Symbol Coding Research Articles

Cognition in Schizophrenia: Exploring the Dynamics of Improvement and the Influencing Determinants

Background: Cognitive impairments are fundamental characteristics of schizophrenia, significantly impacting the overall functioning of individuals with the disorder. However, the trajectory of cognitive deficits and the factors influencing their changes over the course of treatment remain poorly understood. Objectives: The present study aimed to investigate the changes in cognitive status of patients with schizophrenia and the factors that influence these changes following hospitalization and treatment. Methods: The study utilized a longitudinal design, enrolling thirty hospitalized patients (15 males and 15 females) from the psychiatric inpatient unit of a general educational hospital. Cognitive assessments were conducted upon admission and discharge. A Generalized Estimating Equation (GEE) model was used to analyze the data, accounting for demographic and clinical variables such as age, gender, Body Mass Index (BMI), family history, and smoking status. Results: The findings revealed a reduction in cognitive deficits following hospitalization and treatment. Significant improvements were observed in verbal memory, working memory, and executive function. However, older patients showed poorer performance in motor speed, verbal fluency, and symbol coding compared to younger patients. Male patients and smokers demonstrated lower cognitive functioning, particularly in verbal fluency, symbol coding, and executive function. Conclusions: This study highlighted the positive effect of comprehensive inpatient treatment on reducing cognitive impairments in individuals with schizophrenia. While improvements were noted in several cognitive domains, the persistence of certain deficits, particularly in relation to demographic factors (age, gender, and smoking status), underscores the need for further research and tailored cognitive rehabilitation interventions. A personalized, multidimensional approach to managing cognitive deficits in schizophrenia could lead to better functional outcomes and enhance the quality of life for affected individuals.

Narrative elements in “Piano Sonata no. 1, op. 11”, by Robert Schumann

Robert Schumann was an early and significant advocate of a change in musical narrative techniques. Additionally, he presents an instance that is historically specific, demonstrating the interconnectedness of verbal narrative and narrative aspects in instrumental music that lacks text. He frequently described his preferred music using novelistic language and openly admitted that he derived inspiration for his compositions from the techniques employed by his favorite novelists. The shifts in mood, unexpected harmonic changes, and intricate textures all contribute to a sense of inner narrative, as if the music is expressing an unfolding drama or an introspective journey. Schumann was fond of embedding symbolic meanings and codes within his music.

Analysis on the derivative of the discriminant polynomial for the critical almost Mathieu operator

This article first introduces the discriminant polynomial and the central spectral band of the critical almost Mathieu operator. The Hardy–Littlewood method and the symbolic coding of continued fractions are introduced and applied to estimate the first-order and the second-order derivatives of the discriminant polynomial. Finally, these results are applied to obtain a lower bound for the measure of the central spectral band.

Neuropsychological Performance after Extended N-Pep-12 Dietary Supplementation in Supratentorial Ischemic Stroke.

Background: Cognitive deficits following ischemic stroke significantly impair quality of life, highlighting the need for effective interventions. This study evaluates the efficacy and safety of extended N-Pep-12 dietary supplementation in enhancing cognitive recovery post-stroke. Methods: In this randomized, open-label, controlled study, 106 patients with supratentorial ischemic stroke were enrolled to receive either 90mg N-Pep-12 or no supplementation daily for 360 days and were followed-up for 360 days. Cognitive function and emotional well-being were assessed using established neuropsychological scales at baseline, 90 days, and 360 days post-stroke. Safety was monitored through adverse events and mortality rates. Results: Significant improvements were observed in the N-Pep-12 group compared to controls, particularly in the Montreal Cognitive Assessment scores at both 90 and 360 days, and in the Digit Symbol Coding scores at 360 days, suggesting enhanced cognitive recovery with extended N-Pep-12 supplementation. A linear regression for a composite outcome analysis at day 360 further confirmed the efficacy of N-Pep-12 in contributing to cognitive improvement. Safety profiles were favorable, with no significant adverse effects attributed to N-Pep-12. Conclusions: Extended dietary supplementation with N-Pep-12 appears to offer a safe and effective approach to support cognitive recovery in ischemic stroke survivors. These findings underscore the potential of the supplement as an add-on intervention for managing post-stroke cognitive impairments.

Cognitive processing speed improvement after cochlear implantation.

Untreated hearing loss has an effect on cognition. It is hypothesized that the additional processing required to compensate for the sensory loss affects the cognitive resources available for other tasks and that this could be mitigated by a hearing device. The impact on cognition of cochlear implants (CIs) was tested in 100 subjects, ≥60 years old, with bilateral moderately-severe to profound post linguistic deafness using hearing aids. Data was compared pre and 12 and 18 months after cochlear implantation for the speech spatial qualities questionnaire, Mini Mental State Examination (MMSE), Trail making test B (TMTB) and digit symbol coding (DSC) from the Wechsler Adult Intelligence Scale version IV and finally the timed up and go test (TUG). Subjects were divided into young old (60-64), middle old (65-75) and old old (75+) groups. Cognitive test scores and times were standardized according to available normative data. Hearing significantly improved pre- to post-operatively across all age groups. There was no change post-implant in outcomes for TMTB, TUG or MMSE tests. Age-corrected values were within normal expectations for all age groups for the TUG and MMSE. However, DSC scores and TMTB times were worse than normal. There was a significant increase in DSC scores between baseline and 12-months for 60- to 64-year-olds (t[153] = 2.608, p = 0.027), which remained at 18 months (t[153] = 2.663, p = 0.023). The improved attention and processing speed in the youngest age group may be a consequence of reallocation of cognitive resources away from auditory processing due to greatly improved hearing. The oldest age group of participants had cognition scores closest to normal values, suggesting that only the most able older seniors tend to come forward for a CI. Severe to profoundly deaf individuals with hearing aids or cochlear implants were still poorer than age-equivalent normally hearing individuals with respect to cognitive flexibility, attention, working memory, processing speed and visuoperceptual functions. Due to a lack of data for the TUG, TMTB and DSC in the literature for hearing impaired individuals, the results reported here provide an important set of reference data for use in future research.

Knowing Holbein’s Objects: An Object-Oriented-Ontology Analysis of The Ambassadors

Abstract This article investigates the tenet of Object-Oriented Ontology (OOO) that art, like philosophy, is a form of cognition different from literal knowledge by applying key OOO concepts to the analysis of the Renaissance painting The Ambassadors (1533), a double portrait by Hans Holbein the Younger (1497/98–1543). The Ambassadors is found to exemplify the key principles of OOO in its treatment of objects and their relationships. Through an OOO lens, the painting becomes not merely a literal representation of the subjects and their possessions, but a dynamic interplay of real and sensual qualities that exceeds any straightforward paraphrase. The figures and objects in the work are not simply passive symbols, but active agents that withdraw from direct access, preserving their autonomy and inviting the viewer’s participatory engagement. Holbein’s masterpiece comes alive precisely by troubling its own representational coherence, drawing the viewer into an uncanny encounter with the withdrawn depths of objects. By reading The Ambassadors through an object-oriented framework, the painting exemplifies art’s capacity to operate as a non-literal form of cognition, irreducible to mere symbolic codes or propositional knowledge.

The Volcano and the Vampire: The Case for a Volcanic Gothic

This article charts the cultural connections between the vampire and the volcano as gothic symbols. Covering the period between the eighteenth century – when increased volcanic activity on Etna and Vesuvius as well as the excavations at Pompeii sparked a cultural fascination with volcanos – and the publication of Bram Stoker’s Dracula (1897), which originally featured a sensational volcanic ending, I argue that the volcano and the vampire become culturally interconnected and share much of the same symbolic coding and signifying power. Both threaten social orders and even civilizations through the destruction of human bodies, relationships, and property. Both are portals in time – sites where ancient horrors might be spewed forth to menace the present. And both produce uncannily petrified people, from the undead body of the vampire to the human remains from Pompeii. This article makes the case for the volcano as an important and previously overlooked gothic symbol, and for a Volcanic Gothic as a mode through which writers could articulate cultural fears.

Deficits of Facial Emotion Recognition in Elderly Individuals with Mild Cognitive Impairment.

The study of facial emotion recognition is under-explored in subjects with mild cognitive impairment (MCI). We investigated whether deficits in facial emotion recognition are present in patients with MCI. We also analyzed the relationship between facial emotion recognition and different domains of cognitive function. This study included 300 participants aged 60 years or older with cognitive decline. We evaluated 181 MCI and 119 non-MCI subjects using the Seoul Neuropsychological Screening Battery-Core (SNSB-C) and facial emotion recognition task using six facial expressions (anger, disgust, fear, happiness, sadness and surprise). A Generalized Linear Model (GLM) was used to assess the association between cognitive performance and accuracy of facial emotion recognition and to compare facial emotion recognition in the MCI group based on the impairment of five different domains of cognitive function. The model was adjusted for age, sex, years of education, and depressive symptoms. Patients with MCI had a lower score for accurately recognizing total facial emotion (0.48 vs. 0.53; ρ = 0.0003) and surprise (0.73 vs. 0.81; ρ = 0.0215) when compared to cognitively healthy subjects. We also discovered that frontal/executive function domain (Digit Symbol Coding [DSC, 0.38 vs. 0.49; p < 0.0001], Controlled Oral Word Association Test [COWAT, 0.42 vs. 0.49; p = 0.0001], Korean-Trail Making Test [K-TMT, 0.37 vs. 0.48; p = 0.0073], Korean-Color Word Stroop Test [K-CWST, 0.43 vs. 0.49; p = 0.0219]) and language domain (Korean-Boston Naming Test [S-K-BNT, 0.46 vs. 0.47; p = 0.003]) were statistically associated with the deficits of facial emotion recognition in patients with MCI. We observed a significant association between deficits in facial emotion recognition and cognitive impairment in elderly individuals.

Multivariate associations between neuroanatomy and cognition in unmedicated and medicated individuals with schizophrenia

Previous studies that focused on univariate correlations between neuroanatomy and cognition in schizophrenia identified some inconsistent findings. Moreover, antipsychotic medication may impact the brain-behavior profiles in affected individuals. It remains unclear whether unmedicated and medicated individuals with schizophrenia would share common neuroanatomy-cognition associations. Therefore, we aimed to investigate multivariate neuroanatomy-cognition relationships in both groups. A sample of 59 drug-naïve individuals with first-episode schizophrenia (FES) and a sample of 115 antipsychotic-treated individuals with schizophrenia were finally included. Multivariate modeling was conducted in the two patient samples between multiple cognitive domains and neuroanatomic features, such as cortical thickness (CT), cortical surface area (CSA), and subcortical volume (SV). We observed distinct multivariate correlational patterns between the two samples of individuals with schizophrenia. In the FES sample, better performance in token motor, symbol coding, and verbal fluency tests was associated with greater thalamic volumes but lower CT in the prefrontal and anterior cingulate cortices. Two significant multivariate correlations were identified in antipsychotic-treated individuals: 1) worse verbal memory performance was related to smaller volumes for the most subcortical structures and smaller CSA mainly in the temporal regions and inferior parietal lobule; 2) a lower symbol coding test score was correlated with smaller CSA in the right parahippocampal gyrus but greater volume in the right caudate. These multivariate patterns were sample-specific and not confounded by imaging quality, illness duration, antipsychotic dose, or psychopathological symptoms. Our findings may help to understand the neurobiological basis of cognitive impairments and the development of cognition-targeted interventions.

Representation of “Sapa Nandur Ngundhuh” in the Wayang Performance of Cupu Manik Astagina by Ki Enthus Susmono

Wayang kulit not only functions as entertainment, but is also a vehicle for conveying philosophical messages. As in the Cupu Manik Astagina puppet play, there is a philosophical message in the form of "sapa nandur ngundhuh" or whoever plants will reap. Therefore, this study aims to explore the philosophical message of "sapa nandur ngundhuh" in the Cupu Manik Astagina puppet play by Ki Enthus Susmono by representing it so that the message can be conveyed. This qualitative research uses Stuart Hall's representation theory through Roland Barthes' semiotic analysis model, namely symbolic code and action code. The data source is a video of a shadow puppet performance entitled "Pakeliran Solid Wayang Kulit Lakon Cupu Manik Astagina by Ki Enthus Susmono" on YouTube Aa Studio. The listening-note taking technique is used to collect data in the form of words and utterances obtained from ginem and janturan in the story. It is known through the symbol code and action code. The results showed that the concept of "sapa nandur ngundhuh" in the Cupu Manik Astagina puppet play does not only apply to the karma themselves, but can affect other people, including their descendants. In the story of Dewi Windradi, her actions have consequences not only for herself, but also her three children. This research also highlights how karma can be prevented from continuing to reap through some tirakat practices. Such as fasting (ngrowot), meditation and asceticism (tapa brata) which aim to cleanse themselves of past sins and minimize negative karma in the future.

Comparative efficacy and safety of olanzapine and risperidone in the treatment of psychiatric and behavioral symptoms of Alzheimer's disease: Systematic review and meta-analysis.

Olanzapine and risperidone have emerged as the most widely used drugs as short-term prescription in the treatment of behavioral disturbances in dementia. The present systematic review and meta-analysis was hence performed to investigate the effectiveness and safety profile of olanzapine and risperidone in the treatment of behavioral and psychological symptoms of dementia (BPSD), aiming to provide updated suggestion for clinical physicians and caregivers. Prospective controlled clinical studies were included, of which available data was extracted. Outcomes of BEHAVE-AD scores with the variation of grades, specific behaviors variables, as well as safety signals were pooled for the analysis by odds rates and weighted mean differences, respectively. Medline, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang. Prospective, controlled clinical studies, conducted to compare the effectiveness and safety profile of olanzapine and risperidone in the treatment of BPSD. Interested data including baseline characteristics and necessary outcomes from the included studies were extracted independently by 2 investigators. BEHAVE-AD scale was adopted to assess the efficacy in the present study. All behaviors were evaluated at the time of the initiation of the treatment, as well as the completion of drugs courses. Adverse events were assessed with the criteria of Treatment Emergent Symptom Scale, or Coding Symbols for a Thesaurus of Adverse Reaction Terms dictionary. Weighted mean difference was used for the pooled analysis. A total of 2427 participants were included in the present meta-analysis. Comparative OR on response rate, and remarkable response rate between olanzapine and risperidone was 0.65 (95% CI: 0.51-0.84; P = .0008), and 0.62 (95% CI: 0.50-0.78; P < .0001), respectively. There were statistical differences observed by olanzapine on the improvement of variables including delusions (WMD, -1.83, 95% CI, -3.20, -0.47), and nighttime behavior disturbances (WMD, -1.99, 95% CI, -3.60, -0.38) when compared to risperidone. Our results suggested that olanzapine might be statistically superior to risperidone on the reduction of BPSD of Alzheimer's disease, especially in the relief of delusions and nighttime behavior disturbances. In addition, olanzapine was shown statistically lower risks of agitation, sleep disturbance, and extrapyramidal signs.

Association between sleep microarchitecture and cognition in obstructive sleep apnea

Abstract Study Objectives Obstructive sleep apnea (OSA) increases the risk of cognitive impairment. Measures of sleep microarchitecture from EEG may help identify patients at risk of this complication. Methods Participants with suspected OSA (n = 1142) underwent in-laboratory polysomnography and completed sleep and medical history questionnaires, and tests of global cognition (Montreal Cognitive Assessment, MoCA), memory (Rey Auditory Verbal Learning Test, RAVLT) and information processing speed (Digit–Symbol Coding, DSC). Associations between cognitive scores and stage 2 non-rapid eye movement (NREM) sleep spindle density, power, frequency and %-fast (12–16Hz), odds-ratio product (ORP), normalized EEG power (EEGNP), and the delta:alpha ratio were assessed using multivariable linear regression (MLR) adjusted for age, sex, education, and total sleep time. Mediation analyses were performed to determine if sleep microarchitecture indices mediate the negative effect of OSA on cognition. Results All spindle characteristics were lower in participants with moderate and severe OSA (p ≤ .001, vs. no/mild OSA) and positively associated with MoCA, RAVLT, and DSC scores (false discovery rate corrected p-value, q ≤ 0.026), except spindle power which was not associated with RAVLT (q = 0.185). ORP during NREM sleep (ORPNREM) was highest in severe OSA participants (p ≤ .001) but neither ORPNREM (q ≥ 0.230) nor the delta:alpha ratio were associated with cognitive scores in MLR analyses (q ≥ 0.166). In mediation analyses, spindle density and EEGNP (p ≥ .048) mediated moderate-to-severe OSA’s negative effect on MoCA scores while ORPNREM, spindle power, and %-fast spindles mediated OSA’s negative effect on DSC scores (p ≤ .018). Conclusions Altered spindle activity, ORP and normalized EEG power may be important contributors to cognitive deficits in patients with OSA.

Increased and sex-differentiated medial prefrontal cortex activation during the MATRICS Consensus Cognitive Battery in schizophrenia: A fNIRS study

Executive impairment in schizophrenia is common, but the mechanism remains unclear. This is the first study to use simultaneously functional near-infrared spectroscopy (fNIRS) to monitor the hemodynamic response in schizophrenia during the MATRICS Consensus Cognitive Battery (MCCB). Here, we monitored relative changes in oxyhemoglobin concentration in the medial prefrontal cortex (mPFC) during Trail Making Test, Symbol Coding Test and Mazes Test of the MCCB in 63 patients (29 females) with schizophrenia and 32 healthy controls (15 females). Results showed that patients with schizophrenia scored lower than healthy controls on all three tests (P < 0.001), but mPFC activation was significantly higher during the test (P < 0.03). Higher activation of the mPFC may reflect abnormal information processing in schizophrenia. In addition, the results also showed sex differences in hemodynamic activation during the task in patients with schizophrenia, and fNIRS has the potential to be a clinical adjunct to screening for cognitive function in schizophrenia.

Social Media Users’ Visual and Emotional Preferences of Internet-Famous Sites in Urban Riverfront Public Spaces: A Case Study in Changsha, China

With the increasing online exposure of urban public spaces, the new concept of “internet-famous sites” has emerged in China. Social media users are the main contributors to this new phenomenon. To fully understand social media users’ preferences in such kinds of public spaces, this article took 27 typical riverfront internet-famous sites (RIFSs) in Changsha City (China) as an example. Through social media platform selection, keyword research, text and image data extraction, visual and emotional symbol coding, and manual calculations of coding frequency, this study investigated social media users’ perception of RIFSs, especially on visual and emotional preferences. The online images and review comments were extracted from the popular Chinese social media platform “Xiaohongshu”. We found that (1) the popularity of each RIFS had a significant head effect and there were far more positive emotions than neutral and negative emotions in review comments. (2) RIFSs in Changsha were divided into five categories: commercial RIFSs, art exhibition RIFSs, historical and cultural RIFSs, ecological recreational RIFSs, and uncultivated RIFSs. Social media users had different visual focuses on each kind of RIFS. (3) Social media users provided specific reasons for their emotional preferences towards different types of RIFSs. This study can provide a new perspective on improving waterfront vitality and offer a targeted and attractive method for waterfront regeneration that is different from traditional methods.

Predictors of psychosocial functioning in people diagnosed with schizophrenia spectrum disorders that committed violent offences and in those that did not: Results of the Recoviwel study

Psychosocial functioning represents a core treatment target of Schizophrenia Spectrum Disorders (SSD), and several clinical and cognitive factors contribute to its impairment. However, determinants of psychosocial functioning in people living with SSD that committed violent offences remain to be more thoroughly explored. This study aims to separately assess and compare predictors of psychosocial functioning in people with SSD that did and that did not commit violent offences considering several clinical, cognitive and violence-related parameters. Fifty inmates convicted for violent crimes in a forensic psychiatry setting diagnosed with SSD (OP group) and fifty participants matched for age, gender, education, and diagnosis (Non-OP group) were included in the study. A higher risk of violent relapse as measured by HCR-20 clinical subscale scores (p < 0.002) and greater global clinical severity as measured by CGI-S scores (p = 0.023) emerged as individual predictors of worse psychosocial functioning, as measured by PSP scores, in the OP group. Greater global clinical severity (p < 0.001), worse performance in the processing speed domain as measured by the BACS Symbol Coding (p = 0.002) and TMT-A tests (p = 0.016) and higher levels of non-planning impulsivity as measured by BIS-11 scores (p < 0.001) emerged as individual predictors of worse psychosocial functioning in the Non-OP group. These results confirm that clinical severity impacts psychosocial functioning in all individuals diagnosed with SSD and suggest that while cognitive impairment clearly represents a determinant of worse functional outcomes in most patients, the risk of violent relapse is a specific predictor of worse psychosocial functioning in people with SSD that committed criminal offences.

SYMBOLIC METAPHORS IN DURRENMATT’S “THE MINOTAUR” WITHIN MYTHOLOGICAL, POSTMODERN AND EXISTENTIALIST CONTEXTS

The research aims to interpret the symbolic metaphors in the ballad “Minotaur” with a focus on the commonalities and differences in their interpretation by Dürrenmatt in relation to mythological, postmodernist, and existential-philosophical traditions. This is achieved through the application of intertextual, structural-semiotic, and hermeneutical methods of literary analysis in conjunction with linguistic methods such as conceptual blending and the method of interactive theory of metaphor. The metaphors of Labyrinth, Mirrors, and Minotaur, which are polycomponential and polysemantic, with one source space and multiple target spaces, contribute to the hermeneutic, symbolic, and semantic codes of the text. The Labyrinth metaphor includes target spaces of “refuge”, “other”, and “self-discovery”; Mirrors – the Universe of the Minotaur and the “threshold” – a polysemantic metaphor, interpreted in the hermeneutic code as the boundary between the world of the Minotaur and the outer world and between the animal and human elements. The image of the Minotaur is projected into the target space of “loneliness” and the “mirror of Man”. The blended spaces of all the metaphors form the hermeneutic code of the text, which is supported by the semantic code and the symbolic code of oppositions. For the “labyrinth” metaphors, the semantic metaphorical periphery includes, depending on the target space, connotations of “happiness”, “harmony”, “friendliness”, “interconnectedness”, and “bewilderment”, “distrust”, “misunderstanding”. The “Mirrors” metaphors involve connotations of infinity, timelessness, vastness, associated with the target space of the Universe, and “danger”, “cruelty”, “death”, “fear”, which intensify the target space of the Threshold. The semantic periphery of the “Minotaur is Loneliness” metaphor is reinforced by connotations like “prison”, “inevitability”, “abandonment”, “betrayal”, “fear”, “disappointment”. In the symbolic code, the “labyrinth” metaphor unfolds in oppositions such as “trust and betrayal”, “life and death”, “pleasure and pain”, “harmony and chaos”, the insolubility of which is associated with the rhizomatic labyrinth. The “Mirror-Threshold” metaphor is associated with oppositions like self – other, human – animal (with role reversal: the animalistic element in a human teaches the animal to be a beast), commonality – otherness. The symbolic code associated with the “Minotaur is Loneliness” and “Minotaur is the Mirror of Man” metaphors is based on oppositions of naivety, trust, friendliness, and kindness, which characterize the Minotaur-animal before his encounter with a human, and murder, cruelty, and betrayal, which distinguish humans. These oppositions encode the hermeneutic code of the text: Minotaur – the negation of the animal element vs. Man – the negation of the human element in the Minotaur. Reinterpreted in the ballad, the metaphors maintain an allusive connection with mythological archetypes and metaphorical symbolism in postmodernism. In the metaphor of the labyrinth, the mythological symbolism draws on the archetypal image of the labyrinth as a structure of the universe, a cycle of life, the idea of eternal return, and initiation. The postmodern tradition is evident in the interpretation of the labyrinth as a metaphor for chaos, loss of meaning, and disorientation, with the destruction of the deciphered labyrinth. From an existential perspective, the metaphor is interpreted in the ballad in connection with the concepts of the labyrinthine nature of Self, encounters with oneself, the transition from existence to essence, and the anxiety, fear, and despair accompanying such a transition. The metaphor of the mirror in the ballad, in accordance with the postmodern tradition, combines with the archetypal image of the labyrinth in dual symbolic and metaphorical relationships: Mirror – Another world, Mirror – Labyrinth as a metaphor for an otherworldly realm that draws one into the labyrinth. Reminiscences of postmodernism include the images of labyrinthine mirrors as metaphors for infinity, the universe as a mirrored illusion, and as antitheses to loneliness, when the mirrors are populated by beings. The archetype of the Minotaur allusively intersects with ancient Greek mythology and its postmodernism reinterpretations as the encounter of a person with his beastly essence, as well as with existentialist ideas of “Self” and the “Other”, “The Other and the Look”, and the inevitability of conflict and guilt that arise when the Self encounters the Other: when confronted with the Other-Human, the innocent Minotaur becomes guilty solely because he exists.

Cognitive Impairments in Drug-Naive Patients With First-Episode Negative Symptom–Dominant Psychosis

Available antipsychotic medications are predominantly used to treat positive symptoms, such as hallucinations and delusions, in patients with first-episode psychosis (FEP). However, treating negative and cognitive symptoms, which are closely related to functional outcomes, remains a challenge. To explore the cognitive characteristics of patients with negative symptom-dominant (NSD) psychosis. This large-scale cross-sectional study of patients with FEP was led by the Shanghai Mental Health Center in China from 2016 to 2021, with participants recruited from 10 psychiatric tertiary hospitals. A comprehensive cognitive assessment was performed among 788 patients with FEP who were drug-naive. Symptom profiles were determined using the Positive and Negative Symptoms Scale (PANSS), and NSD was defined as a PANSS score for negative symptoms higher than that for positive and general symptoms. Positive symptom-dominant (PSD) and general symptom-dominant (GSD) psychosis were defined similarly. Data were analyzed in 2023. Psychotic symptoms were categorized into 3 groups: NSD, PSD, and GSD. Neurocognitive performance, assessed using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. This study included 788 individuals with FEP (median age, 22 [IQR, 17-28] years; 399 men [50.6%]). Patients with NSD exhibited more-pronounced cognitive impairment than did those with PSD or GSD. Specifically, cognitive differences between the NSD and PSD group, as well as between the NSD and GSD group, were most notable in the processing speed and attention domains (Trail Making [F = 4.410; P = .01], Symbol Coding [F = 4.957; P = .007], Verbal Learning [F = 3.198; P = .04], and Continuous Performance [F = 3.057; P = .05]). Patients with PSD and GSD showed no significant cognitive differences. Cognitive impairment was positively associated with the severity of negative symptoms. Most of the cognitive function tests used were able to differentiate patients with NSD from those with PSD and GSD, with significant differences observed across a range of tests, from Brief Visuospatial Memory Test-Revised (χ2 = 3.968; P = .05) to Brief Assessment of Cognition in Schizophrenia symbol coding (χ2 = 9.765; P = .002). The findings of this cross-sectional study of patients with FEP suggest the presence of a clinical subtype characterized by a predominance of negative symptoms and cognitive impairment.

Breaking down processing speed: Motor and cognitive insights in first-episode psychosis and unaffected first-degree relatives

IntroductionProcessing speed (PS) deficits represent a fundamental aspect of cognitive impairment, evident not only in schizophrenia but also in individuals undergoing their first episode of psychosis (FEP) and their unaffected first-degree relatives. Heterogeneity in tests assessing PS reflects the participation of motor and cognitive subcomponents to varying degrees. We aim to explore differences in performance of the subcomponents of PS in FEP patients, parents, siblings, and controls. Materials and methodsResults from tests, including Trail Making Test part A and part B, Digit Symbol Coding Test, Grooved Pegboard Test, and Stroop Word and Stroop Color subtests, were obtained from 133 FEP patients, 146 parents, and 202 controls. Exploratory factor analysis (EFA) was employed in controls to establish the structure, followed by confirmatory factor analysis (CFA) to verify if the other groups share this structure. ResultsEFA revealed a two-factor model: Factor 1 for the motor subcomponent and Factor 2 for the cognitive subcomponent. Subsequently, CFA indicated a good fit for the remaining groups with differences in the relationship between the factors. ConclusionsDifferences in the relationships of factors within a common structure suggest the involvement of different compensatory strategies among groups, providing insights into the underlying mechanisms of PS deficits in patients and relatives.

Associations of cognitive impairment and functional limitation with all-cause mortality risk in older adults: A population-based study from the National Health and Nutrition Examination Survey

Cognitive impairment and functional limitation are commonly observed in older adults. They have a complex correlation, and both are risk factors for mortality. This prospective cohort study aimed to explore the independent and joint impact of cognitive impairment and functional limitations on all-cause mortality in older adults. A total of 3,759 participants aged ≥ 60 years who had available information on mortality data, cognitive function, physical function, and covariates were enrolled. Cox proportional hazards regression models were employed to assess the independent and joint impacts of cognitive impairment and functional limitation on all-cause mortality. Smoothing curve fitting was used to show the nonlinear relationship between the Digit Symbol Coding (DSC) score and all-cause mortality. An interaction between cognitive impairment and functional limitation was identified when examining their associations with all-cause mortality. Cognitive impairment and functional limitation independently correlated with all-cause mortality risk even after adjusting for covariates and performing mutual adjustments (HR for cognitive impairment: 1.34, 95% CI 1.15–1.56; HR for functional limitation: 1.50, 95% CI 1.32–1.70). When the DSC score was > 18, as the score increased, the risk of death significantly decreased (HR 0.99, 95% CI 0.98–0.99). Participants with both cognitive impairment and functional limitation had the highest hazard ratio for all-cause mortality (HR 1.98, 95%CI 1.63–2.40). In summary, cognitive impairment and functional limitation independently correlated with increased all-cause mortality risk. A higher DSC score was a protective factor reducing the premature mortality risk. Older adults with cognitive impairment and functional limitation demonstrated the highest all-cause mortality risk.

Mythological Number Seven In Turkmen Culture

Numbers are the symbolic codes of mythology. They carry the mysteries of archaic beliefs and traditional life from past to present. Seven appears in all works of folk literature. The number seven is one of these special numbers. There is information about seven in all societies, beliefs and cultures around the world. People make use of the number seven to explain the creation of the universe, the sky, heaven and hell, etc. Seven is the number of nursery rhymes. Many societies do not perform important rituals without repeating them seven times. Among Turkic peoples, seven is very important for Turkmens. In Turkmen mythology, seven is very special. It stands out more than numbers like three, five, nine and forty. Seven is present in all traditions from birth to death. In child rituals, marriage and death, the number seven is present as a formula. With this formula, the message is emphasized. People understand situations, behaviors and names better with seven repetitions. Seven is found as a stylistic number in fairy tales, epics and legends. In Turkmen society, there are even sevens explaining positive and negative situations and behaviors. These sevens bear the traces of mythology and cultural identity. Many Turkmen rituals are not complete without being performed seven times. This article first provides general information about the number seven. Then examples of seven in Turkmen culture, folk literature and beliefs are given. In these sevens, family, lineage, badly behaved women, and traditions of entertaining good guests are included. Finally, examples of the number seven, which has mythological roots in Turkmen culture, are evaluated. It is stated that they are soci­ological, religious and cultural codes.