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P.3.a.012 The impact of neurocognitive function on emotion recognition and emotion experience in stabilized chronic schizophrenia
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P.3.a Psychotic disorders and antipsychotics – Psychotic disorders (clinical)
P.3.a.012 The impact of neurocognitive function on emotion recognition and emotion experience in stabilized chronic schizophrenia H. Rim1 ° , S. Jeong1 , S. Lee1 , Y. Park2 , I. Jeong3 , K. Lee4 . 1 Kyungpook National University, Department of psychiatry, Dae-gu, South-Korea; 2 Daegu Fatima Hospital, Department of psychiatry, Dae-gu, South-Korea; 3 Daedong Hospital, Department of psychiatry, Dae-gu, South-Korea; 4 Donguk University Gyongju Hospital, Department of psychiatry, Dae-gu, South-Korea Backgrounds: Abundant evidence has suggested that the prefrontal cortex may be the primary site of schizophrenia, affecting cognitive functions, especially executive function and working memory. In addition, there is growing evidence that schizophrenia show dysfunction in the domains of ‘emotion experience’ and ‘emotion recognition’, and these dysfunctions appears to be correlated with neurocognitive deficits. However, studies to assess two domains of emotion and their correlation with cognitive ability in schizophrenia within one study were scarce. Methods: Thirty nine stable chronic schizophrenic inpatients (female: 20, mean age: 32.4±7.2) and 33 healthy control subjects (female: 19, mean age: 29.0±8.9) were enrolled. The Facial Affect Identification Test (FAIT) which is a facial emotion recognition test probing the ability to recognize different emotions in others, the Iowa Gambling Task (IGT) which requires the ability to use ones own emotions to guide decision making, so called ‘emotion experience’, and the Wisconsin Card Sorting Test(WCST) which assess the executive function were carried out. ANCOVA with IQ as a covariate was used to compare the performances on each test between two groups. Correlations between the WCST and the FAIT as well as the IGT were tested by Pearson correlation within each group. Results: Patients with schizophrenia identified the emotion of overall facial stimuli less correctly than controls on the FAIT [F(1,70) = 5.04, P = 0.028]. On the performance of the IGT, those patients with schizophrenia performed more poorly than control subjects in the mean overall net score (advantageous minus disadvantageous deck selection) [F(1,70) = 7.20, P = 0.009]. Such a result indicates that healthy participants chose more cards from the advantageous decks (C, D) rather than from the disadvantageous decks (A, B), but schizophrenic patients did not. Schizophrenic patients, when compared to healthy subjects, exhibited significantly poorer performance in all of three variables on the WCST [F(1,70) = 30.24, P < 0.001 for categories completed; F(1,70) = 42.05, P < 0.001 for total errors; F(1,70) = 20.20, P < 0.001 for perseverative errors]. In schizophrenic patients, while total scores on the FAIT negatively correlated with total error (r = −0.50, P = 0.001) and perseverative error (r = −0.50, P = 0.001) on the WCST, the mean overall net score on the IGT positively correlated with these two variables (r = 0.36, P = 0.023 and r = 0.39, P = 0.016). Within normal control group, there was no correlation between any variables in three tests. Conclusion: We replicated that emotion recognition deficits correlated with impaired WCST performance which reflects function of the dorsolateral prefrontal cortex (DLPFC). However, emotion experience deficits, the faulty “somatic marking” in decisionmaking which reflects function of the orbitofrontal cortex (OFC), paradoxically correlated with better performance on the WCST. Speculatively, schizophrenic patients with relatively intact DLPFC functioning might excessively depend on the DLPFC function rather than the OFC function, which lead the faulty detection of
somatic marker. In conclusion, impaired DLPFC function might have a differential influence on emotion recognition and emotion experience in chronic schizophrenia. References [1] Rodriguez-Sanchez JM, Crespo-Facorro B, Perez-Iglesias R, GonzalezBlanch C, Alvarez-Jimenez M, Llorca J, Vazquez-Barquero JL, 2005, Prefrontal cognitive functions in stabilized first-episode patients with schizophrenia spectrum disorders: a dissociation between dorsolateral and orbitofrontal functioning. Schizophr Res 77(2−3), 279–288. [2] Shurman B, Horan WP, Nuechterlein KH, 2005, Schizophrenia patients demonstrate a distinctive pattern of decision-making impairment on the Iowa Gambling Task. Schizophr Res 72(2−3), 215–224. [3] Addington J, Saeedi H, Addington D, 2006, Facial affect recognition: a mediator between cognitive and social functioning in psychosis? Schizophr Res 85(1−3), 142–150.
P.3.a.013 Decreased bone mineral density in patients with schizophrenia treated with risperidone or olanzapine. A. Wyszogrodzka-Kucharska1 ° , J. Rabe-Jablonska2 . 1 Fleming Nuffield Unit, Child and Adolescent Psychiatry, Newcastle upon Tyne, United Kingdom; 2 Medical University of Lodz, Psychiatry, Lodz, Poland Introduction: Decreased bone mass has been reported in patients with schizophrenia (Misra M 2004). Schizophrenia patients are at risk for osteopenia and osteoporosis due to a life style, high prevalence of smoking, limited phisical activity, polydipsia. Antipsychotics can increase the level of prolactin and this can result in amenorrhea and other side-effects. It is not clear whether antipsychotic induced hyperprolactinaemia is an independent risk factor for osteoporosis, especially in men. Purpose of the study: The aim of the study was to evaluate bone mineral density (BMD) in patients with diagnosis of schizophrenia treated with second-generation antipsychotics in reference to a control group. Methods: Sixty patients with diagnosis of schizophrenia according to DSM IV entered the study. Patient’s age range was from 20 to 50 years (mean 31.1, SD 8.6), and the duration of illness from 0.3 to 19 years (mean 4.0, SD 4.0). All patients have been treated with antipsychotic medication in the past. Thirty-four patients were treated with olanzapine and twenty-six with risperidone. The patients had no substance-related disorder or physical illness, which could influence bone mineral density. The control group consisted of thirty-eight healthy volunteers, age range from 20 to 49 years (mean 31.7, SD 8.0). All subjects underwent dual-energy X-ray absorptiometry (DXA) measurement of bone mineral density at the spine (L2-L4). Results: There was a statistically significant difference between mean measurements of Z-score at the spine (L2-L4) in patients with schizophrenia compared to healthy controls (p < 0.01). Decreased BMD was significantly more frequent in the patients with schizophrenia than in the control group (p < 0.05). In females with schizophrenia there was a significantly lower BMD compared to female controls (p < 0.05), but this was not found in male patients. Patients with schizophrenia had a significantly higher rate of abnormal results compared to the control group (p < 0.05). In the control group, 15.8% of patients had abnormal results (13.2% osteopenia and 2.6% osteoporosis), compared to the schizophrenia group where 37.7% of patients had abnormal results (28.3% osteopenia and 9.4% osteoporosis). There was no statistical difference between Z-score measurements and BMD between patients
P.3.a Psychotic disorders and antipsychotics – Psychotic disorders (clinical)
P.3.a.012 The impact of neurocognitive function on emotion recognition and emotion experience in stabilized chronic schizophrenia H. Rim1 ° , S. Jeong1 , S. Lee1 , Y. Park2 , I. Jeong3 , K. Lee4 . 1 Kyungpook National University, Department of psychiatry, Dae-gu, South-Korea; 2 Daegu Fatima Hospital, Department of psychiatry, Dae-gu, South-Korea; 3 Daedong Hospital, Department of psychiatry, Dae-gu, South-Korea; 4 Donguk University Gyongju Hospital, Department of psychiatry, Dae-gu, South-Korea Backgrounds: Abundant evidence has suggested that the prefrontal cortex may be the primary site of schizophrenia, affecting cognitive functions, especially executive function and working memory. In addition, there is growing evidence that schizophrenia show dysfunction in the domains of ‘emotion experience’ and ‘emotion recognition’, and these dysfunctions appears to be correlated with neurocognitive deficits. However, studies to assess two domains of emotion and their correlation with cognitive ability in schizophrenia within one study were scarce. Methods: Thirty nine stable chronic schizophrenic inpatients (female: 20, mean age: 32.4±7.2) and 33 healthy control subjects (female: 19, mean age: 29.0±8.9) were enrolled. The Facial Affect Identification Test (FAIT) which is a facial emotion recognition test probing the ability to recognize different emotions in others, the Iowa Gambling Task (IGT) which requires the ability to use ones own emotions to guide decision making, so called ‘emotion experience’, and the Wisconsin Card Sorting Test(WCST) which assess the executive function were carried out. ANCOVA with IQ as a covariate was used to compare the performances on each test between two groups. Correlations between the WCST and the FAIT as well as the IGT were tested by Pearson correlation within each group. Results: Patients with schizophrenia identified the emotion of overall facial stimuli less correctly than controls on the FAIT [F(1,70) = 5.04, P = 0.028]. On the performance of the IGT, those patients with schizophrenia performed more poorly than control subjects in the mean overall net score (advantageous minus disadvantageous deck selection) [F(1,70) = 7.20, P = 0.009]. Such a result indicates that healthy participants chose more cards from the advantageous decks (C, D) rather than from the disadvantageous decks (A, B), but schizophrenic patients did not. Schizophrenic patients, when compared to healthy subjects, exhibited significantly poorer performance in all of three variables on the WCST [F(1,70) = 30.24, P < 0.001 for categories completed; F(1,70) = 42.05, P < 0.001 for total errors; F(1,70) = 20.20, P < 0.001 for perseverative errors]. In schizophrenic patients, while total scores on the FAIT negatively correlated with total error (r = −0.50, P = 0.001) and perseverative error (r = −0.50, P = 0.001) on the WCST, the mean overall net score on the IGT positively correlated with these two variables (r = 0.36, P = 0.023 and r = 0.39, P = 0.016). Within normal control group, there was no correlation between any variables in three tests. Conclusion: We replicated that emotion recognition deficits correlated with impaired WCST performance which reflects function of the dorsolateral prefrontal cortex (DLPFC). However, emotion experience deficits, the faulty “somatic marking” in decisionmaking which reflects function of the orbitofrontal cortex (OFC), paradoxically correlated with better performance on the WCST. Speculatively, schizophrenic patients with relatively intact DLPFC functioning might excessively depend on the DLPFC function rather than the OFC function, which lead the faulty detection of
somatic marker. In conclusion, impaired DLPFC function might have a differential influence on emotion recognition and emotion experience in chronic schizophrenia. References [1] Rodriguez-Sanchez JM, Crespo-Facorro B, Perez-Iglesias R, GonzalezBlanch C, Alvarez-Jimenez M, Llorca J, Vazquez-Barquero JL, 2005, Prefrontal cognitive functions in stabilized first-episode patients with schizophrenia spectrum disorders: a dissociation between dorsolateral and orbitofrontal functioning. Schizophr Res 77(2−3), 279–288. [2] Shurman B, Horan WP, Nuechterlein KH, 2005, Schizophrenia patients demonstrate a distinctive pattern of decision-making impairment on the Iowa Gambling Task. Schizophr Res 72(2−3), 215–224. [3] Addington J, Saeedi H, Addington D, 2006, Facial affect recognition: a mediator between cognitive and social functioning in psychosis? Schizophr Res 85(1−3), 142–150.
P.3.a.013 Decreased bone mineral density in patients with schizophrenia treated with risperidone or olanzapine. A. Wyszogrodzka-Kucharska1 ° , J. Rabe-Jablonska2 . 1 Fleming Nuffield Unit, Child and Adolescent Psychiatry, Newcastle upon Tyne, United Kingdom; 2 Medical University of Lodz, Psychiatry, Lodz, Poland Introduction: Decreased bone mass has been reported in patients with schizophrenia (Misra M 2004). Schizophrenia patients are at risk for osteopenia and osteoporosis due to a life style, high prevalence of smoking, limited phisical activity, polydipsia. Antipsychotics can increase the level of prolactin and this can result in amenorrhea and other side-effects. It is not clear whether antipsychotic induced hyperprolactinaemia is an independent risk factor for osteoporosis, especially in men. Purpose of the study: The aim of the study was to evaluate bone mineral density (BMD) in patients with diagnosis of schizophrenia treated with second-generation antipsychotics in reference to a control group. Methods: Sixty patients with diagnosis of schizophrenia according to DSM IV entered the study. Patient’s age range was from 20 to 50 years (mean 31.1, SD 8.6), and the duration of illness from 0.3 to 19 years (mean 4.0, SD 4.0). All patients have been treated with antipsychotic medication in the past. Thirty-four patients were treated with olanzapine and twenty-six with risperidone. The patients had no substance-related disorder or physical illness, which could influence bone mineral density. The control group consisted of thirty-eight healthy volunteers, age range from 20 to 49 years (mean 31.7, SD 8.0). All subjects underwent dual-energy X-ray absorptiometry (DXA) measurement of bone mineral density at the spine (L2-L4). Results: There was a statistically significant difference between mean measurements of Z-score at the spine (L2-L4) in patients with schizophrenia compared to healthy controls (p < 0.01). Decreased BMD was significantly more frequent in the patients with schizophrenia than in the control group (p < 0.05). In females with schizophrenia there was a significantly lower BMD compared to female controls (p < 0.05), but this was not found in male patients. Patients with schizophrenia had a significantly higher rate of abnormal results compared to the control group (p < 0.05). In the control group, 15.8% of patients had abnormal results (13.2% osteopenia and 2.6% osteoporosis), compared to the schizophrenia group where 37.7% of patients had abnormal results (28.3% osteopenia and 9.4% osteoporosis). There was no statistical difference between Z-score measurements and BMD between patients