SynopsisTwenty-five schizophrenic patients currently experiencing Schneiderian symptoms performed a series of tasks in which drawings had to be made in the absence of immediate visual feedback. In comparison to 10 normal controls and to 30 patients not experiencing Schneiderian symptoms, the target group had great difficulty in keeping track of their performance and remembering what actions they had made. These results are consistent with the hypothesis that Schneiderian symptoms (such as delusions of alien control) are associated with impairments in the central monitoring of action.

Background/Aim: The Clock Drawing Test (CDT) is a valid alternative screening tool to the Mini-Mental State Examination (MMSE) and, crucially, it may be completed faster. The aim of our study was to standardize and simplify the CDT scoring system for screening in three common conditions: mild cognitive impairment (MCI), Alzheimer’s disease (AD) and mixed dementia (MD). Methods: We included 188 subjects (43 healthy volunteers, 49 patients with MCI, 54 patients with AD, and 42 patients with MD), who performed the MMSE and CDT. The CDT was evaluated using a modified 4-point scoring system. Results: The healthy subjects had the highest median values for the MMSE and CDT, followed by patients with MCI, AD and MD. The optimal cut-off for all patients and each patient group separately was 3 out of 4 points. Sensitivity was 89% for AD, 93% for MD and 83% for all patients, while specificity was 91%. The MMSE produced similar results. In comparison to the MMSE, sensitivity for MCI was significantly higher using the CDT (20 vs. 69%, respectively). Conclusion: A simple, 4-point scoring system may be used as a screening method for fast and accurate detection of cognitive impairment in patients with MCI, AD and MD.

For more than two decades Mini-Mental State Examination (MMSE) has been adapted to the Slovenian language as 'Kratek preizkus spoznavnih sposobnosti' (KPSS). In this study, we evaluated the influences of age and education on the KPSS score, looking for the cut-off point with the optimal ratio of sensitivity (SE) and specificity (SP) to support the use of the KPSS as a screening tool. During the years 2000-03 we examined 258 Slovenian volunteers. Volunteers were divided in two groups based on clinical criteria. A total of 189 were healthy, aged from 45 to 96 years, 69 were demented patients aged from 46 to 91 years, of both sexes, all different levels of education and different degrees of dementia. Median value, SE, SP, positive predictive power and negative predictive power were calculated at cut-off points 23/24, 24/25, 25/26 and 26/27. Younger age and higher education (at least 10 years of education) were each associated with higher KPSS scores. The Slovenian modification of the MMSE demonstrates an optimal cut-off score at 25/26 points for screening dementia in the Slovenian population, due to the best SP (75%)/SE (73%) ratio. The cut-off level 26/27 is recommended for screening highly educated persons.

Schizophrenic disorganisation syndrome is usually considered to be associated with poor performance on frontal lobe tasks, specifically those that require suppression of dominant responses. Two cases are presented who do not fulfil this expectation Despite severe disorganisation of speech and behaviour these patients performed well on several executive tasks in which dominant responses had to be suppressed. One of the patients showed significantly less interference on the Stroop task than normal controls. In contrast, both patients performed badly on a sentence completion task in which production of the dominant response was appropriate. These observations imply that these patients were able to exert ''top-down'' supervisory control in situations where it was necessary to inhibit dominant response tendencies. We propose that, although many patients with schizophrenia and intellectual deficits do show disorganised behaviour associated with a defective supervisory system, there are others in whom this behaviour is a consequence of the failure of ''bottom-up'' control by context. Our cases indicate that disorganisation in schizophrenia may be associated with different underlying cognitive deficits.

Introduction:The present study describes the translation process of the Hospital Anxiety and Depression Scale (HADS) into Slovenian language and testing its reliability and validity on psychological morbidity in female cancer patients.The HADS consists of 14 items to assess anxiety (7 items) and depression (7 items). Each item is rated from 0 to 3. The maximum score on either subscale is 21. Scores of 11 or more on either subscales are considered to be a significant 'case' of psychological morbidity (clinical caseness), while scores of 8-10 represent ‘mood disorder’ (‘borderline’). A score of 7 or below is considered as normal.Methods:The English version of the HADS was translated into Slovene language using the 'forward-backward' procedure. The questionnaire was used in a study of 202 female cancer patients together with a clinical structured interview (CSI) to measure psychological state. A biserial correlation coefficient was calculated.Results:The mean score of participants rating on the HADS-A was 11,6 (sd 4,49) and on the HADS-D was 9,2 (sd 4,46). The value of biserial correlation coefficient was 0.81 for the depression scale and 0.91 for the anxiety scale.Conclusion:The validation process of the Slovenian HADS score version shows metric properties similar to those in international studies, suggesting that it measures the same constructs, in the same way, as the original HADS score form. This validation study of the Slovenian version of the HADS proved that it is an acceptable and valid measure of psychological distress among female cancer patients.

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