Impaired Social Functioning Research Articles

Psychological and functional outcomes following a randomized controlled trial of surf and hike therapy for U.S. service members.

Exercise-based interventions have established benefits for the treatment of depression and other psychological outcomes; however, limited data exist evaluating psychological, social, and functional outcomes for exercise outdoors. The current study sought to expand knowledge about the breadth of effects following outdoor exercise interventions by using data from a randomized control trial comparing Surf and Hike Therapy among 96 U.S. active duty service members with major depressive disorder (MDD). Assessments examining psychological symptoms and functioning were completed before and after the 6-week programs, and 3 months following program completion. Participants also completed assessments before and after each exercise session. Multilevel modeling was used to determine whether psychological and functional outcomes (anxiety, positive and negative affect, resilience, pain, and physical and social functioning) improved for service members receiving Surf or Hike Therapy, and whether improvements differed by intervention. Study findings showed improved anxiety (p < 0.001), negative affect (p < 0.001), psychological resilience (p = 0.013), and social functioning (p < 0.001) following program participation, with no differences by intervention. Positive affect, pain, and physical functioning did not significantly improve after the program. Within sessions, positive affect (p < 0.001) and pain (p = 0.036) changed, and to a greater extent for those in the Surf Therapy condition. Study results suggest that both Surf Therapy and Hike Therapy can improve psychological symptoms and social functioning impairments that commonly co-occur among service members with MDD, but Surf Therapy may provide enhanced immediate effects on positive affect and pain. ClinicalTrials.gov, NCT03302611.

Ayurvedic Management of Schizophrenia - A Case Report

Schizophrenia is ranked by the World Health Organization as one of the top ten illnesses contributing to global burden of disease, commonly associated with impairment in social and occupational functioning. It is defined by abnormalities in one or more of the five domains including delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behaviour (including catatonia) and negative symptoms. A 40-year-old female patient was admitted in the Government Ayurveda Research Institute for Mental Health and Hygiene, Kottakkal, with agitation, anger, harming tendencies along with nudity for 2 months. There were suicidal ideations and escaping tendencies. In Ayurveda, Unmada is the umbrella term where almost all psychotic features are enlisted. Unmada is defined as perversion in Manas, Budhi, Samjnajnana, Smruthi, Bhakthi, Seela, Cheshta and Achara. Management of Unmada is based on the predominance of dosha involved in the pathogenesis. Sodhana, Samana and Satwavajaya are the 3 important treatment modalities used in management of Unmada. Sodhana procedure is foremost important in management of Unmada. The patient was treated on an IP level with a combination of Ayurvedic internal medications and procedures for 30 days. The treatment protocol including Sirodhara, Snehapana, Virechana, Vasti and Nasya was administered. PANSS scale was used to evaluate the symptoms before and after the treatment. There was a significant reduction in score from 115 to 45 after the intervention. This case report shows the importance of Ayurveda in the effective management of schizophrenia.

Obsessive-compulsive disorder in youth and young adults with depression: Clinical characteristics of comorbid presentations

Obsessive-compulsive disorder (OCD), anxiety disorders, and depressive disorders are highly comorbid, and each contribute to significant functional impairment for affected youth. Comorbid anxiety disorders in depressed youth have been associated with greater depressive symptom severity and impairment, but the impact of comorbid OCD in this population remains unclear. Accordingly, the present study examined the differential clinical characteristics of youth with depression and comorbid OCD relative to age/gender matched depressed youth with no such comorbidity and to those with depression and a comorbid (non-OCD) anxiety disorder. A sample of 797 youth and young adults ages 8–20 years who met diagnostic criteria for depression alone, depression with co-occurring OCD or any anxiety disorder were included in the present study. Rates of comorbid anxiety and OCD were very high (60.5% and 15.5%, respectively). Relative to youth with only depression, depressed youth with comorbid OCD or anxiety had greater severity of depression, suicidality, and overall impairment in social, physical, and emotional functioning. These results highlight the contribution of OCD or anxiety comorbidity in more complex clinical presentations for depressed youth.

A Systematic Review and Meta-Analysis of the Association Between Psychopathology and Social Functioning in Schizophrenia.

Impaired social functioning is a major, but under-elucidated area of schizophrenia. It's typically understood as consequential to, eg, negative symptoms, but meta-analyses on the subject have not examined psychopathology in a broader perspective and there's severe heterogeneity in outcome measures. To enhance functional recovery from schizophrenia, a more comprehensive understanding of the nature of social functioning in schizophrenia is needed. In this systematic review and meta-analysis, we searched PubMed, PsycInfo, and Ovid Embase for studies providing an association between psychopathology and social functioning. Meta-analyses of the regression and correlation coefficients were performed to explore associations between social functioning and psychopathology, as well as associations between their subdomains. Thirty-six studies with a total of 4742 patients were included. Overall social functioning was associated with overall psychopathology (95% CI [-0.63; -0.37]), positive symptoms (95% CI [-0.39; -0.25]), negative symptoms (95% CI [-0.61; -0.42]), disorganized symptoms (95% CI [-0.54; -0.14]), depressive symptoms (95% CI [-0.33; -0.11]), and general psychopathology (95% CI [-0.60; -0.43]). There was significant heterogeneity in the results, with I2 ranging from 52% to 92%. This is the first systematic review and meta-analysis to comprehensively examine associations between psychopathology and social functioning. The finding that all psychopathological subdomains seem to correlate with social functioning challenges the view that impaired social functioning in schizophrenia is mainly a result of negative symptoms. In line with classical psychopathological literature on schizophrenia, it may be more appropriate to consider impaired social functioning as a manifestation of the disorder itself.

Training caregivers to make meaningful connections with persons living with dementia: Telehealth strategies from the Pacific island of Guam

AbstractBackgroundAlzheimer’s Disease and Related Dementias (ADRD) are not only characterized by a decline in memory and cognition, but also by marked difficulties in language, communication, and social functioning. As ADRD progresses, it becomes increasingly challenging for persons living with dementia to participate in social interactions with family, friends, and caregivers, adversely impacting their well‐being and quality of life. Despite impairment in social functioning, persons with dementia still enjoy interaction with others and respond positively to social contact even in advanced stages. Thus, there is a need to develop effective strategies for interacting with persons living with dementia in a meaningful way.MethodA telehealth dementia care training initiative was developed in the Pacific island of Guam focused on teaching family and professional caregivers to make meaningful connections with persons with ADRD through a wide range of stimulating, culturally responsive activities adapted to meet their unique needs, interests, and abilities. Activities were designed to provide opportunities for social engagement and simultaneously to help persons with dementia remain mentally and physically active. Examples include: (1) making meaningful connections with persons with dementia during activities of daily living; (2) rediscovering Guam’s history and culture through family‐based virtual museum tours; (3) embracing the oral storytelling traditions of Pacific island cultures by sharing family memories; (4) employing culturally responsive bibliotherapy by reading indigenous stories and picture books together; (5) stimulating the mind through collaborative readings of poetry; (6) soothing the aches and pains that come with aging by providing therapeutic massage; and (7) integrating music, dance, and movement into each day. All trainings were conducted in virtual family caregiver support group sessions as part of a comprehensive telehealth outreach program designed to provide improved access to dementia care support services for persons with dementia and their caregivers in Guam.ResultApproximately 60‐100 family and professional caregivers participate in the program each month.ConclusionProgram outcomes indicate that telehealth training in activity‐based dementia care can be an effective way to help caregivers learn to make meaningful connections with persons living with dementia.

Longitudinal Investigation of Auditory Dynamic Range Deficits in Early Psychosis and its Relationship to Negative Symptoms.

Despite accounting for significant disease morbidity in schizophrenia, the neuropathological basis of negative symptoms remains poorly understood and options for treatment limited. Our recent study identified robust associations between diminished auditory cortex (AC) dynamic range and social functioning impairments and negative symptoms in first episode psychosis (FESz). The current investigation examined the progression of these relationships 4-8 months from baseline testing. Twenty-six FESz and 38 healthy controls (HC) were tested at baseline and follow-up. Magnetoencephalography (MEG) was recorded during binaural presentation of tones (75, 80, and 85 dB). Assessments included the MATRICS cognitive consensus battery (MCCB) and Global Functioning: Role and Social scales (GFR/GFS) and the Positive and Negative Syndrome Scale. Overall, FESz exhibited a blunted response to increasing tone intensity relative to HC. While this deficit did not change over time at the group level, recovery of right hemisphere AC dynamic range (85-75 dB response) among FESz individuals was associated with reductions in negative symptoms (ρ = -0.50). Diminished dynamic range was also associated with impaired GFS (ρ = 0.65), GFR (ρ = 0.51), and MCCB (ρ = 0.49) at baseline and increased negative symptoms at baseline (ρ = -0.53) and follow-up (ρ = -0.51). Despite persistent dynamic range impairment in FESz as a group, individual recovery of this AC response property was associated with significant reduction in negative symptoms. Identification of a functional neural deficit that tracts progression of negative symptoms during a critical period for disease modification is essential to the management of these devastating and historically treatment refractory symptoms.

CP-AnemiC: A ​conjunctival pallor dataset and benchmark for anemia detection in children

Anemia is a universal public health issue, which occurs as the result of a reduction in red blood cells. This disease is common among children in Africa and other developing countries. If not treated early, children may suffer long-term consequences such as impairment in social, emotional, and cognitive functioning. Early detection of anemia in children is highly desirable for effective treatment measures. While there has been research into the development of computer-aided diagnosis (CAD) systems for anemia diagnosis, a significant proportion of these studies encountered limitations when working with limited datasets.To overcome the existing issues, this paper proposes a large dataset, named CP-AnemiC, comprising 710 individuals (range of age, 6–59 months), gathered from several hospitals in Ghana. The conjunctiva image-based dataset is supported with Hb levels (g/dL) annotations for accurate diagnosis of anemia. A joint deep neural network is developed that simultaneously classifies anemia and estimates hemoglobin levels (g/dL) based on the conjunctival pallor images. This paper conducts a comprehensive experiment on the CP-AnemiC dataset. The experimental results demonstrate the efficacy of the joint deep neural network in both the tasks of anemia classification and Hb levels (g/dL) estimation.

The effect of exercise on global, social, daily living and occupational functioning in people living with schizophrenia: A systematic review and meta-analysis.

Schizophrenia is associated with high rates of global, social and occupational functional impairments. While prior meta-analyses have extensively examined the impact of exercise on physical and mental health, the impact on functioning in schizophrenia have yet to be fully established. This review aimed to update the evidence base regarding the impact of exercise on functioning in schizophrenia, and explore moderators of effect. A systematic search was conducted to identify randomized controlled trials (RCTs) of exercise evaluating global functioning versus any comparator in people with schizophrenia; between group meta-analyses of global functioning (and secondary - social, living skills, occupational, adverse events) were computed using a random effects model. Subgroup analyses based on diagnosis and aspects of the intervention were conducted. 18 full text articles were included, involving 734 participants. A moderate impact of exercise on global functioning was found (g=0.40, 95% C·I.=0.12 to 0.69, p=0.006), with a moderate impact of exercise on social (N=5, g=0.54 95% C.I=0.16 to 0.9 p=0.005), and daily living functioning (N=3, g=0.65, 95% C.I.=0.07 to 1.22, p=0.005). There is good evidence that exercise can improve the global functioning of people with schizophrenia, with preliminary evidence for social and daily living skills; exercise should be considered an important adjunct to usual care. Higher impacts on global functioning were seen in aerobic interventions and of at least moderate to vigorous intensity. More research is required into resistance training, in early psychosis cohorts and to evaluate the comparison of exercise with other established psychosocial therapies.

Eating Disorder: The Causes and Effects

Eating disorders (EDs) are a group of psychosomatic disorders characterized by abnormal eating behavior and psychological disorders, with high mortality and easy chronicity. Eating disorders characterized by bulimic behavior include binge eating disorder (BED) and bulimia nervosa (BN) while eating disorders characterized by anorexic behavior include anorexia nervosa (AN). Patients can experience varying mental distress, various somatic complications, and impairment of health and social functioning. Although the pathogenesis of the disease has not been completely elucidated, there is inevitably a strong connection with psychological, biological, family, and social factors. Among them, genetic factors play a tremendous role, with a genetic potential of 28% to 83%. The main treatments nowadays are cognitive behavioral therapy guided self-help (CBT-GSH) which is a kind of cognitive behavioral therapy, dialectical behavior therapy (DBT), interpersonal psychotherapy (IPT), and family-based treatment (FBT). However, the advent of virtual reality technology has provided new ideas for interventions in eating disorders in which binge eating behavior is the main symptom. Virtual reality technology intervenes with BED/BN populations by taking an emotional and cognitive perspective. Related studies show virtual reality exposure therapy is more effective than traditional interventions for BED/BN populations.

Causes and Treatment of Borderline Personality Disorder in Light of Genetic and Environmental Influences

Borderline personality disorder is a common and serious personality disorder, and it has been one of the hotspots of clinical research because of the severe and incurable impairment of social functioning in borderline personality disorder. Based on this issue, this paper summarizes the influencing factors for the formation of bpd through reviewing previous literature, including the intra-individual factors (genetic, biological, gene-environment interaction) and environmental factors (upbringing, parental emotional instability, childhood abuse, low education level, diverse childhood trauma). In addition, relevant treatments including medical and non-medical treatments (psychodynamic therapy, supportive therapy, cognitive-behavioral therapy) are also discussed. It has been found through research that the etiology of borderline personality disorder is complex, has an extremely profound impact on the patient, and is highly debated in terms of treatment. Some of the current psychotherapeutic methods are more effective, on the basis of which some treatments about medical and pharmacological treatments can be added, or the combination of psychological plus pharmacological dual treatments and the combination of different psychological treatments are necessary for further research in order to obtain better treatment results. The summary in this article is intended to give mental health practitioners some suggestions and inspiration for treating borderline personality disorder.

Why do children with autism spectrum disorder have abnormal visual perception?

Autism spectrum disorder (ASD) is associated with severe impairment in social functioning. Visual information processing provides nonverbal cues that support social interactions. ASD children exhibit abnormalities in visual orientation, continuous visual exploration, and visual-spatial perception, causing social dysfunction, and mechanisms underlying these abnormalities remain unclear. Transmission of visual information depends on the retina-lateral geniculate nucleus-visual cortex pathway. In ASD, developmental abnormalities occur in rapid expansion of the visual cortex surface area with constant thickness during early life, causing abnormal transmission of the peak of the visual evoked potential (P100). We hypothesized that abnormal visual perception in ASD are related to the abnormal visual information transmission and abnormal development of visual cortex in early life, what's more, explored the mechanisms of abnormal visual symptoms to provide suggestions for future research.

Exploring the performance of during-treatment substance use outcome measures in predicting longer-term psychosocial functioning and post-treatment abstinence

BackgroundThe selection of appropriate efficacy endpoints in clinical trials has been a long-standing challenge for the substance use disorder field. Using data from a large, multi-site National Drug Abuse Treatment Clinical Trials Network trial (CTN-0044; n=474), this secondary data analysis aimed to explore whether specific proximal (during-treatment) substance use outcome measures predict longer-term improvements in psychosocial functioning and post-treatment abstinence, and whether predictions vary depending on the specific substance (cannabis, cocaine/stimulants, opioids, and alcohol). MethodsGeneralized linear mixed models examined associations between six during-treatment substance use outcome measures and social functioning impairment (Social Adjustment Scale Self-Report) and severity of psychiatric symptoms (Brief Symptom Inventory-18) at end-of-treatment, and 3- and 6-months after treatment as well as post-treatment abstinence. ResultsMaximum days of consecutive abstinence, proportion of days abstinent, ≥3 weeks of continuous abstinence, and the proportion of urine specimens negative for the primary substance were associated with post-treatment psychiatric and social functioning improvement and abstinence. However, only the effects of abstinence during the last 4 weeks of the treatment period on all three post-treatment outcomes was stable over time and did not differ between primary substance groups. In contrast, complete abstinence during the 12-week treatment period was not consistently associated with functioning improvements. ConclusionsSubstance use outcome measures capturing the duration of primary substance abstinence during treatment are suitable predictors of post-treatment abstinence and longer-term psychosocial functioning improvement. Binary outcomes, such as end-of-treatment abstinence, may be particularly stable predictors and attractive given their ease of computation and straightforward clinical interpretability.

Alternation in functional connectivity within default mode network after psychodynamic psychotherapy in borderline personality disorder

BackgroundBorderline personality disorder (BPD) is characterized by impairments in emotion regulation, impulse control, and interpersonal and social functioning along with a deficit in emotional awareness and empathy. In this study, we investigated whether functional connectivity (FC) within the default mode network (DMN) is affected by 1-year psychodynamic psychotherapy in patients with BPD.MethodsNine BPD patients filled out the demography, Interpersonal Reactive Index (IRI), Toronto Alexithymia Scale 20 (TAS 20), the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and the Borderline Evaluation Severity over Time (BEST) questionnaire. The BPD group (9F) and the control group (9F) had a mean ± SD age of 28.2 ± 5.3 years and 30.4 ± 6.1 years, respectively. BPD subjects underwent longitudinal resting-state fMRI before psychodynamic psychotherapy and then every 4 months for a year after initiating psychotherapy. FC in DMN was characterized by calculating the nodal degree, a measure of centrality in the graph theory.ResultsThe results indicated that patients with BPD present with aberrant DMN connectivity compared to healthy controls. Over a year of psychotherapy, the patients with BPD showed both FC changes (decreasing nodal degree in the dorsal anterior cingulate cortex and increasing in other cingulate cortex regions) and behavioral improvement in their symptoms and substance use. There was also a significant positive association between the decreased nodal degree in regions of the dorsal cingulate cortex and a decrease in the score of the TAS-20 indicating difficulty in identifying feelings after psychotherapy.ConclusionIn BPD, there is altered FC within the DMN and disruption in self-processing and emotion regulation. Psychotherapy may modify the DMN connectivity and that modification is associated with positive changes in BPD emotional symptoms.

Executive functions in understanding certain disabilities within an African context

Cognitive and social functioning are important aspects of the development of all children. In the transition from one stage of development to another, children are expected to master related skills. There is sufficient literature depicting that children with learning disabilities often experience challenges in a range of executive functions, which are necessary for the successful negotiation of their educational and life-related tasks. As a result, they may require appropriate intervention measures to enable them to address possible limitations. This paper examines the cognitive and social skills deficits that impact on the planning and decision-making outcomes of children with disabilities, using an Afrocentric approach. The Afrocentric paradigm is central in studying and understanding African experiences from an African perspective. Afrocentricity is used as an alternative knowledge system, which places the needs of Africans at the center of focus. In contrast to Eurocentric tendencies, the holistic being, in the African context, is understood and constituted as body, mind, and spirit. While there is sufficient Western literature acknowledging similar holistic views, and biopsychosocial and spiritual dimensions, this paper points out on the lack of emphasis on the latter dimension. The paper concludes that without providing relevant interventions on learner executive functions, the impairment of cognitive and social functioning is likely to continue.

Association between childhood maltreatment and social functioning in individuals with affective disorders: A systematic review and meta-analysis.

Childhood maltreatment has been linked to impairments in social functioning and social cognition in adults with affective disorders. However, conclusions have been limited by inconsistent findings across different maltreatment subtypes and social domains. We conducted a systematic review and meta-analysis to quantify associations between childhood maltreatment (overall and subtypes - physical, emotional and/or sexual abuse, and/or physical and/or emotional neglect) and different domains of social functioning and social cognition in adults with affective disorders (bipolar disorder or major depressive disorder). We also examined effect moderators and mediators of these associations. A systematic search was performed on 12.12.2022 which identified 29 studies included in qualitative synthesis (n = 3022 individuals with affective disorders), of which 27 (n = 2957) were pooled in meta-analyses. Across studies, five social functioning and five social cognition domains were examined, of which four domains of social functioning and two domains of social cognition had sufficient data for meta-analysis (PROSPERO CRD42022288976). Social functioning: childhood maltreatment was associated with lower global social functioning (r = -0.11 to -0.20), poorer interpersonal relations (r = -0.18 to -0.33), and with aggressive behaviour (r = 0.20-0.29) but was unrelated to vocational functioning. Emotional abuse and emotional neglect showed the largest magnitudes of effect. Social cognition: there was no meta-analytic evidence of associations between maltreatment and social cognition domains. Exploratory moderation analyses did not identify any consistent moderators. Narrative synthesis identified attachment style as possible moderator, and sensory patterns, anxiety, and depressive symptoms as possible mediators between childhood maltreatment and social outcomes. Overall, the available evidence was limited, particularly in relation to social cognition. Adults with affective disorders are at risk of social functioning difficulties after childhood maltreatment exposure, an effect observed across multiple maltreatment subtypes, social functioning domains, and diagnoses. Addressing social functioning problems may benefit maltreated adults with both bipolar disorder and major depressive disorder.

Problems of Adaptation and Impairment of Social Functioning of Persons with Bipolar Affective Disorder Type II

The article presents an analysis of the main theoretical approaches to the violation of adaptation and social functioning of patients with bipolar disorder. The main approaches to socio-psychological adaptation in domestic and foreign psychology are presented. The concept of sustainability is disclosed as the ability to recover and grow positively after periods of impaired adaptation. The main areas of disruption of social functioning during the period of pathopsychological manifestations in patients with bipolar affective disorder are outlined: violations of interpersonal and social functioning, professional and educational activities, identity, self-image, emotional regulation, self-service ability. A study is presented that confirms the hypothesis of a decrease in adaptability and social functioning during periods of pathopsychological manifestations (21 people). The presented data can serve as a basis for effective support of patients with bipolar affective disorder.

Contribution of Comorbid Conditions to the Diagnosis of Insomnia: A Database Study in a Commercially Insured Population.

Insomnia is a common sleep disorder characterized as dissatisfaction with sleep quantity or quality resulting in distress or impairment of social, occupational, or other daily functioning. It is unknown if there are medical conditions that have strong associations with insomnia but are unrecognized in previous literature. In this cross-sectional study based on IBM Marketscan Research Databases, we measured insomnia and 78 medical conditions in patients with 2-year continuous enrollment during 2018-2019. We selected important comorbidities associated with insomnia for eight age-sex groups and built logistic regression models to measure the associations. The prevalence of diagnosed insomnia increased with age, from <0.4% in the age group 0-17 to 4%-5% in the age group ≥65. Females had a higher prevalence of insomnia than males. Anxiety and depression were two important comorbidities across all age-sex subgroups. Most odds ratios of comorbidities remained significant after adjusting for other comorbidities in regression models. We did not find any new medical conditions that had strong associations with insomnia but were unrecognized in previous literature. The findings can help physicians use comorbidities to identify patients with high risk of insomnia.

VR-SOAP, a modular virtual reality treatment for improving social activities and participation of young people with psychosis: a study protocol for a single-blind multi-centre randomized controlled trial

BackgroundYoung people with a psychotic disorder have the same social goals as their healthy peers, but their social networks are smaller, they participate less often in leisure activities and are less successful in work and education. Causes of these problems are multifaceted, but culminate in difficulties with interacting in daily life social situations. Current treatments have only moderate effects on social functioning and often target one specific domain. Virtual reality (VR) has the potential to improve the treatment of social interaction difficulties. We developed a modular VR treatment for social functioning and participation (VR-SOAP). In this study, the effect of this intervention will be investigated in a randomized controlled trial (RCT).MethodsA total of 116 participants (age 18–40) with a DSM-5 diagnosis of schizophrenia spectrum or other psychotic disorder and problems with social functioning will be recruited from mental healthcare institutes in the Netherlands. Participants will be randomized to the experimental condition (VR-SOAP) or active VR control condition (VRelax). VR-SOAP consists of 14 sessions and 5 modules addressing causes of impaired social functioning: four optional modules (1–4) and one fixed module (5). Vrelax consists of 14 sessions that entail psychoeducation, stress management, relaxation techniques, and the exploration of relaxing environments in VR. Primary outcomes are quantity and quality of social contacts, leisure activities and social participation, measured with the experience sampling method (ESM). Secondary outcomes are psychiatric symptoms, social behaviour, social cognition, self-esteem, self-stigma and paranoid thoughts. Treatment effects will be compared at pre-treatment (baseline), post-treatment and at 6-month follow-up.DiscussionIf VR-SOAP proves to be effective, it provides therapists with a much-needed tool to improve social functioning of young adults with a psychotic disorder. Additionally, since the treatment consists of multiple modules targeting different transdiagnostic factors, this trial might provide input for new treatments to improve social functioning in a range of symptoms and disorders, e.g. mood, autism spectrum and anxiety disorders.Trial registrationOn the 10th of November 2021, this trial was registered prospectively in the Dutch Trial Register as NL9784.

Investigation of Apraxia in Patients with Schizophrenia and Bipolar Disorder Type I.

Almost 50% of patients with schizophrenia experience problems in their praxia performance, whereas executive function losses can be seen in patients with bipolar disorder. Although schizophrenia and bipolar disorder can be categorized as different disorders, in patient groups with similar symptom clusters, we aimed to determine whether there are common or disorder-specific praxia defects and to investigate the relationship between the sociodemographic and clinical features with apraxia. 52 Schizophrenia and 77 Bipolar Disorder Type I outpatients in remission for at least 6 months were included in our study. Test of Upper Limb Apraxia (TULIA) and Mayo Clinic Praxia Assessment Test (MCPAT) were used to evaluate praxia performance. Patients with Schizophrenia performed poorer on the TULIA and MCPAT than patients with Bipolar Disorder Type I. While impairment in personal and social functioning was higher in the apraxic schizophrenia group compared to the non-apraxic group, the mean age of disease onset was lower. Functioning in the Apraxic Bipolar Disorder Type I group was lower than in the group without apraxia; whereas the patient's age, duration of disease and number of hospitalizations were higher. Although apraxia, which have an important effect on the functioning and quality of life of the patient by causing impairment in daily activities, are seen at higher rates in patients with schizophrenia, might be also seen in patients with bipolar disorder type I. Decreasing diagnostic confusion and developing appropriate treatment strategies, evaluation of apraxia seems to be clinically important in terms of prognosis of diseases and functioning of patients.

Modulating chronic outcomes after pediatric traumatic brain injury: Distinct effects of social and environmental enrichment

Impairments in social and cognitive function are a common consequence of pediatric traumatic brain injury (TBI). Rehabilitation has the potential to promote optimal behavioral recovery. Here, we evaluated whether an enhanced social and/or cognitive environment could improve long-term outcomes in a preclinical model of pediatric TBI. Male C57Bl/6 J mice received a moderately-severe TBI or sham procedure at postnatal day 21. After one week, mice were randomized to different social conditions (minimal socialization, n = 2/cage; or social grouping, n = 6/cage), and housing conditions (standard cage, or environmental enrichment (EE), incorporating sensory, motor, and cognitive stimuli). After 8 weeks, neurobehavioral outcomes were assessed, followed by post-mortem neuropathology. We found that TBI mice exhibited hyperactivity, spatial memory deficits, reduced anxiety-like behavior, and reduced sensorimotor performance compared to age-matched sham controls. Pro-social and sociosexual behaviors were also reduced in TBI mice. EE increased sensorimotor performance, and the duration of sociosexual interactions. Conversely, social housing reduced hyperactivity and altered anxiety-like behavior in TBI mice, and reduced same-sex social investigation. TBI mice showed impaired spatial memory retention, except for TBI mice exposed to both EE and group housing. In the brain, while TBI led to significant regional tissue atrophy, social housing had modest neuroprotective effects on hippocampal volumes, neurogenesis, and oligodendrocyte progenitor numbers. In conclusion, manipulation of the post-injury environment has benefit for chronic behavioral outcomes, but the benefits are specific to the type of enrichment available. This study improves understanding of modifiable factors that may be harnessed to optimize long-term outcomes for survivors of early-life TBI.