| Summary: | Thesis (MA)--University of Stellenbosch, 2002. === ENGLISH ABSTRACT: Schizophrenia is known to produce positive (e.g. hallucinations) and negative symptoms (e.g. social
withdrawal). Cognitive dysfunction has long been recognised as common in schizophrenia and is now
accepted as a third cardinal feature, thought strongly to be associated with negative symptoms. While
positive symptoms may respond well to antipsychotic medication, the negative symptoms have
typically been resistant to all forms of intervention. A current study looking at the efficacy of
Eicosapentaenoic Acid (EPA), indicated a potential for negative symptoms to improve, although not
significantly (P=O.14). The purpose of this research was to expand the above mentioned study, by
evaluating the potential of EPA for improving cognitive function in patients with schizophrenia.
Forty patients diagnosed with schizophrenia were randomly ascribed to one of two groups in a 12
week, double-blind, placebo-controlled study. The following neuropsychological tests were
administered to patients at baseline and end point: Mini Mental State Examination (MMSE); Rey
Auditory-Verbal Learning Test (RAVLT); Visual Reproduction, Wechsler Memory Scale - Revised
(VR, WMS-R); Rey-Osterreith Complex Figure Test (ROCFT); Trail Making Tests (TMT-A; TMTB);
Controlled Oral Word Association Test (COWAT); Similarities, South African Wechsler Adult
Intelligence Scale - Revised (Similarities, SAWAIS-R); Boston Naming Test (BNT).
There were no overall significant differences in neuropsychological function between the experimental
(EPA) and the control (Placebo) group. In some isolated tests the experimental group did significantly
better than the control group, but for other tests the control group did significantly better than the
experimental group. Large intragroup variation - particularly within the EPA group - was indicated. In
the EPA group only one out of 25 independent neuropsychological test scores showed a significant
correlation with the symptom severity on the Positive and Negative Syndrome Scale (PANSS) total
score (% change). There were no significant correlations between any of the neuropsychological test
scores in the EPA group and on the dyskinesia subscore of the Extrapyramidal Symptom Rating Scale
(ESRS).
There was no evidence to support the hypothesis that EPA improved cognitive functioning in patients
with schizophrenia. === AFRIKAANSE OPSOMMING: Dit is bekend dat skisofrenie positiewe (bv. hallusinasies) en negatiewe simptome (bv. sosiale
onttrekking) voortbring. Kognitiewe disfunksie word lank reeds beskou as algemeen in skisofrenie en
word nou aanvaar as 'n derde kardinale eienskap wat sterk geassosieer word met negatiewe simptome.
Terwyl positiewe simptome goed reageer op antipsigotiese medikasie, is die negatiewe simptome tipies
meer weerstandig teen all vorme van intervensie. 'n Huidige studie wat die effektiwiteit van
Eicosapentaenoic Acid (EPA) ondersoek, het 'n potensiaal vir die verbetering in negatiewe simptome
aangedui, alhoewel nie beduidend nie (P=O.14). Die doel van hierdie navorsing was om bogenoemde
studie uit te brei, deur te evalueer wat die potensiaal van EPA is om kognitiewe simptome in pasiente
met skisofrenie te verbeter.
Veertig pasiente gediagnoseer met skisofrenie is ewekansig toegewys aan een van twee groepe in 'n 12
weke, dubbel-blinde, plasebo-gekontroleerde studie. Die volgende neurosielkundige toetse is afgeneem
op pasiente by basislyn en eindpunt: Mini Mental State Examination (MMSE); Rey Auditory-Verbal
Learning Test (RAVLT); Visual Reproduction, Wechsler Memory Scale - Revised (VR, WMS-R);
Rey-Osterreith Complex Figure Test (ROCFT); Trail Making Tests (TMT-A; TMT-B); Control/ed
Oral Word Association Test (COWAT); Similarities, South African Wechsler Adult Intelligence Scale
- Revised (Similarities, SAWAIS-R); Boston Naming Test (BNT).
Daar was geen beduidende verskille in neurosielkundige funksionering tussen die eksperimentele
(EPA) en kontrole (Plasebo) groep nie. In 'n paar geïsoleerde toetse het die eksperimentele groep
beduidend beter as die kontrolegroep gevaar, maar op ander toetse het die kontrolegroep beduidend
beter as die eksperimentele groep gevaar. Groot intragroep variansie - in veral die EPA groep is
aangetref In die EPA groep het slegs een uit die 25 onafhanklike neurosielkundige toetstellings gedui
op 'n beduidende korrelasie met die ems van simptome op die Positive and Negative Syndrome Scale
(PANSS) totale telling (% verandering). Daar was geen beduidende korrelasie tussen enige van die
neurosielkundige toetstellings in die EPA groep en op die diskinesie-subtelling op die Extrapyramidal
Symptom Rating Scale (ESRS) nie.
Daar was geen bewyse om die hipotese te steun dat EPA kognitiewe funksionering in pasiënte met
skisofrenie verbeter nie.
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