Olfactory identification deficits have received recent attention as a potentially useful endophenotype for schizophrenia. Examination of this deficit in individuals with schizotypal personality features (SPF) offers an alternative approach to multiple confounds present when examining individuals with schizophrenia. The aim of the current study was to compare the relative sensitivity of performance on measures of olfaction identification and sustained attention to the presence of SPF. Twenty-six undergraduates were defined as having SPF based on scoring in the top 10% of the Abbreviated Schizotypal Personality Questionnaire (SPQ-B; mean age 19.6, SD = 1.1; 62% female). These individuals were compared to twenty-six controls (scoring lower than half a standard deviation above the mean; mean age 19.8, SD = 1.6; 62% female). All participants were administered the Schizotypal Personality Disorder (SPD) section of the Structured Clinical Interview for DSM IV Axis II Personality Disorders (SCID-II). In addition, participants were administered the Brief Smell Identification Test (B-SIT) and a six-minute degraded-stimuli Continuous Performance Test (CPT). Group differences in performance indices of the CPT did not approach statistical significance. Similarly, there were no statistically significant group differences for males or females in performance on the B-SIT. Correlational analyses examined cognitive performance with a dimension score derived by summing quantitative ratings from the SPD items on the SCID-II. The SPD dimension score showed a statistically significant positive correlation with several performance indices of the CPT, including omission errors (rs(52) = .51, p ≤ .001) and commission errors (rs(52) = .38, p ≤ .005). In contrast, the B-SIT scores were not correlated with the SPD dimension score for males or females. Contrary to our hypothesis, results from the current study suggest that olfactory identification deficits may not represent a robust endophenotype consistently found in samples with schizotypal personality features. With regard to sustained attention, our differential findings suggest that schizotypal traits may be more adequately assessed through an interview by trained clinicians who use clinical judgment to determine the presence of phenotypic aspects of SPD (e.g., SCID-II), rather than relying on self-report measures (e.g., SPQ-B). Implications as well as limitations and future directions of these findings are discussed.

The purpose of this research was to analyze the effectiveness of psychotherapy for individuals diagnosed with schizophrenia spectrum disorders who reside in community residential settings. The present body of literature did not address the utility of psychotherapy treatment for this population. A key area of focus for this research was whether psychotherapy has an impact on psychiatric hospitalization rates for the target population. An additional research question was whether significant differences exist in psychiatric hospitalization rates between males and females for the target population. Data analyses were conducted using archival data from the Blossom Hill Corporation and Sunrise Farm Corporation in the State of Minnesota. Research questions were analyzed with a 2x2 factorial analysis of variance (ANOVA). Results indicated no significant differences in hospitalization rates for individuals in the target population who received psychotherapy (n = 60) compared to those who did not (n = 76). Hospitalization rates also did not differ between gender in psychotherapy treatment response for individuals diagnosed with schizophrenia spectrum disorders in community residential settings. This study has implications for social change because it informs community residential providers in Minnesota serving individuals in the target population about the impact of psychotherapy on reducing psychiatric hospitalizations. Social change is further affected by providing data about how psychotherapy and theory can be used to better treat and understand the target population's mental health stability.

The goal of this thesis was to investigate the hypothesis whether symptomatic remission for patents with schizophrenia spectrum syndrome would provide practical and qualitative benefits for patients and for society. The first work (Paper I) examines the relationship between cross-sectional remission and the patients’ practical resources. The patients’ adaptations to society as well as their employments, living situations and social networks were studied. Their activity of daily living resources are described in terms of the extent to which they could pursue various undertakings autonomously. Their need for care was also studied. The results showed that the patient group that had achieved remission scored better on all of the variables studied, had better resources and less need for medical care and sheltered housing. The second work (Paper II) analysed the relationship between cross-sectional remission and quality of life, burden placed on patients by the illness, and the patients’ satisfaction with care received and with their medication, and also their capacity for understanding their symptoms and their illness. Even the results of this study showed that the patients in the remission group had a better quality of life, bore a lesser burden, were more satisfied with their care and had better insight into their illness. The third work (Paper III) studied the patients’ neurocognitive capacity to see if a higher capacity resulted in a higher percentage of patients achieving remission. The results showed unequivocally that the patients in remission consistently performed better in the cognitive tests. They also showed that they even had a larger vocabulary indicating a higher premorbid capacity. The fourth work (Paper IV) followed the patients over an average time of 65 months. In this study, the patients’ needs for medical care and for housing were investigated. Patients who were not in cross-sectional remission at baseline had for all the measured variables a higher consumption than those in remission even if the differences were not significant, except for patients who lived in sheltered housing and who had greater need for medical care. Taking all these findings together, the result of this thesis shows that the attainment of remission provides practical and qualitative advantages to the patients and to society.

Les troubles schizophréniques et les troubles du spectre autistique (TSA) ont en commun des troubles de la communication, des interactions sociales, des affects et des émotions. Dans le domaine de la cognition sociale, ces similitudes suscitent des questions sur la similarité ou les différences des processus neurocognitifs sous-jacents. Cependant, à l’heure actuelle, très peu d’études expérimentales comparent directement les personnes avec un trouble schizophrénique et les personnes avec un TSA dans les différents domaines de la cognition. Dans cette thèse, ces questions seront abordées à travers 3 domaines : le profil cognitif (évaluation du fonctionnement cognitif général et analyse qualitative de la fluence verbale), le domaine du langage pragmatique : (compréhension du langage figuré en contexte et des métaphores) et le domaine de la cognition sociale (reconnaissance des émotions faciales et style d’attribution). Ainsi, il sera examiné, si les similitudes apparentes entre les troubles schizophréniques et les TSA à ces différents domaines se matérialisent par des performances similaires et si des comportements et des performances similaires résultent de mécanismes neurocognitifs communs, différents, ou diamétralement opposés. Nos résultats ont montré que malgré des similitudes apparentes, le fonctionnement neurocognitif observé dans les troubles du spectre schizophrénique et autistique se caractérise par des différences qualitatives importantes que nous discutons dans le contexte de la littérature internationale et des perspectives cliniques de ces recherches. / Schizophrenia Spectrum Disorders and Autism Spectrum Disorders (ASD) have similar difficulties in communication, social interaction, affects and emotions. These apparent similarities raise the question whether similar or different neurocognitive processes might underlie similar symptoms and cognitive profiles. However, currently, very few experimental studies directly compare individuals with autism and schizophrenia in different cognition areas.The major aim of the present Doctoral Dissertation was to address these issues by exploring three areas: cognitive profile (the assessment of general cognitive functioning and the quantitative and the qualitative analysis of verbal fluency), pragmatic language (idiom comprehension in context and novels metaphors’ comprehension) and social cognition (facial affect recognition and attributional style). In each of these areas, the major results showed that despite apparent cognitive similarities, neurocognitive functioning observed in patients with schizophrenic disorders and autism were characterized by significant qualitative differences that were examined and discussed in the context of the international literature and in relation to the possible clinical perspectives.

Due to abnormal functioning of the brain’s reward and prediction system patients with schizophrenia spectrum disorders are thought to assign salience to non-relevant objects and events and to form context-inappropriate associations. The brain’s ventral striatum is critical in the formation of associations, and aberrant associations are believed to create delusional content during psychosis. The study wanted to examine the neural response, particularly in the ventral striatum, combined with subjective reports as patients learn associations in an aversive Pavlovian conditioning paradigm. The stimuli were randomized and involved circles of different colors. The conditioned stimuli (CS+) was followed by an unconditioned stimuli (US), consisting of an unpleasant sound, in 50% of events. The unconditioned (CS-) stimuli was followed by a low, not unpleasant sound in 50% of events. The degree of striatal activation was thought to be associated with the severity of patient’s illness. Functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) responses were examined in eleven unmedicated non-institutionalized patients with schizophrenia spectrum disorders and 15 matched healthy controls. No significant within group differences in neural or subjective response to the [CS+ > CS-] contrast were found. No significant associations between severity of illness and degree of striatal activation in response to CS+ or CS- were found. Significant differences in neural activation for the [CS+ > CS-] contrast were found in the ventral striatum, the right inferor frontal gyrus, and the right angular gyrus, with patients exhibiting stronger activation compared to controls. The results and implications are discussed along with suggestions for future research.

No description available.

Kognityvieji sukeltieji potencialai arba su įvykiu susiję potencialai (SĮSP) leidžia įvertinti kai kurias kognityviąsias funkcijas. Jie nuo pat sukūrimo pradžios yra sėkmingai taikomi ir psichikos sutrikimų tyrimuose. SĮSP neinvaziškumas, objektyvumas, saugumas leidžia juos taikyti kognityviųjų funkcijų pokyčių, sukeltų medikamentinio gydymo ar kitos nemedikamentinės terapinės procedūros, įvertinimui. Pagrindinis darbo tikslas buvo įvertinti informacijos apdorojimo klausos sistemoje kitimą atipinių antipsichotikų risperidono ir kvetiapino poveikyje ir nemedikamentinių terapijos metodų - elektros impulsų terapijos bei metaglosoterapijos - poveikyje taikant su įvykiu susijusio potencialo P300 skaitmeninio registravimo ir kiekybinės analizės metodus. Klausos sukeltas P300 potencialas buvo registruojamas taikant „atsitiktinio įvykio“ principą trimis elektrodais (Fz, Cz ir Pz). Buvo matuojami 4 sukeltojo potencialo P300 parametrai: N2 latencija, P300 latencija, P300 amplitudė ir reikšmingo dirgiklio atpažinimo laikas. Darbo rezultatai parodė, kad SĮSP parametrai yra jautrūs informacijos apdorojimo klausos sistemoje procesų pažeidimo šizofrenijos spektro sutrikimų atveju rodikliai. Didesnę teigiamą įtaką klausos sukeltajam potencialui P300 turėjo atipinis antipsichotikas kvetiapinas. Nemedikamentiniai psichikos sutrikimų gydymo metodai nenusileidžia efektyvumu gerinant pacientų kognityviąsias funkcijas medikamentinei terapijai atipiniais antipsichotikais. / Recording and analysis of event-related potentials is safe and harmless method of evaluation of cognition and is suitable to follow the changes of cognitive processes induced by psychoactive drugs or other therapeutic procedures. The main aim of the work was to evaluate the influence of atypical antipsychotics risperidone and quetiapine and such nonpharmacological methods as electroconvulsive therapy and metaglossotherapy on the changes of information processing in the auditory system using event-related potential P300 recording and analysis method. Auditory P300 potential was elicited applying “odd-ball” paradigm and recorded at 3 electrode sites (Fz, Cz, Pz). 4 parameters of P300 potential were measured: N2 latency, P300 latency, P300 amplitude and recognition time of target stimulus. Total number of 85 patients with schizophrenia spectrum disorders and mood disorders were studied. Results of this work showed that the parameters of P300 potential are sensitive indicators of abnormalities of information processing in auditory system in the case of schizophrenia spectrum disorders. More considerable positive influence on the event-related potential P300 had atypical antipsychotic quetiapine and that nonpharmacological methods of treatment of psychiatric disorders are as effective as drug therapy with atypical antipsychotics in remediation of cognitive functions.

Recording and analysis of event-related potentials is safe and harmless method of evaluation of cognition and is suitable to follow the changes of cognitive processes induced by psychoactive drugs or other therapeutic procedures. The main aim of the work was to evaluate the influence of atypical antipsychotics risperidone and quetiapine and such nonpharmacological methods as electroconvulsive therapy and metaglossotherapy on the changes of information processing in the auditory system using event-related potential P300 recording and analysis method. Auditory P300 potential was elicited applying “odd-ball” paradigm and recorded at 3 electrode sites (Fz, Cz, Pz). 4 parameters of P300 potential were measured: N2 latency, P300 latency, P300 amplitude and recognition time of target stimulus. Total number of 85 patients with schizophrenia spectrum disorders and mood disorders were studied. Results of this work showed that the parameters of P300 potential are sensitive indicators of abnormalities of information processing in auditory system in the case of schizophrenia spectrum disorders. More considerable positive influence on the event-related potential P300 had atypical antipsychotic quetiapine and that nonpharmacological methods of treatment of psychiatric disorders are as effective as drug therapy with atypical antipsychotics in remediation of cognitive functions. / Kognityvieji sukeltieji potencialai arba su įvykiu susiję potencialai (SĮSP) leidžia įvertinti kai kurias kognityviąsias funkcijas. Jie nuo pat sukūrimo pradžios yra sėkmingai taikomi ir psichikos sutrikimų tyrimuose. SĮSP neinvaziškumas, objektyvumas, saugumas leidžia juos taikyti kognityviųjų funkcijų pokyčių, sukeltų medikamentinio gydymo ar kitos nemedikamentinės terapinės procedūros, įvertinimui. Pagrindinis darbo tikslas buvo įvertinti informacijos apdorojimo klausos sistemoje kitimą atipinių antipsichotikų risperidono ir kvetiapino poveikyje ir nemedikamentinių terapijos metodų - elektros impulsų terapijos bei metaglosoterapijos - poveikyje taikant su įvykiu susijusio potencialo P300 skaitmeninio registravimo ir kiekybinės analizės metodus. Klausos sukeltas P300 potencialas buvo registruojamas taikant „atsitiktinio įvykio“ principą trimis elektrodais (Fz, Cz ir Pz). Buvo matuojami 4 sukeltojo potencialo P300 parametrai: N2 latencija, P300 latencija, P300 amplitudė ir reikšmingo dirgiklio atpažinimo laikas. Darbo rezultatai parodė, kad SĮSP parametrai yra jautrūs informacijos apdorojimo klausos sistemoje procesų pažeidimo šizofrenijos spektro sutrikimų atveju rodikliai. Didesnę teigiamą įtaką klausos sukeltajam potencialui P300 turėjo atipinis antipsichotikas kvetiapinas. Nemedikamentiniai psichikos sutrikimų gydymo metodai nenusileidžia efektyvumu gerinant pacientų kognityviąsias funkcijas medikamentinei terapijai atipiniais antipsichotikais.

No description available.

Résumé en français Objectifs : Ce mémoire propose d’explorer l’assiduité aux interventions psychosociales chez les personnes atteintes de troubles psychotiques en répondant à trois questions : 1- Quels sont les facteurs influençant l’assiduité aux interventions psychosociales pour une clientèle atteinte de troubles psychotiques? 2- Sont-ils comparables aux facteurs influençant l’observance à la médication? 3- Quel est le taux d’abandon des interventions psychosociales et quels sont les facteurs qui font varier ce taux? Méthodes : Cette étude a permis de faire la synthèse des facteurs influençant l’observance à la médication à partir des revues systématiques publiées sur le sujet, et d’établir les facteurs influençant l’assiduité aux interventions psychosociales à partir des raisons d’abandon citées dans les essais cliniques randomisés publiés. Une méta-analyse a permis de combiner les essais cliniques rapportant les abandons et ainsi d’en établir un taux. Résultats : Nous avons répertorié 92 essais cliniques randomisés sur les interventions psychosociales avec les personnes atteintes de troubles psychotiques. De ce nombre, 43 ont permis de répertorier les raisons d’abandon. Les raisons d’abandon s’avèrent principalement liées à la maladie et liées à l’accessibilité, la continuité et la qualité des soins et services. Un taux d’abandon de 13% a été obtenu à partir de l’agrégation de 74 études dans la méta-analyse. Des facteurs faisant varier ce taux ont été identifiés. Conclusion : Plusieurs facteurs (personnels, lié aux traitements, sociaux) influençant l’assiduité aux interventions psychosociales chez les personnes atteintes de troubles psychotiques ont été identifiés. De plus, le faible taux d’abandon obtenu démontre bien la faisabilité clinique de ce type d’intervention. S’ajoutant à l’efficacité déjà bien démontrée de certaines modalités d’intervention psychosociales, le taux d’assiduité à ces mêmes modalités constitue un argument supplémentaire pour en assurer la disponibilité aux personnes atteintes d’un trouble psychotique. / Abstract Aims : This report suggest investigating the compliance in the psychosocial treatment among persons with schizophrenia spectrum disorder by answering three questions : 1- What are factors influencing compliance in the psychosocial treatment among persons with schizophrenia spectrum disorder? 2- Are they comparable to factors influencing compliance with pharmacological treatment? 3- What is the dropout rate of the psychosocial treatment and which are the factors which make vary this rate? Methods : A systematic review allowed to make the synthesis of factors influencing the compliance in the medication from the systematic reviews published on the subject and to establish factors influencing the compliance in the psychosocial treatment from the reasons of drop-out specified in the published randomized clinical trials. A meta-analysis allowed to combine clinical trials reporting drop-out and so to establish a rate. Results : We listed 92 clinical trials randomized on the psychosocial treatment among persons suffering from schizophrenia spectrum disorder , of this number 43 allowed to list the reasons of drop-out. The reasons of drop-out turn out mainly related to the disease and related to the accessibility, the continuity and the quality of the care and the services. A 13 % dropout rate was obtained from the aggregation of 74 studies in the meta-analysis. Factors making vary this rate were identified. Conclusions: Several factors which influence the compliance in the psychosocial treatment among persons suffering from schizophrenia spectrum disorders are identified. Furthermore, the low drop-out rate calculated demonstrates well the clinical feasibility of this type of treatment. Being added to the efficiency already well demonstrated by certain psychosocial modalities of treatnebt, the compliance rate in these same modalities establishes an additional argument to assure the availability among persons suffering from schizophrenia spectrum disorders.