An Empirical Evaluation of the Arizona Sexual Experience Scale (asex) Question- Naire to Identify Sexual Dysfunction in Patients of the Schizophrenia Spectrum

Patients with prominent negative symptoms consistently perform worse than other clinical groups on Theory of Mind (ToM) tasks. However, the nature of this relationship has not been closely examined. In this study, we investigated the relationship between ToM and the Scale for the Assessment of Negative Symptoms (SANS) components. We replicated our findings in two independent samples and at two timepoints. Methods: 227 patients with DSM-III-R diagnosis of schizophrenia or schizoaffective disorder in two independent samples were administered the Hinting Task and the SANS. One sample (n = 137) was reassessed at 6 months. Pearson’s correlations were used to examine the relationships between the Hinting Task and the SANS subscales and total scores. Subscale scores that were significantly correlated with the Hinting task were entered into a stepwise multiple regression to determine how much of the variance they explained. Results: Results indicate a modest but significant relationship between negative symptoms and the Hinting Task. Examination of the components revealed that Attention is largely responsible. Alogia made a minor contribution. Conclusions: ToM deficits are associated with negative symptoms. A common mechanism may be the allocation of attention to social events and socially relevant stimuli. Disrupted processing at the level of implicit, ‘‘on line’’ representations may contribute to impairments in attentional function as assessed by the SANS as well as contributing to impaired ToM performance on the Hinting Task. The current findings indicate that we should reexamine ToM impairment in patients with negative symptoms and how it might be targeted in therapeutic interventions. ID: 551995 TOWARD A COMPREHENSIVE MODEL OF NEUROLOGICAL SOFT-SIGNS AND PSYCHOPATHOLOGY IN SCHIZOPHRENIA Marie-Odile Krebs, D. Gourion, M. C. Bourdel, I. Amado, J. O. Olié Lab Physiopathologie of Psychiatric Diseases, Inserm, Paris, France; SHU, Hôpital Sainte Anne, Paris, France The goal of this study was to explore interrelations between core dimensions of schizophrenia, neurological soft-signs and age at onset, by using structural modeling. Two hundred and thirty four patients with a DSM-IV diagnosis of schizophrenia were included in the study. All subjects were administered a semi-structured interview (DIGS) for diagnosis and age at psychotic onset, the Positive and Negative Syndrome Scale (PANSS), and neurological signs were assessed with a standardized scaleSeveral structural equations analyses were performed. The best structural model in terms of fit indices incorporated two latent components of the disease and nine observed variables (TLI: 0.86; RMSEA:0.064). The first latent component, Neurological Loading (NL), was mostly related to abnormal motor coordination and motor integration scores (structural coefficients: respectively .81 and .72). The second latent component, Schizophrenic Psychopathology (SP), was strongly linked to the dimension of disorganisation (.99). NL and SP were significantly inter-correlated (.49; P < .001).Age at onset was significantly correlated to SP but not to NL. The close association of neurological abnormalities with core schizophrenic dimensions, particularly disorganisation, suggest common physiopathological pathways. ID: 551957 International Congress on Schizophrenia Research 2. 2. Phenomenology 25 at C ld Sring H abor L abotory-L irary on Feruary 0, 2013 http://schizophletin.oxfordjournals.org/ D ow nladed from 3. 3. Drug Side Effects and Physical Illness ANTIPSYCHOTIC STAY VS. SWITCH FOR METABOLIC BENEFIT: PSYCHIATRIC COST Jonathan M. Meyer,, R. R. Henry, D. L. Braff Psychiatry, UCSD, San Diego, CA, USA; Medicine, UCSD and VA San Diego, San Diego, CA, USA Background: Switching antipsychotics is one option for patients with antipsychotic-induced metabolic effects, yet there is concern that switching stable patients carries a psychiatric cost, and may result in exacerbation. Methods: Data were analyzed from a randomized, 6-month, open-label switch study for overweight or obese nondiabetic schizophrenia patients taking risperidone or olanzapine. Eligible subjects were randomized to usual care non-switch (UC) or open-label switch (S) to ziprasidone. Arms were balanced for gender and race/ethnicity. Imaging measures of adiposity and endocrine measures were obtained at baseline and 6 months. The primary psychiatric outcome measure was total hospital days in each arm, while secondary analyses examined change in total PANSS and PANSS subscale scores. Results: To date, 51 subjects have entered the randomization phase of the study: UC n = 22; S n = 29. Mean age of randomized subjects was 47.3, 78.4% were male, 66.7% white and 9.8% Hispanic. Mean BMI was 33.4 kg/m, 63% smoked, and 15.7% reported a 1st-degree family history of diabetes. Baseline total PANSS score was 64, positive subscale 18, and negative subscale 15. At baseline there were no significant between-group differences on any demographic, adiposity or laboratory variable, nor on total PANSS, positive or negative subscale symptom scores. There were no significant differences in total hospital days between the UC arm (26 days), and the S arm (25 days), or in proportion of subjects hospitalized: UC (14%) vs. S (21%) (v = .338, P = .561). In a linear regression model with change in total PANSS score from baseline to week 26 as the dependent variable, neither treatment arm, nor baseline antipsychotic significantly predicted the outcome variable. Conclusions: Contrary to many assumptions, in this 6-month, open-label, randomized trial, the hospitalization rate and total hospital days in non-switchers did not significantly exceed that seen with careful antipsychotic switching. This inherent relapse rate among stable patients with schizophrenia must be factored into the stay vs. switch decision to change antipsychotic treatment for possible metabolic benefit. References 1. Meyer JM, et al. Change in metabolic syndrome parameters with antipsychotic treatment in the CATIE Schizophrenia Trial: prospective data from phase 1. Schizophr Res 2008;101:273–86. 2. Essock S, et al. Effectiveness of switching antipsychotic medications. Am J Psychiatry 2006;163:2090–5.