Affective and Cognitive Verbal Theory of Mind in Schizophrenia: Results From a Novel Paradigm

Objectives: Impairments of Theory of Mind (ToM) have been repeatedly demonstrated in patients with schizophrenia (SCZ). However, only a handful of studies have explored deficits in affective and cognitive subcomponents of ToM. Thus, this study aims to examine affective and cognitive ToM abilities in SCZ by using a novel, verbal paradigm. Methods: Twenty-four SCZ and 22 healthy comparison subjects (HC) completed a battery of tasks, which consisted of: (i) Brief Cognitive Assessment Tool for Schizophrenia (B-CATS), (ii) three well-established tasks measuring social cognitive abilities, and (iii) original tasks which assess ability to infer cognitive and affective mental states based on everyday verbal social interactions. Results: In line with previous findings, SCZ were outperformed by HC in all tasks. However, the interaction effect of the group and the task showed that cognitive (as opposed to affective) ToM was more profoundly impaired in patients with SCZ. Conclusions: It is proposed that in SCZ group cognitive ToM is more impaired as it involves more effortful reflective processes, while affective ToM, which is more automatic and based on reflexive processes, may differentiate patients from healthy comparison subjects to a lesser extent. (JINS, 2018, 24, 305–309)

Dementia – a diagnostic and therapeutic challenge

SummaryDementia is characterized as a progredient loss of memory, thinking and socials skills leading to need for help in everyday activities till complete dependence on help. Beside decline of mental abilities patients also develop non-cognitive symptoms like euphoria, depression or agitation. In contrast “mild cognitive impairment” describes limited cognitive function but obtained independence in activities of daily life. The prevalence of dementia is age-related, showing an average prevalence of 4 % in 65–70 year old people. While primary dementias are still incurable, there are also dementia-like conditions which can potentially be reversed by appropriate treatment. Of great importance for the diagnosis of dementia is the assessment of the medical history both given by the patient himself as well as family members or care givers. Brief cognitive assessment tools can help to detect possible cognitive impairment. The diagnostic workup also includes a clinical examination, laboratory tests and CT/ MRI Scan. Treatment strategies depend on pathogenesis and leading symptoms. Psychosocial interventions and pharmacological therapy are used.

Cognitive impairment in pediatric-onset multiple sclerosis is detected by the Brief International Cognitive Assessment for Multiple Sclerosis and computerized cognitive testing

Background: Cognitive impairment is a common and troubling feature of pediatric-onset multiple sclerosis (POMS). Brief cognitive assessment in the outpatient setting can identify and longitudinally monitor cognitive involvement so that early intervention is possible. Objectives: The goal of this study was to measure the sensitivity of two cognitive assessment approaches that are brief, repeatable, and suitable for clinical practice and for multicenter investigation. Methods: Participants with POMS ( n = 69) were consecutively evaluated as part of outpatient neurologic visits and compared to healthy control participants (HC, n = 66) using the Brief International Cognitive Assessment for MS (BICAMS) approach and timed information processing measures from Cogstate, a computer-based assessment. Results: There was strong agreement in the detection rate of impairment between both assessments, with 26% for the BICAMS and 27% for Cogstate. Two of the Cogstate tasks were the most sensitive individual measures. Conclusion: Both the BICAMS and Cogstate timed processing measures offer practical, sensitive, and standardized approaches for cognitive screening assessment in POMS.