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Nicolas Hoertel - One of the best experts on this subject based on the ideXlab platform.
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psychiatric symptoms and quality of life in older adults with Schizophrenia Spectrum Disorder results from a multicenter study
European Archives of Psychiatry and Clinical Neuroscience, 2020Co-Authors: Nicolas Hoertel, Léa Rotenberg, Carlos Blanco, Cécile Hanon, Arthur Kaladjian, Rachel Pascal De Raykeer, Frederic LimosinAbstract:The severity of psychopathology has a strong negative impact on quality of life (QoL) among older adults with Schizophrenia Spectrum Disorder. However, because these subjects generally experience multiple psychiatric symptoms, it remains unclear whether decreased QoL in this population is due to specific symptoms (e.g., hallucinations), specific dimensions of psychopathology (e.g., negative symptoms), a general psychopathology dimension representing the shared effect across all psychiatric symptoms, or a combination of these explanations. Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large (N = 353) multicenter sample of older adults with Schizophrenia Spectrum Disorder recruited from French public-sector psychiatric departments. We used structural equation modeling to examine the shared and specific effects of psychiatric symptoms on QoL, while adjusting for sociodemographic characteristics, general medical conditions, global cognitive functioning and psychotropic medications. Psychiatric symptoms and QoL were assessed face-to-face by psychiatrists using the Brief Psychiatric Rating Scale (BPRS) and the Quality of Life Scale (QLS). Among older adults with Schizophrenia Spectrum Disorder, effects of psychiatric symptoms on QoL were exerted mostly through a general psychopathology dimension (β = − 0.43, p < 0.01). Negative symptom dimension had an additional negative effect on QoL beyond the effect of that factor (β = − 0.28, p < 0.01). Because psychiatric symptoms affect QoL mainly through two dimensions of psychopathology, i.e., a general psychopathology dimension and a negative symptom dimension, mechanisms underlying those dimensions should be considered as promising targets for therapeutic interventions to substantially improve quality of life of this vulnerable population.
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benzodiazepine use among older adults with Schizophrenia Spectrum Disorder prevalence and associated factors in a multicenter study
International Psychogeriatrics, 2020Co-Authors: Jeanpierre Schuster, Nicolas Hoertel, Armin Von Gunten, Annesophie Seigneurie, Frederic LimosinAbstract:OBJECTIVES Data on psychotropic medications of older patients with Schizophrenia Spectrum Disorder are scarce. Specifically, information about the use of benzodiazepines among older patients with Schizophrenia Spectrum Disorder is very limited. Because benzodiazepine use in older patients has been associated with many disabling side effects, its use in actual practice must be described and questioned. This study aimed at exploring the prevalence of benzodiazepine use and the clinical factors associated with such use among older patients with Schizophrenia Spectrum Disorder. METHODS/DESIGN Data from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) were used to examine the prevalence of benzodiazepine use among older patients with Schizophrenia Spectrum Disorder. Demographic and clinical characteristics associated with benzodiazepine prescription were also explored. RESULTS The prevalence of benzodiazepine use was 29.8% of older patients with Schizophrenia Spectrum Disorder. These patients were significantly more likely to have medical comorbidities, cognitive and social functioning impairments, to report a lifetime history of suicide attempt, to be institutionalized, and to have been hospitalized in a psychiatric service in the past year compared to those without a benzodiazepine prescription (all p<0.05). There were no between-group differences in Schizophrenia severity and psychiatric comorbidity. CONCLUSIONS Although it can be hypothesized that benzodiazepine prescription is part of a short-term therapeutic strategy toward patients with more severe trouble or comorbid Disorders, our results suggest a strong link between benzodiazepine prescription and a particularly vulnerable subpopulation of older patients with Schizophrenia Spectrum Disorder.
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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
Journal of Affective Disorders, 2019Co-Authors: Nicolas Hoertel, Carlos Blanco, Arthur Kaladjian, Rachel Pascal De Raykeer, Pierre Lavaud, Yvonne BlumenstockAbstract:Abstract Background Little is known about the respective effects of depression and cognitive impairment on quality of life among older adults with Schizophrenia Spectrum Disorder. Methods We used data from the Cohort of individuals with Schizophrenia Aged 55-years or more (CSA) study, a large multicenter sample of older adults with Schizophrenia or schizoaffective Disorder (N = 353). Quality of life (QoL), depression and cognitive impairment were assessed using the Quality of Life Scale (QLS), the Center of Epidemiologic Studies Depression scale and the Mini-Mental State Examination, respectively. We used structural equation modeling to examine the shared and specific effects of depression and cognitive impairment on QoL, while adjusting for sociodemographic characteristics, general medical conditions, psychotropic medications and the duration of the Disorder. Results Depression and cognitive impairment were positively associated (r = 0.24, p Limitations Because of the cross-sectional design of this study, measures of association do not imply causal associations. Conclusions Mechanisms underlying these two broad dimensions should be considered as important potential targets to improve quality of life of this vulnerable population.
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Psychiatric symptoms and quality of life in older adults with Schizophrenia Spectrum Disorder: results from a multicenter study
European Archives of Psychiatry and Clinical Neuroscience, 2019Co-Authors: Nicolas Hoertel, Léa Rotenberg, Carlos Blanco, Rachel Pascal De Raykeer, Cécile Hanon, Arthur Kaladjian, Frederic LimosinAbstract:The severity of psychopathology has a strong negative impact on quality of life (QoL) among older adults with Schizophrenia Spectrum Disorder. However, because these subjects generally experience multiple psychiatric symptoms, it remains unclear whether decreased QoL in this population is due to specific symptoms (e.g., hallucinations), specific dimensions of psychopathology (e.g., negative symptoms), a general psychopathology dimension representing the shared effect across all psychiatric symptoms, or a combination of these explanations. Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large ( N = 353) multicenter sample of older adults with Schizophrenia Spectrum Disorder recruited from French public-sector psychiatric departments. We used structural equation modeling to examine the shared and specific effects of psychiatric symptoms on QoL, while adjusting for sociodemographic characteristics, general medical conditions, global cognitive functioning and psychotropic medications. Psychiatric symptoms and QoL were assessed face-to-face by psychiatrists using the Brief Psychiatric Rating Scale (BPRS) and the Quality of Life Scale (QLS). Among older adults with Schizophrenia Spectrum Disorder, effects of psychiatric symptoms on QoL were exerted mostly through a general psychopathology dimension ( β = − 0.43, p
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Benzodiazepine use among older adults with Schizophrenia Spectrum Disorder: prevalence and associated factors in a multicenter study.
International psychogeriatrics, 2019Co-Authors: Jeanpierre Schuster, Nicolas Hoertel, Armin Von Gunten, Annesophie Seigneurie, Frederic LimosinAbstract:OBJECTIVES Data on psychotropic medications of older patients with Schizophrenia Spectrum Disorder are scarce. Specifically, information about the use of benzodiazepines among older patients with Schizophrenia Spectrum Disorder is very limited. Because benzodiazepine use in older patients has been associated with many disabling side effects, its use in actual practice must be described and questioned. This study aimed at exploring the prevalence of benzodiazepine use and the clinical factors associated with such use among older patients with Schizophrenia Spectrum Disorder. METHODS/DESIGN Data from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) were used to examine the prevalence of benzodiazepine use among older patients with Schizophrenia Spectrum Disorder. Demographic and clinical characteristics associated with benzodiazepine prescription were also explored. RESULTS The prevalence of benzodiazepine use was 29.8% of older patients with Schizophrenia Spectrum Disorder. These patients were significantly more likely to have medical comorbidities, cognitive and social functioning impairments, to report a lifetime history of suicide attempt, to be institutionalized, and to have been hospitalized in a psychiatric service in the past year compared to those without a benzodiazepine prescription (all p
Jan Dirk Blom - One of the best experts on this subject based on the ideXlab platform.
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Sexual Hallucinations in Schizophrenia Spectrum Disorders and Their Relation With Childhood Trauma
Frontiers Media S.A., 2018Co-Authors: Jan Dirk Blom, Esmeralda MangoenkarsoAbstract:Background: Sexual hallucinations are probably the most neglected types of hallucination, even in psychiatric settings. They are often multimodal in nature, and their prevalence rate is unknown. For other types of hallucination, notably auditory hallucinations, childhood trauma is an important risk factor. However, whether this also applies to sexual hallucinations is unexplored.Objective: To establish the prevalence rate of sexual hallucinations in a clinical sample of patients diagnosed with a Schizophrenia Spectrum Disorder, to describe their phenomenological characteristics, and to estimate their relationship with childhood trauma.Methods: After screening 778 patients diagnosed with a Schizophrenia Spectrum Disorder, 42 were considered eligible for inclusion by their treating physician or psychiatrist. Thirty of these patients were interviewed to assess the presence of sexual hallucinations, using a tailor-made questionnaire and the short form of the Childhood Trauma Questionnaire.Results: Of the 30 patients interviewed, 13 reported sexual hallucinations, yielding a 1-year prevalence rate of 0.017 in this clinical sample. Of the hallucinating patients, 46.2% reported multimodal hallucinations, with involvement of up to five sensory modalities. All patients who experienced sexual hallucinations reported a history of childhood trauma, of which 76.9% involved sexual trauma (OR 8.7). In addition, 61.5% of the patients reported high levels of distress.Conclusion: In patients diagnosed with a Schizophrenia Spectrum Disorder, sexual hallucinations warrant appropriate medical attention. They are not as rare as traditionally thought, and their relationship with childhood trauma is overwhelming. Therefore, we recommend that clinical attention be paid to the psychotic and traumatic symptoms of these patients, as well as to the somatic conditions that may underlie them. For clinical and research purposes, we propose a classification of sexual hallucinations in accordance with the sensory modalities involved. As sexual hallucinations are also experienced in the context of temporal lobe epilepsy, narcolepsy, persistent genital arousal Disorder, intoxications and other somatic conditions, further research in transdiagnostic populations seems warranted. In line with the current practice of providing trauma-focused treatment for trauma-related auditory hallucinations, we recommend that future studies explore the effectiveness of this type of treatment for sexual hallucinations
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Data_Sheet_1_Sexual Hallucinations in Schizophrenia Spectrum Disorders and Their Relation With Childhood Trauma.PDF
2018Co-Authors: Jan Dirk Blom, Esmeralda MangoenkarsoAbstract:Background: Sexual hallucinations are probably the most neglected types of hallucination, even in psychiatric settings. They are often multimodal in nature, and their prevalence rate is unknown. For other types of hallucination, notably auditory hallucinations, childhood trauma is an important risk factor. However, whether this also applies to sexual hallucinations is unexplored.Objective: To establish the prevalence rate of sexual hallucinations in a clinical sample of patients diagnosed with a Schizophrenia Spectrum Disorder, to describe their phenomenological characteristics, and to estimate their relationship with childhood trauma.Methods: After screening 778 patients diagnosed with a Schizophrenia Spectrum Disorder, 42 were considered eligible for inclusion by their treating physician or psychiatrist. Thirty of these patients were interviewed to assess the presence of sexual hallucinations, using a tailor-made questionnaire and the short form of the Childhood Trauma Questionnaire.Results: Of the 30 patients interviewed, 13 reported sexual hallucinations, yielding a 1-year prevalence rate of 0.017 in this clinical sample. Of the hallucinating patients, 46.2% reported multimodal hallucinations, with involvement of up to five sensory modalities. All patients who experienced sexual hallucinations reported a history of childhood trauma, of which 76.9% involved sexual trauma (OR 8.7). In addition, 61.5% of the patients reported high levels of distress.Conclusion: In patients diagnosed with a Schizophrenia Spectrum Disorder, sexual hallucinations warrant appropriate medical attention. They are not as rare as traditionally thought, and their relationship with childhood trauma is overwhelming. Therefore, we recommend that clinical attention be paid to the psychotic and traumatic symptoms of these patients, as well as to the somatic conditions that may underlie them. For clinical and research purposes, we propose a classification of sexual hallucinations in accordance with the sensory modalities involved. As sexual hallucinations are also experienced in the context of temporal lobe epilepsy, narcolepsy, persistent genital arousal Disorder, intoxications and other somatic conditions, further research in transdiagnostic populations seems warranted. In line with the current practice of providing trauma-focused treatment for trauma-related auditory hallucinations, we recommend that future studies explore the effectiveness of this type of treatment for sexual hallucinations.
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Prevalence and classification of hallucinations in multiple sensory modalities in Schizophrenia Spectrum Disorders
Schizophrenia Research, 2016Co-Authors: Anastasia Lim, Hans W. Hoek, Mathijs Deen, Jan Dirk Blom, Richard Bruggeman, Wiepke Cahn, Lieuwe De Haan, René S. Kahn, Carin J. Meijer, Inez Myin-germeysAbstract:Abstract Background Auditory hallucinations are experienced by 60–80% of all patients diagnosed with a Schizophrenia Spectrum Disorder. However, in this patient group, the prevalence of hallucinations in multiple sensory modalities, i.e. multimodal hallucinations (MMHs), is unknown. Aims To assess the prevalence of MMHs in patients diagnosed with a Schizophrenia Spectrum Disorder, data were analyzed from 750 patients who participated in the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study. Method We drew on the section of the CASH (Comprehensive Assessment of Symptoms and History) that probes into the lifetime presence of auditory, visual, somatic/tactile, and olfactory hallucinations. Results A lifetime prevalence of 80% was found in this group for hallucinations in any of these modalities. Within the whole group, 27% of the participants reported unimodal hallucinations and 53% MMHs. There were no significant differences in prevalence rate for Dutch versus migrant participants from Morocco, Turkey, Surinam or the (former) Dutch Antilles. Conclusion We conclude that MMHs, rather than auditory hallucinations, are the most frequent perceptual symptom of patients diagnosed with a Schizophrenia Spectrum Disorder. Our data also suggest that hallucinations experienced in a single sensory modality (notably auditory ones) stochastically increase the risk for more sensory modalities to join in. We recommend that future studies take into account all 14 sensory modalities in which hallucinations can be experienced. For this we provide a classification of MMHs that allows characterization of their serial versus simultaneous occurrence and their congruent versus incongruent nature.
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Prevalence and classification of hallucinations in multiple sensory modalities in Schizophrenia Spectrum Disorders.
Schizophrenia research, 2016Co-Authors: Anastasia Lim, Hans W. Hoek, Mathijs L Deen, Jan Dirk BlomAbstract:Auditory hallucinations are experienced by 60-80% of all patients diagnosed with a Schizophrenia Spectrum Disorder. However, in this patient group, the prevalence of hallucinations in multiple sensory modalities, i.e. multimodal hallucinations (MMHs), is unknown. To assess the prevalence of MMHs in patients diagnosed with a Schizophrenia Spectrum Disorder, data were analyzed from 750 patients who participated in the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study. We drew on the section of the CASH (Comprehensive Assessment of Symptoms and History) that probes into the lifetime presence of auditory, visual, somatic/tactile, and olfactory hallucinations. A lifetime prevalence of 80% was found in this group for hallucinations in any of these modalities. Within the whole group, 27% of the participants reported unimodal hallucinations and 53% MMHs. There were no significant differences in prevalence rate for Dutch versus migrant participants from Morocco, Turkey, Surinam or the (former) Dutch Antilles. We conclude that MMHs, rather than auditory hallucinations, are the most frequent perceptual symptom of patients diagnosed with a Schizophrenia Spectrum Disorder. Our data also suggest that hallucinations experienced in a single sensory modality (notably auditory ones) stochastically increase the risk for more sensory modalities to join in. We recommend that future studies take into account all 14 sensory modalities in which hallucinations can be experienced. For this we provide a classification of MMHs that allows characterization of their serial versus simultaneous occurrence and their congruent versus incongruent nature. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.
Frederic Limosin - One of the best experts on this subject based on the ideXlab platform.
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psychiatric symptoms and quality of life in older adults with Schizophrenia Spectrum Disorder results from a multicenter study
European Archives of Psychiatry and Clinical Neuroscience, 2020Co-Authors: Nicolas Hoertel, Léa Rotenberg, Carlos Blanco, Cécile Hanon, Arthur Kaladjian, Rachel Pascal De Raykeer, Frederic LimosinAbstract:The severity of psychopathology has a strong negative impact on quality of life (QoL) among older adults with Schizophrenia Spectrum Disorder. However, because these subjects generally experience multiple psychiatric symptoms, it remains unclear whether decreased QoL in this population is due to specific symptoms (e.g., hallucinations), specific dimensions of psychopathology (e.g., negative symptoms), a general psychopathology dimension representing the shared effect across all psychiatric symptoms, or a combination of these explanations. Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large (N = 353) multicenter sample of older adults with Schizophrenia Spectrum Disorder recruited from French public-sector psychiatric departments. We used structural equation modeling to examine the shared and specific effects of psychiatric symptoms on QoL, while adjusting for sociodemographic characteristics, general medical conditions, global cognitive functioning and psychotropic medications. Psychiatric symptoms and QoL were assessed face-to-face by psychiatrists using the Brief Psychiatric Rating Scale (BPRS) and the Quality of Life Scale (QLS). Among older adults with Schizophrenia Spectrum Disorder, effects of psychiatric symptoms on QoL were exerted mostly through a general psychopathology dimension (β = − 0.43, p < 0.01). Negative symptom dimension had an additional negative effect on QoL beyond the effect of that factor (β = − 0.28, p < 0.01). Because psychiatric symptoms affect QoL mainly through two dimensions of psychopathology, i.e., a general psychopathology dimension and a negative symptom dimension, mechanisms underlying those dimensions should be considered as promising targets for therapeutic interventions to substantially improve quality of life of this vulnerable population.
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benzodiazepine use among older adults with Schizophrenia Spectrum Disorder prevalence and associated factors in a multicenter study
International Psychogeriatrics, 2020Co-Authors: Jeanpierre Schuster, Nicolas Hoertel, Armin Von Gunten, Annesophie Seigneurie, Frederic LimosinAbstract:OBJECTIVES Data on psychotropic medications of older patients with Schizophrenia Spectrum Disorder are scarce. Specifically, information about the use of benzodiazepines among older patients with Schizophrenia Spectrum Disorder is very limited. Because benzodiazepine use in older patients has been associated with many disabling side effects, its use in actual practice must be described and questioned. This study aimed at exploring the prevalence of benzodiazepine use and the clinical factors associated with such use among older patients with Schizophrenia Spectrum Disorder. METHODS/DESIGN Data from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) were used to examine the prevalence of benzodiazepine use among older patients with Schizophrenia Spectrum Disorder. Demographic and clinical characteristics associated with benzodiazepine prescription were also explored. RESULTS The prevalence of benzodiazepine use was 29.8% of older patients with Schizophrenia Spectrum Disorder. These patients were significantly more likely to have medical comorbidities, cognitive and social functioning impairments, to report a lifetime history of suicide attempt, to be institutionalized, and to have been hospitalized in a psychiatric service in the past year compared to those without a benzodiazepine prescription (all p<0.05). There were no between-group differences in Schizophrenia severity and psychiatric comorbidity. CONCLUSIONS Although it can be hypothesized that benzodiazepine prescription is part of a short-term therapeutic strategy toward patients with more severe trouble or comorbid Disorders, our results suggest a strong link between benzodiazepine prescription and a particularly vulnerable subpopulation of older patients with Schizophrenia Spectrum Disorder.
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Psychiatric symptoms and quality of life in older adults with Schizophrenia Spectrum Disorder: results from a multicenter study
European Archives of Psychiatry and Clinical Neuroscience, 2019Co-Authors: Nicolas Hoertel, Léa Rotenberg, Carlos Blanco, Rachel Pascal De Raykeer, Cécile Hanon, Arthur Kaladjian, Frederic LimosinAbstract:The severity of psychopathology has a strong negative impact on quality of life (QoL) among older adults with Schizophrenia Spectrum Disorder. However, because these subjects generally experience multiple psychiatric symptoms, it remains unclear whether decreased QoL in this population is due to specific symptoms (e.g., hallucinations), specific dimensions of psychopathology (e.g., negative symptoms), a general psychopathology dimension representing the shared effect across all psychiatric symptoms, or a combination of these explanations. Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large ( N = 353) multicenter sample of older adults with Schizophrenia Spectrum Disorder recruited from French public-sector psychiatric departments. We used structural equation modeling to examine the shared and specific effects of psychiatric symptoms on QoL, while adjusting for sociodemographic characteristics, general medical conditions, global cognitive functioning and psychotropic medications. Psychiatric symptoms and QoL were assessed face-to-face by psychiatrists using the Brief Psychiatric Rating Scale (BPRS) and the Quality of Life Scale (QLS). Among older adults with Schizophrenia Spectrum Disorder, effects of psychiatric symptoms on QoL were exerted mostly through a general psychopathology dimension ( β = − 0.43, p
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Benzodiazepine use among older adults with Schizophrenia Spectrum Disorder: prevalence and associated factors in a multicenter study.
International psychogeriatrics, 2019Co-Authors: Jeanpierre Schuster, Nicolas Hoertel, Armin Von Gunten, Annesophie Seigneurie, Frederic LimosinAbstract:OBJECTIVES Data on psychotropic medications of older patients with Schizophrenia Spectrum Disorder are scarce. Specifically, information about the use of benzodiazepines among older patients with Schizophrenia Spectrum Disorder is very limited. Because benzodiazepine use in older patients has been associated with many disabling side effects, its use in actual practice must be described and questioned. This study aimed at exploring the prevalence of benzodiazepine use and the clinical factors associated with such use among older patients with Schizophrenia Spectrum Disorder. METHODS/DESIGN Data from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) were used to examine the prevalence of benzodiazepine use among older patients with Schizophrenia Spectrum Disorder. Demographic and clinical characteristics associated with benzodiazepine prescription were also explored. RESULTS The prevalence of benzodiazepine use was 29.8% of older patients with Schizophrenia Spectrum Disorder. These patients were significantly more likely to have medical comorbidities, cognitive and social functioning impairments, to report a lifetime history of suicide attempt, to be institutionalized, and to have been hospitalized in a psychiatric service in the past year compared to those without a benzodiazepine prescription (all p
Lisa Mori - One of the best experts on this subject based on the ideXlab platform.
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Formal thought Disorder in pediatric complex partial seizure Disorder.
Journal of Child Psychology and Psychiatry, 1992Co-Authors: Rochelle Caplan, W. Donald Shields, Donald Guthrie, Lisa MoriAbstract:: We compared the formal thought Disorder ratings of 27 children with complex partial seizure Disorder, 31 schizophrenic children and 58 normal children. The epileptic children with fullscale IQ scores below 100 had significantly more formal thought Disorder than normal children with a similar IQ. The severity of their formal thought Disorder was related to the age of seizure onset, seizure control and a diagnosis of Schizophrenia Spectrum Disorder. The schizophrenic children had thought Disorder irrespective of IQ scores. The cognitive correlates of their formal thought Disorder scores differed from those of the epileptic children. Possible anatomical substrates of thought Disorder in childhood complex partial seizure Disorder and Schizophrenia are discussed.
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Formal thought Disorder in pediatric complex partial seizure Disorder.
Journal of child psychology and psychiatry and allied disciplines, 1992Co-Authors: Rochelle Caplan, W. Donald Shields, Donald Guthrie, Lisa MoriAbstract:We compared the formal thought Disorder ratings of 27 children with complex partial seizure Disorder, 31 schizophrenic children and 58 normal children. The epileptic children with fullscale EQ, scores below 100 had significantly more formal thought Disorder than normal children with a similar IQ. The severity of their formal thought Disorder was related to the age of seizure onset, seizure control and a diagnosis of Schizophrenia Spectrum Disorder. The schizophrenic children had thought Disorder irrespective of IQ scores. The cognitive correlates of their formal thought Disorder scores differed from those of the epileptic children. Possible anatomical substrates of thought Disorder in childhood complex partial seizure Disorder and Schizophrenia are discussed.
Paul H. Lysaker - One of the best experts on this subject based on the ideXlab platform.
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Individual Psychotherapy and Changes in Self-Experience in Schizophrenia: A Qualitative Comparison of Patients in Metacognitively Focused and Supportive Psychotherapy
Psychiatry, 2015Co-Authors: Paul H. Lysaker, Marina Kukla, Elizabeth A. Belanger, Dominique A. White, Kelly D. Buck, Lauren Luther, Ruth L. Firmin, Bethany L. LeonhardtAbstract:Objective: Deficits in metacognition, or the ability to form complex ideas about self and others, may be a root cause of dysfunction in Schizophrenia. Accordingly, forms of psychotherapy have been proposed to address metacognitive deficits. This study explored whether metacognitively focused individual psychotherapy can affect self-experience by conducting narrative interviews of patients with a Schizophrenia Spectrum Disorder enrolled in either metacognitively oriented psychotherapy (n = 12) or supportive psychotherapy (n = 13) in a naturalistic setting. Method: Participants in both groups completed a narrative interview consisting of questions that focused on perceptions and process of psychotherapy and its impact on outcomes. Interviews were audiotaped, transcribed, and coded using an inductive process informed by grounded theory. Results: Qualitative analyses revealed all participants reported psychotherapy led to improvements in self-esteem and the ability to think more clearly and set meaningful goa...
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metacognitive reflective and insight therapy for people in early phase of a Schizophrenia Spectrum Disorder
Journal of Clinical Psychology, 2015Co-Authors: Jaclyn D Hillis, Kelly D. Buck, Bethany L. Leonhardt, Jenifer L Vohs, Giampaolo Salvatore, Raffaele Popolo, Giancarlo Dimaggio, Paul H. LysakerAbstract:Schizophrenia often involves a loss of metacognitive capacity, the ability to form complex and integrated representations of self and others. Independent of symptoms and neurocognition, deficits in synthetic metacognition are related to difficulties of engaging in goal-directed activities in social and vocational settings. Within this backdrop, we provide a case report of the effects of Metacognitive Reflective Insight Therapy (MERIT) that assisted a patient suffering from first episode Schizophrenia during 2 years of individual psychotherapy. A total of 8 elements of MERIT that stimulate and promote metacognitive capacity are presented. As illustrated in this report, these procedures helped the patient move from a state in which he had virtually no complex ideas about himself or others to one in which he had developed integrated and realistic ideas about his own identity and the identity of others. He then could use these representations to understand and effectively respond to life challenges.
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dissociation and social cognition in Schizophrenia Spectrum Disorder
Schizophrenia Research, 2012Co-Authors: Selwyn B Renard, Marieke Pijnenborg, Paul H. LysakerAbstract:Abstract While there is emerging evidence that dissociation is linked with trauma history and possibly symptoms in Schizophrenia, it remains unclear whether dissociation represents a symptom dimensions in its own right in Schizophrenia and as such is uniquely related to other features of illness. To explore this issue the current study sought to find out whether dissociation was uniquely related to an index of social cognition closely linked to social functioning, namely affect recognition. We hypothesized that dissociation would be linked with affect recognition because symptoms of dissociation may uniquely disrupt processes which are expected to be needed for correctly recognizing emotions. The sample contained 49 participants diagnosed with a Schizophrenia Spectrum Disorder who were in a non-acute phase of Disorder. Participants were concurrently administered the Bell–Lysaker Emotion Recognition Task, the Dissociative Experiences Scale, the Post Traumatic Stress Disorder Checklist and the Positive and Negative Symptoms Scale. Stepwise linear regression analyses were performed in which dissociative symptoms were forced to enter after the other symptoms in order to predict deficits in affect recognition. These analyses revealed that greater levels of dissociative symptoms predicted poorer recognition of negative emotions over and above that of positive, negative, cognitive and PTSD symptoms. Results are consistent with the possibility that dissociation represents a unique dimension o f psychopathology in Schizophrenia which may be linked to function.
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the prevalence and correlates of trauma related symptoms in Schizophrenia Spectrum Disorder
Comprehensive Psychiatry, 2008Co-Authors: Paul H. Lysaker, Valerie A LaroccoAbstract:Research has suggested that many with Schizophrenia have been exposed to significant trauma, both after and before the onset of their illness. Less clear is how commonly significant levels of trauma symptoms are found in Schizophrenia, how often they co-occur, and what their relationship is with positive and negative symptoms. To examine these issues, we concurrently assessed trauma history, trauma symptoms using the Trauma Symptom Inventory, and symptoms using the Positive and Negative Syndrome Scale. Participants were 68 individuals with Schizophrenia Spectrum Disorders who provided reliable reports of at least one traumatic event from an original sample of 81 individuals. Results revealed that two thirds of participants reported clinically significant trauma symptoms that included at least intrusive experiences, defensive avoidance, or dissociation. Greater levels of depression and disturbance of volition were significantly correlated with greater levels of anxious arousal, intrusive experiences, defensive avoidance, dissociation, and total number of significantly elevated trauma scales. Delusions were correlated with intrusive experiences, dissociation, and number of significantly elevated trauma scales, whereas hallucinations were correlated with irritability and total number of significantly elevated trauma scales. Results suggest that trauma symptoms may be commonly experienced in Schizophrenia and linked with the phenomenology of the Disorder.
