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- Helldin, Lars, et al.
(författare)
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Neurocognitive variability in schizophrenia spectrum disorders : relationship to real-world functioning
- 2020
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Ingår i: Schizophrenia Research. - : Elsevier. - 2215-0013. ; 20, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Neurocognitive variability exists within the schizophrenia spectrum disorder (SSD) population, with subgroups performing at the same level as healthy samples Here we study the relationship between different levels of neurocognitive responding and real-world functioning. The participants were 291 SSD patients and 302 healthy controls that were assessed with a comprehensive neurocognitive battery. In addition, the patients were assessed with the Specific Level of Functioning Scale (SLOF). The results showed that the mean neurocognitive test responses of the SSD group were significantly below that of the control group. However, there was considerable overlap between the cognitive scores of the two groups, with as many as 24% of the patients performing above the mean healthy score for some domains. Moreover, the patients with the highest level of neurocognitive functioning reached the highest levels of practical and work-related functioning outcome skills. There was no significant relationship between neurocognitive and social function skills. The large differences in cognitive performance and their associations with functional outcome within the patient group are rarely addressed in clinical practice, but indicate a clear need for individualized treatment of SSD. Early identification of cognitive risk factors for poor real-life functional outcome is necessary in order to alert the clinical and rehabilitation services about patients in need of extra care.
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- Johansson, Madeleine, et al.
(författare)
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Cognitive markers related to long-term remission status in Schizophrenia Spectrum Disorders
- 2020
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Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 289
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive impairment is an established feature of schizophrenia. From a cross-sectional perspective, studies have revealed associations between cognition and remission. Few studies have examined this relationship longitudinally. Here we examine which cognitive domains might be related to long-term remission and symptomatic severity. The present study followed 173 outpatients with schizophrenia for five years, divided into groups based on long-term remission status and symptomatic severity, assessed with the Positive and Negative Syndrome Scale. Cognitive functioning was assessed at baseline, with tests of vigilance, executive functions, processing speed, memory and learning, working memory, and premorbid functioning. Cognitive domains related to long-term remission status were executive functions, working memory, and premorbid functioning. The most prominent cognitive differences were found between the group in stable remission with minimal symptoms, and the non-remission group, the first group demonstrating better cognitive functioning. The study highlights the role of premorbid functioning as a cognitive feature in the prediction of long-term remission. It also indicates the possibility of viewing specific cognitive domains as markers for clinical outcome, highlighting the value of early assessment of cognition. In summary, a certain cognitive profile, in coexistence with long-term non-remission, suggests poorer outcome. Hence, this group is in need of increased support.
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- Johansson, Madeleine, et al.
(författare)
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Exploring cross-sectional and longitudinal symptomatic remission and subjective quality of life in Schizophrenia
- 2023
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Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 328
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Tidskriftsartikel (refereegranskat)abstract
- Achieving symptomatic remission, as defined by the Remission in Schizophrenia Working Group, is intended tobe a meaningful outcome for individuals with schizophrenia, resulting in enhanced well-being. Cross-sectionalstudies have reported an association between symptomatic remission and subjective quality of life (QoL). Longitudinal studies aimed at examining this association have showed mixed results. The aim of this study was toexplore the relationship between symptomatic remission and subjective QoL, both cross-sectionally andlongitudinally. The study comprised data from what were at most 386 patients with schizophrenia, of whom 122–140 werefollowed over a period of four years. Based on cross-sectional remission status and longitudinal remissionpattern, differences in subjective QoL were explored. Remission status was assessed using the Positive andNegative Syndrome Scale (PANSS), and subjective QoL using the Short Form-36 Health Survey (SF-36). Both the cross-sectional and the longitudinal approach showed that patients in symptomatic remission hadsignificantly higher subjective QoL. Patients who were in non-remission at baseline, but who achieved remissionat follow-up, also had significantly higher subjective QoL at follow-up compared with baseline. The results from the study show a clear association between symptomatic remission and subjective QoL. However, achieving symptomatic remission does not appear to be a guarantee of sustained subjective QoL, andonly continued stable remission appears to result in such an outcome.
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- Johansson, Madeleine
(författare)
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Longitudinellt perspektiv på symtomatisk remission vid schizofreni
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objective: The overall aim of this thesis was to investigate the remission criteria according to the Remisson in Schizophrenia Working Group (RWSG), mainly from a longitudinal perspective.Paper I showed that all remission symptoms in the RSWG criteria, affected the remission status in the cross-sectional setting. In the longitudinal setting, the symptoms Delusions and Hallucinatory behavior contributed mostly to the fluctuation between remission and non-remission, while negative symptoms were more prominent in the group that never reached remission. Finally, the sustainability of remission was significantly longer when only minimal symptom intensity occurred, compared with mild.Paper II showed that the cognitive areas associated with long-term remission pattern were executive functioning, working memory and verbal functioning, where significant better results were shown in the group of stable remission with only minimal symptoms compared to the group never reaching remission. Verbal functioning was the only cognitive area that could predict long-term remission pattern, as a better result increased the probability of being in long-term remission.Paper III focused on the patient’s perspective and examined the relationship between subjective quality of life (SQoL) and remission. The paper showed significant associations between a better SQoL, self-assessed with Short Form Health Survey-36, and both cross-sectional remission and long-term. A significant better SQoL was present regardless of being in stable remission over time or if remission was reached during the study period.Conclusions: The thesis support that the RSWG criteria for remission is a valuable concept, also from a longitudinal perspective. Taken together, the results emphasize the heterogeneity of schizophrenia, where different groups within the disorder show different clinical characteristics. This thesis highlights the importance of regular assessments of broad clinical status, to support a higher frequency and sustainability of remission.
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- Mohn, Christine, et al.
(författare)
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Marginal relationship between affective dispositions and neurocognitive function in patients with schizophrenia spectrum disorders
- 2021
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 75:5, s. 344-350
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Neurocognitive outcomes are frequently used as indicators of real-world functioning in schizophrenia spectrum disorders (SSD). These test results may be influenced by individual differences, such as affective dispositions. Here we investigate the relationship between positive and negative affect and neuropsychological test scores in a large, mixed-gender, population based group of participants without co-morbid substance abuse. Materials and methods We assessed 129 male and female SSD patients with the Positive and Negative Affect Schedule (PANAS) and a comprehensive neuropsychological test battery. Results and conclusions The neuropsychological test scores were mainly predicted by age and gender, with small contributions from negative psychosis symptoms. There was a statistically significant relationship between Positive Affect and processing speed and between Negative Affect and verbal memory and executive function. However, the level of neurocognitive function variance explained by these affects was only 5%. Thus, the neurocognitive test results were not associated with trait affect in any clinically significant manner. This adds to previous findings of no relationship between affective dispositions and psychosis symptom variables in our participants. We suggest that affective traits constitute an independent dimension that may influence well-being, coping, and real-life outcome in SSD patients directly, and not through neurocognitive function.
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- Mohn, Christine, et al.
(författare)
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Neurocognitive function and mortality in patients with schizophrenia spectrum disorders
- 2023
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Ingår i: Schizophrenia Research. - : Elsevier. - 2215-0013. ; 33
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Tidskriftsartikel (refereegranskat)abstract
- Individuals with schizophrenia spectrum disorders (SSD) have significantly lower life-expectancy than healthy people. Previously, we have identified baseline neurocognitive function in general and verbal memory and executive function in particular as related to mortality nearly two decades later. In this study, we aim to replicate these findings with a larger and age-matched sample. The patient group consisted of 252 individuals, 44 of whom were deceased and 206 alive. Neurocognition was assessed with a comprehensive battery. Results showed that the deceased group, compared to the living group, had significantly more severe neurocognitive deficits across nearly all domains. There were no differences in sex, remission status, psychosis symptoms, or function level between the groups. Immediate verbal memory and executive function were the strongest predictors of survival status. These results were nearly identical to our previous studies, and we conclude that baseline neurocognitive function is an important predictor for mortality in SSD. Clinicians should be mindful of this relationship in patients with significant cognitive deficits.
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