Cognitive deficit measures in schizophrenia: factor structure and clinical correlates

OBJECTIVE: The authors aimed to delineate the 'common denominators' across a representative number of cognitive measures by administering such measures to a large number of schizophrenic subjects. The authors also aimed to study the consistency of the subjects' performance over a 1-year period and to look into the relationship between cognitive task performance and clinical status. METHOD: One hundred fifty-seven schizophrenic subjects with a DSM-III-R diagnosis of schizophrenia were assessed under standardized testing conditions on the dichotic listening and shadowing task, the span of apprehension task, the simple reaction time tasks, the critical stimulus duration, and the interstimulus interval in which they would become free from the masking effect. The clinical status of the subjects was assessed during index assessment, and 97 subjects were reassessed at the end of 1 year. Forty-seven subjects were randomly selected for reassessment on the cognitive tasks administered 1 year earlier. The subjects' performance was compared to that of 56 nonschizophrenic patients with nasopharyngeal carcinoma who had undergone radiation therapy. RESULTS: The cognitive task scores were factor analyzed, giving five distinct factors made up of the span of apprehension accuracy scores, simple reaction time scores, shadowing accuracy scores, span of apprehension error scores, and susceptibility to interference scores. At index assessment, the subjects' shadowing accuracy and reaction time were significantly related to their quality of life, social adjustment, and positive symptoms. The subjects' span of apprehension scores were related to their negative symptoms, measured in terms of work and daily life functions. The initial relationship between the subjects' cognitive test scores and their outcome status remained consistent at follow-up. CONCLUSIONS: The documented cognitive deficits in schizophrenic patients probably reflect a more enduring trait-like status with correlations with outcome status. These results also indicate that the cognitive measures may be simplified in complexity without a corresponding reduction in their clinical significance

Genetic discrimination and mental illness: a case report

With advances in genetic technology, there are increasing concerns about the way in which genetic information may be abused, particularly in people at increased genetic risk of developing certain disorders. In a recent case in Hong Kong, the court ruled that it was unlawful for the civil service to discriminate in employment, for the sake of public safety, against people with a family history of mental illness. The plaintiffs showed no signs of any mental health problems and no genetic testing was performed. This was the first case concerning genetic discrimination in common law jurisdictions, therefore the court's judgment has implications for how genetic discrimination cases may be considered in the future. The court considered it inappropriate to apply population statistics or lifetime risks to individuals while examining fitness for work. It recommended an individualised assessment of specific risks within the job, relative to other risks posed by that workplace. Key Words: Schizophrenia • employment • prejudice • genetic

Semantic verbal fluency deficit as a familial trait marker in schizophrenia

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Neurological signs in Chinese schizophrenic patients and their non-psychotic siblings

Session: 11. Psychology, neuro-These journal issues entitled: Abstracts of the VIIth International Congress on Schizophrenia Researc

Teaching and learning of medical professionalism - medical students' experience at the University of Hong Kong

Short Communications - 2G. Professionalism 1: The development of professional values 1: no. 2G 4BACKGROUND: Little is known in published literature about Asian medical students’ perception and understanding of medical professionalism, as well as their experiences and views on learning about professional attitudes/behavior in medical schools. Summary of work: We performed a qualitative study at the University of Hong Kong to examine the above. Fifty-nine medical students (in nine focus groups), representing year 3 and year 5 students participated in this study. Summary of results: Participants expressed concerns about effective learning and teaching of professionalism at the medical school. A recurring theme was that learning of professionalism by students built on their existing moral values before entering the medical school. We explored how observation of teachers’ role modelling (good or bad) influenced students’ learning of professionalism. Formal teaching in medical ethics and professional qualities was perceived as less useful, possibly due to its focus on knowledge, with less emphasis on skills or behaviour. We discovered problems with existing assessment of professionalism from the students’ perspective. Take home messages: As medical educators, strategies for educating future professional doctors include: (1) selection of medical students with appropriate moral values (2) proper role modelling and (3) developing a valid and reliable assessment strategy for your own medical school