Towards personalized medicine in psychosis: the roles of social cognition and metacognition

[eng] People with psychosis experience a range of symptoms and impairments that significantly impact their lives and often concur with disability. The best predictors of functional outcome are social cognition and metacognition, which are often impaired in psychosis. Interventions to improve both do...

Descripción completa

Detalles Bibliográficos
Autor: Ferrer Quintero, Marta
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/203131
Acceso en línea:https://hdl.handle.net/2445/203131
http://hdl.handle.net/10803/689211
Access Level:acceso abierto
Palabra clave:Psicosi
Diferències entre sexes (Psicologia)
Medicina personalitzada
Percepció social
Metacognició
Psychoses
Sex differences (Psychology)
Personalized medicine
Social perception
Metacognition
id ES_0b7c00419ffe946bbdaaeb96d1ea35bd
oai_identifier_str oai:diposit.ub.edu:2445/203131
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Towards personalized medicine in psychosis: the roles of social cognition and metacognition
title Towards personalized medicine in psychosis: the roles of social cognition and metacognition
spellingShingle Towards personalized medicine in psychosis: the roles of social cognition and metacognition
Ferrer Quintero, Marta
Psicosi
Diferències entre sexes (Psicologia)
Medicina personalitzada
Percepció social
Metacognició
Psychoses
Sex differences (Psychology)
Personalized medicine
Social perception
Metacognition
title_short Towards personalized medicine in psychosis: the roles of social cognition and metacognition
title_full Towards personalized medicine in psychosis: the roles of social cognition and metacognition
title_fullStr Towards personalized medicine in psychosis: the roles of social cognition and metacognition
title_full_unstemmed Towards personalized medicine in psychosis: the roles of social cognition and metacognition
title_sort Towards personalized medicine in psychosis: the roles of social cognition and metacognition
dc.creator.none.fl_str_mv Ferrer Quintero, Marta
author Ferrer Quintero, Marta
author_facet Ferrer Quintero, Marta
author_role author
dc.contributor.none.fl_str_mv Gómez Benito, Juana
Huerta Ramos, María Elena
Universitat de Barcelona. Facultat de Psicologia
dc.subject.none.fl_str_mv Psicosi
Diferències entre sexes (Psicologia)
Medicina personalitzada
Percepció social
Metacognició
Psychoses
Sex differences (Psychology)
Personalized medicine
Social perception
Metacognition
topic Psicosi
Diferències entre sexes (Psicologia)
Medicina personalitzada
Percepció social
Metacognició
Psychoses
Sex differences (Psychology)
Personalized medicine
Social perception
Metacognition
description [eng] People with psychosis experience a range of symptoms and impairments that significantly impact their lives and often concur with disability. The best predictors of functional outcome are social cognition and metacognition, which are often impaired in psychosis. Interventions to improve both domains are effective, but this efficacy does not always translate into better functioning. Delivering early, and targeted social cognitive or metacognitive interventions to patients with psychosis could be instrumental in preventing poor functional outcome and preventing relapse, but the grounds on how to personalize these interventions are unknown. Although it has been suggested that the approach should take sex differences, the refining of measurement instruments and the use of sophisticated statistical models, these have not been explored yet. Under this rationale, the present doctoral dissertation aims to: 1) validate a test of facial emotion recognition (Baron Cohen’s Face Test) in healthy population, with the aim of detecting whether it is an appropriate tool to use in clinical research, 2) detect whether patients with first episode psychosis have different, clinically meaningful profiles of performance in social cognition and metacognition, 3) explore the sociodemographic, clinical, and neurocognitive characteristics of each profile, 4) examine if males and females with first episode psychosis are similar in their heterogeneity in social cognition and metacognition, 5) explore the role of social cognition and sex in functional outcome in people with established psychosis (schizophrenia). This broad aim yielded four research articles. The main findings of this doctoral dissertation are a) Baron Cohen’s Face Test is an adequate and reliable instrument to measure facial emotion recognition in Spanish population but it presents a ceiling effect, b) People with first-episode psychosis have distinct profiles of social cognition and metacognition that have specific clinical and neurocognitive correlates. Having worse social cognition is associated with worse clinical presentation, even if metacognition is preserved, c) Men and women with first-episode psychosis have similar configurations of social cognition and metacognition. However, there are sex- specific profiles that should be considered when delivering treatment. Sex-specific profiles seem to be associated with more severity of the disorder than the common profiles. These results suggest that people with psychosis can receive social cognitive or metacognitive targeted treatment as early as after the first episode, but these should be chosen considering the profile of each individual and their biological sex. Thus, patients with psychosis should always be carefully assessed for social cognitive and metacognitive performance.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/doctoralThesis
info:eu-repo/semantics/publishedVersion
format doctoralThesis
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/203131
http://hdl.handle.net/10803/689211
url https://hdl.handle.net/2445/203131
http://hdl.handle.net/10803/689211
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv cc by-nc (c) Ferrer Quintero, Marta, 2023
http://creativecommons.org/licenses/by-nc/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc (c) Ferrer Quintero, Marta, 2023
http://creativecommons.org/licenses/by-nc/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universitat de Barcelona
publisher.none.fl_str_mv Universitat de Barcelona
dc.source.none.fl_str_mv Tesis Doctorals - Facultat - Psicologia
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869403228578250752
spelling Towards personalized medicine in psychosis: the roles of social cognition and metacognitionFerrer Quintero, MartaPsicosiDiferències entre sexes (Psicologia)Medicina personalitzadaPercepció socialMetacognicióPsychosesSex differences (Psychology)Personalized medicineSocial perceptionMetacognition[eng] People with psychosis experience a range of symptoms and impairments that significantly impact their lives and often concur with disability. The best predictors of functional outcome are social cognition and metacognition, which are often impaired in psychosis. Interventions to improve both domains are effective, but this efficacy does not always translate into better functioning. Delivering early, and targeted social cognitive or metacognitive interventions to patients with psychosis could be instrumental in preventing poor functional outcome and preventing relapse, but the grounds on how to personalize these interventions are unknown. Although it has been suggested that the approach should take sex differences, the refining of measurement instruments and the use of sophisticated statistical models, these have not been explored yet. Under this rationale, the present doctoral dissertation aims to: 1) validate a test of facial emotion recognition (Baron Cohen’s Face Test) in healthy population, with the aim of detecting whether it is an appropriate tool to use in clinical research, 2) detect whether patients with first episode psychosis have different, clinically meaningful profiles of performance in social cognition and metacognition, 3) explore the sociodemographic, clinical, and neurocognitive characteristics of each profile, 4) examine if males and females with first episode psychosis are similar in their heterogeneity in social cognition and metacognition, 5) explore the role of social cognition and sex in functional outcome in people with established psychosis (schizophrenia). This broad aim yielded four research articles. The main findings of this doctoral dissertation are a) Baron Cohen’s Face Test is an adequate and reliable instrument to measure facial emotion recognition in Spanish population but it presents a ceiling effect, b) People with first-episode psychosis have distinct profiles of social cognition and metacognition that have specific clinical and neurocognitive correlates. Having worse social cognition is associated with worse clinical presentation, even if metacognition is preserved, c) Men and women with first-episode psychosis have similar configurations of social cognition and metacognition. However, there are sex- specific profiles that should be considered when delivering treatment. Sex-specific profiles seem to be associated with more severity of the disorder than the common profiles. These results suggest that people with psychosis can receive social cognitive or metacognitive targeted treatment as early as after the first episode, but these should be chosen considering the profile of each individual and their biological sex. Thus, patients with psychosis should always be carefully assessed for social cognitive and metacognitive performance.[spa] Las personas con psicosis experimentan una serie de síntomas y déficits que afectan significativamente a sus vidas y que a menudo concurren con la discapacidad. Los mejores predictores de funcionamiento son la cognición social y la metacognición, que a menudo presentan deterioro en personas con psicosis. Diversas intervenciones para mejorar ambos dominios son eficaces, pero esto no siempre se traduce en un mejor funcionamiento. Para ello, se ha propuesto que intervenciones en cognición social y metacognición tempranas y dirigidas podrían maximizar su efecto sobre el funcionamiento y la prevención de recaídas. No obstante, se desconocen los fundamentos que debería guiar su personalización. Aunque se ha sugerido que el enfoque debería tener en cuenta las diferencias de sexo, el perfeccionamiento de los instrumentos de medida y el uso de modelos estadísticos sofisticados, éstos aún no se han explorado en la literatura. Bajo este razonamiento, la presente tesis doctoral pretende: 1) validar una prueba de reconocimiento facial de emociones (Test de Caras de Baron Cohen) en población sana, con el objetivo de detectar si es un instrumento adecuado para utilizar en la investigación clínica, 2) detectar si los pacientes con primer episodio de psicosis tienen perfiles diferentes y clínicamente significativos de rendimiento en cognición social y metacognición, 3) explorar las características sociodemográficas, clínicas y neurocognitivas de cada perfil, 4) examinar si los hombres y las mujeres con primer episodio psicótico son similares en su heterogeneidad en la cognición social y la metacognición, 5) explorar el papel de la cognición social y el sexo en el resultado funcional en personas con psicosis establecida (esquizofrenia). Este amplio objetivo dio lugar a cuatro artículos de investigación. Los principales hallazgos de esta tesis doctoral son: a) El Test de Caras de Baron Cohen es un instrumento adecuado y fiable para medir el reconocimiento de emociones faciales en población española, pero presenta un efecto techo, b) Las personas con primer episodio psicótico tienen perfiles distintos de cognición social y metacognición, con correlatos clínicos y neurocognitivos específicos asociados. Tener una peor cognición social se asocia con una peor presentación clínica, incluso si la metacognición está preservada, c) Los hombres y las mujeres con primer episodio psicótico tienen configuraciones similares de cognición social y metacognición. Sin embargo, existen perfiles específicos de cada sexo que deben tenerse en cuenta a la hora de aplicar el tratamiento, ya que éstos parecen estar asociados a una mayor gravedad del trastorno que los perfiles comunes. Estos resultados sugieren que las personas con psicosis pueden recibir tratamiento en cognición social o metacognición específico desde el primer episodio psicótico, pero éste debe elegirse teniendo en cuenta el perfil de cada individuo y su sexo biológico. Para ello, se pone de manifiesto la necesidad de una correcta evaluación de sus habilidades cognitivo-sociales y metacognitivas.Universitat de BarcelonaGómez Benito, JuanaHuerta Ramos, María ElenaUniversitat de Barcelona. Facultat de Psicologia2022info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/203131http://hdl.handle.net/10803/689211Tesis Doctorals - Facultat - Psicologiareponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaIngléscc by-nc (c) Ferrer Quintero, Marta, 2023http://creativecommons.org/licenses/by-nc/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2031312026-05-27T06:46:51Z
score 15,300724

Similares en LA Referencia