Cognitive insight and acute psychosis in schizophrenia

Cognitive insight and acute psychosis in schizophrenia
Psychiatry and Clinical Neurosciences, 03/11/09

Bora E et al. - The present findings suggest that both overconfidence in judgments and impaired self-reflectiveness are associated with acute psychosis. Methods

• The Beck Cognitive Insight Scale was used to compare the cognitive insight of schizophrenia patients with (n=93) and without (n=45) current psychotic symptoms.
• Clinical symptoms and clinical insight of the patients were also assessed.

Results

• Only diminished self-reflectiveness seem to be improved following hospitalization.
• Overconfidence of schizophrenia patients in their judgments was more severe in schizophrenia patients with psychotic symptoms.
• Self-certainty of schizophrenia patients may be a relatively persistent characteristic that is also present after recovery of psychosis.

 

 

 

Differential effects of venlafaxine in the treatment of major depressive disorder according to baseline severity
European Archives of Psychiatry and Clinical Neuroscience, 03/11/09

Schmitt A et al. ? Meta-analysis shows that venlafaxine may be superior to selective serotonin reuptake inhibitors (SSRIs) in achieving remission in both mild/moderate and severely depressed pts. The greater difference in remission rates among pts with baseline HAM-D17 ≥30 suggests a more pronounced clinical benefit that may be achieved with venlafaxine in severely depressed pts. Methods

• Comparison of relative efficacy of venlafaxine to SSRIs in pts with major depressive disorder classified by baseline disease severity
• Pool of data from 31 double-blind randomized clinical trials comparing venlafaxine and SSRIs (intent-to-treat 6,492 pts)
• For secondary analysis, stratification of pts into groups based on baseline HAM-D17 total score (≥30, <30, ≥25, and <25)
• Analysis of remission rates (HAM-D17 < 8) for each subgroup using Fisher?s exact test to compare treatment effects between venlafaxine and SSRIs
• Analysis of last observation carried forward (LOCF) and observed cases (OC) data
• Determination of number needed to treat (NNT) to benefit for each analysis.

Results

• Statistically significant remission rate differences, favoring venlafaxine, in LOCF and OC analyses for each subgroup
• Differences in pts with baseline HAM-D17 < 25 (3,928): LOCF 7.3 (NNT 14) and OC 6.2 (NNT 16)
• Differences in pts with baseline HAM-D17 ≥25 (2,564): LOCF 5.7 (NNT 17) and OC 6.7 (NNT 15)
• Differences in pts with baseline HAM-D17 <30 (5,836): LOCF 6.4 (NNT 16) and OC 5.5 (NNT 18)
• Differences in pts with baseline HAM-D17 ≥30 (656) LOCF 8.9 (NNT 11) and OC 14.8 (NNT 7)

 

 

 

Citicoline affects appetite and cortico-limbic responses to images of high-calorie foods
International Journal of Eating Disorders, 03/11/09

Killgore W et al. - In cocaine-addicted individuals, citicoline has been shown to increase brain dopamine levels and reduce cravings. These preliminary findings suggest a potential usefulness of citicoline in modulating appetite. Methods

• We compared the effects of treatment with Cognizin� citicoline (500 mg/day versus 2,000 mg/day) for 6 weeks on changes in appetite ratings, weight, and cortico-limbic responses to images of high-calorie foods using functional magnetic resonance imaging (fMRI).

Results

• After 6 weeks, there was no significant change in weight status, although significant declines in appetite ratings were observed for the 2,000 mg/day group.
• The higher dose group also showed significant increases in functional brain responses to food stimuli within the amygdala, insula, and lateral orbitofrontal cortex.
• Increased activation in these regions correlated with declines in appetite rating.