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Based on technologies capable of data collection between the millimeter and nanometer scales, correlative imaging has been transforming how researchers obtain molecular and spatial information from specimens. Attempts to combine multidimensional data are often met with the challenge of overcoming suboptimal sample conditions such as reduced fluorescence signal, poor specimen preservation, anisotropic specimen deformation, and low specimen contrast. These issues motivated the development and use of enhanced sample preparation procedures, as well as specialized imaging software to overcome such challenges. In this work we present three simple methods to correlate optical and scanning electron microscopy images.
The majority of available US-published reports present populations with community spread in urban areas. The objective of this report is to describe a rural healthcare system's utilisation of therapeutic options available to treat Coronavirus Disease 2019 (COVID-19) and subsequent patient outcomes. A total of 150 patients were treated for COVID-19 at three hospitals in the Dakotas from 21 March 2020 to 30 April 2020. The most common pharmacological treatment regimens administered were zinc, hydroxychloroquine plus azithromycin and convalescent plasma. Adjunctive treatments included therapeutic anticoagulation, tocilizumab and corticosteroids. As of 1 June 2020, 127 patients have survived to hospital discharge, 12 patients remain hospitalised and 11 patients have expired. The efficacy of hydroxychloroquine and azithromycin use has yet to be determined but was not without risks of corrected QT interval prolongation and arrhythmias in our cohort. We did not appreciate any adverse effects that appeared related to tocilizumab or convalescent plasma administration in those patient subsets. These findings may provide insight into disease severity and treatment options in the rural setting with limited resources to participate in clinical trials and encourage larger comparative studies evaluating treatment efficacy.
One hypothesis proposed to underlie formal thought disorder (FTD), the incoherent speech is seen in some patients with schizophrenia, is that it reflects impairment in frontal/executive function. While this proposal has received support in neuropsychological studies, it has been relatively little tested using functional imaging. This study aimed to examine brain activations associated with FTD, and its two main factor-analytically derived subsyndromes, during the performance of a working memory task.
Seventy patients with schizophrenia showing a full range of FTD scores and 70 matched healthy controls underwent fMRI during the performance of the 2-back version of the n-back task. Whole-brain corrected, voxel-based correlations with FTD scores were examined in the patient group.
During 2-back performance the patients showed clusters of significant inverse correlation with FTD scores in the inferior frontal cortex and dorsolateral prefrontal cortex bilaterally, the left temporal cortex and subcortically in the basal ganglia and thalamus. Further analysis revealed that these correlations reflected an association only with ‘alogia’ (poverty of speech, poverty of content of speech and perseveration) and not with the ‘fluent disorganization’ component of FTD.
This study provides functional imaging support for the view that FTD in schizophrenia may involve impaired executive/frontal function. However, the relationship appears to be exclusively with alogia and not with the variables contributing to fluent disorganization.
Until now, no reliable biological markers of risk and relapse in substance-dependent patients have been identified. The yawn-inducing test with apomorphine has been proposed as a marker of the functional status of the dopaminergic system and therefore a predictor of suffering an addiction or predisposition to relapse.
Studying the safety and efficacy of apomorphine test as a predictor of relapse in intranasal cocaine dependent, diagnosed according to DSM-IV-TR.
We performed the test of apomorphine at the beginning (day 1) and end (day 11/12) of a detoxification program in 33 patients (29 men). The majority of patients relapsed after 22 weeks of follow up (87% relapse). The average yawns in the sample were 10.9 ± 9.3 in the initial test (Apo 1) and 10.2 ± 10.2 in the final test (Apo 2). The 42% of patients relapsed early (before 4 weeks) and 45% late (afther 4 weeks). 58% of the sample (N = 19), which did not fall belatedly filled an average of 8.0 yawns in Apo1 and 8.1 on Apo2 and 42% who did so early (N = 14), 14,8 in Apo1 and 14.6 in Apo2. Therefore there are an increased number of yawns in patients with early relapse. No important side effects were reported.
Patients with early relapse have a higher number of yawns that those falling late or abstainers The apomorphine test is a safe test and it is a readily applicable tool in clinical practice and may be a biological marker of risk.
Addictive disorders are frequent in schizophrenia and dual diagnose is the norm rather than the exception. Dopamine transmission is implicated both in addictive disorders as in psychotic diseases. The objective is to know if addiction is one independent dimension in schizophrenia or if it can be included in to the positive, negative or affective syndromes.
We conduct one cross-sectional study on 60 schizophrenia out-patients (43 male; average age: 38.9 years, SD 9.4). The diagnosis were: paranoid schizophrenia 26.7%, schizoaffective disorder 25.0%, residual schizophrenia 21.7%, other schizophrenia subtypes 26.6%. It was applied the PANSS and one addiction composite score (ACS) that reflects the life use of drugs and addiction: tobacco, coffee, alcohol, cannabis, cocaine, amphetamines, hallucinogens, opiates and gambling. For every substance and gambling were scored: first use, frequency, length of use, last time use and harmful consequences. All the scores were transformed in to Z values. Factor analysis using principal components (Varimax rotation) was performed introducing in the model: PANSS positive and negative items, depression item an the ACS.
Five factors were defined, that explains for 78.4 of the variance: negative (N1, N2, N3, N4, N6), disorganized (P2, P4, N5, N7), positive and depressive (P1, P3, G6), hostility (P5, P6, P7) and addictive (ACS).
Addiction is one independent dimension in schizophrenia, differentiated from positive, negative, disorganized and hostility syndromes. We propose the systematic study of addiction as one intrinsic dimension of schizophrenia due to its independence of other dimensions, its high prevalence and its clinical relevance.
We present the case of a schizophrenic patient with severe insomnia that had a partial response to high doses of benzodiazepines and sedating antipsychotics. Treatment with agomelatine allowed to suspend benzodiazepine treatment and restore quality of sleep.
Mr. Y is a 36 year old male patient diagnosed with simple schizophrenia that has complained of insomnia since the age of sixteen. During the last three years the treatment that the patient was following was stable and consisted of 100 mg of diazepam, 300 mg of levomepromazine and 120 mg of clotiapine every night. During the last year 60 mg of duloxetine were added to treat a moderate depression. His mood improved with the prescribed treatment, but eleven months later it worsened. In an attempt to simultaneously treat the mood and the sleep disorder, during a period of 4 days, a dosis of 12.5 mg of aglomelatin at dinner was introduced while the morning dose of duloxetine was reduced to 30mg. On the fifth day, agomelatine was increased to 25 mg at dinner while duloxetine was suspended. The antipsychotic treatment was kept stable while the patient was instructed to reduce 10 mg of diazepam every week until next appointment one month later. In the next appointment the patient had completely suspended diazepam one week before the appointment. The patient referred improved sleep quality and no rebound insomnia.
Agomelatine may be a valid treatment of insomnia in schizophrenia.
To estimate the prevalence and severity of neuropsychiatric symptoms in patients with dementia in nursing homes, assessing their association with certain factors that may promote or prevent its occurrence.
A cross-sectional study was carried out. We included all elderly diagnosed with degenerative, vascular, or mixed dementia, stage 4 to 7 of the GDS, and residents in 6 nursing homes in the province of Ourense (Spain). The assessment of symptoms was performed using the Neuropsychiatric Inventory - Nursing Home (NPI-NH) test. A sample size of 120 individuals was determined to be necessary.
We included 212 cases, with an average age of 85.7 (SD = 6.7) years. The prevalence of neuropsychiatric symptoms was 84.4%. The most common symptom was apathy, followed by agitation and delirium, the least frequent were euphoria and hallucinations. The symptom that produced most occupational disruption was agitation. Multivariate analysis showed that a higher score on the NPI-NH was associated with the use of neuroleptics, both typical and atypical, and with a higher score on the Reisberg Scale. Negative association was demonstrated with the number of days of institutionalization and the diagnosis of vascular dementia.
Patients with dementia in nursing homes in our area have a high frequency of neuropsychiatric symptoms that are associated with neuroleptic use and decreases as the patient remains institutionalized for longer. Patients diagnosed with vascular dementia have lower scores on the NPI-NH test.
Stress and trauma have been reported as leading contributing factors in schizophrenia. And certainly child abuse (neglect, emotional, physical and sexual abuse among others) has a lasting negative impact, which is well established in literature.
To consider the presence of infant trauma and its relationship with psychopathology in paranoid schizophrenics.Methods. 37 patients (mean age 29±6.3; years from onset 9.20±4.7), meeting DSM IV paranoid schizophrenia criteria, undergoing treatment in a university hospital are studied. The PANSS is administered in order to rate psychopathology.
27 patients had infant trauma (55.8%). Main traumas are: sexual abuse (12.8%), child abuse (7.7%), both sexual and child abuse (5.18%), parental separation (7.7%), extra-rigid parents (2.6%), alcoholic parents (18.2%), child abuse and mother's death in childhood (2.6%). Infant trauma and psychopathology showed a significant relationship concerning Hostility (No 1.75±1.209, Yes 2.26±1.759), Unnatural Movements and Posture (No 1.55±0.945, Yes 1.16±0.545), Depression (No 1.25±0.550, Yes 1.74±1.284) and Preoccupation (No 2.75±1.410, Yes 3.26±1.996).
Infant trauma is common in paranoid schizophrenia and our findings give some evidence to a relationship with psychopathology, especially with dimensions as Hostility, Unnatural Movements and Posture, Depression and Preoccupation. Despite sample size, a high proportion (55.8%) of the patients presented infant trauma and future research is needed in order to open new avenues in this field, particularly studies concerning infant trauma and symptomatology specificity will be greatly appreciated as well as the plausible link to personality traits and personality disorders.
Cocaine consumption can induce transient psychotic symptoms, expressed as paranoia or hallucinations. Cocaine induced psychosis (CIP) is common but not developed in all cases.
To describe the Risk Factors for developing cocaine-induced psychosis in cocaine dependent patients, according DSM-IV-TR criteria.
This is the first European study about the relationship of CIP with consumption pattern variables and personality disorders, we evaluated 220 cocaine dependents over 18 years, 80'5% males, mean age 33.9 years (SD = 7.6). Patients were recluted from an outpatient clinic department and subsequently systematically evaluated using SCID I and SCID II interviews for comorbidity disorders, and a clinical-based systematic psychotic symptoms form.
A high proportion of cocaine dependent patients reported psychotic symptoms (51.8%) under influence of cocaine. The most frequent reported psychotic symptoms were paranoid beliefs and suspiciousness (42.4%). After a logistic regression analysis we found that a model consisted of high cocaine consumption (mean of 12.01 grams per week), cannabis dependence history and to use intranasal or smoked rout of administration had a sensitivity of 63.2% and a specificity of 70.2%.
We conclude that is relevant to evaluate CIP in patients consuming high amounts of cocaine, with cannabis dependence history and who do not use intranasal rout. It could be useful for preventing consequences or risks of psychotic states for themselves or others.
Drug substance abuse has been related with chronic insomnia and other sleep disorders that are thought to interfere in detoxification treatment and relapse induction. These disorders can persist after drug detoxification.
To describe sleep disorders refered by drug dependents patients in an inpatient detoxification unit.
We prospectively studied drug dependents patients admitted to our Detoxification Unit from January 2005 to March 2009. The first night, patients were asked to complete an 11-item questionnaire measure designed to assess the relationship between sleep disorders and drug use. Responses ranged from 1 to 7. The questionnaire measured the following:
a) insomnia before hospitalization;
b) patients’ beliefs about the relationship between insomnia and drug use;
c) insomnia in previous detoxifications;
d) patients’ worry about insomnia;
e) treatment of sleep disorder with benzodiazepines.
The study sample included 150 patients (75.3% men). 39% of the patients suffered from alcohol abuse, 34.67% from cocaine abuse, 22.67% from opiod abuse, 21% from cannabis abuse, 18% from benzodiazepine abuse, and 12.67% of patients were polydrug users.Lifetime prevalence of sleep disorders was 68.1%. 64% had suffered insomnia the months previous to detoxification. 80.1% of patients’ refered sleep disorders in relationship with substance abuse. 69.4% were worried about insomnia during detoxification. 75.4% of patients took benzodiazepines without prescription.
Sleep disorders in patients with drug abuse are frequent. A high prevalence of patients having worries about insomnia during the detoxification treatment and believing in a relationship between their sleep disorders and the drug abuse was found.
The dysexecutive syndrome is present in half of the schizophrenia patients and is highly dependent on the dopamine functioning. We hypothesize that early and mild dysexecutive syndrome in schizophrenia is mainly subjective. The objective is to study the subjective manifestation of the dysexecutive syndrome and its relationship with other symptoms of schizophrenia.
One cross-sectional study was conducted on 60 schizophrenia out-patients (43 male; average age: 38.9 years, SD 9.4). The diagnosis were: paranoid schizophrenia 26.7%, schizoaffective disorder 25.0%, residual schizophrenia 21.7%, other schizophrenia subtypes 26.6%. The dysexecutive syndrome was assessed by DEX Scale (self-applied and applied by one external observer). Using PANSS and one addiction composite score (ACS) it was defined five symptom dimensions: negative (N1, N2, N3, N4, N6), disorganized (P2, P4, N5, N7), positive and depressive (P1, P3, G6), hostility (P5, P6, P7) and addictive (ACS). Basic symptoms were studied with FCQ-III. All the scores were transformed in to Z values. Correlations between DEX and the clinical dimensions were studied using Spearman's Rho coefficient.
Dysexecutive syndrome is associated with basic symptoms (self-applied: r = 0.83, p< 0.001; external observer: r = 0.54, p < 0.001), disorganization (external observer: r = 0.46, p = 0.001), positive and depressive symptoms (self-applied: r = 0.54, p< 0.001; external observer: r = 0.44, p = 0.001) and addiction (self-applied: r = 0.35, p< 0.01).
Basic, hallucinatory, delusional and depressive symptoms in schizophrenia, as well as the disorganized dimension, could reflect the subjective experience of one dysexecutive dysfunction.
Schizophrenia is a chronic disease. Several etiopathogenic aetiologies have been posed, among them the existence of cerebral inflammation. S100B is a calcium-binding protein, mainly produced and secreted by astrocytes, that mediates the interaction among glial cells and between glial cells and neurons. Serum S100B levels have been proposed as a peripheral marker of brain inflammation.
The aim of this research is to study if the serum level of the protein S100B has relationship with positive psychopathology.
31 paranoid schizophrenic inpatients (22 male and 9 female, 36.7±10.3 years) meeting DSM-IV criteria participated in the study. Blood was sampled by venipuncture at 12:00 and 24:00 hours. Blood extractions were carried out during the first 48 hours after hospital admission. Psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Serum S100B levels were measured by sandwich ELISA techniques.
Correlations between serum levels of S100B protein and PANSS positive scores are shown in the following table. The first figure corresponds to the Pearson's correlation coefficient, while the figure in brackets corresponds to its statistical significance.
Total Positive Score
Serum levels of S100B protein may be used as a biological marker of positive psychopathology in paranoid schizophrenia.Acknowledgement
To know prevalence of depression in Spanish nursing home(NH) by analysing the clinical profile of residents from RESYDEM study (Identification of patients with cognitive deterioration and dementia in NH).
A multicentral, transversal, observational study was carried out in April 2005. 71 geriatrician from 54 NH representing the Spanish state participated. Depression was analysed in patient´s history and determined by NPI of Cummings, NH version.
1037 residents were randomized, 1020 were used by clinical data analysis. 941 were used to determine depression prevalence. Median age 83,4yo, 66.6% were women, 70.9% with basic educational level, 57.4% widows, 25.7% single, 41.5% had some degree of functional deterioration, 22.1% had delirium. In 26.4% were documented Stroke(17,9% TIA). 61.7% had dementia.
Depression appears in 31.4% of elderly institutionalized with the only diagnosis of depression or independent of others. There were no significant differences in age groups. However, was most frequent in women. 95.7% of patients with diagnosis of dementia had at least one drug for depression. Most used anti-depressants were trazadone (23%), citalopram (20.9%), sertraline (15.8%), fluoxetine (10.1%). No tricyclical anti-depressant reached 1% of consumption.
Depression affects practically one in three institutionalized elderly in Spain
Institutionalized elderly with depression are largely treated with ISRS. It is believed that the use of trazadone is linked with the effects on sleep and anxiety.
The high prevalence of depression, its overlapping with other processes and the comorbility of residents requires a careful search and approach in NH which implies a challenge for professionals in order to treat it.
Patients with schizophrenia and bipolar disorder appear to have more difficulties with smoking cessation than the general population. Moreover, gender and unsuccessful smoking cessation are associated with depression and negative emotional experience. Less attention has been given to the association of cigarette smoking in women and the use of other substances.
To determine the influence of gender and substance abuse on smoking cessation in a long-term follow up after a first psychotic episode.
Patients were evaluated at years 1, 3, and 5 obtaining information about functional outcome, positive and negative symptoms and substance use. At 8th year, functional outcome and use of substance were recorded. Patients were classified in two groups: those who stopped smoking during follow-up, and those who did not stop.
At baseline, rates of tobacco smoking were high with no differences between genders. Difficulty with smoking cessation was associated with female (p = 0.017) and typical antipsychotics (p = 0.032). Those who used alcohol continuously were less likely to stop smoking (p = 0.050) controlling for typical antipsychotics. The interaction with gender was not significant. Continuous cannabis use was not associated with smoking cessation, but women who use cannabis continuously were less able to stop smoking than men (adjusted p = 0.036).
Women are less prone to quit smoking than men during long-term follow-up after the development of psychosis. Different treatments should be considered for men and women in relation to tobacco dependence in patients with psychotic disorder. Treatment for women smokers should probably be more supportive and intensive.
Musical hallucinations are a rare phenomenon in clinical practice. The purpose of this study was to analyze the clinical spectrum of musical hallucinations.
We analysed demographic and clinical features of cases published in English, Italian, French or Spanish between 1991 and 2006 registered in MEDLINE, including three of our own cases. The cases were separated into four groups according to their main diagnoses (hearing impairment; psychiatric disorder; neurological disorder; toxic or metabolic disorder).
115 patients with musical hallucinations were included, of which 63.5% were female. The mean age was 57,25 years. Main diagnoses were: psychiatric disorder (46.1%; schizophrenia 30.4%), neurological disorder (21,7%), hearing impairment (17,4%), toxic or metabolic disorder (12.2%) and 2.6% other diagnoses.
61.7% patients presented simple diagnoses while 36.5% presented two or more diagnoses. 2.1% of patients didn't receive any diagnoses. 35.7% of patients and 60.9% of non psychiatric patients presented hearing impairment.
Both instrumental and vocal were the more frequent musical hallucinations and most of the patients had insight about the abnormality of their perceptions. Another kind of hallucinations was present in 40.9% of patients, auditory hallucinations being the most common. Also, 38,3% of the global sample had abnormalities in brain structural image (MRI, CT).
Musical hallucinations are a heterogeneous phenomenon in clinical practice. published cases describe them as more common in women and in psychiatric and neurological patients. Hearing impairment seem to be an important risk factor in the development of musical hallucinations.
The prevalence of social anxiety is estimated of 7-12% of the general population and 18% of university student. Social anxiety has a high prevalence of psychiatry and personality comorbidity. At age of 18-25 years old 80% of social anxiety cases have onset. To detect social anxiety at that age maybe important to avoid chronicity of the illness.
To study personality traits associated with social anxiety in university students.
We designed a cross-sectional study at the Autonomous University of Barcelona. Student were recruited by an advertisement. All student signed the informed consent. We collected: Socio-demographic data, personal and family psychiatry history, and the Liebowitz Anxiety Scale (LSAS) and the Temperament and Character Inventory of Cloninger. We defined as a social anxiety group a LSAS ≥50 total score.
Five hundred ninety-one students enter in the study. Final sample after excluded those who did not filled the rating scales was 574 participants: 75% were women, mean age (SD): 22.7 (5.3), 156 (124 women/32 men), 26% had social anxiety. Eighteen percent had family and 22% personal psychiatry history. The personality profile of the social anxiety group was: high harm avoidance (HA) (p< .001), low novelty seeking (NS) (p< .001), and low self-directedness (SD) (p< .001).
By logistic regression, after corrected by sex, age, personal and family psychiatry history, HA (OR=1.118; 95%CI=1.081-1.155), NS (OR=0.954;95%CI=0.927-0.982) and SD (OR=0.957;95%CI=0.930-0.985) predicted social anxiety. R2Nagelkerke=0.442. Hosmer-Lemeshow test (p>.05).
A profile of high HA, low NS and SD personality dimensions may predict those university students with social anxiety.
Chronic consumption of cocaine can induce transient psychotic symptoms, expressed as paranoia or hallucinations. This is typically prevented by abstinence. The term Cocaine-Induced Psychosis (CIP) has been used to describe this syndrome. Impulsivity has been hypothesised are likked with CIP.
This study examined the relationship between CIP and substance consumption variables and impulsivity disorders including ADHD (Axis I) and Borderline personality disorders (BPD) (Axis II), and attempted to evaluated their link as a risk factors for CIP.
Trained psychiatrists systematically conducted a structured interview in which the conclusions from the psychotic symptoms were summarized. We used the CADDID to evaluate Adult ADHD, SCID II for axis II disorders, and the Barrat Impulsivity Scale (BIS-11).
We evaluated 163 (34,16 yo, 85,80% men) cocaine-dependent patients, according to DSM-IV criteria.
We found statistically significant association between CIP and Early age at onset of cocaine addiction (p = 0,04), cocaine use per day 6 months before starting treatment (p = 0,03), Barrat cognitive impulsivity subscale (p < 0,004), and Adult ADHD (p < 0,041). No relationship between BPD and CIP was found.
We confirm previous findings that Impulsivity disorders as ADHD or high impulsivity trails are liked to CIP. Coinciding with our previous findings, relationship between early age of onset cocaine dependence or high amounts of cocaine use and CIP was found. CIP are related with impulsivity disorders spectrum.
Verbal memory and processing speed are two of the proposed neurocognitive predictors in schizophrenia. the objective is to determinate neurocognitive predictors of functioning in one five years follow-up period on ambulatory schizophrenia patients.
We conduct one cohort study on 30 schizophrenia out-patients (19 male; age mean: 32.8 years; SD:7.2). at the moment of inclusion it was applied one neuropsychological battery sensitive to neuropsychological deficit in schizophrenia: WAIS-III, BADS, WCST, Colour Trails, Trail Making A and B, BVRT, California Verbal Learning Test (Spanish version: TAVEC). Variables was summarized determining Z values and principal components. the cohort was prospectively studied for up to five years. as result variables it were considered: time to the first antipsychotic-drug change, time to the first psychiatric admission, and average five-years annual score in the Strauss-Carpenter Outcome Scale. It was constructed Cox and Linear Regression Models to determinate the better predicting neurocognitive components.
The better global outcome was directly related with WAIS-III processing speed index (corrected R square: 0.19; p = 0.02; beta constant= 0.469; beta WAIS-III processing speed= 0.125). None predictor was selected for the outcome variable change of antipsychotic. Psychiatric admission was predicted (p=0.006) by implicit learning (beta= -2.19), executive functioning (beta= 1.02), WAIS-III Total IQ (beta= 0.45) and WAIS-III Perceptual Organization Index (beta= -0.20).
Higher processing speed index predicts one better functioning outcome during five-years follow-up. the risk for psychiatric admission was heterogeneously related with neurocognitive predictors. Verbal memory did not predict functional outcome.
Patients with schizophrenia show deficits in many cognitive domains and social functioning, social skills, and self management skills in their daily life activities.
To evaluate the relationship between general-social cognition, mental state and social functioning, and impact on quality of life.
Twenty patients with chronic disorder of schizophrenia were evaluated and compared with 20 siblings and 20 healthy controls regarding performance in a series of tests: Cognitive Screening: Word Accentuation Test, MCCB (Matrics Consensus Cognitive Battery) Social Functioning: UPSA (University of California Performance Skills Assessment), TABS (Test of Adaptive Behaviour in Schizophrenia), SSPA (Social Skills Performance Assessment), Beck and Hamilton depression scales, Scale for Positive and Negative Syndrome of Schizophrenia, and SF-36 as indicator of quality of life.
Patients showed significant differences from controls and siblings in MCCB total score (p < 0.001), whereas siblings showed significant differences compared to controls in MCCB total score (p = 0.053). Siblings performed differently from patients (p < 0.001) and controls (p = 0.019) in social functioning measured with TABS. A series of correlations between general cognition and social functioning were demonstrated for patients and their unaffected siblings (not shown).
Results suggest that the performance of nonpsychotic siblings is located between patients and healthy controls, suggesting that social performance measures are (or associated with) intermediate phenotypes of the disease. General and social cognition have a complex relationship with social functioning and quality of life.
Dual diagnosis of schizophrenic disorders and drug abuse/dependence are increasing due to more frequent use of cannabis and cocaine. It is important to differentiate between primary schizophrenia with associate drug abuse/dependence and drug-induced psychosis. The objective is to detect neuropsychological differences between drug users and non-users in schizophrenia patients, which could be used as diagnostic tools.
We conduct one case-control study on 12 schizophrenia out-patients (10 male) with vital history of drug abuse/dependence (mainly cannabis and cocaine) and one control group of 18 schizophrenia out-patients (12 male) who never used illegal drugs (global age mean: 32.8 years; SD:7.2). It was applied one neuropsychological battery sensitive to the neuropsychological deficit frequent in schizophrenia: WAIS-III, BADS, WCST, Colour Trails, Trail Making A and B, BVRT, California Verbal Learning Test (spanish version: TAVEC). Variables was summarized determining Z values and principal components. It was constructed one Logistic Regression Model to determinate the better predicting model of drug use state.
The resultant model included two predictors: WAIS Perceptive Organization Index and Trails Component. The prediction formula for Ln Odd Ratio of drug abuse/dependence group is: -13.83 + 1.09 (Trails Z score) + 0.16 (WAIS Perceptive Organization Index). It explains for 63% of the variance (p = 0.001). The ROC curve for using in diagnose was constructed.
Neuropsychological diagnosis can contribute to the differential diagnosis of schizophrenia in dual pathology. The better functioning in visual-spatial tasks increases the probability of psychosis related with drugs use.