Relationship of negative symptom severity with cognitive symptoms and functioning in subjects at ultra‐high risk for psychosis

Üçok, Alp; Direk, Neşe; Kaya, Hatice; Çağlar, Nuran; Çıkrıkçılı, Uğur; Noyan, Handan; Yokuşoğlu, Çağdaş; Devrim‐Üçok, Müge

doi:10.1111/eip.13042

Cited by 10 publications

(21 citation statements)

References 50 publications

(43 reference statements)

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“…Relative to expressive deficits, motivation and pleasure deficits are linked to worse outcomes in schizophrenia, including poorer occupational attainment ( Llerena et al, 2018 ) and quality of life ( Savill et al, 2016 ). Motivation and pleasure deficits also better predict real-life functioning and quality of life among individuals at clinical high-risk for psychosis (CHR) ( Glenthøj et al, 2020 ; Üçok et al, 2021 ). Despite their profound functional impact, there are no established treatments for motivation and pleasure deficits in schizophrenia ( Kirkpatrick et al, 2006 ; Galderisi et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Psychological Dimensions Relevant to Motivation and Pleasure in Schizophrenia

Abram

Weittenhiller

Bertrand

et al. 2022

Front. Behav. Neurosci.

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Motivation and pleasure deficits are common in schizophrenia, strongly linked with poorer functioning, and may reflect underlying alterations in brain functions governing reward processing and goal pursuit. While there is extensive research examining cognitive and reward mechanisms related to these deficits in schizophrenia, less attention has been paid to psychological characteristics that contribute to resilience against, or risk for, motivation and pleasure impairment. For example, psychological tendencies involving positive future expectancies (e.g., optimism) and effective affect management (e.g., reappraisal, mindfulness) are associated with aspects of reward anticipation and evaluation that optimally guide goal-directed behavior. Conversely, maladaptive thinking patterns (e.g., defeatist performance beliefs, asocial beliefs) and tendencies that amplify negative cognitions (e.g., rumination), may divert cognitive resources away from goal pursuit or reduce willingness to exert effort. Additionally, aspects of sociality, including the propensity to experience social connection as positive reinforcement may be particularly relevant for pursuing social goals. In the current review, we discuss the roles of several psychological characteristics with respect to motivation and pleasure in schizophrenia. We argue that individual variation in these psychological dimensions is relevant to the study of motivation and reward processing in schizophrenia, including interactions between these psychological dimensions and more well-characterized cognitive and reward processing contributors to motivation. We close by emphasizing the value of considering a broad set of modulating factors when studying motivation and pleasure functions in schizophrenia.

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Section: Introductionmentioning

confidence: 99%

Psychological Dimensions Relevant to Motivation and Pleasure in Schizophrenia

Abram

Weittenhiller

Bertrand

et al. 2022

Front. Behav. Neurosci.

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“…In particular, the independence of cognitive deficits from positive symptoms has been shown previously ( Green, 1996 ; Mohamed et al, 1999 ; Hughes et al, 2003 ; Gladsjo et al, 2004 ; Wagner et al, 2005 ; Keefe et al, 2006 ). On the other hand, a relationship between negative symptom severity and cognitive performance has been observed ( Mohamed et al, 1999 ; Gladsjo et al, 2004 ; Keefe et al, 2006 ; Üçok et al, 2020 ). Furthermore, improvements in negative symptoms have been found to be associated with amelioration of cognitive deficits in people with schizophrenia treated with olanzapine or AMI for eight weeks ( Wagner et al, 2005 ).…”

Section: Discussionmentioning

confidence: 99%

Cannabidiol and Amisulpride Improve Cognition in Acute Schizophrenia in an Explorative, Double-Blind, Active-Controlled, Randomized Clinical Trial

et al. 2021

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Cannabidiol (CBD), a principal phytocannabinoid constituent, has demonstrated antipsychotic properties in recent clinical trials. While it has also been suggested a promising candidate for the treatment of neurodegenerative disorders, it failed to demonstrate efficacy in cognitive impairments associated with schizophrenia as an add-on treatment (600 mg/day for 6 weeks) in 18 chronically ill patients co-treated with a variety of psychopharmacologic drugs. Here, we report on the results of parallel-group, active-controlled, mono-therapeutic, double-blind, randomized clinical trial (CBD-CT1; ClinicalTrials.gov identifier: NCT00628290) in 42 acute paranoid schizophrenic patients receiving either CBD (up to 800 mg/day) or amisulpride (AMI, up to 800 mg/day) for four weeks in an inpatient setting with neurocognition as a secondary objective. Twentynine patients (15 and 14 in the CBD and AMI group, respectively) completed two cognitive assessments at baseline and the end of the treatment period. We investigated the following cognitive domains: pattern recognition, attention, working memory, verbal and visual memory and learning, processing speed, and verbal executive functions. When applying the Bonferroni correction for multiple testing, p < 0.0004 would indicate statistical significance. There was no relevant difference in neurocognitive performance between the CBD and the AMI group at baseline, and we observed no post-treatment differences between both groups. However, we observed improvements within both groups from pre-to post-treatment (standardized differences reported as Cohen’s d) in visual memory (CBD: 0.49, p = 0.015 vs. AMI: 0.63, p = 0.018) and processing speed (CBD: 0.41, p = 0.004 vs. AMI: 0.57, p = 0.023). Furthermore, CBD improved sustained attention (CBD: 0.47, p = 0.013, vs. AMI: 0.52, p = 0.085), and visuomotor coordination (CBD: 0.32, p = 0.010 vs. AMI: 0.63, p = 0.088) while AMI led to enhanced working memory performance in two different paradigms (Subject Ordered Pointing Task–AMI: 0.53, p = 0.043 vs. CBD: 0.03, p = 0.932 and Letter Number Sequencing–AMI: 0.67, p = 0.017 vs. CBD: 0.08 p = 0.755). There was no relevant correlation between changes in neurocognitive parameters and psychotic symptoms or anandamide serum levels. This study shows that both CBD and AMI improve neurocognitive functioning with comparable efficacy in young and acutely ill schizophrenia patients via an anandamide-independent mechanism.

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“…Recent studies have now examined PNS in this population in relation to functioning and neurocognitive capacity and one report described a significant difference in verbal fluency between clinical high risk individuals with and without PNS (Yung et al, 2019); although no such differences were observed in another recent and large longitudinal study (Devoe et al, 2020). Finally, another recent study (Ucok et al, 2020) found that negative symptoms had an impact on functioning in a cohort of clinical high risk.…”

Section: Discussionmentioning

confidence: 99%