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Couturier A, Chaumette B, Kebir O, Iftimovici A, Krebs E, He Q, Jiao C, Krebs MO, Scoriels L, Frajerman A. The impact of BDNF on the cognitive functions of ultra-high risk patients: An exploratory study. Schizophr Res 2023; 262:211-213. [PMID: 36481244 DOI: 10.1016/j.schres.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Alexandre Couturier
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France; AP-HP, GHU AP-HP Nord, DMU ESPRIT, service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France
| | - Boris Chaumette
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France; GHU Paris Psychiatrie et Neurosciences, F-75674 Paris, France; Department of Psychiatry, McGill University, Montréal, QC H3A 0G4, Canada.
| | - Oussama Kebir
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France; GHU Paris Psychiatrie et Neurosciences, F-75674 Paris, France
| | - Anton Iftimovici
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France; GHU Paris Psychiatrie et Neurosciences, F-75674 Paris, France
| | - Emma Krebs
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
| | - Qin He
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
| | - Chuan Jiao
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
| | - Marie-Odile Krebs
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France; GHU Paris Psychiatrie et Neurosciences, F-75674 Paris, France
| | - Linda Scoriels
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France; GHU Paris Psychiatrie et Neurosciences, F-75674 Paris, France
| | - Ariel Frajerman
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France; MOODS Team, INSERM, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France
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2
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Chaumette B, Sengupta SM, Lepage M, Malla A, Iyer SN, Kebir O, Dion PA, Rouleau GA, Krebs MO, Shah JL, Joober R. A polymorphism in the glutamate metabotropic receptor 7 is associated with cognitive deficits in the early phases of psychosis. Schizophr Res 2022; 249:56-62. [PMID: 32624350 DOI: 10.1016/j.schres.2020.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 02/08/2023]
Abstract
Schizophrenia is an illness characterized by positive symptoms, negative symptoms, and cognitive impairments. Cognitive impairments occur before the onset of psychosis and could reflect glutamatergic dysregulation. Thus, identifying associations between genetic variations in genes coding for glutamatergic receptors and cognitive impairment in schizophrenia may help in understanding the basis of these deficits and in identifying potential drug targets. In a discovery cohort of 144 first-episode of psychosis patients (FEP), we genotyped 58 candidate Single Nucleotide Polymorphisms (SNPs) located in NMDA and metabotropic glutamatergic receptors. These SNPs were selected according to the results from the Psychiatric Genomic Consortium and were tested for association with intellectual quotient (IQ) as assessed with the Wechsler Intelligence Scales. For replication, we used the ICAAR cohort including 121 ultra-high-risk patients (UHR) with the same cognitive assessment. A polymorphism located in GRM7, rs1396409, was significantly associated with performance IQ in the discovery cohort of FEP. This association was replicated in the UHR cohort. This polymorphism is also associated with total IQ and verbal IQ in the merged dataset, with a predominant effect on the arithmetic subtest. The rs1396409 polymorphism is significantly associated with cognitive impairment during the onset of psychosis. This genetic association highlights the possible impact of glutamatergic genes in cognitive deficits in the early phases of psychosis and enforces the interest for new therapeutic interventions targeting the glutamatergic pathway.
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Affiliation(s)
- Boris Chaumette
- Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, CNRS, GDR3557-Institut de Psychiatrie, Paris, France; GHU Paris Psychiatrie et Neurosciences, Paris, France; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
| | - Sarojini M Sengupta
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Ashok Malla
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Srividya N Iyer
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Oussama Kebir
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, CNRS, GDR3557-Institut de Psychiatrie, Paris, France; GHU Paris Psychiatrie et Neurosciences, Paris, France
| | | | - Patrick A Dion
- Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Marie-Odile Krebs
- Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, CNRS, GDR3557-Institut de Psychiatrie, Paris, France; GHU Paris Psychiatrie et Neurosciences, Paris, France
| | - Jai L Shah
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
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3
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Millman ZB, Roemer C, Vargas T, Schiffman J, Mittal VA, Gold JM. Neuropsychological Performance Among Individuals at Clinical High-Risk for Psychosis vs Putatively Low-Risk Peers With Other Psychopathology: A Systematic Review and Meta-Analysis. Schizophr Bull 2022; 48:999-1010. [PMID: 35333372 PMCID: PMC9434467 DOI: 10.1093/schbul/sbac031] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND HYPOTHESIS Youth at clinical high-risk (CHR) for psychosis present with neuropsychological impairments relative to healthy controls (HC), but whether these impairments are distinguishable from those seen among putatively lower risk peers with other psychopathology remains unknown. We hypothesized that any excess impairment among CHR cohorts beyond that seen in other clinical groups is minimal and accounted for by the proportion who transition to psychosis (CHR-T). STUDY DESIGN We performed a systematic review and meta-analysis of studies comparing cognitive performance among CHR youth to clinical comparators (CC) who either sought mental health services but did not meet CHR criteria or presented with verified nonpsychotic psychopathology. STUDY RESULTS Twenty-one studies were included representing nearly 4000 participants. Individuals at CHR showed substantial cognitive impairments relative to HC (eg, global cognition: g = -0.48 [-0.60, -0.34]), but minimal impairments relative to CC (eg, global cognition: g = -0.13 [-0.20, -0.06]). Any excess impairment among CHR was almost entirely attributable to CHR-T; impairment among youth at CHR without transition (CHR-NT) was typically indistinguishable from CC (eg, global cognition, CHR-T: g = -0.42 [-0.64, -0.19], CHR-NT: g = -0.09 [-0.18, 0.00]; processing speed, CHR-T: g = -0.59 [-0.82, -0.37], CHR-NT: g = -0.12 [-0.25, 0.07]; working memory, CHR-T: g = -0.42 [-0.62, -0.22], CHR-NT: g = -0.03 [-0.14, 0.08]). CONCLUSIONS Neurocognitive impairment in CHR cohorts should be interpreted cautiously when psychosis or even CHR status is the specific clinical syndrome of interest as these impairments most likely represent a transdiagnostic vs psychosis-specific vulnerability.
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Affiliation(s)
- Zachary B Millman
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Caroline Roemer
- Psychology Department, University of Maryland, Baltimore County, Baltimore, MD, USA
| | - Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - James M Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
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4
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Karcher NR, Merchant J, Pine J, Kilciksiz CM. Cognitive Dysfunction as a Risk Factor for Psychosis. Curr Top Behav Neurosci 2022; 63:173-203. [PMID: 35989398 DOI: 10.1007/7854_2022_387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The current chapter summarizes recent evidence for cognition as a risk factor for the development of psychosis, including the range of cognitive impairments that exist across the spectrum of psychosis risk symptoms. The chapter examines several possible theories linking cognitive deficits with the development of psychotic symptoms, including evidence that cognitive deficits may be an intermediate risk factor linking genetic and/or neural metrics to psychosis spectrum symptoms. Although there is not strong evidence for unique cognitive markers associated specifically with psychosis compared to other forms of psychopathology, psychotic disorders are generally associated with the greatest severity of cognitive deficits. Cognitive deficits precede the development of psychotic symptoms and may be detectable as early as childhood. Across the psychosis spectrum, both the presence and severity of psychotic symptoms are associated with mild to moderate impairments across cognitive domains, perhaps most consistently for language, cognitive control, and working memory domains. Research generally indicates the size of these cognitive impairments worsens as psychosis symptom severity increases. The chapter points out areas of unclarity and unanswered questions in each of these areas, including regarding the mechanisms contributing to the association between cognition and psychosis, the timing of deficits, and whether any cognitive systems can be identified that function as specific predictors of psychosis risk symptoms.
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Affiliation(s)
- Nicole R Karcher
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
| | - Jaisal Merchant
- Department of Brain and Psychological Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Jacob Pine
- Department of Brain and Psychological Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Can Misel Kilciksiz
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Influence of polygenic risk scores for schizophrenia and resilience on the cognition of individuals at-risk for psychosis. Transl Psychiatry 2021; 11:518. [PMID: 34628483 PMCID: PMC8502171 DOI: 10.1038/s41398-021-01624-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/25/2021] [Accepted: 09/09/2021] [Indexed: 12/13/2022] Open
Abstract
Cognitive impairment is a core feature of schizophrenia which precedes the onset of full psychotic symptoms, even in the ultra-high-risk stage (UHR). Polygenic risk scores (PRS) can be computed for many psychiatric disorders and phenotyping traits, including scores for resilience. We explored the correlations between several PRS and neurocognition in UHR individuals. We included 107 UHR individuals; 29.9% of them converted to psychosis (UHR-C) while 57.0% did not (UHR-NC) during the 1-year follow-up. Cognitive performances were assessed with the Wechsler Adult Intelligence Scale estimating the Intelligence Quotient (IQ), the Trail Making Test, the verbal fluency, the Stroop test, and the Wisconsin card sorting test. Linear regression models were used to test their association with the PRS for schizophrenia, bipolar disorder, major depression, ADHD, cross-disorders, cognitive performance, intelligence, education attainment, and resilience to schizophrenia. UHR-C had a lower IQ than UHR-NC. The PRS for schizophrenia negatively correlated with IQ, while the PRS for cognitive performance and for resilience positively correlated with IQ. PRS for schizophrenia showed a significant correlation with working memory and processing speed indices. PRS for schizophrenia showed a higher effect on IQ in UHR-NC, and UHR-NC with high PRS for schizophrenia had a similar IQ as UHR-C. Conversely, UHR-C with a high PRS for resilience performed as well as UHR-NC. Our findings suggest that cognitive deficits may predate the onset of psychosis. The genetic architecture of schizophrenia seems to impacts the cognition in UHR-NC. Cognition is also mediated by PRS for resilience.
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Millman ZB, Gold JM, Mittal VA, Schiffman J. The Critical Need for Help-Seeking Controls in Clinical High-Risk Research. Clin Psychol Sci 2019; 7:1171-1189. [PMID: 33614257 PMCID: PMC7891463 DOI: 10.1177/2167702619855660] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Despite rapidly growing knowledge of the clinical high-risk (CHR) state for psychosis, the vast majority of case-control studies have relied on healthy volunteers as a reference point for drawing inferences about the CHR construct. Researchers have long recognized that results generated from this design are limited by significant interpretive concerns, yet little attention has been given to how these concerns affect the growing field of CHR research. We argue that overreliance on healthy controls in CHR research threatens the validity of inferences concerning group differences, hinders advances in understanding the development of psychosis, and limits clinical progress. We suggest that the combined use of healthy and help-seeking (i.e., psychiatric) controls is a necessary step for the next generation of CHR research. We then evaluate methods for help-seeking control studies, identify the available CHR studies that have used such designs, discuss select findings in this literature, and offer recommendations for research.
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Affiliation(s)
| | - James M. Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Vijay A. Mittal
- Department of Psychology, Northwestern University
- Department of Psychiatry, Northwestern University
- Institute for Policy Research, Northwestern University
- Medical Social Sciences, Northwestern University
- Institute for Innovations in Developmental Sciences, Northwestern University
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County
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Oppetit A, Bourgin J, Martinez G, Kazes M, Mam-Lam-Fook C, Gaillard R, Olié JP, Krebs MO. The C'JAAD: a French team for early intervention in psychosis in Paris. Early Interv Psychiatry 2018; 12:243-249. [PMID: 27677625 DOI: 10.1111/eip.12376] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/11/2016] [Accepted: 06/12/2016] [Indexed: 01/16/2023]
Abstract
AIM The aim is to describe a centre operating in Paris that pioneers the early intervention for young people at the onset and at high risk of psychosis in France. METHODS Comprehensive descriptive analysis of different clinical and service measures is used in describing the implementation of the C'JAAD (Evaluation Centre for Young Adults and Adolescents) using data from an ongoing prospective non-interventional research programme. RESULTS Over a 2-year period, 151 patients were referred to the C'JAAD and included in the ICAAR research programme. After evaluation by the Comprehensive Assessment of the At-Risk Mental States Scale, 53.7% were identified at risk of developing a psychosis, 20.6% presented a full-blown psychosis and 25.7% were considered not at risk of developing a psychosis. A total of 84% of the at-risk subjects suffered from a psychiatric co-morbidity, of which anxiodepressive symptoms being the most frequent (39%). The global functioning of these at-risk subjects was seriously impaired (average Social and Occupational Functioning Assessment Scale score = 48.9). More than one third of the patients was self-referred (33.8%), 22.5% were addressed by a psychiatrist whereas 10.6% were referred by a general practitioner. CONCLUSIONS In this paper, we report for the first time the activities of the C'JAAD, the pioneer unit in France for early detection and treatment of young adults with early psychosis. These observations indicate that such early intervention centre is a feasible and sustainable extension of traditional care for people with mental disorders in this country and offers promising perspective for the development of further centres.
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Affiliation(s)
- Alice Oppetit
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.,Université Paris Descartes, Inserm Centre de Psychiatrie et Neurosciences, Laboratoire de 'Physiopathologie des maladies Psychiatriques, Paris, France.,CNRS, GDR 3557, Institut de Psychiatrie, Paris, France
| | - Julie Bourgin
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.,Université Paris Descartes, Inserm Centre de Psychiatrie et Neurosciences, Laboratoire de 'Physiopathologie des maladies Psychiatriques, Paris, France.,CNRS, GDR 3557, Institut de Psychiatrie, Paris, France
| | - Gilles Martinez
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.,Université Paris Descartes, Inserm Centre de Psychiatrie et Neurosciences, Laboratoire de 'Physiopathologie des maladies Psychiatriques, Paris, France.,CNRS, GDR 3557, Institut de Psychiatrie, Paris, France
| | - Mathilde Kazes
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.,Université Paris Descartes, Inserm Centre de Psychiatrie et Neurosciences, Laboratoire de 'Physiopathologie des maladies Psychiatriques, Paris, France.,CNRS, GDR 3557, Institut de Psychiatrie, Paris, France
| | - Célia Mam-Lam-Fook
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.,Université Paris Descartes, Inserm Centre de Psychiatrie et Neurosciences, Laboratoire de 'Physiopathologie des maladies Psychiatriques, Paris, France.,CNRS, GDR 3557, Institut de Psychiatrie, Paris, France
| | - Raphael Gaillard
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.,Université Paris Descartes, Inserm Centre de Psychiatrie et Neurosciences, Laboratoire de 'Physiopathologie des maladies Psychiatriques, Paris, France.,CNRS, GDR 3557, Institut de Psychiatrie, Paris, France
| | - Jean-Pierre Olié
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.,Université Paris Descartes, Inserm Centre de Psychiatrie et Neurosciences, Laboratoire de 'Physiopathologie des maladies Psychiatriques, Paris, France.,CNRS, GDR 3557, Institut de Psychiatrie, Paris, France
| | - Marie-Odile Krebs
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Faculté de Médecine Paris Descartes, Paris, France.,Université Paris Descartes, Inserm Centre de Psychiatrie et Neurosciences, Laboratoire de 'Physiopathologie des maladies Psychiatriques, Paris, France.,CNRS, GDR 3557, Institut de Psychiatrie, Paris, France
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8
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Caldani S, Amado I, Bendjemaa N, Vialatte F, Mam-Lam-Fook C, Gaillard R, Krebs MO, Pia Bucci M. Oculomotricity and Neurological Soft Signs: Can we refine the endophenotype? A study in subjects belonging to the spectrum of schizophrenia. Psychiatry Res 2017; 256:490-497. [PMID: 28759882 DOI: 10.1016/j.psychres.2017.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 06/02/2017] [Accepted: 06/04/2017] [Indexed: 12/24/2022]
Abstract
Alterations in eye tracking and motor impairments as well as Neurological Soft Signs (NSS) are frequently reported in patients with schizophrenia as well as in their relatives, and are proposed as endophenotype of the disease. This study investigated smooth pursuit eye movement and fixation task with distractors with a gap condition, two markers of inhibitory control mechanism, in 49 patients with schizophrenia, 24 ultra-high risk subjects, 41 full biological clinical siblings of patients and 48 controls. NSS were assessed as a marker of abnormal neurodevelopment. The results revealed more intrusive saccades respectively in smooth pursuit eye movement and in fixation task with distractors with a gap condition in patients, respect to controls and full siblings. Ultra high-risk participants with high NSS committed intrusive saccades compared to controls. Patients with schizophrenia with high NSS also displayed more of these abnormalities, compared to patients with schizophrenia with low NSS and controls. These findings highlight a global inhibitory control defect, and suggested that ultra-high risk subjects and patients with schizophrenia could share oculomotor abnormalities, especially when they express a high neurodevelopmental deviance. These oculomotor alterations might suggest that cerebral structures such as prefrontal and cerebellum could be involved in the expression of this vulnerability.
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Affiliation(s)
- Simona Caldani
- Université Paris Descartes, Sorbonne Paris Cité, INSERM, Centre de Psychiatrie et Neurosciences, UMR S 894, Physiopathologie des Maladies Psychiatriques, CNRS, GDR3557-Institut de Psychiatrie, Paris, France; UMR 1141 Inserm - Université Paris Diderot, Hôpital Robert Debré, 75019 Paris, France
| | - Isabelle Amado
- Université Paris Descartes, Sorbonne Paris Cité, INSERM, Centre de Psychiatrie et Neurosciences, UMR S 894, Physiopathologie des Maladies Psychiatriques, CNRS, GDR3557-Institut de Psychiatrie, Paris, France; Faculté de Médecine Paris Descartes, Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Narjes Bendjemaa
- Université Paris Descartes, Sorbonne Paris Cité, INSERM, Centre de Psychiatrie et Neurosciences, UMR S 894, Physiopathologie des Maladies Psychiatriques, CNRS, GDR3557-Institut de Psychiatrie, Paris, France
| | - François Vialatte
- UMR 8249 CNRS Laboratoire Plasticité du Cerveau, Paris 75005, France
| | - Célia Mam-Lam-Fook
- Université Paris Descartes, Sorbonne Paris Cité, INSERM, Centre de Psychiatrie et Neurosciences, UMR S 894, Physiopathologie des Maladies Psychiatriques, CNRS, GDR3557-Institut de Psychiatrie, Paris, France; Faculté de Médecine Paris Descartes, Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Raphael Gaillard
- Université Paris Descartes, Sorbonne Paris Cité, INSERM, Centre de Psychiatrie et Neurosciences, UMR S 894, Physiopathologie des Maladies Psychiatriques, CNRS, GDR3557-Institut de Psychiatrie, Paris, France; Faculté de Médecine Paris Descartes, Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Marie-Odile Krebs
- Université Paris Descartes, Sorbonne Paris Cité, INSERM, Centre de Psychiatrie et Neurosciences, UMR S 894, Physiopathologie des Maladies Psychiatriques, CNRS, GDR3557-Institut de Psychiatrie, Paris, France; Faculté de Médecine Paris Descartes, Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire, Paris, France.
| | - Maria Pia Bucci
- UMR 1141 Inserm - Université Paris Diderot, Hôpital Robert Debré, 75019 Paris, France
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9
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Neuropsychology of subjects with ultra-high risk (UHR) of psychosis: A critical analysis of the literature. Encephale 2017; 43:241-253. [DOI: 10.1016/j.encep.2017.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 11/21/2016] [Accepted: 02/10/2017] [Indexed: 11/18/2022]
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10
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Caldani S, Bucci MP, Lamy JC, Seassau M, Bendjemaa N, Gadel R, Gaillard R, Krebs MO, Amado I. Saccadic eye movements as markers of schizophrenia spectrum: Exploration in at-risk mental states. Schizophr Res 2017; 181:30-37. [PMID: 27639418 DOI: 10.1016/j.schres.2016.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 01/27/2023]
Abstract
Schizophrenia is a neurodevelopmental disease with cognitive and motor impairments. Motor dysfunctions, such as eye movements or Neurological Soft Signs (NSS), are proposed as endophenotypic markers. Antisaccade (AS) and memory-guided saccades (MGS), two markers of inhibitory control mechanism, are altered in both patients with schizophrenia and their relatives, although these tools may have different sensitivities. Recently, emphasis has been put on identifying markers predictive of psychosis transition in subjects with ultra-high-risk psychosis in order to develop targeted prevention. This study investigates AS and MGS in 46 patients with schizophrenia, 23 ultra-high-risk subjects, and 39 full siblings compared to 47 healthy volunteers. NSS were assessed as a marker of abnormal neurodevelopment. The results revealed more errors in MGS in patients, ultra-high-risk subjects and siblings, than in controls, and more specifically ultra-high-risk subjects with high NSS scores. By contrast, the error rate in AS was significantly higher only in patients with schizophrenia compared to controls. These findings suggest that MGS could be more accurate to detect deficient inhibitory processes as a marker of vulnerability before the onset of schizophrenia. The use of the different paradigms (AS, MGS) revealed distinct profiles depending on the stage of the disease, indicating that some alterations could be pure endophenotypic markers of vulnerability for schizophrenia, while others could be markers of the disease progression.
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Affiliation(s)
- Simona Caldani
- UMR 1141 Inserm-Université Paris Diderot, Hôpital Robert Debré, 75019 Paris, France; INSERM U894, Laboratory of Pathophysiology of Psychiatric Diseases, Center of Psychiatry and Neurosciences, Institut de Psychiatrie, GDR3557, France
| | - Maria Pia Bucci
- UMR 1141 Inserm-Université Paris Diderot, Hôpital Robert Debré, 75019 Paris, France
| | - Jean-Charles Lamy
- INSERM U894, Laboratory of Pathophysiology of Psychiatric Diseases, Center of Psychiatry and Neurosciences, Institut de Psychiatrie, GDR3557, France; University Paris Descartes, Faculty of Medicine Paris Descartes, Service Hospitalo-Universitaire, Sainte-Anne Hospital, Paris, France
| | | | - Narjes Bendjemaa
- INSERM U894, Laboratory of Pathophysiology of Psychiatric Diseases, Center of Psychiatry and Neurosciences, Institut de Psychiatrie, GDR3557, France; University Paris Descartes, Faculty of Medicine Paris Descartes, Service Hospitalo-Universitaire, Sainte-Anne Hospital, Paris, France
| | - Rémi Gadel
- INSERM U894, Laboratory of Pathophysiology of Psychiatric Diseases, Center of Psychiatry and Neurosciences, Institut de Psychiatrie, GDR3557, France; University Paris Descartes, Faculty of Medicine Paris Descartes, Service Hospitalo-Universitaire, Sainte-Anne Hospital, Paris, France
| | - Raphael Gaillard
- INSERM U894, Laboratory of Pathophysiology of Psychiatric Diseases, Center of Psychiatry and Neurosciences, Institut de Psychiatrie, GDR3557, France; University Paris Descartes, Faculty of Medicine Paris Descartes, Service Hospitalo-Universitaire, Sainte-Anne Hospital, Paris, France
| | - Marie-Odile Krebs
- INSERM U894, Laboratory of Pathophysiology of Psychiatric Diseases, Center of Psychiatry and Neurosciences, Institut de Psychiatrie, GDR3557, France; University Paris Descartes, Faculty of Medicine Paris Descartes, Service Hospitalo-Universitaire, Sainte-Anne Hospital, Paris, France.
| | - Isabelle Amado
- INSERM U894, Laboratory of Pathophysiology of Psychiatric Diseases, Center of Psychiatry and Neurosciences, Institut de Psychiatrie, GDR3557, France; University Paris Descartes, Faculty of Medicine Paris Descartes, Service Hospitalo-Universitaire, Sainte-Anne Hospital, Paris, France
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Chaumette B, Kebir O, Mam-Lam-Fook C, Morvan Y, Bourgin J, Godsil BP, Plaze M, Gaillard R, Jay TM, Krebs MO. Salivary cortisol in early psychosis: New findings and meta-analysis. Psychoneuroendocrinology 2016; 63:262-70. [PMID: 26520686 DOI: 10.1016/j.psyneuen.2015.10.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/12/2015] [Accepted: 10/13/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Schizophrenia is a multifactorial disorder and environmental risk factors for it might contribute to hypothalamo-pituitary-adrenal axis (HPA) dysregulation. While increased cortisol levels have been reported in schizophrenia, as well as in early psychosis (compared to healthy controls), a crucial unresolved issue is whether elevated cortisol levels could be related to the distress of an emerging illness, rather than being specific to psychosis. Here, we report new findings from the first French cohort of young help-seekers (ICAAR) including ultra-high risk subjects (UHR), first-episode of psychosis (FEP) and non at-risk help seekers controls (HSC), followed by a meta-analysis of all available reports on salivary basal cortisol levels in early psychosis (UHR and FEP). METHODS In the ICAAR study, 169 individuals (15-30 years old) had their basal cortisol levels sampled and they were categorized (at baseline) as either UHR, FEP, or HSC using the criteria of the Comprehensive Assessment of At-Risk Mental States (CAARMS). The three groups were compared at baseline, and the UHR and HSC individuals were also included in a one-year longitudinal follow-up. UHRs who converted to psychosis at the follow up (UHR-P) were compared to non-converters (UHR-NP). We also performed a meta-analysis from case-control studies with basal salivary measures of cortisol, drawing from a systematic bibliographic search using the keywords 'cortisol', 'glucocorticoid', 'HPA' with 'UHR', 'CHR', 'at-risk mental state', 'schizotypal ', 'prodromal schizophrenia', 'first-episode psychosis', 'first episode schizophrenia', 'newly diagnosed schizophrenia', 'recent onset schizophrenia' [in Medline, Web of Knowledge (WOS), EBSCO], followed by a systematic screening of the resulting articles. RESULTS Basal cortisol levels were not significantly different between UHR, FEP, and HSC controls in the ICAAR cohort. Interestingly, initial cortisol levels were correlated with positive symptoms at the one year follow-up in the ICAAR cohort. The meta-analysis revealed a significant elevation of the salivary basal cortisol levels in UHR individuals compared to controls (8 studies--1060 individuals), but not between FEP and controls (6 studies--441 individuals). Indirect comparison of salivary basal cortisol levels between UHR and FEP did not yield significant differences. Finally, no differences were detected between the baseline cortisol of UHR-P and UHR-NP (4 studies--301 individuals). CONCLUSION The meta-analysis (including new data) indicates that basal cortisol levels were increased in UHR compared to controls, but FEP levels were not different from UHR or controls. Many confounding factors could decrease the effect size in FEP especially medication intake. Taken together with our new results (which made use of help-seeker controls, and not merely healthy controls), the findings indicate that basal cortisol levels may not be a reliable biomarker for early psychosis. Further studies are needed to clarify the precise role of the HPA axis in psychotic conversion.
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Affiliation(s)
- Boris Chaumette
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire-S14, Faculté de Médecine Paris Descartes, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; INSERM UMR 894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Institut de Psychiatrie-GDR 3557 de Psychiatrie, 75014 Paris, France
| | - Oussama Kebir
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire-S14, Faculté de Médecine Paris Descartes, 75014 Paris, France; INSERM UMR 894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Institut de Psychiatrie-GDR 3557 de Psychiatrie, 75014 Paris, France
| | - Célia Mam-Lam-Fook
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire-S14, Faculté de Médecine Paris Descartes, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; INSERM UMR 894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Institut de Psychiatrie-GDR 3557 de Psychiatrie, 75014 Paris, France
| | - Yannick Morvan
- Université Paris Ouest Nanterre La Défense, EVACLIPSY-CLIPSYD EA443, 92000 Nanterre, France
| | - Julie Bourgin
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire-S14, Faculté de Médecine Paris Descartes, 75014 Paris, France; INSERM UMR 894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Institut de Psychiatrie-GDR 3557 de Psychiatrie, 75014 Paris, France
| | - Bill P Godsil
- INSERM UMR 894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Institut de Psychiatrie-GDR 3557 de Psychiatrie, 75014 Paris, France
| | - Marion Plaze
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire-S14, Faculté de Médecine Paris Descartes, 75014 Paris, France; INSERM UMR 894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Institut de Psychiatrie-GDR 3557 de Psychiatrie, 75014 Paris, France
| | - Raphaël Gaillard
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire-S14, Faculté de Médecine Paris Descartes, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; INSERM UMR 894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Institut de Psychiatrie-GDR 3557 de Psychiatrie, 75014 Paris, France
| | - Thérèse M Jay
- Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; INSERM UMR 894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Institut de Psychiatrie-GDR 3557 de Psychiatrie, 75014 Paris, France
| | - Marie-Odile Krebs
- Centre Hospitalier Sainte-Anne, Service Hospitalo-Universitaire-S14, Faculté de Médecine Paris Descartes, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; INSERM UMR 894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Institut de Psychiatrie-GDR 3557 de Psychiatrie, 75014 Paris, France.
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12
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Development of a blood-based molecular biomarker test for identification of schizophrenia before disease onset. Transl Psychiatry 2015; 5:e601. [PMID: 26171982 PMCID: PMC5068725 DOI: 10.1038/tp.2015.91] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 05/21/2015] [Indexed: 12/31/2022] Open
Abstract
Recent research efforts have progressively shifted towards preventative psychiatry and prognostic identification of individuals before disease onset. We describe the development of a serum biomarker test for the identification of individuals at risk of developing schizophrenia based on multiplex immunoassay profiling analysis of 957 serum samples. First, we conducted a meta-analysis of five independent cohorts of 127 first-onset drug-naive schizophrenia patients and 204 controls. Using least absolute shrinkage and selection operator regression, we identified an optimal panel of 26 biomarkers that best discriminated patients and controls. Next, we successfully validated this biomarker panel using two independent validation cohorts of 93 patients and 88 controls, which yielded an area under the curve (AUC) of 0.97 (0.95-1.00) for schizophrenia detection. Finally, we tested its predictive performance for identifying patients before onset of psychosis using two cohorts of 445 pre-onset or at-risk individuals. The predictive performance achieved by the panel was excellent for identifying USA military personnel (AUC: 0.90 (0.86-0.95)) and help-seeking prodromal individuals (AUC: 0.82 (0.71-0.93)) who developed schizophrenia up to 2 years after baseline sampling. The performance increased further using the latter cohort following the incorporation of CAARMS (Comprehensive Assessment of At-Risk Mental State) positive subscale symptom scores into the model (AUC: 0.90 (0.82-0.98)). The current findings may represent the first successful step towards a test that could address the clinical need for early intervention in psychiatry. Further developments of a combined molecular/symptom-based test will aid clinicians in the identification of vulnerable patients early in the disease process, allowing more effective therapeutic intervention before overt disease onset.
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Schvarcz A, Bearden CE. Early Detection of Psychosis: Recent Updates from Clinical High-Risk Research. Curr Behav Neurosci Rep 2015; 2:90-101. [PMID: 26693133 DOI: 10.1007/s40473-015-0033-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The debilitating nature of schizophrenia necessitates early detection of individuals at clinical high-risk (CHR) in order to facilitate early intervention. In particular, comparisons between those who develop fully psychotic features (CHR+) and those who do not (CHR-) offer the opportunity to reveal distinct risk factors for psychosis, as well as possible intervention target points. Recent studies have investigated baseline clinical, neurocognitive, neuroanatomic, neurohormonal, and psychophysiological predictors of outcome; premorbid social dysfunction, deficits in neurocognitive performance, neuroanatomic changes, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction have been implicated in psychosis emergence. However, several challenges within CHR research remain: heterogeneity in long-term diagnostic outcome, the variability of research tools and definitions utilized, and limited longitudinal follow-up. Future work in the field should focus on replication via extended longitudinal designs, aim to explore the trajectories and inter-relationships of hypothesized biomarkers, and continue to investigate interventions that seek to prevent psychosis emergence through symptom reduction.
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Affiliation(s)
- Ariel Schvarcz
- Department of Psychology, University of California, Los Angeles
| | - Carrie E Bearden
- Department of Psychology, University of California, Los Angeles ; Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles ; Brain Research Institute, University of California, Los Angeles
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Krebs MO, Magaud E, Willard D, Elkhazen C, Chauchot F, Gut A, Morvan Y, Bourdel MC, Kazes M. [Assessment of mental states at risk of psychotic transition: validation of the French version of the CAARMS]. L'ENCEPHALE 2014; 40:447-56. [PMID: 25127895 DOI: 10.1016/j.encep.2013.12.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 12/05/2013] [Indexed: 11/26/2022]
Abstract
This article aims to present the validation study of the French version of the Comprehensive Assessment of at risk mental states (CAARMS), an interview that seeks to determine whether young adults criteria for at-risk (AR) mental states, or psychosis. We assessed 40 young subjects, 15 were considered as "prodromal" (Prd) and 10 as experiencing a first episode of psychosis (PEP) by our expert clinician at the center - centre d'évaluation des jeunes adultes et adolescents, University Hospital Centre, Paris - and 15 were healthy controls matched for age and sex. When assessed with the CAARMS, 73 % (n=11) of the prodromal subjects reached the criteria for AR mental state, four subjects did not reach the criteria for AR, nor psychosis (P) and 100 % of the PEP reached the criteria for P. The three groups were significantly different on CAARMS total score (P<0.001) and subscores ; Prd subjects had intermediate scores between PEP (P<0.001) and controls (P<0.001) scores, PEP showing the highest scores. Post-hoc analysis showed that Prd significantly differed from Controls on each subscale (P<0.001) and that Prd differed from PEP on the "positive symptoms" subscale (P<0.001), as well as on "behavioural change" (P=0.021), owing to difference on the item "impaired role function". We used the brief psychiatric rating scale 24 items with anchor (BPRS24-EA) in addition to with the CAARMS, the AR group showed intermediate scores between controls and P subjects. Total scores of both scales were correlated (r=0.408 ; P=0.043) and the BPRS24-EA "positive symptoms" score was correlated with CAARMS' scores on the "Positive symptoms" subscale (r=0.456, P=0.022), "emotional disturbance" (r=0.506, P=0.01), and "behavioural change" (r=0.666 P=0.001). We found no correlation between BPRS negative and depression subscales and any of the CAARMS' subscales. When looking at its reliability, reliability coefficients (Cronbach's alpha) showed excellent reliability for "positive symptoms", "emotional disturbance", "behavioural change" and "general psychopathology" (respectively r=0.82, 0.75, 0.78, 0.84, 0.83) and moderate reliability for "cognitive change", "negative symptoms" and "motor/physical change" (respectively r=0.39, 0.59, 0.43). Overall, analysis of the results of construct validity, concurrent validity and reliability of the CAARMS indicates that the French version is valid and reliable. It is now available to develop and implement early detection programs in French speaking countries.
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Affiliation(s)
- M-O Krebs
- Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm, laboratoire de physiopathologie de maladies psychiatriques, université Paris-Descartes, PRES Paris-Sorbonne-Cité, centre de psychiatrie et neurosciences, UMR894, GDR 3557 psychiatrie, 75014 Paris, France.
| | - E Magaud
- Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm, laboratoire de physiopathologie de maladies psychiatriques, université Paris-Descartes, PRES Paris-Sorbonne-Cité, centre de psychiatrie et neurosciences, UMR894, GDR 3557 psychiatrie, 75014 Paris, France
| | - D Willard
- Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm, laboratoire de physiopathologie de maladies psychiatriques, université Paris-Descartes, PRES Paris-Sorbonne-Cité, centre de psychiatrie et neurosciences, UMR894, GDR 3557 psychiatrie, 75014 Paris, France
| | - C Elkhazen
- Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm, laboratoire de physiopathologie de maladies psychiatriques, université Paris-Descartes, PRES Paris-Sorbonne-Cité, centre de psychiatrie et neurosciences, UMR894, GDR 3557 psychiatrie, 75014 Paris, France
| | - F Chauchot
- Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - A Gut
- Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Y Morvan
- Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm, laboratoire de physiopathologie de maladies psychiatriques, université Paris-Descartes, PRES Paris-Sorbonne-Cité, centre de psychiatrie et neurosciences, UMR894, GDR 3557 psychiatrie, 75014 Paris, France
| | - M-C Bourdel
- Inserm, laboratoire de physiopathologie de maladies psychiatriques, université Paris-Descartes, PRES Paris-Sorbonne-Cité, centre de psychiatrie et neurosciences, UMR894, GDR 3557 psychiatrie, 75014 Paris, France
| | - M Kazes
- Service hospitalo-universitaire S14, faculté de médecine Paris-Descartes, université Paris-Descartes, centre hospitalier Sainte-Anne, 75014 Paris, France; Inserm, laboratoire de physiopathologie de maladies psychiatriques, université Paris-Descartes, PRES Paris-Sorbonne-Cité, centre de psychiatrie et neurosciences, UMR894, GDR 3557 psychiatrie, 75014 Paris, France
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