6 research outputs found
Handicaps mental铆sticos en pacientes esquizofr茅nicos estabilizados
Descripci贸 del recurs: 25 febrer 2010La presente tesis examina el rendimiento en habilidades mental铆sticas en pacientes esquizofr茅nicos estabilizados. En el estudio principal exploramos la relaci贸n entre d茅ficits en Teor铆a de la Mente (ToM), un pobre ajuste prem贸rbido y la disfunci贸n ejecutiva en una muestra formada por 58 pacientes en contraste con la poblaci贸n control. Asimismo, estudiamos la relaci贸n entre anomal铆as ToM y la historia de suicidio en 57 pacientes esquizofr茅nicos de la misma muestra. Finalmente, la tesis eval煤a la calidad de vida subjetiva en otra muestra formada por 44 pacientes esquizofr茅nicos estables. Las medidas ToM se obtuvieron mediante tareas experimentales verbales de primer y segundo orden, el ajuste prem贸rbido de la escala PAS modificada de Cannon-Spoor y las medidas neuropsicol贸gicas de una bater铆a estandarizada que incluye atenci贸n, funci贸n ejecutiva y memoria. La calidad de vida subjetiva se examin贸 con la escala de Lehman Quality of Life Interview-versi贸n reducida. Los pacientes esquizofr茅nicos presentaron peores rendimientos, en las tareas ToM de primer y de segundo orden, en comparaci贸n con el grupo control. El an谩lisis de regresi贸n revel贸 una asociaci贸n global entre los d茅ficits en tareas ToM de primer y segundo orden y un ajuste prem贸rbido social pobre. Adicionalmente, d茅ficits en tareas ToM de primer orden mostraron una asociaci贸n con un bajo rendimiento en el Trail Making Test B, mientras que d茅ficits en tareas de segundo orden se relacionaron con el g茅nero masculino, un bajo rendimiento en Cubos y el tratamiento con clozapina. Los valores del R2 alcanzados fueron de 0,300 y 0,657, respectivamente. Por otro lado, un subsiguiente an谩lisis de regresi贸n mostr贸 una asociaci贸n entre un bajo rendimiento en tareas ToM de segundo orden y una elevada probabilidad de suicidio en los pacientes (OR=4.02, 95% CI 1.18-13.62) con independencia del estado cl铆nica y neuropsicol贸gico, con la excepci贸n de un pobre ajuste prem贸rbido durante la infancia y la adolescencia. El an谩lisis descriptivo de la calidad de vida subjetivo de la muestra constat贸 niveles bajos de satisfacci贸n en la mayor铆a de subescalas. El predominio de s铆ntomas positivos en pacientes esquizofr茅nicos, pero no aquellos con predominio de los negativos, covari贸 con bajos niveles de satisfacci贸n de calidad de vida. El tratamiento con antipsic贸ticos de primera o segunda generaci贸n no demostr贸 una asociaci贸n con calidad de vida subjetiva de los pacientes. Conclusiones principales: El ajuste prem贸rbido deficiente en la esquizofrenia puede vincularse a un d茅ficit ToM evaluable en tareas sencillas. Los resultados del estudio permiten definir un subgrupo fenot铆pico homog茅neo de pacientes, caracterizado por factores de pobre pron贸stico, junto con d茅ficits en la ToM y una disfunci贸n en capacidades ejecutivas, con un componente visuo-perceptivo. Estas anomal铆as podr铆an explicar las dificultades en las rutinas que implican el funcionamiento social. Los d茅ficits en ToM pueden contribuir a un elevado riesgo de suicidio en la esquizofrenia. Finalmente, los pacientes presentaron niveles bajos de calidad de vida subjetiva.The present thesis examine the performance in mentalistic skills in stabilised schizophrenia patients in comparison to a standard control group. In the main study we explore the relationship between Theory of Mind (ToM) deficits, poor premorbid adjustment, and executive dysfunction in 58 patients of sample in contrast to a control group. Futhermore, in the study we explore relationship between ToM anomalies and suicidal history in 57 patients of sample. Finally, the thesis assess the subjective quality of life in another sample of 44 schizophrenic stable patients. ToM measurements were obtained by means of first and second order verbal experimental tasks, premorbid adjustment was evaluated using the modified Cannon-Spoor premorbid adjustment scale and neuropsychological measures though of standard battery that included attention, executive function and memory. The subjective quality of life was assess by Lehman Quality of Life Interview-short version. Schizophrenic patients presented poorer performance in first- and second- order ToM tasks in comparison with control group. Ordinal regression analysis revealed an global asociation between deficits in both first- and second-order ToM tasks and poor social premorbid adjustment. In addition, deficits in first-order tasks showed an association with a low performance on the Trail Making Test B, while deficits in second-order tasks were related to male, a low performance on Block Design, and clozapine treatment. The R2 values amounted to 0.300 and 0.657, respectively. Another hand, next logistic regression analysis showed an association between poor performance on second order ToM tasks and a greater likelihood of suicide in patients (OR=4.02, 95% CI 1.18-13.62) which was independent of current clinical and neuropsychological status, with the exception of poor premorbid adjustment in infancy and adolescence. The descriptive analysis of the subjective quality of life profile obtained in the sample shows low levels of satisfaction in most subscales. A predominance of positive symptoms in schizophrenic patients, but not a predominance of negative symptoms covaried with lower levels of satisfaction in the quality of life. First o second generation antipsychotic treatment do not show an association with subjective quality of life. Main conclusions: Deficient premorbid adjustment in schizophrenia may be linked to a ToM deficit that can be assessed with simple tasks. Results of this study define a homogeneous phenotypic subgroup of patients, characterized by poor prognostic outcome factors, together with deficits in ToM and dysfunctional executive capacities with a visuo-perceptual component. These deficits could explain social functioning impairment in patients'daily routine. ToM deficits may contribute to the high risk of suicide in schizophrenia. Finally, patients present low levels of subjective quality of life
Religiosity and Psychotic Ideation in Stable Schizophrenia : A Role for Empathic Perspective-Taking
The relationship between religiosity and different components of empathy was explored in schizophrenia patients. A total of 81 stable schizophrenia patients and 95 controls from the nearby community completed self-reported questionnaires assessing religiosity and empathy (through the Interpersonal Reactivity Index, IRI). Patients with schizophrenia showed higher religiousness than controls and they presented less perspective-taking and empathic concern but increased personal distress in IRI scores. Regression analyses unveiled an association between religiosity and perspective-taking in schizophrenics after adjusting for age, gender, and psychotic symptoms. In conclusion, religiosity in patients with schizophrenia may be linked to variations in perspective- taking as a component of empathy
Efic脿cia i seguretat de l'administraci贸 d'haloperidol intranasal en pacients esquizofr猫nics agitats : assaig cl铆nic controlat unic猫ntric, al路leatorizat de grups paral路lels
Pharmacotherapy. 2008 Jul;28(7):875-8
Religiosity and Psychotic Ideation in Stable Schizophrenia : A Role for Empathic Perspective-Taking
The relationship between religiosity and different components of empathy was explored in schizophrenia patients. A total of 81 stable schizophrenia patients and 95 controls from the nearby community completed self-reported questionnaires assessing religiosity and empathy (through the Interpersonal Reactivity Index, IRI). Patients with schizophrenia showed higher religiousness than controls and they presented less perspective-taking and empathic concern but increased personal distress in IRI scores. Regression analyses unveiled an association between religiosity and perspective-taking in schizophrenics after adjusting for age, gender, and psychotic symptoms. In conclusion, religiosity in patients with schizophrenia may be linked to variations in perspective- taking as a component of empathy