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Although language deficits have often been reported in schizophrenia, the specific relevance of single linguistic levels of processing is still under debate. Moreover, little is known about language disturbances in bipolar disorder.
The aims of this study were to:
1) investigate micro-linguistic (lexicon, morphology, syntax) and macro-linguistic (discourse coherence, pragmatics) dimensions of speech production and
2) evaluate syntactic comprehension skills in both schizophrenia and, for the first time, bipolar disorder.
A story telling task and a computer-based test of syntactic comprehension were administered to 30 Italian speaking DSM-IV patients suffering from schizophrenia, 30 participants with bipolar disorder and 30 healthy controls, comparable for age and educational level (p>0.05). Analysis of variance with post-hoc correction was performed to compare linguistic performance between groups.
In comparison to healthy participants, patients with schizophrenia had significantly impaired productivity, syntactic complexity and local/global discourse coherence and bipolar disorder subjects showed deficits in mean length of utterance (p< 0.05). Also, both groups of patients collected more grammatical errors than controls (p< 0.05), but they differed in regard to the grammatical type of construction they missed (passive-affirmative and active-negative, respectively).
Our results showed the presence of both micro and macro-linguistic deficits in linguistic production in schizophrenia, but not in bipolar disorder, suggesting that these abnormalities are specific for schizophrenia. On the contrary, syntactic construction comprehension was altered in both schizophrenia and bipolar disorder, potentially representing the target of innovative rehabilitation strategies.
Chronic illness in a child requires successful organisational and emotional adjustment of the child and the family. The way in which the child and the family adapt to the illness will affect their psychological well-being and their quality of life. This review summarizes recent research findings on the relationship between illness factors, individual and family functioning, coping strategies and psychosocial adjustment. The findings are presented within the framework of three complementary theoretical models: the family developmental approach; the psychosocial typology of illnesses; and the process model of stress and coping. These models are useful for a better understanding of the complex interactions between illness, family and coping and offer to the professionals engaged in the care of chronically sick children, guidelines for assessment and the development of intervention programs. The review starts with examining the impact of chronic illness on the psychosocial adjustment of the sick child, his/her siblings and parents. Then psychosocial Stressors and risk factors in terms of illness and family related characteristics are discussed. Coping resources and strategies are presented which have been shown to be related to child and parental adjustment; and finally, successful intervention programs are described.
Several neuroimaging studies have shown impaired microstructural integrity of corpus callosum in schizophrenia, which may support inter-hemispheric misconnection. However, functional connectivity has rarely been investigated in schizophrenia.
To explore inter-hemispheric communication in a sample of patients with schizophrenia in comparison to healthy controls.
Twenty-five patients with schizophrenia and forty-one healthy controls were studied. Subjects were asked to press a key with the index-finger of their right or the left hand as quickly as possible following appearance of either a single or a double stimulus. Two measures were calculated: the difference between manual reaction times (RT) after the presentation of single stimuli to the ipsilateral (uncrossed response) or contralateral (crossed response) visual hemifield (the so-called Poffenberger Paradigm), as a measure of interhemispheric transfer time (ITT), and the difference between double and single stimuli (the Redundant Target Effect, RTE), as a measure of interhemispheric integration.
Overall, patients with schizophrenia responded faster with the left than with the right hand (Paired sample t-test p=0.019). Importantly, in schizophrenics there was no group difference in ITT but there was a significantly enhanced RTE .
The slower RT for right hand in schizophrenics possibly reflects a general delay of the left cerebral hemisphere in visuomotor RT. Moreover, the enhanced RTE suggests an impairment of interhemispheric integration in schizophrenia.
Language disturbances, such as impoverishment, disorganization and dysregulation, are a prominent feature of schizophrenia. Several neuroimaging studies have suggested the superior temporal gyrus (STG) as a likely anatomical substrate of language deficits in schizophrenia. The aim of this study was to verify a correlation between structural measures of STG and Heschl's gyrus (HG) and language dimensions.
An extensive language examination battery, which included narrative and conversational expressive tasks, and syntactic and pragmatic comprehension tests, was administered to 23 schizophrenia patients (mean age±SD= 40.30±11.60) and 21 normal controls (mean age±SD= 42.19±11.05). All subjects also underwent a 1.5T MRI session, and STG and HG were manually traced and volumes were obtained, bilaterally, using Brains2.
Specific language deficits were shown in subjects with schizophrenia compared to healthy individuals (p<0.001), particularly in verbal fluency, syntactic complexity, lexical diversity and metaphor/idiom comprehension. Interestingly, speech fluency significantly directly associated with left STG gray matter volumes in controls (r=0.46, p=0.03) but not in patients (r=-0.27, p=0.21). In contrast, complex syntax and word diversity significantly correlated, respectively, with left and right HG volumes in schizophrenia patients (r=0.45, p=0.02; r=-0.47, p=0.02), but not in controls (p>0.05).
This study confirmed a widespread impairment of language in schizophrenia. Interestingly, distinct language dimensions differently correlated with STG-HG volumes in patients with schizophrenia and controls, particularly with regard to verbal fluency and syntactic measures.
Lately on these pages, a discussion is going on over the opportunity of the use of the definition ‘outsider’. Especially in the USA, it is judged as demeaning, discriminating and inappropriate, whilst in Europe, it is used in a much more unconcerned way. Mr Gioni curator of numerous international exhibitions including Manifesta 5 (2004), the 4th Berlin Biennale (2006), the 8th Gwangju Biennale (2010) and the 55th Venice Biennale (2013) shares his perspective on contemporary culture and self-taught art.
This paper aims at providing an overview of the background, design and initial findings of Psychosis Incident Cohort Outcome Study (PICOS).
PICOS is a large multi-site population-based study on first-episode psychosis (FEP) patients attending public mental health services in the Veneto region (Italy) over a 3-year period. PICOS has a naturalistic longitudinal design and it includes three different modules addressing, respectively, clinical and social variables, genetics and brain imaging. Its primary aims are to characterize FEP patients in terms of clinical, psychological and social presentation, and to investigate the relative weight of clinical, environmental and biological factors (i.e. genetics and brain structure/functioning) in predicting the outcome of FEP.
An in-depth description of the research methodology is given first. Details on recruitment phase and baseline and follow-up evaluations are then provided. Initial findings relating to patients' baseline assessments are also presented. Future planned analyses are outlined.
Both strengths and limitations of PICOS are discussed in the light of issues not addressed in the current literature on FEP. This study aims at making a substantial contribution to research on FEP patients. It is hoped that the research strategies adopted in PICOS will enhance the convergence of methodologies in ongoing and future studies on FEP.
Abnormalities in incentive decision making, typically assessed using the Iowa Gambling Task (IGT), have been reported in both schizophrenia (SZ) and bipolar disorder (BD). We applied the Expectancy–Valence (E–V) model to determine whether motivational, cognitive and response selection component processes of IGT performance are differentially affected in SZ and BD.
Performance on the IGT was assessed in 280 individuals comprising 70 remitted patients with SZ, 70 remitted patients with BD and 140 age-, sex- and IQ-matched healthy individuals. Based on the E–V model, we extracted three parameters, ‘attention to gains or loses’, ‘expectancy learning’ and ‘response consistency’, that respectively reflect motivational, cognitive and response selection influences on IGT performance.
Both patient groups underperformed in the IGT compared to healthy individuals. However, the source of these deficits was diagnosis specific. Associative learning underlying the representation of expectancies was disrupted in SZ whereas BD was associated with increased incentive salience of gains. These findings were not attributable to non-specific effects of sex, IQ, psychopathology or medication.
Our results point to dissociable processes underlying abnormal incentive decision making in BD and SZ that could potentially be mapped to different neural circuits.
This paper examined the hypothesis that males with first-episode psychosis (FEP) experience lower pre-morbid adjustment, greater social disability and more self-perceived needs at illness onset than females (by controlling for duration of untreated psychosis, diagnosis, age and symptoms at onset). Results disconfirming this hypothesis were thought to suggest the potentially mediating role of social context in determining the impact of symptoms and disability on the everyday lives of male patients in the early phase of psychosis.
A large epidemiologically representative cohort of FEP patients (n=517) was assessed within the Psychosis Incident Cohort Outcome Study (PICOS) framework – a multi-site research project examining incident cases of psychosis in Italy's Veneto region.
Despite poorer pre-morbid functioning and higher social disability at illness onset, males reported fewer unmet needs in the functioning domain than females did. An analysis of help provided by informal caregivers showed that males received more help from their families than females did. This finding led us to disconfirm the second part of the hypothesis and suggest that the impact of poorer social performance and unmet needs on everyday life observed in male patients might be hampered by higher tolerance and more support within the family context.
These findings shed new light on rarely investigated sociocultural and contextual factors that may account for the observed discrepancy between social disability and needs for care in FEP patients. They also point to a need for further research on gender differences, with the ultimate aim of delivering gender-sensitive effective mental health care.
The amygdala plays a central role in the fronto-limbic network involved in the processing of emotions. Structural and functional abnormalities of the amygdala have recently been found in schizophrenia, although there are still contradictory results about its reduced or preserved volumes.
In order to address these contradictory findings and to further elucidate the possibly underlying pathophysiological process of the amygdala, we employed structural magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI), exploring amygdalar volume and microstructural changes in 69 patients with schizophrenia and 72 matched healthy subjects, relating these indices to psychopathological measures.
Measuring water diffusivity, the apparent diffusion coefficients (ADCs) for the right amygdala were found to be significantly greater in patients with schizophrenia compared with healthy controls, with a trend for abnormally reduced volumes. Also, significant correlations between mood symptoms and amygdalar volumes were found in schizophrenia.
We therefore provide evidence that schizophrenia is associated with disrupted tissue organization of the right amygdala, despite partially preserved size, which may ultimately lead to abnormal emotional processing in schizophrenia. This result confirms the major role of the amygdala in the pathophysiology of schizophrenia and is discussed with respect to amygdalar structural and functional abnormalities found in patients suffering from this illness.