Janina Carlson

Adaptation and validation of the quality-of-life scale: Satisfaction with Life Domains Scale by Baker and Intagliata.

OBJECTIVES There are few quality-of-life instruments specifically for schizophrenia; thus, the objective of our study is to adapt and validate the Satisfaction with Life Domains Scale (SLDS) by Baker and Intagliata. METHOD This is a validation study in which the subjects were evaluated on 2 occasions (24-48 hours). The sample is composed of people with schizophrenia from 18 to 65 years old and who were seen in one of the following centers: Sant Joan de Déu-SSM, Hospital Clínic, Hospital de Mataró and Hospital Pere Mata. The SLDS was administered, along with Positive and Negative Syndrome Scale, the Clinical General Impression for Schizophrenia, Global Assessment of Function, Disability Assessment Scale--short version, Beck Cognitive Insight, and the Strauss and Carpenter Prognostic Scale. The Cronbach alpha test was carried out, and the intraclass correlation coefficient was used to assess test-retest reliability, along with Pearson correlations for discriminating validity. RESULTS The intraclass correlation coefficients oscillated between 0.51 and 0.83. The SLDS did correlate with any of the other instruments with the exception of the Positive and Negative Syndrome Scale general subscale and the Strauss and Carpenter prognostic scale. CONCLUSIONS The Spanish version of the SLDS was shown to be valid and reliable and provides a fast and specific measure for schizophrenia.

Cognitive profiles of three clusters of patients with a first-episode psychosis

OBJECTIVE The primary objective was to identify specific groups of patients with a first-episode psychosis based on family history, obstetric complications, neurological soft signs, and premorbid functioning. The secondary objective was to relate these groups with cognitive variables. METHOD A total of 62 first-episode psychoses were recruited from adult and child and adolescent mental health services. The inclusion criteria were patients between 7 and 65 years old (real range of the samples was 13-35 years old), two or more psychotic symptoms and less than one year from the onset of the symptoms. Premorbid functioning (PAS), soft signs (NES), obstetric complications and a neuropsychological battery (CPT, TMTA/TMTB, TAVEC/TAVECI, Stroop, specific subtest of WAIS-III/WISC-IV) were administered. RESULTS We found three clusters: 1) higher neurodevelopment contribution (N=14), 2) higher genetic contribution (N=30), and 3) lower neurodevelopment contribution (N=18). Statistical differences were found between groups in TMTB, learning curve of the TAVEC, digits of the WAIS and premorbid estimated IQ, the cluster 1 being the most impaired. CONCLUSIONS A cluster approach could differentiate several groups of patients with different cognitive performance. Neuropsychological interventions, as cognitive remediation, should be addressed specifically to patients with more impaired results.

Adaptación y validación española de la Escala Pronóstica para la Esquizofrenia de Strauss y Carpenter

INTRODUCTION The aim of this study was to validate the Spanish version of the Strauss and Carpenter Prognostic Scale for Schizophrenia (Strauss and Carpenter, 1977). METHOD We performed a multicenter, longitudinal, descriptive study. Forward and backtranslation of the original scale was performed. The sample was composed of persons diagnosed with schizophrenia aged between 18 and 65 years. We calculated interrater reliability, construct validity according to the Global Assessment Scale (GAS), Satisfaction with Life Domains Scale (SLDS), the Global Clinical Impression-Schizophrenia (GCI) scale, The World Health. Organization Short Disability Assessment Schedule (WHO-DAS) and the Positive and Negative Syndrome Scale (PANSS), and predictive validity at the 1-year follow-up using three criterion measures of the GCI, WHO-DAS and GAS scales. RESULTS The internal consistency coefficient (Cronbachs alpha) was 0.70. The intraclass correlation coefficient ranged from 0.54 to 0.99, except for item 5 (resources for the current treatment), which was -0.13. The correlation between the distinct scales (measuring construct validity) was significant, with a p-value of < 0.01, except for the SLDS, which showed a higher p-value (p<0.05). The Strauss-Carpenter score correlated with all three scores at 1 year (GCI, GAS and WHO-DAS) with an alpha of less than 0.01, showing good predictive validity. CONCLUSIONS The Spanish adaptation of the Strauss and Carpenter prognostic scale is reliable and valid and allows a more severe disease course to be predicted.

Adaptation and validation of the Spanish version of the Strauss and Carpenter Prognostic Scale for Schizophrenia | Adaptación y validación Española de la Escala Pronóstica para la Esquizofrenia de Strauss y Carpenter

INTRODUCTION The aim of this study was to validate the Spanish version of the Strauss and Carpenter Prognostic Scale for Schizophrenia (Strauss and Carpenter, 1977). METHOD We performed a multicenter, longitudinal, descriptive study. Forward and backtranslation of the original scale was performed. The sample was composed of persons diagnosed with schizophrenia aged between 18 and 65 years. We calculated interrater reliability, construct validity according to the Global Assessment Scale (GAS), Satisfaction with Life Domains Scale (SLDS), the Global Clinical Impression-Schizophrenia (GCI) scale, The World Health. Organization Short Disability Assessment Schedule (WHO-DAS) and the Positive and Negative Syndrome Scale (PANSS), and predictive validity at the 1-year follow-up using three criterion measures of the GCI, WHO-DAS and GAS scales. RESULTS The internal consistency coefficient (Cronbachs alpha) was 0.70. The intraclass correlation coefficient ranged from 0.54 to 0.99, except for item 5 (resources for the current treatment), which was -0.13. The correlation between the distinct scales (measuring construct validity) was significant, with a p-value of < 0.01, except for the SLDS, which showed a higher p-value (p<0.05). The Strauss-Carpenter score correlated with all three scores at 1 year (GCI, GAS and WHO-DAS) with an alpha of less than 0.01, showing good predictive validity. CONCLUSIONS The Spanish adaptation of the Strauss and Carpenter prognostic scale is reliable and valid and allows a more severe disease course to be predicted.

Incidence of stressful life events and influence of sociodemographic and clinical variables on the onset of first-episode psychosis

This study presents a quantitative analysis of the incidence of stressful life events (SLEs) and the variables gender, age at onset, family history and psychotic symptoms in patients with first-episode psychosis (FEP). A descriptive, cross-sectional methodology was used to interview 68 patients with FEP between 13 and 47 years of age. The Psychiatric Epidemiology Research Interview Life Events Scale collected one-year period prior to onset of FEP - used to analyse the subcategories academic, work, love and marriage, children, residence, legal affairs, finances and social activities-, Positive and Negative Syndrome Scale, and Clinical Global Impression-Schizophrenia scale were used to assess the relevance of certain SLEs during adolescence. Age at onset showed a significant negative correlation with the categories academic and social activities. By contrast, it showed a positive correlation with work and children. A significant relationship was found between paternal family history and social activities and between maternal family history and academic and love and marriage. Finally, an inverse relationship was observed between negative symptoms and the categories children and finance. Depressive symptoms were significantly correlated with the category academic. Our results show the importance of SLEs during adolescence and suggest that there is a clear need to develop preventive actions that promote effective strategies for dealing with the accumulation of psychosocial stress.

Influence of cognition, premorbid adjustment and psychotic symptoms on psycho-social functioning in first-episode psychosis

OBJECTIVE The aim of this study is to evaluate the relationship between psycho-social functioning and symptoms, cognitive function, and premorbid adjustment, in patients with a first-episode psychosis. METHOD Clinical data were obtained from 90 patients, who were assessed with the Disability Assessment Scale (DAS-sv), the Positive and Negative Syndrome Scale (PANSS), the Premorbid Adjustment Scale (PAS-S) and with a battery of cognitive tests including Trail Making Tests A and B (TMTA- B), Continous Performance Test (CPT), some subscales of the Wechler Adult Intelligence Scale (WAIS), and the Verbal Learning Test España-Complutense (TAVEC). RESULTS The results of the study suggest that psycho-social functioning in first-episode psychosis is significantly related to: positive, negative, excitative, affective and disorganized symptoms, social premorbid adjustment, cognitive flexibility, working memory, short term and long term memory. Of these, those which best explained psycho-social functioning are the positive and excitative symptoms, premorbid adjustment, flexibility and memory. CONCLUSIONS These findings highlight the importance early intervention on cognitive and clinical variables to help provide a better psycho-social functioning in people with a first-episode of psychosis.

Birth weight and obstetric complications determine age at onset in first episode of psychosis.

BACKGROUND Earlier age at onset of psychosis (AOP) has been associated with poor social adjustment and clinical outcome. Genetic and environmental factors such as obstetric complications, parental history of psychosis, advanced paternal age at time of birth, low birth weight and gestational age, and use of drugs have been described as bringing AOP forward. This study aims to evaluate the relationship between AOP and these factors in a sample of first episode of psychosis (FEP) patients. METHODS Clinical and sociodemographic data, age at FEP, age of parents at birth, parental history of psychosis, drug-use habits of the mother during pregnancy and of the patient before psychotic onset, and Lewis and Murray obstetric complication scale were obtained from 90 patients with FEP. Statistical analysis was performed by means of Pearson correlations, Chi-square tests, Student T-test analyses and a linear regression model using SPSS version 22. RESULTS Pre-eclampsia, need for incubator at birth, use of forceps, parental history of psychosis, and low birth weight were associated with an earlier AOP. Use of forceps and birth weight are the variables which best predict AOP in FEP. Stimulant drugs, which were mostly used together with cannabis and cocaine, were the only substances associated with an earlier AOP. CONCLUSIONS Our findings are consistent with previous study results and underline the role of the prenatal period in the development of psychosis and the importance of careful monitoring of pregnancy and delivery, especially in cases with familial history.

Relationship between menarche and psychosis onset in women with first episode of psychosis

The aim of this study was to explore the relationship between age at menarche and age at first episode of psychosis, as well as clinical severity and outcome, in a population of women with first‐episode psychosis.