WAIS-IV Seven-Subtest Short Form: Validity and Clinical Use in ă Schizophrenia

International audienceObjective: This study assesses the psychometric properties of Ward's ă seven-subtest short form (SF) for WAIS-IV in a sample of adults with ă schizophrenia (SZ) and schizoaffective disorder. ă Method: Seventy patients diagnosed with schizophrenia or schizoaffective ă disorder were administered the full version of the WAIS-IV. Four ă different versions of the Ward's SF were then calculated. The subtests ă used were: Similarities, Digit Span, Arithmetic, Information, Coding, ă Picture Completion, and Block Design (BD version) or Matrix Reasoning ă (MR version). Prorated and regression-based formulae were assessed for ă each version. ă Results: The actual and estimated factorial indexes reflected the ă typical pattern observed in schizophrenia. The four SFs correlated ă significantly with their full-version counterparts, but the Perceptual ă Reasoning Index (PRI) correlated below the acceptance threshold for all ă four versions. The regression-derived estimates showed larger ă differences compared to the full form. The four forms revealed ă comparable but generally low clinical category agreement rates for ă factor indexes. All SFs showed an acceptable reliability, but they were ă not correlated with clinical outcomes. ă Conclusions: The WAIS-IV SF offers a good estimate of WAIS-IV ă intelligence quotient, which is consistent with previous results. ă Although the overall scores are comparable between the four versions, ă the prorated forms provided a better estimation of almost all indexes. ă MR can be used as an alternative for BD without substantially changing ă the psychometric properties of the SF. However, we recommend a cautious ă use of these abbreviated forms when it is necessary to estimate the ă factor index scores, especially PRI, and Processing Speed Index

Validation and refinement of the clinical staging model in a French cohort of outpatient with schizophrenia (FACE-SZ)

International audienceObjective: Existing staging models have not been fully validated. Thus, after classifying patients with schizophrenia according to the staging model proposed by McGorry et al. (2010), we explored the validity of this staging model and its stability after one-year of follow-up.Method: Using unsupervised machine-learning algorithm, we classified 770 outpatients into 5 clinical stages, the highest being the most severe. Analyses of (co)variance were performed to compare each stage in regard to socio-demographics factors, clinical characteristics, co-morbidities, ongoing treatment and neuropsychological profiles.Results: The precision of clinical staging can be improved by sub-dividing intermediate stages (II and III). Clinical validators of class IV include the presence of concomitant major depressive episode (42.6% in stage IV versus 3.4% in stage IIa), more severe cognitive profile, lower adherence to medication and prescription of >3 psychotropic medications. Follow-up at one-year showed good stability of each stage.Conclusion: Clinical staging in schizophrenia could be improved by adding clinical elements such as mood symptoms and cognition to severity, relapses and global functioning. In terms of therapeutic strategies, attention needs to be paid on the factors associated with the more stages of schizophrenia such as treatment of comorbid depression, reduction of the number of concomitant psychotropic medications, improvement of treatment adherence, and prescription of cognitive remediation

Prevalence of and Risk Factors for Extrapyramidal Side Effects of Antipsychotics

International audienceBackground: Extrapyramidal side effects (EPS) have been identified as a complication of antipsychotic treatment. Previous meta-analyses have investigated EPS prevalence and risk factors in randomized clinical trials with highly selected patients, but studies in real-world schizophrenia are missing. Objective: To examine the prevalence and clinical correlates associated with EPS in a nonselected national multicenter sample of stabilized patients with schizophrenia. Methods: Between 2010 and 2016, patients suffering from schizophrenia (DSM-IV-TR criteria) were recruited through the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) network and data were collected during a comprehensive 1-day-long standardized evaluation. The Simpson-Angus Scale and the Abnormal Involuntary Movement Scale were used to assess drug-induced parkinsonism (DIP) and tardive dyskinesia, respectively. Results: The overall prevalence of DIP and tardive dyskinesia was 13.2% and 8.3%, respectively, in this community-dwelling sample of 674 patients. DIP was associated with negative symptoms (Positive and Negative Syndrome Scale [PANSS] subscore) (adjusted odds ratio [aOR] = 1.102, P Conclusions: Our results indicate the high prevalence of EPS in a nonselected community-dwelling clinically stable sample of outpatients with schizophrenia. In the monitoring of antipsychotic treatment, EPS should be systematically evaluated, especially when negative symptoms and disorganization or cognitive alteration are present. Monotherapy with a second-generation antipsychotic should be preferentially initiated for patients with these side effects

Early and very early‐onset schizophrenia compared with adult‐onset schizophrenia: French FACE‐SZ database

International audienceObjective: To compare the clinical symptomatology in patients with Early-Onset Schizophrenia (EOS, N = 176), especially the subgroup Very Early Onset Schizophrenia (VEOS) and Adult Onset Schizophrenia (AOS, N = 551). Method: In a large French multicentric sample, 727 stable schizophrenia patients, classified by age at onset of the disorder, were assessed using standardized and extensive clinical and neuropsychological batteries: AOS with onset ≥ 18 years and EOS with onset < 18 years (including 22 VEOS < 13 years). Results: The importance of better diagnosing EOS group, and in particularly VEOS, appeared in a longer DUP Duration of Untreated Psychosis (respectively, 2.6 years ± 4.

Self-reported pain in patients with schizophrenia. Results from the national first-step FACE-SZ cohort

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Remission of depression in patients with schizophrenia and comorbid major depressive disorder: results from the FACE-SZ cohort

International audienceBackground Major depressive disorder (MDD) is underdiagnosed and undertreated in schizophrenia, and has been strongly associated with impaired quality of life. Aims To determine the prevalence and associated factors of MDD and unremitted MDD in schizophrenia, to compare treated and non-treated MDD. Method Participants were included in the FondaMental Expert Centers for Schizophrenia and received a thorough clinical assessment. MDD was defined by a Calgary score ≥6. Non-remitted MDD was defined by current antidepressant treatment (unchanged for >8 weeks) and current Calgary score ≥6. Results 613 patients were included and 175 (28.5%) were identified with current MDD. MDD has been significantly associated with respectively paranoid delusion (odds ratio 1.8; P = 0.01), avolition (odds ratio 1.8; P = 0.02), blunted affect (odds ratio 1.7; P = 0.04) and benzodiazepine consumption (odds ratio 1.8; P = 0.02). Antidepressants were associated with lower depressive symptoms score (5.4 v. 9.5; P Conclusions Antidepressant administration is associated with lower depressive symptom level in patients with schizophrenia and MDD. Paranoid delusions and alcohol misuse disorder should be specifically explored and treated in cases of non-remission under treatment. MetS may play a role in MDD onset and/or maintenance in patients with schizophrenia. Declaration of interest None

Chronic Peripheral Inflammation is Associated With Cognitive Impairment ă in Schizophrenia: Results From the Multicentric FACE-SZ Dataset

International audienceObjectives: Inflammation, measured by abnormal blood C-reactive protein ă (CRP) level, has been described in schizophrenia (SZ), being ă inconsistently related to impaired cognitive functions. The aim of the ă present study is to investigate cognitive impairment associated with ă abnormal CRP levels in a large multi-centric sample of ă community-dwelling SZ patients, using a comprehensive neuropsychological ă battery. Method: Three hundred sixty-nine community-dwelling stable SZ ă subjects (76.2% men, mean age 32.7 y) were included and tested with a ă comprehensive battery of neuropsychological tests. Abnormal CRP level ă was defined as >3 mg/L. Results: Multiple factor analysis revealed that ă abnormal CRP levels, found in 104 patients (28.2%), were associated ă with impaired General Intellectual Ability and Abstract Reasoning (aOR = ă 0.56, 95% CI 0.35-0.90, P = .014), independently of age, sex, education ă level, psychotic symptomatology, treatments, and addiction ă comorbidities. Abnormal CRP levels were also associated with the decline ă of all components of working memory (respectively effect size [ ES] = ă 0.25, P = .033; ES = 0.27, P = .04; ES = 0.33, P = .006; and ES = 0.38, ă P = .004) and a wide range of other impaired cognitive functions, ă including memory (ES = 0.26, P = .026), learning abilities (ES = 0.28, P ă = .035), semantic memory (ES = 0.26, P = .026), mental flexibility (ES = ă 0.26, P = .044), visual attention (ES = 0.23, P = .004) and speed of ă processing (ES = 0.23, P = .043). Conclusion: Our results suggest that ă abnormal CRP level is associated with cognitive impairment in SZ. ă Evaluating the effectiveness of neuroprotective anti-inflammatory ă strategies is needed in order to prevent cognitive impairment in SZ