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Park J, Lee E, Cho G, Hwang H, Kim BG, Kim G, Joo YY, Cha J. Gene-environment pathways to cognitive intelligence and psychotic-like experiences in children. eLife 2024; 12:RP88117. [PMID: 38441539 PMCID: PMC10942586 DOI: 10.7554/elife.88117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
In children, psychotic-like experiences (PLEs) are related to risk of psychosis, schizophrenia, and other mental disorders. Maladaptive cognitive functioning, influenced by genetic and environmental factors, is hypothesized to mediate the relationship between these factors and childhood PLEs. Using large-scale longitudinal data, we tested the relationships of genetic and environmental factors (such as familial and neighborhood environment) with cognitive intelligence and their relationships with current and future PLEs in children. We leveraged large-scale multimodal data of 6,602 children from the Adolescent Brain and Cognitive Development Study. Linear mixed model and a novel structural equation modeling (SEM) method that allows estimation of both components and factors were used to estimate the joint effects of cognitive phenotypes polygenic scores (PGSs), familial and neighborhood socioeconomic status (SES), and supportive environment on NIH Toolbox cognitive intelligence and PLEs. We adjusted for ethnicity (genetically defined), schizophrenia PGS, and additionally unobserved confounders (using computational confound modeling). Our findings indicate that lower cognitive intelligence and higher PLEs are significantly associated with lower PGSs for cognitive phenotypes, lower familial SES, lower neighborhood SES, and less supportive environments. Specifically, cognitive intelligence mediates the effects of these factors on PLEs, with supportive parenting and positive school environments showing the strongest impact on reducing PLEs. This study underscores the influence of genetic and environmental factors on PLEs through their effects on cognitive intelligence. Our findings have policy implications in that improving school and family environments and promoting local economic development may enhance cognitive and mental health in children.
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Affiliation(s)
- Junghoon Park
- Interdisciplinary Program in Artificial Intelligence, College of Engineering, Seoul National UniversitySeoulRepublic of Korea
| | - Eunji Lee
- Department of Psychology, College of Social Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Gyeongcheol Cho
- Department of Psychology, College of Arts and Sciences, The Ohio State UniversityColumbusUnited States
| | - Heungsun Hwang
- Department of Psychology, McGill UniversityMontréalCanada
| | - Bo-Gyeom Kim
- Department of Psychology, College of Social Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Gakyung Kim
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Yoonjung Yoonie Joo
- Department of Psychology, College of Social Sciences, Seoul National UniversitySeoulRepublic of Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan UniversitySeoulRepublic of Korea
- Samsung Medical CenterSeoulRepublic of Korea
| | - Jiook Cha
- Interdisciplinary Program in Artificial Intelligence, College of Engineering, Seoul National UniversitySeoulRepublic of Korea
- Department of Psychology, College of Social Sciences, Seoul National UniversitySeoulRepublic of Korea
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National UniversitySeoulRepublic of Korea
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Kendler KS, Keefe RSE, Ohlsson H, Sundquist J, Sundquist K. Risk for psychiatric and substance use disorders as a function of transitions in Sweden's public educational system: a national study. Psychol Med 2024; 54:117-124. [PMID: 36878890 PMCID: PMC10916708 DOI: 10.1017/s003329172300048x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
BACKGROUND To clarify, in a national sample, associations between risk for seven psychiatric and substance use disorders and five key transitions in Sweden's public educational system. METHODS Swedish-born individuals (1972-1995, N = 1 997 910) were followed through 12-31-2018, at mean age 34.9. We predicted, from these educational transitions, risk for major depression (MD), obsessive-compulsive disorder (OCD), bipolar disorder (BD), schizophrenia (SZ), anorexia nervosa (AN), alcohol use disorder (AUD), and drug use disorder (DUD), assessed from Swedish national registers, by Cox regression, censoring individuals with onsets ⩽17. We also predicted risk from the deviation of grades from family-genetic expectations (deviation 1) and from changes in grades from ages 16 to 19 (deviation 2). RESULTS We observed four major risk patterns across transitions in our disorders: (i) MD and BD, (ii) OCD and SZ, (iii) AUD and DUD, and (iv) AN. Failing early educational transitions had the greatest impact on risk for OCD and SZ while for other disorders, not progressing from basic to upper high school had the largest effect. Completing vocational v. college-prep upper high school was strongly associated with risk for AUD and DUD, had little relation with MD, OCD, BD, and SZ risk, and was protective for AN. Deviation 1 predicted risk most strongly for SZ, AN, and MD. Deviation 2 predicted risk most strongly for SZ, AUD, and DUD. CONCLUSIONS The pattern of educational transitions and within family and within person development deviations are strongly and relatively specifically associated with future risk for seven psychiatric and substance-use disorders.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, New York, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, New York, USA
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Rotstein A, Fund S, Levine SZ, Reichenberg A, Goldenberg J. Is cognition integral to psychopathology? A population-based cohort study. Psychol Med 2023; 53:7350-7357. [PMID: 37114455 PMCID: PMC10719669 DOI: 10.1017/s0033291723000934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/11/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Lower cognitive functioning has been documented across psychiatric disorders and hypothesized to be a core deficit of mental disorders. Situating psychopathology and cognition as part of a unitary construct is therefore important to understanding the etiology of psychiatric disorders. The current study aims to test competing structural models of psychopathology and cognition in a large national cohort of adolescents. METHODS The analytic sample consisted of 1189 participants aged 16-17 years, screened by the Israeli Draft Board. Psychopathology was assessed using a modified version of the Brief Symptom Inventory, and cognition was assessed based on four standardized test scores ((1) mathematical reasoning, concentration, and concept manipulation; (2) visual-spatial problem-solving skills and nonverbal abstract reasoning; (3) verbal understanding; (4) categorization and verbal abstraction). Confirmatory factor analysis was implemented to compare competing structural models of psychopathology with and without cognition. Sensitivity analyses examined the models in different subpopulations. RESULTS Confirmatory factor analysis indicated a better model fit of psychopathological symptoms without cognition (RMSEA = 0.037; TLI = 0.991; CFI = 0.992) than with cognition (RMSEA = 0.04-0.042; TLI = 0.987-0.988; CFI = 0.988-0.989). Sensitivity analyses supported the robustness of these results with a single exception. Among participants with low cognitive abilities (N = 139), models that integrated psychopathological symptoms with cognition had a better fit compared to models of psychopathology without cognition. CONCLUSIONS The current study suggests that cognition and psychopathology are, generally, independent constructs. However, within low cognitive abilities, cognition was integral to the structure of psychopathology. Our results point toward an increased vulnerability to psychopathology in individuals with low cognitive abilities and may provide valuable information for clinicians.
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Affiliation(s)
- Anat Rotstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Gerontology, University of Haifa, Haifa, Israel
| | - Suzanne Fund
- Department of Behavioral Sciences, Israel Defense Forces, Israel
| | | | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Judy Goldenberg
- Department of Behavioral Sciences, Israel Defense Forces, Israel
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Jo YT, Lee JS, Park J, Lee J, Joo YH. Linguistic anomalies observed in the Sentence Completion Test in patients with schizophrenia. Cogn Neuropsychiatry 2023; 28:226-236. [PMID: 37167542 DOI: 10.1080/13546805.2023.2209313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Schizophrenia is a chronic, debilitating disorder characterised by distorted thinking, perceptions, behaviours, and even language impairments. We investigated the linguistic anomalies in Korean schizophrenia patients compared to non-psychotic psychiatric controls to determine whether the linguistic anomalies in English speakers with schizophrenia were replicated in Korean speakers. METHODS Thirty-four schizophrenia patients and 70 non-psychotic psychiatric controls were included in this study. The SCT was utilised as the text data for analysis. For linguistic analysis, we evaluated texts regarding semantics and syntax. We separately counted the number of semantic or syntactic errors in the written texts of study participants and compared them between patients and controls. RESULTS Schizophrenia patients showed significantly more semantic errors (p < .001) and syntactic errors (p < .001) per 1,000 characters than non-psychotic psychiatric controls. Specifically, inappropriate word or syntactic component selection is noticeable in schizophrenia patients. These differences were still significant after adjusting for general intelligence measured by the K-WAIS-IV. CONCLUSION Schizophrenia patients showed both semantic and syntactic errors in written language. Moreover, these errors seemed to be partly independent of general intelligence. Notably, patients showed a noticeable number of syntactic errors. Further investigation into the language of patients with schizophrenia and schizophrenia-spectrum disorders is required.
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Affiliation(s)
- Young Tak Jo
- Department of Psychiatry, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Ji Soo Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaiyoung Park
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jungsun Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yeon Ho Joo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Subcortical Structures in Demented Schizophrenia Patients: A Comparative Study. Biomedicines 2023; 11:biomedicines11010233. [PMID: 36672741 PMCID: PMC9855401 DOI: 10.3390/biomedicines11010233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
There are few studies on dementia and schizophrenia in older patients looking for structural differences. This paper aims to describe relation between cognitive performance and brain volumes in older schizophrenia patients. Twenty schizophrenic outpatients -10 without-dementia (SND), 10 with dementia (SD)- and fifteen healthy individuals -as the control group (CG)-, older than 50, were selected. Neuropsychological tests were used to examine cognitive domains. Brain volumes were calculated with magnetic resonance images. Cognitive performance was significantly better in CG than in schizophrenics. Cognitive performance was worst in SD than SND, except in semantic memory and visual attention. Hippocampal volumes showed significant differences between SD and CG, with predominance on the right side. Left thalamic volume was smaller in SD group than in SND. Structural differences were found in the hippocampus, amygdala, and thalamus; more evident in the amygdala and thalamus, which were mainly related to dementia. In conclusion, cognitive performance and structural changes allowed us to differentiate between schizophrenia patients and CG, with changes being more pronounced in SD than in SND. When comparing SND with SD, the functional alterations largely coincide, although sometimes in the opposite direction. Moreover, volume lost in the hippocampus, amygdala, and thalamus may be related to the possibility to develop dementia in schizophrenic patients.
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KAYA H, AYIK B. Şizofreni hastalarında TSH, fT3 ve fT4 düzeylerinin nörobilişsel belirtiler üzerine etkisi. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1135374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Amaç: Bu çalışmamızda ötiroid psikoz hastalarında tiroid hormon düzeyleri ile pozitif, negatif, genel ve bilişsel belirtiler arasındaki ilişkiyi incelemeyi amaçladık.
Gereç ve Yöntem: Çalışmaya 33 şizofreni hastası dahil edildi. Katılımcıların sosyodemografik ve klinik verileri, Pozitif ve Negatif Belirtileri Değerlendirme Ölçeği (PANSS), İşlevselliğin Genel Değerlendirilmesi Ölçeği (IGD), Klinik Global İzlenim Ölçeği (KGI) skorları kaydedildi. İz sürme, Sözel Akıcılık Testi, İleri ve Geri Sayı Menzili ile Wisconsin Kart Sayma Testinden (WKST) oluşan bir nörobilişsel batarya uygulanan hastaların bilişsel performanslarının TSH, sT3 ve sT4 düzeyleri ile ilişkisi araştırıldı.
Bulgular: sT4 düzeyleri ile İz Sürme B (r=-,376; p=0,031) ve Sözel Akıcılık test (p=,355; p=0,043) performansları arasında anlamlı derecede ilişki saptandı. Linear regresyon modelinde sT3 düzeylerinin WKST- tamamlanan kategori sayısını (UB=1.680; p=0.029) anlamlı derecede yordadığı saptandı..
Sonuç: Çalışmamızın sonuçları sT3 ün özellikle yürütücü işlevler üzerinde sT4’e kıyasla daha belirleyici etkileri olduğunu düşündürmüştür. İleride yapılacak daha geniş katılımlı araştırmalar, bilişsel belirtilerin tedavisinde tiroid hormon replasmanının etkinliğini belirlemek açısından önemli görünmektedir.
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Affiliation(s)
| | - Batuhan AYIK
- UNIVERSITY OF HEALTH SCIENCES, İSTANBUL ERENKÖY APPLICATION AND RESEARCH CENTER FOR PSYCHIATRIC AND NERVE DISEASES
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Karcher NR, Merchant J, Pine J, Kilciksiz CM. Cognitive Dysfunction as a Risk Factor for Psychosis. Curr Top Behav Neurosci 2022; 63:173-203. [PMID: 35989398 DOI: 10.1007/7854_2022_387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The current chapter summarizes recent evidence for cognition as a risk factor for the development of psychosis, including the range of cognitive impairments that exist across the spectrum of psychosis risk symptoms. The chapter examines several possible theories linking cognitive deficits with the development of psychotic symptoms, including evidence that cognitive deficits may be an intermediate risk factor linking genetic and/or neural metrics to psychosis spectrum symptoms. Although there is not strong evidence for unique cognitive markers associated specifically with psychosis compared to other forms of psychopathology, psychotic disorders are generally associated with the greatest severity of cognitive deficits. Cognitive deficits precede the development of psychotic symptoms and may be detectable as early as childhood. Across the psychosis spectrum, both the presence and severity of psychotic symptoms are associated with mild to moderate impairments across cognitive domains, perhaps most consistently for language, cognitive control, and working memory domains. Research generally indicates the size of these cognitive impairments worsens as psychosis symptom severity increases. The chapter points out areas of unclarity and unanswered questions in each of these areas, including regarding the mechanisms contributing to the association between cognition and psychosis, the timing of deficits, and whether any cognitive systems can be identified that function as specific predictors of psychosis risk symptoms.
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Affiliation(s)
- Nicole R Karcher
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
| | - Jaisal Merchant
- Department of Brain and Psychological Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Jacob Pine
- Department of Brain and Psychological Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Can Misel Kilciksiz
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Rotstein A, Goldenberg J, Fund S, Levine SZ, Reichenberg A. Capturing adolescents in need of psychiatric care with psychopathological symptoms: A population-based cohort study. Eur Psychiatry 2021; 64:e76. [PMID: 34842124 PMCID: PMC8727710 DOI: 10.1192/j.eurpsy.2021.2251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The current study aims to overcome past methodological limitations and capture adolescents in need of psychiatric care with psychopathological symptoms in a cohort with unrestricted access to mental health professionals. METHODS The study source population consisted of a random sample of adolescents aged 16-17 years (N=1,369) assessed by the Israeli Draft Board. An adapted version of the Brief Symptom Inventory was used to identify clinically relevant psychopathological symptoms with scores categorized as severe if they were in the top 10th percentile of symptoms, otherwise not severe. An independent interview with a subsequent referral to a mental health professional was used to categorize adolescents in need of psychiatric care. To examine the association between severe psychopathological symptoms and the need for psychiatric care, logistic regression models were fitted unadjusted and adjusted for age, sex, and intellectual assessment scores. Adjusted classification measures were estimated to examine the utility of severe psychopathological symptoms for clinical prediction of need for psychiatric care. RESULTS Information on 1,283 adolescents was available in the final analytic sample. Logistic regression modeling showed a statistically significant (p<0.001) association between self-reported severe psychopathological symptoms and the need for psychiatric care (OR adjusted: 4.38; 95% CI: 3.55-5.40). Severe psychopathological symptoms had a classification accuracy of 83% (CI: 81%-85%). CONCLUSIONS Severe psychopathological symptoms, although accounting for a fair proportion of treatment seeking, would perhaps be better useful for classification purposes alongside other variables rather than in isolation.
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Affiliation(s)
- Anat Rotstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Judy Goldenberg
- Department of Behavioral Sciences, Israel Defense Forces, Tel Aviv, Israel
| | - Suzan Fund
- Department of Behavioral Sciences, Israel Defense Forces, Tel Aviv, Israel
| | - Stephen Z. Levine
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- The Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine, New York, New York, USA
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Burger TJ, Schirmbeck F, Vermeulen JM, Quee PJ, de Koning MB, Bruggeman R, de Haan L. Association between cognitive phenotype in unaffected siblings and prospective 3- and 6-year clinical outcome in their proband affected by psychosis. Psychol Med 2021; 51:1916-1926. [PMID: 32290874 DOI: 10.1017/s0033291720000719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cognitive alterations are a central and heterogeneous trait in psychotic disorders, driven by environmental, familial and illness-related factors. In this study, we aimed to prospectively investigate the impact of high familial risk for cognitive alterations, unconfounded by illness-related factors, on symptomatic outcomes in patients. METHODS In total, 629 probands with non-affective psychosis and their sibling not affected by psychosis were assessed at baseline, 3- and 6-year follow-up. Familial cognitive risk was modeled by three cognitive subtypes ('normal', 'mixed' and 'impaired') in the unaffected siblings. Generalized linear mixed models assessed multi-cross-sectional associations between the sibling cognitive subtype and repeated measures of proband symptoms across all assessments. Between-group differences over time were assessed by adding an interaction effect of time and sibling cognitive subtype. RESULTS Probands affected by psychosis with a sibling of the impaired cognitive subtype were less likely to be in symptomatic remission and showed more disorganization across all time points. When assessing differences over time, probands of siblings with the impaired cognitive subtype showed less remission and less improvement of disorganization after 3 and 6 years relative to the other subtypes. They also showed less reduction of positive, negative and excitement symptoms at 6-year follow-up compared to probands with a sibling of the normal cognitive subtype. CONCLUSIONS Cross-sibling pathways from higher levels of familial cognitive vulnerability to worse long-term outcomes may be informative in identifying cognition-related environmental and genetic risks that impact psychotic illness heterogeneity over time.
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Affiliation(s)
- Thijs J Burger
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Frederike Schirmbeck
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jentien M Vermeulen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Piotr J Quee
- Department of Neurorehabilitation, Rijndam Revalidatie, Rotterdam, the Netherlands
| | - Mariken B de Koning
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
| | - Lieuwe de Haan
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Leweke FM, Rohleder C, Gerth CW, Hellmich M, Pukrop R, Koethe D. Cannabidiol and Amisulpride Improve Cognition in Acute Schizophrenia in an Explorative, Double-Blind, Active-Controlled, Randomized Clinical Trial. Front Pharmacol 2021; 12:614811. [PMID: 33995015 PMCID: PMC8117353 DOI: 10.3389/fphar.2021.614811] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/08/2021] [Indexed: 12/17/2022] Open
Abstract
Cannabidiol (CBD), a principal phytocannabinoid constituent, has demonstrated antipsychotic properties in recent clinical trials. While it has also been suggested a promising candidate for the treatment of neurodegenerative disorders, it failed to demonstrate efficacy in cognitive impairments associated with schizophrenia as an add-on treatment (600 mg/day for 6 weeks) in 18 chronically ill patients co-treated with a variety of psychopharmacologic drugs. Here, we report on the results of parallel-group, active-controlled, mono-therapeutic, double-blind, randomized clinical trial (CBD-CT1; ClinicalTrials.gov identifier: NCT00628290) in 42 acute paranoid schizophrenic patients receiving either CBD (up to 800 mg/day) or amisulpride (AMI, up to 800 mg/day) for four weeks in an inpatient setting with neurocognition as a secondary objective. Twentynine patients (15 and 14 in the CBD and AMI group, respectively) completed two cognitive assessments at baseline and the end of the treatment period. We investigated the following cognitive domains: pattern recognition, attention, working memory, verbal and visual memory and learning, processing speed, and verbal executive functions. When applying the Bonferroni correction for multiple testing, p < 0.0004 would indicate statistical significance. There was no relevant difference in neurocognitive performance between the CBD and the AMI group at baseline, and we observed no post-treatment differences between both groups. However, we observed improvements within both groups from pre-to post-treatment (standardized differences reported as Cohen’s d) in visual memory (CBD: 0.49, p = 0.015 vs. AMI: 0.63, p = 0.018) and processing speed (CBD: 0.41, p = 0.004 vs. AMI: 0.57, p = 0.023). Furthermore, CBD improved sustained attention (CBD: 0.47, p = 0.013, vs. AMI: 0.52, p = 0.085), and visuomotor coordination (CBD: 0.32, p = 0.010 vs. AMI: 0.63, p = 0.088) while AMI led to enhanced working memory performance in two different paradigms (Subject Ordered Pointing Task–AMI: 0.53, p = 0.043 vs. CBD: 0.03, p = 0.932 and Letter Number Sequencing–AMI: 0.67, p = 0.017 vs. CBD: 0.08 p = 0.755). There was no relevant correlation between changes in neurocognitive parameters and psychotic symptoms or anandamide serum levels. This study shows that both CBD and AMI improve neurocognitive functioning with comparable efficacy in young and acutely ill schizophrenia patients via an anandamide-independent mechanism.
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Affiliation(s)
- F Markus Leweke
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany.,Youth Mental Health Team, Brain and Mind Centre, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Cathrin Rohleder
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany.,Youth Mental Health Team, Brain and Mind Centre, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Christoph W Gerth
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of General Psychiatry, Rheinhessen-Fachklinik Alzey, Alzey, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ralf Pukrop
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Dagmar Koethe
- Youth Mental Health Team, Brain and Mind Centre, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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11
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Liu D, Fan HZ, Zhao WX, Wang YH, Li D, Wu JL, Yan TY, Tan SP. Deficits of Tactile Passive Perception Acuity in Patients With Schizophrenia. Front Psychiatry 2020; 11:519248. [PMID: 33192644 PMCID: PMC7652750 DOI: 10.3389/fpsyt.2020.519248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 09/09/2020] [Indexed: 11/14/2022] Open
Abstract
Background: Scarce literature has yet to characterize the tactile discrimination capability as well as the underlying mechanism of tactile deficits in psychotic disorder. In particular, very little is known regarding the tactile perception acuity in schizophrenia. Methods: A total of 131 clinically stable patients with schizophrenia (SCZ) and 79 healthy control (HC) volunteers were enrolled in the study. All the participants were tested on a tactile stimulus device which could quantify the tactile discrimination capability with right index finger scanned over the angles via the passive finger-movement apparatus. The MATRICS Consensus Cognitive Battery (MCCB) was adapted to assess the neurocognition of the participants. Correlation analysis and multivariate linear regression analysis were performed to investigate the relationship between tactile perception performance and neurocognitive function. Results: It was discovered that there existed a significant deficits in the tactile passive perception acuity (i.e., tactile angle discrimination threshold) in patients with schizophrenia compared with their healthy controls (F (3, 206) = 11.458, P = 0.001,partial η2 = 0.053). The MCCB total score and its six domains were significantly lower in SCZ patients than those in HCs (all p < 0.001). In the SCZ group, the composite score of the MCCB (r = -0.312, P < 0.001) and domains of neurocognition including speed of processing (r = -0.191, P = 0.031), attention/vigilance (r = -0.177, P = 0.047), working memory (r = -0.316, P < 0.001), verbal learning (r = - 0.332, P < 0.001), visual learning (r = -0.260, P = 0.004), and reasoning and problem solving (r = -0.209, P = 0.018) showed significant negative correlations with the tactile angle discrimination threshold. Multivariate linear regression analysis revealed that neurocognition impairment, especially the decline of working memory (B = -0.312, P < 0.001),underpin the tactile perception discrimination deficits in patients with SCZ. Conclusion: To the best of our knowledge, this is the first study to unravel the deficits of tactile passive perception acuity and its underlying neurocognition basis in patients with SCZ. This finding adds novel evidence to the subtle variation in haptic discrimination skills in schizophrenia which contributes to a more comprehensive understanding of the sensory profiles of this disorder.
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Affiliation(s)
- Dan Liu
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Hong Zhen Fan
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Wen Xuan Zhao
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Yun Hui Wang
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Dong Li
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Jing Long Wu
- School of Mechatronical Engineering, Intelligent Robotics Institute, Beijing Institute of Technology, Beijing, China
| | - Tian Yi Yan
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Shu Ping Tan
- Huilongguan College of Clinical Medicine, Peking University, Beijing Huilongguan Hospital, Beijing, China
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12
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de Zwarte SMC, Brouwer RM, Agartz I, Alda M, Alonso‐Lana S, Bearden CE, Bertolino A, Bonvino A, Bramon E, Buimer EEL, Cahn W, Canales‐Rodríguez EJ, Cannon DM, Cannon TD, Caseras X, Castro‐Fornieles J, Chen Q, Chung Y, De la Serna E, del Mar Bonnin C, Demro C, Di Giorgio A, Doucet GE, Eker MC, Erk S, Fatjó‐Vilas M, Fears SC, Foley SF, Frangou S, Fullerton JM, Glahn DC, Goghari VM, Goikolea JM, Goldman AL, Gonul AS, Gruber O, Hajek T, Hawkins EL, Heinz A, Hidiroglu Ongun C, Hillegers MHJ, Houenou J, Hulshoff Pol HE, Hultman CM, Ingvar M, Johansson V, Jönsson EG, Kane F, Kempton MJ, Koenis MMG, Kopecek M, Krämer B, Lawrie SM, Lenroot RK, Marcelis M, Mattay VS, McDonald C, Meyer‐Lindenberg A, Michielse S, Mitchell PB, Moreno D, Murray RM, Mwangi B, Nabulsi L, Newport J, Olman CA, van Os J, Overs BJ, Ozerdem A, Pergola G, Picchioni MM, Piguet C, Pomarol‐Clotet E, Radua J, Ramsay IS, Richter A, Roberts G, Salvador R, Saricicek Aydogan A, Sarró S, Schofield PR, Simsek EM, Simsek F, Soares JC, Sponheim SR, Sugranyes G, Toulopoulou T, Tronchin G, Vieta E, Walter H, Weinberger DR, Whalley HC, Wu M, Yalin N, Andreassen OA, Ching CRK, Thomopoulos SI, van Erp TGM, Jahanshad N, Thompson PM, Kahn RS, van Haren NEM. Intelligence, educational attainment, and brain structure in those at familial high-risk for schizophrenia or bipolar disorder. Hum Brain Mapp 2020; 43:414-430. [PMID: 33027543 PMCID: PMC8675411 DOI: 10.1002/hbm.25206] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/28/2020] [Accepted: 09/03/2020] [Indexed: 12/25/2022] Open
Abstract
First-degree relatives of patients diagnosed with schizophrenia (SZ-FDRs) show similar patterns of brain abnormalities and cognitive alterations to patients, albeit with smaller effect sizes. First-degree relatives of patients diagnosed with bipolar disorder (BD-FDRs) show divergent patterns; on average, intracranial volume is larger compared to controls, and findings on cognitive alterations in BD-FDRs are inconsistent. Here, we performed a meta-analysis of global and regional brain measures (cortical and subcortical), current IQ, and educational attainment in 5,795 individuals (1,103 SZ-FDRs, 867 BD-FDRs, 2,190 controls, 942 schizophrenia patients, 693 bipolar patients) from 36 schizophrenia and/or bipolar disorder family cohorts, with standardized methods. Compared to controls, SZ-FDRs showed a pattern of widespread thinner cortex, while BD-FDRs had widespread larger cortical surface area. IQ was lower in SZ-FDRs (d = -0.42, p = 3 × 10-5 ), with weak evidence of IQ reductions among BD-FDRs (d = -0.23, p = .045). Both relative groups had similar educational attainment compared to controls. When adjusting for IQ or educational attainment, the group-effects on brain measures changed, albeit modestly. Changes were in the expected direction, with less pronounced brain abnormalities in SZ-FDRs and more pronounced effects in BD-FDRs. To conclude, SZ-FDRs and BD-FDRs show a differential pattern of structural brain abnormalities. In contrast, both had lower IQ scores and similar school achievements compared to controls. Given that brain differences between SZ-FDRs and BD-FDRs remain after adjusting for IQ or educational attainment, we suggest that differential brain developmental processes underlying predisposition for schizophrenia or bipolar disorder are likely independent of general cognitive impairment.
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Affiliation(s)
- Sonja M. C. de Zwarte
- Department of PsychiatryUniversity Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands
| | - Rachel M. Brouwer
- Department of PsychiatryUniversity Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of OsloOsloNorway,Centre for Psychiatry Research, Department of Clinical NeuroscienceKarolinska Institutet & Stockholm Health Care Services, Stockholm RegionStockholmSweden,Department of PsychiatryDiakonhjemmet HospitalOsloNorway
| | - Martin Alda
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanada,National Institute of Mental HealthKlecanyCzech Republic
| | - Silvia Alonso‐Lana
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain,CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain
| | - Carrie E. Bearden
- Semel Institute for Neuroscience and Human Behavior, University of CaliforniaCaliforniaLos AngelesUSA,Department of PsychologyUniversity of CaliforniaCaliforniaLos AngelesUSA
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense OrgansUniversity of Bari 'Aldo Moro'BariItaly
| | - Aurora Bonvino
- Department of Basic Medical Science, Neuroscience and Sense OrgansUniversity of Bari 'Aldo Moro'BariItaly
| | - Elvira Bramon
- Division of Psychiatry, Neuroscience in Mental Health Research DepartmentUniversity College LondonLondonUK
| | - Elizabeth E. L. Buimer
- Department of PsychiatryUniversity Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands
| | - Wiepke Cahn
- Department of PsychiatryUniversity Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands
| | - Erick J. Canales‐Rodríguez
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain,CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain
| | - Dara M. Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland GalwayGalwayIreland
| | - Tyrone D. Cannon
- Department of PsychologyYale UniversityNew HavenConnecticutUSA,Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Xavier Caseras
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Josefina Castro‐Fornieles
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881Institute of Neuroscience, Hospital Clínic of BarcelonaBarcelonaSpain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain,University of BarcelonaBarcelonaSpain
| | - Qiang Chen
- Lieber Institute for Brain Development, Johns Hopkins Medical CampusBaltimoreMarylandUSA
| | - Yoonho Chung
- Department of PsychologyYale UniversityNew HavenConnecticutUSA
| | - Elena De la Serna
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881Institute of Neuroscience, Hospital Clínic of BarcelonaBarcelonaSpain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain,University of BarcelonaBarcelonaSpain
| | - Caterina del Mar Bonnin
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain,Bipolar and Depressive Disorders UnitHospital Clinic, University of BarcelonaBarcelonaSpain
| | - Caroline Demro
- Department of Psychiatry and Behavioral SciencesUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | - Gaelle E. Doucet
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Boys Town National Research HospitalOmahaNEUSA
| | - Mehmet Cagdas Eker
- SoCAT LAB, Department of PsychiatrySchool of Medicine, Ege UniversityIzmirTurkey
| | - Susanne Erk
- Research Division of Mind and Brain, Department of Psychiatry and PsychotherapyCharité Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Mar Fatjó‐Vilas
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain,CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain
| | - Scott C. Fears
- Department of Psychiatry and Biobehavioral ScienceUniversity of CaliforniaLos AngelesCaliforniaUSA,Center for Neurobehavioral GeneticsUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Sonya F. Foley
- Cardiff University Brain Research Imaging Centre, Cardiff UniversityCardiffUK
| | - Sophia Frangou
- Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Janice M. Fullerton
- Neuroscience Research AustraliaSydneyAustralia,School of Medical Sciences, University of New South WalesSydneyAustralia
| | - David C. Glahn
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford HospitalHartfordConnecticutUSA,Tommy Fuss Center for Neuropsychiatric Disease ResearchBoston Children's HospitalBostonMassachusettsUSA,Harvard Medical SchoolBostonMassachusettsUSA
| | - Vina M. Goghari
- Department of Psychology and Graduate Department of Psychological Clinical ScienceUniversity of TorontoTorontoOntarioCanada
| | - Jose M. Goikolea
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain,Bipolar and Depressive Disorders UnitHospital Clinic, University of BarcelonaBarcelonaSpain
| | - Aaron L. Goldman
- Lieber Institute for Brain Development, Johns Hopkins Medical CampusBaltimoreMarylandUSA
| | - Ali Saffet Gonul
- SoCAT LAB, Department of PsychiatrySchool of Medicine, Ege UniversityIzmirTurkey,Department of Psychiatry and Behavioral SciencesMercer University School of MedicineMaconGeorgiaUSA
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General PsychiatryUniversity of HeidelbergHeidelbergGermany
| | - Tomas Hajek
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanada,National Institute of Mental HealthKlecanyCzech Republic
| | - Emma L. Hawkins
- Division of PsychiatryRoyal Edinburgh Hospital, University of EdinburghEdinburghUK
| | - Andreas Heinz
- SoCAT LAB, Department of PsychiatrySchool of Medicine, Ege UniversityIzmirTurkey
| | | | - Manon H. J. Hillegers
- Department of PsychiatryUniversity Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands,Department of Child and Adolescent Psychiatry/PsychologyErasmus University Medical Center‐Sophia Children's HospitalRotterdamNetherlands
| | - Josselin Houenou
- APHP, Mondor University HospitalsCréteilFrance,INSERM U955 Team 15 "Translational Psychiatry"CréteilFrance,NeuroSpin neuroimaging platform, Psychiatry Team, UNIACT Lab, CEA SaclayGif‐Sur‐YvetteFrance
| | - Hilleke E. Hulshoff Pol
- Department of PsychiatryUniversity Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands
| | - Christina M. Hultman
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Martin Ingvar
- Section for Neuroscience, Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden,Department of NeuroradiologyKarolinska University HospitalStockholmSweden
| | - Viktoria Johansson
- Centre for Psychiatry Research, Department of Clinical NeuroscienceKarolinska Institutet & Stockholm Health Care Services, Stockholm RegionStockholmSweden,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Erik G. Jönsson
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of OsloOsloNorway,Centre for Psychiatry Research, Department of Clinical NeuroscienceKarolinska Institutet & Stockholm Health Care Services, Stockholm RegionStockholmSweden
| | - Fergus Kane
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College LondonLondonUK
| | - Matthew J. Kempton
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College LondonLondonUK
| | - Marinka M. G. Koenis
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA,Olin Neuropsychiatry Research Center, Institute of Living, Hartford HospitalHartfordConnecticutUSA
| | - Miloslav Kopecek
- National Institute of Mental HealthKlecanyCzech Republic,Department of Psychiatry, Third Faculty of MedicineCharles UniversityPragueCzech Republic
| | - Bernd Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General PsychiatryUniversity of HeidelbergHeidelbergGermany
| | - Stephen M. Lawrie
- Division of PsychiatryRoyal Edinburgh Hospital, University of EdinburghEdinburghUK
| | - Rhoshel K. Lenroot
- Neuroscience Research AustraliaSydneyAustralia,School of Psychiatry, University of New South WalesSydneyAustralia,Department of Psychiatry and Behavioral SciencesUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Machteld Marcelis
- Department of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht UniversityMaastrichtNetherlands
| | - Venkata S. Mattay
- Lieber Institute for Brain Development, Johns Hopkins Medical CampusBaltimoreMarylandUSA,Departments of Neurology and RadiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland GalwayGalwayIreland
| | - Andreas Meyer‐Lindenberg
- Department of Psychiatry and PsychotherapyCentral Institute of Mental Health, Medical Faculty Mannheim, University of HeidelbergMannheimGermany
| | - Stijn Michielse
- Department of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht UniversityMaastrichtNetherlands
| | | | - Dolores Moreno
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain,Child and Adolescent Psychiatry DepartmentHospital General Universitario Gregorio Marañón (IiSGM), School of Medicine, Universidad ComplutenseMadridSpain
| | - Robin M. Murray
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College LondonLondonUK
| | - Benson Mwangi
- Department of Psychiatry and Behavioral SciencesThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Leila Nabulsi
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland GalwayGalwayIreland
| | - Jason Newport
- Department of PsychiatryDalhousie UniversityHalifaxNova ScotiaCanada
| | - Cheryl A. Olman
- Department of Psychology and Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Jim van Os
- Department of PsychiatryUniversity Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands,Department of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht UniversityMaastrichtNetherlands
| | | | - Aysegul Ozerdem
- Department of Psychiatry, Faculty of MedicineDokuz Eylül UniversityIzmirTurkey,Department of NeurosciencesHealth Sciences Institute, Dokuz Eylül UniversityIzmirTurkey,Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Giulio Pergola
- Department of Basic Medical Science, Neuroscience and Sense OrgansUniversity of Bari 'Aldo Moro'BariItaly
| | - Marco M. Picchioni
- Department of Forensic and Neurodevelopmental ScienceInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Camille Piguet
- INSERM U955 Team 15 "Translational Psychiatry"CréteilFrance,NeuroSpin neuroimaging platform, Psychiatry Team, UNIACT Lab, CEA SaclayGif‐Sur‐YvetteFrance,Department of Psychiatry, Faculty of MedicineUniversity of GenevaGenevaSwitzerland,School of Medicine, Universitat Internacional de CatalunyaBarcelonaSpain
| | - Edith Pomarol‐Clotet
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain,CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain
| | - Joaquim Radua
- Centre for Psychiatry Research, Department of Clinical NeuroscienceKarolinska Institutet & Stockholm Health Care Services, Stockholm RegionStockholmSweden,CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain,Early Psychosis: Interventions and Clinical‐detection (EPIC) lab, Department of Psychosis StudiesInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Ian S. Ramsay
- Department of Psychiatry and Behavioral SciencesUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Anja Richter
- Section for Experimental Psychopathology and Neuroimaging, Department of General PsychiatryUniversity of HeidelbergHeidelbergGermany
| | - Gloria Roberts
- School of Psychiatry, University of New South WalesSydneyAustralia
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain,CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain
| | - Aybala Saricicek Aydogan
- Department of NeurosciencesHealth Sciences Institute, Dokuz Eylül UniversityIzmirTurkey,Department of Psychiatry, Faculty of MedicineIzmir Katip Çelebi UniversityIzmirTurkey
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research FoundationBarcelonaSpain,CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain
| | - Peter R. Schofield
- School of Medical Sciences, University of New South WalesSydneyAustralia,Olin Neuropsychiatry Research Center, Institute of Living, Hartford HospitalHartfordConnecticutUSA
| | | | - Fatma Simsek
- SoCAT LAB, Department of PsychiatrySchool of Medicine, Ege UniversityIzmirTurkey,Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK,Cigli State HospitalDepartment of PsychiatryIzmirTurkey
| | - Jair C. Soares
- Department of Psychiatry and Behavioral SciencesThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Scott R. Sponheim
- Department of Psychiatry and Behavioral SciencesUniversity of MinnesotaMinneapolisMinnesotaUSA,Minneapolis VA Health Care SystemMinneapolisMinnesotaUSA
| | - Gisela Sugranyes
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881Institute of Neuroscience, Hospital Clínic of BarcelonaBarcelonaSpain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain,University of BarcelonaBarcelonaSpain
| | - Timothea Toulopoulou
- Department of PsychologyBilkent UniversityAnkaraTurkey,Department of Basic and Clinical NeuroscienceInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Giulia Tronchin
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland GalwayGalwayIreland
| | - Eduard Vieta
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental)MadridSpain,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain,Bipolar and Depressive Disorders UnitHospital Clinic, University of BarcelonaBarcelonaSpain
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and PsychotherapyCharité Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Daniel R. Weinberger
- Bipolar and Depressive Disorders UnitHospital Clinic, University of BarcelonaBarcelonaSpain
| | - Heather C. Whalley
- Department of Psychology, Faculty of ArtsDokuz Eylül UniversityİzmirTurkey
| | - Mon‐Ju Wu
- Department of Psychology and Center for Magnetic Resonance ResearchUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Nefize Yalin
- Centre for Affective Disorders, Department of Psychological MedicineInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Ole A. Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of OsloOsloNorway,Division of Mental Health and AddictionOslo University HospitalOsloNorway
| | - Christopher R. K. Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Theo G. M. van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA,Center for the Neurobiology of Learning and MemoryUniversity of California IrvineIrvineCaliforniaUSA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - René S. Kahn
- Department of PsychiatryUniversity Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands,Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Neeltje E. M. van Haren
- Department of PsychiatryUniversity Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht UniversityUtrechtNetherlands,Department of Child and Adolescent Psychiatry/PsychologyErasmus University Medical Center‐Sophia Children's HospitalRotterdamNetherlands
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Solot CB, Moore TM, Crowley TB, Gerdes M, Moss E, McGinn DE, Emanuel BS, Zackai EH, Gallagher S, Calkins ME, Ruparel K, Gur RC, McDonald-McGinn D, Gur RE. Early language measures associated with later psychosis features in 22q11.2 deletion syndrome. Am J Med Genet B Neuropsychiatr Genet 2020; 183:392-400. [PMID: 32715620 PMCID: PMC8050829 DOI: 10.1002/ajmg.b.32812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 02/18/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022]
Abstract
The 22q11.2 deletion syndrome (22q11DS) is associated with impaired cognitive functions and increased risk for schizophrenia spectrum disorders. Speech and language deficits are prominent, with evidence of decline anteceding emergence of psychosis. There is paucity of data examining language function in children with 22q11DS with follow-up assessment of psychosis spectrum (PS) symptoms. We examined the association between early language measures, obtained clinically, and PS status, obtained on average 10.1 years later, in 166 youths with 22q11DS, with repeated language testing in 48. Participants were administered the Preschool Language Scale (receptive/expressive), and/or, for school aged children, the Clinical Evaluation of Language Fundamentals (receptive/expressive), and age appropriate IQ tests. The structured interview for prodromal syndromes (SIPS) assessed PS symptoms. We found that performance on all preschool measures showed age associated decline, and males performed more poorly on core composite (receptive/expressive) and receptive language measures. For language assessment later in childhood, poorer performance was consistently associated with subsequent PS status. Furthermore, steeper age-related decline was seen in the PS group across language measures and marginally for full-scale IQ. These findings suggest that while preschool language testing is useful in characterizing performance decline in individuals with 22q11DS, it does not robustly differentiate those with subsequent PS from those without. However, language testing in the school age population can help identify individuals with 22q11DS who are at risk for psychosis. Such data are needed for elucidating a lifespan trajectory for affected individuals and may help understand pathways to psychosis applicable to the general population.
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Affiliation(s)
- Cynthia B. Solot
- Department of Speech-Language Pathology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tyler M. Moore
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - T. Blaine Crowley
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Marsha Gerdes
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Edward Moss
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Daniel E. McGinn
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Beverly S. Emanuel
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elaine H. Zackai
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sean Gallagher
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Monica E. Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kosha Ruparel
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Donna McDonald-McGinn
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raquel E. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia
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14
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Chen YL, Pan CH, Chang CK, Chen PH, Chang HM, Tai MH, Su SS, Tsai SY, Chen CC, Kuo CJ. Physical Illnesses Before Diagnosed as Schizophrenia: A Nationwide Case-Control Study. Schizophr Bull 2020; 46:785-794. [PMID: 32052838 PMCID: PMC7342094 DOI: 10.1093/schbul/sbaa009] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Some physical illnesses are potentially associated with the development of schizophrenia. However, few studies have investigated these associations. Here, we examined physical illnesses and medical utilization patterns existing before patients received a diagnosis of schizophrenia. We enrolled a large representative cohort of the general population in Taiwan (N = 1 000 000) and identified 1969 young patients with a new diagnosis of schizophrenia from January 1, 2000 to December 31, 2013. We conducted a nested case-control study based on risk-set sampling. Each case was age-matched and sex-matched with 4 controls selected from the general population. The case and control groups were compared on the basis of various clinical characteristics. Conditional logistic regression was used to estimate the magnitude of risk associated with newly diagnosed schizophrenia. Within the 1 year before the schizophrenia diagnosis, the cases were most likely to visit the psychiatry department, followed by internal medicine and family medicine departments. According to multivariate analysis, compared with the controls, the cases had substantially higher risk of physical conditions in the prodromal phase, including hypertension (adjusted risk ratio [aRR] = 1.93, P = .001), other forms of heart disease (aRR = 2.07, P < .001), cerebrovascular diseases (aRR = 2.96, P = .001), chronic obstructive pulmonary disease (aRR = 1.50, P = .005), asthma (aRR = 1.76, P = .003), and irritable bowel syndrome (aRR = 2.00, P < .001). A wide range of psychiatric diseases and concomitant use of medications were significantly associated with schizophrenia development. In conclusion, several physical illnesses were identified to be associated with schizophrenia development, indicating that people with these illnesses could be vulnerable to schizophrenia.
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Affiliation(s)
- Yi-Lung Chen
- Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan,Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan,Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Chi-Kang Chang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Pao-Huan Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hu-Ming Chang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Ming-Hong Tai
- Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Sheng-Shiang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chiao-Chicy Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan,Department of Psychiatry, Mackay Medical College, Taipei, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan,To whom correspondence should be addressed; Department of General Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309 Sung-Te Road, Taipei, 110, Taiwan; tel: +886-2-27263141, fax: +886-2-27285059, e-mail:
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15
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Fountoulakis KN, Moeller HJ, Kasper S, Tamminga C, Yamawaki S, Kahn R, Tandon R, Correll CU, Javed A. The report of the joint WPA/CINP workgroup on the use and usefulness of antipsychotic medication in the treatment of schizophrenia. CNS Spectr 2020; 26:1-25. [PMID: 32594935 DOI: 10.1017/s1092852920001546] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This is a report of a joint World Psychiatric Association/International College of Neuropsychopharmacology (WPA/CINP) workgroup concerning the risk/benefit ratio of antipsychotics in the treatment of schizophrenia. It utilized a selective but, within topic, comprehensive review of the literature, taking into consideration all the recently discussed arguments on the matter and avoiding taking sides when the results in the literature were equivocal. The workgroup's conclusions suggested that antipsychotics are efficacious both during the acute and the maintenance phase, and that the current data do not support the existence of a supersensitivity rebound psychosis. Long-term treated patients have better overall outcome and lower mortality than those not taking antipsychotics. Longer duration of untreated psychosis and relapses are modestly related to worse outcome. Loss of brain volume is evident already at first episode and concerns loss of neuropil volume rather than cell loss. Progression of volume loss probably happens in a subgroup of patients with worse prognosis. In humans, antipsychotic treatment neither causes nor worsens volume loss, while there are some data in favor for a protective effect. Schizophrenia manifests 2 to 3 times higher mortality vs the general population, and treatment with antipsychotics includes a number of dangers, including tardive dyskinesia and metabolic syndrome; however, antipsychotic treatment is related to lower mortality, including cardiovascular mortality. In conclusion, the literature strongly supports the use of antipsychotics both during the acute and the maintenance phase without suggesting that it is wise to discontinue antipsychotics after a certain period of time. Antipsychotic treatment improves long-term outcomes and lowers overall and specific-cause mortality.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Hans-Jurgen Moeller
- Department of Psychiatry, Ludwig Maximilian University of Munich, Munich, Germany
| | - Siegfried Kasper
- Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Vienna, Austria
| | - Carol Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Shigeto Yamawaki
- Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Hiroshima, Japan
| | - Rene Kahn
- Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rajiv Tandon
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
| | - Christoph U Correll
- Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, New York, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Afzal Javed
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
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16
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Age of onset group characteristics in forensic patients with schizophrenia. Eur Psychiatry 2020; 29:149-52. [DOI: 10.1016/j.eurpsy.2012.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 11/14/2012] [Accepted: 11/23/2012] [Indexed: 11/30/2022] Open
Abstract
AbstractThis study aims to empirically identify age of onset groups and their clinical and background characteristics in forensic patients with schizophrenia. Hospital charts were reviewed of all 138 forensic patients with schizophrenia admitted to Geha Psychiatric Hospital that serves a catchment area of approximately 500,000 people, from 2000 to 2009 inclusive. Admixture analysis empirically identified early- (M = 19.99, SD = 3.31) and late-onset groups (M = 36.13, SD = 9.25). Early-onset was associated with more suicide attempts, violence before the age of 15, and early conduct problems, whereas late-onset was associated with a greater likelihood of violence after the age of 18 and marriage (P < 0.01). The current findings provide clinicians with a unique direction for risk assessment and indicate differences in violence between early- and late-onset schizophrenia, particularly co-occurrence of harmful behavioral phenotypes.
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17
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Dickinson D, Zaidman SR, Giangrande EJ, Eisenberg DP, Gregory MD, Berman KF. Distinct Polygenic Score Profiles in Schizophrenia Subgroups With Different Trajectories of Cognitive Development. Am J Psychiatry 2020; 177:298-307. [PMID: 31838871 PMCID: PMC9627722 DOI: 10.1176/appi.ajp.2019.19050527] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Different cognitive development histories in schizophrenia may reflect variation across dimensions of genetic influence. The authors derived and characterized cognitive development trajectory subgroups within a schizophrenia sample and profiled the subgroups across polygenic scores (PGSs) for schizophrenia, cognition, educational attainment, and attention deficit hyperactivity disorder (ADHD). METHODS Demographic, clinical, and genetic data were collected at the National Institute of Mental Health from 540 schizophrenia patients, 247 unaffected siblings, and 844 control subjects. Cognitive trajectory subgroups were derived through cluster analysis using estimates of premorbid and current IQ. PGSs were generated using standard methods. Associations were tested using general linear models and logistic regression. RESULTS Cluster analyses identified three cognitive trajectory subgroups in the schizophrenia group: preadolescent cognitive impairment (19%), adolescent disruption of cognitive development (44%), and cognitively stable adolescent development (37%). Together, the four PGSs significantly predicted 7.9% of the variance in subgroup membership. Subgroup characteristics converged with genetic patterns. Cognitively stable individuals had the best adult clinical outcomes and differed from control subjects only in schizophrenia PGSs. Those with adolescent disruption of cognitive development showed the most severe symptoms after diagnosis and were cognitively impaired. This subgroup had the highest schizophrenia PGSs and had disadvantageous cognitive PGSs relative to control subjects and cognitively stable individuals. Individuals showing preadolescent impairment in cognitive and academic performance and poor adult outcome exhibited a generalized PGS disadvantage relative to control subjects and were the only subgroup to differ significantly in education and ADHD PGSs. CONCLUSIONS Subgroups derived from patterns of premorbid and current IQ showed different premorbid and clinical characteristics, which converged with broad genetic profiles. Simultaneous analysis of multiple PGSs may contribute to useful clinical stratification in schizophrenia.
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Affiliation(s)
- Dwight Dickinson
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Sofia R. Zaidman
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Evan J. Giangrande
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Daniel P. Eisenberg
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Michael D. Gregory
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Karen F. Berman
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
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18
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Shelef L, Tomer G, Tatsa-Laur L, Kedem R, Bonne O, Fruchter E. Risk factors for suicide in the Israeli army between the years 1992–2012: A case-control study. Eur Psychiatry 2020; 39:106-113. [DOI: 10.1016/j.eurpsy.2016.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 11/27/2022] Open
Abstract
AbstractObjectiveYoung age, availability of weapons, and stressful life events, increase the risk of suicide. The aim of the present study was to assess additional risk factors for suicide in the Israeli army.MethodsWe conducted a case-control study, to assess risk factors for suicide. The cases comprised soldiers who died by suicide during their military service (n = 462; 0.039% of all soldiers in the cohort). The control group consisted of soldiers who did not commit suicide but were in active service during the investigated period (n = 1,170,895; 99.96%). Predictor variables, including socio-demographic and psychiatric diagnoses, were considered.ResultsUsing a Generalized Linear Model with a Binary Logistic dependent variable to predict suicide, while controlling the effect of intervening variables, we found the following variables enhanced the risk for committing suicide: male (RR = 6.703; P < 0.001), country of origin: Ethiopia (RR = 4.555; P = 0.014), low socioeconomic status (RR = 1.448; P = 0.016) and low adjustment difficulties (RR = 2.324; P < 0.001). In addition, we found that in males only, Cluster B Personality Disorder (RR = 2.548; P = 0.027), low (RR = 1.657; P = 0.002), to average motivation to serve in a combat unit (RR = 1.322; P = 0.046) increased the risk for suicide.ConclusionsIDF Soldiers bearing a psychiatric diagnosis or severe adjustment difficulties remained tightly monitored through their military service, and were found to be at a lower risk for suicide. However, those enlisted with mild (low) difficulties, were found to be at greater risk for suicide, as well as soldiers whose country of origin is Ethiopia. Suicide prevention program should focus on monitoring soldiers with these risk factors, together with soldiers’ guidance regarding help seeking and de-stigmatizing suicide.
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19
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Van Haren NEM, Van Dam DS, Stellato RK. Change in IQ in schizophrenia patients and their siblings: a controlled longitudinal study. Psychol Med 2019; 49:2573-2581. [PMID: 30674361 DOI: 10.1017/s0033291718003537] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lower intelligence quotient (IQ) has frequently been reported in patients with schizophrenia. However, it is unclear whether IQ declines (further) after illness onset and what the familial contribution is to this change. Therefore, we investigate IQ changes during the course of illness in patients with non-affective psychosis, their siblings and controls. METHODS Data are part of the longitudinal Genetic Risk and Outcome of Psychosis (GROUP) study in the Netherlands and Belgium. Participants underwent three measurements, each approximately 3 years apart. A total of 1022 patients with non-affective psychosis [illness duration: 4.34 (s.d. = 4.50) years], 977 of their siblings, and 565 controls had at least one measure of IQ (estimated from four subtests of the WAIS-III). RESULTS At baseline, IQ was significantly lower in patients (IQ = 97.8) and siblings (IQ = 108.2; p < 0.0001) than in controls (IQ = 113.0; p < 0.0001), and in patients as compared with siblings (p < 0.0001). Over time, IQ increased in all groups. In siblings, improvement in IQ was significantly more pronounced (+0.7 points/year) than in patients (+0.5 points/year; p < 0.0001) and controls (+0.3 points/year; p < 0.0001). IQ increase was not significantly correlated with improvement in (sub)clinical outcome in any of the groups. CONCLUSIONS During the first 10 years of the illness, IQ increases to a similar (and subtle) extent in a relatively high-functioning group of schizophrenia patients and controls, despite the lower IQ in patients at baseline. In addition, the siblings' IQ was intermediate at baseline, but over time the increase in IQ was more pronounced.
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Affiliation(s)
- N E M Van Haren
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - D S Van Dam
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - R K Stellato
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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20
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Lam M, Hill WD, Trampush JW, Yu J, Knowles E, Davies G, Stahl E, Huckins L, Liewald DC, Djurovic S, Melle I, Sundet K, Christoforou A, Reinvang I, DeRosse P, Lundervold AJ, Steen VM, Espeseth T, Räikkönen K, Widen E, Palotie A, Eriksson JG, Giegling I, Konte B, Hartmann AM, Roussos P, Giakoumaki S, Burdick KE, Payton A, Ollier W, Chiba-Falek O, Attix DK, Need AC, Cirulli ET, Voineskos AN, Stefanis NC, Avramopoulos D, Hatzimanolis A, Arking DE, Smyrnis N, Bilder RM, Freimer NA, Cannon TD, London E, Poldrack RA, Sabb FW, Congdon E, Conley ED, Scult MA, Dickinson D, Straub RE, Donohoe G, Morris D, Corvin A, Gill M, Hariri AR, Weinberger DR, Pendleton N, Bitsios P, Rujescu D, Lahti J, Le Hellard S, Keller MC, Andreassen OA, Deary IJ, Glahn DC, Malhotra AK, Lencz T. Pleiotropic Meta-Analysis of Cognition, Education, and Schizophrenia Differentiates Roles of Early Neurodevelopmental and Adult Synaptic Pathways. Am J Hum Genet 2019; 105:334-350. [PMID: 31374203 PMCID: PMC6699140 DOI: 10.1016/j.ajhg.2019.06.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022] Open
Abstract
Susceptibility to schizophrenia is inversely correlated with general cognitive ability at both the phenotypic and the genetic level. Paradoxically, a modest but consistent positive genetic correlation has been reported between schizophrenia and educational attainment, despite the strong positive genetic correlation between cognitive ability and educational attainment. Here we leverage published genome-wide association studies (GWASs) in cognitive ability, education, and schizophrenia to parse biological mechanisms underlying these results. Association analysis based on subsets (ASSET), a pleiotropic meta-analytic technique, allowed jointly associated loci to be identified and characterized. Specifically, we identified subsets of variants associated in the expected ("concordant") direction across all three phenotypes (i.e., greater risk for schizophrenia, lower cognitive ability, and lower educational attainment); these were contrasted with variants that demonstrated the counterintuitive ("discordant") relationship between education and schizophrenia (i.e., greater risk for schizophrenia and higher educational attainment). ASSET analysis revealed 235 independent loci associated with cognitive ability, education, and/or schizophrenia at p < 5 × 10-8. Pleiotropic analysis successfully identified more than 100 loci that were not significant in the input GWASs. Many of these have been validated by larger, more recent single-phenotype GWASs. Leveraging the joint genetic correlations of cognitive ability, education, and schizophrenia, we were able to dissociate two distinct biological mechanisms-early neurodevelopmental pathways that characterize concordant allelic variation and adulthood synaptic pruning pathways-that were linked to the paradoxical positive genetic association between education and schizophrenia. Furthermore, genetic correlation analyses revealed that these mechanisms contribute not only to the etiopathogenesis of schizophrenia but also to the broader biological dimensions implicated in both general health outcomes and psychiatric illness.
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Affiliation(s)
- Max Lam
- Institute of Mental Health, Singapore, 539747, Singapore; Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
| | - W David Hill
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom; Department of Psychology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom
| | - Joey W Trampush
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Jin Yu
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA
| | - Emma Knowles
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Gail Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom; Department of Psychology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom
| | - Eli Stahl
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Institute for Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Laura Huckins
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Institute for Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - David C Liewald
- Department of Psychology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway
| | - Ingrid Melle
- Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo 1039, Blindern 0315, Norway
| | - Kjetil Sundet
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo 1039, Blindern 0315, Norway; Department of Psychology, University of Oslo, Oslo 1094, Blindern 0317, Norway
| | - Andrea Christoforou
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen 7804, N-5020 Bergen, Norway
| | - Ivar Reinvang
- Department of Psychology, University of Oslo, Oslo 1094, Blindern 0317, Norway
| | - Pamela DeRosse
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, 7807, N-5020, Norway
| | - Vidar M Steen
- Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen 7804, N-5020 Bergen, Norway
| | - Thomas Espeseth
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo 1039, Blindern 0315, Norway; Department of Psychology, University of Oslo, Oslo 1094, Blindern 0317, Norway
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, 00014, Finland
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014, Finland; Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge CB10 1SA, United Kingdom; Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, 00014, Finland
| | - Johan G Eriksson
- Department of General Practice, University of Helsinki and Helsinki University Hospital, Helsinki, 00014, Finland; National Institute for Health and Welfare, Helsinki FI-00271, Finland; Folkhälsan Research Center, Helsinki 00290, Finland
| | - Ina Giegling
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle 06108, Germany
| | - Bettina Konte
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle 06108, Germany
| | - Annette M Hartmann
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle 06108, Germany
| | - Panos Roussos
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Institute for Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, Bronx, NY 10468, USA
| | | | - Katherine E Burdick
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, Bronx, NY 10468, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115
| | - Antony Payton
- Division of Informatics, Imaging, and Data Sciences, School of Health Sciences, University of Manchester, Manchester M139NT, United Kingdom
| | - William Ollier
- Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester M139PL, United Kingdom; School of Healthcare Sciences, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
| | - Ornit Chiba-Falek
- Department of Neurology, Bryan Alzheimer Disease Research Center, Duke University Medical Center, Durham, NC 27705, USA; Center for Genomic and Computational Biology, Duke University Medical Center, Durham, NC 27705, USA
| | - Deborah K Attix
- Department of Neurology, Bryan Alzheimer Disease Research Center, Duke University Medical Center, Durham, NC 27705, USA; Center for Genomic and Computational Biology, Duke University Medical Center, Durham, NC 27705, USA; Psychiatry and Behavioral Sciences, Division of Medical Psychology, Duke University Medical Center, Durham, NC 27708, USA; Department of Neurology, Duke University Medical Center, Durham, NC 27708, USA
| | - Anna C Need
- Division of Brain Sciences, Department of Medicine, Imperial College, London W12 0NN, UK
| | | | - Aristotle N Voineskos
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto M6J 1H4, Canada
| | - Nikos C Stefanis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece; University Mental Health Research Institute, Athens 115 27, Greece; Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - Dimitrios Avramopoulos
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Alex Hatzimanolis
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto M6J 1H4, Canada; Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece; University Mental Health Research Institute, Athens 115 27, Greece
| | - Dan E Arking
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Nikolaos Smyrnis
- Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto M6J 1H4, Canada; Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Robert M Bilder
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Nelson A Freimer
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT 06511, USA
| | - Edythe London
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, USA
| | | | - Fred W Sabb
- Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, OR, 97401, USA
| | - Eliza Congdon
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, USA
| | | | - Matthew A Scult
- Laboratory of NeuroGenetics, Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA
| | - Dwight Dickinson
- Clinical and Translational Neuroscience Branch, Intramural Research Program, National Institute of Mental Health, National Institute of Health, Bethesda, MD 20814, USA
| | - Richard E Straub
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD 21205, USA
| | - Gary Donohoe
- Neuroimaging, Cognition, and Genomics Centre, School of Psychology and Discipline of Biochemistry, National University of Ireland, Galway, Ireland
| | - Derek Morris
- Neuroimaging, Cognition, and Genomics Centre, School of Psychology and Discipline of Biochemistry, National University of Ireland, Galway, Ireland
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Ahmad R Hariri
- Laboratory of NeuroGenetics, Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA
| | - Daniel R Weinberger
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, MD 21205, USA
| | - Neil Pendleton
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester M13 9PL, United Kingdom
| | - Panos Bitsios
- Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete GR-71003, Greece
| | - Dan Rujescu
- Department of Psychiatry, Martin Luther University of Halle-Wittenberg, Halle 06108, Germany
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, 00014, Finland; Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki 00014, Finland
| | - Stephanie Le Hellard
- Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen 7804, N-5020 Bergen, Norway
| | - Matthew C Keller
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO 80303, USA
| | - Ole A Andreassen
- Norsk Senter for Forskning på Mentale Lidelser, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen 4956, Nydalen 0424, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo 1039, Blindern 0315, Norway; Institute of Clinical Medicine, University of Oslo, Oslo 0318, Norway
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom; Department of Psychology, University of Edinburgh, Edinburgh, Scotland, EH8 9JZ, United Kingdom
| | - David C Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Anil K Malhotra
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY 11030, USA
| | - Todd Lencz
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA; Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY 11030, USA.
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21
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Foute Nelong T, Manduca JD, Zonneveld PM, Perreault ML. Asenapine maleate normalizes low frequency oscillatory deficits in a neurodevelopmental model of schizophrenia. Neurosci Lett 2019; 711:134404. [PMID: 31356843 DOI: 10.1016/j.neulet.2019.134404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 07/25/2019] [Indexed: 12/24/2022]
Abstract
Asenapine maleate (AM) is an atypical antipsychotic that, unlike many other antipsychotics, shows some efficacy in treating cognitive dysfunction in schizophrenia. Normal cognitive function has long since been associated with high frequency neuronal oscillations. However, recent research has highlighted the potential importance of low frequency oscillations. Here, the impact of AM on low frequency neural oscillatory activity was evaluated in the methylazoxymethanol acetate (MAM) rat model system used for the study schizophrenia, and the oscillatory signatures compared to those of haloperidol (HAL) and clozapine (CLZ). AM and CLZ normalized low frequency spectral power deficits in the prefrontal cortex, while HAL and AM reversed corticostriatal and corticocortical delta coherence deficits. However, only chronic AM administration normalized corticostriatal and corticocortical delta coherence deficits between 3-4 Hz. These findings support the idea that antipsychotic-induced amelioration of both delta coherence and power may be important for therapeutic efficacy in treating the cognitive deficits inherent in schizophrenia.
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Affiliation(s)
- Tapia Foute Nelong
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, N1G 2W1 Ontario, Canada.
| | - Joshua D Manduca
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, N1G 2W1 Ontario, Canada.
| | - Paula M Zonneveld
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, N1G 2W1 Ontario, Canada.
| | - Melissa L Perreault
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, N1G 2W1 Ontario, Canada.
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22
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Stochl J, Whittier A, Wagner AP, Veijola J, Jääskeläinen E, Miettunen J, Khandaker GM, Jones PB. Association between developmental milestones and age of schizophrenia onset: Results from the Northern Finland Birth Cohort 1966. Schizophr Res 2019; 208:228-234. [PMID: 30852114 PMCID: PMC6551363 DOI: 10.1016/j.schres.2019.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 11/04/2022]
Abstract
We investigated relationships between early developmental milestones, schizophrenia incidence and variability in its age at onset. We hypothesized that the period of risk for schizophrenia would be longer for those with later development. The Northern Finland Birth Cohort 1966 was followed until 47 years of age, and those members diagnosed with schizophrenia or any other non-affective psychoses identified. Latent profile analysis was used to classify people into homogenous classes with respect to developmental milestones, and subsequently survival analysis explored relationship between classes and age of schizophrenia onset. Results suggest that 4-classes (early, regular, late, and extra late developers) can be identified, but due to few cases in one class (n = 93, <0.01% of 10,501), only 3 classes (early, regular, late) could be meaningfully compared. Schizophrenia incidence until 47 years of age differed systematically between classes: late developers had the highest cumulative incidence (2.39%); regular were intermediate (1.25%); and early developers had the lowest incidence (0.99%). However, age at onset and its variability was similar across classes, suggesting that our hypothesis of a wider 'window' for schizophrenia onset in late developers was not supported.
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Affiliation(s)
- Jan Stochl
- Department of Psychiatry, University of Cambridge, Cambridge, UK; National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England, Cambridge, UK; Department of Kinanthropology, Charles University, Prague, Czech Republic.
| | | | - Adam P Wagner
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England, Cambridge, UK; Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Juha Veijola
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.
| | - Erika Jääskeläinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Golam M Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK; National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
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23
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McClure MM, Graff F, Triebwasser J, Perez-Rodriguez M, Rosell DR, Koenigsberg H, Hazlett EA, Siever LJ, Harvey PD, New AS. Guanfacine Augmentation of a Combined Intervention of Computerized Cognitive Remediation Therapy and Social Skills Training for Schizotypal Personality Disorder. Am J Psychiatry 2019; 176:307-314. [PMID: 30654644 PMCID: PMC6443471 DOI: 10.1176/appi.ajp.2018.18030349] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Impaired cognition is a hallmark of schizophrenia spectrum disorders, including schizotypal personality disorder, and it is the best predictor of functional outcome. Cognitive remediation therapy has demonstrated efficacy for improving cognition, augmenting other rehabilitation efforts in schizophrenia, and effecting gains in real-world functioning. Pharmacological augmentation of cognitive remediation has been attempted, but the effects of augmentation on combined therapies, such as cognitive remediation and social skills training, have not been studied. METHODS Twenty-eight participants with schizotypal personality disorder enrolled in an 8-week, randomized, double-blind, placebo-controlled trial of guanfacine plus cognitive remediation and social skills training (15 guanfacine, 13 placebo). Cognition was assessed with the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) Consensus Cognitive Battery (MCCB), social cognition with the Movie for the Assessment of Social Cognition (MASC), and functional capacity with the University of California San Diego Performance-Based Skills Assessment (UPSA). RESULTS A statistically significant pre- versus posttreatment effect was observed for MCCB speed of processing, verbal learning, and visual learning and UPSA total score. A significant time-by-medication (guanfacine, placebo) interaction was observed for MCCB reasoning and problem solving and UPSA total score; the time-by-treatment interaction approached significance for MASC hypomentalizing errors. CONCLUSIONS Both guanfacine and cognitive remediation plus social skills training were well tolerated, with no side effects or dropouts. Participants treated with cognitive remediation, social skills training, and guanfacine demonstrated statistically significant improvements in reasoning and problem solving, as well as in functional capacity and possibly social cognition, compared with those treated with cognitive remediation, social skills training, and placebo. Cognitive remediation plus social skills training may be an appropriate intervention for individuals with schizotypal personality disorder, and guanfacine appears to be a promising pharmaceutical augmentation to this psychosocial intervention.
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Affiliation(s)
- Margaret M. McClure
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY,Department of Psychology, Fairfield University, Fairfield, CT
| | - Fiona Graff
- War Related Illness and Injury Study Center, VA NJ Healthcare System, East Orange, NJ
| | | | | | - Daniel R. Rosell
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY
| | - Harold Koenigsberg
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY,Department of Veterans Affairs, VISN2 MIRECC, Bronx, NY
| | - Erin A. Hazlett
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY,Department of Veterans Affairs, VISN2 MIRECC, Bronx, NY
| | - Larry J. Siever
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY,Department of Veterans Affairs, VISN2 MIRECC, Bronx, NY
| | - Philip D. Harvey
- Department of Psychiatry, University of Miami Heath School of Medicine, Miami, FL
| | - Antonia S. New
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY
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24
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Rottenstreich M, Drukker L, Reichman O, Kedem R, Rottenstreich A, Sela HY. Adherence to no-cost oral contraceptives among active-duty servicewomen. BMJ SEXUAL & REPRODUCTIVE HEALTH 2019; 45:bmjsrh-2018-200052. [PMID: 30792191 DOI: 10.1136/bmjsrh-2018-200052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 11/02/2018] [Accepted: 01/02/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND We aimed to evaluate the adherence to no-cost oral contraceptives (OC) among young single women and to identify factors associated with non-adherence. METHODS Retrospective cohort study included all single female soldiers who received free-of-charge OCs from military pharmacies in Israel between 2006 and 2015. Military pharmacies' dispensing registries were queried to assess the number of OC packages dispensed. Women were included in the study if their service continued for a period of at least 12 months from the time of receiving their first OC pack. Study outcomes were twelve cycles medication possession ratio (MPR), which is defined as the number of OC packs dispensed over a 12-cycle period divided by 12, presented as a percentage, and factors associated with the OC MPR as evaluated by multivariable regression analysis. RESULTS During the study period, there were 3 05 923 active servicewomen aged 18-24 years. A total of 82 203 (26.9%) women were dispensed at least one pack of OCs. The mean MPR was 51.8% (35.2%). Only 14% of women had good adherence (MPR ≥90%). Multivariate regression models showed that non-adherence (MPR <90%) was more common among servicewomen (adjusted OR (95% CI)): who failed to graduate from high school (1.9 (1.54-2.33)) and with combat or combat-support type of service (1.66 (1.30-2.13)). Other social/ethnic factors, including first-generation immigrant (1.13 (1.05-1.21)), sub-Saharan African origin (1.28 (1.04-1.58)), lower IQ scores (1.28 (1.22-1.34)) and combat-support type of service (1.22 (1.12-1.34)) were associated with non-adherence, but to smaller degrees. Neither income nor health status predicted adherence in this population receiving no-cost OCs. CONCLUSIONS Overall, 12 cycles OC adherence was universally low among active servicewomen. Adherence demonstrated small, but significant, associations with sociodemographic factors, with the lowest levels of adherence predicted by low educational attainment and combat service.
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Affiliation(s)
- Misgav Rottenstreich
- Obstetrics & Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Lior Drukker
- Obstetrics & Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Orna Reichman
- Obstetrics & Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Ron Kedem
- Medical Corps, Israel Defense Forces, Tel Aviv, Israel
| | | | - Hen Y Sela
- Obstetrics & Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
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25
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Kappelmann N, Khandaker GM, Dal H, Stochl J, Kosidou K, Jones PB, Dalman C, Karlsson H. Systemic inflammation and intelligence in early adulthood and subsequent risk of schizophrenia and other non-affective psychoses: a longitudinal cohort and co-relative study. Psychol Med 2019; 49:295-302. [PMID: 29622048 PMCID: PMC6316362 DOI: 10.1017/s0033291718000831] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 01/11/2018] [Accepted: 03/14/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Schizophrenia is associated with impaired neurodevelopment as indexed by lower premorbid IQ. We examined associations between erythrocyte sedimentation rate (ESR), a marker of low-grade systemic inflammation, IQ, and subsequent schizophrenia and other non-affective psychoses (ONAP) to elucidate the role of neurodevelopment and inflammation in the pathogenesis of psychosis. METHODS Population-based data on ESR and IQ from 638 213 Swedish men assessed during military conscription between 1969 and 1983 were linked to National Hospital Discharge Register for hospitalisation with schizophrenia and ONAP. The associations of ESR with IQ (cross-sectional) and psychoses (longitudinal) were investigated using linear and Cox-regression. The co-relative analysis was used to examine effects of shared familial confounding. We examined mediation and moderation of effect between ESR and IQ on psychosis risk. RESULTS Baseline IQ was associated with subsequent risk of schizophrenia (adjusted HR per 1-point increase in IQ = 0.961; 95% confidence interval (CI) 0.960-0.963) and ONAP (adjusted HR = 0.973; 95% CI 0.971-0.975). Higher ESR was associated with lower IQ in a dose-response fashion. High ESR was associated with increased risk for schizophrenia (adjusted HR = 1.14; 95% CI 1.01-1.28) and decreased risk for ONAP (adjusted HR = 0.85; 95% CI 0.74-0.96), although these effects were specific to one ESR band (7-10 mm/hr). Familial confounding explained ESR-IQ but not ESR-psychoses associations. IQ partly mediated the ESR-psychosis relationships. CONCLUSIONS Lower IQ is associated with low-grade systemic inflammation and with an increased risk of schizophrenia and ONAP in adulthood. Low-grade inflammation may influence schizophrenia risk by affecting neurodevelopment. Future studies should explore the differential effects of inflammation on different types of psychosis.
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Affiliation(s)
- Nils Kappelmann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Golam M Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Henrik Dal
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Kinanthropology, Charles University, Prague, Czech Republic
| | - Kyriaki Kosidou
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Christina Dalman
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Karlsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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26
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Sørensen HJ, Debost JC, Agerbo E, Benros ME, McGrath JJ, Mortensen PB, Ranning A, Hjorthøj C, Mors O, Nordentoft M, Petersen L. Polygenic Risk Scores, School Achievement, and Risk for Schizophrenia: A Danish Population-Based Study. Biol Psychiatry 2018; 84:684-691. [PMID: 29807621 DOI: 10.1016/j.biopsych.2018.04.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/17/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Studies have suggested that poor school achievement is associated with increased risk of schizophrenia; however, the possible genetic contribution to this association is unknown. We investigated the possible effect of the polygenic risk score (PRS) for schizophrenia (PRSSCZ) and for educational attainment (PRSEDU) on the association between school performance and later schizophrenia. METHODS We conducted a case-cohort study on a Danish population-based sample born from 1987 to 1995 comprising 1470 individuals with schizophrenia and 7318 subcohort noncases. Genome-wide data, school performance, and family psychiatric and socioeconomic background information were obtained from national registers and neonatal biobanks. PRSSCZ and PRSEDU were calculated using discovery effect size estimates from a meta-analysis of 34,600 cases and 45,968 controls and 293,723 individuals. RESULTS Higher PRSSCZ increased the risk (incidence rate ratio [IRR]: 1.28; 95% confidence interval [CI], 1.19-1.36), whereas higher PRSEDU decreased the risk of schizophrenia (IRR, 0.87; 95% CI, 0.82-0.92) per standard deviation. Not completing primary school and receiving low school marks were associated with increased risk of schizophrenia (IRR, 2.92; 95% CI, 2.37-3.60; and IRR, 1.58; 95% CI, 1.27-1.97, respectively), which was not confounded by PRSSCZ or PRSEDU. Adjusting for social factors and parental psychiatric history, effects of not completing primary school and receiving low school marks were attenuated by up to 25% (IRR, 2.19; 95% CI, 1.75-2.73; and IRR, 1.39; 95% CI, 1.11-1.75, respectively). Increasing PRSEDU correlated with better school performance (p < .01; R2 = 7.6%). PRSSCZ and PRSEDU was significantly negatively correlated (r = -.31, p < .01). CONCLUSIONS The current PRS did not account for the observed association between primary school performance and risk of schizophrenia.
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Affiliation(s)
- Holger J Sørensen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark.
| | - Jean-Christophe Debost
- i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark; National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Department of Psychosis, Aarhus University Hospital, Risskov, Denmark
| | - Esben Agerbo
- i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark; National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Centre for Integrated Register-Based Research and National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Michael E Benros
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark
| | - John J McGrath
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Queensland Brain Institute, University of Queensland, St Lucia, Australia
| | - Preben Bo Mortensen
- i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark; National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Anne Ranning
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark
| | - Carsten Hjorthøj
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark
| | - Ole Mors
- i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark; Centre for Integrated Register-Based Research and National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Department of Psychosis, Aarhus University Hospital, Risskov, Denmark
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark
| | - Liselotte Petersen
- i-PSYCH initiative for Integrative Psychiatric Research, Lundbeck Foundation, Copenhagen, Denmark; National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Centre for Integrated Register-Based Research and National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
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27
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Lam M, Lee J, Rapisarda A, See YM, Yang Z, Lee SA, Abdul-Rashid NA, Kraus M, Subramaniam M, Chong SA, Keefe RSE. Longitudinal Cognitive Changes in Young Individuals at Ultrahigh Risk for Psychosis. JAMA Psychiatry 2018; 75:929-939. [PMID: 30046827 PMCID: PMC6142925 DOI: 10.1001/jamapsychiatry.2018.1668] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Cognitive deficits are a key feature of risk for psychosis. Longitudinal changes in cognitive architecture may be associated with the social and occupational functioning in young people. OBJECTIVES To examine longitudinal profiles of cognition in individuals at ultrahigh risk (UHR) for psychosis, compared with healthy controls, and to investigate the association of cognition with functioning. DESIGN, SETTING, AND PARTICIPANTS This study has a multiple-group prospective design completed in 24 months and was conducted from January 1, 2009, to November 11, 2012, as part of the Longitudinal Youth at-Risk Study conducted in Singapore. Participants either were recruited from psychiatric outpatient clinics, educational institutions, and community mental health agencies or self-referred. Follow-up assessments were performed every 6 months for 2 years or until conversion to psychosis. Individuals with medical causes for psychosis, current illicit substance use, or color blindness were excluded. Data analysis was conducted from June 2014 to May 2018. MAIN OUTCOMES AND MEASURES Neuropsychological, perceptual, and social cognitive tasks; semi-structured interviews, and the Structured Clinical Interview for DSM-IV Axis I disorders were administered every 6 months. The UHR status of nonconverters, converters, remitters, and nonremitters was monitored. Cognitive domain scores and functioning were investigated longitudinally. RESULTS In total, 384 healthy controls and 173 UHR individuals between ages 14 and 29 years were evaluated prospectively. Of the 384 healthy controls, 153 (39.8%) were female and 231 (60.2%) were male with a mean (SD) age of 21.69 (3.26) years. Of the 173 individuals at UHR for psychosis, 56 (32.4%) were female and 117 (67.6%) were male with a mean (SD) age of 21.27 (3.52) years). After 24 months of follow-up, 383 healthy controls (99.7%) and 122 individuals at UHR for psychosis (70.5%) remained. Baseline cognitive deficits were associated with psychosis conversion later (mean odds ratio [OR], 1.66; combined 95% CI, 1.08-2.83; P = .04) and nonremission of UHR status (mean OR, 1.67; combined 95% CI, 1.09-2.95; P = .04). Five cognitive components-social cognition, attention, verbal fluency, general cognitive function, and perception-were obtained from principal components analysis. Longitudinal component structure change was observed in general cognitive function (maximum vertical deviation = 0.59; χ2 = 8.03; P = .01). Group-by-time interaction on general cognitive function (F = 12.23; η2 = 0.047; P < .001) and perception (F = 8.33; η2 = 0.032; P < .001) was present. Changes in attention (F = 5.65; η2 = 0.013; P = .02) and general cognitive function (F = 7.18; η2 = 0.014; P = .01) accounted for longitudinal changes in social and occupational functioning. CONCLUSIONS AND RELEVANCE Individuals in this study who met the UHR criteria appeared to demonstrate cognitive deficits, and those whose UHR status remitted were seen to recover cognitively. Cognition appeared as poor in nonremitters and appeared to be associated with poor functional outcome. This study suggests that cognitive dimensions are sensitive to the identification of young individuals at risk for psychosis and to the longitudinal course of those at highest risk.
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Affiliation(s)
- Max Lam
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health,
Singapore, Singapore,Department of General Psychiatry 1, Institute of
Mental Health, Singapore, Singapore
| | - Attilio Rapisarda
- Research Division, Institute of Mental Health,
Singapore, Singapore,Neuroscience and Behavioural Disorders, Duke-NUS
Medical School, Singapore, Singapore
| | - Yuen Mei See
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Zixu Yang
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Sara-Ann Lee
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | | | - Michael Kraus
- Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, North Carolina
| | | | - Siow-Ann Chong
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Richard S. E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, North Carolina
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28
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Stefanatou P, Karatosidi CS, Tsompanaki E, Kattoulas E, Stefanis NC, Smyrnis N. Premorbid adjustment predictors of cognitive dysfunction in schizophrenia. Psychiatry Res 2018; 267:249-255. [PMID: 29940456 DOI: 10.1016/j.psychres.2018.06.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 11/24/2022]
Abstract
Premorbid adjustment (PA) in academic and social domain is a key-predictor of cognitive performance in schizophrenia. Prior studies provided inconsistent findings regarding the differential relationships of PA domains with post-illness cognition. Multivariate associations of academic and social PA in each developmental stage (childhood, early and late adolescence) with post-onset cognitive variables were explored. Furthermore, possible differential relationships of PA domain deterioration courses with post-onset cognitive dysfunction were investigated. Seventy-five schizophrenia patients were evaluated with Premorbid Adjustment Scale (PAS). General cognitive ability, verbal IQ, verbal memory and learning, processing speed, working memory, executive function and premorbid IQ were assessed. Canonical Correlation Analyses revealed that poorer academic PA across childhood and early adolescence was related to worse post-onset verbal IQ, working memory, verbal learning and executive function, while academic PA deterioration between early and late adolescence was associated with poorer verbal learning and executive function and, as further analysis indicated, predicts IQ decline. Academic PA was exclusively associated with post-onset cognitive impairment. New evidence emerged for the specificity of each developmental period in constructing academic PA in its relation to post-illness cognition. Early premorbid academic maladjustment possibly constitutes the onset of a cognitive dysmaturational process which results to post-diagnosis impaired cognition.
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Affiliation(s)
- Pentagiotissa Stefanatou
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Chrysovalado-Sofia Karatosidi
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Evgenia Tsompanaki
- Department of Statistics, School of Information Sciences and Technology, Athens University of Economics and Business, Athens, Greece
| | - Emmanouil Kattoulas
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Nicholas C Stefanis
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece; University Mental Health Research Institute, Athens, Greece
| | - Nikolaos Smyrnis
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece; University Mental Health Research Institute, Athens, Greece.
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Lyne J, O'Donoghue B, Roche E, Renwick L, Cannon M, Clarke M. Negative symptoms of psychosis: A life course approach and implications for prevention and treatment. Early Interv Psychiatry 2018; 12:561-571. [PMID: 29076240 DOI: 10.1111/eip.12501] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 07/29/2017] [Accepted: 08/20/2017] [Indexed: 01/09/2023]
Abstract
AIM Negative symptoms are a cause of enduring disability in serious mental illness. In spite of this, the development of effective treatments for negative symptoms has remained slow. The challenge of improving negative symptom outcomes is compounded by our limited understanding of their aetiology and longitudinal development. METHODS A literature search was conducted for life course approach of negative symptoms using PubMed. Further articles were included following manual checking of reference lists and other search strategies. The paper contains a theoretical synthesis of the literature, summarized using conceptual models. RESULTS Negative symptom definitions are compared and considered within a context of the life course. Previous studies suggest that several illness phases may contribute to negative symptoms, highlighting our uncertainty in relation to the origin of negative symptoms. CONCLUSIONS Similar to other aspects of schizophrenia, negative symptoms likely involve a complex interplay of several risk and protective factors at different life phases. Concepts suggested in this article, such as "negative symptom reserve" theory, require further research, which may inform future prevention and treatment strategies.
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Affiliation(s)
- John Lyne
- Royal College of Surgeons in Ireland, North Dublin Mental Health Service, Ashlin Centre, Dublin, Ireland.,Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland
| | - Brian O'Donoghue
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre of Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Eric Roche
- Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland
| | - Laoise Renwick
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Clarke
- Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.,Saint John of God Community Services Ltd, Blackrock, Co., Dublin, Ireland
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30
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Khandaker GM, Dalman C, Kappelmann N, Stochl J, Dal H, Kosidou K, Jones PB, Karlsson H. Association of Childhood Infection With IQ and Adult Nonaffective Psychosis in Swedish Men: A Population-Based Longitudinal Cohort and Co-relative Study. JAMA Psychiatry 2018; 75:356-362. [PMID: 29450471 PMCID: PMC5875340 DOI: 10.1001/jamapsychiatry.2017.4491] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Associations between childhood infection, IQ, and adult nonaffective psychosis (NAP) are well established. However, examination of sensitive periods for exposure, effect of familial confounding, and whether IQ provides a link between childhood infection and adult NAP may elucidate pathogenesis of psychosis further. OBJECTIVES To test the association of childhood infection with IQ and adult NAP, to find whether shared familial confounding explains the infection-NAP and IQ-NAP associations, and to examine whether IQ mediates and/or moderates the childhood infection-NAP association. DESIGN, SETTING, AND PARTICIPANTS Population-based longitudinal cohort study using linkage of Swedish national registers. The risk set included all Swedish men born between 1973 and 1992 and conscripted into the military until the end of 2010 (n = 771 698). We included 647 515 participants in the analysis. MEASUREMENT OF EXPOSURES Hospitalization with any infection from birth to age 13 years. MAIN OUTCOMES AND MEASURES Hospitalization with an International Classification of Diseases diagnosis of NAP until the end of 2011. At conscription around age 18 years, IQ was assessed for all participants. RESULTS At the end of follow-up, the mean (SD) age of participants was 30.73 (5.3) years. Exposure to infections, particularly in early childhood, was associated with lower IQ (adjusted mean difference for infection at birth to age 1 year: -1.61; 95% CI, -1.74 to -1.47) and with increased risk of adult NAP (adjusted hazard ratio for infection at birth to age 1 year: 1.19; 95% CI, 1.06 to 1.33). There was a linear association between lower premorbid IQ and adult NAP, which persisted after excluding prodromal cases (adjusted hazard ratio per 1-point increase in IQ: 0.976; 95% CI, 0.974 to 0.978). The infection-NAP and IQ-NAP associations were similar in the general population and in full-sibling pairs discordant for exposure. The association between infection and NAP was both moderated (multiplicative, β = .006; SE = 0.002; P = .02 and additive, β = .008; SE = 0.002; P = .001) and mediated (β = .028; SE = 0.002; P < .001) by IQ. Childhood infection had a greater association with NAP risk in the lower, compared with higher, IQ range. CONCLUSIONS AND RELEVANCE Early childhood is a sensitive period for the effects of infection on IQ and NAP. The associations of adult NAP with early-childhood infection and adolescent IQ are not fully explained by shared familial factors and may be causal. Lower premorbid IQ in individuals with psychosis arises from unique environmental factors, such as early-childhood infection. Early-childhood infections may increase the risk of NAP by affecting neurodevelopment and by exaggerating the association of cognitive vulnerability with psychosis.
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Affiliation(s)
- Golam M. Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, England,Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | - Christina Dalman
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Nils Kappelmann
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Henrik Dal
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Kyriaki Kosidou
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England,Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | - Håkan Karlsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Chawner SJRA, Doherty JL, Moss H, Niarchou M, Walters JTR, Owen MJ, van den Bree MBM. Childhood cognitive development in 22q11.2 deletion syndrome: case-control study. Br J Psychiatry 2017; 211:223-230. [PMID: 28882829 PMCID: PMC5623878 DOI: 10.1192/bjp.bp.116.195651] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 05/31/2017] [Accepted: 06/12/2017] [Indexed: 12/19/2022]
Abstract
Background22q11.2 deletion syndrome (22q11.2DS) is associated with a high risk of childhood as well as adult psychiatric disorders, in particular schizophrenia. Childhood cognitive deterioration in 22q11.2DS has previously been reported, but only in studies lacking a control sample.AimsTo compare cognitive trajectories in children with 22q11.2DS and unaffected control siblings.MethodA longitudinal study of neurocognitive functioning (IQ, executive function, processing speed and attention) was conducted in children with 22q11.2DS (n = 75, mean age time 1 (T1) 9.9, time 2 (T2) 12.5) and control siblings (n = 33, mean age T1 10.6, T2 13.4).ResultsChildren with 22q11.2DS exhibited deficits in all cognitive domains. However, mean scores did not indicate deterioration. When individual trajectories were examined, some participants showed significant decline over time, but the prevalence was similar for 22q11.2DS and control siblings. Findings are more likely to reflect normal developmental fluctuation than a 22q11.2DS-specific abnormality.ConclusionsChildhood cognitive deterioration is not associated with 22q11.2DS. Contrary to previous suggestions, we believe it is premature to recommend repeated monitoring of cognitive function for identifying individual children with 22q11.2DS at high risk of developing schizophrenia.
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Affiliation(s)
| | | | | | | | | | | | - Marianne B. M. van den Bree
- Correspondence: Marianne B.M. van den Bree, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, 2nd Floor Hadyn Ellis Building, Cardiff University, Maindy Road, Cathays, Cardiff CF24 4HQ, UK.
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Antshel KM, Fremont W, Ramanathan S, Kates WR. Predicting Cognition and Psychosis in Young Adults With 22q11.2 Deletion Syndrome. Schizophr Bull 2017; 43:833-842. [PMID: 27798222 PMCID: PMC5472116 DOI: 10.1093/schbul/sbw135] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess the extent to which the trajectories of intellectual, academic achievement, executive functioning, attention, working memory, and emotion recognition tests will be predictive of psychosis in young adults with 22q11.2 deletion syndrome (22q11DS). METHODS Eighty-two participants with 22q11DS were assessed for psychiatric disorders and neuropsychological functioning with validated instruments. Siblings and community controls were employed as comparison groups. RESULTS Individuals with 22q11DS differed significantly from siblings and controls in longitudinal trajectories of visual and auditory working memory as well as academic achievement. Longitudinal trajectories of cognitive set shifting, reading decoding, and emotion recognition predicted the presence of positive symptoms of psychosis in early adulthood. Cognitive set shifting improved at a slower rate for individuals with 22q11DS + psychosis than those without psychosis. Emotion recognition increased steadily in individuals without psychosis, whereas for those with psychosis, scores increased until approximately 15 years of age, at which point they began to decrease rapidly. A similar, but more subtle effect, was seen for reading decoding. CONCLUSIONS Our data are the first to go beyond IQ assessments in assessing longitudinal neuropsychological outcomes and risk for psychosis in 22q11DS. Individuals with 22q11DS who developed psychotic symptoms improved less appreciably and continued to demonstrate difficulties with cognitive flexibility relative to individuals with 22q11DS who did not have psychotic symptoms. Individuals with 22q11DS who developed psychosis had weaker reading skills in childhood and, after an initial improvement into adolescence, these individuals with psychosis had a decline in reading skills. In 22q11DS, cognitive deficits are both (a) traits that are preexisting and raise the risk for psychosis and (b) associated with the onset of psychotic symptoms. Future research should consider the extent to which cognitive set shifting and reading decoding are related to the Verbal IQ declines observed in the 22q11DS population.
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Affiliation(s)
- Kevin M Antshel
- Department of Psychology, Syracuse University, Syracuse, NY
- Department of Psychiatry and Behavioral Science, SUNY-Upstate Medical University, Syracuse, NY
| | - Wanda Fremont
- Department of Psychiatry and Behavioral Science, SUNY-Upstate Medical University, Syracuse, NY
| | - Seetha Ramanathan
- Department of Psychiatry and Behavioral Science, SUNY-Upstate Medical University, Syracuse, NY
- Hutchings Psychiatric Center, Syracuse, NY
| | - Wendy R Kates
- Department of Psychiatry and Behavioral Science, SUNY-Upstate Medical University, Syracuse, NY
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Zhang LC, Brenner CA. The Factor Structure of the Schizotypal Personality Questionnaire in Undergraduate and Community Samples. J Pers Disord 2017; 31:1-15. [PMID: 26845533 DOI: 10.1521/pedi_2016_30_233] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The prevailing theoretical model of the Schizotypal Personality Questionnaire (SPQ) is a three-factor model based on subscale-level analyses. However, recent item-level factor analyses of the SPQ suggest a four- or five-factor model. To examine the factor structure of the SPQ and how this structure may differ between undergraduate and community samples, the authors conducted exploratory and confirmatory item-level factor analyses of this measure on undergraduate (N = 1,850) and community participants (N = 1,464). A clear three-factor solution was found in the community sample, whereas a somewhat equivocal four-factor solution was found in the undergraduate sample. Both structures displayed gender invariance. This is the first study to address the issues of undergraduate sample generalizability and gender invariance in an item-level exploratory factor analysis of the SPQ. Given the disparate findings in the samples, this study indicates the importance of using both community and undergraduate samples when examining the factor structure of the SPQ.
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Affiliation(s)
| | - Colleen A Brenner
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
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Akiyama K, Saito S, Saito A, Ozeki Y, Watanabe T, Fujii K, Honda G, Shimoda K. Predictive value of premorbid IQ, negative symptoms, and age for cognitive and social functions in Japanese patients with schizophrenia: A study using the Japanese version of the Brief Assessment of Cognition in Schizophrenia. Psychiatry Res 2016; 246:663-671. [PMID: 27838018 DOI: 10.1016/j.psychres.2016.10.070] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/30/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
Abstract
Enduring cognitive impairment in patients with schizophrenia represents a global health burden. The Japanese-language version of the Brief Assessment of Cognition in Schizophrenia (BACS) and the Japanese Adult Reading Test were administered to 288 patients with chronic schizophrenia and 308 unrelated healthy control subjects. The Japanese version of self-reported Social Functioning Scale (SFS) was administered to a subpopulation of 157 patients with schizophrenia. In patients with schizophrenia, premorbid IQ and age were significantly related to most of the BACS subdomains, composite score, and intra-individual variability of BACS subdomains, whereas negative symptoms were significantly related to all BACS indices. Dosages of the first-generation antipsychotics had a significant negative impact on Tower of London task and intra-individual variability of BACS subdomains. The relationship of symbol coding with age was significantly lower in patients than in healthy control subjects. Multiple regression analysis revealed that negative symptoms were significantly negatively related to the total SFS scale, whereas better performance of token motor task was associated with higher total SFS. The present study revealed the role of premorbid IQ, age, and negative symptoms in predicting cognitive performance, and the significant correlation of negative symptoms and token motor task with social function in patients with schizophrenia.
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Affiliation(s)
- Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan.
| | - Satoshi Saito
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan; Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Atsushi Saito
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street/Meyer 3-146, Baltimore, MD 21287, USA
| | - Yuji Ozeki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Kumiko Fujii
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Gyo Honda
- Seiseido Kohseikai, Mori Hospital, 419 Iidamachi, Utsunomiya, Tochigi 3210347, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
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36
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Kake TR, Garrett N, Te Aonui M. Cognitive neuropsychological functioning in New Zealand Māori diagnosed with schizophrenia. Aust N Z J Psychiatry 2016; 50:566-76. [PMID: 26494850 DOI: 10.1177/0004867415607986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Previous research suggests that New Zealand Māori may have an elevated rate of schizophrenia. However, there is limited evidence on important clinical features of the illness in this population. This study examined cognitive neuropsychological functioning in 54 adult Māori diagnosed with schizophrenia and 56 Māori controls. This study also examined associations between cognition, medication and symptoms of psychosis in the schizophrenia group. METHOD The groups were matched on socio-demographic variables, handedness and premorbid cognitive ability. Participants were assessed on neuropsychological tests of attention, executive ability, motor, premorbid ability, verbal/non-verbal memory and verbal fluency (English/Māori versions). The Positive and Negative Syndrome Scale was used to assess psychotic symptoms. Information on cultural identity, duration of illness, duration of untreated psychosis, medication and substance abuse was collected. RESULTS The performance of the schizophrenia group was significantly lower than the control group on all the neuropsychological tests, except the test of attention. The effect sizes were moderate to large: 0.78 for motor function; 1.3 for executive ability, verbal fluency and visual memory; 1.6 for verbal learning and 1.8 for verbal memory. These differences remained after adjustment for multiple comparisons and covariates. A higher dose of antipsychotic medication and a higher anticholinergic load were associated with greater verbal memory impairment (r = -0.38 and r = -0.38, respectively). A longer duration of illness was associated with greater impairment of verbal memory (rho = -0.48), verbal learning (rho = -0.41) and visual memory (rho = -0.44). CONCLUSION The findings for the schizophrenia group show a profile of generalised cognitive impairment with greater impairment of verbal memory. The cognitive impairment in this group was independent of psychotic symptoms, but was associated with a higher antipsychotic dose, higher anticholinergic load and longer duration of illness. These findings have implications for clinical prescribing practices and rehabilitation for New Zealand Māori diagnosed with schizophrenia.
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Affiliation(s)
- Tai R Kake
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Nicholas Garrett
- Department of Biostatistics and Epidemiology, AUT University, Auckland, New Zealand
| | - Menetta Te Aonui
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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Discontinuity in the genetic and environmental causes of the intellectual disability spectrum. Proc Natl Acad Sci U S A 2015; 113:1098-103. [PMID: 26711998 PMCID: PMC4743770 DOI: 10.1073/pnas.1508093112] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Intellectual disability (ID) is present in almost 3% of children and fundamentally characterized by IQ scores below 70. Genetic research has shown that it is among the most heritable traits, and it has been accepted that ID is the extreme low of the normal IQ distribution. However, we show that, while the genetic and environmental factors influencing mild ID (lowest 3% of IQ distribution) are similar to those influencing IQ in the normal range, factors influencing severe ID (lowest 0.5%) differ from those influencing mild ID or IQ scores in the normal range. Therefore, severe ID is a distinct disorder, qualitatively different from the majority of ID, which in turn represents the low extreme of the normal distribution of intelligence. Intellectual disability (ID) occurs in almost 3% of newborns. Despite substantial research, a fundamental question about its origin and links to intelligence (IQ) still remains. ID has been shown to be inherited and has been accepted as the extreme low of the normal IQ distribution. However, ID displays a complex pattern of inheritance. Previously, noninherited rare mutations were shown to contribute to severe ID risk in individual families, but in the majority of cases causes remain unknown. Common variants associated with ID risk in the population have not been systematically established. Here we evaluate the hypothesis, originally proposed almost 1 century ago, that most ID is caused by the same genetic and environmental influences responsible for the normal distribution of IQ, but that severe ID is not. We studied more than 1,000,000 sibling pairs and 9,000 twin pairs assessed for IQ and for the presence of ID. We evaluated whether genetic and environmental influences at the extremes of the distribution are different from those operating in the normal range. Here we show that factors influencing mild ID (lowest 3% of IQ distribution) were similar to those influencing IQ in the normal range. In contrast, the factors influencing severe ID (lowest 0.5% of IQ distribution) differ from those influencing mild ID or IQ scores in the normal range. Taken together, our results suggest that most severe ID is a distinct condition, qualitatively different from the preponderance of ID, which, in turn, represents the low extreme of the normal distribution of intelligence.
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Velthorst E, Reichenberg A, Rabinowitz J, Levine SZ. Study of resilience and environmental adversity in midlife health (STREAM). Soc Psychiatry Psychiatr Epidemiol 2015; 50:1915-22. [PMID: 26464376 PMCID: PMC4654741 DOI: 10.1007/s00127-015-1126-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 09/21/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE The Jerusalem study of resilience and environmental adversity in midlife health (STREAM) was established to examine the prevalence of common mental and physical health issues in mid-adulthood in the inner city of Jerusalem, and to examine their association with lifespan psychosocial factors of vulnerability and resilience. METHOD Participants were 811 randomly selected individuals from 7000 individuals who were born and grew up in inner-Jerusalem. Participants were 34-44 years old during first wave of STREAM assessment. Initial telephone surveys took place in 2007-2008 and participants were followed-up for a second survey 1 year later. Upon funding, a new wave is planned for 2017-2018. Survey topics comprised common health problems (e.g., type 2 diabetes/migraine), health markers (e.g., BMI), and psychiatric vulnerabilities (e.g., anxiety, post-traumatic stress, depressive symptoms, psychosis). Other measures included socioeconomic status, creativity, life style behavior (e.g., smoking, exercise), social contact and adaptation to change. Survey data were retrospectively merged with data of national registry sources that included adverse psychosocial factors, psychiatric and social measures assessed across all developmental stages through midlife. This includes data available on birth factors, school achievement and adjustment, cognitive and behavioral functioning during young adulthood, psychiatric hospitalizations, immigration and socioeconomic status. RESULTS Results on health outcomes of the first STREAM wave indicate that prevalence rates of health problems are comparable to recent World Mental Health Surveys. CONCLUSIONS Apart from measures on adverse psychosocial factors, STREAM provides a cohort to examine resilience to developing health problems and having a poor health and functional outcome.
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Affiliation(s)
- Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY, 10029, USA.
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands.
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY, 10029, USA
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | | | - Stephen Z Levine
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Cukierman-Yaffe T, Kasher-Meron M, Fruchter E, Gerstein HC, Afek A, Derazne E, Tzur D, Karasik A, Twig G. Cognitive Performance at Late Adolescence and the Risk for Impaired Fasting Glucose Among Young Adults. J Clin Endocrinol Metab 2015; 100:4409-16. [PMID: 26431506 DOI: 10.1210/jc.2015-2012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
CONTEXT Although dysglycemia is a risk factor for cognitive decline, it is unknown whether cognitive performance among young and apparently healthy adults affect the risk for impaired fasting glucose (IFG). OBJECTIVE This study aimed to characterize the relationship between cognitive function and the risk for IFG among young adults. DESIGN AND SETTING This was a retrospective cohort study utilizing data collected at pre-military recruitment assessments with information collected at the screening center of Israeli Army Medical Corps. PARTICIPANTS Normoglycemic adults (n = 17 348) (free of IFG and diabetes; mean age 31.0 ± 5.6 y; 87% men) of the Metabolic Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort with data regarding their General Intelligence Score (GIS), a comprehensive measure of cognitive function, at age 17 y. INTERVENTIONS Fasting plasma glucose was assessed every 3-5 y at scheduled visits. Cox proportional hazards models were applied. MAIN OUTCOMES MEASURES The main outcome of the study was incident IFG (≥ 100 mg/dL and <126 mg/dL) at scheduled visits. RESULTS During a median followup of 6.6 y, 1478 cases of IFG were recorded (1402 men). After adjustment for age and sex, participants in the lowest GIS category had a 1.9-fold greater risk for incident IFG compared with those in the highest GIS category. In multivariable analysis adjusted for age, sex, body mass index, fasting plasma glucose, family history of diabetes, country of origin, socioeconomic status, education, physical activity, smoking status, alcohol consumption, breakfast consumption, triglyceride level, white blood cell count, the risk for IFG was nearly doubled in the lowest GIS category compared with the highest GIS category (hazard ratio, 1.8; 95% confidence interval, 1.4-2.3; P < .001). These results persisted when GIS was treated as a continuous variable and when the model was adjusted also for body mass index at the end of followup. CONCLUSIONS This study demonstrates that lower cognitive function at late adolescence is independently associated with an elevated risk IFG in both men and women.
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Affiliation(s)
- Tali Cukierman-Yaffe
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Michal Kasher-Meron
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Eyal Fruchter
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Hertzel C Gerstein
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Estela Derazne
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Dorit Tzur
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Avraham Karasik
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
| | - Gilad Twig
- The Sackler School of Medicine (T.C.-Y., A.A., E.D., A.K., G.T.), Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology (T.C.-Y., M.K.-M., A.K.), Sheba Medical Center, Tel Hashomer, Israel; Gertner Institute for Epidemiology (T.C.-Y.), Tel Hashomer, Israel; The Israel Defense Forces Medical Corps (E.F., E.D., D.T., G.T.), Israel; Division of Endocrinology & Metabolism, and Population Healthy Research Institute (H.C.G.), McMaster University & Hamilton Health Sciences, Hamilton, Canada; The Israel Ministry of Health (A.A.), Jerusalem, Israel; Department of Medicine B (G.T.), Sheba Medical Center, Tel Hashomer 52621, Israel; and The Dr Pinchas Bornstein Talpiot Medical Leadership Program (G.T.), Sheba Medical Center, Tel Hashomer, Israel
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Woodward ND, Heckers S. Brain Structure in Neuropsychologically Defined Subgroups of Schizophrenia and Psychotic Bipolar Disorder. Schizophr Bull 2015; 41:1349-59. [PMID: 25904725 PMCID: PMC4601708 DOI: 10.1093/schbul/sbv048] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Neuropsychological impairment is heterogeneous in psychosis. The association of intracranial volume (ICV) and total brain volume (TBV) with cognition suggests brain structure abnormalities in psychosis will covary with the severity of cognitive impairment. We tested the following hypotheses: (1) brain structure abnormalities will be more extensive in neuropsychologically impaired psychosis patients; (2) psychosis patients with premorbid cognitive limitations will show evidence of hypoplasia (ie, smaller ICV); and (3) psychosis patients with evidence of cognitive decline will demonstrate atrophy (ie, smaller TBV, but normal ICV). METHODS One hundred thirty-one individuals with psychosis and 97 healthy subjects underwent structural magnetic resonance imaging and neuropsychological testing. Patients were divided into neuropsychologically normal and impaired groups. Impaired patients were further subdivided into deteriorated and compromised groups if estimated premorbid intellect was average or below average, respectively. ICV and TBV were compared across groups. Localized brain volumes were qualitatively examined using voxel-based morphometry. RESULTS Compared to healthy subjects, neuropsychologically impaired patients exhibited smaller TBV, reduced grey matter volume in frontal, temporal, and subcortical brain regions, and widespread white matter volume loss. Neuropsychologically compromised patients had smaller ICV relative to healthy subjects, and neuropsychologically normal and deteriorated patient groups, but relatively normal TBV. Deteriorated patients exhibited smaller TBV compared to healthy subjects, but relatively normal ICV. Unexpectedly, TBV, adjusted for ICV, was reduced in neuropsychologically normal patients. CONCLUSIONS Patients with long-standing cognitive limitations exhibit evidence of early cerebral hypoplasia, whereas neuropsychologically normal and deteriorated patients show evidence of brain tissue loss consistent with progression or later cerebral dysmaturation.
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Affiliation(s)
- Neil D. Woodward
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN,*To whom correspondence should be addressed; Department of Psychiatry, Vanderbilt University School of Medicine, 1601 23rd Avenue South, Suite 3057, Nashville, TN 37212, US; tel: 615-322-8361, fax: 615-936-3563, e-mail:
| | - Stephan Heckers
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN
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Shmukler AB, Gurovich IY, Agius M, Zaytseva Y. Long-term trajectories of cognitive deficits in schizophrenia: A critical overview. Eur Psychiatry 2015; 30:1002-10. [PMID: 26516984 DOI: 10.1016/j.eurpsy.2015.08.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/15/2015] [Accepted: 08/18/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Cognitive disturbances are widely pronounced in schizophrenia and schizophrenia spectrum disorders. Whilst cognitive deficits are well established in the prodromal phase and are known to deteriorate at the onset of schizophrenia, there is a certain discrepancy of findings regarding the cognitive alterations over the course of the illness. METHODS We bring together the results of the longitudinal studies identified through PubMed which have covered more than 3 years follow-up and to reflect on the potential factors, such as sample characteristics and stage of the illness which may contribute to the various trajectories of cognitive changes. RESULTS A summary of recent findings comprising the changes of the cognitive functioning in schizophrenia patients along the longitudinal course of the illness is provided. The potential approaches for addressing cognition in the course of schizophrenia are discussed. CONCLUSIONS Given the existing controversies on the course of cognitive changes in schizophrenia, differentiated approaches specifically focusing on the peculiarities of the clinical features and changes in specific cognitive domains could shed light on the trajectories of cognitive deficits in schizophrenia and spectrum disorders.
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Affiliation(s)
- A B Shmukler
- Moscow Research Institute of Psychiatry, Moscow, Russian Federation.
| | - I Y Gurovich
- Moscow Research Institute of Psychiatry, Moscow, Russian Federation
| | - M Agius
- Clare College Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK; East London NHS Foundation Trust, London, UK
| | - Y Zaytseva
- Moscow Research Institute of Psychiatry, Moscow, Russian Federation; National Institute of Mental Health, Klecany, Charles University in Prague, Prague, Czech Republic; Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; Human Science Centre and Institute of Medical Psychology, Ludwig-Maximilians Universität, Munich, Germany
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Furer A, Afek A, Beer Z, Derazne E, Tzur D, Pinhas-Hamiel O, Reichman B, Twig G. Height at Late Adolescence and Incident Diabetes among Young Men. PLoS One 2015; 10:e0136464. [PMID: 26305680 PMCID: PMC4549289 DOI: 10.1371/journal.pone.0136464] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/03/2015] [Indexed: 02/05/2023] Open
Abstract
Background Short stature was suggested as a risk factor for diabetes onset among middle age individuals, but whether this is the case among young adults is unclear. Our goal was to assess the association between height and incident diabetes among young men. Methods and Findings Incident diabetes was assessed among 32,055 men with no history of diabetes, from the prospectively followed young adults of the MELANY cohort. Height was measured at two time points; at adolescence (mean age 17.4±0.3 years) and grouped according to the US-CDC percentiles and at young adulthood (mean age 31.0±5.6 years). Cox proportional hazards models were applied. There were 702 new cases of diabetes during a mean follow-up of 6.3±4.3 years. There was a significant increase in the crude diabetes incidence rate with decreasing adolescent height percentile, from 4.23 cases/104 person-years in the <10th percentile group to 2.44 cases/104 person-years in the 75th≤ percentile group. These results persisted when clinical and biochemical diabetes risk factors were included in multivariable models. Compared to the 75th≤ percentile group, height below the 10th percentile was associated with a hazard ratio (HR) of 1.64 (95%CI 1.09–2.46, p = 0.017) for incident diabetes after adjustment for age, body mass index (BMI), fasting plasma glucose, HDL-cholesterol and triglyceride levels, white blood cells count, socioeconomic status, country of origin, family history of diabetes, sleep quality and physical activity. At age 30 years, each 1-cm decrement in adult height was associated with a 2.5% increase in diabetes adjusted risk (HR 1.025, 95%CI 1.01–1.04, p = 0.001). Conclusions Shorter height at late adolescence or young adulthood was associated with an increased risk of incident diabetes among young men, independent of BMI and other diabetes risk factors.
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Affiliation(s)
- Ariel Furer
- Department of Medicine I, Tel-Aviv Medical Center, Tel-Aviv, Israel
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| | - Arnon Afek
- Israel Ministry of Health, Jerusalem, Israel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zivan Beer
- Department of Medicine I, Tel-Aviv Medical Center, Tel-Aviv, Israel
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| | - Estela Derazne
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel
| | - Orit Pinhas-Hamiel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrinology and Metabolism Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Brian Reichman
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel
| | - Gilad Twig
- The Israel Defense Forces Medical Corps, Tel Hashomer, Israel
- The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
- * E-mail:
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Barbero JD, Gutiérrez-Zotes A, Montalvo I, Creus M, Cabezas Á, Solé M, Algora MJ, Garcia-Parés G, Vilella E, Labad J. Free thyroxine levels are associated with cognitive abilities in subjects with early psychosis. Schizophr Res 2015; 166:37-42. [PMID: 25982813 DOI: 10.1016/j.schres.2015.04.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/02/2015] [Accepted: 04/23/2015] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Subjects with a psychotic disorder show mild to moderate cognitive impairment, which is an important determinant of functional outcome. The underlying biological process of cognitive impairment in psychosis is unclear. We aimed to explore whether hypothalamic-pituitary-thyroid axis hormones or thyroid autoimmunity modulate cognitive functioning in subjects with early psychosis. METHODS We studied 70 patients with a psychotic disorder (<3years of illness) and a control group of 37 healthy subjects (HS). Plasma levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4) and thyroid-peroxidase (TPO-Abs) and thyroglobulin antibodies (TG-Abs) were determined. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery. We also explored the relationship between thyroid variables and cognition in three subgroups of psychotic patients: psychosis not otherwise specified, affective psychosis (bipolar disorder or schizoaffective disorder) and non-affective psychosis (schizophrenia or schizophreniphorm disorder). RESULTS In patients with early psychosis, higher FT4 levels (but not TSH or thyroid antibodies) were associated with better cognitive performance in attention/vigilance and overall cognition. The relationship between FT4 levels and the attention/vigilance domain remained significant in a multivariate analysis after adjusting for education level, age, gender, substance use, and benzodiazepine and antipsychotic treatments. We did not find a significant association between FT4 and cognitive performance in HS. In the exploratory analysis by psychotic subtypes, subjects with affective psychosis had increased FT4 levels and better cognitive profile than those with non-affective psychosis. CONCLUSIONS Our study suggests that FT4 levels are associated with cognitive abilities (attention/vigilance and overall cognition) in individuals with early psychosis.
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Affiliation(s)
- Juan D Barbero
- Department of Psychiatry, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, Spain
| | - Alfonso Gutiérrez-Zotes
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Itziar Montalvo
- Department of Psychiatry, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, Spain
| | - Marta Creus
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Ángel Cabezas
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Montse Solé
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Maria José Algora
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Gemma Garcia-Parés
- Department of Psychiatry, Hospital Nostra Senyora de Meritxell, Servei Andorrà d'Atenció Sanitària, Andorra
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Javier Labad
- Department of Psychiatry, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, Spain.
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Vorstman JA, Breetvelt EJ, Duijff SN, Eliez S, Schneider M, Jalbrzikowski M, Armando M, Vicari S, Shashi V, Hooper SR, Chow EW, Fung WLA, Butcher NJ, Young DA, McDonald-McGinn DM, Vogels A, van Amelsvoort T, Gothelf D, Weinberger R, Weizman A, Klaassen PWJ, Koops S, Kates WR, Antshel KM, Simon TJ, Ousley OY, Swillen A, Gur RE, Bearden CE, Kahn RS, Bassett AS. Cognitive decline preceding the onset of psychosis in patients with 22q11.2 deletion syndrome. JAMA Psychiatry 2015; 72:377-85. [PMID: 25715178 PMCID: PMC4383767 DOI: 10.1001/jamapsychiatry.2014.2671] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Patients with 22q11.2 deletion syndrome (22q11DS) have an elevated (25%) risk of developing schizophrenia. Recent reports have suggested that a subgroup of children with 22q11DS display a substantial decline in cognitive abilities starting at a young age. OBJECTIVE To determine whether early cognitive decline is associated with risk of psychotic disorder in 22q11DS. DESIGN, SETTING, AND PARTICIPANTS Prospective longitudinal cohort study. As part of an international research consortium initiative, we used the largest data set of intelligence (IQ) measurements in patients with 22q11DS reported to date to investigate longitudinal IQ trajectories and the risk of subsequent psychotic illness. A total of 829 patients with a confirmed hemizygous 22q11.2 deletion, recruited through 12 international clinical research sites, were included. Both psychiatric assessments and longitudinal IQ measurements were available for a subset of 411 patients (388 with ≥1 assessment at age 8-24 years). MAIN OUTCOMES AND MEASURES Diagnosis of a psychotic disorder, initial IQ, longitudinal IQ trajectory, and timing of the last psychiatric assessment with respect to the last IQ test. RESULTS Among 411 patients with 22q11DS, 55 (13.4%) were diagnosed as having a psychotic disorder. The mean (SD) age at the most recent psychiatric assessment was 16.1 (6.2) years. The mean (SD) full-scale IQ at first cognitive assessment was lower in patients who developed a psychotic disorder (65.5 [12.0]) compared with those without a psychotic disorder (74.0 [14.0]). On average, children with 22q11DS showed a mild decline in IQ (full-scale IQ, 7.04 points) with increasing age, particularly in the domain of verbal IQ (9.02 points). In those who developed psychotic illness, this decline was significantly steeper (P < .001). Those with a negative deviation from the average cognitive trajectory observed in 22q11DS were at significantly increased risk for the development of a psychotic disorder (odds ratio = 2.49; 95% CI, 1.24-5.00; P = .01). The divergence of verbal IQ trajectories between those who subsequently developed a psychotic disorder and those who did not was distinguishable from age 11 years onward. CONCLUSIONS AND RELEVANCE In 22q11DS, early cognitive decline is a robust indicator of the risk of developing a psychotic illness. These findings mirror those observed in idiopathic schizophrenia. The results provide further support for investigations of 22q11DS as a genetic model for elucidating neurobiological mechanisms underlying the development of psychosis.
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Affiliation(s)
- Jacob A.S. Vorstman
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elemi J Breetvelt
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sasja N. Duijff
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Stephan Eliez
- Office Médico-Pédagogique Research Unit, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Maude Schneider
- Office Médico-Pédagogique Research Unit, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Maria Jalbrzikowski
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, United States
| | - Marco Armando
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Rome
| | - Stefano Vicari
- Child Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, Rome
| | - Vandana Shashi
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, United States
| | - Stephen R. Hooper
- Departments of Psychiatry and Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States
| | - Eva W.C. Chow
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Wai Lun Alan Fung
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- The Dalglish Family Hearts and Minds Clinic for Adults with 22q11.2 Deletion Syndrome, Toronto General Research Institute and Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
| | - Nancy J. Butcher
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Donald A. Young
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Donna M. McDonald-McGinn
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | | | - Therese van Amelsvoort
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Doron Gothelf
- The Behavioral Neurogenetics Center, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 52621, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Ronnie Weinberger
- The Behavioral Neurogenetics Center, The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer 52621, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Abraham Weizman
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Felsenstein Medical Research Center and Geha Mental Health Center, Petah Tikva 49202, Israel
| | - Petra WJ Klaassen
- Department of Pediatric Psychology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, the Netherlands
| | - Sanne Koops
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wendy R. Kates
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States
| | - Kevin M. Antshel
- Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, NY, United States
- Department of Psychology, Syracuse University, Syracuse, New York, United States
| | - Tony J. Simon
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, United States
| | - Opal Y. Ousley
- Emory University School of Medicine, Emory Autism Center, Department of Psychiatry and Behavioral Sciences, 1551 Shoup Court, 30322 Atlanta, Georgia, United States
| | - Ann Swillen
- Center for Human Genetics, KU Leuven, Belgium
| | - Raquel E. Gur
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, United States
| | - Carrie E. Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, United States
| | - René S. Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anne S. Bassett
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- The Dalglish Family Hearts and Minds Clinic for Adults with 22q11.2 Deletion Syndrome, Toronto General Research Institute and Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
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Twig G, Gluzman I, Tirosh A, Gerstein HC, Yaniv G, Afek A, Derazne E, Tzur D, Karasik A, Gordon B, Fruchter E, Lubin G, Rudich A, Cukierman-Yaffe T. Cognitive function and the risk for diabetes among young men. Diabetes Care 2014; 37:2982-8. [PMID: 25092683 DOI: 10.2337/dc14-0715] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diabetes is a risk factor for an accelerated rate of cognitive decline and dementia. However, the relationship between cognitive function and the subsequent development of diabetes is unclear. RESEARCH DESIGN AND METHODS We conducted a historical-prospective cohort study merging data collected at premilitary recruitment assessment with information collected at the Staff Periodic Examination Center of the Israeli Army Medical Corps. Included were men aged 25 years or older without a history of diabetes at the beginning of follow-up with available data regarding their general intelligence score (GIS), a comprehensive measure of cognitive function, at age 17 years. RESULTS Among 35,500 men followed for a median of 5.5 years, 770 new cases of diabetes were diagnosed. After adjustment for age, participants in the lowest GIS category had a 2.6-fold greater risk for developing diabetes compared with those in the highest GIS category. In multivariable analysis adjusted for age, BMI, fasting plasma glucose, sociogenetic variables, and lifestyle risk factors, those in the lowest GIS category had a twofold greater risk for incident diabetes when compared with the highest GIS category (hazard ratio 2.1 [95% CI 1.5-3.1]; P < 0.001). Additionally, participants in the lowest GIS category developed diabetes at a mean age of 39.5 ± 4.7 years and those in the highest GIS group at a mean age of 41.5 ± 5.1 years (P for comparison 0.042). CONCLUSIONS This study demonstrates that in addition to a potential causal link between diabetes and enhanced cognitive decline, lower cognitive function at late adolescence is independently associated with an elevated risk for future diabetes.
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Affiliation(s)
- Gilad Twig
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel Israel Defense Forces Medical Corps, Israel
| | - Israel Gluzman
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Tirosh
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard School of Public Health, Boston, MA
| | - Hertzel C Gerstein
- Division of Endocrinology & Metabolism and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Gal Yaniv
- Israel Defense Forces Medical Corps, Israel Department of Radiology and Imaging, Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Israel Ministry of Health, Jerusalem, Israel
| | - Estela Derazne
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- Israel Defense Forces Medical Corps, Israel
| | - Avraham Karasik
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - Barak Gordon
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Fruchter
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gadi Lubin
- Israel Defense Forces Medical Corps, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assaf Rudich
- Department of Clinical Biochemistry and Pharmacology and the National Institute of Biotechnology in the Negev, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Tali Cukierman-Yaffe
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel Gertner Institute for Epidemiology, Tel Hashomer, Israel
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Morgan VA, McGrath JJ, Jablensky A, Badcock JC, Waterreus A, Bush R, Carr V, Castle D, Cohen M, Galletly C, Harvey C, Hocking B, McGorry P, Neil AL, Saw S, Shah S, Stain HJ, Mackinnon A. Psychosis prevalence and physical, metabolic and cognitive co-morbidity: data from the second Australian national survey of psychosis. Psychol Med 2014; 44:2163-76. [PMID: 24365456 PMCID: PMC4045165 DOI: 10.1017/s0033291713002973] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 11/05/2013] [Accepted: 11/09/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND There are insufficient data from nationwide surveys on the prevalence of specific psychotic disorders and associated co-morbidities. METHOD The 2010 Australian national psychosis survey used a two-phase design to draw a representative sample of adults aged 18-64 years with psychotic disorders in contact with public treatment services from an estimated resident population of 1 464 923 adults. This paper is based on data from 1642 participants with an International Classification of Diseases (ICD)-10 psychotic disorder. Its aim is to present estimates of treated prevalence and lifetime morbid risk of psychosis, and to describe the cognitive, physical health and substance use profiles of participants. RESULTS The 1-month treated prevalence of psychotic disorders was 3.10 cases per 1000 population aged 18-64 years, not accounting for people solely accessing primary care services; lifetime morbid risk was 3.45 per 1000. Mean premorbid intelligence quotient was approximately 0.5 s.d.s below the population mean; current cognitive ability (measured with a digit symbol coding task) was 1.6 s.d.s below the population mean. For both cognitive tests, higher scores were significantly associated with better independent functioning. The prevalence of the metabolic syndrome was high, affecting 60.8% of participants, and pervasive across diagnostic groups. Of the participants, two-thirds (65.9%) were current smokers, 47.4% were obese and 32.4% were sedentary. Of the participants, half (49.8%) had a lifetime history of alcohol abuse/dependence and 50.8% lifetime cannabis abuse/dependence. CONCLUSIONS Our findings highlight the need for comprehensive, integrative models of recovery to maximize the potential for good health and quality of life for people with psychotic illness.
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Affiliation(s)
- V. A. Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - J. J. McGrath
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - A. Jablensky
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - J. C. Badcock
- School of Psychology, The University of Western Australia, Crawley, Western Australia
- Clinical Research Centre, North Metropolitan Health Service-Mental Health, Mount Claremont, WA, Australia
| | - A. Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - R. Bush
- School of Population Health, The University of Queensland, Ipswich, QLD, Australia
| | - V. Carr
- School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
| | - D. Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- St Vincent's Hospital, Melbourne, VIC, Australia
| | - M. Cohen
- Hunter New England Mental Health, Newcastle, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - C. Galletly
- School of Medicine, University of Adelaide, Adelaide, SA, Australia
- Ramsay Health Care (SA) Mental Health Services, Adelaide, SA, Australia
- Northern Sector, Adelaide Metro Mental Health Directorate, Adelaide, SA, Australia
| | - C. Harvey
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- Psychosocial Research Centre, North West Area Mental Health Services, Coburg, VIC, Australia
| | - B. Hocking
- SANE Australia, Melbourne, VIC, Australia
| | - P. McGorry
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- Orygen Youth Health Research Centre, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - A. L. Neil
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - S. Saw
- Australian Government Department of Health and Ageing, Canberra, ACT, Australia
| | - S. Shah
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia
| | - H. J. Stain
- Centre for Rural and Remote Mental Health, University of Newcastle, Newcastle, NSW, Australia
- School of Medicine, Pharmacy and Health, Durham University, Durham, UK
| | - A. Mackinnon
- Orygen Youth Health Research Centre, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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Bahorik AL, Newhill CE, Eack SM. Neurocognitive functioning of individuals with schizophrenia: using and not using drugs. Schizophr Bull 2014; 40:856-67. [PMID: 23884348 PMCID: PMC4059433 DOI: 10.1093/schbul/sbt099] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Research on neurocognition in schizophrenia, using modest samples and self-rated assessments, reports drug use contributes to improved rather than impaired cognitive function. We have sought to replicate these findings in a large sample of patients that had their drug-use status confirmed by laboratory assays and evaluated the potential differences in cognitive function between patients with positive and negative results. METHODS Nine hundred and seventy four schizophrenia patients completed neuropsychological and laboratory tests at screening/baseline of the Clinical Antipsychotic Trials of Intervention Effectiveness study. Radioimmunoassay (RIA) of hair tested for cannabis, cocaine and methamphetamine. RESULTS Many patients screened positive for drug use (n = 262; 27%), and there were no differences between patients with positive and negative results in terms of cognitive function after adjusting for multiple inference testing, except patients with positive RIA for methamphetamine demonstrated increased processing speed (corrected, P = .024). Moderator models were employed to explore potential subgroup differences in this pattern of results. At low medication dosages, patients with positive RIA for cocaine demonstrated decreased processing speed compared with patients with negative RIA for cocaine (uncorrected, P = .008). And for any other drugs with low psychopathology, patients with positive RIA demonstrated decreased working memory compared with patients with negative RIA (uncorrected, P = .006). CONCLUSIONS No positive effects of cannabis on cognitive function were observed, and drug use was not associated with improved neurocognition across most of the subgroup characteristics explored in this sample of schizophrenia patients.
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Affiliation(s)
- Amber L. Bahorik
- School of Social Work, University of Pittsburgh, Pittsburgh, PA;,Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA,*To whom correspondence should be addressed; School of Social Work, University of Pittsburgh, 2117 Cathedral of Learning, 4200 Fifth Avenue, Pittsburgh, PA 15260, US; tel: 814-659-5713; e-mail:
| | | | - Shaun M. Eack
- School of Social Work, University of Pittsburgh, Pittsburgh, PA;,Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA
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Bratlien U, Øie M, Haug E, Møller P, Andreassen OA, Lien L, Melle I. Environmental factors during adolescence associated with later development of psychotic disorders - a nested case-control study. Psychiatry Res 2014; 215:579-85. [PMID: 24495574 DOI: 10.1016/j.psychres.2013.12.048] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 12/22/2013] [Accepted: 12/29/2013] [Indexed: 11/29/2022]
Abstract
Etiologies of psychotic disorders (schizophrenia and bipolar disorder) are conceptualized as interplay between genetic and environmental factors. The adolescent period is characterized by changes in social roles and expectations that may interact with biological changes or psychosocial stressors. Few studies focus on the adolescents' own reports of perceived risk factors. To assess differences at age 16 between persons who later develop psychotic disorders ("Confirmed Psychosis", CP) and their class-mates ("Population Controls", PC) we collected information on: (1) Social support factors (size of social network and expectancies of social support from friends), (2) Cognitive functioning (concentrating in the classroom, actual grades and expectancies of own academic achievements) and (3) Problems and stressors in families (illness or loss of work for parents), and in relationship with others (exposure to bullying, violence or sexual violation). Self-reported data from students at 15-16 years of age were linked to the case-registers from the "Thematically Organized Psychosis (TOP) Study". The CP group reported more economic problems in their families, smaller social network and lower academic expectation than the PC group. The results support the notion that long-term socioeconomic stressors in adolescence may serve as risk factors for the development of psychotic disorders.
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Affiliation(s)
- Unni Bratlien
- Innlandet Hospital Trust, Division of Mental Health, Norway.
| | - Merete Øie
- Innlandet Hospital Trust, Division of Mental Health, Norway; Department of Psychology, University of Oslo, Norway
| | - Elisabeth Haug
- Innlandet Hospital Trust, Division of Mental Health, Norway
| | - Paul Møller
- Department of Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Norway
| | - Ole A Andreassen
- KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo, and Oslo University Hospital, Norway
| | - Lars Lien
- Innlandet Hospital Trust, Division of Mental Health, Norway; Faculty of Public Health, Hedmark University College, Norway
| | - Ingrid Melle
- KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo, and Oslo University Hospital, Norway
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Increased prolactin levels are associated with impaired processing speed in subjects with early psychosis. PLoS One 2014; 9:e89428. [PMID: 24586772 PMCID: PMC3933530 DOI: 10.1371/journal.pone.0089428] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/20/2014] [Indexed: 11/19/2022] Open
Abstract
Hyperprolactinaemia, a common side effect of some antipsychotic drugs, is also present in drug-naïve psychotic patients and subjects at risk for psychosis. Recent studies in non-psychiatric populations suggest that increased prolactin may have negative effects on cognition. The aim of our study was to explore whether high plasma prolactin levels are associated with poorer cognitive functioning in subjects with early psychoses. We studied 107 participants: 29 healthy subjects and 78 subjects with an early psychosis (55 psychotic disorders with <3 years of illness, 23 high-risk subjects). Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery, and prolactin levels were determined as well as total cortisol levels in plasma. Psychopathological status was assessed and the use of psychopharmacological treatments (antipsychotics, antidepressants, benzodiazepines) recorded. Prolactin levels were negatively associated with cognitive performance in processing speed, in patients with a psychotic disorder and high-risk subjects. In the latter group, increased prolactin levels were also associated with impaired reasoning and problem solving and poorer general cognition. In a multiple linear regression analysis conducted in both high-risk and psychotic patients, controlling for potential confounders, prolactin and benzodiazepines were independently related to poorer cognitive performance in the speed of processing domain. A mediation analysis showed that both prolactin and benzodiazepine treatment act as mediators of the relationship between risperidone/paliperidone treatment and speed of processing. These results suggest that increased prolactin levels are associated with impaired processing speed in early psychosis. If these results are confirmed in future studies, strategies targeting reduction of prolactin levels may improve cognition in this population.
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