Jean-Pierre Mottard

Dream content in chronically-treated persons with schizophrenia.

Many clinical, laboratory and non-laboratory studies have examined dream content reported by patients with schizophrenia but findings have been variable and inconsistent. Using both questionnaire-based measures and laboratory REM sleep awakenings, we investigated dream content in 14 patients with schizophrenia (mean age=25.5+/-3.2 years) under atypical antipsychotic medication and 15 healthy controls (mean age=22.3+/-4.2 years). The relationship between eye movement density during REM sleep and dream content was also explored. Questionnaire data revealed that when compared to controls, patients with schizophrenia report experiencing a greater number of nightmares but no significant differences were found on other measures including overall dream recall, presence of recurrent dreams, and frequency of specific emotions. 39 dream reports were collected from each group following awakenings from REM sleep. Laboratory dream narratives from the patients were shorter and, after controlling for report length, most significant differences in dream content between the two groups disappeared with the exception of a greater proportion of unknown characters in the participant group. Patients with schizophrenia spontaneously rated their dream reports as being less bizarre than did controls, despite a similar density of bizarre elements as scored by external judges. Finally, both groups had a comparable density of rapid eye movements during REM sleep but a significant positive correlation between eye-movement density and dream content variables was only found in controls. Taken together, the findings suggest that dream content characteristics in schizophrenia may reflect neurocognitive processes, including emotional processing, specific to this disorder.

The Influence of Schizophrenia and Standard or Atypical Neuroleptics on Sexual and Sociosexual Functioning: A Review

It is difficult to dissociate the influence of schizophrenia and neuroleptics on sexuality since the majority of schizophrenic patients are treated with neuroleptic medication. Standard neuroleptics can cause sexual dysfunctions. However, atypical neuroleptics minimally influence sexual function. Hypoactive sexual desire is the most commonly reported sexual difficulty by schizophrenics, treated or not, with neuroleptic medications. The majority of patients notice a progressive deterioration of their sexual and sociosexual functioning beginning in adolescence or young adulthood. This article focuses on the sexual and sociosexual differences reported by schizophrenics.

Postsecondary academic achievement and first-episode psychosis: A mixed-methods study.

Background. Postsecondary academic achievement as an area of functional recovery for young adults living with mental illness has received little research attention. Purpose. This study had three purposes: to compare rates of participation, performance, and satisfaction in postsecondary education between young adults with first-episode psychosis and closely matched young adults; to identify characteristics associated with academic participation; and to explore the processes associated with educational experiences. Method. One hundred young adults ages 18 to 30 participated in the study. Quantitative data on academic engagement, performance, and satisfaction, and qualitative data (n = 52) on academic experiences were integrated through pattern analyzes. Findings. Young adults with psychosis were significantly less likely to be engaged in postsecondary education. No difference appeared for the extent of engagement, but performance and satisfaction were lower among participants with psychosis. Participants engaged in reflexive decision making to access postsecondary education and to maintain adequate academic performance. Strategies used by successful students with mental illness were identified. Implications. Assessment and intervention focused on educational needs and skills should become landmark practices for psychiatric rehabilitation practitioners, including occupational therapists.

Perception of Community Functioning in Young Adults with Recent-Onset Psychosis: Implications for Practice

Introduction: Early and intensive rehabilitation for individuals living with first-episode psychosis (FEP) is a key issue for occupational therapists working in mental health settings. Purpose: The purpose of this multiple case study was to explore the perception of outpatients in a youth psychosis clinic in Montreal regarding their community functioning. Method: Nineteen young adults with FEP were interviewed, using a set of questions developed on the basis of a person-environment relationship theoretical model. The steps of data analysis included the transcription and coding of data, data reduction, the aggregation of themes and visual representation. Findings: The participants experienced more handicap-creating situations than competence situations. The themes included a diminished quality of relationship with parents, social isolation and difficulties in work and academic performance, as well as poor access to education. The perception of the participants on each of these themes is elaborated. Practice implications: Specific intervention targets for young adults with FEP should include issues such as the management of energy level, communication and social skills training, residential stability, academic and work rehabilitation and attention to physical features of the home, school and work environments.

Transitions to adulthood in first-episode psychosis: a comparative study

The first aim of this study is to compare attainment of five markers of transition to adulthood between young adults with first‐episode psychosis and young adults without any psychopathology. The second aim is to examine if the association between age group and transition to adulthood is similar for individuals who experience first‐episode psychosis versus those who do not.

Patterns of Daily Time Use of Young Adults With or Without First-Episode Psychosis

This study compared patterns of daily activities and satisfaction with time use of young adults with first-episode psychosis and healthy volunteers. Fifty young adults participated in retrospective structured interviews on time use. Young adults with first-episode psychosis spend more time in sleep, passive leisure, and personal care activities, and less in total productive activities and education. No difference appeared for leisure, paid work, and household work, or satisfaction with daily time use. Reasons underlying dissatisfaction with daily time use differed between the groups. Clinical and research implications are discussed.

Preserved priming effect in individuals with schizophrenia: cues towards rehabilitation.

Introduction. Individuals with schizophrenia and affective disorders show relatively intact implicit memory as compared to declarative memory. Implicit memory is usually assessed with skill learning and priming tasks. Whereas priming is thought to involve storage changes in the posterior neocortex, skill learning is thought to rely more on the corticostriatal pathway. Since frontostriatal and frontotemporal dysfunctions are, respectively, found in schizophrenia and affective disorders, we hypothesised that individuals with schizophrenia and first-episode psychosis would exhibit disturbances in skill learning, but not priming. Methods. Thirty-five patients (11 first-episode psychosis; 11 schizophrenia; 13 affective disorders) and 10 controls completed a procedural learning and priming task. Participants had to identify fragmented images throughout five training sessions. The improvement of the threshold at which the images could be identified between the first and last session was used as an index of procedural learning. In a final session, the identification thresholds for old and new images were compared to assess the priming effect. Results. Whereas individuals with schizophrenia and first-episode psychosis showed impaired skill learning, the priming effect was similar in all groups. Conclusion. Even though some aspects of learning and memory are affected in schizophrenia, our results suggest that the posterior cortical pathway remains efficient at modulating the priming effect. This intact ability could be used to guide the elaboration of new rehabilitation programmes.