Abstract
BackgroundPatients with psychosis often present significant neurocognitive deficits, with executive function deficits (EEFF) being one of the most relevant cognitive impairments with the greatest impact on the functioning of their daily lives. However, although various findings of executive involvement were reported, it is not entirely clear whether there is a differential pattern of involvement according to the clinical symptoms or the deficits occur in all or only in some subcomponents of EEFF.ObjectiveThe present study had a double objective: to study the specific deficits in the cool and hot EEFF in a group of psychotic patients with a predominance of negative symptoms; and determine the possible associations between the performance of the patients in the cool an hot EEFF tasks with the negative symptoms, and with the behavioral alterations associated with the dysexecutive syndrome.Method:66 participants, 33 psychotic patients with a predominance of negative symptoms and 33 healthy control subjects matched in gender, age and educational level participated. Both groups were administered 4 cool EEFF tasks (coding/maintenance and updating of information in working memory, ability to change the mental set and planning), and 3 hot EEFF tasks (decision making in situations of uncertainty, recognition of emotions through facial expressions and theory of mind). In the group of patients, the Negative symptoms were evaluated through the Scale for the Evaluation of Negative Symptoms (SANS), and the behavioral alterations associated with dysexecutive syndrome through the subscale of “Executive Dysfunction” of the Frontal Systems Behavior Scale.ResultsPatients performed worse on three cool EEFF tasks and on two of the hot EEFF tasks. Additionally, we found a correlation between the SANS score and the “executive dysfunction” subscale, with the cold EEFF task that measures planning.ConclusionOur findings showed that in psychotic patients with a predominance of negative symptoms, both, the cognitive (cool) and emotional (hot) components of executive functions are affected. The results reinforce the need for a cognitive rehabilitation treatment of the executive components of the working memory and of those more socio-emotional aspects.
Highlights
Negative symptoms (NS) have been considered as a central characteristic of psychosis, constituting a serious cause of disability and having a clear impact on the patient’s daily life functioning (Fonseca et al, 2015)
With respect to the experimental group, psychotic patients were included in the study with a definitive diagnosis of psychosis, and with a confirmed diagnosis with 2 years of evolution, as well as patients with a predominance of NSs, these being the patients who presented a higher percentage in the Scale for the Assessment of Negative Symptoms (SANS) than the Scale for the Assessment of Positive Symptoms (SAPS)
The final sample consisted of n = 66 participants (Range of age min = 20 – max = 60), both genders: male (n = 49, 74.2%, Mage = 43.6, SD = 11.0), female (n = 17, 25.8%, Mage = 44.2, SD = 11.0); 33 psychotic patients, and 33 participants in the control group
Summary
Negative symptoms (NS) have been considered as a central characteristic of psychosis, constituting a serious cause of disability and having a clear impact on the patient’s daily life functioning (Fonseca et al, 2015). Patients with predominantly NSs (affective flattening, alogia, abulia or apathy, anhedonia and asociality) have been associated with considerable cognitive impairment, some previous studies have found deficits in Executive Functions (EEFF) It is important to note that in all previous studies the EEFF are not defined in the same way or measured with the same instruments. Patients with psychosis often present significant neurocognitive deficits, with executive function deficits (EEFF) being one of the most relevant cognitive impairments with the greatest impact on the functioning of their daily lives. Various findings of executive involvement were reported, it is not entirely clear whether there is a differential pattern of involvement according to the clinical symptoms or the deficits occur in all or only in some subcomponents of EEFF
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