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Ayesa-Arriola R, de la Foz VOG, Murillo-García N, Vázquez-Bourgon J, Juncal-Ruiz M, Gómez-Revuelta M, Suárez-Pinilla P, Setién-Suero E, Crespo-Facorro B. Cognitive reserve as a moderator of outcomes in five clusters of first episode psychosis patients: a 10-year follow-up study of the PAFIP cohort. Psychol Med 2023; 53:1891-1905. [PMID: 37310335 DOI: 10.1017/s0033291721003536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive reserve (CR) has been associated with the development and prognosis of psychosis. Different proxies have been used to estimate CR among individuals. A composite score of these proxies could elucidate the role of CR at illness onset on the variability of clinical and neurocognitive outcomes. METHODS Premorbid intelligence quotient (IQ), years of education and premorbid adjustment were explored as proxies of CR in a large sample (N = 424) of first-episode psychosis (FEP) non-affective patients. Clusters of patients were identified and compared based on premorbid, clinical and neurocognitive variables at baseline. Additionally, the clusters were compared at 3-year (N = 362) and 10-year (N = 150) follow-ups. RESULTS The FEP patients were grouped into five CR clusters: C1 (low premorbid IQ, low education and poor premorbid) 14%; C2 (low premorbid IQ, low education and good premorbid adjustment) 29%; C3 (normal premorbid IQ, low education and poor premorbid adjustment) 17%; C4 (normal premorbid IQ, medium education and good premorbid adjustment) 25%; and C5 (normal premorbid IQ, higher education and good premorbid adjustment) 15%. In general, positive and negative symptoms were more severe in the FEP patients with the lowest CR at baseline and follow-up assessments, while those with high CR presented and maintained higher levels of cognitive functioning. CONCLUSIONS CR could be considered a key factor at illness onset and a moderator of outcomes in FEP patients. A high CR could function as a protective factor against cognitive impairment and severe symptomatology. Clinical interventions focused on increasing CR and documenting long-term benefits are interesting and desirable.
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Murillo-García N, Ortíz-García de la Foz V, Miguel-Corredera M, Vázquez-Bourgon J, Setién-Suero E, Neergaard K, Moya-Higueras J, Crespo-Facorro B, Ayesa-Arriola R. Intelligence quotient changes over 10 years: Diversity of cognitive profiles in first episode of psychosis and healthy controls. Schizophr Res 2023; 254:163-172. [PMID: 36905766 DOI: 10.1016/j.schres.2023.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 11/24/2022] [Accepted: 02/23/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE This study aimed to analyse whether intelligence quotient (IQ) improves, declines, or remains stable over 10 years among FEP patients and healthy subjects. METHODS A group of FEP patients enrolled in a Program of First Episode Psychosis in Spain called PAFIP, and a sample of Healthy Controls (HC) completed the same neuropsychological battery at baseline and approximately 10 years later, which included the WAIS vocabulary subtest to estimate premorbid IQ and 10-year IQ. Cluster analysis was performed separately in the patient group and the HC group to determine their profiles of intellectual change. RESULTS One hundred and thirty-seven FEP patients were grouped into five clusters: "Improved low IQ" (9.49 % of patients), "Improved average IQ" (14.6 %), "Preserved low IQ" (17.52 %), "Preserved average IQ" (43.06 %), and "Preserved high IQ" (15.33 %). Ninety HC were grouped into three clusters: "Preserved low IQ" (32.22 % of the HC), "Preserved average IQ" (44.44 %), and "Preserved high IQ" (23.33 %). The first two clusters of FEP patients, characterized by a low IQ, earlier age at illness onset, and lower educational attainment, showed a substantial cognitive improvement. The remaining clusters demonstrated cognitive stability. CONCLUSIONS The FEP patients showed intellectual improvement or stability, but no decline post-onset of psychosis. However, their profiles of intellectual change are more heterogeneous than that of HC over 10 years. Particularly, there is a subgroup of FEP patients with a significant potential for long-term cognitive enhancement.
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Constantinides C, Han LKM, Alloza C, Antonucci LA, Arango C, Ayesa-Arriola R, Banaj N, Bertolino A, Borgwardt S, Bruggemann J, Bustillo J, Bykhovski O, Calhoun V, Carr V, Catts S, Chung YC, Crespo-Facorro B, Díaz-Caneja CM, Donohoe G, Plessis SD, Edmond J, Ehrlich S, Emsley R, Eyler LT, Fuentes-Claramonte P, Georgiadis F, Green M, Guerrero-Pedraza A, Ha M, Hahn T, Henskens FA, Holleran L, Homan S, Homan P, Jahanshad N, Janssen J, Ji E, Kaiser S, Kaleda V, Kim M, Kim WS, Kirschner M, Kochunov P, Kwak YB, Kwon JS, Lebedeva I, Liu J, Mitchie P, Michielse S, Mothersill D, Mowry B, de la Foz VOG, Pantelis C, Pergola G, Piras F, Pomarol-Clotet E, Preda A, Quidé Y, Rasser PE, Rootes-Murdy K, Salvador R, Sangiuliano M, Sarró S, Schall U, Schmidt A, Scott RJ, Selvaggi P, Sim K, Skoch A, Spalletta G, Spaniel F, Thomopoulos SI, Tomecek D, Tomyshev AS, Tordesillas-Gutiérrez D, van Amelsvoort T, Vázquez-Bourgon J, Vecchio D, Voineskos A, Weickert CS, Weickert T, Thompson PM, Schmaal L, van Erp TGM, Turner J, Cole JH, Dima D, Walton E. Brain ageing in schizophrenia: evidence from 26 international cohorts via the ENIGMA Schizophrenia consortium. Mol Psychiatry 2023; 28:1201-1209. [PMID: 36494461 PMCID: PMC10005935 DOI: 10.1038/s41380-022-01897-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 10/14/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022]
Abstract
Schizophrenia (SZ) is associated with an increased risk of life-long cognitive impairments, age-related chronic disease, and premature mortality. We investigated evidence for advanced brain ageing in adult SZ patients, and whether this was associated with clinical characteristics in a prospective meta-analytic study conducted by the ENIGMA Schizophrenia Working Group. The study included data from 26 cohorts worldwide, with a total of 2803 SZ patients (mean age 34.2 years; range 18-72 years; 67% male) and 2598 healthy controls (mean age 33.8 years, range 18-73 years, 55% male). Brain-predicted age was individually estimated using a model trained on independent data based on 68 measures of cortical thickness and surface area, 7 subcortical volumes, lateral ventricular volumes and total intracranial volume, all derived from T1-weighted brain magnetic resonance imaging (MRI) scans. Deviations from a healthy brain ageing trajectory were assessed by the difference between brain-predicted age and chronological age (brain-predicted age difference [brain-PAD]). On average, SZ patients showed a higher brain-PAD of +3.55 years (95% CI: 2.91, 4.19; I2 = 57.53%) compared to controls, after adjusting for age, sex and site (Cohen's d = 0.48). Among SZ patients, brain-PAD was not associated with specific clinical characteristics (age of onset, duration of illness, symptom severity, or antipsychotic use and dose). This large-scale collaborative study suggests advanced structural brain ageing in SZ. Longitudinal studies of SZ and a range of mental and somatic health outcomes will help to further evaluate the clinical implications of increased brain-PAD and its ability to be influenced by interventions.
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Ayesa-Arriola R, Castro Quintas Á, Ortiz-García de la Foz V, Miguel Corredera M, San Martín González N, Murillo-García N, Neergaard K, Fañanás Saura L, de Las Cuevas-Terán I. Exploring the impact of COVID-19 on newborn neurodevelopment: a pilot study. Sci Rep 2023; 13:2983. [PMID: 36805488 PMCID: PMC9941470 DOI: 10.1038/s41598-023-29680-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/08/2023] [Indexed: 02/22/2023] Open
Abstract
The COVID-19 pandemic can seize the opportunity to explore the hypothesis of prenatal exposure to viral infections increases the risk for neurodevelopmental disorders. Advancing our knowledge in this regard would improve primary prevention of mental disorders in children. For this pilot study, six-week-old infants born to mothers exposed (n = 21) or unexposed (n = 21) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were assessed in Santander-Cantabria (Spain) using the Neonatal Behavioral Assessment Scale (NBAS). Groups comparisons were performed to explore the effects that infection and timing of exposure (in terms of the three trimesters of pregnancy). The infants' competencies and performances on the NBAS were generally similar in the exposed and unexposed to SARS-CoV-2 groups. The most significant difference found was a less optimally response to cuddliness (item on the state regulation domain) particularly in infants born to mothers exposed in the third trimester of pregnancy, and in pull-to-sit (item on the motor system domain). Although our interpretations must be careful, these preliminary results highlight the possible association between prenatal SARS-CoV-2 exposure and poorer development in motor skills and infant interactive behavior. Further longitudinal studies are needed to explore these relationships and disentangle the biological mechanisms implicated.
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Gas C, Ayesa-Arriola R, Vázquez-Bourgon J, Crespo-Facorro B, García-Gavilán J, Labad J, Martorell L, Muntané G, Sanchez-Gistau V, Vilella E. Cross-sectional and longitudinal assessment of the association between DDR1 variants and processing speed in patients with early psychosis and healthy controls. J Psychiatr Res 2023; 158:49-55. [PMID: 36571911 DOI: 10.1016/j.jpsychires.2022.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
Recent evidence indicates that DDR1 participates in myelination and that variants of DDR1 are associated with decreased cognitive processing speed (PS) in schizophrenia (SZ). Here, we explored whether DDR1 variants were associated with PS in subjects diagnosed with an early psychosis (EP), a condition often preceding SZ. Data from two Spanish independent samples (from Reus and Santander) including patients with EP (n = 75 and n = 312, respectively) and healthy controls (HCs; n = 57 and n = 160) were analyzed. The Trail Making Test part A was used to evaluate PS. Participants underwent genotyping to identify DDR1 variants rs1264323 and rs2267641. Cross-sectional data were analyzed with general linear models and longitudinal data were analyzed using mixed models. We examined the combined rs1264323AA-rs2267641AC/CC genotypes (an SZ-risk combination) on PS. The SZ-risk combined genotypes were associated with increased PS in EP patients but not in HCs in the cross-sectional analysis. In the longitudinal analysis, the SZ-risk combined genotypes were significantly associated with increased PS in both HCs and EP patients throughout the 10-year follow-up but no genotype × time interaction was observed. These results provide further evidence that DDR1 is involved in cognition and should be replicated with other samples.
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Ayesa-Arriola R, Miguel-Corredera M, de la Foz VOG, Neergaard KD, Correa-Ghisays P, Setién-Suero E, Crespo-Facorro B. Education and long-term outcomes in first episode psychosis: 10-year follow-up study of the PAFIP cohort. Psychol Med 2023; 53:66-77. [PMID: 33952364 DOI: 10.1017/s0033291721001112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Lower levels of education have been associated with the development of psychosis. Investigating educational achievement in the first episode of psychosis (FEP) patients may shed light on the origins of the alterations and on the variability of outcomes in psychotic disorders. METHODS Education achievement was explored in a large sample (n = 659) of FEP patients enrolled in programa de atención a fases iniciales de psicosis (PAFIP), a research and assistance program conducted in Spain. Patients were stratified according to the Spanish educational system according to their attendance in primary (low), secondary (medium) or university studies (high). The three groups were compared on available premorbid, clinical and neuropsychological variables. A subgroup of patients (n = 209), comprising the 10-year follow-up PAFIP cohort, were again compared. RESULTS Overall, 49% and 37% of FEP patients had low and medium levels of education, respectively. In total, 13% of the patients with a higher level of education were more frequently women (64%) and older at illness onset (36 years old), reported better premorbid adjustment, presented less severe positive symptoms and better functioning; and showed higher premorbid intelligence quotient and better performance on all the explored cognitive domains. Ten years later the FEP patients in the medium- and high-education groups had good global functioning and a neurocognitive performance within the normal limits. CONCLUSIONS Higher education is associated with better initial conditions and more favourable outcomes after an FEP. Sharing this information with the world's educational systems is essential to targeting resources and designing innovative programs or strategies to compensate for student difficulties.
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Garrido-Torres N, Cerrillos L, García Cerro S, Pérez Gómez A, Canal-Rivero M, de Felipe B, Alameda L, Marqués Rodríguez R, Anillo S, Praena J, Duque Sánchez C, Roca C, Paniagua M, López Díaz A, Romero-García R, Olbrich P, Puertas Albarracín MDP, Reguera Pozuelo P, Sosa IL, Moreno Dueñas MB, Pineda Cachero R, Zamudio Juan L, García Rumi V, Guerrero Benitez M, Figueroa R, Martín Rendón AM, Partida A, Rodríguez Cocho MI, Gallardo Trujillo C, Gallego Jiménez I, García Spencer S, Gómez Verdugo M, Bermejo Fernández C, Pérez Benito M, Castillo Reina RE, Cejudo López A, Sánchez Tomás C, Chacón Gamero MÁ, Rubio A, Moreno Mellado A, Ramos Herrero V, Starr E, González Fernández de Palacios M, García Victori E, Pavón Delgado A, Fernández Cuervo I, Arias Ruiz A, Menéndez Gil IE, Domínguez Gómez I, Coca Mendoza I, Ayesa-Arriola R, Fañanas L, Leza JC, Cisneros JM, Sánchez Céspedes J, Ruiz-Mateos E, Crespo-Facorro B, Ruiz-Veguilla M. Examining the immune signatures of SARS-CoV-2 infection in pregnancy and the impact on neurodevelopment: Protocol of the SIGNATURE longitudinal study. Front Pediatr 2022; 10:899445. [PMID: 36619503 PMCID: PMC9811261 DOI: 10.3389/fped.2022.899445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/26/2022] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 pandemic represents a valuable opportunity to carry out cohort studies that allow us to advance our knowledge on pathophysiological mechanisms of neuropsychiatric diseases. One of these opportunities is the study of the relationships between inflammation, brain development and an increased risk of suffering neuropsychiatric disorders. Based on the hypothesis that neuroinflammation during early stages of life is associated with neurodevelopmental disorders and confers a greater risk of developing neuropsychiatric disorders, we propose a cohort study of SARS-CoV-2-infected pregnant women and their newborns. The main objective of SIGNATURE project is to explore how the presence of prenatal SARS-CoV-2 infection and other non-infectious stressors generates an abnormal inflammatory activity in the newborn. The cohort of women during the COVID-19 pandemic will be psychological and biological monitored during their pregnancy, delivery, childbirth and postpartum. The biological information of the umbilical cord (foetus blood) and peripheral blood from the mother will be obtained after childbirth. These samples and the clinical characterisation of the cohort of mothers and newborns, are tremendously valuable at this time. This is a protocol report and no analyses have been conducted yet, being currently at, our study is in the recruitment process step. At the time of this publication, we have identified 1,060 SARS-CoV-2 infected mothers and all have already given birth. From the total of identified mothers, we have recruited 537 SARS-COV-2 infected women and all of them have completed the mental health assessment during pregnancy. We have collected biological samples from 119 mothers and babies. Additionally, we have recruited 390 non-infected pregnant women.
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Correa-Ghisays P, Vicent Sánchez-Ortí J, Balanzá-Martínez V, Fuentes-Durá I, Martinez-Aran A, Ruiz-Bolo L, Correa-Estrada P, Ruiz-Ruiz JC, Selva-Vera G, Vila-Francés J, Macias Saint-Gerons D, San-Martín C, Ayesa-Arriola R, Tabarés-Seisdedos R. MICEmi: A method to identify cognitive endophenotypes of mental illnesses. Eur Psychiatry 2022; 65:e85. [PMID: 36440538 PMCID: PMC9807453 DOI: 10.1192/j.eurpsy.2022.2348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Characterizing neurocognitive endophenotypes of mental illnesses (MIs) could be useful for identifying at-risk individuals, increasing early diagnosis, improving disease subtyping, and proposing therapeutic strategies to reduce the negative effects of the symptoms, in addition to serving as a scientific basis to unravel the physiopathology of the disease. However, a standardized algorithm to determine cognitive endophenotypes has not yet been developed. The main objective of this study was to present a method for the identification of endophenotypes in MI research. METHODS For this purpose, a 14-expert working group used a scoping review methodology and designed a method that includes a scoring template with five criteria and indicators, a strategy for their verification, and a decision tree. CONCLUSIONS This work is ongoing since it is necessary to obtain external validation of the applicability of the method in future research.
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Murillo-García N, Barrio-Martínez S, Setién-Suero E, Soler J, Papiol S, Fatjó-Vilas M, Ayesa-Arriola R. Overlap between genetic variants associated with schizophrenia spectrum disorders and intelligence quotient: a systematic review. J Psychiatry Neurosci 2022; 47:E393-E408. [PMID: 36414327 PMCID: PMC9710545 DOI: 10.1503/jpn.220026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/27/2022] [Accepted: 09/06/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To study whether there is genetic overlap underlying the risk for schizophrenia spectrum disorders (SSDs) and low intelligence quotient (IQ), we reviewed and summarized the evidence on genetic variants associated with both traits. METHODS We performed this review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and preregistered it in PROSPERO. We searched the Medline databases via PubMed, PsycInfo, Web of Science and Scopus. We included studies in adults with a diagnosis of SSD that explored genetic variants (single nucleotide polymorphisms [SNPs], copy number variants [CNVs], genomic insertions or genomic deletions), estimated IQ and studied the relationship between genetic variability and both traits (SSD and IQ). We synthesized the results and assessed risk of bias using the Quality of Genetic Association Studies (Q-Genie) tool. RESULTS Fifty-five studies met the inclusion criteria (45 case-control, 9 cross-sectional, 1 cohort), of which 55% reported significant associations for genetic variants involved in IQ and SSD. The SNPs more frequently explored through candidate gene studies were in COMT, DTNBP1, BDNF and TCF4. Through genome-wide association studies, 2 SNPs in CHD7 and GATAD2A were associated with IQ in patients with SSD. The studies on CNVs suggested significant associations between structural variants and low IQ in patients with SSD. LIMITATIONS Overall, primary studies used heterogeneous IQ measurement tools and had small samples. Grey literature was not screened. CONCLUSION Genetic overlap between SSD and IQ supports the neurodevelopmental hypothesis of schizophrenia. Most of the risk polymorphisms identified were in genes relevant to brain development, neural proliferation and differentiation, and synaptic plasticity.
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Setién-Suero E, Ayesa-Arriola R, Peña J, Crespo-Facorro B, Ojeda N. Trauma and psychosis: The mediating role of premorbid adjustment and recent stressful events in a 3-year longitudinal study. J Psychiatr Res 2022; 155:279-285. [PMID: 36166937 DOI: 10.1016/j.jpsychires.2022.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/30/2022] [Accepted: 09/16/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Some of the most-studied environmental factors that can contribute to the development of psychosis are the adversities experienced at an early age. Among these, childhood interpersonal trauma (CIT) has been considered especially influential in the onset of the disease. The aim of the study was to explore the relationship between CIT and the first episode of psychosis (FEP), as well as the relationship between CIT and clinical and functional outcomes 3 years after illness onset. METHODS A total of 278 patients with a FEP and 52 healthy controls were studied. Logistic regression analysis was carried out to examine the explained variation by CIT at the beginning of psychosis. Recent stressful events and premorbid adjustment related to CIT, were introduced in path analyses to determine their mediating effects between CIT and the disease and its clinical and functional results. RESULTS Mediation analyses showed that CIT was indirectly associated with belonging to the FEP group through recent stressful events (Effect = 0.981; SE = 0.323; CI = 0.485 to 1.761). Premorbid academic adjustment in late adolescence mediated the relationship between CIT and clinical and functional outcomes, specifically in the measurements of the Scales for Assessment of Positive and Negative Symptoms, in the Brief Psychiatric Rating Scale, and in the Disability Assessment Scale. CONCLUSIONS These findings suggest that early traumatic experiences play an important role in the FEP. Early intervention that promotes good academic adjustment during adolescence and/or avoids retraumatisation could positively impact both the onset and the course of psychotic illness.
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van Velzen LS, Dauvermann MR, Colic L, Villa LM, Savage HS, Toenders YJ, Zhu AH, Bright JK, Campos AI, Salminen LE, Ambrogi S, Ayesa-Arriola R, Banaj N, Başgöze Z, Bauer J, Blair K, Blair RJ, Brosch K, Cheng Y, Colle R, Connolly CG, Corruble E, Couvy-Duchesne B, Crespo-Facorro B, Cullen KR, Dannlowski U, Davey CG, Dohm K, Fullerton JM, Gonul AS, Gotlib IH, Grotegerd D, Hahn T, Harrison BJ, He M, Hickie IB, Ho TC, Iorfino F, Jansen A, Jollant F, Kircher T, Klimes-Dougan B, Klug M, Leehr EJ, Lippard ETC, McLaughlin KA, Meinert S, Miller AB, Mitchell PB, Mwangi B, Nenadić I, Ojha A, Overs BJ, Pfarr JK, Piras F, Ringwald KG, Roberts G, Romer G, Sanches M, Sheridan MA, Soares JC, Spalletta G, Stein F, Teresi GI, Tordesillas-Gutiérrez D, Uyar-Demir A, van der Wee NJA, van der Werff SJ, Vermeiren RRJM, Winter A, Wu MJ, Yang TT, Thompson PM, Rentería ME, Jahanshad N, Blumberg HP, van Harmelen AL, Schmaal L. Structural brain alterations associated with suicidal thoughts and behaviors in young people: results from 21 international studies from the ENIGMA Suicidal Thoughts and Behaviours consortium. Mol Psychiatry 2022; 27:4550-4560. [PMID: 36071108 PMCID: PMC9734039 DOI: 10.1038/s41380-022-01734-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 06/24/2022] [Accepted: 08/05/2022] [Indexed: 12/14/2022]
Abstract
Identifying brain alterations associated with suicidal thoughts and behaviors (STBs) in young people is critical to understanding their development and improving early intervention and prevention. The ENIGMA Suicidal Thoughts and Behaviours (ENIGMA-STB) consortium analyzed neuroimaging data harmonized across sites to examine brain morphology associated with STBs in youth. We performed analyses in three separate stages, in samples ranging from most to least homogeneous in terms of suicide assessment instrument and mental disorder. First, in a sample of 577 young people with mood disorders, in which STBs were assessed with the Columbia Suicide Severity Rating Scale (C-SSRS). Second, in a sample of young people with mood disorders, in which STB were assessed using different instruments, MRI metrics were compared among healthy controls without STBs (HC; N = 519), clinical controls with a mood disorder but without STBs (CC; N = 246) and young people with current suicidal ideation (N = 223). In separate analyses, MRI metrics were compared among HCs (N = 253), CCs (N = 217), and suicide attempters (N = 64). Third, in a larger transdiagnostic sample with various assessment instruments (HC = 606; CC = 419; Ideation = 289; HC = 253; CC = 432; Attempt=91). In the homogeneous C-SSRS sample, surface area of the frontal pole was lower in young people with mood disorders and a history of actual suicide attempts (N = 163) than those without a lifetime suicide attempt (N = 323; FDR-p = 0.035, Cohen's d = 0.34). No associations with suicidal ideation were found. When examining more heterogeneous samples, we did not observe significant associations. Lower frontal pole surface area may represent a vulnerability for a (non-interrupted and non-aborted) suicide attempt; however, more research is needed to understand the nature of its relationship to suicide risk.
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Grants
- UG3 MH111929 NIMH NIH HHS
- R37 MH101495 NIMH NIH HHS
- R01 MH103291 NIMH NIH HHS
- P41 RR008079 NCRR NIH HHS
- UL1 TR001872 NCATS NIH HHS
- UL1 TR001863 NCATS NIH HHS
- R61 MH111929 NIMH NIH HHS
- RC1 MH088366 NIMH NIH HHS
- R01 MH117601 NIMH NIH HHS
- K23 MH090421 NIMH NIH HHS
- R21 AA027884 NIAAA NIH HHS
- K01 MH106805 NIMH NIH HHS
- R61 AT009864 NCCIH NIH HHS
- R01 MH069747 NIMH NIH HHS
- K01 AA027573 NIAAA NIH HHS
- R01 MH070902 NIMH NIH HHS
- K01 MH117442 NIMH NIH HHS
- R01 MH085734 NIMH NIH HHS
- R21 AT009173 NCCIH NIH HHS
- MQ Brighter Futures Award MQBFC/2 and the U.S. National Institute of Mental Health under Award Number R01MH117601. National Suicide Prevention Research Fund, managed by Suicide Prevention Australia
- MQ Brighter Futures Award MQBFC/2. Interdisziplinäres Zentrum für Klinische Forschung, UKJ
- Italian Ministry of Health grant RC17-18-19-20-21/A
- Instituto de Salud Carlos III through the projects PI14/00639, PI14/00918 and PI17/01056 (Co-funded by European Regional Development Fund/European Social Fund "Investing in your future") and Fundación Instituto de Investigación Marqués de Valdecilla (NCT0235832 and NCT02534363)
- National Institute of Mental Health (K23MH090421), the National Alliance for Research on Schizophrenia and Depression, the University of Minnesota Graduate School, the Minnesota Medical Foundation, and the Biotechnology Research Center (P41 RR008079 to the Center for Magnetic Resonance Research), University of Minnesota, and the Deborah E. Powell Center for Women’s Health Seed Grant, University of Minnesota
- Medical Leader Foundation of Yunnan Province (L2019011) and Famous Doctors Project of Yunnan Province Plan (YNWR-MY-2018-041)
- CJ Martin Fellowship (NHMRC app 1161356). “Investissements d’avenir” ANR-10-IAIHU-06
- German Research Foundation (DFG, grant FOR2107-DA1151/5-1 and DA1151/5-2 to UD, and DFG grants HA7070/2-2, HA7070/3, HA7070/4 to TH)
- Australian National Health and Medical Research Council of Australia (NHMRC) Project Grants 1024570 NHMRC Career Development Fellowships (1061757)
- Medical Faculty Münster, Innovative Medizinische Forschung (Grant IMF KO 1218 06)
- Australian National Medical and Health Research Council (Program Grant 1037196 and Investigator Grant 1177991 to PBM, Project Grant 1066177 to JMF), the Lansdowne Foundation, Good Talk and the Keith Pettigrew Family Bequest (PM) Janette Mary O’Neil Research Fellowship. IHG is supported in part by R37MH101495
- Australian National Health and Medical Research Council of Australia (NHMRC) Project Grants 1064643 (principal investigator, BJH) NHMRC Career Development Fellowships (1124472)
- National Institute of Mental Health (K01MH106805). Klingenstein Third Generation Foundation, the National Institute of Mental Health (K01MH117442), the Stanford Maternal Child Health Research Institute, and the Stanford Center for Cognitive and Neurobiological Imaging. TCH receives partial support from the Ray and Dagmar Dolby Family Fund
- German Research Foundation (DFG, grant FOR2107-JA 1890/7-1 and JA 1890/7-2 to AJ, and DFG, grant FOR2107-KI588/14-1 and FOR2107-KI588/14-2 to TK)
- NIAAA (K01AA027573, R21AA027884) and the American Foundation for Suicide Prevention
- National Institute of Mental Health (R01-MH103291)
- National Center for Complementary and Integrative Health (NCCIH) R21AT009173 and R61AT009864 National Center for Advancing Translational Sciences (CTSI), National Institutes of Health, through UCSF-CTSI UL1TR001872 American Foundation for Suicide Prevention (AFSP) SRG-1-141-18 UCSF Research Evaluation and Allocation Committee (REAC) and J. Jacobson Fund to TTY; by the National Institute of Mental Health (NIMH) R01MH085734 and the Brain and Behavior Research Foundation (formerly NARSAD)
- MQ Brighter Futures Award MQBFC/2 R61MH111929RC1MH088366, R01MH070902, R01MH069747, American Foundation for Suicide Prevention, International Bipolar Foundation, Brain and Behavior Research Foundation, For the Love of Travis Foundation and Women’s Health Research at Yale
- MQ Brighter Futures Award MQBFC/2 Social Safety and Resilience programme of Leiden University
- MQ Brighter Futures Award MQBFC/2 National Institute of Mental Health under Award Number R01MH117601 NHMRC Career Development Fellowship (1140764)
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Canal-Rivero M, Ayesa-Arriola R, Ruiz-Veguilla M, Ortiz-García de la Foz V, Labad J, Crespo-Facorro B. Insight trajectories and their impact on psychosocial functioning: A 10-year follow-up study in first episode psychosis patients. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:808-816. [PMID: 36222628 DOI: 10.1037/abn0000776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Insight has been considered a core symptom of psychosis and closely related to functional outcome. However, little is known regarding the role of insight and its progression in different long-term functioning subdomains among First Episode Psychosis (FEP) patients. A total of 209 participants were followed up over a 10-year period. Latent class mixed models were used to identify trajectory classes in each of the three different insight dimensions. Multivariate analyses were performed to explore predictive value of insight dimensions and its long-term trajectories in psychosocial functioning over a 10-year follow-up period including in the analyses a complete set of baseline and follow-up measures. Three different trajectories (improvement, continued awareness, and worsening) were differentiated in each of the insight dimensions, resulting continued awareness the most common trajectory. Awareness into mental illness at baseline represented one of the main predictors of very long-term instrumental and global functioning. Moreover, enhancement/maintenance of illness awareness was significantly related to better interpersonal functioning. Early intervention programs that promote the acquisition of awareness in the very early stages of the psychotic disorder could have a relevant impact on long-term functioning in FEP patients. Insight dimensions showed mostly trait-like properties although a considerable proportion of FEP patients experienced changes in insight dimensions over the follow-up period. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Setién-Suero E, Murillo-García N, Sevilla-Ramos M, Abreu-Fernández G, Pozueta A, Ayesa-Arriola R. Corrigendum: Exploring the relationship between deficits in social cognition and neurodegenerative dementia: A systematic review. Front Aging Neurosci 2022; 14:1031955. [PMID: 36225890 PMCID: PMC9549906 DOI: 10.3389/fnagi.2022.1031955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
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Moreno-Sancho L, Juncal-Ruiz M, Vázquez-Bourgon J, Ortiz-Garcia de la Foz V, Mayoral-van Son J, Tordesillas-Gutierrez D, Setien-Suero E, Ayesa-Arriola R, Crespo-Facorro B. Naturalistic study on the use of clozapine in the early phases of non-affective psychosis: A 10-year follow-up study in the PAFIP-10 cohort. J Psychiatr Res 2022; 153:292-299. [PMID: 35878537 DOI: 10.1016/j.jpsychires.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 06/22/2022] [Accepted: 07/02/2022] [Indexed: 11/16/2022]
Abstract
Clozapine is seldom prescribed in treatment-resistant schizophrenia (TRS) patients during early phases of the illness. We aimed to examine the pathway and patterns and the impact of clozapine use in patients with TRS who were followed up for 10 years after the first outbreak of the illness. Data were obtained retrospectively from an epidemiological cohort of first episode schizophrenia patients (n = 218) who had been treated in a specialized intervention program (PAFIP). Out of 218, 35 (16%) individuals were on clozapine at 10-year assessment, while 183 (84%) were taking other antipsychotics. Among those 183 psychosis subjects who were not on clozapine, 13 (7.1%) met criteria for TRS. In the clozapine group, ten (28.6%) met criteria for early-TR and twenty-five (71.4%) met criteria for late-TR. Before clozapine treatment was initiated, the median number of days under other antipsychotic treatment was 1551 days (IQR = 1715) and the median time that subjects remained on clozapine was 6.3 years (IC95%: 5.49-7.20). At 10 years, we found that those individuals taking clozapine had higher CGI total scores (F = 12.0, p = 0.001) and SANS total scores (F = 9.27, p = 0.003) than subjects taking other antipsychotics after correcting for baseline values. Interestingly, when performing these analyses at 10 years between subjects taking clozapine (n = 35) and subjects who despite meeting TRS criteria were not taking clozapine (n = 13), we found that subjects taking clozapine had significantly lower total scores on all clinical scales compared with subjects who met TRS criteria and were not taking clozapine (p values < 0.05). TRS patients who took the longest time to start clozapine (third tertile) showed significantly higher CGI scores at 10-year follow-up compared to those who initiated clozapine earlier (first tertile) (t = 2.60; p = 0.043). Our findings reinforce the need of a timely assessment of treatment-resistant criteria in early schizophrenia patients and highlight the long-term benefits of an early introduction of clozapine on those patients meeting treatment-resistant criteria.
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Patel Y, Shin J, Abé C, Agartz I, Alloza C, Alnæs D, Ambrogi S, Antonucci LA, Arango C, Arolt V, Auzias G, Ayesa-Arriola R, Banaj N, Banaschewski T, Bandeira C, Başgöze Z, Cupertino RB, Bau CHD, Bauer J, Baumeister S, Bernardoni F, Bertolino A, Bonnin CDM, Brandeis D, Brem S, Bruggemann J, Bülow R, Bustillo JR, Calderoni S, Calvo R, Canales-Rodríguez EJ, Cannon DM, Carmona S, Carr VJ, Catts SV, Chenji S, Chew QH, Coghill D, Connolly CG, Conzelmann A, Craven AR, Crespo-Facorro B, Cullen K, Dahl A, Dannlowski U, Davey CG, Deruelle C, Díaz-Caneja CM, Dohm K, Ehrlich S, Epstein J, Erwin-Grabner T, Eyler LT, Fedor J, Fitzgerald J, Foran W, Ford JM, Fortea L, Fuentes-Claramonte P, Fullerton J, Furlong L, Gallagher L, Gao B, Gao S, Goikolea JM, Gotlib I, Goya-Maldonado R, Grabe HJ, Green M, Grevet EH, Groenewold NA, Grotegerd D, Gruber O, Haavik J, Hahn T, Harrison BJ, Heindel W, Henskens F, Heslenfeld DJ, Hilland E, Hoekstra PJ, Hohmann S, Holz N, Howells FM, Ipser JC, Jahanshad N, Jakobi B, Jansen A, Janssen J, Jonassen R, Kaiser A, Kaleda V, Karantonis J, King JA, Kircher T, Kochunov P, Koopowitz SM, Landén M, Landrø NI, Lawrie S, Lebedeva I, Luna B, Lundervold AJ, MacMaster FP, Maglanoc LA, Mathalon DH, McDonald C, McIntosh A, Meinert S, Michie PT, Mitchell P, Moreno-Alcázar A, Mowry B, Muratori F, Nabulsi L, Nenadić I, O'Gorman Tuura R, Oosterlaan J, Overs B, Pantelis C, Parellada M, Pariente JC, Pauli P, Pergola G, Piarulli FM, Picon F, Piras F, Pomarol-Clotet E, Pretus C, Quidé Y, Radua J, Ramos-Quiroga JA, Rasser PE, Reif A, Retico A, Roberts G, Rossell S, Rovaris DL, Rubia K, Sacchet M, Salavert J, Salvador R, Sarró S, Sawa A, Schall U, Scott R, Selvaggi P, Silk T, Sim K, Skoch A, Spalletta G, Spaniel F, Stein DJ, Steinsträter O, Stolicyn A, Takayanagi Y, Tamm L, Tavares M, Teumer A, Thiel K, Thomopoulos SI, Tomecek D, Tomyshev AS, Tordesillas-Gutiérrez D, Tosetti M, Uhlmann A, Van Rheenen T, Vazquez-Bourgón J, Vernooij MW, Vieta E, Vilarroya O, Weickert C, Weickert T, Westlye LT, Whalley H, Willinger D, Winter A, Wittfeld K, Yang TT, Yoncheva Y, Zijlmans JL, Hoogman M, Franke B, van Rooij D, Buitelaar J, Ching CRK, Andreassen OA, Pozzi E, Veltman D, Schmaal L, van Erp TGM, Turner J, Castellanos FX, Pausova Z, Thompson P, Paus T. Virtual Ontogeny of Cortical Growth Preceding Mental Illness. Biol Psychiatry 2022; 92:299-313. [PMID: 35489875 PMCID: PMC11080987 DOI: 10.1016/j.biopsych.2022.02.959] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/02/2022] [Accepted: 02/23/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Morphology of the human cerebral cortex differs across psychiatric disorders, with neurobiology and developmental origins mostly undetermined. Deviations in the tangential growth of the cerebral cortex during pre/perinatal periods may be reflected in individual variations in cortical surface area later in life. METHODS Interregional profiles of group differences in surface area between cases and controls were generated using T1-weighted magnetic resonance imaging from 27,359 individuals including those with attention-deficit/hyperactivity disorder, autism spectrum disorder, bipolar disorder, major depressive disorder, schizophrenia, and high general psychopathology (through the Child Behavior Checklist). Similarity of interregional profiles of group differences in surface area and prenatal cell-specific gene expression was assessed. RESULTS Across the 11 cortical regions, group differences in cortical area for attention-deficit/hyperactivity disorder, schizophrenia, and Child Behavior Checklist were dominant in multimodal association cortices. The same interregional profiles were also associated with interregional profiles of (prenatal) gene expression specific to proliferative cells, namely radial glia and intermediate progenitor cells (greater expression, larger difference), as well as differentiated cells, namely excitatory neurons and endothelial and mural cells (greater expression, smaller difference). Finally, these cell types were implicated in known pre/perinatal risk factors for psychosis. Genes coexpressed with radial glia were enriched with genes implicated in congenital abnormalities, birth weight, hypoxia, and starvation. Genes coexpressed with endothelial and mural genes were enriched with genes associated with maternal hypertension and preterm birth. CONCLUSIONS Our findings support a neurodevelopmental model of vulnerability to mental illness whereby prenatal risk factors acting through cell-specific processes lead to deviations from typical brain development during pregnancy.
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González-Rodríguez A, Seeman MV, Díaz-Pons A, Ayesa-Arriola R, Natividad M, Calvo E, Monreal JA. Do Sex/Gender and Menopause Influence the Psychopathology and Comorbidity Observed in Delusional Disorders? J Clin Med 2022; 11:jcm11154550. [PMID: 35956165 PMCID: PMC9369646 DOI: 10.3390/jcm11154550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/23/2022] [Accepted: 08/02/2022] [Indexed: 12/04/2022] Open
Abstract
Background: While sex differences and gonadal hormone levels are taken seriously in the understanding and treatment of schizophrenia, their influence in the psychopathology of delusional disorders (DD) remains unknown. Methods: Our strategy was to conduct a narrative review of the effects of (a) sex/gender difference and (b) menopause on delusional content, affective and anxiety-related comorbidity, substance use disorders, cognition, aggressivity, and suicide risk in DD. Results: Because the literature is scarce, our results are tentative. We found that erotomania was more prevalent in women than in men, and especially in women with premenopausal onset. In contrast, jealous and somatic delusions were more commonly seen in DD women with postmenopausal onset. With respect to depressive comorbidity, women with premenopausal onset appear more vulnerable to depression than those with later onset. Age at menopause is reported to correlate positively with intensity of suicidal ideation. Anxiety symptoms may be related to estrogen levels. Men present with higher rates of substance use disorders, particularly alcohol use. Conclusions: Many male/female differences in DD may be attributable to sociocultural factors but menopause, and, therefore, levels of female hormones, influence symptom expression in women and mediate the expression of psychiatric comorbidities. Further research in this area promises to lead to improved individualized treatment.
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Garrido-Torres N, Ruiz-Veguilla M, Alameda L, Canal-Rivero M, Ruiz MJ, Gómez-Revuelta M, Ayesa-Arriola R, Rubio-García A, Crespo-Facorro B, Vázquez-Bourgon J. Prevalence of metabolic syndrome and related factors in a large sample of antipsychotic naïve patients with first-episode psychosis: Baseline results from the PAFIP cohort. Schizophr Res 2022; 246:277-285. [PMID: 35878542 DOI: 10.1016/j.schres.2022.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 06/03/2022] [Accepted: 07/10/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Few investigations have been carried out on metabolic syndrome in antipsychotic- naïve patients with schizophrenia. METHODS Our primary objective was to compare the prevalence of Metabolic Syndrome (MetS), as defined by the National Cholesterol Education Program, Adult Treatment Panel III in 2001 (NCEP-ATP III), between a Spanish cohort of 303 drug-naïve patients with a first episode of psychosis (FEP) without any previous cardiovascular condition, and 153 healthy individuals. RESULTS Participants included 303 patients with FEP (M:F 53:46) and 153 control subjects (M:F 56:43). The mean and standard deviation ages were 31(9.38) and 29 (7.57) years in the study and control groups respectively (F = 4.09; p = 0.93). We found that the prevalence of MetS in drug-naïve patients with FEP (5.6 %) was similar to the prevalence of MetS in age-sex matched controls (5.12 %). However, 60.7 % of patients with FEP met at least one of the five MetS components, while among the control subjects only 36.5 % met at least one component. Additionally, we found that other factors not included among the operational definition of MetS, but still important in cardiovascular risk, were also altered. CONCLUSION FEP patients have a greater risk of presenting at least one altered MetS component than healthy controls which could indicate the need of development of screening methods detecting cardiovascular risk. Likewise, gender differences in metabolic components such as waist circumference, which is a predictor of cardiovascular events have been found. Similarly, research should focus on metabolic risk predictors that include not only MetS, but also specific parameters for the early psychosis population.
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González-Blanch C, Gleeson JF, McEnery C, O'Sullivan S, Ayesa-Arriola R, D'Alfonso S, Valentine L, Tremain H, Bell I, Bendall S, Alvarez-Jimenez M. The impact of persistent social anxiety on social functioning and health-related quality of life in young people with remitted first-episode psychosis. Early Interv Psychiatry 2022; 16:868-874. [PMID: 34716667 DOI: 10.1111/eip.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/26/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Comorbid social anxiety is common in psychotic disorders and is associated with multiple negative consequences. However, the long-term effects of persistent social anxiety versus fluctuating or no anxiety on social functioning and health-related quality of life (HR-QoL) have received scant attention. Therefore, we aimed to examine the prevalence of persistent social anxiety to determine its effect on social functioning and HR-QoL in first-episode psychosis (FEP). METHODS One hundred and eight individuals with remitted FEP were classified into three groups (persistent, fluctuating or no social anxiety) according to the Social Interaction Anxiety Scale over an 18-month follow-up period. The three groups were then compared at 18 months follow-up to assess the influence of social anxiety on social functioning and HR-QoL before and after controlling for confounders. RESULTS Of the 108 individuals with FEP, 25 (23.1%) had persistent social anxiety. This group presented lower social functioning and HR-QoL levels compared to the groups with fluctuating or no anxiety symptoms. The effect on HR-QoL remained significant after controlling for positive psychotic and depressive symptoms. CONCLUSIONS In this study, nearly one-quarter of young people with remitted FEP experienced persistent social anxiety symptoms, which had a negative impact on HR-QoL. Thus, individuals with persistent social anxiety constitute a highly vulnerable group and may require targeted interventions to improve their social functioning and HR-QoL.
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Garrido-Sánchez L, Gómez-Revuelta M, Ortiz-García de la Foz V, Pelayo-Terán JM, Juncal-Ruiz M, Ruiz-Veguilla M, Mayoral-Van Son J, Ayesa-Arriola R, Vázquez-Bourgon J, Crespo-Facorro B. Aripiprazole vs Risperidone Head-to-Head Effectiveness in First-Episode Non-Affective-Psychosis: A 3-Month Randomized, Flexible-Dose, Open-Label Clinical Trial. Int J Neuropsychopharmacol 2022; 25:900-911. [PMID: 35894865 PMCID: PMC9670751 DOI: 10.1093/ijnp/pyac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/24/2022] [Accepted: 07/21/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Antipsychotic choice for the acute phase of a first episode of psychosis (FEP) is of the utmost importance since it may influence long-term outcome. However, head-to-head comparisons between second-generation antipsychotics remain scarce. The aim of this study was to compare the effectiveness in the short term of aripiprazole and risperidone after FEP outbreak. METHODS From February 2011 to October 2018, a prospective, randomized, open-label study was undertaken. Two hundred-sixty-six first-episode drug-naïve patients were randomly assigned to aripiprazole (n = 136) or risperidone (n = 130) and followed-up for 12 weeks. The primary effectiveness measure was all-cause treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted to assess clinical efficacy. RESULTS The overall dropout rate at 12 weeks was small (6.39%). Effectiveness measures were similar between treatment arms as treatment discontinuation rates (χ 2 = 0,409; P = .522), and mean time to all-cause discontinuation (log rank χ 2 = -1.009; P = .316) showed no statistically significant differences. Despite no statistically significant differences between groups regarding clinical efficacy, aripiprazole required higher chlorpromazine equivalent dosage (χ 2 = 2.160; P = .032) and extended mean time (W = 8183.5; P = .008) to reach clinical response. Sex-related adverse events and rigidity were more frequent in the risperidone group, whereas sialorrhea was on the aripiprazole group. CONCLUSIONS No differences regarding effectiveness were found between aripiprazole and risperidone for the short-phase treatment of FEP. Despite the importance of efficacy during this phase, differences in side effect profiles and patient's preferences are essential factors that may lead clinical decisions for these patients. CLINICALTRIALS.GOV NCT02532491. Effectiveness of Second-Generation Antipsychotics in First Episode Psychosis Patients: 1-year Follow-up (PAFIP3_1Y).
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Díaz-Pons A, González-Rodríguez A, Ortiz-García De La Foz V, Seeman M, Facorro C, Ayesa-Arriola R. Disentangling early and late onset of psychosis in women. Eur Psychiatry 2022. [PMCID: PMC9565191 DOI: 10.1192/j.eurpsy.2022.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Women present a second peak of incidence of psychosis during menopausal transition, partially explained by the loss of estrogen protection conferred during the reproductive years. Despite this, few studies compare sociodemographic, biological, clinical varibles and neurocognitive performance between women with early onset of psychosis (EOP) and those with late onset of psychosis (LOP). Objectives Our aim was to characterize both groups in a large sample of women, of which 294 were FEP patients (EOP = 205; LOP = 85) and 202 were healthy controls (HC) grouped following cutoff point (<>40 years of age) in previous studies. Methods Clinical and laboratory assessments were completed. Neurocognitive performance was also evaluated, and a cognitive global deficit score (GDS) was derived. ANCOVA was used for comparisons. Results EOP women were more frequently single and unemployed than comparable HC. Cholesterol levels in LOP women were higher than those of EOP women. LOP presented less severe symptoms, and higher scores in processing speed and premorbid IQ than EOP patients. Cannabis and alcohol use were also more frequent in EOP than LOP women. ![]()
Conclusions Women with EOP and LOP show several sociodemographic, neuropsychological and clinical differences which may be valuable for planning personalized treatment emphasizing in socialization and differential generational dynamics. Some of these differences may be due to the aging process, while others might be influenced by factors such as lack of estrogen neuroprotection. In turn, drug consumption, low IQ and recent experienced trauma could as well reduce efficacy of hormonal neuroprotection. Disclosure No significant relationships.
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Murillo-García N, Soler J, Fatjó-Vilas M, Ayesa-Arriola R. Family aggregation of the Intelligence Quotient: understanding its role in first episode of psychosis. Eur Psychiatry 2022. [PMCID: PMC9564031 DOI: 10.1192/j.eurpsy.2022.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
The familiality of intelligence quotient (IQ), understood as its similarity among family members, might be related to different manifestations in first episode of psychosis (FEP) patients. Objectives To estimate the IQ familiality through the intra-family resemblance score (IRS) in FEP patients and their unaffected first-degree relatives; and to analyze if the deviation from the family-IQ is related to the patients’ premorbid, clinical and cognitive characteristics. Methods Individuals from 129 families participated in this study (129 patients, 143 parents, 97 siblings). For each family, two values were estimated: the family-IQ, obtained by the mean IQ of the patient and his/her relatives (using the WAIS vocabulary subtest); and the IRS, an index previously reported that indicate intra-family heterogeneity (IRS<0) or homogeneity (IRS>0) for a given trait. According to the IRS and the family-IQ, patients were assigned to 6 groups (Figure 1). Results FEP patients in families with heterogeneous IQ (IRS<0) had a significantly lower IQ than their relatives (p<0.001). Also, those with low IQ and from heterogeneous families had poorer childhood adjustment (p=0.001). The patients with high IQ belonging to homogenous families showed less positive symptoms at baseline (p=0.009). FEP patients in homogenous families due to low IQ evidenced the lowest neuropsychological performance (Figure 2). ![]()
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Conclusions
The analysis of the IQ familiality and the concordance/discordance of the patients’ and relatives’ IQ, offers a new approach for the characterization of different premorbid, clinical and cognitive profiles in FEP patients. The relationship between deviation from the family-IQ and poor premorbid childhood adjustment supports the neurodevelopmental hypothesis of schizophrenia. Disclosure No significant relationships.
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Castro Quintas Á, San Martín N, De Las Cuevas I, Eixarch E, Daura-Corral M, Lopez M, De La Fuente Tomas L, Garcia-Portilla M, Fañanas L, Ayesa-Arriola R. The impact of maternal SARS-COV-2 infection in early stages of newborn neurodevelopment: preliminary results in a multicenter Spanish study. Eur Psychiatry 2022. [PMCID: PMC9564262 DOI: 10.1192/j.eurpsy.2022.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction
The consequences for the COVID-19 pandemic in the newborns of affected mothers remains unknown. Previous clinical experiences with other infections during pregnancy lead to considered pregnant women and their offspring especially vulnerable for SARS-COV-2. That is, the underlying physiopathological changes caused by the infection (e.g. storm of cytokines, micro-coagulation in placenta or vertical transmission) could clearly compromise fetal neurodevelopment. Objectives To analyze the impact of maternal SARS-COV-2 infection during pregnancy in early neurodevelopment of infants gestated during the COVID-19 pandemic period compared to those gestated immediately prior (2017-2021). Methods
212 pregnant women (14% infected) were followed throughout their pregnancy and postpartum, including newborn development. SARS-COV-2 infection was serologically confirmed during pregnancy. The Brazelton Neonatal Assessment Scale (NBAS) was administered at 6 weeks old by a trained neonatologist to evaluate neurological, social and behavioral aspects of newborn’s functioning. Differences in NBAS scores between cases and controls were tested by ANOVAs. All the analysis were adjusted for maternal age, sociodemographic status, anxious-depressive symptomatology, infant’s sex and gestational age at birth and NBAS, and for the period of gestation (previous or during COVID-19 pandemic). Results NBAS social interactive dimension was significantly decreased in those infants exposed to prenatal SARS-COV-2 (F=4.248, p=.043), particularly when the infection occurred before the week 20 of gestation. Gestation during COVID-19 pandemic did not alter NBAS subscales. Conclusions SARS-COV-2 infection during pregnancy seems to be associated with lower NBAS scores on social dimension in 6 weeks old exposed newborns. Disclosure No significant relationships.
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Ayesa-Arriola R, Murillo-García N, Díaz-Pons A, Miguel-Corredera M, Barrio-Martínez S, Ortiz-García De La Foz V. A family study on first episode of psychosis patients: exploring neuropsychological performance as an endophenotype. Eur Psychiatry 2022. [PMCID: PMC9567453 DOI: 10.1192/j.eurpsy.2022.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Family studies provide the opportunity to investigate endophenotypes as a powerful neurobiological platform to better understand the underlying neurobiological mechanisms of schizophrenia spectrum disorders. Shared features between the patients and their first-degree relatives may shed some light on the path to identify potential causes of psychosis, and to implement preventive and therapeutic interventions.
Objectives
This study aimed to explore and compare neuropsychological measures in first episodes of psychosis (FEP) patients, their first-degree relatives and healthy controls (HC), participants on the PAFIP-FAMILIES project.
Methods
Statistical analyses were performed using one-way ANOVA, followed by multiple comparisons test where appropriate. Age, sex and years of education were introduced as covariates.
Results
From 387 eligible FEP patients enrolled in a previous cohort, 133 were included. In addition, 244 of their first-degree relatives (146 parents and 98 siblings) and 202 HC participated in this study (see Figure 1). In general, relatives showed an intermediate neuropsychological performance between the HC and the FEP patients (see Figure 2). Specifically, siblings performed similar to HC in the domains verbal memory, visual memory, working memory, motor dexterity and theory of mind, since their values practically overlap those of HC. The parents presented significant deficits, similar to that of the affected individuals, in executive functions and attention domains.
Conclusions
These findings suggest that executive and attention dysfunction might have a greater family aggregation and could be a relevant cognitive endophenotype for psychotic disorders. The study shows the potential of exploring intra-family neuropsychological performance supporting neurobiological and genetic research in schizophrenia.
Disclosure
No significant relationships.
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López-Díaz Á, Ayesa-Arriola R, Garrido-Torres N, Otíz-García de la Foz V, Suárez-Pinilla P, Ramírez-Bonilla ML, Vázquez-Bourgon J, Ruiz-Veguilla M, Crespo-Facorro B. A proxy measure of premorbid adjustment in psychosis for large-scale epidemiological studies and electronic health record-based research. Schizophr Res 2022; 243:467-469. [PMID: 35288002 DOI: 10.1016/j.schres.2022.02.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/18/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022]
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Setién-Suero E, Murillo-García N, Sevilla-Ramos M, Abreu-Fernández G, Pozueta A, Ayesa-Arriola R. Exploring the Relationship Between Deficits in Social Cognition and Neurodegenerative Dementia: A Systematic Review. Front Aging Neurosci 2022; 14:778093. [PMID: 35572150 PMCID: PMC9093607 DOI: 10.3389/fnagi.2022.778093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundNeurodegenerative diseases might affect social cognition in various ways depending on their components (theory of mind, emotional processing, attribution bias, and social perception) and the subtype of dementia they cause. This review aims to explore this difference in cognitive function among individuals with different aetiologies of dementia.MethodsThe following databases were explored: MEDLINE via PubMed, Cochrane Library, Lilacs, Web of Science, and PsycINFO. We selected studies examining social cognition in individuals with neurodegenerative diseases in which dementia was the primary symptom that was studied. The neurodegenerative diseases included Alzheimer's disease, Lewy body disease and frontotemporal lobar degeneration. The search yielded 2,803 articles.ResultsOne hundred twenty-two articles were included in the present review. The summarised results indicate that people with neurodegenerative diseases indeed have deficits in social cognitive performance. Both in populations with Alzheimer's disease and in populations with frontotemporal dementia, we found that emotional processing was strongly affected. However, although theory of mind impairment could also be observed in the initial stages of frontotemporal dementia, in Alzheimer's disease it was only appreciated when performing highly complex task or in advanced stages of the disease.ConclusionsEach type of dementia has a differential profile of social cognition deterioration. This review could provide a useful reference for clinicians to improve detection and diagnosis, which would undoubtedly guarantee better interventions.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020152562, PROSPERO, identifier: CRD42020152562.
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