Doubtful association of antipsychotic polypharmacy and high dosage with cognition in chronic schizophrenia

Despite consistent recommendations for antipsychotic monotherapy, antipsychotic polypharmacy (the use of two or more antipsychotic agents) and the administration of excessive doses (higher than 1000 mgr/day of chloropromazine equivalents) is a common practice in schizophrenia The therapeutic and adverse effects of this practice are poorly studied, in particular with regards to the cognitive symptoms of the disease In this cross-sectional study we investigated the cognitive effects of antipsychotic polypharmacy and excessive doses in 53 patients with chronic schizophrenia using non-verbal cognitive tasks involving speed of movement, memory and executive functions No significant difference in performance scores was found between the groups under polypharmacy and monotherapy, or the groups receiving either excessive or normal closes of antipsychotics. Since these groups did not also differ in demographic, clinical, other pharmacologic parameters, in the relative anticholinergic potency of antipsychotics, or in intelligence scores, we raise doubts about the association of polypharmacy and excessive doses with non-verbal cognitive performance in chronic schizophrenia (C) 2010 Elsevier Inc All rights reserve

Translation and Validation Study of the Hypoglycemia Fear Survey in a Greek Population of Children and Adolescents with Type 1 Diabetes Mellitus and their Parents

The present study attempted to translate and culturally adapt an established research instrument, the Hypoglycemia Fear Survey (HFS) questionnaire, to the Greek population and evaluate its validity and internal consistency so that it can be used for the assessment of hypoglycemia fear in Greek children and adolescents with T1DM and their parents. One hundred Greek children and adolescents with T1DM, 54 males, 6–18 years old, and one of their parents participated in this validation study. The participants completed the translated Greek HFS, which includes one version for children (CHFS) and one for parents (PHFS). Exploratory Factor Analysis (EFA) was used to assess construct validity. Internal consistency was assessed using Cronbach’s alpha, and convergent validity was established by estimating the correlation coefficients between the scores of the HFS scales/subscales and the different constructs of the Pediatric Quality of Life Inventory. The CHFS and PHFS exhibited adequate internal consistency for the total score and the Worry subscale, but lower consistency for the Behavior subscale. High test–retest reliability was also shown. We conclude that the Greek version of the HFS is a valid and reliable instrument to assess the fear of hypoglycemia in Greek children and adolescents with T1DM and their parents

Obsessive compulsive symptoms are associated with better functioning independently of cognition in schizophrenia

Objectives: Although the relationship of obsessive compulsive symptoms (OCSs) with both cognition and social functioning (SF) has already been the focus of research in schizophrenia, the moderation of the relationship of OCSs with SF by cognition has not been explored to date. We investigated the association of OCSs with SF and its interaction with cognition in schizophrenia. Methods: We recruited 110 schizophrenia patients and assessed OCSs (Yale-Brown Scale), schizophrenia symptoms (Positive and Negative Syndrome Scale), SF (Strauss-Carpenter Scale) and cognition. 51 patients had one obsessive compulsive symptom or more, whereas 59 patients had no obsessive compulsive-symptom, according to the Yale-Brown Scale. We mainly investigated: a) the predictive effect of OCSs on SF, controlling for cognition, illness duration and symptoms' severity and b) the moderating effect of cognition on the OCSs-SF relationship. Results: The mean score of OCSs for patients having at least one symptom was 13.43 (SD = 8.32). Higher OCSs predicted increased SF (B = 0.98, t = 2.41, df = 88, p = 0.018). This relationship was driven by the association of compulsions with job functioning (B = 0.074, t = 2.029, df = 88, p = 0.046). Patients without OCSs demonstrated worse functioning compared with those having at least one obsessive compulsive symptom (mean difference = 2.496, t = 3.732, df = 88, p < 0.001). We failed to find evidence that cognition moderates the effect of OCSs on SF. Conclusion: There may be a beneficial effect of OCSs on SF in patients with schizophrenia which is independent of their cognitive performance. (C) 2016 Elsevier Inc. All rights reserved

COMT and MTHFR polymorphisms interaction on cognition in schizophrenia: An exploratory study

The investigation of the catechol-O-methyltransferase (COMT-[rs4680]) and methylenetetrahydrofolate reductase (MTHFR-[rs1801133]) polymorphisms’ interaction might shed light into the pathogenetic mechanisms of the cognitive dysfunction in schizophrenia. In an exploratory study, we hypothesized that the MTHFR 677T allele which has been related to a hypoactive MTHFR enzyme would augment the unfavorable effects of COMT Val158 homozygosity which has been associated with COMT enzyme hyperfunction. 90 schizophrenia patients and 55 healthy volunteers were assessed on psychomotor speed, pattern and spatial recognition memory (SRM), spatial working memory (SWM), attentional flexibility and planning (Stockings of Cambridge-SOC). IQ scores in a random subgroup of patients were also measured. A significant COMT x MTHFR interaction on SWM (p = 0.048) and planning (p = 0.026) was revealed in both groups. Among COMT-Val/Val participants, MTHFR-C/C made more SWM errors (p = 0.033) and solved fewer SOC problems (p = 0.025) than MTHFR-T carriers. In patients, there was a significant COMT x MTHFR interaction on full scale IQ (p = 0.035): among COMT-Met carriers, MTHFR-T carriers performed significantly worse than MTHFR-C/C (p = 0.021), which was driven by a COMT x MTHFR interaction involving performance IQ(p = 0.047). In conclusion, COMT and MTHFR polymorphisms interacted on cognition, suggesting that the MTHFR enzyme activity might moderate the effects of the COMT enzyme. In contrast to our initial hypothesis, the MTHFRT-allele attenuated the cognitive effects of COMT Val homozygosity. In this preliminary study, we propose that dopaminergic and intracellular methylation mechanisms could interact on cognitive deficits in schizophrenia. (c) 2013 Elsevier Ireland Ltd. All rights reserved