Longitudinal Neuropsychological Assessment in Two Elderly Adults With Attention-Deficit/Hyperactivity Disorder: Case Report

The neuropsychological deficits in attention-deficit/hyperactivity disorder (ADHD) may present clinical features similar to mild and/or major neurocognitive disorder and may act as a confounding factor, making it difficult to detect cognitive decline. In this paper, we present the results of longitudinal neuropsychological evaluations in two elderly women with ADHD. Three neuropsychological assessments were performed in two women with ADHD (60 and 77 years old) between 2010 and 2013 at intervals varying from 12 to 15 months. We used structural magnetic resonance imaging to rule out significant abnormalities that could account for cognitive impairment. The results showed two different cognitive profiles with fluctuations in performance over these 2 years, sometimes with improvement and sometimes with decline of some functions such as attention, memory, inhibitory control, and reaction time. To minimize confounding aspects of these fluctuations in clinical practice, we used a longer follow-up with the application of a reliable change index and a minimum of three spaced assessments to provide a more consistent baseline cognitive profile. Our findings did not indicate a consistent cognitive decline, suggesting a less pessimistic perspective about cognitive impairments that could be a prodrome of ADHD-related dementia

Conjugated estrogens as adjuvant therapy in the treatment of acute schizophrenia: a double-blind study

Abstract In a double-blind, placebo controlled study, conjugated estrogens (CE) (0.625 mg/day) were added to a fixed dosage of haloperidol (5 mg daily). Forty-four female inpatients with acute schizophrenia were included in the study and randomized to one of the groups; 40 patients completed the trial. They were followed for 28 days and evaluated periodically with the BPRS, Negative Symptoms Rating Scale, Simpson Angus Extrapyramidal Rating Scale and UKU rating scale. Hormonal concentrations (estradiol, estrone, progesterone, FSH, LH and prolactine) were measured at baseline and weekly throughout the trial. Both groups showed similar clinical improvement during the evaluation, although there was a trend for the CE group to show a better improvement than the placebo group ( p < 0.10). Side effects and the use of anticholinergics were similar in both groups. Conjugated estrogens caused elevation only of estrone levels in the CE group; estradiol and prolactin showed a similar profile for both groups. Our negative findings regarding the antipsychotic effect of conjugated estrogens does not preclude, however, a possible efficacy of other estrogens, such as 17-beta-estradiol, in schizophrenia.

Effects of socioeconomic status in cognition of people with schizophrenia:Results from a Latin American collaboration network with 1175 subjects

Background Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. Methods We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. Results Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. Conclusions Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low-and middle-income countries.Fil: Sanguinetti Czepielewski, Letícia. Hospital de Clinicas de Porto Alegre; Brasil. Universidade Federal do Rio Grande do Sul; BrasilFil: Alliende, Luz Maria. Pontificia Universidad Católica de Chile; Chile. Instituto Psiquiátrico Dr. Horwitz Barak; ChileFil: Castañeda, Carmen Paz. Instituto Psiquiátrico Dr. Horwitz Barak; ChileFil: Castro, Mariana Nair. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia. Instituto de Neurociencias - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Neurociencias; Argentina. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Ciencias Fisiológicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Salud Mental; ArgentinaFil: Guinjoan, Salvador Martín. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia. Instituto de Neurociencias - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Neurociencias; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Salud Mental; ArgentinaFil: Massuda, Raffael. Universidade Federal do Paraná; BrasilFil: Berberian, Arthur A.. Universidade Federal de Sao Paulo; BrasilFil: Fonseca, Ana Olivia. Universidade Federal de Sao Paulo; BrasilFil: Gadelha, Ary. Universidade Federal de Sao Paulo; BrasilFil: Bressan, Rodrigo. Universidade Federal de Sao Paulo; BrasilFil: Crivelaro, Marisa. Universidade de Sao Paulo; BrasilFil: Louzã, Mario. Universidade de Sao Paulo; BrasilFil: Undurraga, Juan. Universidad del Desarrollo; Chile. Instituto Psiquiátrico Dr. Horwitz Barak; ChileFil: González Valderrama, Alfonso. Instituto Psiquiátrico Dr. Horwitz Barak; Chile. Universidad Finis Terrae; ChileFil: Nachar, Rubén. Instituto Psiquiátrico Dr. Horwitz Barak; Chile. Universidad Finis Terrae; ChileFil: Nieto, Rodrigo. Universidad de Chile; ChileFil: Montes, Cristian. Universidad de Chile; ChileFil: Silva, Hernan. Universidad de Chile; ChileFil: Langer, Álvaro I.. Millennium Nucleus To Improve The Mental Health Of Adolescents And Youths; Chile. Millennium Institute For Research In Depression And Personality; Chile. Universidad Austral de Chile; ChileFil: Schmidt, Carlos. Universidad de Barcelona; España. Millennium Institute For Research In Depression And Personality; ChileFil: Mayol Troncoso, Rocío. Universidad de Chile. Facultad de Medicina; Chile. Millennium Nucleus To Improve The Mental Health Of Adolescents And Youths; ChileFil: Díaz Zuluaga, Ana M.. Universidad de Antioquia; ColombiaFil: Valencia Echeverry, Johanna. Universidad de Antioquia; ColombiaFil: López Jaramillo, Carlos. Universidad de Antioquia; ColombiaFil: Solís Vivanco, Rodolfo. Instituto Nacional de Neurología y Neurocirugía; MéxicoFil: Reyes Madrigal, Francisco. Instituto Nacional de Neurología y Neurocirugía; MéxicoFil: De La Fuente Sandoval, Camilo. Instituto Nacional de Neurología y Neurocirugía; MéxicoFil: Crossley, Nicolás A.. Universidad Católica de Chile; Chile. Pontificia Universidad Católica de Chile; Chile. King's College London; Reino UnidoFil: Gama, Clarissa S.. Universidade Federal do Rio Grande do Sul; Brasil. Hospital de Clinicas de Porto Alegre; Brasi