V. Sanchez-Gistau

Processing speed and executive functions predict real-world everyday living skills in adolescents with early-onset schizophrenia.

Cognition and clinical variables are known to be among the most predictive factors of real-world social functioning and daily living skills in adult-onset schizophrenia. Fewer studies have focused on their impact in adolescents with early-onset schizophrenia (EOS). The aim of this study is to examine the relationships and the predictive value of cognition and clinical variables on real-world daily living skills in a sample of adolescents with EOS. Cognitive, clinical and real-world everyday living skills measures were administered to 45 clinically and pharmacologically stabilized adolescent outpatients with EOS and 45 healthy control subjects matched by age and sex. Multi-variant analyses to compare cognitive and real-world functioning profiles between patients and controls and regression analysis to identify predictors of real-world functioning scores in patients were used. Adolescents with EOS showed a generalized cognitive and real-world daily living skills dysfunction. Several cognitive and clinical variables significantly correlated with real-world daily living skills functioning but only the processing speed and executive functions emerged as independent predictors of everyday living skills scores, explaining 25.1% of the variance. Slowness in processing information and executive dysfunction showed a significant impact on real-world daily living skills in EOS, independently from clinical symptoms and other cognitive variables. Nevertheless, much of the variance in the daily living skills measure remained unaccounted for, suggesting that other factors were involved as well in this young population.

Neuropsychological characteristics of child and adolescent offspring of patients with schizophrenia or bipolar disorder

BACKGROUND Schizophrenia (SZ) and bipolar disorder (BD) are considered neurobiological disorders which share some clinical, cognitive and neuroimaging characteristics. Studying child and adolescent offspring of patients diagnosed with bipolar disorder (BDoff) or schizophrenia (SZoff) is regarded as a reliable method for investigating early alterations and vulnerability factors for these disorders. This study compares the neuropsychological characteristics of SZoff, BDoff and a community control offspring group (CC) with the aim of examining shared and differential cognitive characteristics among groups. METHODS 41 SZoff, 90 BDoff and 107 CC were recruited. They were all assessed with a complete neuropsychological battery which included intelligence quotient, working memory (WM), processing speed, verbal memory and learning, visual memory, executive functions and sustained attention. RESULTS SZoff and BDoff showed worse performance in some cognitive areas compared with CC. Some of these difficulties (visual memory) were common to both offspring groups, whereas others, such as verbal learning and WM in SZoff or PSI in BDoff, were group-specific. CONCLUSIONS The cognitive difficulties in visual memory shown by both the SZoff and BDoff groups might point to a common endophenotype in the two disorders. Difficulties in other cognitive functions would be specific depending on the family diagnosis.

Assessment of real-world daily-living skills in early-onset schizophrenia trough the Life Skills Profile scale

BACKGROUND Adolescents with early-onset schizophrenia (EOS) have marked deficits in their functional outcome. However, few short and reliable instruments for assessing real-world functioning have been specifically validated in EOS. The Life Skills Profile (LSP) is a brief scale widely used in schizophrenia and considered one of the optimal instruments for assessing real-world daily living skills. The purpose of this study was to examine the usefulness and the feasibility of the LSP to assess daily living skills in EOS. METHODS The sample included 53 clinically and pharmacologically stabilized adolescent patients with EOS and 53 healthy adolescents. Content review of the scale and internal consistency analysis were conducted in the EOS group. A subgroup of 30 patients was re-assessed over a 10-day interval to establish the test-retest reliability. Measures of functional outcome were used to assess convergent validity, and measures of intelligence and symptoms were used to assess divergent validity. Discriminant validity was analyzed through logistic analysis and the receiver-operating characteristic curve. RESULTS The LSP and its subscales showed high reliability, adequate internal consistency and adequate convergent and divergent validity. The LSP was also found to be a sensitive instrument for detecting differences between patients and healthy adolescents, correctly classifying 84% of the sample. The estimated area under the curve was 0.925 (95% CI 0.875-0.976). CONCLUSIONS The LSP showed adequate psychometric characteristics in adolescents with EOS and appeared to be a valid, reliable and time-efficient instrument for use in clinical practice and research settings to assess real-world daily-living skills in EOS.

Verbal Memory and IQ Predict Adaptive Behavior in Children and Adolescents with High-Functioning Autism Spectrum Disorders

Adaptive deficits are commonly found in high functioning autism spectrum disorders (HF-ASD) despite of cognitive potential. Most studies have focused on the relationships between adaptive behavior and intellectual quotient (IQ) and have used correlations to study relationships between them. Few studies have analyzed cognitive variables other than IQ as potential predictors of adaptive behavior in HF-ASD using regression methods. This study aimed to analyze the impact of several cognitive variables on adaptive behavior in a sample of children and adolescents with HF-ASD. METHODS: Sample included 16 child and adolescent boys with HF-ASD (age between 7-17 years). Cognitive assessment included measures of general intelligence, visual memory, verbal memory, working memory and problem solving/flexibility tests. Vineland Adaptive Behavior Scales (VABS) was used to evaluate adaptive behavior. To establish the predictive capacity of the cognitive variables for adaptive functioning, linear regression models were fitted for each adaptive domain using a stepwise method. RESULTS: Verbal memory and IQ emerged as the main independent predictors for VABS adaptive scores. The 41% of the variance in Communication was predicted by IQ. The 35% of the variance in Daily Living Skills was predicted by verbal memory. Almost half of the variance in Socialization was predicted by both, verbal memory and IQ (49%). No other cognitive functions were associated with adaptive scores. CONCLUSIONS: The results highlight the strong impact of IQ and verbal memory on adaptive behavior in HF-ASD patients. These findings could contribute to identify potential targets of intervention.