Problem solving in schizophrenia

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Sleep And Problem Solving In Schizophrenia:

Sleep And Problem Solving In Schizophrenia Honble.Prof. Dr. Gudrun. Sartory Department Of Clinical Psychology University Of Wuppertal

Research Methodology:

Research Methodology Population: Experimental group: N 20 Patient with diagnosis of schizophrenia or schizo-affective disorder (DSM IV or ICD 10) for experimental group. Age : 18-55 Years Exclusion criteria: Substance abuse / dependence, current / lifetime; benzodiazepine intake

Research Methodology:

Research Methodology Control Group: N 20 Healthy individuals without any chronic or lifetime ailments. The healthy control groups were parallelized by age groups, gender, level of education and socioeconomic status of the patient group. Age: 18-55 years

Sleep EEG:

Sleep EEG Sleep stages scored according to Rechtschaffen A and Kales (R&K, 1968) Manual * Awake, NREM I to IV, REM, Movement Time * Polysomnogram: - EEG - EOG - EMG

Sleep Cycle:

Sleep Cycle

Sleep Cycle:

Sleep Cycle

Sleep EEG:

Sleep EEG

Other Sleep Characteristics:

Other Sleep Characteristics Sleep latency REM latency Sleep efficiency REM density

Instruments Used:

Instruments Used A) Neuropsychological testing: VLMT-Verbal learning and memory test (Direct retrieval) (Helmstaedter at al., 2001) Trail making A & B (Reitan, 1979) MWT-B multiple choice vocabulary intelligence test (Lehrl et al., 2001) Number symbol test (Os wald and Fleischmann, 1986) VLMT ,Delayed retrieval and recognition(Helmstaedter at al., 2001 FAS – Word naming task (Benton et al., 1983)

Instruments Used:

Instruments Used B) Problem solving: 1) Tower of London (Shallice, 1982)(Morris et al. 1988;1990) C) Polysomonographical recording: 1) Polysomonographical recording (EEG, EMG & EOG) is done with an 8-channel EEG amplifier Psy Lab Company (London, UK)

Problem Solving In Schizophrenia:

Problem Solving In Schizophrenia Schizophrenics have significant cognitive deficits, especially in the areas problem solving (Gold JM, Harvey PD. Cognitive deficits in schizophrenia. Psychiatr Clin N Am. 1993; 16:295–312). Many patients with schizophrenia are impaired not only by positive and negative symptoms, but also by persistent and severe deficits in cognition (Gold and Harvey 1993; Green 1998).

Problem Solving In Schizophrenia:

Problem Solving In Schizophrenia Schizophrenics took significantly more moves to solve a series of problems and solved significantly fewer problems in the predetermined minimum number of moves. The patient’s response times, as measured using a control version of the task (3-D CTL CONTROL); were longer than those of controls. (Morris R.G., Rushe T., Woodruffe P.W.R., Murray R.M. Problem solving in schizophrenia: A specific deficit in planning ability (1995) Schizophrenia Research, 14 (3), pp. 235-246).

Problem Solving In Schizophrenia:

Problem Solving In Schizophrenia Neuropsychological deficits in schizophrenia are well documented, and include impairments in a variety of domains, including executive processes, memory functioning and language (Morris, 1993; Shallice et al., 1991; Tamlyn et al., 1992). Cognitive impairments have been demonstrated most frequently in the neuropsychological assessment of attention, memory, and executive functioning (Calev 1984; Gold et al. 1992; Braff 1993). The research study on sleep and problem solving by (Linde l and M. Bergstrom) significant decline in performance when there is less sleep. Rapid Eye Movement (REM) sleep enhances creative problem-solving (University of California - San Diego School of Medicine) Sleep deprivation have a negative effect on vigilance tasks (Johnson, 1969)

Sleep And Problem Solving In Schizophrenia:

Sleep And Problem Solving In Schizophrenia Not many studies were done on problem solving with reference to sleep EEG in schizophrenia.

Tower Of London Test:

Tower Of London Test Tower of London test was developed by Shallice (1982) to investigate problem solving Computerized version was developed by Morris et al. (1988;1990;1993) Subjects required to move colored beads between three vertical rods of different lengths in the window on (working area) until they acheive Arrangement in window (Goal Position) Subjects are instructed to try to acheive the goal arrangement in as few moves as possible. This test requires forward thinking or planning, since an early incorrect move can render problem virtually unsolvable.

Tower Of London:

Tower Of London Insert Video

Two Groups:

Two Groups Group One – Day after night conditon- 6 Patients (N=6) Group Two – Night after day condition- 8 Patients (N=8)

Day After Night Condition:

Day After Night Condition DAY AFTER NIGHT CONDITION 8 HOURS INTERVAL BETWEEN MORNING AND EVENING TESTINGS OR EVENING AND MORNING ONE WEEK INTERVAL BETWEEN DAY TESTING AND NIGHT TESTING DAY (PATIENTS PLACE) MORNING EVENING TOL TEST ADMINISTERED (AT PATIENT’S PLACE) TOL TEST ADMINISTERED (AT PATIENT’S PLACE) EXPERIMENTAL NIGHT (SLEEP LAB) EVENING MORNING TOL TEST PARALLEL VERSION ADMINISTERED (AT SLEEP LAB) TOL TEST PARALLEL VERSION ADMINISTERED (AT SLEEP LAB)

Night After Day Condition:

Night After Day Condition NIGHT AFTER DAY CONDITION 8 HOURS INTERVAL BETWEEN MORNING AND EVENING TESTINGS OR VICE VERSA ONE WEEK INTERVAL BETWEEN EXPERIMENTAL NIGHT TESTING AND DAY TESTING EXPERIMENTAL NIGHT (SLEEP LABOR) EVENING MORNING TOL TEST ADMINISTERED (AT SLEEP LAB) TOL TEST ADMINISTERED (AT SLEEP LAB NEXT MORNING) DAY (PATIENTS PLACE) MORNING EVENING TOL TEST PARALLEL VERSION ADMINISTERED (AT PATIENT’S PLACE) TOL TEST PARALLEL VERSION ADMINISTERED (AT PATIENT’S PLACE)

Current Status of Study:

Current Status of Study 14 tested patients 20 controls (Day conditon) Planned to study EEG on 20 Healthy Controls

Analysis Of Tower Of London Data:

Analysis Of Tower Of London Data The preliminary analysis made with Tower of London test data of 14 patients and the results are presented below.

Graph 1 :

Graph 1 Mean of total time taken (Learning and recall) to complete the Tower Of London Test (Group 1 & 2)

Graph 2:

Graph 2 Mean of total number of tasks solved (Learning and recall) by patients in Tower Of London Test (Group 1 & 2)

Analysis of Tower of London Test:

Analysis of Tower of London Test

Present Findings :

Present Findings 1) Whether it is day or night condition the performance on the task have not much difference. The condition or order doesn‘t matters. 2) When we compare the day testing data of two groups,there is significant difference in total learning time and recall. 3) There is a learning effect.

Significance of overall study:

Significance of overall study Expected Outcomes: *I t is expected that the night-time interval will be more beneficial to the problem solving ability of the patients than the day-time interval. * The benefit incurred during sleep will depend on the duration of slow wave sleep (SWS) * Healthy controls will show better problem-solving abilities than patients with schizophrenia

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