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ABERRANTLY HYPERSENSITIVE RESPONSIVITY TO THE NEGATIVE EMOTIONAL WORDS IN PATIENTS WITH SCHIZOPHRENIA
Abstracts / Schizophrenia Research 102/1–3, Supplement 2 (2008) 1–279
228 – ABERRANTLY HYPERSENSITIVE RESPONSIVITY TO THE NEGATIVE EMOTIONAL WORDS IN PATIENTS WITH SCHIZOPHRENIA Suk Kyoon An 1 , Bora Kim 2 , Jee In Kang 3 , Jin Young Park 3 , Eun Lee 4 1 Yonsei University College of Medicine, Seoul, South Korea, Gwangju-si, Gyeonggi-do; 2 Dept. Psychiatry, Yonsei University College of Medicine, Seoul; 3 Dept. Psychiatry & Inst. Behavioural Sciences in Medicine, Yonsei University Col, Seoul; 4 Institute of Behavioural Sciences in Medicine, Yonsei University College of Medi, Seoul, South Korea [email protected] Introduction: The aim is to investigate whether schizophrenia showed aberrant responsivity to the negative emotional words. Methods: Eighteen schizophrenia patients and 17 normal controls were requested to rate the feeling induced by emotional words using 7 points L-scale for each 6 basic emotion of happiness, sadness, fear, anger, surprise, and disgust. The emotional stimuli were composed of the happiness, sadness, fear, and disgust eliciting words, which were frequency-matched 10 words selected from Korean emotional words list (Kim et al, Unpublished). Results: Repeated measured ANOVAs with responses as repeated variable were done in respect of each stimuli of happiness, sadness, fear and disgust. To the happiness words, there was no different responses between groups (F=1.57, p=0.2). To the sadness, fear, and disgust words, there were significant interaction effect of responses x groups (F=2.79, p=0.036; F=5.49, p=0.001; F=3.67, p=0.001, respectively). Patients with schizophrenia showed hypersensitive responses to all 4 emotional words (F= 8.45 - 9.73). The sadness responses to the sadness-eliciting words in schizophrenia was comparable to those in normal control, while hapiness, fear, anger, surprise, and disgust responses of schizophrenia were significantly increased than those of normal control. This response pattern was also observed in fear and disgust words. Conclusions: These findings suggest that the emotional experiences of schizophrenia may be aberrantly hypersensitive responsivity to the negative emotional words, which is in line with previous findings of the aberrant responses to the negative pictures in schizophrenia. References [1] Eun Lee, Jae-Jin Kim, Kee Namkoong, Suk Kyoon An, Jeong-Ho Seok, Yu Jin Lee, Jee In Kang, Jae Hyuk Choi, Taekyong Hong, Jong Hee Jeon, Hong Shick Lee. Aberrantly flattened responsivity to the emotional pictures in patients with paranoid schizophrenia. Psychiatry Research 143: 135-145, 2006
229 – THE EFFECTS OF ESCITALOPRAM ON COGNITIVE FUNCTION Rune Andersen, Bob Oranje, Malene Wienberg, Birte Y. Glenthøj Center for Neuropsychiatric Schizophrenia Research, Glostrup, Denmark [email protected] Introduction: Cognitive deficits are commonly found in all major psychiatric illnesses, while at the biochemical level serotonin seems to play a role in all these psychiatric disorders. However, the role of serotonin in cognition is less clear. The present study was designed to study the effects of increased serotonergic activity on sustained attention, spatial working memory, movement- and reaction time. Methods: In a randomized, double-blind, cross-over experiment with 18 healthy male volunteers, the effects on cognitive function of a single, orally administered dose of 15 mg escitalopram (a highly selective serotonin reuptake inhibitor or “SSRI”) was compared to a placebo. Cognitive function was assessed using selected tests from the computerised Cambridge Neuropsychological Test Automated Battery (CANTAB). Results: Escitalopram did not alter the performance on any of the selected CANTAB tests, although it did marginally decrease the number
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of errors that subjects made in the spatial working memory test (trend p= 0.087). Conclusions: The data from the current study do not support an important serotonergic involvement in cognitive functions such as sustained attention and movement- and reaction time. The data do, however, indicate a marginal involvement of serotonin in spatial working memory. References [1] Amado-Boccara I, Gougoulis N, Poirier Littré MF, Galinowski A, Lôo H. (1995). Effects of antidepressants on cognitive functions: a review. Neurosci Biobehav Rev. 19(3):479-93.
230 – SPECIFICITY OF THE REPRESENTATION OF THEIR OWN ILLNESS BY PATIENTS WITH SCHIZOPHRENIA HAVING BEEN INFORMED OF THEIR DIAGNOSIS Elisabeth Bacon 1 , Alexandra Herbay 2 1 INSERM U 666, and Université Louis Pasteur, Clinique psychiatrique, Hôpital civil, Strasbourg, France; 2 Clinique psychiatrique, Strasbourg, France [email protected] Introduction: Like in any field of medicine, the psychiatrist is faced to the need and the duty to inform the patient with loyalty, clarity and adequacy. However, in the case of schizophrenia, the diagnosis and the related information raise specific problems. Several studies have shown that there is a link between information and observance, that operates through the informed consent. However, the capacity of patients with schizophrenia to understand and to integrate the diagnosis may be impaired by their cognitive dysfunction as well as by their lack of insight and introspective abilities. The aim of this study was to explore the understanding of their own illness of patients having been informed of their diagnosis. Methods: In two separate sessions, patients having been informed of their diagnosis were interviewed about their knowledge of their own illness, and also about their knowledge of several organic and psychiatric illnesses, including schizophrenia. The illnesses were selected in accordance with several criteria: chronic-acute, infectious-non infectious, benign-severe, etc. The description by the patients of their own illness was then compared to the way how they described the illness schizophrenia and the other pathologies. The patients’ descriptions were also confronted to the way how healthy controls, matched with respect with age, gender and educational level, described the same illnesses. Results: Twelve patients and 12 controls were enrolled in the study. Nine patients recognized that their suffered from a psychiatric illness, whereas 3 totally denied it. The patients’ descriptions of organic diseases were clear and coherent, and were only quantitatively less precise than those of the controls. The descriptions of depression by patients and controls were quite similar, except that patients felt more concerned by the illness. The description of the illness schizophrenia was not very accurate in both groups, but the patients’ description was even less accurate and confused. Conclusions: In spite of cognitive impairment and of lack of insight, most of the patients in the study recognized their own diagnosis. Their pathology seemed to interfere mostly with their representation of schizophrenia, and not with their knowledge of the other illnesses. The study has also confirmed the lack of knowledge of the general population about schizophrenia and the bad public image of the illness. Acknowledgements: The authors thank Professor Anne DanionGrillat. References [1] Ferreri M., Rouillon F., Nuss P. & al. (2000). De quelles informations les patients souffrant de schizophrénie disposent-ils sur leur maladie et leur traitement? L’Encéphale, 2000, 26, 30-8. [2] Bacon E., Herbay A. & Danion-Grillat A. (2006). Ethique, diagnostic et information. La lettre du psychiatre, II, 222-5.
228 – ABERRANTLY HYPERSENSITIVE RESPONSIVITY TO THE NEGATIVE EMOTIONAL WORDS IN PATIENTS WITH SCHIZOPHRENIA Suk Kyoon An 1 , Bora Kim 2 , Jee In Kang 3 , Jin Young Park 3 , Eun Lee 4 1 Yonsei University College of Medicine, Seoul, South Korea, Gwangju-si, Gyeonggi-do; 2 Dept. Psychiatry, Yonsei University College of Medicine, Seoul; 3 Dept. Psychiatry & Inst. Behavioural Sciences in Medicine, Yonsei University Col, Seoul; 4 Institute of Behavioural Sciences in Medicine, Yonsei University College of Medi, Seoul, South Korea [email protected] Introduction: The aim is to investigate whether schizophrenia showed aberrant responsivity to the negative emotional words. Methods: Eighteen schizophrenia patients and 17 normal controls were requested to rate the feeling induced by emotional words using 7 points L-scale for each 6 basic emotion of happiness, sadness, fear, anger, surprise, and disgust. The emotional stimuli were composed of the happiness, sadness, fear, and disgust eliciting words, which were frequency-matched 10 words selected from Korean emotional words list (Kim et al, Unpublished). Results: Repeated measured ANOVAs with responses as repeated variable were done in respect of each stimuli of happiness, sadness, fear and disgust. To the happiness words, there was no different responses between groups (F=1.57, p=0.2). To the sadness, fear, and disgust words, there were significant interaction effect of responses x groups (F=2.79, p=0.036; F=5.49, p=0.001; F=3.67, p=0.001, respectively). Patients with schizophrenia showed hypersensitive responses to all 4 emotional words (F= 8.45 - 9.73). The sadness responses to the sadness-eliciting words in schizophrenia was comparable to those in normal control, while hapiness, fear, anger, surprise, and disgust responses of schizophrenia were significantly increased than those of normal control. This response pattern was also observed in fear and disgust words. Conclusions: These findings suggest that the emotional experiences of schizophrenia may be aberrantly hypersensitive responsivity to the negative emotional words, which is in line with previous findings of the aberrant responses to the negative pictures in schizophrenia. References [1] Eun Lee, Jae-Jin Kim, Kee Namkoong, Suk Kyoon An, Jeong-Ho Seok, Yu Jin Lee, Jee In Kang, Jae Hyuk Choi, Taekyong Hong, Jong Hee Jeon, Hong Shick Lee. Aberrantly flattened responsivity to the emotional pictures in patients with paranoid schizophrenia. Psychiatry Research 143: 135-145, 2006
229 – THE EFFECTS OF ESCITALOPRAM ON COGNITIVE FUNCTION Rune Andersen, Bob Oranje, Malene Wienberg, Birte Y. Glenthøj Center for Neuropsychiatric Schizophrenia Research, Glostrup, Denmark [email protected] Introduction: Cognitive deficits are commonly found in all major psychiatric illnesses, while at the biochemical level serotonin seems to play a role in all these psychiatric disorders. However, the role of serotonin in cognition is less clear. The present study was designed to study the effects of increased serotonergic activity on sustained attention, spatial working memory, movement- and reaction time. Methods: In a randomized, double-blind, cross-over experiment with 18 healthy male volunteers, the effects on cognitive function of a single, orally administered dose of 15 mg escitalopram (a highly selective serotonin reuptake inhibitor or “SSRI”) was compared to a placebo. Cognitive function was assessed using selected tests from the computerised Cambridge Neuropsychological Test Automated Battery (CANTAB). Results: Escitalopram did not alter the performance on any of the selected CANTAB tests, although it did marginally decrease the number
133
of errors that subjects made in the spatial working memory test (trend p= 0.087). Conclusions: The data from the current study do not support an important serotonergic involvement in cognitive functions such as sustained attention and movement- and reaction time. The data do, however, indicate a marginal involvement of serotonin in spatial working memory. References [1] Amado-Boccara I, Gougoulis N, Poirier Littré MF, Galinowski A, Lôo H. (1995). Effects of antidepressants on cognitive functions: a review. Neurosci Biobehav Rev. 19(3):479-93.
230 – SPECIFICITY OF THE REPRESENTATION OF THEIR OWN ILLNESS BY PATIENTS WITH SCHIZOPHRENIA HAVING BEEN INFORMED OF THEIR DIAGNOSIS Elisabeth Bacon 1 , Alexandra Herbay 2 1 INSERM U 666, and Université Louis Pasteur, Clinique psychiatrique, Hôpital civil, Strasbourg, France; 2 Clinique psychiatrique, Strasbourg, France [email protected] Introduction: Like in any field of medicine, the psychiatrist is faced to the need and the duty to inform the patient with loyalty, clarity and adequacy. However, in the case of schizophrenia, the diagnosis and the related information raise specific problems. Several studies have shown that there is a link between information and observance, that operates through the informed consent. However, the capacity of patients with schizophrenia to understand and to integrate the diagnosis may be impaired by their cognitive dysfunction as well as by their lack of insight and introspective abilities. The aim of this study was to explore the understanding of their own illness of patients having been informed of their diagnosis. Methods: In two separate sessions, patients having been informed of their diagnosis were interviewed about their knowledge of their own illness, and also about their knowledge of several organic and psychiatric illnesses, including schizophrenia. The illnesses were selected in accordance with several criteria: chronic-acute, infectious-non infectious, benign-severe, etc. The description by the patients of their own illness was then compared to the way how they described the illness schizophrenia and the other pathologies. The patients’ descriptions were also confronted to the way how healthy controls, matched with respect with age, gender and educational level, described the same illnesses. Results: Twelve patients and 12 controls were enrolled in the study. Nine patients recognized that their suffered from a psychiatric illness, whereas 3 totally denied it. The patients’ descriptions of organic diseases were clear and coherent, and were only quantitatively less precise than those of the controls. The descriptions of depression by patients and controls were quite similar, except that patients felt more concerned by the illness. The description of the illness schizophrenia was not very accurate in both groups, but the patients’ description was even less accurate and confused. Conclusions: In spite of cognitive impairment and of lack of insight, most of the patients in the study recognized their own diagnosis. Their pathology seemed to interfere mostly with their representation of schizophrenia, and not with their knowledge of the other illnesses. The study has also confirmed the lack of knowledge of the general population about schizophrenia and the bad public image of the illness. Acknowledgements: The authors thank Professor Anne DanionGrillat. References [1] Ferreri M., Rouillon F., Nuss P. & al. (2000). De quelles informations les patients souffrant de schizophrénie disposent-ils sur leur maladie et leur traitement? L’Encéphale, 2000, 26, 30-8. [2] Bacon E., Herbay A. & Danion-Grillat A. (2006). Ethique, diagnostic et information. La lettre du psychiatre, II, 222-5.