Awareness dimensions and associated factors in Alzheimer's disease

International audienceABSTRACTObjectives – We recently reported the major role depression and apathy in awareness among Alzheimer patients, using the stage of the disease as an exposure factor and exploring different assessment methods. We aimed here to explore the different dimensions of awareness using the various domains of awareness assessed by different sub-scales in awareness scales.Method – Sixty-one Alzheimer patients were examined using four awareness scales relating to three assessment methods : (a) patient-caregiver discrepancy; (b) clinical rating; and (c) prediction of performance discrepancy. Global cognition, executive functioning, autonomy, depression and apathy were also assessed. Multivariate logistic models were performed using disease stage as an exposure factor for awareness scales and sub-scales. Correlations across the different factors and patient and caregiver awareness ratings were computed.Results – The patient-caregiver discrepancy and clinical rating methods (a, b) both identified the factors associated with awareness, in the overall scales and the sub-scales as being depression and/or apathy. Depression correlated with patient self-ratings while apathy correlated with caregiver-ratings. The prediction of performance discrepancy method (c) identified different factors in the overall scale, executive factors in three sub-scales involving executive domains and memory factor in a subscale involving mnesic domain.Discussion – The awareness scales using a referential based on a human rating (a, b) suggest that awareness is unidimensional with depression impacting self-reports and apathy influencing caregiver/clinical reports. Those with referential based on a test rating (c) appear more associated with the dimensions assessed. This highlights the role of the reference system for awareness assessment in Alzheimer’s disease

Self-disorders in individuals with attenuated psychotic symptoms: contribution of a dysfunction of autobiographical memory

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Reconnaissance des expressions faciales émotionnelles et théorie de l’esprit dans la schizophrénie : la difficulté à identifier les états mentaux d’autrui serait-elle liée à un trouble de la reconnaissance des émotions faciales ?

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Effects of depression and cognitive impairment on quality of life in older adults with schizophrenia spectrum disorder: Results from a multicenter study

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A comprehensive model of predictors of quality of life in older adults with schizophrenia: results from the CSA study

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Psychiatric and physical outcomes of long-term use of lithium in older adults with bipolar disorder and major depressive disorder: A cross-sectional multicenter study

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Late-onset and nonlate-onset schizophrenia: A comparison of clinical characteristics in a multicenter study

International audienceObjectives Data are scarce regarding the potential clinical differences between non-late onset schizophrenia (NLOS, i.e., disorder occurring before 40 years of age), late-onset schizophrenia (LOS, occurring between ages 40 and 60 years) and very-late-onset schizophrenia-like psychosis (VLOSLP, occurring after 60 years of age). Furthermore, previous research compared LOS patients with non-age matched NLOS patients. In this study, we sought to examine potential clinical differences between patients of similar age with LOS and NLOS. Methods/Design This is a cross-sectional multicentre study that recruited in- and outpatients older adults (aged >= 55 years) with an ICD-10 diagnosis of schizophrenia or schizoaffective disorder with NLOS and LOS. Sociodemographic and clinical characteristics, comorbidity, psychotropic medications, quality of life, functioning, and mental health care utilization were drawn for comparison. Results Two hundred seventy-two participants (79.8%) had NLOS, 61 (17.9%) LOS, and 8 (2.3%) VLOSLP. LOS was significantly and independently associated with greater severity of emotional withdrawal and lower severity of depression (all p < 0.05). However, the magnitude of these associations was modest, with significant adjusted odds ratios ranging from 0.71 to 1.24, and there were no significant between-group differences in other characteristics. Conclusion In an age-matched multicenter sample of elderly patients with schizophrenia, older adults with LOS were largely similar to older adults with NLOS in terms of clinical characteristics. The few differences observed may be at least partially related to symptom fluctuation with time. Implications of these findings for pharmacological and nonpharmacological management is yet to be determined