Preferences for befriending schemes: a survey of patients with severe mental illness

This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Reference Number RP-PG-0611-20002). The funding body was not involved in, and did not influence, the design of the study, data collection, analysis or interpretation of the data. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health

Fonaments i eficàcia de l’entrenament cognitiu Repyflec per a pacients amb esquizofrènia

[cat] A partir dels anys 90, les alteracions cognitives de l'esquizofrènia han resultat de gran interès per la seva relació amb altres aspectes del funcionament general que posen en relleu el paper nuclear del dèficit cognitiu en aquest trastorn (Kraus i Keefe, 2007; Wykes i Reeder, 2005). Les alteracions de la memòria, la funció executiva i l'atenció han mostrat ser les més rellevants tant per la seva repercussió funcional com per la seva intensitat (Brazo i cols., 2002; Hoff i Kremen, 2003; Medalia i Lim, 2004; Penadés i cols., 1999; Reed i cols., 2002; Sharma i Antonova, 2003; Sponheim i cols., 2003; Wykes i Reeder, 2005; Zandio i cols., 2005). Arran d'aquestes troballes s'ha desenvolupat una eina de rehabilitació coneguda com a remediació cognitiva, que consisteix en un entrenament conductual per a millorar els processos cognitius d'atenció, memòria, funció executiva, cognició social i metacognició (Wykes i cols., 2011). Té com a objectius millorar el funcionament cognitiu de les persones amb esquizofrènia i aconseguir que aquestes millores es traslladin a una major competència en la resolució de problemes quotidians (Medalia i Freilich, 2008). Diversos estudis han trobat que la millora de la funció executiva mitjançant procediments de remediació cognitiva està fortament associada a la millora de l'autonomia personal i del funcionament en la comunitat (Green, 1996; Reeder i cols., 2006; Penadés i cols., 2006 ; Wykes i cols., 2007b; Wykes i Huddy, 2009, Wykes i cols. 2011). Els resultats obtinguts en revisions i metanàlisis han indicat millores consistents en un ampli rang de funcions cognitives, en els símptomes i en el funcionament en la comunitat (Lindenmayer i cols., 2008; McGurk i cols., 2007; Twamley i cols., 2003; Wykes i cols., 2011). En el marc de la Unitat de Recerca i Desenvolupament del Parc Sanitari Sant Joan de Déu (Sant Boi de Llobregat), es va desenvolupar un programa propi de remediació cognitiva i es va dur a terme l'estudi de la seva eficàcia. El programa REPYFLEC és un entrenament de remediació cognitiva en format de paper i llapis, que es realitza en grup (4-6 participants) i es porta a terme dos dies a la setmana durant 4 mesos (32 sessions). Els continguts que es treballen es divideixen en dues àrees principals: Resolució de Problemes i Flexibilitat Cognitiva, i es realitzen 16 sessions de cadascuna. L'objectiu d'aquest tractament és intervenir en les funcions cognitives superiors que estan afectades en l'esquizofrènia, com són la funció executiva i la metacognició. Amb l’objectiu d’avaluar l’entrenament Repyflec es va realitzar un assaig clínic controlat i aleatoritzat, de doble cegament i en comparació a un grup control actiu que realitzava 32 sessions d’un grup d’oci sense objectius específics. Als resultats s'ha trobat que el Repyflec ha produït un canvi superior i estadísticament significatiu a favor del grup experimental en variables cognitives i socials. Més concretament, al post tractament s'han trobat millores a favor del Repyflec en la funció executiva, en les àrees de cura personal, relacions socials -contacte social i en l'ocupació. Els resultats obtinguts al seguiment mostren que les millores en la funció executiva i en el funcionament social es mantenen 6 mesos després d'haver finalitzat el tractament. Així mateix, el Repyflec apunta a influir en la millora d’algunes variables simptomatològiques. El Repyflec és una intervenció de grup, multifunció i restitutiva, que aconsegueix canvis superiors i estadísticament significatius en el funcionament executiu i social de pacients ambulatoris amb esquizofrènia. La intervenció en la funció executiva s'ha mostrat associada a guanys en les àrees de funcionament psicosocial.[eng] "REPYFLEC cognitive remediation group training in schizophrenia. Randomised controlled tria'l TEXT: BACKGROUND: Cognitive difficulties are well known in people with a diagnosis of schizophrenia and are associated with poor long-term functioning. Cognitive remediation trainings are developed to treat cognitive problems that affect functioning. Current international studies about cognitive remediation obtain improvements in cognitive and social functioning and in some psychiatric symptoms. AIMS: To evaluate the efficacy of a cognitive remediation group training program, namely Problem Solving and Cognitive Flexibility training, addressed to improve psicosocial functioning of patients with schizophrenia. METHOD: Participants with a diagnosis of schizophrenia or schizoaffective disorder (n=52) were randomized to 32 -twice a week- group sessions of REPYFLEC training, or to 32 -twice a week- group sessions of activities without specific objectives and focused to leisure. Social functioning, psychiatric symptoms and Theory of Mind (ToM) were measured at weeks 0, 8, 16 and 40. Cognitive function was measured at weeks 0, 16 and 40. Mixed Models were used to estimate statistical differences. RESULTS: Patients in the cognitive remediation training group demonstrated significantly improvements on executive function, social functioning and negative symptoms at post-treatment compared to patients in the control group. At 6 month follow-up assessment, significant improvements in executive function and social functioning remained. CONCLUSIONS: REPYFLEC cognitive training is associated with significant improvements on executive function, social functioning and specific symptoms in outpatients with schizophrenia

Measurement invariance of the Spanish Launay-Slade Hallucinations Scale-Extended version between putatively healthy controls and people diagnosed with a mental disorder.

peer reviewed[en] OBJECTIVES: The current study aimed at evaluating the reliability, convergent and divergent validity, and factor structure of the Spanish Launay-Slade Hallucinations Scale-Extended version (LSHS-E) in people with mental disorders and healthy controls. METHODS: Four hundred and twenty-two individuals completed the Spanish LSHS-E and the Spanish Community Assessment of Psychic Experiences. The convergent and divergent validity of the LSHS-E was assessed with the three dimensions of the Community Assessment of Psychic Experiences (positive, negative, and depressive dimensions) in healthy controls and people with a mental disorder. Factor structure of the LSHS-E was assessed using confirmatory factor analysis and measurement invariance. RESULTS: The LSHS-E had a good reliability in healthy controls and people with a mental disorder (Cronbach's = 0.83 and 0.91, respectively). The LSHS-E was more strongly associated with positive psychotic-like experiences than with depressive and negative symptoms. Four factors were found: (a) "intrusive thoughts"; (b) "vivid daydreams"; (c) "multisensory hallucination-like experiences"; and (d) "auditory-visual hallucination-like experiences" that were invariant between the group of healthy controls and people with a mental disorder. CONCLUSION: The Spanish version of the LSHS-E possesses adequate psychometric properties, and the confirmatory factor analysis findings provide further support for the multidimensionality of proneness to hallucination in clinical and nonclinical samples

Measurement invariance of the Spanish Launay–Slade Hallucinations Scale‐Extended version between putatively healthy controls and people diagnosed with a mental disorder

peer reviewedOBJECTIVES: The current study aimed at evaluating the reliability, convergent and divergent validity, and factor structure of the Spanish Launay-Slade Hallucinations Scale-Extended version (LSHS-E) in people with mental disorders and healthy controls. METHODS: Four hundred and twenty-two individuals completed the Spanish LSHS-E and the Spanish Community Assessment of Psychic Experiences. The convergent and divergent validity of the LSHS-E was assessed with the three dimensions of the Community Assessment of Psychic Experiences (positive, negative, and depressive dimensions) in healthy controls and people with a mental disorder. Factor structure of the LSHS-E was assessed using confirmatory factor analysis and measurement invariance. RESULTS: The LSHS-E had a good reliability in healthy controls and people with a mental disorder (Cronbach's = 0.83 and 0.91, respectively). The LSHS-E was more strongly associated with positive psychotic-like experiences than with depressive and negative symptoms. Four factors were found: (a) "intrusive thoughts"; (b) "vivid daydreams"; (c) "multisensory hallucination-like experiences"; and (d) "auditory-visual hallucination-like experiences" that were invariant between the group of healthy controls and people with a mental disorder. CONCLUSION: The Spanish version of the LSHS-E possesses adequate psychometric properties, and the confirmatory factor analysis findings provide further support for the multidimensionality of proneness to hallucination in clinical and nonclinical samples

Correspondence between negative symptoms and potential sources of secondary negative symptoms over time.

There has been a debate in the literature about the distinction between primary and secondary negative symptoms of schizophrenia. Our aim was to study the associations between negative symptoms and potential sources of secondary negative symptoms over time. A sample of 275 participants with at least mid-moderate negative symptoms was randomized into body psychotherapy or Pilates class in a previous study. No significant differences were found between groups over time and changes in the symptom domains were modest. The present investigation considers the longitudinal correlation between variables of interest at baseline, 3 and 9 months follow-up. Measures were the Clinical Assessment Interview for Negative Symptoms (CAINS), the Positive and Negative Symptom Scale (PANSS), the Calgary Depression Scale (CDSS) and the Simpson-Angus Extrapyramidal side-effects Scale (SAS). Mixed models were computed to test the longitudinal association between these variables. In a sensitivity analysis, the dosages of antipsychotic, illness duration and allocated intervention were taken into account. Overall, the course of extrapyramidal side-effects, depressive and positive symptoms was significantly related to the course of negative symptoms. Only extrapyramidal effects were longitudinally correlated to expressive negative symptoms. The sensitivity analyses showed unaltered results for positive symptoms and depression but a lack of association between extrapyramidal effects and the CAINS outcomes. In conclusion, the unambiguous interpretation between primary and secondary negative symptoms may lead to refined treatment approaches for schizophrenia and to increased effects of the interventions.The data was collected as part of the NESS study, a trial funded by a grant from the National Institute for Health Research-Health Technology Assessment programme (REF: 08/116/68). The funding source had no role in the present study design, analysis, interpretation or manuscript submission