The second way is recovery: the recovery approach, by using generally narrative analysis, contributes to identify human processus of recovery and reinsertion, as hope, sense of agency of the own actions and redefinition of identity. [Copyright &y& Elsevier]

Cognitive sciences research on Schizophrenia has led to the identification of information processing disturbances in Schizophrenia. These cognitive impairments (affecting attention, memory, executive control and social cognition) contribute to the functional outcome and constitute an important factor of social exclusion. They are the specific target of "cognitive remediation", a newly developed therapeutic tool whose rationale is to rehabilitate disturbed cognitive processes and foster preserved processing. Cognitive remediation completes psychotherapy or medication and constitutes an important aspect of rehabilitation programs (alongside with psychoeducation and social skill training). Four programs, each one with specific indications, are currently available (CRT, IPT, RECOS and RehaCom). Further perspectives encompass the development of specific tools (addressing social cognition impairments) and the role of subjective factors (motivation, metacognition…) in determining the outcome of cognitive rehabilitation programs. [ABSTRACT FROM AUTHOR]

Abstract: Lived experiences mentioned by patients with schizophrenia can be addressed with neurocognitive models. In particular, these models allow us to better understand self-consciousness and social cognition impairment that is a core feature of schizophrenia. Abnormal brain functioning related to this impairment has been shown. These data show that these symptoms are related to specific neurocognitive correlates. They shed a new light on the understanding of schizophrenic symptoms. [ABSTRACT FROM AUTHOR]

Abstract: Contemporary experimental research has emphasised the role of centrally generated signals arising from premotor areas in voluntary muscular force perception. It is therefore generally accepted that judgements of force are based on a central sense, known as the sense of effort, rather than on a sense of intra-muscular tension. Interestingly, the concept of effort is also present in the classical philosophy: to the French philosopher Maine de Biran [. Mémoire sur la décomposition de la pensée (Tome III), Vrin, Paris (1963)], the sense of effort is the fundamental component of self-experience, the landmark of the exercise of the will. In the present review, after a presentation of the nature and neurophysiological bases of effort sensation, we will examine its possible involvement in the neurocognitive process of agency. We will further focus on delusions of alien control in schizophrenic patients. Experimental data suggest that these patients have an abnormal awareness of effort caused by cerebral anomalies in the frontal and parietal lobes. [Copyright &y& Elsevier]

Abstract: Impairments in facial affect recognition have been well-established in schizophrenia. Programs of cognitive remediation specifically aiming at correcting these deficiencies are being developed. This paper reviews these programs’ results, and presents a critical perspective on the connections between cognitive remediation and social cognition. [Copyright &y& Elsevier]

Abstract: Schizophrenia is characterized by an altered sense of the reality, associated with hallucinations and delusions. Some theories suggest that schizophrenia is related to a deficiency of the system that generates information about the sensory consequences of the actions realized by the subject. This system monitors the reafferent information resulting from an action and allows its anticipation. In the present study, we examined visual-event-related potentials (ERPs) generated by a sensorimotor task in 15 patients with schizophrenia and 15 normal controls. The visual feedback from hand movements performed by the subjects was experimentally distorted. Behavioral results showed that patients were impaired in recognizing their own movements. The ERP signal in patients also differed from those of control subjects. In patients, the ERP waveform was affected during the early part of the response (200 ms). This early effect in schizophrenic patients reveals a modified processing of the visual consequence of their actions. To cite this article: A. Posada et al., C. R. Biologies 330 (2007). [Copyright &y& Elsevier]

Abstract: We used facial affect labeling and matching tasks to study effects of (1) emotion and (2) identity on facial affect processing in patients with remitted schizophrenia (n=30) compared with healthy controls (n=30). The patients (1) had a specific deficit for labeling facial affects of sadness and anger but not happiness, disgust and fear; they (2) performed as well as controls in matching facial affects in one face but were impaired in matching facial affects in two different faces. The patients'' impairment in facial affect processing may be emotion-specific. The effects of identity on facial affect processing are discussed in the light of several hypotheses (a deficit of context processing, a global–local processing impairment or a selective attention deficit), and may be related to frontal, prefrontal or amygdala dysfunctions. [Copyright &y& Elsevier]

Patients with first-rank symptoms (FRS) of schizophrenia do not experience all of their actions and personal states as their own. FRS may be associated with an impaired ability to correctly attribute an action to its origin. In the present study, we examined regional cerebral blood flow (rCBF) with positron emission tomography during an action-attribution task in a group of patients with FRS. We used a device previously used with healthy subjects that allows the experimenter to modulate the subject''s degree of movement control (and thus action attribution) of a virtual hand presented on a screen. In healthy subjects, the activity of the right angular gyrus and the insula cortex appeared to be modulated by the subject''s degree of movement control of the virtual hand. In the present study, the schizophrenic patients did not show this pattern. We found an aberrant relationship between the subject''s degree of control of the movements and rCBF in the right angular gyrus and no modulation in the insular cortex. The implications of these results for understanding pathological conditions such as schizophrenia are discussed. [Copyright &y& Elsevier]

It has been proposed that an impairment in gaze determination is responsible for the paranoid symptoms reported in schizophrenia. To address this, we examined the gaze discrimination system in schizophrenia. Thirty-two patients suffering from schizophrenia (20 patients with persecutory delusions and 12 patients without such delusions) were compared to 32 control subjects on two specific tasks. In the first task, the subjects had to determine whether 130 portraits were looking right or left. In the second task the subjects were asked to determine whether or not 130 portraits were looking at them.The absolute threshold of difference used to investigate the influence of instruction on gaze discrimination did not show any difference between patients with schizophrenia, whatever paranoid or not, and control subjects. Paranoid patients, as well as controls, displayed a significantly finer discrimination threshold in the right vs. left judgment than in the self vs. non-self judgment. Subjects with schizophrenia were able to discriminate gaze direction in the two tasks, but they took significantly more time in the task requiring to determine the presence or the absence of a mutual gaze contact than in the other one, whereas controls took the same duration to elicit both tasks. These data are consistent with those reporting that perceptual abilities are spared in schizophrenia while delusions are related to an impairment of a higher level of analysis. [Copyright &y& Elsevier]

Schizophrenia is associated with cognitive deficits and information-processing anomalies. Several studies have shown impairments in frontal lobe functions such as discovering rules, adopting strategies and working memory. We have evaluated the performances of schizophrenic patients on three different tasks of information processing. The first was a simple reaction time task, the second consisted of discriminating the color of the stimuli, and the third required the use of a rule of permutation. The schizophrenic patients (n=17) showed a task-dependent increase in time for responses in comparison with the control group (n=17). This increase was particularly important in the last task, which requires the use of the rule. These results confirm and expand the previously described impairment of patients with schizophrenia in the ability to use rules. They are discussed in terms of deficit in executive functions probably due to frontal lobe malfunctioning. [Copyright &y& Elsevier]

Explores defective recognition of one's own actions in patients with schizophrenia. Delusions of influence; Abnormal recognition of one's own actions; Specific impairment of a neural action attribution system; Manifestations characterizing schizophrenia; Factors responsible for misattribution in patients.

Purpose/Objective: In schizophrenia, insight, the recognition that one has a medical illness that requires treatment, has long been related to deteriorated quality of life. Yet, insight and quality of life are broad constructs that encompass several dimensions. Here, we investigated differential associations between insight and quality-of-life dimensions using a psychological network approach. Research Method/Design: We extracted data from the French network of rehabilitation centers REHABase (January 2016 to December 2022, N = 1,056). Our psychological network analysis modeled insight and quality of life as a network of interacting dimensions: three insight dimensions (awareness of illness, reattribution of symptoms to the disease, and recognition of treatment need) and eight quality-of-life dimensions (autonomy, physical and psychosocial well-being, relationships with family, friends and romantic partners, resilience, and self-esteem). Results: Insight was negatively associated with quality of life. Our psychological network analysis revealed a strong negative association between awareness of disease and self-esteem. Both dimensions were the strongest nodes in the overall network. Our network analysis also revealed a significant but positive connection between recognition of treatment needs and resilience. Conclusion/Implications: While insight and quality of life are overall negatively associated, we found both negative and positive connections between insight and quality-of-life dimensions. The negative relationship between insight and quality of life may reflect the deleterious effects of diagnostic labeling on a patient's self-esteem. Yet, acknowledgment of treatment needs may have positive effects on quality of life and may promote recovery, perhaps because it emphasizes the need for support rather than labels and abnormalities. Impact and Implications: As they try to educate their patients with schizophrenia on the nature of their diagnosis, clinicians should be aware of the so-called insight paradox, where increased insight is associated with decreased quality of life. Our findings suggest that rehabilitation treatment interventions aiming to improve quality of life may focus on self-esteem, in addition to helping patients obtain necessary resources and valued roles in society. Our findings also suggest that psychoeducation programs should focus on the need for treatment rather than disease labeling and abnormalities to prevent the deterioration of self-esteem and promote resilience. [ABSTRACT FROM AUTHOR]

Children and adolescents with Williams-Beuren syndrome (WBS) have been described as having specific memory abilities and emotional reactivity. Although it is well established in the literature that emotion can enhance memory, no such studies have been undertaken in individuals with WBS. In three experiments, the present study tested whether the negative or positive emotional valence of stimuli can influence verbal, visual and visuo-spatial memory by specifically evaluating two memory components: item and associative memory. Sixteen 8- to 18-year-old individuals with WBS performed the first two experiments and, among them, twelve participated in the third. They were compared to equivalent groups of typically developing control children. Participants completed intentional-encoding tasks followed by immediate item recognition, associative recall or item recall tasks. Event-related potential measures during encoding and recognition of pictures were also added in the third experiment. Results demonstrated, for the first time, effects of emotions on visual item memory and visuo-spatial associative memory in individuals with WBS, that were similar to those observed in typically developing children. By combining behavioral and neural measures, our study provides new knowledge of the interaction between emotion and memory in WBS individuals, which seems to be unaffected by their atypical development. [ABSTRACT FROM AUTHOR]

Alcohol-related liver disease (ALD) is one of the main indications for liver transplantation (LT). For 20 years, tacrolimus (Tac) is the cornerstone immunosuppressive drug used after LT and is very efficient for the prevention of rejection. Nevertheless, the major drawback of long-term use of Tac is the risk for developing dose-dependent adverse effects. The aim of the present study was to assess the impact of Tac exposure (trough concentrations and concentration/dose (C/D) ratio) during the first year after LT, on short- and long-term complications after LT for ALD. All patients who underwent a LT for ALD at Lyon Edouard Herriot Hospital from October 1990 to September 2010, and who were treated with Tac for at least one year after LT, were analyzed. The study population consisted in 251 patients, mean age 53.4 ± 7.3 years, and followed during 11.6 ± 4.8 years. Post-LT complications included severe infectious events (44.6%), malignancies (41.4%), arterial hypertension (49.4%) dyslipidemia (44.2%), diabetes (18.7%) and cardiovascular events (15.5%). De novo hypertension, cardiovascular event, CMV infection, non-melanoma skin cancers and HCC recurrence after transplantation were significantly associated with higher Tac trough blood concentration. In addition, Tac fast-metabolizers (defined as C/D < 1.8) had significantly more impaired renal function at 1, 5, and 10 years and more cardiovascular events, PTLD, diabetes and hypertension than slow-metabolizers. Our results strongly support that, in addition to blood trough concentrations, Tac metabolism, as estimated by the simple C/D ratio, could be an efficient parameter in daily practice to identify LT patients at risk to develop long term general complications of Tac. • The impact of Tac exposure on complications after LT for ALD was evaluated. • Hypertension, cardiovascular event, CMV infection, skin cancer and HCC recurrence were associated with higher Tac trough blood concentration. • Fast Tac metabolizers (defined as C/D < 1.8) had significantly more renal failure, cardiovascular events, PTLD, diabetes and hypertension. [ABSTRACT FROM AUTHOR]

Left temporoparietal repetitive transcranial magnetic stimulation (rTMS) reportedly diminishes verbal hallucinations. A 21-year-old schizophrenic man, who had killed his mother in the belief that she was a demon, failed to respond to combined treatment with a variety of antipsychotic agents. His persistent hallucinations consisted of two voices (God and the Devil). As an adjunct to continued antipsychotic medication, the patient received a course of rTMS: 10 sessions of 1-Hz stimulations near Wernicke''s area. After rTMS, the patient''s hallucinations grew less intrusive and he no longer required isolation. Although the improvement could be a delayed effect of medication, further trials of rTMS in cases of this type appear justified. [Copyright &y& Elsevier]

Objective: Identifying specific insight and/or metacognitive measures predicting vocational outcomes would lead to a refinement of cognitive and behavioral assessment and treatment of people with severe mental illness. Methods: We conducted a systematic review of empirical research following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Studies published in PubMed and PsycINFO from January 1, 2000 to April 30, 2020 and including words referring to "vocational outcomes", "insight," and "metacognition" were screened. Results: Twenty-eight studies were included, 19 assessing insight and 9 assessing metacognition and their relationships with vocational outcomes in patients with severe mental illness. Thirteen studies (68%) identified statistically significant relationships between insight scores and vocational outcomes. Five studies (56%) identified statistically significant relationships between metacognition scores or metacognitive training and vocational outcomes. The most common tools whose measures were significantly related to vocational outcomes were the Schedule for the Assessment of Insight, the Scale to assess Unawareness of Mental Disorder and the Metacognition Assessment Scale–Abbreviated. Conclusions and Implications for Practice: Insight and metacognition appeared to be related to the vocational outcomes of people with severe mental illness. However, due to the heterogeneity of variables used to operationalize insight, metacognition, and vocational outcomes, it was not possible to determine the overall effect of insight and metacognition. Nevertheless, assessment including the measures of insight and metacognition would be relevant in vocational rehabilitation centers and in centers providing care through employment. The literature lacks predictive models of employment variables including insight and metacognition, so further studies should address this. Impact and Implications: Insight and metacognitive levels of people with severe mental illness appeared to be related to their vocational outcomes. Assessment including the measures of insight and metacognition would be relevant in vocational rehabilitation centers and in centers providing care through employment. Further studies should focus on possible predictive relationships between insight/metacognition and the ability to (return to) work of people with severe mental illness. [ABSTRACT FROM AUTHOR]

In schizophrenia, insight, the recognition that one has a medical illness that requires treatment, has long been related to deteriorated quality of life, a phenomenon that has been described as the "insight paradox". Here, we aimed to determine whether certain socio-demographic and clinical characteristics strengthen or weaken this negative relationship. We used data from the French network of rehabilitation centers REHABase (N = 769). We explored mean differences in quality-of-life scores between patients with good insight vs. poor insight. We also explored modifying effects of socio-demographic and clinical characteristics (sex, education, age, functioning, clinical severity, duration of illness). Patients with good insight had a decreased quality-of-life total score. Similar effects were found for the following sub-dimensions of quality of life: autonomy, physical and psychological well-being, and self-esteem. The negative effect of insight on quality of life was attenuated for people who had >12 years of education and for people with a higher level of functioning. By contrast, the negative effect of insight on quality of life was accentuated in people with greater clinical severity. Functioning and clinical severity showed similar modifying effects for other quality-of-life dimensions: autonomy, physical and psychological well-being, and self-esteem. Finally, males demonstrated an increased negative association between insight and self-esteem. The relationship between insight and quality of life is moderated by socio-demographic and clinical circumstances. Future inquiries may utilize our findings by integrating socio-demographic and clinical factors in treatment programs designs to conjointly improve insight and quality of life. [ABSTRACT FROM AUTHOR]

Therapeutic alliance determines medical treatment adherence, the success of psychotherapy, and the effectiveness of care. This systematic review aims at better understanding its determinants. The electronic databases Pubmed, Cochrane Library, and Web of Science were searched, using combinations of terms relating to psychosis and therapeutic alliance. Studies were selected and data were extracted using a PRISMA statement. Forty-one studies were selected, including 20 cross-sectional studies, 10 cohort studies, five randomized controlled trials, four literature reviews, and two retrospective studies. The quality of therapeutic alliance correlates with clinical symptoms, insight, social and family support, the therapist's qualities, the availability of shared therapeutic decision making, and the types of hospitalization. Although current evidence needs to be completed with further studies, it is already clear that group and family psychoeducation, cognitive remediation, community-based psychiatric services, and shared therapeutic decision making are essential approaches in the management of patients with psychosis. [ABSTRACT FROM AUTHOR]

Background: Cognitive biases are recognized as important treatment targets for reducing symptoms associated with severe mental disorders. Although cognitive biases have been linked to symptoms in most studies, few studies have looked at such biases transdiagnostically. The Cognitive Bias Questionnaire for psychosis (CBQp) is a self-reported questionnaire that assesses cognitive biases amongst individuals with a psychotic disorder, as well as individuals with other severe mental disorders. The current study aims to validate a French version of the CBQp and to explore transdiagnostic cognitive biases in individuals with psychotic disorders, individuals with depression, and in healthy controls. Methods: The CBQp was translated into French following a protocol based on international standards. Discriminant validity and internal consistency were determined for total score and each subscale score. Confirmatory factor analyses were performed to test construct validity. Finally, cluster analyses were conducted to investigate cognitive biases across diagnostic groups. Results: Our results were similar to those of the original authors, with the one-factor solution (assessment of a general thinking bias) being the strongest, but the two-factor solution (assessing biases within two themes relating to psychosis) and the five-factor solution (assessment of multiple distinct biases) being clinically more interesting. A six-cluster solution emerged, suggesting that individuals with similar diagnoses score differently on all cognitive biases, and that individuals with different diagnoses might have similar cognitive biases. Conclusions: The current findings support the validity of the French translation of the CBQp. Our cluster analyses overall support the transdiagnostic presence of cognitive biases. [ABSTRACT FROM AUTHOR]

Abstract: Unique deficits in synthetic metacognition have been found in schizophrenia when compared with other psychiatric conditions and community controls. Although persons with autism spectrum disorders (ASD) display similar deficits in social cognition relative to those with schizophrenia, to date no study has compared metacognitive function between these groups. We aimed to compare the metacognitive capacities of persons with schizophrenia and ASD and their associations with other outcomes (neurocognition, social cognition, depression, and quality of life). Fifty-six outpatients with schizophrenia or ASD (mean age, 32.50 [9.05]; 67.9% male) were recruited from two French Centers of Reference for Psychiatric Rehabilitation of the REHABase cohort. Evaluation included the Indiana Psychiatric Illness Interview, Metacognition Assessment Scale-Abbreviated, Movie for the Assessment of Social Cognition, and a large cognitive battery. Compared with those with schizophrenia, participants with ASD had higher self-reflectivity ( p = 0.025; odds ratio, 1.38 [1.05-1.86]) in univariable analyses. Metacognitive deficits may be found in ASD with a profile that varies from what is found in schizophrenia. It is possible that methods for enhancing metacognitive abilities during psychiatric rehabilitation may be refined to assist adults with ASD to better manage their own recovery. [ABSTRACT FROM AUTHOR]

Background: Cognitive biases are recognized as important treatment targets for reducing symptoms associated with severe mental disorders. Although cognitive biases have been linked to symptoms in most studies, few studies have looked at such biases transdiagnostically. The Cognitive Bias Questionnaire for psychosis (CBQp) is a self-reported questionnaire that assesses cognitive biases amongst individuals with a psychotic disorder, as well as individuals with other severe mental disorders. The current study aims to validate a French version of the CBQp and to explore transdiagnostic cognitive biases in individuals with psychotic disorders, individuals with depression, and in healthy controls. Methods: The CBQp was translated into French following a protocol based on international standards. Discriminant validity and internal consistency were determined for total score and each subscale score. Confirmatory factor analyses were performed to test construct validity. Finally, cluster analyses were conducted to investigate cognitive biases across diagnostic groups. Results: Our results were similar to those of the original authors, with the one-factor solution (assessment of a general thinking bias) being the strongest, but the two-factor solution (assessing biases within two themes relating to psychosis) and the five-factor solution (assessment of multiple distinct biases) being clinically more interesting. A six-cluster solution emerged, suggesting that individuals with similar diagnoses score differently on all cognitive biases, and that individuals with different diagnoses might have similar cognitive biases. Conclusions: The current findings support the validity of the French translation of the CBQp. Our cluster analyses overall support the transdiagnostic presence of cognitive biases. [ABSTRACT FROM AUTHOR]

Résumé Objectifs Les mouvements oculaires sont utilisés à des fins diagnostiques en psychopathologie depuis les années 1980. Ce type d’investigation a montré sa pertinence mais seuls les mouvements de poursuite régulière (i.e. de glissement régulier ou de pistage) ont fait l’objet de procédures expérimentales, que ce soit dans cette discipline, en psychologie cognitive ou encore en ergonomie. Il existe pourtant une deuxième catégorie de mouvements impliqués dans le comportement de changement de direction du regard, les saccades oculaires (passage d’un point de fixation à un autre), qui, elles, n’ont fait l’objet d’aucune investigation scientifique en psychopathologie, à tout le moins en situation d’interaction. Méthode Afin de mesurer la fréquence des saccades oculomotrices dans la dynamique du discours et du dialogue, nous avons mis au point un double système d’enregistrement simultané axé à la fois sur le comportement visio-moteur et sur le comportement verbal. Nous l’avons testé en situation clinique « personne porteuse de schizophrénie–psychologue » comparée à une situation « personne typique–psychologue ». Ces mouvements involontaires de contrôle de l’attention sont eux aussi susceptibles de nous fournir des informations précises en matière de confirmation ou d’anticipation diagnostique mais encore relativement aux stratégies d’adaptation comportementale de l’un et l’autre interlocuteur dans le cours de l’entretien clinique. Résultats Convertis en marqueur d’attention, nos résultats montrent que le nombre de saccades par seconde permet de différencier le comportement interlocutoire des personnes souffrant de schizophrénie à celui des sujets témoins. De même, cet indicateur permet d’apprécier les variations comportementales que l’interlocuteur–psychologue adopte lorsqu’il interagit avec la personne atteinte de schizophrénie ou lorsqu’il interagit avec les sujets témoins. Discussion Tout en étant parfaitement adaptée à la situation clinique, la mesure des saccades oculaires confirme les principaux résultats fournis par les mesures des mouvements oculaires de poursuite linéaire, en particulier au plan diagnostique. Mais le type de mesure que nous avons mis au point permet de plus d’analyser les mouvements comportementaux asymétriques qui opposent le patient à son interlocuteur. Enfin les marqueurs de la variation du comportement attentionnel des interlocuteurs que sont les saccades, pourront être bientôt combinés à l’analyse du déplacement du regard au cours de l’interaction (fixations), puis rapportés à l’analyse des discontinuités discursives et autres spécificités langagières des patients accueillis en psychiatrie. Conclusion Cet article a donc pour principal objectif d’anticiper la mise au point d’une stratégie diagnostique (confirmatoire puis prodromique) et d’analyse clinique nettement plus heuristique que ce dont nous disposons actuellement et qui s’appuiera conjointement sur la modélisation d’attitudes comportementales visuo-motrices associées à la compétence verbale. Aims Eye movements have been used for diagnostic purposes in psychopathology since the 1980s. While this investigation has demonstrated some relevance, only smooth pursuit (regular pursuit or tracking) has been the subject of investigations, whether in this discipline, in cognitive psychology or in ergonomics. Yet there is a second category of movements implicated in charges in eye movement, that is to say saccades (shifting from one fixed point to another), which have not been scientifically investigated in psychopathology, or at least not in situations of interaction. Methods In order to measure the frequency of oculo-motor saccades in the dynamics of discourse and dialogue, we developed a system for simultaneous recording of visual-motor behaviour and verbal behaviour. This was tested in a clinical setting with the dyad “schizophrenic–psychologist”, in comparison with the dyad “typical subject–psychologist”. These involuntary movements in the control of attention are liable to provide precise information to confirm or anticipate diagnosis, and also information on the behavioural adaptation strategies of the different protagonists in the clinical interviews. Results Once converted into attention indicators, our results show that the number of saccades per second enables a differentiation of the conversational interaction behaviour between subjects with schizophrenia and control subjects. Likewise, this indicator enables the assessment of behavioural variations adopted by the psychologist protagonist in the dyad, when interacting with subjects with schizophrenia or with controls. Discussion Not only is measurement of ocular saccades perfectly suited to clinical situations, it also confirms the main results provided by measures of smooth, linear, eye pursuit, in particular in the area of diagnosis. However; this type of measure also enables analysis of the asymmetric behaviours of patient and interviewer. Finally, the indicators for variations in attention provided by saccades could be combined with analysis of shifts in points of fixation, and then related to analyses of discontinuities in discourse and other language features among patients seen in psychiatric care. Conclusion This article thus aims to anticipate the development of a diagnostic strategy (confirmatory and then prodromic) and a considerably more heuristic clinical analysis than what we have available today. It could be based on a combination of a modelling of visual-motor behavioural attitudes and verbal skills and behaviours. [ABSTRACT FROM AUTHOR]

It has been established that the recognition of facial expressions integrates contextual information. In this study, we aimed to clarify the influence of contextual odors. The participants were asked to match a target face varying in expression intensity with non-ambiguous expressive faces. Intensity variations in the target faces were designed by morphing expressive faces with neutral faces. In addition, the influence of verbal information was assessed by providing half the participants with the emotion names. Odor cues were manipulated by placing participants in a pleasant (strawberry), aversive (butyric acid), or no-odor control context. The results showed two main effects of the odor context. First, the minimum amount of visual information required to perceive an expression was lowered when the odor context was emotionally congruent: happiness was correctly perceived at lower intensities in the faces displayed in the pleasant odor context, and the same phenomenon occurred for disgust and anger in the aversive odor context. Second, the odor context influenced the false perception of expressions that were not used in target faces, with distinct patterns according to the presence of emotion names. When emotion names were provided, the aversive odor context decreased intrusions for disgust ambiguous faces but increased them for anger. When the emotion names were not provided, this effect did not occur and the pleasant odor context elicited an overall increase in intrusions for negative expressions. We conclude that olfaction plays a role in the way facial expressions are perceived in interaction with other contextual influences such as verbal information. [ABSTRACT FROM AUTHOR]

In psychiatry, recent years have seen a change of focus from a clinician- to a patient-centered perspective that emphasizes quality of life as a treatment target. As a complex construct, quality of life is composed of multiple dimensions that interact with one-another (e.g. physical and psychological well-being, relationships, autonomy, self-esteem). Here, we used data from the REHABase cohort, which includes N = 2180 patients from 15 psychosocial rehabilitation centers in France, to explore networks of quality-of-life dimensions among six psychiatric disorders: schizophrenia, neurodevelopmental, bipolar, depressive, anxiety, and personality disorders. Stronger connections (edges) involved the Self-Esteem dimension, such as Self-Esteem–Physical Well-Being, Self-Esteem–Autonomy, Self-Esteem–Psychological Well-Being, and Self-Esteem–Resilience. Self-esteem was also consistently retrieved as the most central node (the dimension with the most connections within each network). Between-group tests did not reveal any differences regarding network structure, overall connectivity, edge-weights, and nodes' centrality. Despite presenting with different symptom profiles, various psychiatric disorders may demonstrate similar inter-relationships among quality-of-life dimensions. In particular, self-esteem may have a crucial inter-connecting role in patients' quality of life. Our findings could support treatment programmes that specifically target self-esteem to improve patients' quality of life in a cost-effective way. [ABSTRACT FROM AUTHOR]

The Emotional Enhancement of Memory (EEM) has been well-demonstrated in adults, but less is known about EEM in children. The present study tested the impact of emotional valence of pictures on episodic memory using behavioral and neurophysiological measures. Twenty-six 8- to 11-year-old children were tested and compared to 30 young adults. Both groups participated in pictures' intentional encoding tasks while event-related potentials (ERPs) were recorded, followed by immediate free recall tasks. Behavioral results revealed a general EEM in free recall performances in both groups, along with a negativity effect in children. ERP responses revealed a particular sensitivity to negative pictures in children with a late emotion effect at anterior clusters, as well as a greater successful encoding effect for emotional pictures compared to neutral ones. For adults, the emotion effect was more pronounced for positive pictures across all time windows from the centro-parietal to the frontal part, and localized in the left hemisphere. Positive pictures also elicited a greater successful encoding effect at anterior clusters in adults. By combining behavioral and neurophysiological measures to assess the EEM in children compared with adults, our study provides new knowledge concerning the interaction between emotional and memory processes during development. [ABSTRACT FROM AUTHOR]

Background: Few studies have explored whether high-anticholinergic load may hamper rehabilitation in persons with schizophrenia. We aim to explore the associations between anticholinergic load of psychotropic treatment and functioning or cognitive performances of persons with psychosis engaged in psychosocial rehabilitation. Methods: The study was performed using data collected at baseline assessment in the REHABase cohort including persons referred to a French network of psychosocial rehabilitation centers. The composite-rating scale developed by Salahudeen et al. was used to rate the anticholinergic load of psychotropic drugs prescribed at baseline assessment. The associations between total anticholinergic load score (categorized as 'low' <3 v. 'high' ⩾3) and functioning or cognitive characteristics were explored using multivariate analyses. Results: Of the 1012 participants with schizophrenia spectrum disorders identified in the REHABase, half used at least two psychotropic drugs with anticholinergic activity and one out of three was prescribed at least one psychotropic drug with high-anticholinergic activity. High-anticholinergic load was significantly associated with lower stage of recovery [odds ratio (OR) = 1.70, 95% confidence interval (CI) 1.05–2.76, p = 0.03], poor mental well-being (OR = 1.55, 95% CI 1.02–2.33, p = 0.04) and poor self-rated medication adherence (OR = 2.14, 95% CI 1.29–3.53, p = 0.003). Regarding cognition, a high-anticholinergic score was associated with poorer delayed-episodic memory (OR = 1.69, 95% CI 1.01–2.85, p = 0.05) and at the trend level with faster completion time on the test exploring executive performance (OR = 0.67, 95% CI 0.43–1.04, p = 0.07). Conclusions: The psychosocial rehabilitation plan of persons with psychosis should integrate optimization of psychotropic treatment in order to lessen the functional and cognitive impact of high-anticholinergic load. [ABSTRACT FROM AUTHOR]

The aim of the present study was to explore the characteristics of psychotropic treatment and of psychosocial functioning associated with self-reported medication adherence in persons with psychosis engaged in rehabilitation. The study was performed in the REHABase cohort including persons referred to a French network of psychosocial rehabilitation centers. Treatment adherence was assessed using the Medication Adherence Rating Scale (MARS). The associations between MARS score (categorized as "low" < 7 vs. "high" ≥ 7) and functioning or psychotropic treatment characteristics were explored using multivariate analyses in 326 participants with schizophrenia spectrum disorders. Regarding psychotropic treatment, high anticholinergic load was the only characteristic associated with poor medication adherence (adjusted OR, aOR 1.98, 95% CI 1.07–3.66). Regarding functioning measures, participants with poor medication adherence were more likely to present with lower stage of recovery (aOR 2.38, 95% CI 1.31–4.32), poor quality of life (aOR 2.17, 95% CI 1.27–3.71), mental well-being (aOR 1.68, 95% CI 1.03–2.72) and self-esteem (aOR 1.74, 95% CI 1.05–2.87), and higher internalized stigma (aOR 1.88, 95% CI 1.09–3.23). Self-reported poor medication adherence is a marker of poor functioning in persons with psychosis. The MARS is a quick and simple measure of adherence that may be helpful in clinical and rehabilitation settings to identify persons with specific rehabilitation needs. [ABSTRACT FROM AUTHOR]

Abstract: Social cognition, which refers to how people think about themselves and others in the social world, is a core component for social, professional and interpersonal functioning and is commonly impaired in schizophrenia. This cognitive domain has strong associations with daily activities and could act as a link between social functioning and neurocognition. Two primary domains of social cognition: theory of mind and emotions perception have been studied for long and many arguments highlighted the direct relationship between impairments of these processes and the alteration of functional outcomes in schizophrenia. During the past 15years, researchers are interested in social cognition and developed, in the field of cognitive remediation, some therapeutic approaches with the aim of reducing difficulties and handicaps. The first programs were supported by the assumption that the improvement of neurocognition was necessary before enhancing social cognition. At the same time, other authors hypothesized that it is possible to improve the performance of people with schizophrenia by directly targeting impaired functions, and so developed specific programs. More recently, researchers intend to develop global programs that take into account all components of social cognition impaired in schizophrenia in order to improve functional outcomes. [Copyright &y& Elsevier]

The dominant cognitive model that accounts for the persistence of delusional beliefs in schizophrenia postulates that patients suffer from a general deficit in belief revision. It is generally assumed that this deficit is a consequence of impaired reasoning skills. However, the possibility that such inflexibility affects the entire system of a patient's beliefs has rarely been empirically tested. Using delusion-neutral material in a well-documented advice-taking task, the present study reports that patients with schizophrenia: 1) revise their beliefs, 2) take into account socially provided information to do so, 3) are not overconfident about their judgments, and 4) show less egocentric advice-discounting than controls. This study thus shows that delusional patients' difficulty in revising beliefs is more selective than had been previously assumed. The specificities of the task and the implications for a theory of delusion formation are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Patients with schizophrenia have pronounced deficits in face recognition memory that severely hamper their social skills. The functional mechanisms of these impairments remain unknown. According to the dual-process theory, recognition memory comprises two distinct components: recollection and familiarity. Studies using the Remember/Know procedure in patients with schizophrenia showed impairments in conscious recollection as measured by remember responses, but not in familiarity as measured by know responses. Unfortunately, none of these studies used face material. We investigated both recognition memory components using words and faces and the ‘Remember/Know’ procedure in 25 patients with schizophrenia and 24 control participants. In the same task, size congruency of stimuli was manipulated between the study and test phases to have a selective impact on know responses for faces. Patients reported fewer remember responses than controls. Size changes between the study and the test affected know responses in controls but not in patients. These results reveal that patients with schizophrenia are impaired in terms of their ability to recollect details about previously seen faces as they are for words. [Copyright &y& Elsevier]