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Dolz M, Tor J, Puig O, de la Serna E, Muñoz-Samons D, Pardo M, Alvarez-Subiela X, Rodriguez-Pascual M, Sugranyes G, Ilzarbe D, Baeza I. Clinical and neurodevelopmental predictors of psychotic disorders in children and adolescents at clinical high risk for psychosis: the CAPRIS study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02436-4. [PMID: 38642116 DOI: 10.1007/s00787-024-02436-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND The neurodevelopmental hypothesis of schizophrenia represents the disorder as an expression of an alteration during the brain development process early in life. Neurodevelopmental variables could become a trait marker, and the study of these variables in children and adolescents at clinical high risk for psychosis (CHR) could identify a specific cluster of patients who later developed psychosis. The aim of this study is to describe clinical and neurodevelopment predictors of transition to psychosis in child and adolescent participants at CHR. Naturalistic longitudinal two-center study of 101 CHR and 110 healthy controls (HC) aged 10-17. CHR participants were children and adolescents aged 10-17, meeting one or more of the CHR criteria assessed at baseline and at 18 months' follow-up. Neurodevelopmental variables assessed were obstetric complications, delay in principal development milestones, and presence of a neurodevelopment diagnosis. Pairwise comparisons, linear regressions, and binary logistic regression were performed.A transition rate of 23.3% at 1.5 years was observed. Participants who developed psychosis (CHR-P) showed higher rates of grandiosity and higher proportions of antipsychotic medication intake at baseline compared to participants who did not develop a psychotic disorder (CHR-NP). In terms of neurodevelopment alterations, CHR-P group showed a higher proportion of participants reporting delay in language development than the CHR-NP and HC groups. The odds of psychosis increased by 6.238 CI 95% [1.276-30.492] for a one-unit increase in having a positive score in grandiosity; they increased by 4.257 95% CI [1.293-14.023] for a one-unit increase in taking antipsychotic medication, and by 4.522 95% [1.185-64.180] for showing language development delay. However, the p-values did not reach significance after adjusting for multiple comparisons.A combination of clinical and neurodevelopmental alterations could help predict the transition to psychotic disorder in a CHR child and adolescent sample. Our results suggest the potential utility of collecting information about neurodevelopment and using these variable multifactorial models to predict psychosis disorders.
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Affiliation(s)
- Montserrat Dolz
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
- Universitat Autonoma de Barcelona, Bellaterra, Spain
| | - Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain.
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain.
| | - Olga Puig
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, Barcelona, SGR2021-01319, Spain
| | - Daniel Muñoz-Samons
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Marta Pardo
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Xavier Alvarez-Subiela
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Marta Rodriguez-Pascual
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Gisela Sugranyes
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Daniel Ilzarbe
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, Barcelona, SGR2021-01319, Spain
- Fundació Clínic per a la Recerca Biomèdica-IDIBAPS, Barcelona, Spain
- Department of Medicine, Institute of Neurosciences, University of Barcelona, Bellaterra, Spain
| | - Inmaculada Baeza
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
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Xie XM, Sha S, Smith RD, Liang S, Ungvari GS, Amoretti S, Wang G, Xiang YT, Vieta E. Cognitive reserve in patients with mood disorders: Validation study of the Chinese version of the cognitive reserve assessment scale in health. J Affect Disord 2023; 325:480-486. [PMID: 36621675 DOI: 10.1016/j.jad.2022.12.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cognitive reserve (CR) is closely associated with cognitive and functional outcome, disease severity, progression and prognosis in psychiatric patients; however, it has not been extensively tested in mood disorders. This study examined the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH) in mood disorder patients. METHODS Altogether 166 subjects were recruited, 44 with major depressive disorder (MDD), 64 with bipolar disorder (BD), and 58 healthy controls. CR was assessed using the CRASH and the Cognitive Reserve Questionnaire (CRQ). RESULTS Internal consistency (Cronbach's alpha) was 0.779 for the CRASH. The Receiver Operating Characteristic (ROC) curve analysis revealed an area under the ROC curve (AUC) value of 0.73 (95 % CI: 0.647-0.809). The optimal cut-off score of 51 generated the best combination of sensitivity (0.78) and specificity (0.43) for discriminating between patients with mood disorders and healthy controls. The CRASH score was highly correlated with the CRQ score in both mood disorder patients (rs = 0.586, P < 0.001) and healthy controls (rs = 0.627, P < 0.001), indicating acceptable convergent validity for the CRASH. Within the mood disorder sample, the CRASH score was associated with functional outcomes (FAST: rs = -0.243, P = 0.011). CONCLUSIONS The CRASH is a useful tool to measure CR in mood disorder with acceptable psychometric properties and could be used in both research and clinical practice.
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Affiliation(s)
- Xiao-Meng Xie
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Robert D Smith
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Sixiang Liang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, Australia
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, 170 Villarroel St, 08036 Barcelona, Catalonia, Spain
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, 170 Villarroel St, 08036 Barcelona, Catalonia, Spain.
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Development of social responsiveness and theory of mind in children of parents with schizophrenia or bipolar disorder. Schizophr Res Cogn 2022; 28:100242. [PMID: 35242611 PMCID: PMC8881607 DOI: 10.1016/j.scog.2022.100242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/20/2022] Open
Abstract
Social impairments are suggested as vulnerability markers for schizophrenia and bipolar disorder. Therefore, we investigated the development of social responsiveness and theory of mind (ToM) in children at familial high-risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP). This study is part of The Danish High Risk and Resilience Study, a longitudinal cohort study of children at FHR-SZ or FHR-BP and population-based controls (PBC). Social responsiveness was measured with the Social Responsiveness Scale (SRS-2), completed by teachers and primary caregivers. ToM was measured using The Animated Triangles Task (ATT). Both SRS-2 and ATT were applied at age 7 and 11. A total of 520 children participated (FHR-SZ, n = 201; FHR-BP, n = 119; PBC, n = 200). Results showed no significant time by group interactions. At follow-up, children at FHR-SZ exhibited impaired social responsiveness compared with PBC regardless of the informant. At both timepoints, a higher proportion of children at FHR-SZ were rated at a clinically significant level, implying inference in everyday social interactions. Compared with PBC, primary caregivers reported impairments in social responsiveness in children at FHR-BP at follow-up. The three groups did not differ in ToM at follow-up. Social responsiveness and ToM do not develop differently in children at FHR-SZ, FHR-BP and PBC from age 7 to 11, but impairments in social responsiveness remain stable and may constitute a vulnerability marker particularly in children at FHR-SZ, but also FHR-BP. ToM abilities seem to improve and remain intact, but ToM development and ToM task properties should be taken into consideration. No developmental differences in social abilities in children at familial high-risk Children at familial high-risk exhibit impaired social responsiveness. Social responsiveness impairments are detectable already at an early age. Impairments in social responsiveness may constitute a vulnerability marker. 11-Year-olds at familial high-risk have intact theory of mind.
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Premorbid characteristics of patients with DSM-IV psychotic disorders. Compr Psychiatry 2022; 115:152310. [PMID: 35385814 DOI: 10.1016/j.comppsych.2022.152310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/09/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Psychotic disorder not otherwise specified (PNOS) is considered part of the psychosis spectrum, together with schizophrenia spectrum disorders (SSD) and psychotic bipolar spectrum disorders (PBD). The atypical clinical presentations of PNOS conditions may lead to uncertainty regarding treatment choices and expected outcomes. PNOS is understudied, and little is known about patients' premorbid characteristics including premorbid adjustment, prevalence of early cannabis use and childhood trauma. Knowledge about early illness phases can increase our understanding of this diagnostic group. METHODS We included 1099 participants from the Norwegian TOP-study; 688 with narrow SSD diagnoses (schizophrenia, schizoaffective disorder, schizophreniform disorder), 274 with PBD (psychotic bipolar 1 and bipolar NOS) and 137 with PNOS diagnosed with the SCID-I for DSM-IV. Participants were assessed with the Premorbid Adjustment Scale (PAS) divided into the areas of premorbid academic and social functioning. We obtained information on age at first exposure to cannabis and use of cannabis before the age of 16. The participants also provided information regarding early traumatic experiences using the Childhood Trauma Questionnaire (CTQ). RESULTS Participants with PNOS and SSD had poorer premorbid academic functioning than those with PBD (F2, 1029 = 7.81, p < 0.001, pη2 = 0.015). Premorbid social adjustment was significantly worse in the SSD group compared to the PBD group (F2, 1024 = 3.10, p = 0.045, pη2 = 0.006), with PNOS in the middle position. Significantly more of the participants with PNOS (17.5%) and SSD (11.5%) used cannabis before the age of 16 compared with PBD (5.3%, Wald χ2 = 6.86, p = 0.03). There were no significant differences between the three groups regarding mean CTQ scores or in the proportion of participants who had experienced at least one type of childhood adversity. CONCLUSIONS Participants with PNOS appear as more similar to participants with SSD than to those with PBD regarding early premorbid adjustment and early cannabis use. The results indicate that many conditions classified as PNOS have functional impairments and problematic substance use from an early age. The prevalence of childhood adversities are high in all three groups.
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Ferraro L, La Cascia C, La Barbera D, Sanchez-Gutierrez T, Tripoli G, Seminerio F, Sartorio C, Marrazzo G, Sideli L, Arango C, Arrojo M, Bernardo M, Bobes J, Del-Ben CM, Gayer-Anderson C, Jongsma HE, Kirkbride JB, Lasalvia A, Tosato S, Llorca PM, Menezes PR, Rutten BP, Santos JL, Sanjuán J, Selten JP, Szöke A, Tarricone I, Muratori R, Tortelli A, Velthorst E, Rodriguez V, Quattrone A, Jones PB, Van Os J, Vassos E, Morgan C, de Haan L, Reininghaus U, Cardno AG, Di Forti M, Murray RM, Quattrone D. The relationship of symptom dimensions with premorbid adjustment and cognitive characteristics at first episode psychosis: Findings from the EU-GEI study. Schizophr Res 2021; 236:69-79. [PMID: 34403965 PMCID: PMC8473991 DOI: 10.1016/j.schres.2021.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 07/14/2021] [Accepted: 08/04/2021] [Indexed: 01/19/2023]
Abstract
Premorbid functioning and cognitive measures may reflect gradients of developmental impairment across diagnostic categories in psychosis. In this study, we sought to examine the associations of current cognition and premorbid adjustment with symptom dimensions in a large first episode psychosis (FEP) sample. We used data from the international EU-GEI study. Bifactor modelling of the Operational Criteria in Studies of Psychotic Illness (OPCRIT) ratings provided general and specific symptom dimension scores. Premorbid Adjustment Scale estimated premorbid social (PSF) and academic adjustment (PAF), and WAIS-brief version measured IQ. A MANCOVA model examined the relationship between symptom dimensions and PSF, PAF, and IQ, having age, sex, country, self-ascribed ethnicity and frequency of cannabis use as confounders. In 785 patients, better PSF was associated with fewer negative (B = -0.12, 95% C.I. -0.18, -0.06, p < 0.001) and depressive (B = -0.09, 95% C.I. -0.15, -0.03, p = 0.032), and more manic (B = 0.07, 95% C.I. 0.01, 0.14, p = 0.023) symptoms. Patients with a lower IQ presented with slightly more negative and positive, and fewer manic, symptoms. Secondary analysis on IQ subdomains revealed associations between better perceptual reasoning and fewer negative (B = -0.09, 95% C.I. -0.17, -0.01, p = 0.023) and more manic (B = 0.10, 95% C.I. 0.02, 0.18, p = 0.014) symptoms. Fewer positive symptoms were associated with better processing speed (B = -0.12, 95% C.I. -0.02, -0.004, p = 0.003) and working memory (B = -0.10, 95% C.I. -0.18, -0.01, p = 0.024). These findings suggest that the negative and manic symptom dimensions may serve as clinical proxies of different neurodevelopmental predisposition in psychosis.
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Affiliation(s)
- Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy.
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | | | - Giada Tripoli
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Giovanna Marrazzo
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Lucia Sideli
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), C/Doctor Esquerdo 46, 28007 Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Julián Clavería s/n, 33006 Oviedo, Spain
| | - Cristina Marta Del-Ben
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Hannah E. Jongsma
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK
| | - James B. Kirkbride
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK
| | - Antonio Lasalvia
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | | | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Bart P. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital "Virgen de la Luz", C/Hermandad de Donantes de Sangre, 16002 Cuenca, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Avda. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Jean-Paul Selten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200, MD, Maastricht, the Netherlands,Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZLeiden, the Netherlands
| | - Andrei Szöke
- INSERM, U955, Equipe 15, 51 Avenue de Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy
| | - Roberto Muratori
- Dapertment of Mental Health and pathological addictions, Bologna Local Health Authority, Italy
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, Paris 75020, France
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Andrea Quattrone
- National Health Service, Villa Betania Institute, Reggio Calabria, Italy
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK,Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, the Netherlands
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Ulrich Reininghaus
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200, MD, Maastricht, the Netherlands,Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alastair G. Cardno
- Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK,Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
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6
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Verdolini N, Amoretti S, Mezquida G, Cuesta MJ, Pina-Camacho L, García-Rizo C, Lobo A, González-Pinto A, Merchán-Naranjo J, Corripio I, Salagre E, Baeza I, Bergé D, Garriga M, Bioque M, Vallespir C, Serra M, Vieta E, Bernardo M. The effect of family environment and psychiatric family history on psychosocial functioning in first-episode psychosis at baseline and after 2 years. Eur Neuropsychopharmacol 2021; 49:54-68. [PMID: 33857739 DOI: 10.1016/j.euroneuro.2021.03.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 01/13/2023]
Abstract
The aim of the present study was to evaluate the contribution of family environment styles and psychiatric family history on functioning of patients presenting first-episode psychosis (FEP). Patients with FEP and healthy controls (HC) were assessed at baseline and after 2 years. The Functional Assessment Short Test (FAST) was used to assess functional outcome and the Family Environment Scale (FES) to evaluate family environment. Linear regressions evaluated the effect that family environment exerts on functioning at baseline and at 2-year follow-up, when FEP patients were diagnosed according to non-affective (NA-PSYCH) or affective psychoses (A-PSYCH). The influence of a positive parents' psychiatric history on functioning was evaluated through one-way between-groups analysis of covariance (ANCOVA) models, after controlling for family environmental styles. At baseline, FEP patients presented moderate functioning impairment, significantly worse than HC (28.65±16.17 versus 3.25±7.92; p<0.001, g = 1.91). At 2-year follow-up, the functioning of NA-PSYCH patients was significantly worse than in A-PSYCH (19.92±14.83 versus 12.46±14.86; p = 0.020, g = 0.50). No specific family environment style was associated with functioning in FEP patients and HC. On the contrary, a positive psychiatric father's history influenced functioning of FEP patients. After 2 years, worse functioning in NA-PSYCH patients was associated with lower rates of active-recreational and achievement orientated family environment and with higher rates of moral-religious emphasis and control. In A-PSYCH, worse functioning was associated with higher rates of conflict in the family. Both family environment and psychiatric history influence psychosocial functioning, with important implications for early interventions, that should involve both patients and caregivers.
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Affiliation(s)
- Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Laura Pina-Camacho
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry. Universidad de Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Hospital Universitario de Alava, UPV/EHU, BIOARABA, CIBERSAM, Vitoria, Spain
| | - Jessica Merchán-Naranjo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Estela Salagre
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Immaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain
| | - Daniel Bergé
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Spain; Autonomous University of Barcelona (UAB), Spain
| | - Marina Garriga
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Catalina Vallespir
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Maria Serra
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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7
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Post F, Buchta M, Kemmler G, Pardeller S, Frajo-Apor B, Hofer A. Resilience Predicts Self-Stigma and Stigma Resistance in Stabilized Patients With Bipolar I Disorder. Front Psychiatry 2021; 12:678807. [PMID: 34093288 PMCID: PMC8176112 DOI: 10.3389/fpsyt.2021.678807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/23/2021] [Indexed: 11/19/2022] Open
Abstract
The identification of factors that prevent self-stigma and on the other hand promote stigma resistance are of importance in the long-term management of bipolar disorder. Accordingly, the aim of the current study was to investigate the association of factors deemed relevant in this context, i.e., resilience, premorbid functioning, and residual mood symptoms, with self-stigma/stigma resistance. Sixty patients diagnosed with bipolar I disorder were recruited from a specialized outpatient clinic. Self-stigma and stigma resistance were measured by the Internalized Stigma of Mental Illness (ISMI) Scale. The presence and severity of symptoms were assessed by the Montgomery-Asberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale (YMRS). Resilience and premorbid functioning were measured by the Resilience Scale (RS-25) and the Premorbid Adjustment Scale (PAS), respectively. Resilience correlated negatively with self-stigma and positively with stigma resistance and was a predictor for self-stigma/stigma resistance in multiple linear regression analysis. Residual depressive symptoms correlated positively with self-stigma and negatively with stigma resistance. There were no significant correlations between sociodemographic variables, premorbid functioning as well as residual manic symptoms and self-stigma/stigma resistance. The findings of this study implicate that resilience may be considered as an important component of self-stigma reduction interventions.
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Affiliation(s)
- Fabienne Post
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Melanie Buchta
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Georg Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Silvia Pardeller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Beatrice Frajo-Apor
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Alex Hofer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
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8
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Hatzimanolis A, Stefanatou P, Kattoulas E, Ralli I, Dimitrakopoulos S, Foteli S, Kosteletos I, Mantonakis L, Selakovic M, Soldatos RF, Vlachos I, Xenaki LA, Smyrnis N, Stefanis NC. Familial and socioeconomic contributions to premorbid functioning in psychosis: Impact on age at onset and treatment response. Eur Psychiatry 2020; 63:e44. [PMID: 32345391 PMCID: PMC7355181 DOI: 10.1192/j.eurpsy.2020.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background. Premorbid adjustment (PA) abnormalities in psychotic disorders are associated with an earlier age at onset (AAO) and unfavorable clinical outcomes, including treatment resistance. Prior family studies suggest that familial liability, likely reflecting increased genetic risk, and socioeconomic status (SES) contribute to premorbid maladjustment. However, their joint effect possibly indicating gene–environment interaction has not been evaluated. Methods. We examined whether family history of psychosis (FHP) and parental SES may predict PA and AAO in unrelated cases with first-episode psychosis (n = 108) and schizophrenia (n = 104). Premorbid academic and social functioning domains during childhood and early adolescence were retrospectively assessed. Regression analyses were performed to investigate main effects of FHP and parental SES, as well as their interaction. The relationships between PA, AAO, and response to antipsychotic medication were also explored. Results. Positive FHP associated with academic PA difficulties and importantly interacted with parental SES to moderate social PA during childhood (interaction p = 0.024). Positive FHP and parental SES did not predict differences in AAO. Nevertheless, an earlier AAO was observed among cases with worse social PA in childhood (β = −0.20; p = 0.005) and early adolescence (β = −0.19; p = 0.007). Further, confirming evidence emerged for an association between deficient childhood social PA and poor treatment response (p = 0.04). Conclusions. Familial risk for psychosis may interact with parental socioeconomic position influencing social PA in childhood. In addition, this study supports the link between social PA deviations, early psychosis onset, and treatment resistance, which highlights premorbid social functioning as a promising clinical indicator.
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Affiliation(s)
- Alex Hatzimanolis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece.,Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, 11521 Athens, Greece
| | - Pentagiotissa Stefanatou
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Emmanouil Kattoulas
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Irene Ralli
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Stefanos Dimitrakopoulos
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Stefania Foteli
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Ioannis Kosteletos
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Leonidas Mantonakis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Mirjana Selakovic
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Rigas-Filippos Soldatos
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Ilias Vlachos
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Lida-Alkisti Xenaki
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece
| | - Nikolaos Smyrnis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece.,University Mental Health, Neurosciences and Precision Medicine Research Institute, 11527 Athens, Greece
| | - Nicholas C Stefanis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, 11528 Athens, Greece.,Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, 11521 Athens, Greece.,University Mental Health, Neurosciences and Precision Medicine Research Institute, 11527 Athens, Greece
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9
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Association of cognitive and P50 suppression deficits in chronic patients with schizophrenia. Clin Neurophysiol 2020; 131:725-733. [DOI: 10.1016/j.clinph.2019.12.405] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/03/2019] [Accepted: 12/23/2019] [Indexed: 12/30/2022]
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10
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Dolz M, Tor J, De la Serna E, Pardo M, Muñoz-Samons D, Rodríguez-Pascual M, Puig O, Sugranyes G, Usall J, Sánchez-Gistau V, Baeza I. Characterization of children and adolescents with psychosis risk syndrome: The Children and Adolescents Psychosis Risk Syndrome (CAPRIS) study. Early Interv Psychiatry 2019; 13:1062-1072. [PMID: 30478873 DOI: 10.1111/eip.12728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 06/20/2018] [Accepted: 07/29/2018] [Indexed: 01/18/2023]
Abstract
AIM Despite the interest in psychosis risk syndrome (PRS) in children and adolescents, information on the syndrome in this population is scarce. METHODS Prospective naturalistic multi-site study in which 10- to 17-year-old help-seeking subjects who met PRS criteria (positive or negative attenuated symptoms; brief limited intermittent psychotic symptoms; genetic risk or schizotypal personality disorder plus impairment in functioning) were included, along with 45 age and sex-matched healthy controls (HC). All subjects were clinically and functionally assessed. RESULTS Ninety-one PRS subjects (PRSS) with a mean age of 15.5 ± 1.4 met inclusion criteria (IC). Compared with HC, PRSS presented worse global and academic functioning in the previous year, had experienced more psychiatric and psychological problems, and presented gestational ages outside the normal range. More than 80% of PRSS met ≥2 IC, with 65.9% having one Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision diagnosis, and 61.7% of those having ≥2 diagnoses. Some 49.5% of PRSS had a first- or second-degree family history (FH) of psychosis. Patients with first- and second-degree FH do not differ in their clinical expression. CONCLUSIONS Children and adolescents with PRS are a patient group with a pattern of neurodevelopmental impairment and clinical complexity similar to patients with schizophrenia spectrum disorders, highlighting the importance of assessing these variables in child and adolescent samples. PRSS with first- and second-degree relatives with FH do not present differences in their clinical presentation, suggesting that including these two groups of patients in the genetic risk criteria would enrich knowledge of these criteria.
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Affiliation(s)
- Montserrat Dolz
- Child and Adolescent Mental Health Research Group, Sant Joan de Déu Research Insitute, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain.,Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain
| | - Jordina Tor
- Child and Adolescent Mental Health Research Group, Sant Joan de Déu Research Insitute, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain.,Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain
| | - Elena De la Serna
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Universitari of Barcelona. CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), (2014SGR489), Barcelona, Spain.,Institut Clinic of Neurosciences, CERCA-IDIBAPS. (Institut d'Investigacions Biomèdiques August Pi Sunyer), Hospital Clínic Universitari of Barcelona, Department of Psychiatry and Psychobiology, Health Sciences Division, University of Barcelona, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
| | - Marta Pardo
- Child and Adolescent Mental Health Research Group, Sant Joan de Déu Research Insitute, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain.,Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain
| | - Daniel Muñoz-Samons
- Child and Adolescent Mental Health Research Group, Sant Joan de Déu Research Insitute, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain.,Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain
| | - Marta Rodríguez-Pascual
- Child and Adolescent Mental Health Research Group, Sant Joan de Déu Research Insitute, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
| | - Olga Puig
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Universitari of Barcelona. CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), (2014SGR489), Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Universitari of Barcelona. CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), (2014SGR489), Barcelona, Spain.,Institut Clinic of Neurosciences, CERCA-IDIBAPS. (Institut d'Investigacions Biomèdiques August Pi Sunyer), Hospital Clínic Universitari of Barcelona, Department of Psychiatry and Psychobiology, Health Sciences Division, University of Barcelona, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
| | - Judith Usall
- Research Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, CIBERSAM, Barcelona, Spain
| | - Vanessa Sánchez-Gistau
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Universitari of Barcelona. CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), (2014SGR489), Barcelona, Spain.,Early Intervention Service, Pere Mata Institut Universitary Hospital, IISPV (Institut d'Investigació Sanitaria Pere Vigili), Rovira Virgili University and CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Reus, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Universitari of Barcelona. CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), (2014SGR489), Barcelona, Spain.,Institut Clinic of Neurosciences, CERCA-IDIBAPS. (Institut d'Investigacions Biomèdiques August Pi Sunyer), Hospital Clínic Universitari of Barcelona, Department of Psychiatry and Psychobiology, Health Sciences Division, University of Barcelona, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
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11
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Jauhar S, Krishnadas R, Nour MM, Cunningham-Owens D, Johnstone EC, Lawrie SM. Is there a symptomatic distinction between the affective psychoses and schizophrenia? A machine learning approach. Schizophr Res 2018; 202:241-247. [PMID: 30054176 DOI: 10.1016/j.schres.2018.06.070] [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: 10/14/2017] [Revised: 04/21/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022]
Abstract
Dubiety exists over whether clinical symptoms of schizophrenia can be distinguished from affective psychosis, the assumption being that absence of a "point of rarity" indicates lack of nosological distinction, based on prior group-level analyses. Advanced machine learning techniques, using unsupervised (hierarchical clustering) and supervised (regularized logistic regression algorithm and nested-cross-validation) were applied to a dataset of 202 patients with functional psychosis (schizophrenia n = 120, affective psychosis, n = 82). Patients were initially assessed with the Present State Examination (PSE), and followed up 2.5 years later, when DSM III diagnoses were applied (independent of initial PSE). Based on PSE syndromes, unsupervised learning discriminated depressive (approximately unbiased probability, AUP = 0.92) and mania/psychosis (AUP = 0.94) clusters. The mania/psychosis cluster further split into two groups - a mania (AUP = 0.84) and a psychosis cluster (AUP = 0.88). Supervised machine learning classified schizophrenia or affective psychosis with 83.66% (95% CI = 77.83% to 88.48%) accuracy. Area under the ROC curve (AUROC) was 89.14%. True positive rate for schizophrenia was 88.24% (95%CI = 81.05-93.42%) and affective psychosis 77.11% (95%CI = 66.58-85.62). Classification accuracy and AUROC remained high when PSE syndromes corresponding to affective symptoms (those that corresponded to the depressive and mania clusters) were removed. PSE syndromes, based on clinical symptoms, therefore discriminated between schizophrenia and affective psychosis, suggesting validity to these diagnostic constructs.
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Affiliation(s)
- S Jauhar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom.
| | - R Krishnadas
- Sackler Institute for Psychobiological Research, Glasgow Clinical Research Facility, Queen Elizabeth University Hospital, Glasgow, G51 4TF, United Kingdom.
| | - M M Nour
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Denmark Hill, London SE5 8AF, United Kingdom.
| | - D Cunningham-Owens
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom.
| | - E C Johnstone
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom.
| | - S M Lawrie
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom.
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12
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Sheffield JM, Karcher NR, Barch DM. Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective. Neuropsychol Rev 2018; 28:509-533. [PMID: 30343458 DOI: 10.1007/s11065-018-9388-2] [Citation(s) in RCA: 237] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/15/2018] [Indexed: 12/15/2022]
Abstract
Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated with the experience of psychosis. These impairments negatively impact functional outcome, contributing to the disabling nature of schizophrenia, bipolar disorder, and psychotic depression. The robust and reliable nature of cognitive deficits has led researchers to explore the timing and profile of impairments, as this may elucidate different neurodevelopmental patterns in individuals who experience psychosis. Here, we review the literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences, highlighting the dimensional nature of both psychosis and cognitive ability. We identify premorbid generalized cognitive impairment in schizophrenia that worsens throughout development, and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course. Research in affective psychosis is less clear, with mixed evidence regarding premorbid deficits, but a fairly reliable generalized deficit at first-episode, which appears to worsen into the chronic state. In general, cognitive impairments are most severe in schizophrenia, intermediate in bipolar disorder, and the least severe in psychotic depression. In all groups, cognitive deficits are associated with poorer functional outcome. Finally, while the generalized deficit is the clearest and most reliable signal, data suggests specific deficits in verbal memory across all groups, specific processing speed impairments in schizophrenia and executive functioning impairments in bipolar disorder. Cognitive deficits are a core feature of psychotic disorders that provide a window into understanding developmental course and risk for psychosis.
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Affiliation(s)
- Julia M Sheffield
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Nashville, TN, 37212, USA.
| | - Nicole R Karcher
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
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13
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Dannevang AL, Randers L, Gondan M, Krakauer K, Nordholm D, Nordentoft M. Premorbid adjustment in individuals at ultra-high risk for developing psychosis: a case-control study. Early Interv Psychiatry 2018; 12:839-847. [PMID: 27684654 DOI: 10.1111/eip.12375] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 05/22/2016] [Accepted: 06/12/2016] [Indexed: 11/30/2022]
Abstract
AIM Deterioration in premorbid adjustment is related to ultra-high risk (UHR) individuals developing psychosis, but it has not been examined how UHR individuals' development differs compared to healthy controls. This study investigates differences in premorbid adjustment between UHR individuals and a healthy control group. METHOD A total of 48 UHR individuals and 50 healthy controls matched on group level for age, gender and parents' socio-economic status were included in the study. Both groups were assessed with the Premorbid Adjustment Scale (PAS). Based on the PAS scores, composite social and academic scales were computed. RESULTS Compared to the healthy controls the UHR individuals' social and academic premorbid adjustment declined across age periods. Social premorbid adjustment declined particularly between late adolescence and adulthood. Academic premorbid adjustment declined particularly between childhood and early adolescence. The UHR individuals had more premorbid adjustment difficulties on both the social and academic scale, and on the individual PAS scales. CONCLUSION From childhood UHR individuals have lower levels of social and academic premorbid adjustment compared to healthy controls, and the difficulties increase with age. As such, social and academic premorbid adjustment could be an important focus for early intervention.
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Affiliation(s)
- Anders L Dannevang
- Department of Psychology, Copenhagen, Denmark.,Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Lasse Randers
- Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark.,Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Kristine Krakauer
- Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark.,Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dorte Nordholm
- Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark.,Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark
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14
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Bucci P, Galderisi S, Mucci A, Rossi A, Rocca P, Bertolino A, Aguglia E, Amore M, Andriola I, Bellomo A, Biondi M, Cuomo A, dell'Osso L, Favaro A, Gambi F, Giordano GM, Girardi P, Marchesi C, Monteleone P, Montemagni C, Niolu C, Oldani L, Pacitti F, Pinna F, Roncone R, Vita A, Zeppegno P, Maj M. Premorbid academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition. Acta Psychiatr Scand 2018; 138:253-266. [PMID: 29984409 DOI: 10.1111/acps.12938] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. METHOD Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment in unaffected first-degree relatives and healthy controls. Its associations with psychopathology, cognition, and real-life functioning were investigated. The associations of PA with primary negative symptoms and their two factors were explored. RESULTS We found an impairment of academic and social PA in patients (P ≤ 0.000001) and an impairment of academic aspects of early adjustment in relatives (P ≤ 0.01). Patients with poor PA showed greater severity of negative symptoms (limited to avolition after excluding the effect of depression/parkinsonism), working memory, social cognition, and real-life functioning (P ≤ 0.01 to ≤0.000001). Worse academic and social PA were associated with greater severity of psychopathology, cognitive impairment, and real-life functioning impairment (P ≤ 0.000001). Regression analyses showed that worse PA in the academic domain was mainly associated to the impairment of working memory, whereas worse PA in the social domain to avolition (P ≤ 0.000001). CONCLUSION Our findings suggest that poor early adjustment may represent a marker of vulnerability to schizophrenia and highlight the need for preventive/early interventions based on psychosocial and/or cognitive programs.
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Affiliation(s)
- P Bucci
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
| | - S Galderisi
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
| | - A Mucci
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
| | - A Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - P Rocca
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - A Bertolino
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - E Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - M Amore
- Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - I Andriola
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - A Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - M Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - A Cuomo
- Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
| | - L dell'Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - A Favaro
- Department of Neurosciences, Psychiatric Clinic, University of Padua, Padua, Italy
| | - F Gambi
- Chair of Psychiatry, Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy
| | - G M Giordano
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
| | - P Girardi
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - C Marchesi
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy
| | - P Monteleone
- Chair of Psychiatry, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - C Montemagni
- Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy
| | - C Niolu
- Chair of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - L Oldani
- Department of Psychiatry, University of Milan, Milan, Italy
| | - F Pacitti
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - F Pinna
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - R Roncone
- Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - A Vita
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy.,Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - P Zeppegno
- Psychiatric Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - M Maj
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
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15
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Parellada M, Gomez-Vallejo S, Burdeus M, Arango C. Developmental Differences Between Schizophrenia and Bipolar Disorder. Schizophr Bull 2017; 43:1176-1189. [PMID: 29045744 PMCID: PMC5737496 DOI: 10.1093/schbul/sbx126] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Ample evidence supports a neurodevelopmental origin in some cases of schizophrenia (SZ). More inconsistent information is available for bipolar disorder (BD). We herein review studies with a focus on premorbid (adjustment and functionality) and early developmental milestones that include both SZ and BD patients. A search was performed in the PubMed electronic database, retrieving 619 abstracts; 30 were ultimately included in this systematic review. Eight prospective cohorts, 15 retrospective studies, and 7 studies based on national registries. Psychomotor developmental deviations and general adjustment problems characterize the childhood of subjects later diagnosed with SZ or BD; they are more marked in those later diagnosed with SZ vs BD, earlier onset vs later onset, and psychotic vs nonpsychotic disorders. Cognitive impairment follows a linear risk trend for SZ and a U-shaped trend for BD. Social isolation and visuoperceptual/reading anomalies more frequently antecede SZ. Pervasive developmental disorders increase the risk for both SZ and BD, more so in cases with normal intelligence. The predictive risk of each isolated developmental marker is low, but a significant percentage of subjects with SZ and a minority of adults with BD showed signs of premorbid abnormalities in childhood. The great limitation is still the lack of studies comparing SZ and BD that include psychotic and nonpsychotic bipolar cases separately. There are many cases, even in childhood/adolescent SZ, where no premorbid anomalies are found, and immunological disorders or other etiologies should be searched for. At least in cases with clear neurodevelopmental markers, rare genetic variants should be investigated.
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Affiliation(s)
- Mara Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain,To whom correspondence should be addressed; Mara Parellada, Hospital General Universitario Gregorio Marañón, Ibiza 43, Madrid 28009, Spain; tel: +34-91-5868133, fax: +34-91-4265004, e-mail:
| | - Sandra Gomez-Vallejo
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Monica Burdeus
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain,IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
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16
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Social and academic premorbid adjustment domains predict different functional outcomes among youth with first episode mania. J Affect Disord 2017; 219:133-140. [PMID: 28550765 DOI: 10.1016/j.jad.2017.05.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/21/2017] [Accepted: 05/19/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Premorbid characteristics may help predict the highly variable functional and illness outcomes of young people with early stage Bipolar Disorder (BD). We sought to examine the relationships between premorbid adjustment and short to medium-term outcomes after a first treated episode of mania. METHODS We examined the baseline and 18-month follow-up characteristics of 117 participants with first episode of mania, treated at two tertiary early intervention services in Melbourne, Australia. The baseline demographic, family history, diagnoses, comorbidity and clinical features were determined using unstructured questionnaires and structured diagnostic interviews. Premorbid adjustment was determined using the Premorbid Adjustment Scale (PAS), the components of which were identified using a principal component analysis. Eighteen-month follow-up outcome measures included the Clinical Global Impressions scale, Social and Occupational Functioning Assessment Scale and the Heinrichs' Quality of Life Scale (QLS). Correlations and linear regressions were utilised to examine the relationships between component scores and outcomes, while controlling for baseline and follow-up confounders. RESULTS The social adjustment component of the PAS correlated with the interpersonal relations (rs = -0.46, p<0.001) domain of QLS while the academic adjustment component of the PAS correlated with the vocational functioning domain of QLS (rs =-0.39, p = 0.004). Premorbid adjustment did not predict illness severity or objective functioning. LIMITATIONS Lack of information on cognition, personality factors and prodromal symptoms limited the assessment of their impact on outcomes. CONCLUSIONS Impairments in domains of premorbid adjustment may be early markers of persistent difficulties in social and vocational functioning and may benefit from targeted interventions.
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17
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Oldis M, Murray G, Macneil CA, Hasty MK, Daglas R, Berk M, Conus P, Cotton SM. Trajectory and predictors of quality of life in first episode psychotic mania. J Affect Disord 2016; 195:148-55. [PMID: 26896807 DOI: 10.1016/j.jad.2016.02.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 01/26/2016] [Accepted: 02/06/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Little is known about the trajectory of quality of life (QoL) following a first episode of psychotic mania in bipolar disorder (BD). This 18-month longitudinal study investigated the trajectory of QoL, and the influence of premorbid adjustment and symptoms on 18-month QoL in a cohort of young people experiencing a first episode of psychotic mania. METHODS As part of an overarching clinical trial, at baseline, sixty participants presenting with a first episode of psychotic mania (BD Type 1 - DSM-IV) completed symptomatic and functional assessments in addition to the Premorbid Adjustment Scale - General Subscale. Symptom measures were repeated at 18-month follow up. QoL was rated using the Quality of Life Scale (QLS) at designated time points. RESULTS Mean QLS scores at initial measurement (8 weeks) were 61% of the maximum possible score, increasing significantly to 70% at 12 months, and 71.2% at 18-month follow-up. Premorbid adjustment and 18-month depressive symptoms were significantly associated with QoL at 18-month follow-up. LIMITATIONS Study limitations include the small sample size, inclusion of participants with psychotic mania only, use of measures originally designed for use with schizophrenia spectrum disorders, and lack of premorbid or baseline measurement of QoL. CONCLUSIONS Results suggest that QoL can be maintained early in BD, and reinforce the importance of assertively treating depressive symptoms throughout the course of this disorder. The emergence of a link between premorbid adjustment and poorer QoL in this cohort highlights the importance of assessing facets of adjustment when planning psychological interventions.
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Affiliation(s)
- Meredith Oldis
- Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Greg Murray
- Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Australia.
| | - Craig A Macneil
- Orygen Youth Health - Clinical Program, Parkville, Australia
| | - Melissa K Hasty
- Orygen Youth Health - Clinical Program, Parkville, Australia
| | - Rothanthi Daglas
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Michael Berk
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; IMPACT Strategic Research Centre, Deakin University, School of Medicine, Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Australia; Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Clinique de Cery, 1008 Prilly, Switzerland
| | - Sue M Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
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18
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Pejovic-Milovancevic MM, Mandic-Maravic VD, Coric VM, Mitkovic-Voncina MM, Kostic MV, Savic-Radojevic AR, Ercegovac MD, Matic MG, Peljto AN, Lecic-Tosevski DR, Simic TP, Pljesa-Ercegovac MS. Glutathione S-Transferase Deletion Polymorphisms in Early-Onset Psychotic and Bipolar Disorders: A Case-Control Study. Lab Med 2016; 47:195-204. [PMID: 27114251 DOI: 10.1093/labmed/lmw017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 02/23/2016] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To examine glutathione S-transferase (GST) deletion polymorphisms in development of early-onset severe mental disorders, with the hypothesis that patients with GSTM1-null and GSTT1-null genotypes will develop psychotic disorders at a younger age. METHODS We identified GSTM1 and GSTT1 deletion polymorphisms by multiplex polymerase chain reaction (PCR) in 93 patients with early onset severe mental disorders and 278 control individuals. The diagnoses were confirmed by Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and Schedule for Affective Disorders and Schizophrenia-Life-Time Version (K-SADS-PL) interviews. RESULTS Individuals with the GSTM1-null genotype were at 3.36-fold higher risk of developing early-onset severe mental disorders than carriers of a corresponding active genotype. The risk of those disorders was increased by 6.59-fold in patients with GSTM1-null/GSTT1-active genotype. Patients with the GSTM1-null genotype were at approximately 2-fold increased risk for developing early-onset schizophrenia-spectrum disorder (EOS), early-onset bipolar disorder (EOBD) with psychotic symptoms, or early-onset first-episode psychosis (EOFEP), compared with patients with the GSTM1-active genotype. CONCLUSION The GSTM1-null genotype might be associated with higher risk for early onset severe mental disorders.
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Affiliation(s)
| | | | - Vesna M Coric
- Faculty of Medicine, University in Belgrade, Belgrade, Serbia Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
| | | | | | - Ana R Savic-Radojevic
- Faculty of Medicine, University in Belgrade, Belgrade, Serbia Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
| | - Marko D Ercegovac
- Faculty of Medicine, University in Belgrade, Belgrade, Serbia Clinic of Neurology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Marija G Matic
- Faculty of Medicine, University in Belgrade, Belgrade, Serbia Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
| | | | - Dusica R Lecic-Tosevski
- Institute of Mental Health, Belgrade, Serbia Faculty of Medicine, University in Belgrade, Belgrade, Serbia Serbian Academy of Science and Arts, Belgrade, Serbia
| | - Tatjana P Simic
- Faculty of Medicine, University in Belgrade, Belgrade, Serbia Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
| | - Marija S Pljesa-Ercegovac
- Faculty of Medicine, University in Belgrade, Belgrade, Serbia Institute of Medical and Clinical Biochemistry, Belgrade, Serbia
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19
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Betts KS, Williams GM, Najman JM, Alati R. Predicting spectrums of adult mania, psychosis and depression by prospectively ascertained childhood neurodevelopment. J Psychiatr Res 2016; 72:22-9. [PMID: 26519766 DOI: 10.1016/j.jpsychires.2015.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 09/03/2015] [Accepted: 10/16/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND We used a novel approach to investigate early neurodevelopmental factors of later adult spectrums of mania, depression and psychosis as a means to identify etiological similarities and differences among the three constructs. METHODS Participants were from the Mater University Study of Pregnancy (MUSP), a pre-birth cohort study started in Brisbane, Australia in 1981. A range of neurodevelopmental variables were ascertained at age 5, including measures of cognitive ability, developmental delay and behaviour problems. At age 21, offspring were assessed using a semi-structured psychiatric interview. We used structural equation modelling to establish three latent factors of mania, depression and psychotic symptoms. We then regressed these factors on the neurodevelopmental variables and covariates. RESULTS In both univariate and multivariate analysis premorbid cognitive ability predicted only psychotic symptoms, developmental delay predicted only manic symptoms, while behaviour problems predicted both depressive and psychotic symptoms. In a supplementary analysis the three factors were also found to have unique relationships with a number of outcomes also measured at age 21, including anxiety and substance use. CONCLUSION By assessing the impact of early childhood neurodevelopment on the continuous spectrums which underlie three serious adult psychiatric disorders in a general population sample, we provide unique evidence regarding potential etiological similarities and differences. Perhaps of most interest is that our findings suggest that the manic and depressive symptoms in bipolar depression, despite often overlapping in clinical presentations, may in fact be somewhat separate entities with origins that are at least partly unique to either disorder.
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Affiliation(s)
- Kim S Betts
- School of Population Health, University of Queensland, Brisbane, Australia.
| | - Gail M Williams
- School of Population Health, University of Queensland, Brisbane, Australia.
| | - Jacob M Najman
- School of Social Science and Population Health, University of Queensland, Brisbane, Australia.
| | - Rosa Alati
- School of Public Health and Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Australia.
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20
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Del Rey-Mejías Á, Fraguas D, Díaz-Caneja CM, Pina-Camacho L, Castro-Fornieles J, Baeza I, Espliego A, Merchán-Naranjo J, González-Pinto A, de la Serna E, Payá B, Graell M, Arango C, Parellada M. Functional deterioration from the premorbid period to 2 years after the first episode of psychosis in early-onset psychosis. Eur Child Adolesc Psychiatry 2015; 24:1447-59. [PMID: 25726022 DOI: 10.1007/s00787-015-0693-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 02/10/2015] [Indexed: 01/10/2023]
Abstract
The aim of the study was to analyze changes in functional adjustment from childhood to 2 years after the first episode of psychosis (FEP) in patients with early-onset schizophrenia spectrum disorders (SSD) and affective psychoses (AFP) and a good or intermediate level of premorbid adjustment. We followed 106 adolescents (aged 12-17 years) with FEP for 2 years after recruitment. Premorbid adjustment in childhood was assessed in 98 patients with the childhood subscale of the Cannon-Spoor Premorbid Adjustment Scale (c-PAS). Global functioning was assessed 2 years after the FEP with the Children's Global Assessment Scale (c-GAS) or the Global Assessment of Functioning scale (GAF), as appropriate. Functional deterioration was defined as a downward shift in the level of functional adjustment from childhood to 2 years after the FEP. In patients with good or intermediate premorbid adjustment, functional deterioration was observed in 28.2 % (26.5 % of the AFP group, 29.4 % of the SSD group). Longer duration of untreated psychosis (Beta = 0.01; P = 0.01) and higher symptom severity at the FEP, as measured with the Clinical Global Impression Scale (Beta = 1.12; P = 0.02), significantly predicted the presence of functional deterioration, accounting for 21.4 % of the variance. Irrespective of diagnosis (SSD or AFP), almost one-third of adolescents with FEP and good or intermediate premorbid adjustment showed functional deterioration from the premorbid period to 2 years after the FEP.
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Affiliation(s)
- Ángel Del Rey-Mejías
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.
| | - David Fraguas
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Laura Pina-Camacho
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Ana Espliego
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Jessica Merchán-Naranjo
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Ana González-Pinto
- Mood Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, CIBERSAM, Vitoria, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Beatriz Payá
- Department of Child Psychiatry, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Santander, Spain
| | - Montserrat Graell
- Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesus, CIBERSAM, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
| | - Mara Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain
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21
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Gade K, Malzahn D, Anderson-Schmidt H, Strohmaier J, Meier S, Frank J, Falkai PG, Rietschel M, Schulze TG. Functional outcome in major psychiatric disorders and associated clinical and psychosocial variables: A potential cross-diagnostic phenotype for further genetic investigations? World J Biol Psychiatry 2015; 16:237-48. [PMID: 25771936 DOI: 10.3109/15622975.2014.995221] [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] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Functional outcome has recently become of interest for cross-diagnostic subphenotype approaches in psychiatric genetics. Therefore, it is crucial to know about clinical, demographic and psychosocial variables that correlate with long-term functioning. Unfortunately, there is a lack of studies that directly compare the importance of correlates for functional outcome between different disorders. METHODS Applying regression models to samples of patients with schizophrenia (SZ, n = 238), bipolar disorder (BD, n = 533) and major depressive disorder (MDD, n = 398), we compared the magnitude of association of potential correlates with functional outcome, measured by the Global Assessment of Functioning (GAF) score. RESULTS Shared correlates for worse functional outcome were poor premorbid functioning, insidious illness onset and poor premorbid work or social adjustment in all three disorders, and negative symptomatology in SZ and BD. Disorder-specific correlates for SZ were longer duration of illness, lower functioning during episodes and being life-time single, for BD substance abuse and suicidality, and for MDD premorbid unemployment and having a premorbid personality disorder. CONCLUSIONS We found different patterns of correlates for long-term functioning in SZ, BD and MDD. Knowledge of these patterns may improve the quality of genetic investigations focussing on functional outcome.
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Affiliation(s)
- Katrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University , Göttingen , Germany
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22
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Neurocognitive functioning in the premorbid stage and in the first episode of bipolar disorder: a systematic review. Psychiatry Res 2015; 226:23-30. [PMID: 25618475 DOI: 10.1016/j.psychres.2014.12.044] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 12/04/2014] [Accepted: 12/30/2014] [Indexed: 12/25/2022]
Abstract
It is well known that patients with bipolar disorder (BD) have cognitive impairments even during periods of euthymia. However, to date it remains unclear the moment when these deficits onset. Therefore, the aim of this study was to review the evidence focusing on the cognitive status of patients with BD in their premorbid stage and in their first episode. An extensive search was conducted through the online databases Pubmed/PsychInfo, covering the period between 1980 and 2014. A total of 23 studies were selected for the review (nine studies explored premorbid stage of people who lately develop BD and 14 examined first-episodes in bipolar patients). There is evidence that general intelligence is not impaired in the premorbid stage. Impairments in verbal memory, attention, and executive functions tend to be present during and after the first episode. Preliminary evidence suggests that these deficits in specific cognitive domains might precede the onset of illness.
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23
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Forcada I, Mur M, Mora E, Vieta E, Bartrés-Faz D, Portella MJ. The influence of cognitive reserve on psychosocial and neuropsychological functioning in bipolar disorder. Eur Neuropsychopharmacol 2015; 25:214-22. [PMID: 25172270 DOI: 10.1016/j.euroneuro.2014.07.018] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 07/21/2014] [Accepted: 07/26/2014] [Indexed: 12/18/2022]
Abstract
Cognitive reserve (CR) refers to the hypothesized capacity of an adult brain to cope with brain pathology in order to minimize symptomatology. CR was initially investigated in dementia and acute brain damage, but it is being applied to other neuropsychiatric conditions. The present study aims at examining the fit of this concept to a sample of euthymic bipolar patients compared with healthy controls in order to investigate the role of CR in predicting psychosocial and cognitive outcome in bipolar disorder (BD). The sample included 101 subjects: 52 patients meeting DSM-IV-TR criteria for BD type I or II and 49 healthy controls (HC) matched for age and gender. They were all assessed with a cognitive battery tapping into executive and memory functioning. CR was obtained using three different proxies: education-occupation, leisure activities and premorbid IQ. Psychosocial functioning was evaluated by means of the Functioning Assessment Short Test (FAST). MANCOVAs were performed to determine differences in cognitive and functioning variables. Linear regression analyses were carried out to predict neuropsychological and psychosocial outcomes. Euthymic bipolar patients showed worse neuropsychological performance and psychosocial functioning than HC. The linear regression models revealed that CR was significantly predictive of FAST score (β = -0.47, p < 0.0001), Executive Index (β = 0.62, p < 0.0001) and Visual Memory Index (β = 0.44, p = 0.0004), indicating that CR is a significant predictor of cognitive and psychosocial functioning in euthymic bipolar outpatients. Therefore, CR may contribute to functional outcome in BD and may be applied in research and clinical interventions to prevent cognitive and functional impairment.
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Affiliation(s)
- Irene Forcada
- Psychiatric Service, Hospital Santa Maria, University of Lleida, IRBLleida (Biomedicine Research Institute), Lleida, Spain
| | - Maria Mur
- Psychiatric Service, Hospital Santa Maria, University of Lleida, IRBLleida (Biomedicine Research Institute), Lleida, Spain
| | - Ester Mora
- Children and Adolescents Center of Mental Health, Sant Joan de Déu, University of Lleida, IRBLleida (Biomedicine Research Institute), Lleida, Spain
| | - Eduard Vieta
- Bipolar Disorders Program, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - David Bartrés-Faz
- Departament de Psiquiatria i Psicobiologia Clínica, Fac. Medicina, Universitat de Barcelona, Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Maria J Portella
- Departament de Psiquiatria, Institut d׳Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Hospital de la Sant Creu i Sant Pau, Universitat Autònoma de Barcelona, CIBERSAM, Sant Antoni Ma. Claret 167, 08025 Barcelona, Spain.
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Petruzzelli MG, Margari L, Craig F, Campa MG, Martinelli D, Pastore A, Simone M, Margari F. Markers of neurodevelopmental impairments in early-onset psychosis. Neuropsychiatr Dis Treat 2015; 11:1793-8. [PMID: 26229474 PMCID: PMC4516349 DOI: 10.2147/ndt.s83904] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The aim of this study was to assess the association between the clinical and neurobiological markers of neurodevelopmental impairments and early-onset schizophrenia spectrum psychosis. METHODS A sample of 36 patients with early-onset schizophrenia spectrum psychosis was compared to a control sample of 36 patients with migraine. We assessed early childhood neurodevelopmental milestones using a modified version of the General Developmental Scale, general intellectual ability using the Wechsler Intelligence Scale for Children-Revised or Leiter International Performance Scale-Revised for patients with speech and language abnormalities, and neurological soft signs with specific regard to subtle motor impairment. RESULTS Subjects with early-onset psychosis had a higher rate of impaired social development (P=0.001), learning difficulties (P=0.04), enuresis (P=0.0008), a lower intelligence quotient (P<0.001), and subtle motor impairments (P=0.005) than control subjects. CONCLUSION We suggest that neurodevelopment in early-onset psychosis is characterized by a global impairment of functional and adaptive skills that manifests from early childhood, rather than a delay or limitation in language and motor development. The current evidence is based on a small sample and should be investigated in larger samples in future research.
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Affiliation(s)
- Maria Giuseppina Petruzzelli
- Child and Adolescence Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University "Aldo Moro" of Bari, Foggia, Italy
| | - Lucia Margari
- Child and Adolescence Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University "Aldo Moro" of Bari, Foggia, Italy
| | - Francesco Craig
- Child and Adolescence Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University "Aldo Moro" of Bari, Foggia, Italy
| | - Maria Gloria Campa
- Child and Adolescence Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University "Aldo Moro" of Bari, Foggia, Italy
| | - Domenico Martinelli
- Department of Medical and Surgical Sciences; University of Foggia, Foggia, Italy
| | - Adriana Pastore
- Psychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organ, University "Aldo Moro" of Bari, Bari, Italy
| | - Marta Simone
- Child and Adolescence Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University "Aldo Moro" of Bari, Foggia, Italy
| | - Francesco Margari
- Psychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organ, University "Aldo Moro" of Bari, Bari, Italy
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25
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A longitudinal study on the relationship between duration of untreated psychosis and executive function in early-onset first-episode psychosis. Schizophr Res 2014; 158:126-33. [PMID: 25034759 DOI: 10.1016/j.schres.2014.06.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 06/23/2014] [Accepted: 06/26/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND The relationship between duration of untreated psychosis (DUP) and executive function (EF) in patients with first-episode psychosis (FEP) is controversial. We aim to assess the influence of DUP on changes in EF over a 2-year period in subjects with early-onset FEP (first psychotic symptom before age 18) and less than 6 months of positive symptoms. METHODS A total of 66 subjects were included in the study (19 females [28.8%], mean age 16.2 ± 1.6 years). The influence of DUP on changes in EF over the 2-year follow-up (expressed as a composite score of 5 cognitive abilities: attention, working memory, cognitive flexibility, response inhibition, and problem solving) was estimated using a multivariate linear regression model after removing the effect of intelligence quotient and controlling for age, gender, diagnosis, premorbid adjustment, severity of positive and negative symptoms at baseline, global functioning at baseline, and mean daily antipsychotic dosage during follow-up. RESULTS Mean DUP was 65.0 ± 6.9 days (95% confidence interval [CI], 51.2, 78.8). Median DUP was 47.5 days (range 2-180 days). Negative symptoms at baseline was the only variable significantly associated with EF at baseline (10.9% of explained variance [e.v. 10.9%], p=0.007). Only shorter DUP (e.v. 8.7%, p=0.013) and greater severity of baseline negative symptoms (e.v. 10.0%, p=0.008) were significantly associated with greater improvement in EF. CONCLUSIONS In early-onset FEP, shorter DUP was associated with greater improvement in EF over a 2-year follow-up period.
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26
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Puetz V, Günther T, Kahraman-Lanzerath B, Herpertz-Dahlmann B, Konrad K. Neuropsychological Deficits in the Prodromal Phase and Course of an Early-Onset Schizophrenia. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2014; 42:167-76. [DOI: 10.1024/1422-4917/a000286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives: Although clear advances have been achieved in the study of early-onset schizophrenia (EOS), little is known to date about premorbid and prodromal neuropsychological functioning in EOS. Method: Here, we report on a case of an adolescent male with EOS who underwent neuropsychological testing before and after illness onset. Results: Marked cognitive deficits in the domains of attention, set-shifting, and verbal memory were present both pre-onset and during the course of schizophrenia, though only deficits in verbal memory persisted after illness-onset and antipsychotic treatment. Conclusion: The findings of this case study suggest that impairments in the verbal memory domain are particularly prominent symptoms of cognitive impairment in prodromal EOS and persist in the course of the disorder, which further demonstrates the difficult clinical situation of adequate schooling opportunities for adolescent patients with EOS.
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Affiliation(s)
- Vanessa Puetz
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
| | - Thomas Günther
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
| | - Berrak Kahraman-Lanzerath
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
| | - Beate Herpertz-Dahlmann
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
- JARA Translational Brain Medicine, Aachen & Jülich, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, Germany
- JARA Translational Brain Medicine, Aachen & Jülich, Germany
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27
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Arango C, Fraguas D, Parellada M. Differential neurodevelopmental trajectories in patients with early-onset bipolar and schizophrenia disorders. Schizophr Bull 2014; 40 Suppl 2:S138-46. [PMID: 24371326 PMCID: PMC3934406 DOI: 10.1093/schbul/sbt198] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Schizophrenia and bipolar disorders share not only clinical features but also some risk factors such as genetic markers and childhood adversity, while other risk factors such as urbanicity and obstetric complications seem to be specific to schizophrenia. An intriguing question is whether the well-established abnormal neurodevelopment present in many children and adolescents who eventually develop schizophrenia is also present in bipolar patients. The literature on adult bipolar patients is controversial. We report data on a subgroup of patients with pediatric-onset psychotic bipolar disorder who seem to share some developmental trajectories with patients with early-onset schizophrenia. These early-onset psychotic bipolar patients have low intelligence quotient, more neurological signs, reduced frontal gray matter at the time of their first psychotic episode, and greater brain changes than healthy controls in a pattern similar to early-onset schizophrenia cases. However, patients with early-onset schizophrenia seem to have more social impairment, developmental abnormalities (eg, language problems), and lower academic achievement in childhood than early-onset bipolar patients. We suggest that some of these abnormal developmental trajectories are more related to the phenotypic features (eg, early-onset psychotic symptoms) of these 2 syndromes than to categorically defined Diagnostic and Statistical Manual of Mental Disorders disorders.
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Affiliation(s)
- Celso Arango
- *To whom correspondence should be addressed; Hospital General Universitario Gregorio Marañón, Ibiza 43, 28009 Madrid, Spain; tel: 34-914265006; fax: 34-91426004, e-mail:
| | - David Fraguas
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - Mara Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
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