No abstract

Cognitive insight is a new concept. There are very few data regarding the relationship between cognitive insight and positive symptoms. The goal of the present study was to investigate the impact of acute psychosis (delusions and hallucinations) on overconfidence in judgments and self-reflectiveness of patients with schizophrenia. The Beck Cognitive Insight Scale was used to compare the cognitive insight of schizophrenia patients with (n = 93) and without (n = 45) current psychotic symptoms. Clinical symptoms and clinical insight of the patients were also assessed. The present findings suggest that both overconfidence in judgments and impaired self-reflectiveness are associated with acute psychosis. Only diminished self-reflectiveness seem to be improved following hospitalization. Although overconfidence of schizophrenia patients in their judgments was more severe in schizophrenia patients with psychotic symptoms, self-certainty of schizophrenia patients may be a relatively persistent characteristic that is also present after recovery of psychosis. Studies with larger samples involving follow up for longer periods will be valuable to understand the nature of the relationship between cognitive insight and clinical symptoms of schizophrenia.

Although ToM deficit in schizophrenia is widely accepted, findings regarding remitted schizophrenia patients are contradictory. Because residual symptoms are present out of psychotic exacerbation periods, the differences between definition of remission may be important to interpret these findings. The purpose of this study was to investigate the relationship between performance of 2 different aspects of theory of mind (ToM) and residual clinical symptoms and other cognitive deficits in schizophrenia. Ninety-one stable outpatients with schizophrenia and 55 healthy controls were assessed with a neuropsychological battery. Both social-cognitive and social-perceptual aspects of ToM were impaired in schizophrenia, even in patients who were totally free of residual symptoms. Still, the results showed that ToM deficit is related to residual symptoms of schizophrenia. Social-cognitive ToM abilities seem to be related to both positive and negative symptoms. The ToM deficits of fully remitted patients without persistent negative symptoms may be secondary to a more general cognitive dysfunction in schizophrenia.

Obsessive-compulsive symptoms (OCS) have been observed in a substantial proportion of schizophrenic patients. In this study, the rate of occurrence of OCS and obsessive-compulsive disorder (OCD) in schizophrenic patients, and also the interrelationship between OCS and schizophrenic symptoms and depressive symptoms were assessed. A total of 100 subjects with a diagnosis of schizophrenia from the 4th edition of the Diagnostic and Statistical Manual (DSM-IV) were evaluated by the structured and clinical interview for axis-1 DSM-IV disorders -patient edition (SCID-P), the Positive and Negative Syndrome Scale (PANSS), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and the Calgary Depression Rating Scale for Schizophrenia. The prevalance of OCS in individuals meeting criteria for schizophrenia was 64%. A total of 30 of these patients (Y-BOCS total score ≥ 7) also met the DSM-IV criteria for OCD. The total score on Y-BOCS was significantly correlated with total score on PANSS, Positive-PANSS score, General-PANSS score and total score on Calgary Depression Rating Scale for Schizophrenia. OCS and OCD relatively frequent in schizophrenic patients and OCS are significantly correlated with the severity of psychosis, positive symptoms, and depressive symptoms in schizophrenic patients. These findings provide further evidence for the importance of OCS in schizophrenia.

OBJECTIVE This study assessed the impact of a psychosocial skills training program, consisting of psychoeducation, interpersonal group therapy and family education incorporated into social skills training, as an integrative approach on social functioning and quality of life of patients with schizophrenia, in comparison to standard care for an 8-month period. METHOD Thirty patients with DSM-IV schizophrenia were included in the study. Patients were assessed using the Positive and Negative Syndrome Scale (PANSS), Quality of Life Scale (QLS), Social Functioning Scale (SFS), and Global Assessment of Function (GAF) at baseline. Fifteen patients underwent an 8-month psychosocial skills training group program and another fifteen patients (waiting list) continued in standard care. Both groups were reassessed and analyzed at the end of the study. RESULTS Two groups were not statistically different in terms of total PANSS, QLS, SFS, GAF scores, and demographic characteristics at baseline. However, there was a significant improvement in the mean total QLS, SFS, GAF, and even in total PANSS scores (respectively from 64.46±19.58 to 89.67±24.10, P<0.001, from 93.20±22.85 to 132.60±33.85, P<0.002, from 57.40±8.78 to 63.86±7.57, P<0.012, and from 63.53±14.48 to 53.33±15.71, P<0.029) for those who underwent the PSST program, but there was no statistically significant change for those on standard care at the end of the study. CONCLUSION This study highlights the 'social functioning' and 'quality of life' benefits of the psychosocial skills training program for patients with schizophrenia. It can be concluded that this comprehensive psychosocial skills training program might be an important contribution to the functioning of the patients.