151
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Zhu Y, Womer FY, Leng H, Chang M, Yin Z, Wei Y, Zhou Q, Fu S, Deng X, Lv J, Song Y, Ma Y, Sun X, Bao J, Wei S, Jiang X, Tan S, Tang Y, Wang F. The Relationship Between Cognitive Dysfunction and Symptom Dimensions Across Schizophrenia, Bipolar Disorder, and Major Depressive Disorder. Front Psychiatry 2019; 10:253. [PMID: 31105603 PMCID: PMC6498739 DOI: 10.3389/fpsyt.2019.00253] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/02/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Cognitive dysfunction is considered a core feature among schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD). Despite abundant literature comparing cognitive dysfunction among these disorders, the relationship between cognitive dysfunction and symptom dimensions remains unclear. The study aims are a) to identify the factor structure of the BPRS-18 and b) to examine the relationship between symptom domains and cognitive function across SZ, BD, and MDD. Methods: A total of 716 participants [262 with SZ, 104 with BD, 101 with MDD, and 249 healthy controls (HC)] were included in the study. One hundred eighty participants (59 with SZ, 23 with BD, 24 with MDD, and 74 HC) completed the MATRICS Consensus Cognitive Battery (MCCB), and 507 participants (85 with SZ, 89 with BD, 90 with MDD, and 243 HC) completed the Wisconsin Card Sorting Test (WCST). All patients completed the Brief Psychiatric Rating Scale (BPRS). Results: We identified five BPRS exploratory factor analysis (EFA) factors ("affective symptoms," "psychosis," "negative/disorganized symptoms," "activation," and "noncooperation") and found cognitive dysfunction in all of the participant groups with psychiatric disorders. Negative/disorganized symptoms were the most strongly associated with cognitive dysfunctions across SZ, BD, and MDD. Conclusions: Our findings suggest that cognitive dysfunction severity relates to the negative/disorganized symptom domain across SZ, BD, and MDD, and negative/disorganized symptoms may be an important target for effective cognitive remediation in SZ, BD, and MDD.
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Affiliation(s)
- Yue Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fay Y Womer
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
| | - Haixia Leng
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Miao Chang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhiyang Yin
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yange Wei
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Qian Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Shanghai Mental Health Center, Shanghai, China
| | - Shinan Fu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xin Deng
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Lv
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yanzhuo Song
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yinzhu Ma
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xinyu Sun
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Bao
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Shengnan Wei
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaowei Jiang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Shuping Tan
- Center for Psychiatric Research, Beijing Huilongguan Hospital, Beijing, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
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152
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Pu S, Noda T, Setoyama S, Nakagome K. Empirical evidence for discrete neurocognitive subgroups in patients with non-psychotic major depressive disorder: clinical implications. Psychol Med 2018; 48:2717-2729. [PMID: 29679991 DOI: 10.1017/s003329171800034x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Neuropsychological deficits are present across various cognitive domains in major depressive disorder (MDD). However, a consistent and specific profile of neuropsychological abnormalities has not yet been established. METHODS We assessed cognition in 170 patients with non-psychotic MDD using the Brief Assessment of Cognition in Schizophrenia and the scores were compared with those of 42 patients with schizophrenia as a reference for severity of cognitive impairment. Hierarchical cluster analysis was conducted to determine whether there are discrete neurocognitive subgroups in MDD. We then compared the subgroups in terms of several clinical factors and social functioning. RESULTS Three distinct neurocognitive subgroups were found: (1) a mild impairment subgroup with near-normative performance and mild dysfunction in motor speed; (2) a selective impairment subgroup, which exhibited preserved working memory and executive function, but moderate to severe deficits in verbal memory, motor speed, verbal fluency, and attention/information processing speed; and (3) a global impairment subgroup with moderate to severe deficits across all neurocognitive domains, comparable with deficits in schizophrenia. The global impairment subgroup was characterized by lower pre-morbid intelligence quotient (IQ). Moreover, a significant difference between groups was observed in premorbid IQ (p = 0.003), antidepressant dose (p = 0.043), antipsychotic dose (p = 0.013), or anxiolytic dose (p < 0.001). CONCLUSIONS These results suggest the presence of multiple neurocognitive subgroups in non-psychotic MDD with unique profiles, one of which exhibits deficits comparable to those of schizophrenia. The results of the present study may help guide future efforts to target these disabling symptoms using different treatments.
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Affiliation(s)
- Shenghong Pu
- Integrative Brain Imaging Center,National Center Hospital,National Center of Neurology and Psychiatry,4-1-1 Ogawa-Higashi,Kodaira,Tokyo 187-8551,Japan
| | - Takamasa Noda
- Integrative Brain Imaging Center,National Center Hospital,National Center of Neurology and Psychiatry,4-1-1 Ogawa-Higashi,Kodaira,Tokyo 187-8551,Japan
| | - Shiori Setoyama
- Department of Psychiatry,National Center Hospital,National Center of Neurology and Psychiatry,4-1-1 Ogawa-Higashi,Kodaira,Tokyo 187-8551,Japan
| | - Kazuyuki Nakagome
- National Institute of Mental Health,National Center of Neurology and Psychiatry,4-1-1 Ogawa-Higashi,Kodaira,Tokyo 187-8551,Japan
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153
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Culbreth AJ, Foti D, Barch DM, Hajcak G, Kotov R. Electrocortical Responses to Emotional Stimuli in Psychotic Disorders: Comparing Schizophrenia Spectrum Disorders and Affective Psychosis. Front Psychiatry 2018; 9:586. [PMID: 30505284 PMCID: PMC6250820 DOI: 10.3389/fpsyt.2018.00586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/25/2018] [Indexed: 12/12/2022] Open
Abstract
Emotion dysfunction has long been considered a cardinal feature across psychotic disorders, including schizophrenia and affective psychosis. However, few studies have used objective markers of emotional function to compare psychotic disorders to one another, and fewer studies have examined such markers within a longitudinal framework. Here, we examine one objective marker of emotional responsivity, the late positive potential (LPP), which is a centro-parietal event-related potential (ERP) that tracks the dynamic allocation of attention to emotional vs. neutral stimuli. We used the LPP to characterize abnormal emotional responsivity by relating it to negative, depressive, and psychotic symptoms among two clinical groups: individuals diagnosed with affective psychosis and individuals with schizophrenia. We also used a long-term longitudinal framework, examining concurrent associations between LPP amplitude and symptom severity, as well as prospective associations with symptoms 4 years later. Participants were 74 individuals with psychotic illness: 37 with schizophrenia spectrum disorders and 37 with a primary affective disorder (psychotic bipolar disorder, psychotic depression). There were no mean-level differences in LPP amplitude between the schizophrenia spectrum and primary affective psychosis group. In the primary affective psychosis group, reduced LPP amplitude was associated with greater depressive, negative, and psychotic symptom severity, both concurrently and at follow-up; associations between LPP and symptoms were not observed within the schizophrenia spectrum group. This pattern of results suggests that the neural correlates of emotion dysfunction may differ across psychotic disorders. One possibility is that schizophrenia is characterized by a decoupling of symptom severity and emotional processing. Such findings underscore the importance of analyzing transdiagnostic samples to determine common or specific symptom relationships across various patient populations.
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Affiliation(s)
- Adam J. Culbreth
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, Saint Louis, MO, United States
| | - Dan Foti
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, United States
| | - Deanna M. Barch
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, Saint Louis, MO, United States
- Departments of Psychiatry and Radiology, Washington University in Saint Louis, Saint Louis, MO, United States
| | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States
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154
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Setién-Suero E, Martínez-García O, de la Foz VOG, Vázquez-Bourgon J, Correa-Ghisays P, Ferro A, Crespo-Facorro B, Ayesa-Arriola R. Age of onset of Cannabis use and cognitive function in first-episode non-affective psychosis patients: Outcome at three-year follow-up. Schizophr Res 2018; 201:159-166. [PMID: 29861266 DOI: 10.1016/j.schres.2018.05.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/04/2018] [Accepted: 05/26/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND In recent years, the effects of cannabis use on cognitive functions in patients with psychosis have been widely studied. Recently, special emphasis has been placed on the impact of age at the onset of consumption on cognition in these patients. METHOD 349 patients with a first episode of non-affective psychosis were studied. Patients were classified as cannabis users and non-users. Users were divided, according to their age when they began using cannabis, into: early-onset (age < 16) and late-onset (age ≥ 16) users. Differences between groups at baseline were studied based on sociodemographic, clinical, and cognitive variables. The groups were longitudinally (3-year) compared on cognitive variables. RESULTS Out of the 349 patients included in this study, 38.7% (N = 135) were cannabis users. Of them, 39.3% (N = 53) were early-onset and 60.7% (N = 82) were late-onset cannabis users. No baseline differences were found between the early-onset and late-onset groups on cognitive domains. Longitudinally, only patients who had withdrawn from cannabis use during follow-up showed a significant improvement in verbal memory. CONCLUSION Our results did not show differences between the early-onset group and the other two groups in long-term cognitive performance, even if they kept consuming cannabis during the first three years of disease progression. Further studies are needed to elucidate the true relationship between early-onset cannabis use and cognitive function in patients with a first episode of psychosis.
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Affiliation(s)
- Esther Setién-Suero
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain.
| | - Obdulia Martínez-García
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Víctor Ortiz-García de la Foz
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Javier Vázquez-Bourgon
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Patricia Correa-Ghisays
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Adele Ferro
- Department of Pathophysiology and Transplantation, Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Benedicto Crespo-Facorro
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Rosa Ayesa-Arriola
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain
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155
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Chung DW, Chung Y, Bazmi HH, Lewis DA. Altered ErbB4 splicing and cortical parvalbumin interneuron dysfunction in schizophrenia and mood disorders. Neuropsychopharmacology 2018; 43:2478-2486. [PMID: 30120408 PMCID: PMC6180093 DOI: 10.1038/s41386-018-0169-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/28/2018] [Accepted: 07/25/2018] [Indexed: 01/01/2023]
Abstract
Working memory requires the activity of parvalbumin (PV) interneurons in the dorsolateral prefrontal cortex (DLPFC). Impaired working memory and lower PV expression in the DLPFC are reported in schizophrenia and to a lesser degree in mood disorders. We previously proposed that activity-dependent PV expression is lower in schizophrenia due to a shift in the splicing of erb-b2 receptor tyrosine kinase 4 (ErbB4) transcripts from major to inactive minor variants that reduces excitatory drive to PV interneurons. Here, we tested the hypothesis that the degree of major-to-minor shift in ErbB4 splicing predicts the level of PV expression across schizophrenia and mood disorders. Levels of ErbB4 splice variants and PV mRNA were quantified by PCR in the DLPFC from 40 matched tetrads (N = 160 subjects) of schizophrenia, bipolar disorder (BD), major depressive disorder (MDD), and unaffected comparison subjects. Relative to unaffected comparison subjects, the magnitude of increases in minor variant levels and decreases in major variant levels was greatest in schizophrenia, intermediate in BD, and least in MDD. The same rank order was present for the magnitude of increases in the composite splicing score, which reflects the degree of major-to-minor shift across all ErbB4 splice loci, and for the magnitude of deficient PV expression. Finally, the composite splicing score negatively predicted PV expression across all subject groups. Together, these findings demonstrate a shared relationship between ErbB4 splicing and PV expression and suggest that scaling of the major-to-minor shift in ErbB4 splicing may influence the severity of deficient PV interneuron activity across diagnoses.
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Affiliation(s)
- Daniel W Chung
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Youjin Chung
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, NY, 14260, USA
| | - H Holly Bazmi
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - David A Lewis
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
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156
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Gill SK, Gomez RG, Keller J, Schatzberg AF. Diagnostic differences in verbal learning strategies and verbal memory in patients with mood disorders and psychotic disorders. Psychiatry Res 2018; 269:733-739. [PMID: 30273898 DOI: 10.1016/j.psychres.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 08/30/2018] [Accepted: 09/03/2018] [Indexed: 11/28/2022]
Abstract
A better understanding of verbal learning strategies can offer insight to the difference in verbal memory performance and learning between patients with schizophrenia and schizoaffective disorders, non-psychotic major depression, and psychotic major depression. To date, a comparison of the use of verbal learning strategies and verbal memory performance amongst these specific diagnostic groups has not been investigated. This study examined differences in verbal learning and memory between psychotic major depression (n = 31), nonpsychotic major depression (n = 30), and schizophrenia spectrum disorders (n = 17) disorders. Verbal learning and memory were assessed through the use of the California Verbal Learning Test-II (CVLT-II). Correlations and multiple regression analyses were conducted to analyze differences in verbal learning and memory amongst these groups. There were no significant differences in the use of Semantic Clustering. Diagnostic differences were observed in the use of Serial and Subjective Clustering. The psychotic major depression group utilized Serial Clustering strategy significantly less than the nonpsychotic major depression group. Learning strategies significantly predicted learning and recall. These findings lend support to the hypothesis that learning strategies predict verbal memory performance across diagnostic groups. The present study contains useful information on diagnostic differences in verbal learning and memory, and a framework by which treatment could be tailored to enhance learning specific to these diagnostic groups.
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Affiliation(s)
- Supria K Gill
- Pacific Graduate School of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304, United States.
| | - Rowena G Gomez
- Pacific Graduate School of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304, United States; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5723, United States
| | - Jennifer Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5723, United States
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5723, United States
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157
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Rey R, Chauvet-Gelinier JC, Suaud-Chagny MF, Ragot S, Bonin B, d'Amato T, Teyssier JR. Distinct Expression Pattern of Epigenetic Machinery Genes in Blood Leucocytes and Brain Cortex of Depressive Patients. Mol Neurobiol 2018; 56:4697-4707. [PMID: 30377985 PMCID: PMC6647377 DOI: 10.1007/s12035-018-1406-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/24/2018] [Indexed: 12/25/2022]
Abstract
In major depressive disorder (MDD), altered gene expression in brain cortex and blood leucocytes may be due to aberrant expression of epigenetic machinery coding genes. Here, we explore the expression of these genes both at the central and peripheral levels. Using real-time quantitative PCR technique, we first measured expression levels of genes encoding DNA and histone modifying enzymes in the dorsolateral prefrontal cortex (DLPFC) and cingulate cortex (CC) of MDD patients (n = 24) and healthy controls (n = 12). For each brain structure, transcripts levels were compared between subject groups. In an exploratory analysis, we then compared the candidate gene expressions between a subgroup of MDD patients with psychotic characteristics (n = 13) and the group of healthy subjects (n = 12). Finally, we compared transcript levels of the candidate genes in blood leucocytes between separate samples of MDD patients (n = 17) and healthy controls (n = 16). In brain and blood leucocytes of MDD patients, we identified an overexpression of genes encoding enzymes which transfer repressive transcriptional marks: HDAC4-5-6-8 and DNMT3B in the DLPFC, HDAC2 in the CC and blood leucocytes. In the DLPFC of patients with psychotic characteristics, two genes (KAT2A and UBE2A) were additionally overexpressed suggesting a shift to a more transcriptionally permissive conformation of chromatin. Aberrant activation of epigenetic repressive systems may be involved in MDD pathogenesis both in brain tissue and blood leucocytes.
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Affiliation(s)
- Romain Rey
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, F-69000, Lyon, France. .,University Lyon 1, F-69000, Villeurbanne, France. .,Schizophrenia Expert Centre, Le Vinatier Hospital, Bron, France. .,INSERM U1028; CNRS UMR5292; Université Claude Bernard Lyon 1; Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2; Centre Hospitalier Le Vinatier, Pole Est, Centre Expert Schizophrénie, 95 boulevard Pinel BP 30039, 69678, Bron Cedex, France.
| | - Jean-Christophe Chauvet-Gelinier
- Psychiatry Unit, Neurosciences Department, Le Bocage University Hospital, Marion Building, Dijon, France.,Laboratory of Psychopathology and Medical Psychology (IFR 100), Bourgogne University, Dijon, France
| | - Marie-Françoise Suaud-Chagny
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, F-69000, Lyon, France.,University Lyon 1, F-69000, Villeurbanne, France.,Schizophrenia Expert Centre, Le Vinatier Hospital, Bron, France
| | - Sylviane Ragot
- Department of Genetics and Laboratory of Molecular Genetics, University Hospital, Dijon, France
| | - Bernard Bonin
- Psychiatry Unit, Neurosciences Department, Le Bocage University Hospital, Marion Building, Dijon, France.,Laboratory of Psychopathology and Medical Psychology (IFR 100), Bourgogne University, Dijon, France
| | - Thierry d'Amato
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, F-69000, Lyon, France.,University Lyon 1, F-69000, Villeurbanne, France.,Schizophrenia Expert Centre, Le Vinatier Hospital, Bron, France
| | - Jean-Raymond Teyssier
- Department of Genetics and Laboratory of Molecular Genetics, University Hospital, Dijon, France
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158
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Sheffield JM, Karcher NR, Barch DM. Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective. Neuropsychol Rev 2018; 28:509-533. [PMID: 30343458 DOI: 10.1007/s11065-018-9388-2] [Citation(s) in RCA: 297] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/15/2018] [Indexed: 12/15/2022]
Abstract
Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated with the experience of psychosis. These impairments negatively impact functional outcome, contributing to the disabling nature of schizophrenia, bipolar disorder, and psychotic depression. The robust and reliable nature of cognitive deficits has led researchers to explore the timing and profile of impairments, as this may elucidate different neurodevelopmental patterns in individuals who experience psychosis. Here, we review the literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences, highlighting the dimensional nature of both psychosis and cognitive ability. We identify premorbid generalized cognitive impairment in schizophrenia that worsens throughout development, and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course. Research in affective psychosis is less clear, with mixed evidence regarding premorbid deficits, but a fairly reliable generalized deficit at first-episode, which appears to worsen into the chronic state. In general, cognitive impairments are most severe in schizophrenia, intermediate in bipolar disorder, and the least severe in psychotic depression. In all groups, cognitive deficits are associated with poorer functional outcome. Finally, while the generalized deficit is the clearest and most reliable signal, data suggests specific deficits in verbal memory across all groups, specific processing speed impairments in schizophrenia and executive functioning impairments in bipolar disorder. Cognitive deficits are a core feature of psychotic disorders that provide a window into understanding developmental course and risk for psychosis.
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Affiliation(s)
- Julia M Sheffield
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Nashville, TN, 37212, USA.
| | - Nicole R Karcher
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
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159
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Bjoerke-Bertheussen J, Schoeyen H, Andreassen OA, Malt UF, Oedegaard KJ, Morken G, Sundet K, Vaaler AE, Auestad B, Kessler U. Right unilateral electroconvulsive therapy does not cause more cognitive impairment than pharmacologic treatment in treatment-resistant bipolar depression: A 6-month randomized controlled trial follow-up study. Bipolar Disord 2018; 20:531-538. [PMID: 29267990 DOI: 10.1111/bdi.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/13/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Electroconvulsive therapy is an effective treatment for bipolar depression, but there are concerns about whether it causes long-term neurocognitive impairment. METHODS In this multicenter randomized controlled trial, in-patients with treatment-resistant bipolar depression were randomized to either algorithm-based pharmacologic treatment or right unilateral electroconvulsive therapy. After the 6-week treatment period, all of the patients received maintenance pharmacotherapy as recommended by their clinician guided by a relevant treatment algorithm. Patients were assessed at baseline and at 6 months. Neurocognitive functions were assessed using the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery, and autobiographical memory consistency was assessed using the Autobiographical Memory Interview-Short Form. RESULTS Seventy-three patients entered the trial, of whom 51 and 26 completed neurocognitive assessments at baseline and 6 months, respectively. The MATRICS Consensus Cognitive Battery composite score improved by 4.1 points in both groups (P = .042) from baseline to 6 months (from 40.8 to 44.9 and from 41.9 to 46.0 in the algorithm-based pharmacologic treatment and electroconvulsive therapy groups, respectively). The Autobiographical Memory Interview-Short Form consistency scores were reduced in both groups (72.3% vs 64.3% in the algorithm-based pharmacologic treatment and electroconvulsive therapy groups, respectively; P = .085). CONCLUSIONS This study did not find that right unilateral electroconvulsive therapy caused long-term impairment in neurocognitive functions compared to algorithm-based pharmacologic treatment in bipolar depression as measured using standard neuropsychological tests, but due to the low number of patients in the study the results should be interpreted with caution. TRIAL REGISTRATION ClinicalTrials.gov: NCT00664976.
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Affiliation(s)
| | - Helle Schoeyen
- Department of Psychiatry, Helse Stavanger, Stavanger Universitetssjukehus, Stavanger, Norway
| | | | - Ulrik F Malt
- Department of Neuropsychiatry and Psychosomatic Medicine, University of Oslo, Oslo, Norway
| | - Ketil J Oedegaard
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Gunnar Morken
- Sankt Olavs Hospital Universitetssykehuset i Trondheim, Trondheim, Norway
| | - Kjetil Sundet
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Arne E Vaaler
- Sankt Olavs Hospital Universitetssykehuset i Trondheim, Trondheim, Norway
| | | | - Ute Kessler
- Haukeland Universitetssjukehus, Bergen, Norway
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160
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Eisenacher S, Rausch F, Ainser F, Englisch S, Becker A, Mier D, Fenske S, Meyer-Lindenberg A, Kirsch P, Zink M. Early cognitive basic symptoms are accompanied by neurocognitive impairment in patients with an 'at-risk mental state' for psychosis. Early Interv Psychiatry 2018; 12:586-595. [PMID: 27169782 DOI: 10.1111/eip.12350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 01/15/2016] [Accepted: 03/28/2016] [Indexed: 11/29/2022]
Abstract
AIM Patients with an increased risk for psychosis ('at-risk mental state' (ARMS)) present various neurocognitive deficits. Not least because of differences in identifying the ARMS, results of previous studies are inconsistent. In most studies ARMS-patients are classified by the experience of attenuated psychotic symptoms (APS) and/or brief limited intermittent psychotic symptoms (BLIPS). Few studies additionally assessed cognitive basic symptoms (BS). A comprehensive assessment in the very early stage of the ARMS is missing. METHODS In the present study we characterized ARMS-patients for cognitive BS (ARMS-BS), APS and BLIPS (ARMS-A/B) according to the Early Recognition Inventory based on IRAOS (ERIraos). Furthermore, we assessed neurocognitive deficits using the MATRICS consensus cognitive battery for schizophrenia with a primary hypothesis regarding working memory performance. Groups of 38 ARMS-patients and 38 healthy controls were matched for age, gender, education and premorbid verbal intelligence. RESULTS Between-group comparisons revealed significant poorer working memory performance in addition to lower verbal learning and problem solving, slower processing speed and lower global neurocognitive functioning in ARMS-patients as compared to controls. ARMS-BS did not differ from ARMS-A/B. CONCLUSIONS These results underscore the presence of cognitive limitations in patients only presenting with cognitive BS. Knowledge of these early cognitive deviations supports the inclusion of early ARMS-stages into a comprehensive concept of the psychosis risk state. Therapeutic interventions already applied at this stage might prevent deterioration of constraints. Longitudinal and interventional studies investigating the interaction of cognitive BS and neurocognitive as well as metacognitive deficits are warranted.
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Affiliation(s)
- Sarah Eisenacher
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Germany
| | - Franziska Rausch
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Germany
| | - Fabian Ainser
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Germany
| | - Susanne Englisch
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Germany
| | - Anna Becker
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Germany
| | - Daniela Mier
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Sabrina Fenske
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | | | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Mathias Zink
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Germany
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161
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Roux P, Urbach M, Fonteneau S, Berna F, Brunel L, Capdevielle D, Chereau I, Dubreucq J, Faget-Agius C, Fond G, Leignier S, Perier CC, Richieri R, Schneider P, Schürhoff F, Tronche AM, Yazbek H, Zinetti-Bertschy A, Passerieux C, Brunet-Gouet E. Screening for cognitive deficits with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale. Clin Rehabil 2018; 33:113-119. [PMID: 30012064 DOI: 10.1177/0269215518787324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE: This study aimed to evaluate the validity of the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale (ECPDS) to discriminate for cognitive impairment in schizophrenia. DESIGN: This multicentre cross-sectional study used a validation design with receiver operating characteristic (ROC) curve analysis. SETTINGS: The study was undertaken in a French network of seven outward referral centres. SUBJECTS: We recruited individuals with clinically stable schizophrenia diagnosed based on the Structured Clinical Interview for assessing Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; DSM-IV-R) criteria. MAIN MEASURES: The index test for cognitive impairment was ECPDS (independent variable), a 13-item scale completed by a relative of the participant. The reference standard was a standardized test battery that evaluated seven cognitive domains. Cognitive impairment was the dependent variable and was defined as an average z-score more than 1 SD below the normative mean in two or more cognitive domains. RESULTS: Overall, 97 patients were included (67 with schizophrenia, 28 with schizoaffective disorder, and 2 with schizophreniform disorder). The mean age was 30.2 (SD 7.7) years, and there were 75 men (77.3%). There were 59 (60.8%) patients with cognitive impairment on the neuropsychological battery, and the mean ECPDS score was 27.3 (SD 7.3). The ROC curve analysis showed that the optimal ECPDS cut-off was 29.5. The area under the curve was 0.77, with 76.3% specificity and 71.1% sensitivity to discriminate against cognitive impairment. CONCLUSION: The ECPDS is a valid triage tool for detecting cognitive impairment in schizophrenia, before using an extensive neuropsychological battery, and holds promise for use in everyday clinical practice.
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Affiliation(s)
- Paul Roux
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Mathieu Urbach
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Sandrine Fonteneau
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Fabrice Berna
- 1 Fondation FondaMental, Créteil, France.,4 Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, University of Strasbourg, Strasbourg, France
| | - Lore Brunel
- 1 Fondation FondaMental, Créteil, France.,5 INSERM U955, Translational Psychiatry Team, Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY, Department of Adult Psychiatry, Henri Mondor University Hospitals, Créteil, France
| | - Delphine Capdevielle
- 1 Fondation FondaMental, Créteil, France.,6 University Department of Adult Psychiatry, La Colombière Hospital, CHU Montpellier, University of Montpellier 1, INSERM 1061, Montpellier, France
| | - Isabelle Chereau
- 1 Fondation FondaMental, Créteil, France.,7 CMP B, Clermont-Ferrand University Hospital, EA 7280, Faculty of Medicine, Auvergne University, Clermont-Ferrand Cedex 1, France
| | - Julien Dubreucq
- 1 Fondation FondaMental, Créteil, France.,8 Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Catherine Faget-Agius
- 1 Fondation FondaMental, Créteil, France.,9 Academic Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | | | - Sylvain Leignier
- 1 Fondation FondaMental, Créteil, France.,8 Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Claire-Cécile Perier
- 1 Fondation FondaMental, Créteil, France.,8 Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Raphaëlle Richieri
- 1 Fondation FondaMental, Créteil, France.,9 Academic Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | - Priscille Schneider
- 1 Fondation FondaMental, Créteil, France.,4 Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, University of Strasbourg, Strasbourg, France
| | - Franck Schürhoff
- 1 Fondation FondaMental, Créteil, France.,5 INSERM U955, Translational Psychiatry Team, Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY, Department of Adult Psychiatry, Henri Mondor University Hospitals, Créteil, France
| | - Anne Marie Tronche
- 1 Fondation FondaMental, Créteil, France.,7 CMP B, Clermont-Ferrand University Hospital, EA 7280, Faculty of Medicine, Auvergne University, Clermont-Ferrand Cedex 1, France
| | - Hanan Yazbek
- 1 Fondation FondaMental, Créteil, France.,6 University Department of Adult Psychiatry, La Colombière Hospital, CHU Montpellier, University of Montpellier 1, INSERM 1061, Montpellier, France
| | - Anna Zinetti-Bertschy
- 1 Fondation FondaMental, Créteil, France.,4 Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, University of Strasbourg, Strasbourg, France
| | | | - Christine Passerieux
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Eric Brunet-Gouet
- 1 Fondation FondaMental, Créteil, France.,2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France.,3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
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162
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Ayesa-Arriola R, Setién-Suero E, Neergaard KD, Belzunces ÀA, Contreras F, van Haren NEM, Crespo-Facorro B. Premorbid IQ subgroups in first episode non affective psychosis patients: Long-term sex differences in function and neurocognition. Schizophr Res 2018; 197:370-377. [PMID: 29275855 DOI: 10.1016/j.schres.2017.12.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/07/2017] [Accepted: 12/13/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Low IQ has been associated with schizophrenia, even to the point of being posited as a possible causal factor for psychosis. However, individuals with normal and high IQ also develop psychotic illnesses. The aim of this study was to characterize premorbid IQ subgroups at first episode of psychosis (FEP). METHODS The study sample comes from a large epidemiological, 3-year longitudinal, intervention program on psychosis containing individuals living in a catchment area in Spain. Estimated premorbid IQ (epIQ) scores were used to build low (<90), normal (90-110) and high (>110) epIQ subgroups in samples of FEP patients (N=292) and healthy controls (N=199). The epIQ subgroups were compared in sociodemographic, neuropsychological, clinical and premorbid characteristics. Long-term functional and cognitive outcome, with a focus on sex differences, were also explored. RESULTS Low-epIQ was more frequently found in FEP patients (28.8%) than in healthy controls (14.6%). Low-epIQ patients were more likely to have worse premorbid adjustment, belong to low socioeconomic status families, have less years of education, and to be single, unemployed, and younger. They presented more severe impairments in processing speed, executive and global cognitive function. Female patients with low-epIQ showed better baseline function and more stable outcome than males. CONCLUSIONS Our results indicate that low premorbid IQ is a morbid manifestation, easily detected in a subgroup of FEP patients that predicts poorer outcome particularly in males. This perspective provides important information for the tailoring of subgroup-specific early intervention programs for psychosis.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Karl David Neergaard
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Àuria Albacete Belzunces
- Psychiatry Department, Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Fernando Contreras
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychiatry Department, Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Neeltje E M van Haren
- Brain Centre Rudolf Magnus, Department of Psychiatry, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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163
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Lynham AJ, Hubbard L, Tansey KE, Hamshere ML, Legge SE, Owen MJ, Jones IR, Walters JTR. Examining cognition across the bipolar/schizophrenia diagnostic spectrum. J Psychiatry Neurosci 2018; 43:245-253. [PMID: 29947606 PMCID: PMC6019354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/12/2017] [Accepted: 09/11/2017] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Cognitive impairments are well-established features of schizophrenia, but there is ongoing debate about the nature and degree of cognitive impairment in patients with schizoaffective disorder and bipolar disorder. We hypothesized that there is a spectrum of increasing impairment from bipolar disorder to schizoaffective disorder bipolar type, to schizoaffective disorder depressive type and schizophrenia. METHODS We compared performance on the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery between participants with schizophrenia (n = 558), schizoaffective disorder depressive type (n = 112), schizoaffective disorder type (n = 76), bipolar disorder (n = 78) and healthy participants (n = 103) using analysis of covariance with post hoc comparisons. We conducted an ordinal logistic regression to examine whether cognitive impairments followed the hypothesized spectrum from bipolar disorder (least severe) to schizophrenia (most severe). In addition to categorical diagnoses, we addressed the influence of symptom domains, examining the association between cognition and mania, depression and psychosis. RESULTS Cognitive impairments increased in severity from bipolar disorder to schizoaffective disorder bipolar type, to schizophrenia and schizoaffective disorder depressive type. Participants with schizophrenia and schizoaffective disorder depressive type showed equivalent performance (d = 0.07, p = 0.90). The results of the ordinal logistic regression were consistent with a spectrum of deficits from bipolar disorder to schizoaffective disorder bipolar type, to schizophrenia/schizoaffective disorder depressive type (odds ratio = 1.98, p < 0.001). In analyses of the associations between symptom dimensions and cognition, higher scores on the psychosis dimension were associated with poorer performance (B = 0.015, standard error = 0.002, p < 0.001). LIMITATIONS There were fewer participants with schizoaffective disorder and bipolar disorder than schizophrenia. Despite this, our analyses were robust to differences in group sizes, and we were able to detect differences between groups. CONCLUSION Cognitive impairments represent a symptom dimension that cuts across traditional diagnostic boundaries.
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Affiliation(s)
- Amy J Lynham
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Leon Hubbard
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Katherine E Tansey
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Marian L Hamshere
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Sophie E Legge
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Michael J Owen
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Ian R Jones
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - James T R Walters
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
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164
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Quidé Y, O'Reilly N, Watkeys OJ, Carr VJ, Green MJ. Effects of childhood trauma on left inferior frontal gyrus function during response inhibition across psychotic disorders. Psychol Med 2018; 48:1454-1463. [PMID: 28994360 DOI: 10.1017/s0033291717002884] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Childhood trauma is a risk factor for psychosis. Deficits in response inhibition are common to psychosis and trauma-exposed populations, and associated brain functions may be affected by trauma exposure in psychotic disorders. We aimed to identify the influence of trauma-exposure on brain activation and functional connectivity during a response inhibition task. METHODS We used functional magnetic resonance imaging to examine brain function within regions-of-interest [left and right inferior frontal gyrus (IFG), right dorsolateral prefrontal cortex, right supplementary motor area, right inferior parietal lobule and dorsal anterior cingulate cortex], during the performance of a Go/No-Go Flanker task, in 112 clinical cases with psychotic disorders and 53 healthy controls (HCs). Among the participants, 71 clinical cases and 21 HCs reported significant levels of childhood trauma exposure, while 41 clinical cases and 32 HCs did not. RESULTS In the absence of effects on response inhibition performance, childhood trauma exposure was associated with increased activation in the left IFG, and increased connectivity between the left IFG seed region and the cerebellum and calcarine sulcus, in both cases and healthy individuals. There was no main effect of psychosis, and no trauma-by-psychosis interaction for any other region-of-interest. Within the clinical sample, the effects of trauma-exposure on the left IFG activation were mediated by symptom severity. CONCLUSIONS Trauma-related increases in activation of the left IFG were not associated with performance differences, or dependent on clinical diagnostic status; increased IFG functionality may represent a compensatory (overactivation) mechanism required to exert adequate inhibitory control of the motor response.
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Affiliation(s)
- Y Quidé
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
| | - N O'Reilly
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
| | - O J Watkeys
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
| | - V J Carr
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
| | - M J Green
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
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165
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Canal-Rivero M, López-Moríñigo JD, Setién-Suero E, Ruiz-Veguilla M, Ayuso-Mateos JL, Ayesa-Arriola R, Crespo-Facorro B. Predicting suicidal behaviour after first episode of non-affective psychosis: The role of neurocognitive functioning. Eur Psychiatry 2018; 53:52-57. [PMID: 29929113 DOI: 10.1016/j.eurpsy.2018.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 06/06/2018] [Accepted: 06/09/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Suicide has been recognised as one of the major causes of premature death in psychosis. However, predicting suicidal behaviour (SB) is still challenging in the clinical setting and the association of neurocognition with SB in psychosis remains poorly understood. This study aimed to investigate the role of neurocognitive performance as predictor of SB. Also, we sought to explore differences in the evolution of clinical and neurocognitive functioning between participants with/without history of suicide attempts (SA) over follow-up period. METHODS The sample of the study is composed by 517 patients. Sociodemographic, clinical, functional and neurocognitive measures were evaluated at baseline as well as 1-year and 3 years after first episode of psychosis. Bivariate and multivariate analyses explored the influence of these variables as putative baseline predictors of SB. Repeated measures analyses of variance tested differences in clinical and neurocognitive outcomes at 1- and 3-year follow-up. RESULTS Global cognitive functioning (GCF) (OR = 1.83, 95% CI = 1.25-2.67) and severe depressive symptoms (OR = 1.17, 95% CI = 1.07-1.28) predicted SB. Longitudinal analyses revealed that patients with SB at follow-up presented with higher levels of remission in terms of positive psychotic symptoms and depression. In addition, those with a history of SB had worse GCF and visual memory than those without such antecedents. CONCLUSIONS GCF was found to be the most robust predictor of SB along with severe depressive symptomatology. Hence, poorer cognitive performance in FEP appears to emerge as a risk factor for suicidal behaviour from early stages of the illness and a comprehensive neurocognitive assessment may contribute to risk assessment.
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Affiliation(s)
- M Canal-Rivero
- Department of Psychiatry. Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - J D López-Moríñigo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - E Setién-Suero
- Department of Psychiatry. Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - M Ruiz-Veguilla
- Seville Biomedicine Institute Neurodevelopment and Psychosis Group (IBIS), Virgen del Rocío University Hospital, CSIC, University of Seville, UGC Mental Health HVR, Spain
| | - J L Ayuso-Mateos
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, Spain; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
| | - R Ayesa-Arriola
- Department of Psychiatry. Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - B Crespo-Facorro
- Department of Psychiatry. Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Harvey PD, Rosenthal JB. Cognitive and functional deficits in people with schizophrenia: Evidence for accelerated or exaggerated aging? Schizophr Res 2018; 196:14-21. [PMID: 28506706 DOI: 10.1016/j.schres.2017.05.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/05/2017] [Accepted: 05/07/2017] [Indexed: 10/19/2022]
Abstract
Cognitive and functional deficits are commonly seen in people with schizophrenia. The profile of these impairments has a resemblance to the cognitive changes seen in healthy aging. In specific, many of the cognitive ability domains that change the most with aging in healthy people are the most salient of these deficits seen in people with schizophrenia, including prominent deficits in processing speed, working memory, and episodic memory. Functional deficits seen in schizophrenia are also similar to those seen in healthy aging. There is a relationship between multiple psychotic relapses and treatment resistance and longitudinal cognitive and functional changes in schizophrenia, with this relationship starting early in the course of illness. Cognitive performance in people with schizophrenia may be consistent with accelerated or premature aging. People with schizophrenia perform similarly to healthy people who are 3 or more decades older on indices of both cognition and their everyday functional skills. Some people with schizophrenia show exaggerated cognitive changes as well. Cognitive and functional performance worsens at the outset of the illness in schizophrenia compared to premorbid functioning, meaning that these deficits are not due to development disabilities. There are multiple medical and substance abuse comorbidities in schizophrenia and although these comorbidities affect cognitive functioning, they are not completely responsible for age-related changes.
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Affiliation(s)
- Philip D Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, USA.
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167
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Drymalski WM, Nunley MR. Sensitivity of the ASAM Criteria to Psychiatric Need. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-017-9801-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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168
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Treen Calvo D, Giménez-Donoso S, Setién-Suero E, Toll Privat A, Crespo-Facorro B, Ayesa Arriola R. Targeting recovery in first episode psychosis: The importance of neurocognition and premorbid adjustment in a 3-year longitudinal study. Schizophr Res 2018; 195:320-326. [PMID: 28844434 DOI: 10.1016/j.schres.2017.08.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/11/2017] [Accepted: 08/18/2017] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Recovery in psychotic disorders remains a major challenge across mental health. Identifying predictors of recovery in first psychotic episodes is a priority in order to increase knowledge on underlying mechanisms of the illness and to obtain objective severity markers at initial phases. In this study we gathered sociodemographic, clinical and cognitive data to explore predictive variables of recovery after three years follow-up in a sample of 399 patients with a first episode of psychosis (FEP). MATERIAL AND METHOD This is a longitudinal study including patients with a FEP. A dichotomic variable of recovery was created according to symptomatic and functional outcome after 3years follow-up. Significant variables in univariate analysis were entered into a binary logistic regression to obtain a multivariate prediction model of recovery. RESULTS The predictive model was statistically significant and classified an overall of 76% of patients correctly, specifically 86.7% of patients that would not recover and 55% of the patients that would recover. From all the variables that where significantly different between recovered and not recovered patients, only speed of processing, executive functions and premorbid adjustment were found to be significant predictors of recovery. DISCUSSION This study provides evidence that the degree of basal impairment in cognitive functions related to the Prefrontal Cortex and a worst premorbid adaptation predict in a significant way which patients are less likely to recover three years after a FEP.
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Affiliation(s)
- Devi Treen Calvo
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain.
| | | | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Center Of Biomedical Investigation in mental health, Madrid, Spain
| | - Alba Toll Privat
- Neuropsychiatry and Addiction Institute, Parc de Salut Mar, Barcelona, Spain
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Center Of Biomedical Investigation in mental health, Madrid, Spain
| | - Rosa Ayesa Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Center Of Biomedical Investigation in mental health, Madrid, Spain.
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169
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Lynham AJ, Hubbard L, Tansey KE, Hamshere ML, Legge SE, Owen MJ, Jones IR, Walters JTR. Examining cognition across the bipolar/schizophrenia diagnostic spectrum. J Psychiatry Neurosci 2018; 43:170076. [PMID: 29620518 PMCID: PMC6019354 DOI: 10.1503/jpn.170076] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/12/2017] [Accepted: 09/11/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Cognitive impairments are well-established features of schizophrenia, but there is ongoing debate about the nature and degree of cognitive impairment in patients with schizoaffective disorder and bipolar disorder. We hypothesized that there is a spectrum of increasing impairment from bipolar disorder to schizoaffective disorder bipolar type, to schizoaffective disorder depressive type and schizophrenia. METHODS We compared performance on the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery between participants with schizophrenia (n = 558), schizoaffective disorder depressive type (n = 112), schizoaffective disorder type (n = 76), bipolar disorder (n = 78) and healthy participants (n = 103) using analysis of covariance with post hoc comparisons. We conducted an ordinal logistic regression to examine whether cognitive impairments followed the hypothesized spectrum from bipolar disorder (least severe) to schizophrenia (most severe). In addition to categorical diagnoses, we addressed the influence of symptom domains, examining the association between cognition and mania, depression and psychosis. RESULTS Cognitive impairments increased in severity from bipolar disorder to schizoaffective disorder bipolar type, to schizophrenia and schizoaffective disorder depressive type. Participants with schizophrenia and schizoaffective disorder depressive type showed equivalent performance (d = 0.07, p = 0.90). The results of the ordinal logistic regression were consistent with a spectrum of deficits from bipolar disorder to schizoaffective disorder bipolar type, to schizophrenia/schizoaffective disorder depressive type (odds ratio = 1.98, p < 0.001). In analyses of the associations between symptom dimensions and cognition, higher scores on the psychosis dimension were associated with poorer performance (B = 0.015, standard error = 0.002, p < 0.001). LIMITATIONS There were fewer participants with schizoaffective disorder and bipolar disorder than schizophrenia. Despite this, our analyses were robust to differences in group sizes, and we were able to detect differences between groups. CONCLUSION Cognitive impairments represent a symptom dimension that cuts across traditional diagnostic boundaries.
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Affiliation(s)
- Amy J Lynham
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Leon Hubbard
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Katherine E Tansey
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Marian L Hamshere
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Sophie E Legge
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Michael J Owen
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - Ian R Jones
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
| | - James T R Walters
- From the MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK (Lynham, Hubbard, Hamshere, Legge, Owen, Jones, Walters); and the College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK (Tansey)
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170
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Van Rheenen TE, Cropley V, Zalesky A, Bousman C, Wells R, Bruggemann J, Sundram S, Weinberg D, Lenroot RK, Pereira A, Shannon Weickert C, Weickert TW, Pantelis C. Widespread Volumetric Reductions in Schizophrenia and Schizoaffective Patients Displaying Compromised Cognitive Abilities. Schizophr Bull 2018; 44:560-574. [PMID: 28981831 PMCID: PMC5890481 DOI: 10.1093/schbul/sbx109] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Progress toward understanding brain mechanisms in psychosis is hampered by failures to account for within-group heterogeneity that exists across neuropsychological domains. We recently identified distinct cognitive subgroups that might assist in identifying more biologically meaningful subtypes of psychosis. In the present study, we examined whether underlying structural brain abnormalities differentiate these cognitively derived subgroups. METHOD 1.5T T1 weighted structural scans were acquired for 168 healthy controls and 220 patients with schizophrenia/schizoaffective disorder. Based on previous work, 47 patients were categorized as being cognitively compromised (impaired premorbid and current IQ), 100 as cognitively deteriorated (normal premorbid IQ, impaired current IQ), and 73 as putatively cognitively preserved (premorbid and current IQ within 1 SD of controls). Global, subcortical and cortical volume, thickness, and surface area measures were compared among groups. RESULTS Whole cortex, subcortical, and regional volume and thickness reductions were evident in all subgroups compared to controls, with the largest effect sizes in the compromised group. This subgroup also showed abnormalities in regions not seen in the other patient groups, including smaller left superior and middle frontal areas, left anterior and inferior temporal areas and right lateral medial and inferior frontal, occipital lobe and superior temporal areas. CONCLUSIONS This pattern of more prominent brain structural abnormalities in the group with the most marked cognitive impairments-both currently and putatively prior to illness onset, is consistent with the concept of schizophrenia as a progressive neurodevelopmental disorder. In this group, neurodevelopmental and neurodegenerative factors may be important for cognitive function.
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Affiliation(s)
- Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia,Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia,To whom correspondence should be addressed; Melbourne Neuropsychiatry Centre, Level 3, Alan Gilbert Building, 161 Barry Street, Carlton, VIC 3053, Australia; tel: +61-03-9035 8628, e-mail:
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, Australia
| | - Chad Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Ruth Wells
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, Parkville, Australia,Mental Health Program, Monash Health, Clayton, Australia,Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Danielle Weinberg
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia
| | - Roshel K Lenroot
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia
| | - Avril Pereira
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Cynthia Shannon Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia
| | - Thomas W Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia,Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, Australia
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171
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Dorofeikova M, Neznanov N, Petrova N. Cognitive deficit in patients with paranoid schizophrenia: Its clinical and laboratory correlates. Psychiatry Res 2018; 262:542-548. [PMID: 28951142 DOI: 10.1016/j.psychres.2017.09.041] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/11/2017] [Accepted: 09/17/2017] [Indexed: 12/16/2022]
Abstract
The aim of this study was to search for correlates of cognitive impairment in patients with paranoid schizophrenia among clinical, demographic, anamnestic and biochemical markers (NSE, S100B protein, BDNF, hs-CRP). Patients with paranoid schizophrenia (n=125) were examined using the Brief Assessment of Cognitive Function in Schizophrenia, the Rey-Osterrieth Complex Figure task, and a number of clinical scales including the Positive and Negative Syndrome Scale. The majority of patients demonstrated cognitive impairment. The type of impairment was highly heterogeneous and individual. Relationships were found between the degree of executive functioning and family history of mental illness; working memory and age of onset of schizophrenia; and visual memory and psychopathological symptomatology. Negative and affective symptoms were not significantly associated with cognitive functioning. Treatment with first generation antipsychotics was associated with a more frequent impairment of motor skills, and concomitant anticholinergic drugs, with reduced accuracy. Use of second-generation antipsychotics only was associated with better accuracy, working memory and speech fluency. Among the patients, 21.4% had signs of a systemic inflammatory response, indicating a possible role of inflammatory response in the development of schizophrenia. CRP, S100B and NSE levels reflected features of the course of illness and therapeutic response. Patients with lower concentrations of BDNF were characterized by lower processing speeds.
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Affiliation(s)
- Mariia Dorofeikova
- State Federal Budgetary Institution, Saint-Petersburg Bekhterev Psychoneurological Research Institute, Saint-Petersburg, Russia.
| | - Nikolay Neznanov
- State Federal Budgetary Institution, Saint-Petersburg Bekhterev Psychoneurological Research Institute, Saint-Petersburg, Russia
| | - Nataliia Petrova
- State Federal Budgetary Institution for Higher Education, Saint-Petersburg State University,Saint-Petersburg, Russia
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172
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Huang X, Fox KR, Ribeiro JD, Franklin JC. Psychosis as a risk factor for suicidal thoughts and behaviors: a meta-analysis of longitudinal studies. Psychol Med 2018; 48:765-776. [PMID: 28805179 DOI: 10.1017/s0033291717002136] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Research has long noted higher prevalence rates of suicidal thoughts and behaviors among individuals with psychotic symptoms. Major theories have proposed several explanations to account for this association. Given the differences in the literature regarding the operationalization of psychosis and sample characteristics, a quantitative review is needed to determine to what extent and how psychosis confers risk for suicidality. METHODS We searched PsycInfo, PubMed, and GoogleScholar for studies published before 1 January 2016. To be included in the analysis, studies must have used at least one psychosis-related factor to longitudinally predict suicide ideation, attempt, or death. The initial search yielded 2541 studies. Fifty studies were retained for analysis, yielding 128 statistical tests. RESULTS Suicide death was the most commonly studied outcome (43.0%), followed by attempt (39.1%) and ideation (18.0%). The median follow-up length was 7.5 years. Overall, psychosis significantly conferred risk across three outcomes, with weighted mean ORs of 1.70 (1.39-2.08) for ideation, 1.36 (1.25-1.48) for attempt, and 1.40 (1.14-1.72) for death. Detailed analyses indicated that positive symptoms consistently conferred risk across outcomes; negative symptoms were not significantly associated with ideation, and were protective against death. Some small moderator effects were detected for sample characteristics. CONCLUSIONS Psychosis is a significant risk factor for suicide ideation, attempt, and death. The finding that positive symptoms increased suicide risk and negative symptoms seemed to decrease risk sheds light on the potential mechanisms for the association between psychosis and suicidality. We note several limitations of the literature and offer suggestions for future directions.
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Affiliation(s)
- X Huang
- Department of Psychology,Florida State University,Tallahassee, FL,USA
| | - K R Fox
- Department of Psychology,Harvard University,Cambridge, MA,USA
| | - J D Ribeiro
- Department of Psychology,Florida State University,Tallahassee, FL,USA
| | - J C Franklin
- Department of Psychology,Florida State University,Tallahassee, FL,USA
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173
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Bogaty SER, Lee RSC, Hickie IB, Hermens DF. Meta-analysis of neurocognition in young psychosis patients with current cannabis use. J Psychiatr Res 2018; 99:22-32. [PMID: 29407284 DOI: 10.1016/j.jpsychires.2018.01.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/12/2018] [Accepted: 01/12/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Adult psychosis patients (i.e. over the age of 25 years) who are also lifetime cannabis users (CANN±) appear to exhibit superior cognition compared to never-using patients (CANN-). The objective of this meta-analysis was to evaluate the cognitive differences between CANN- and patients who currently use cannabis (CANN+) (i.e. during the CANN± patients' cannabis-using stage). Specifically, focusing on young patients under the age of 25 years, the typical stage of both psychosis- and cannabis-onset. METHOD Of the 308 studies identified through database searches and secondary referencing, 14 compared neurocognition of CANN+ and CANN- in young people with psychotic disorders (mean age between 15 and 45 years). Effect sizes were extracted using neurocognitive test performance between CANN+ and CANN- and random effects modelling was conducted on pooled ES and moderator analyses. RESULTS CANN+ performed worse on several cognitive domains (i.e. premorbid IQ, current IQ, verbal learning, verbal working memory, motor inhibition) compared to CANN-. The association between age and performance in CANN+ cognition was varied, with older age predictive of worse performance in processing speed, sustained attention, verbal memory, and better performance in verbal learning and very fluency. Of note, CANN+ outperformed CANN- in tests of conceptual set-shifting. CONCLUSION These results are consistent with previous findings indicating that CANN+ demonstrate poorer neurocognition than CANN-; and that this is exacerbated with increasing age. Our findings demonstrate significant cognitive differences between patients with CANN+ versus CANN- even at early-onset psychosis, which could suggest a different underlying mechanism towards psychosis for cannabis users.
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Affiliation(s)
| | - Rico S C Lee
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia; Brain and Mental Health Laboratory, Monash University, Melbourne, VIC, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Daniel F Hermens
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia; Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia.
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174
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Duration of untreated illness as a key to early intervention in schizophrenia: A review. Neurosci Lett 2018; 669:59-67. [DOI: 10.1016/j.neulet.2016.10.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 09/05/2016] [Accepted: 10/02/2016] [Indexed: 12/25/2022]
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175
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Huber RS, Kondo DG, Shi XF, Prescot AP, Clark E, Renshaw PF, Yurgelun-Todd DA. Relationship of executive functioning deficits to N-acetyl aspartate (NAA) and gamma-aminobutyric acid (GABA) in youth with bipolar disorder. J Affect Disord 2018; 225:71-78. [PMID: 28800423 DOI: 10.1016/j.jad.2017.07.052] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/27/2017] [Accepted: 07/27/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although cognitive deficits in bipolar disorder (BD) have been repeatedly observed, our understanding of these impairments at a mechanistic level remains limited. Few studies that investigated cognitive impairments in bipolar illness have examined the association with brain biochemistry. This pilot study utilized proton magnetic resonance spectroscopy (1H-MRS) to evaluate the relationship between neurocognitive performance and brain metabolites in youth with BD. METHODS Thirty participants, twenty depressed BD participants and ten healthy comparison participants, ages 13-21, completed mood and executive function measures. 1H-MRS data were also acquired from the anterior cingulate cortex (ACC) using two-dimensional (2D) J-resolved 1H-MRS sequence. Proton metabolites including N-acetyl aspartate (NAA) and gamma-aminobutyric acid (GABA) were quantified for both groups. RESULTS Participants with BD performed significantly lower on executive functioning measures than comparison participants. There were significant positive correlations between Wisconsin Card Sorting Test (WCST) performance and NAA (p < .001) and GABA (p < .01) in the ACC in bipolar youth, such that as WCST performance increased, both NAA and GABA levels increased. LIMITATIONS Small sample size and lack of control for medications. CONCLUSIONS These findings build on previous observations of biochemical alterations associated with BD and indicate that executive functioning deficits in bipolar youth are correlated with NAA and GABA. These results suggest that cognitive deficits occur early in the course of illness and may reflect risk factors associated with altered neurochemistry. Further investigation of the relationship between brain metabolites and cognition in BD may lead to important information for developing novel, targeted interventions.
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Affiliation(s)
- Rebekah S Huber
- University of Utah School of Medicine, Department of Psychiatry, 383 Colorow Drive, Salt Lake City, UT 84108, United States.
| | - Douglas G Kondo
- University of Utah School of Medicine, Department of Psychiatry, 383 Colorow Drive, Salt Lake City, UT 84108, United States; Veterans Affairs VISN 19 Mental Illness Research, Education and Clinical Center, Salt Lake City, UT, United States
| | - Xian-Feng Shi
- University of Utah School of Medicine, Department of Psychiatry, 383 Colorow Drive, Salt Lake City, UT 84108, United States
| | - Andrew P Prescot
- University of Utah School of Medicine, Department of Radiology, Salt Lake City, UT, United States
| | - Elaine Clark
- University of Utah, Department of Educational Psychology, Salt Lake City, UT, United States
| | - Perry F Renshaw
- University of Utah School of Medicine, Department of Psychiatry, 383 Colorow Drive, Salt Lake City, UT 84108, United States; Veterans Affairs VISN 19 Mental Illness Research, Education and Clinical Center, Salt Lake City, UT, United States
| | - Deborah A Yurgelun-Todd
- University of Utah School of Medicine, Department of Psychiatry, 383 Colorow Drive, Salt Lake City, UT 84108, United States; Veterans Affairs VISN 19 Mental Illness Research, Education and Clinical Center, Salt Lake City, UT, United States
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Russo M, Van Rheenen TE, Shanahan M, Mahon K, Perez-Rodriguez MM, Cuesta-Diaz A, Larsen E, Malhotra AK, Burdick KE. Neurocognitive subtypes in patients with bipolar disorder and their unaffected siblings. Psychol Med 2017; 47:2892-2905. [PMID: 28587689 PMCID: PMC5856455 DOI: 10.1017/s003329171700143x] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Our previous work revealed substantial heterogeneity in the cognitive profile of bipolar disorder (BD) due to the presence of three underlying cognitive subgroups characterized as: globally impaired, selectively impaired, or cognitively intact. In an effort to determine whether these subgroups are differentially related to genetic risk for the illness, we investigated whether cognitive deficits were more pronounced in unaffected siblings (UAS) of BD probands within identified clusters. METHODS Cluster analysis was used to identify cognitive clusters in BD (N = 60). UAS (N = 49) were classified into groups according to their proband sibling's cluster assignment; comparisons were made across all clusters and healthy controls (HCs; N = 71). RESULTS Three cognitive clusters in BD emerged: a globally impaired (36.7%), a selectively impaired (30%), and a cognitively intact cluster (33.3%). UAS showed a qualitatively similar pattern to their BD siblings; UAS of the globally impaired BD cluster showed verbal memory and general cognitive impairments relative to HCs. In contrast, UAS of the other two clusters did not differ from HCs. CONCLUSIONS This study corroborates findings from prior work regarding the presence of cognitive heterogeneity in BD. UAS of subjects in the globally impaired BD cluster presented with a qualitatively similar cognitive profile to their siblings and performed worse than all other BD clusters and UAS groups. This suggests that inherited risk factors may be contributing to cognitive deficits more notably in one subgroup of patients with BD, pointing toward differential causes of cognitive deficits in discrete subgroups of patients with the disorder.
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Affiliation(s)
- M. Russo
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - T. E. Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Brain and Psychological Sciences Research Centre, School of Health Sciences, Swinburne University, Melbourne, Australia
- Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | - M. Shanahan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - K. Mahon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - M. M. Perez-Rodriguez
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - A. Cuesta-Diaz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - E. Larsen
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
| | - A. K. Malhotra
- Zucker Hillside Hospital – Northwell Health System, Glen Oaks, NY, USA
| | - K. E Burdick
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
- James J Peters Veteran Administration (VA) Hospital, Bronx, NY, USA
- Brigham and Women’s Hospital, Boston, MA, USA
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177
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Martino DJ, Scápola M, Strejilevich SA. Letter to the editor: Longitudinal stability of neurocognitive subtypes in bipolar disorder. J Psychiatr Res 2017; 95:46-47. [PMID: 28777982 DOI: 10.1016/j.jpsychires.2017.07.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 07/20/2017] [Accepted: 07/27/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Diego J Martino
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Council of Scientific and Technical Research (CONICET), Argentina; Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
| | - María Scápola
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
| | - Sergio A Strejilevich
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
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178
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Neu P, Gooren T, Niebuhr U, Schlattmann P. Cognitive impairment in schizophrenia and depression: A comparison of stability and course. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 26:215-228. [PMID: 29161150 DOI: 10.1080/23279095.2017.1392962] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Cognitive deficits are clinically relevant features in schizophrenia and depression, yet little comparative data on changes in both disorders is available. This study compares cognitive performance of inpatients with schizophrenia (N = 52) and unipolar major depression (N = 67) during psychiatric treatment, assessing performance twice: after admission to hospital (acute) and prior to discharge (postacute) on average seven weeks later. A group of healthy controls was tested at comparable intervals. Data was analyzed using a multivariate linear model. Patients with schizophrenia and depression showed significantly impaired performance compared to healthy controls. On follow-up both patient groups showed improved performance. Contrary to expectation, patients with schizophrenia showed greater improvement in verbal memory, visual memory, and psychomotor speed than depressive patients. Verbal fluency presented as a possible candidate to differentiate between both disorders. Similar profiles of generalized cognitive deficits were observed in both patient-groups on acute and postacute assessment, which might indicate trait-like deficits with persistent functional implications in both disorders. Findings do not support assumptions of greater cognitive impairment in schizophrenia compared to depression. A distinction of the disorders on the grounds of cognitive functioning seems to be less specific than presumed.
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Affiliation(s)
- Peter Neu
- a Clinic of Psychiatry and Psychotherapy , Charité - University Medicine Berlin , Berlin , Germany.,b Clinic of Psychiatry and Psychotherapy , Jewish Hospital , Berlin , Germany
| | - Tina Gooren
- a Clinic of Psychiatry and Psychotherapy , Charité - University Medicine Berlin , Berlin , Germany
| | - Ulrike Niebuhr
- c Clinic of Psychiatry and Psychotherapy , Vivantes Hospital Neukölln , Berlin , Germany
| | - Peter Schlattmann
- d Department of Medical Statistics, Computer Sciences and Documentation , Jena University Hospital , Jena , Germany
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Moreira HS, Costa AS, Castro SL, Lima CF, Vicente SG. Assessing Executive Dysfunction in Neurodegenerative Disorders: A Critical Review of Brief Neuropsychological Tools. Front Aging Neurosci 2017; 9:369. [PMID: 29170636 PMCID: PMC5684643 DOI: 10.3389/fnagi.2017.00369] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/26/2017] [Indexed: 02/05/2023] Open
Abstract
Executive function (EF) has been defined as a multifaceted construct that involves a variety of high-level cognitive abilities such as planning, working memory, mental flexibility, and inhibition. Being able to identify deficits in EF is important for the diagnosis and monitoring of several neurodegenerative disorders, and thus their assessment is a topic of much debate. In particular, there has been a growing interest in the development of neuropsychological screening tools that can potentially provide a reliable quick measure of EF. In this review, we critically discuss the four screening tools of EF currently available in the literature: Executive Interview-25 (EXIT 25), Frontal Assessment Battery (FAB), INECO Frontal Screening (IFS), and FRONTIER Executive Screen (FES). We first describe their features, and then evaluate their psychometric properties, the existing evidence on their neural correlates, and the empirical work that has been conducted in clinical populations. We conclude that the four screening tools generally present appropriate psychometric properties, and are sensitive to impairments in EF in several neurodegenerative conditions. However, more research will be needed mostly with respect to normative data and neural correlates, and to determine the extent to which these tools add specific information to the one provided by global cognition screening tests. More research directly comparing the available tools with each other will also be important to establish in which conditions each of them can be most useful.
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Affiliation(s)
- Helena S Moreira
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal
| | - Ana S Costa
- Neurology Department, Hospital de Braga, Braga, Portugal
| | - São L Castro
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal
| | - César F Lima
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal.,Institute of Cognitive Neuroscience, University College London, London, United Kingdom.,Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Selene G Vicente
- Faculty of Psychology and Education Sciences, Centre for Psychology, University of Porto, Porto, Portugal
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180
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Liang S, Vega R, Kong X, Deng W, Wang Q, Ma X, Li M, Hu X, Greenshaw AJ, Greiner R, Li T. Neurocognitive Graphs of First-Episode Schizophrenia and Major Depression Based on Cognitive Features. Neurosci Bull 2017; 34:312-320. [PMID: 29098645 DOI: 10.1007/s12264-017-0190-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 08/18/2017] [Indexed: 02/05/2023] Open
Abstract
Neurocognitive deficits are frequently observed in patients with schizophrenia and major depressive disorder (MDD). The relations between cognitive features may be represented by neurocognitive graphs based on cognitive features, modeled as Gaussian Markov random fields. However, it is unclear whether it is possible to differentiate between phenotypic patterns associated with the differential diagnosis of schizophrenia and depression using this neurocognitive graph approach. In this study, we enrolled 215 first-episode patients with schizophrenia (FES), 125 with MDD, and 237 demographically-matched healthy controls (HCs). The cognitive performance of all participants was evaluated using a battery of neurocognitive tests. The graphical LASSO model was trained with a one-vs-one scenario to learn the conditional independent structure of neurocognitive features of each group. Participants in the holdout dataset were classified into different groups with the highest likelihood. A partial correlation matrix was transformed from the graphical model to further explore the neurocognitive graph for each group. The classification approach identified the diagnostic class for individuals with an average accuracy of 73.41% for FES vs HC, 67.07% for MDD vs HC, and 59.48% for FES vs MDD. Both of the neurocognitive graphs for FES and MDD had more connections and higher node centrality than those for HC. The neurocognitive graph for FES was less sparse and had more connections than that for MDD. Thus, neurocognitive graphs based on cognitive features are promising for describing endophenotypes that may discriminate schizophrenia from depression.
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Affiliation(s)
- Sugai Liang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
- Huaxi Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Roberto Vega
- Department of Computing Science, University of Alberta, Edmonton, AB, T6G 2R7, Canada
| | - Xiangzhen Kong
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, 6525 XD, Nijmegen, The Netherlands
| | - Wei Deng
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
- Huaxi Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qiang Wang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaohong Ma
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Mingli Li
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xun Hu
- Huaxi Biobank, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB, T6G 2R7, Canada
| | - Russell Greiner
- Department of Computing Science, University of Alberta, Edmonton, AB, T6G 2R7, Canada
| | - Tao Li
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, 610041, China.
- Huaxi Brain Research Centre, West China Hospital, Sichuan University, Chengdu, 610041, China.
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181
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Strassnig M, Cornaccio D, Harvey PD, Kotov R, Fochtmann L, Bromet EJ. Health status and mobility limitations are associated with residential and employment status in schizophrenia and bipolar disorder. J Psychiatr Res 2017; 94:180-185. [PMID: 28743064 PMCID: PMC5605443 DOI: 10.1016/j.jpsychires.2017.07.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/30/2017] [Accepted: 07/13/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Schizophrenia (SCZ) and bipolar disorder (BP) are linked to multiple impairments in everyday functioning which share cognitive and symptom risk factors. Other risk factors for critical aspects of every day functioning (e.g., gainful employment; residential independence) such as physical health have not been evaluated, despite poor health in SCZ and BP. METHODS We analyzed 20-year follow-up data from the Suffolk County Mental Health Project cohort of consecutive first admissions with a psychotic disorder to 12 psychiatric facilities in Suffolk County, NY, between September 1989 and December 1995. Both 20-year symptom, health, and cognition data, and the 20-year course of weight gain were included as predictors of employment and residence status. RESULTS The analysis sample consisted of 122 participants with SCZ ad BP, with SCZ participants less likely to work or live independently. Correlational analyses showed symptoms and cognition predicted vocational outcomes in both samples. The effect of diagnosis was significant for both gainful employment and independence in residence. After consideration of diagnosis, mobility and negative symptoms predicted gainful employment in both samples, but there were no additional predictors of residential independence. Prospective analysis of BMI found that baseline BMI, but not changes during the 20-year follow up, predicted labor force participation. DISCUSSION Health status limitations were associated with residential and, particularly, employment status independent from other, previously established predictors of everyday outcomes, including cognition and symptoms. The importance of health status limitations for predicting outcome was confirmed in both SCZ and BP, with schizophrenia representing the more impaired group.
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Affiliation(s)
- M Strassnig
- Department of Integrated Medical Science, Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, United States.
| | - D Cornaccio
- School of Integrated Science and Humanity, Florida International University, Miami, FL
| | - PD Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL
| | - R Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY
| | - L Fochtmann
- Department of Psychiatry, Stony Brook University, Stony Brook, NY
| | - EJ Bromet
- Department of Psychiatry, Stony Brook University, Stony Brook, NY
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182
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Neurocognition in patients with psychotic and non-psychotic bipolar I disorder. A comparative study with individuals with schizophrenia. J Affect Disord 2017; 222:169-176. [PMID: 28709024 DOI: 10.1016/j.jad.2017.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/02/2017] [Accepted: 07/06/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND It has been suggested that patients with bipolar disorder with psychotic symptoms (BD-P) have larger neurocognitive impairment than patients with bipolar disorder without a history of psychotic symptoms (BD-NP). The objective of this study was to compare neurocognitive performance of BD-P and BD-NP relative to a group of patients with schizophrenia (SZ), and healthy controls (HC). METHODS Neurocognitive function was examined in 100 subjects with bipolar I disorder (50 BD-P, 50 BD-NP), 50 SZ, and 51 HC. All patients with BD fulfilled criteria for euthymia, while all SZ patients were stabilised for at least the previous 3 months. RESULTS Patients with BD-P and BD-NP performed worse than HC in all neurocognitive measures, except for sustained attention. Differences between BD-P and BD-NP were subtle and circumscribed to the working memory domain (effect size: 0.29). SZ performed worse than BD-NP in the neurocognitive composite index (NCI) and in the working memory domain. There were no differences between SZ and BD-P in any neurocognitive measure. LIMITATIONS The relatively small sample size, the cross-sectional design and, that patients were receiving pharmacological treatment are the main limitations of this study. CONCLUSIONS Our findings show that the three groups of patients have a large neurocognitive impairment. Differences are quantitative and only present in some neurocognitive domains, such as working memory. These results suggest that patients with BD and SZ can benefit from the same strategies of cognitive remediation.
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183
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Transcriptome Alterations in Prefrontal Pyramidal Cells Distinguish Schizophrenia From Bipolar and Major Depressive Disorders. Biol Psychiatry 2017; 82:594-600. [PMID: 28476208 PMCID: PMC5610065 DOI: 10.1016/j.biopsych.2017.03.018] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Impairments in certain cognitive processes (e.g., working memory) are typically most pronounced in schizophrenia (SZ), intermediate in bipolar disorder, and least in major depressive disorder. Given that working memory depends, in part, on neural circuitry that includes pyramidal cells in layer 3 (L3) and layer 5 (L5) of the dorsolateral prefrontal cortex (DLPFC), we sought to determine if transcriptome alterations in these neurons were shared or distinctive for each diagnosis. METHODS Pools of L3 and L5 pyramidal cells in the DLPFC were individually captured by laser microdissection from 19 matched tetrads of unaffected comparison subjects and subjects with SZ, bipolar disorder, and major depressive disorder, and the messenger RNA was subjected to transcriptome profiling by microarray. RESULTS In DLPFC L3 and L5 pyramidal cells, transcriptome alterations were numerous in subjects with SZ, but rare in subjects with bipolar disorder and major depressive disorder. The leading molecular pathways altered in subjects with SZ involved mitochondrial energy production and the regulation of protein translation. In addition, we did not find any significant transcriptome signatures related to psychosis or suicide. CONCLUSIONS In concert, these findings suggest that molecular alterations in DLPFC L3 and L5 pyramidal cells might be characteristic of the disease processes operative in individuals diagnosed with SZ and thus might contribute to the circuitry alterations underlying cognitive dysfunction in individuals with SZ.
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184
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Brown MA, Velligan DI. Issues and developments related to assessing function in serious mental illness. DIALOGUES IN CLINICAL NEUROSCIENCE 2017. [PMID: 27489453 PMCID: PMC4969700 DOI: 10.31887/dcns.2016.18.2/dvelligan] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Serious mental illness (SMI) results in functional disability that imposes a significant burden on individuals, caregivers, and society. Development of novel treatments is under way in an effort to improve the illness domains of cognitive impairment and negative symptoms and subsequently to improve functional outcomes. The assessment of functional outcomes in SMI faces a number of challenges, including the proliferation of assessment instruments and the differential prioritization of functional goals among stakeholder groups. Functional assessments relying on self- and informant report present a number of limitations. Identifying alternative strategies to assess functioning that are reliable, valid, and sensitive to change is necessary for use in clinical trials. Measures of functional capacity have been proposed for clinical trials investigating compounds to treat cognitive impairment in schizophrenia. Alternative approaches employing effort-based decision making or daily activity recording using instruments such as the Daily Activity Report may be more appropriate for studies focused on improving negative symptoms.
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Affiliation(s)
- Matt A Brown
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Dawn I Velligan
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
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185
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Bustamante ML, Herrera L, Gaspar PA, Nieto R, Maturana A, Villar MJ, Salinas V, Silva H. Shifting the focus toward rare variants in schizophrenia to close the gap from genotype to phenotype. Am J Med Genet B Neuropsychiatr Genet 2017; 174:663-670. [PMID: 28901686 DOI: 10.1002/ajmg.b.32550] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 04/25/2017] [Indexed: 01/16/2023]
Abstract
Schizophrenia (SZ) is a disorder with a high heritability and a complex architecture. Several dozen genetic variants have been identified as risk factors through genome-wide association studies including large population-based samples. However, the bulk of the risk cannot be accounted for by the genes associated to date. Rare mutations have been historically seen as relevant only for some infrequent, Mendelian forms of psychosis. Recent findings, however, show that the subset of patients that present a mutation with major effect is larger than expected. We discuss some of the molecular findings of these studies. SZ is clinically and genetically heterogeneous. To identify the genetic variation underlying the disorder, research should be focused on features that are more likely a product of genetic heterogeneity. Based on the phenotypical correlations with rare variants, cognition emerges as a relevant domain to study. Cognitive disturbances could be useful in selecting cases that have a higher probability of carrying deleterious mutations, as well as on the correct ascertainment of sporadic cases for the identification of de novo variants.
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Affiliation(s)
- M Leonor Bustamante
- Faculty of Medicine, Program of Human Genetics, Biomedical Sciences Institute, Universidad de Chile, Santiago de Chile, Chile.,Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile
| | - Luisa Herrera
- Faculty of Medicine, Program of Human Genetics, Biomedical Sciences Institute, Universidad de Chile, Santiago de Chile, Chile
| | - Pablo A Gaspar
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile.,Faculty of Medicine, Department of Neurosciences, Universidad de Chile, Santiago de Chile, Chile.,Biomedical Neurosciences Institute, Universidad de Chile, Santiago de Chile, Chile
| | - Rodrigo Nieto
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile.,Faculty of Medicine, Department of Neurosciences, Universidad de Chile, Santiago de Chile, Chile
| | - Alejandro Maturana
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile
| | - María José Villar
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile
| | - Valeria Salinas
- Faculty of Medicine, Program of Human Genetics, Biomedical Sciences Institute, Universidad de Chile, Santiago de Chile, Chile
| | - Hernán Silva
- Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago de Chile, Chile.,Faculty of Medicine, Department of Neurosciences, Universidad de Chile, Santiago de Chile, Chile.,Biomedical Neurosciences Institute, Universidad de Chile, Santiago de Chile, Chile
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186
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Corréard N, Consoloni JL, Raust A, Etain B, Guillot R, Job S, Loftus J, Médecin I, Bougerol T, Polosan M, Fredembach B, Gard S, M’Bailara K, Kahn JP, Roux P, Homassel AS, Carminati M, Matos L, Olié E, Bellivier F, Courtet P, Henry C, Leboyer M, Azorin JM, Belzeaux R, FACE-BD collaborators. Neuropsychological functioning, age, and medication adherence in bipolar disorder. PLoS One 2017; 12:e0184313. [PMID: 28873468 PMCID: PMC5584797 DOI: 10.1371/journal.pone.0184313] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 08/22/2017] [Indexed: 12/19/2022] Open
Abstract
Objectives Poor adherence to medication is frequent in bipolar disorder (BD) and has been associated with several factors. To date, the relationship between low adherence and neuropsychological functioning in BD is still unclear. As age and neuropsychological functioning might have opposing influences on adherence, our aim was to investigate this link with a particular focus on the effect of age. Methods In a cross-sectional study, we included 353 patients divided into two age-groups (16–46; 47–71) from a French cohort diagnosed with BD (type I, II, NOS) and strictly euthymic. All patients had a standardized clinical and neuropsychological assessment and were categorized as high (n = 186) or low (n = 167) adherent based on their score from the Medication Adherence Rating Scale. Clinical information was collected based on a standardized interview and clinical validated scales. Neuropsychological performances were evaluated with an established standardized neuropsychological battery for bipolar disorder patients. After univariate analysis, neuropsychological and clinical predictors of low adherence were included in two age-specific stepwise multiple logistic regressions. Results A smaller number of hospitalizations (OR = 0.846, p = 0.012), a shorter illness duration (OR = 0.937, p = 0.003) and higher adverse effects (OR = 1.082, p<0.001) were associated with a greater risk of low adherence in the younger patients. In the older patients, low adherence was also predicted by a smaller number of hospitalizations (OR = 0.727, p = 0.008) and higher adverse effects (OR = 1.124, p = 0.005). Interestingly poor inhibition performance was also a significant predictor of low adherence in older patients (OR = 0.924, p = 0.030). Conclusions We found an age-specific relationship between cognitive functioning and adherence in patients with BD. Poor inhibition performances predicted low adherence in older patients only. Our results highlight the need to provide age-adapted therapeutic interventions to improve adherence in patients with BD.
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Affiliation(s)
- Nadia Corréard
- Department of Psychiatry, AP-HM, Marseille, France
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
| | - Julia-Lou Consoloni
- Department of Psychiatry, AP-HM, Marseille, France
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CRN2M-UMR7286, Aix-Marseille University, CNRS, Marseille, France
| | - Aurélie Raust
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Academic Hospital Henri Mondor, Psychiatric and Addictology pole, Créteil, France
| | - Bruno Etain
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Fernand Widal Hospital, Department of Addictology-Toxicology-Psychiatry and University Paris-7, Paris, France
| | - Romain Guillot
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry and Clinical Psychology, Psychotherapeutic Centre of Nancy, Laxou, France
| | - Sophie Job
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry and Clinical Psychology, Psychotherapeutic Centre of Nancy, Laxou, France
| | - Joséphine Loftus
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Princess-Grace Hospital, Monaco, Monaco
| | - Isabelle Médecin
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Princess-Grace Hospital, Monaco, Monaco
| | - Thierry Bougerol
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Academic Hospital of Grenoble, Grenoble, France
| | - Mircea Polosan
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Academic Hospital of Grenoble, Grenoble, France
- U1216 INSERM-UGA – Brain stimulation and Systems neuroscience, Grenoble Institute of Neurosciences, La Tronche, France
| | - Benjamin Fredembach
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Academic Hospital of Grenoble, Grenoble, France
| | - Sébastien Gard
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Charles-Perrens Hospital, Department of clinical and academic Psychiatry, Bordeaux, France
| | - Katia M’Bailara
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Charles-Perrens Hospital, Department of clinical and academic Psychiatry, Bordeaux, France
- University of Bordeaux, Laboratory of psychology, Bordeaux, France
| | - Jean-Pierre Kahn
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry and Clinical Psychology, Psychotherapeutic Centre of Nancy, Laxou, France
- French Addictovigilance network (CEIP-A) CHRU of Nancy, Nancy, France
- University of Lorraine, Nancy, France
| | - Paul Roux
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry for adults, Academic Hospital of Versailles, UFR of Health Sciences Simone Veil, University of Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Anne-Sophie Homassel
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry for adults, Academic Hospital of Versailles, UFR of Health Sciences Simone Veil, University of Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Mathilde Carminati
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Fernand Widal Hospital, Department of Addictology-Toxicology-Psychiatry and University Paris-7, Paris, France
| | - Lucile Matos
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CHRU Lapeyronie, Department of Emergency Psychiatry and Post-Acute Care, Montpellier, France
| | - Emilie Olié
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CHRU Lapeyronie, Department of Emergency Psychiatry and Post-Acute Care, Montpellier, France
- Inserm, U1061, University of Montpellier, Montpellier, France
| | - Frank Bellivier
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Fernand Widal Hospital, Department of Addictology-Toxicology-Psychiatry and University Paris-7, Paris, France
| | - Philippe Courtet
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CHRU Lapeyronie, Department of Emergency Psychiatry and Post-Acute Care, Montpellier, France
- Inserm, U1061, University of Montpellier, Montpellier, France
| | - Chantal Henry
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Academic Hospital Henri Mondor, Psychiatric and Addictology pole, Créteil, France
- Inserm, U955, Translational Psychiatry, Mondor Institute, Créteil, France
| | - Marion Leboyer
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Academic Hospital Henri Mondor, Psychiatric and Addictology pole, Créteil, France
- Inserm, U955, Translational Psychiatry, Mondor Institute, Créteil, France
| | - Jean-Michel Azorin
- Department of Psychiatry, AP-HM, Marseille, France
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CNRS, UMR 7289, Institute of Neurosciences Timone, Marseille, France
| | - Raoul Belzeaux
- Department of Psychiatry, AP-HM, Marseille, France
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CRN2M-UMR7286, Aix-Marseille University, CNRS, Marseille, France
- * E-mail:
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187
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Grimes KM, Zanjani A, Zakzanis KK. Memory impairment and the mediating role of task difficulty in patients with schizophrenia. Psychiatry Clin Neurosci 2017; 71:600-611. [PMID: 28294468 DOI: 10.1111/pcn.12520] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 01/08/2017] [Accepted: 03/07/2017] [Indexed: 02/04/2023]
Abstract
Using meta-analytic methods, we sought to synthesize the research literature on memory impairment in schizophrenia. Additionally, we compared performances across memory measures to determine if task difficulty (e.g., effortful encoding and retrieval vs non-effortful encoding and retrieval) could account for variance across studies. Our primary measures of interest included the California Verbal Learning Test, Wechsler Memory Scale, Rey Auditory Verbal Learning Test, Hopkins Verbal Learning Test, Rey-Osterrieth Complex Figure Test, and the Benton Visual Retention Test. We searched for all studies that met inclusion criteria using PubMed, PsycINFO, Scholars Portal Search, and Google Scholar. Studies were included if: (i) they were published after 1980; (ii) healthy controls were compared to patients with schizophrenia; (iii) at least one of the noted measures of interest was employed in the primary study; and (iv) the primary study included data that could be transformed to point estimate effect sizes (i.e., Cohen's d). Cohen's d was calculated between patients and healthy controls, along with overall 95% confidence intervals. A two-tailed independent samples t-test was conducted to assess if performance differed on various paired subtests of the same domain. Large effect sizes were found for all memory tests. No significant differences were found between subtests. In conclusion, patients with schizophrenia experience significant verbal and visual memory impairments, which are not explained by task difficulty. Patients were unable to learn or retrieve more reliably despite repetition and cuing strategies, suggesting that memory impairment in the illness is not a function of task difficulty.
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Affiliation(s)
- Kyrsten M Grimes
- Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Canada
| | - Anosha Zanjani
- Graduate School of Architecture, Columbia University, New York, USA
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188
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Cannabis use in male and female first episode of non-affective psychosis patients: Long-term clinical, neuropsychological and functional differences. PLoS One 2017; 12:e0183613. [PMID: 28832666 PMCID: PMC5568402 DOI: 10.1371/journal.pone.0183613] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Numerous studies show the existence of a high prevalence of cannabis use among patients with psychosis. However, the differences between men and women who debut with a first episode of psychosis (FEP) regarding cannabis use have not been largely explored. The aim of this study was to identify the specific sex factors and differences in clinical evolution associated with cannabis use. METHOD Sociodemographic characteristics at baseline were considered in our sample of FEP patients to find differences depending on sex and the use of cannabis. Clinical, functional and neurocognitive variables at baseline, 1-year, and 3-years follow-up were also explored. RESULTS A total of 549 patients, of whom 43% (N = 236) were cannabis users, 79% (N = 186) male and 21% (N = 50) female, were included in the study. There was a clear relationship between being male and being a user of cannabis (OR = 5.6). Cannabis users were younger at illness onset. Longitudinal analysis showed that women significantly improved in all three dimensions of psychotic symptoms, both in the subgroup of cannabis users and in the non-users subgroup. Conversely, subgroups of men did not show improvement in the negative dimension. In cognitive function, only men presented a significant time by group interaction in processing speed, showing a greater improvement in the subgroup of cannabis users. CONCLUSION Despite knowing that there is a relationship between cannabis use and psychosis, due to the high prevalence of cannabis use among male FEP patients, the results showed that there were very few differences in clinical and neurocognitive outcomes between men and women who used cannabis at the start of treatment compared to those who did not.
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189
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Samad N, Haleem DJ. Antioxidant effects of rice bran oil mitigate repeated haloperidol-induced tardive dyskinesia in male rats. Metab Brain Dis 2017; 32:1099-1107. [PMID: 28374238 DOI: 10.1007/s11011-017-0002-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/26/2017] [Indexed: 10/19/2022]
Abstract
Tardive dyskinesia (TD) is associated with the use of antipsychotic drugs such as D2 antagonist haloperidol (HP). The chronic use of HP is involved in the causation of free radicals and/or oxidative stress. In view of the nootropic, anti-anxiety, anti-inflammatory-like effects of rice bran oil (RBO) in a variety of investigations, we assessed the protective properties of RBO on HP-induced TD and neurochemical alteration. Rats treated with HP orally at a dose of 0.2 mg/kg/day for a period of 5 weeks developed VCMs which increased progressively as the treatment continued for 5 weeks. Co-administration of RBO by oral tubes at a dose of 0.4 ml/day prevented the induction of HP-induced VCMs. Repeated administration of HP increases the turnover of dopamine metabolism in the striatum. Conversely animals treated with HP + RBO decrease the metabolism of DA than water + HP treated animals. Striatal, malondieldehyde (MDA), hydrogen peroxide (H2O2) and antioxidant enzyme superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were also determined. It is suggested that beneficial role of RBO in attenuation of HP-induced TD. The results therefore recommended that supplementation of RBO may be useful in the HP-induced TD. The findings have also potential implication in the treatment of schizophrenia and motor disorders.
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Affiliation(s)
- Noreen Samad
- Department of Biochemistry, Bahauddin Zakariya University, Multan, 60800, Pakistan.
| | - Darakhshan Jabeen Haleem
- Neuroscience Research Laboratory, Dr. Panjwani Center for Molecular Medicine and Drug Research, University of Karachi, Karachi, 75270, Pakistan
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190
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Terachi S, Yamada T, Pu S, Yokoyama K, Matsumura H, Kaneko K. Comparison of neurocognitive function in major depressive disorder, bipolar disorder, and schizophrenia in later life: A cross-sectional study of euthymic or remitted, non-demented patients using the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS-J). Psychiatry Res 2017; 254:205-210. [PMID: 28476012 DOI: 10.1016/j.psychres.2017.04.058] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/29/2017] [Accepted: 04/23/2017] [Indexed: 12/11/2022]
Abstract
Major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) are associated with cognitive dysfunction both in adulthood and in later life. In this study, we directly compared neurocognitive function between these three conditions in later life, employing stringent definitions of euthymia and symptomatic remission. Cognitive function in 60 elderly outpatients with MDD, BD, or SZ (20 patients per group) was assessed using the Japanese version of the Brief Assessment of Cognition in Schizophrenia. Patients with MDD had significantly higher z scores than both the other groups with large or moderately large effect sizes, for verbal fluency, attention and speed of information processing, and composite scores. In contrast, there were no significant differences in the degree of neurocognitive impairment between patients with BD and SZ. In later life, patients with BD and SZ showed a similar degree of neurocognitive impairment, while patients with MDD showed smaller impairments in several neurocognitive domains compared to patients with either of the other two disorders.
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Affiliation(s)
- Sayaka Terachi
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan; Kurayoshi Hospital, Kurayoshi, Tottori, Japan.
| | | | - Shenghong Pu
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Katsutoshi Yokoyama
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Hiroshi Matsumura
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
| | - Koichi Kaneko
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
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191
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Forsyth JK, Lewis DA. Mapping the Consequences of Impaired Synaptic Plasticity in Schizophrenia through Development: An Integrative Model for Diverse Clinical Features. Trends Cogn Sci 2017; 21:760-778. [PMID: 28754595 DOI: 10.1016/j.tics.2017.06.006] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 05/13/2017] [Accepted: 06/09/2017] [Indexed: 01/19/2023]
Abstract
Schizophrenia is associated with alterations in sensory, motor, and cognitive functions that emerge before psychosis onset; identifying pathogenic processes that can account for this multi-faceted phenotype remains a challenge. Accumulating evidence suggests that synaptic plasticity is impaired in schizophrenia. Given the role of synaptic plasticity in learning, memory, and neural circuit maturation, impaired plasticity may underlie many features of the schizophrenia syndrome. Here, we summarize the neurobiology of synaptic plasticity, review evidence that plasticity is impaired in schizophrenia, and explore a framework in which impaired synaptic plasticity interacts with brain maturation to yield the emergence of sensory, motor, cognitive, and psychotic features at different times during development in schizophrenia. Key gaps in the literature and future directions for testing this framework are discussed.
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Affiliation(s)
- Jennifer K Forsyth
- Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA.
| | - David A Lewis
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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192
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Cognitive remediation and occupational outcome in schizophrenia spectrum disorders: A 2year follow-up study. Schizophr Res 2017; 185:122-129. [PMID: 28041917 DOI: 10.1016/j.schres.2016.12.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 12/15/2016] [Accepted: 12/17/2016] [Indexed: 01/31/2023]
Abstract
Neurocognitive impairment is prominent in schizophrenia and a significant predictor of poor occupational outcomes. Vocational rehabilitation (VR) is frequently implemented to counteract high unemployment rates. Individuals with schizophrenia however face numerous challenges such as neurocognitive impairments and psychotic symptoms. Hence, augmenting VR to address illness-related factors may optimize occupational outcomes. The aim of this study was to examine the effects of Cognitive Remediation (CR) combined with VR(CR+VR) compared to techniques from Cognitive Behavioral Therapy (CBT) combined with VR(CBT+VR) on neurocognition and occupational functioning over a 2year period. A total of 131participants underwent assessment with the MATRICS Consensus Cognitive Battery (MCCB) at baseline, post treatment (after 10months) and follow-up (2years after randomization). Occupational status and number of hours worked were recorded at all assessment points. Both groups improved on several neurocognitive domains. All improvements were however in favor of the CR group. There was a significant increase in number of participants working and hours worked in both groups throughout the project period, with no between-group differences. Number of hours worked at follow-up was predicted by change in Working Memory and the Composite Score in the CR group. CR-augmented VR improved several domains, particularly Verbal Learning and Working Memory, which were central in the CR program. The combination of VR and CR or CBT thus enabled a significant proportion of participants to attain and maintain work.
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193
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Sabharwal A, Kotov R, Szekely A, Leung HC, Barch DM, Mohanty A. Neural markers of emotional face perception across psychotic disorders and general population. JOURNAL OF ABNORMAL PSYCHOLOGY 2017; 126:663-678. [PMID: 28557508 PMCID: PMC5695570 DOI: 10.1037/abn0000279] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
There is considerable variation in negative and positive symptoms of psychosis, global functioning, and emotional face perception (EFP), not only in schizophrenia but also in other psychotic disorders and healthy individuals. However, EFP impairment and its association with worse symptoms and global functioning have been examined largely in the domain of schizophrenia. The present study adopted a dimensional approach to examine the association of behavioral and neural measures of EFP with symptoms of psychosis and global functioning across individuals with schizophrenia spectrum (SZ; N = 28) and other psychotic (OP; N = 29) disorders, and never-psychotic participants (NP; N = 21). Behavioral and functional MRI data were recorded as participants matched emotional expressions of faces and geometrical shapes. Lower accuracy and increased activity in early visual regions, hippocampus, and amygdala during emotion versus shape matching were associated with higher negative, but not positive, symptoms and lower global functioning, across all participants. This association remained even after controlling for group-related (SZ, OP, and NP) variance, dysphoria, and antipsychotic medication status, except in amygdala. Furthermore, negative symptoms mediated the relationship between behavioral and brain EFP measures and global functioning. This study provides some of the first evidence supporting the specific relationship of EFP measures with negative symptoms and global functioning across psychotic and never-psychotic samples, and transdiagnostically across different psychotic disorders. Present findings help bridge the gap between basic EFP-related neuroscience research and clinical research in psychosis, and highlight EFP as a potential symptom-specific marker that tracks global functioning. (PsycINFO Database Record
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Affiliation(s)
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University
| | - Akos Szekely
- Department of Psychology, Stony Brook University
| | | | - Deanna M. Barch
- Departments of Psychology, Psychiatry, and Radiology, Washington University in St. Louis
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194
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Victoria LW, Whyte EM, Butters MA, Meyers BS, Alexopoulos GS, Mulsant BH, Rothschild AJ, Banerjee S, Flint AJ. Improvement in Depression is Associated with Improvement in Cognition in Late-Life Psychotic Depression. Am J Geriatr Psychiatry 2017; 25:672-679. [PMID: 28285771 DOI: 10.1016/j.jagp.2017.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To characterize cognitive function at baseline and investigate the relationship between change in cognition, depression, and psychosis after treatment among older adults with major depressive disorder with psychotic features. METHODS This was a secondary analysis of a double-blind, randomized, controlled treatment trial at inpatient and outpatient settings at four academic health centers on "Young Old" (aged 60-71 years, N = 71) and "Older" (aged 72-86 years, N = 71) participants diagnosed with psychotic depression. Olanzapine plus sertraline or olanzapine plus placebo were given until week 12 or termination. RESULTS At baseline, Young Old and Older participants did not differ on measures of depression severity or global cognition, information processing speed, and executive function. Improvement in depressive and psychotic symptoms from baseline to treatment end was similar in both the Young Old and Older groups. However, improvement in depressive symptoms was significantly associated with improvement in global cognitive function in Young Old participants but not in Older participants. CONCLUSION Cognitive dysfunction was not a detriment to improvement in symptoms of psychotic major depression in our geriatric patients. Young Old and Older patients improved to a similar degree on measures of depression and delusions from baseline to treatment end. However, improvement in cognition over the course of treatment was more prominent in the Young Old group than in the Older group.
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Affiliation(s)
- Lindsay W Victoria
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine and New York-Presbyterian Hospital, Westchester Division, White Plains, NY.
| | - Ellen M Whyte
- Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Meryl A Butters
- Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Barnett S Meyers
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine and New York-Presbyterian Hospital, Westchester Division, White Plains, NY
| | - George S Alexopoulos
- Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine and New York-Presbyterian Hospital, Westchester Division, White Plains, NY
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Anthony J Rothschild
- University of Massachusetts Medical School and University of Massachusetts Memorial Health Care, Worcester, MA
| | - Samprit Banerjee
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY
| | - Alastair J Flint
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
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195
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Jenkins LM, Bodapati AS, Sharma RP, Rosen C. Working memory predicts presence of auditory verbal hallucinations in schizophrenia and bipolar disorder with psychosis. J Clin Exp Neuropsychol 2017; 40:84-94. [PMID: 28562181 DOI: 10.1080/13803395.2017.1321106] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The recent dramatic increase in research investigating auditory verbal hallucinations (AVHs) has broadened the former narrow focus on schizophrenia to incorporate additional populations that experience these symptoms. However, an understanding of potential shared mechanisms remains elusive. Based on theories suggesting a failure of top-down cognitive control, we aimed to compare the relationship between AVHs and cognition in two categorical diagnoses of psychosis, schizophrenia and psychotic bipolar disorder. METHOD A total of 124 adults aged 21-60 participated, of whom 76 had present-state psychosis (schizophrenia, n = 53; bipolar disorder with psychosis, n = 23), and 48 were non-clinical controls. Diagnosis and hallucination presence was determined using the Structured Clinical Diagnostic Interview for DSM-IV TR. AVHs severity was assessed using the Positive and Negative Syndrome Scale. Participants also completed the MATRICS cognitive battery. RESULTS The bipolar disorder with psychosis group performed better than the schizophrenia group for cognitive domains of Processing speed, Attention, Working memory (WM), and Visual memory. Hierarchical binary logistic regression found that WM significantly predicted presence of AVHs in both psychotic groups, but diagnosis did not significantly increase the predictive value of the model. A hierarchical multiple linear regression found that schizophrenia diagnosis was the only significant predictor of hallucination severity. CONCLUSIONS The findings of this study-the first, to our knowledge, to compare the relationship between AVHs and MATRICS domains across schizophrenia and bipolar disorder with psychosis-support theories that deficits in WM underly the genesis of AVHs. WM potentially represents a shared mechanism of AVHs across diagnoses, supporting dimensional classifications of these psychotic disorders. However, non-cognitive factors predictive of hallucination severity may be specific to schizophrenia.
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Affiliation(s)
- Lisanne M Jenkins
- a Department of Psychiatry , University of Illinois at Chicago , Chicago , IL , USA
| | - Anjuli S Bodapati
- a Department of Psychiatry , University of Illinois at Chicago , Chicago , IL , USA
| | - Rajiv P Sharma
- a Department of Psychiatry , University of Illinois at Chicago , Chicago , IL , USA.,b Jesse Brown Veterans Affairs Medical Center , Chicago , IL , USA
| | - Cherise Rosen
- a Department of Psychiatry , University of Illinois at Chicago , Chicago , IL , USA
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196
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Self versus informant reports on the specific levels of functioning scale: Relationships to depression and cognition in schizophrenia and schizoaffective disorder. SCHIZOPHRENIA RESEARCH-COGNITION 2017; 9:1-7. [PMID: 28740827 PMCID: PMC5514389 DOI: 10.1016/j.scog.2017.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 04/20/2017] [Indexed: 12/02/2022]
Abstract
The goal of the current study was to examine the relationships between insight and both cognitive function and depression in schizophrenia and schizoaffective disorder, and to determine if there were similar relationships across diagnostic categories. We examined discrepancies between self and informant reports of function on the Specific levels of function scale as a metric of insight for interpersonal, social acceptance, work and activities. We examined two samples of individuals with schizophrenia and/or schizoaffective disorder (Ns of 188 and 67 respectively). In Sample 1, cognition was measured using the Dot Probe Expectancy Task. In Sample 2, cognition was measured by averaging several subtests from the MATRICS consensus cognitive battery, as well as additional measures of working memory. In both samples, depression was measured using the Brief Psychiatric Rating Scale. In both samples, we found significant relationships between worse cognition and overestimations of work function, as well as between higher depression levels and underestimation of interpersonal function. These relationships were specific to interpersonal and work function, with significantly stronger correlations with interpersonal and work function compared to the other areas of function. Similar results were found across diagnostic categories. These results have important implications for treatment planning, as they suggest the need to take into account depression and cognitive function when evaluating the patient's self-report of function, and highlight the utility of informant reports in evaluating function and treatment planning. Further, they add to the literature on the similarity across schizophrenia and schizoaffective disorder in a variety of pathological mechanisms.
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197
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Missonnier P, Curtis L, Ventura J, Herrmann FR, Merlo MCG. Differences of temporal dynamics and signal complexity of gamma band oscillations in first-episode psychosis during a working memory task. J Neural Transm (Vienna) 2017; 124:853-862. [PMID: 28466380 DOI: 10.1007/s00702-017-1728-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 04/18/2017] [Indexed: 01/01/2023]
Abstract
Gamma band oscillations participate in the temporal binding needed to synchronize cortical networks, involved in early sensory and short term memory processes. In earlier studies, alterations of these neurophysiological parameters have been found in psychotic disorders. To date no study has explored the temporal dynamics and signal complexity of gamma band oscillations in first episode psychosis (FEP). To address this issue, gamma band analysis was performed in 15 FEP patients and 18 healthy controls who successfully performed an adapted 2-back working memory task. Multiple linear and logistic regression models were computed to explore the relationship between the cognitive status and gamma oscillation changes over time. Based on regression model results, phase diagrams were constructed and their complexity was estimated using fractal dimension, a mathematical tool that describes shapes as numeric values. When adjusted for gamma values at time lags -3 to -4 ms and -15 to -16 ms, FEP patients displayed significantly higher time-dependent changes than controls, independently of the nature of the task. The present results are consistent with a discoordination of the activity of cortical generators engaged by the stimulus apparition in FEP patients, leading to a global binding deficit. In addition, fractal analysis showing higher complexity of gamma signal, confirmed this deficit. Our results provide evidence for recruitment of supplementary cortical generators as compensating mechanisms and yield further understanding for the pathophysiology cognitive impairments in FEP.
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Affiliation(s)
- Pascal Missonnier
- Unit of Psychiatric Neuroscience and Psychotherapy, Department of Medicine, Faculty of Science, University of Fribourg, Chemin du Musée 5, 1700, Fribourg, Switzerland. .,Mental Health Network Fribourg (RFSM), Sector of Psychiatry and Psychotherapy for Adults, L'Hôpital 140, Case postale 90, 1633, Marsens, Switzerland.
| | - Logos Curtis
- Young Adult Psychiatry Unit, Division of Specialized Psychiatry, Department of Mental Health and Psychiatry, Faculty of Medicine of the University of Geneva, University Hospitals of Geneva, Rue de Lausanne 67, Genève, 1202, Geneva, Switzerland
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, UCLA Department of Psychiatry, 300 Medical Plaza, Room 2243, Los Angeles, CA, 90095-6968, USA
| | - François R Herrmann
- Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals of Geneva, 3 chemin Pont-Bochet, Thônex, 1226, Geneva, Switzerland
| | - Marco C G Merlo
- Unit of Psychiatric Neuroscience and Psychotherapy, Department of Medicine, Faculty of Science, University of Fribourg, Chemin du Musée 5, 1700, Fribourg, Switzerland
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198
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Morgan CJ, Coleman MJ, Ulgen A, Boling L, Cole JO, Johnson FV, Lerbinger J, Bodkin JA, Holzman PS, Levy DL. Thought Disorder in Schizophrenia and Bipolar Disorder Probands, Their Relatives, and Nonpsychiatric Controls. Schizophr Bull 2017; 43:523-535. [PMID: 28338967 PMCID: PMC5463905 DOI: 10.1093/schbul/sbx016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Thought disorder (TD) has long been associated with schizophrenia (SZ) and is now widely recognized as a symptom of mania and other psychotic disorders as well. Previous studies have suggested that the TD found in the clinically unaffected relatives of SZ, schizoaffective and bipolar probands is qualitatively similar to that found in the probands themselves. Here, we examine which quantitative measures of TD optimize the distinction between patients with diagnoses of SZ and bipolar disorder with psychotic features (BP) from nonpsychiatric controls (NC) and from each other. In addition, we investigate whether these same TD measures also distinguish their respective clinically unaffected relatives (RelSZ, RelBP) from controls as well as from each other. We find that deviant verbalizations are significantly associated with SZ and are co-familial in clinically unaffected RelSZ, but are dissociated from, and are not co-familial for, BP disorder. In contrast, combinatory thinking was nonspecifically associated with psychosis, but did not aggregate in either group of relatives. These results provide further support for the usefulness of TD for identifying potential non-penetrant carriers of SZ-risk genes, in turn enhancing the power of genetic analyses. These findings also suggest that further refinement of the TD phenotype may be needed in order to be suitable for use in genetic studies of bipolar disorder.
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Affiliation(s)
- Charity J Morgan
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | | | - Ayse Ulgen
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY
| | - Lenore Boling
- Psychology Research Laboratory, McLean Hospital, Belmont, MA
| | - Jonathan O Cole
- Psychology Research Laboratory, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | | | - Jan Lerbinger
- Psychology Research Laboratory, McLean Hospital, Belmont, MA
| | - J Alexander Bodkin
- Psychology Research Laboratory, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Philip S Holzman
- Psychology Research Laboratory, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Deborah L Levy
- Psychology Research Laboratory, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
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199
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Szmulewicz AG, Valerio MP, Smith JM, Samamé C, Martino DJ, Strejilevich SA. Neuropsychological profiles of major depressive disorder and bipolar disorder during euthymia. A systematic literature review of comparative studies. Psychiatry Res 2017; 248:127-133. [PMID: 28040657 DOI: 10.1016/j.psychres.2016.12.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 11/09/2016] [Accepted: 12/23/2016] [Indexed: 11/16/2022]
Abstract
Bipolar disorder and major depressive disorder have been shown to be associated with neurocognitive abnormalities during periods of clinical remission. However, at present, there is no consensus on whether these disorders have distinctive cognitive profiles. The aim of this study was to provide an updated systematic review of studies comparing neuropsychological functioning between bipolar disorder and major depressive disorder during remission. Main findings included the following: 1) no differences regarding performances in measures of attention and processing speed, executive functions and theory of mind were found between both patient groups and 2) regarding verbal memory, preliminary evidence points towards a more defective performance in patients with bipolar disorder than those with major depressive disorder. However, several variables with negative impact on cognition (medication status, age at onset, premorbid IQ, bipolar subtype, among others) were not adequately controlled in most studies. In conclusion, evidence from studies exploring neuropsychological profiles in bipolar disorder and major depressive disorder could not provide clues to differentiate these mood disorders. Larger studies with adequate control of confounding variables would be necessary to elucidate if the finding of more defective verbal memory performance in bipolar disorder is truly explained by distinct underlying mechanisms.
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Affiliation(s)
- Alejandro G Szmulewicz
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina; Department of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina.
| | - Marina P Valerio
- Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - José M Smith
- Hospital de Emergencias Psiquiátricas Torcuato de Alvear, Buenos Aires, Argentina
| | - Cecilia Samamé
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | - Diego J Martino
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Sergio A Strejilevich
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
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200
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Anticevic A. Understanding the role of thalamic circuits in schizophrenia neuropathology. Schizophr Res 2017; 180:1-3. [PMID: 27939828 DOI: 10.1016/j.schres.2016.11.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 11/28/2016] [Accepted: 11/28/2016] [Indexed: 01/05/2023]
Affiliation(s)
- Alan Anticevic
- Department of Psychiatry, Yale University, United States; Department of Psychology, Yale University, United States.
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