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Polysomnographic abnormalities in schizophrenia: A replication
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BIOL PSYCHIATRY 1996:39:500-666
consistent with previous investigations. this sample had a higher than expected I'3te of severe alcohol abuse nndlor dependence. Funhennorc, the schizophrenic paticnts reported an early onset of strnnge thoughts and ideas, and many reported using alcohol in an allempl to reduce or contra] those early symptoms. TIle Rochester Adaptive Behavior Inventory (RABI) was administered to all subjects, and produced diITcrcntial prolilcs for each group. The schizophrenic subjects presented themselves a.~ more socially wilhdrolwn and poorly adjusted as youths than did the alcoholics or the controls. No differences were found between the schizophrenic patients who reported abusing nlcohol and those who did not.
177. LEARNING SOCIAL SKILLS IN PSYCHOTIC PATIENTS: GENDER EFFECTS T.E. Smith. J,W. Hull, M. Goodman, D.T. Anthony, & M.K. Kentros Cornell University Mcdical College nnu Westche"ler Division, New York Hospital,White Plains, NY 10605 This is tl study of the Community Re-Entry Program, a tmining module for hospit3tizell patients that teaches community functioning skills, We previously documented that: a) :lcutcly ill inpatients acquired skills regardless of medication effects or IcvC'!s of psychotic symptoms, :lnd b) skill levels were more prcdictive of post-distharge udjustrnenl thurt symptom levels, We now document n gender cffect, which was studied after :mecdolal reports that females obtained greater benefit from the program,The study cohort included 32 hospitalized p3tients with schizo. phrenia or schizoaffective disorder who particlpated in the m:lnualizell 16·session small-group training program. Assessments of !lkilllcvcls ,lnd psychotic symptoms were made art admission ami upart completion of training. A series of multiple regression analyses were undertaken, with post-test skill level as the dependent measure (lnd pre-test skill, partici. pation. gender nnd positive anll negative symptoms liS prellictors. From ndmission to cHscltnrgll, symptoms diminisher.l anll 8killleveis incrcalied to a statistically significant degree, The finnl model for sklllnequi!;ition incllldell gentler. program p:lrticipation and nllgmivc symptom::; Uli preuittors, and accounted for42% of the variance in post-lmining ski11levcl. Partieipalion ami pre·test skill levIII made unique contributions 10 the model (p < 0.04 and p < 0.03, rcspcclivcly), while negative symptoms dill not. Gender made a contribution approaching significance (p < 0,07). Women nnll pilticnls with high levels of participalion had greater mles or skill Dcquisition. While many studies report a mure favomble progno.~is for female schizophrenics, this is :lmons the first suggesting a gender effect in responSll 10 a psychosocial treatment inlervention.
178. POLYSOMNOGRAPHIC ABNORMALITIES IN SCHIZOPHRENIA: A REPLICATION S. Maixner, R. Tandon, A. Douglass, lE. Shipley, L. Decker, & M. Goldman Schizophrcnin Progmm, Univcrsity of Michigan Mlltlical Center. Ann Arbor, M148109·0I16 Although thcre havo been se\'eral sleep-electroencephalographic (EEG) studies in schizophreniil. the precise polysomnogrDphie profile in schizo-
Abslracls
phrenia is still undefined. While a vast majority of studies document disruption in slcep cOlltinuity, there is less asrecment on the presence of shortening of rapid-eyc-movcment (REM) lutency anll reduction in SIOW-W3VC slecp (SWS) in schizophrenic paticnts. We have previOUsly reponed that bOlh dl1lg-nah'e amI previously-mctHcateli schizophrenic patients exhibit disruptcd sleep continuity and shortening of REM Illtency when eontpared to healthy controls (Tandon et ai, Arch Grll Ps)'clliarry 1992: 49:185-194); we also observcd th:lt REM latellcy was inversely correlated to the severity of negative symptoms. To replicate these findings, we rccordlld EEG sleep in llnothcr sample of 35 medication-free (minimum 2 weeks) schizophrenic patients (OSM·!II-R and SADS/RDC) and 2S health)' control!l. The two groups were similar in age and sender di::.tributioll. We ob::.crvcd a signllicnnt lIisruption in sleep continuity in the schizophrenic group a~ charncterized by increased sleep Itltency, more minute~ awake after falling nsleep, more arousals. less time spent asleep. and reduced sleep llrliciency antl mainlcn
179. HYPERCORTISOLEMJA AND COGNITIVE DYSFUNCTION IN SCHIZOPHRENIA G. HlIang~ R. Tandon, R. Goldman, I.e. Smet~ S.F. Taylor, l.R. DeQuardo, & M. Goldman Schizophrenill Pro~ml11, University or Michigan Medical Cenler, Ann Arbor, MI 4R109·0116 Allhough hypcrcGrtisolemia. lIeSI chamcteri1.cd by cortisol nonsuppre!lsion on the del(amethasone suppression lest (DST), was originillly considllred to bll a findins specific to depressive disordcrs. severnl recent studies have document~d this abnormality in severnl schiwphrcnic patients as well. Along willi other groups, we have previously shown a strong association between post.dexamethasone cortisol levels lind neg· ative symptoms in medication-free. :leutely ps)'chotic schizophrenic plltients but not in medication-stabilized partly.remitled paticnts (Tantlon et ai, Bioi P.fyc!J/CItry, 1991 :29:953-964). Schizophrenic paticnts exhibit significant cognitive llbnonnalilies and some experts have suggested lhat hypcrcortisolemill may be one importilnt factor that contributes to the development of neuropsychological dysfunction in !ichlzophrcnia. There have been relalively few studies that eVllluated the ilssocialion between response to the OST lind cognitive function in schizophrenic patients: findings, hitherto h:lve been discrepant. We studied 18 schizophrenic inpatients (SADS/ROC Dnd DSM-lII-R) lItl11cdiclltion·free baseline anti after four weeks of clinically-uetennined antipsychotic treatment. A I-lOg DST WlL!I performed at both timepoints nnd patients received lin extensive ncuropsychological battery, Symptoms were assessed at both tlmcpoints. We observed a Irend towarlls 1m associalion retween postdexamethasone cortisol levels nnd poor perrormance on II variety of neuropsychological tasks at medication-free baseline: a.~soci:l\ions with post-trentment (4-week) PQst·dexnmclhnsone corti::;ol levels were much weaker. Imp1icnlions of Ihese findinl::s will be di::;eussed.
BIOL PSYCHIATRY 1996:39:500-666
consistent with previous investigations. this sample had a higher than expected I'3te of severe alcohol abuse nndlor dependence. Funhennorc, the schizophrenic paticnts reported an early onset of strnnge thoughts and ideas, and many reported using alcohol in an allempl to reduce or contra] those early symptoms. TIle Rochester Adaptive Behavior Inventory (RABI) was administered to all subjects, and produced diITcrcntial prolilcs for each group. The schizophrenic subjects presented themselves a.~ more socially wilhdrolwn and poorly adjusted as youths than did the alcoholics or the controls. No differences were found between the schizophrenic patients who reported abusing nlcohol and those who did not.
177. LEARNING SOCIAL SKILLS IN PSYCHOTIC PATIENTS: GENDER EFFECTS T.E. Smith. J,W. Hull, M. Goodman, D.T. Anthony, & M.K. Kentros Cornell University Mcdical College nnu Westche"ler Division, New York Hospital,White Plains, NY 10605 This is tl study of the Community Re-Entry Program, a tmining module for hospit3tizell patients that teaches community functioning skills, We previously documented that: a) :lcutcly ill inpatients acquired skills regardless of medication effects or IcvC'!s of psychotic symptoms, :lnd b) skill levels were more prcdictive of post-distharge udjustrnenl thurt symptom levels, We now document n gender cffect, which was studied after :mecdolal reports that females obtained greater benefit from the program,The study cohort included 32 hospitalized p3tients with schizo. phrenia or schizoaffective disorder who particlpated in the m:lnualizell 16·session small-group training program. Assessments of !lkilllcvcls ,lnd psychotic symptoms were made art admission ami upart completion of training. A series of multiple regression analyses were undertaken, with post-test skill level as the dependent measure (lnd pre-test skill, partici. pation. gender nnd positive anll negative symptoms liS prellictors. From ndmission to cHscltnrgll, symptoms diminisher.l anll 8killleveis incrcalied to a statistically significant degree, The finnl model for sklllnequi!;ition incllldell gentler. program p:lrticipation and nllgmivc symptom::; Uli preuittors, and accounted for42% of the variance in post-lmining ski11levcl. Partieipalion ami pre·test skill levIII made unique contributions 10 the model (p < 0.04 and p < 0.03, rcspcclivcly), while negative symptoms dill not. Gender made a contribution approaching significance (p < 0,07). Women nnll pilticnls with high levels of participalion had greater mles or skill Dcquisition. While many studies report a mure favomble progno.~is for female schizophrenics, this is :lmons the first suggesting a gender effect in responSll 10 a psychosocial treatment inlervention.
178. POLYSOMNOGRAPHIC ABNORMALITIES IN SCHIZOPHRENIA: A REPLICATION S. Maixner, R. Tandon, A. Douglass, lE. Shipley, L. Decker, & M. Goldman Schizophrcnin Progmm, Univcrsity of Michigan Mlltlical Center. Ann Arbor, M148109·0I16 Although thcre havo been se\'eral sleep-electroencephalographic (EEG) studies in schizophreniil. the precise polysomnogrDphie profile in schizo-
Abslracls
phrenia is still undefined. While a vast majority of studies document disruption in slcep cOlltinuity, there is less asrecment on the presence of shortening of rapid-eyc-movcment (REM) lutency anll reduction in SIOW-W3VC slecp (SWS) in schizophrenic paticnts. We have previOUsly reponed that bOlh dl1lg-nah'e amI previously-mctHcateli schizophrenic patients exhibit disruptcd sleep continuity and shortening of REM Illtency when eontpared to healthy controls (Tandon et ai, Arch Grll Ps)'clliarry 1992: 49:185-194); we also observcd th:lt REM latellcy was inversely correlated to the severity of negative symptoms. To replicate these findings, we rccordlld EEG sleep in llnothcr sample of 35 medication-free (minimum 2 weeks) schizophrenic patients (OSM·!II-R and SADS/RDC) and 2S health)' control!l. The two groups were similar in age and sender di::.tributioll. We ob::.crvcd a signllicnnt lIisruption in sleep continuity in the schizophrenic group a~ charncterized by increased sleep Itltency, more minute~ awake after falling nsleep, more arousals. less time spent asleep. and reduced sleep llrliciency antl mainlcn
179. HYPERCORTISOLEMJA AND COGNITIVE DYSFUNCTION IN SCHIZOPHRENIA G. HlIang~ R. Tandon, R. Goldman, I.e. Smet~ S.F. Taylor, l.R. DeQuardo, & M. Goldman Schizophrenill Pro~ml11, University or Michigan Medical Cenler, Ann Arbor, MI 4R109·0116 Allhough hypcrcGrtisolemia. lIeSI chamcteri1.cd by cortisol nonsuppre!lsion on the del(amethasone suppression lest (DST), was originillly considllred to bll a findins specific to depressive disordcrs. severnl recent studies have document~d this abnormality in severnl schiwphrcnic patients as well. Along willi other groups, we have previously shown a strong association between post.dexamethasone cortisol levels lind neg· ative symptoms in medication-free. :leutely ps)'chotic schizophrenic plltients but not in medication-stabilized partly.remitled paticnts (Tantlon et ai, Bioi P.fyc!J/CItry, 1991 :29:953-964). Schizophrenic paticnts exhibit significant cognitive llbnonnalilies and some experts have suggested lhat hypcrcortisolemill may be one importilnt factor that contributes to the development of neuropsychological dysfunction in !ichlzophrcnia. There have been relalively few studies that eVllluated the ilssocialion between response to the OST lind cognitive function in schizophrenic patients: findings, hitherto h:lve been discrepant. We studied 18 schizophrenic inpatients (SADS/ROC Dnd DSM-lII-R) lItl11cdiclltion·free baseline anti after four weeks of clinically-uetennined antipsychotic treatment. A I-lOg DST WlL!I performed at both timepoints nnd patients received lin extensive ncuropsychological battery, Symptoms were assessed at both tlmcpoints. We observed a Irend towarlls 1m associalion retween postdexamethasone cortisol levels nnd poor perrormance on II variety of neuropsychological tasks at medication-free baseline: a.~soci:l\ions with post-trentment (4-week) PQst·dexnmclhnsone corti::;ol levels were much weaker. Imp1icnlions of Ihese findinl::s will be di::;eussed.