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Alessandro DL, Leuci E, Quattrone E, Azzali S, Paulillo G, Pupo S, Pellegrini P, Marco M, Lorenzo P. Obsessive-compulsive symptoms in individuals at clinical high risk for psychosis: A 2-year longitudinal study. Schizophr Res 2024; 274:11-20. [PMID: 39244946 DOI: 10.1016/j.schres.2024.09.005] [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: 11/15/2023] [Revised: 09/02/2024] [Accepted: 09/03/2024] [Indexed: 09/10/2024]
Abstract
Aim - Recent findings suggest that OCS are prevalent in individuals with early psychosis. However, their clinical relevance still needs to be clarified. This research specifically explored OCS in subjects at Clinical High Risk for Psychosis (CHRP), with the aims of determining their baseline prevalence, examining their 2-year stability, and analyzing their association with sociodemographic data, clinical characteristics and outcomes. Methods - Clinical assessments at baseline and during the 2-year follow-up period included: the Comprehensive Assessment of At-Risk Mental states (CAARMS), the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF). OCS were identified using the CAARMS item 7.6 subscore. Results - Among 180 CHR-P participants, 66 (36.7 %) had OCS at baseline. CHR-P with OCS had higher PANSS scores and greater antidepressant prescription rates. OCS severity levels improved in the first year, but plateaued over two years, correlating with longitudinal changes in GAF and PANSS total scores. OCS improvement was specifically associated with antidepressant use and intensity of individual psychotherapy sessions. CHR-P subjects with OCS had higher service engagement rates. Conclusions - The presence of OCS could characterize a distinct CHR-P subtype with specific clinical and prognostic characteristics, requiring tailored diagnostic and therapeutic approaches. Recognizing the heterogeneity in CHR-P population is crucial for optimizing care.
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Affiliation(s)
- Di Lisi Alessandro
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addictions, AUSL di Parma, Largo Palli n. 1/a, 43100 Parma, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addictions, AUSL di Parma, Largo Palli n. 1/a, 43100 Parma, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addictions, AUSL-IRCCS di Reggio Emilia, Via Amendola n. 2, 42100 Reggio Emilia, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addictions, AUSL di Parma, Largo Palli n. 1/a, 43100 Parma, Italy
| | - Simona Pupo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di di Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addictions, AUSL di Parma, Largo Palli n. 1/a, 43100 Parma, Italy
| | - Menchetti Marco
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy
| | - Pelizza Lorenzo
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy; Department of Mental Health and Pathological Addictions, AUSL di Parma, Largo Palli n. 1/a, 43100 Parma, Italy.
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Ricci C, Leuci E, Quattrone E, Palmisano D, Pellegrini P, Menchetti M, Pupo S, Pelizza L. Persistent negative symptoms in young people at clinical high risk of psychosis treated with an Italian early intervention program: a longitudinal study. Eur Arch Psychiatry Clin Neurosci 2024; 274:1311-1326. [PMID: 38668766 PMCID: PMC11362215 DOI: 10.1007/s00406-024-01808-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/02/2024] [Indexed: 08/30/2024]
Abstract
Negative symptoms in CHR-P people are generally not responsive to treatments and commonly related to poorer functional outcome. However, less research attention has been dedicated to Persistent Negative Symptoms (PNS), defined as clinically stable negative symptoms of moderate severity evident for at least 6 months. This study aims to (a) determine the prevalence of PNS in a sample of young people at CHR-P; (b) investigate any association of PNS with functioning and clinical features; (c) examine longitudinal course of PNS across 2 years of follow-up and changes in PNS severity levels with specialized treatments. One Hundred Eighty CHR-P participants were recruited and were divided into CHR-P/PNS + and CHR-P/PNS- subgroups. The clinical assessments were based on the PANSS and the GAF and were conducted at baseline and every 12 months during the follow-up. Twenty four participants showed PNS at entry. Of them, 21 concluded the 2-year follow-up period. At baseline, the CHR-P/PNS + participants showed more educational and employment deficits, and more social and functioning impairment. During the follow-up, the CHR-P/PNS + subgroup had a significant longitudinal decrease in negative symptoms, which was specifically related to antidepressant treatment. CHR-P/PNS + subjects also showed a higher incidence of new hospitalization and a lower functional recovery over time. Our findings support that the persistence of negative symptoms in CHR-P people is longitudinally related to worse daily functioning and more severe clinical conditions that are at higher risk of hospitalization and are less responsive to specialized treatments.
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Affiliation(s)
- Camilla Ricci
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, 40123, Bologna, Italy
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Derna Palmisano
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, 40123, Bologna, Italy
| | - Simona Pupo
- Division of Pain Medicine, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy
| | - Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, 40123, Bologna, Italy.
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100, Parma, Italy.
- "Paolo Ottonello" Psychiatry Institute, Via Pepoli 5, 40123, Bologna, BO, Italy.
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de Filippis R, Aloi M, Liuzza MT, Pugliese V, Carbone EA, Rania M, Segura-Garcia C, De Fazio P. Aberrant salience mediates the interplay between emotional abuse and positive symptoms in schizophrenia. Compr Psychiatry 2024; 133:152496. [PMID: 38718481 DOI: 10.1016/j.comppsych.2024.152496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION Childhood trauma and adversities (CTA) and aberrant salience (AS) have a pivotal role in schizophrenia development, but their interplay with psychotic symptoms remains vague. We explored the mediation performed by AS between CTA and psychotic symptomatology in schizophrenia. METHODS We approached 241 adults suffering from schizophrenia spectrum disorders (SSDs), who have been in the unit for at least 12 consecutive months, excluding the diagnosis of dementia, and recent substance abuse disorder, and cross-sectional evaluated through the Aberrant Salience Inventory (ASI), Childhood Trauma Questionnaire Short-Form (CTQ-SF), and Positive and Negative Symptom Scale (PANSS). We tested a path-diagram where AS mediated the relationship between CTA and psychosis, after verifying each measure one-dimensionality through confirmatory factor analysis. RESULTS The final sample comprised 222 patients (36.9% female), with a mean age of 42.4 (± 13.3) years and an average antipsychotic dose of 453.6 (± 184.2) mg/day (chlorpromazine equivalents). The mean duration of untreated psychosis was 1.8 (± 2.0) years while the mean onset age was 23.9 (± 8.2) years. Significant paths were found from emotional abuse to ASI total score (β = 0.39; p < .001) and from ASI total score to PANSS positive (β = 0.17; p = .019). Finally, a statistically significant indirect association was found from emotional abuse to PANSS positive mediated by ASI total score (β = 0.06; p = .041; CI 95% [0.01, 0.13]). CONCLUSION Emotional abuse has an AS-mediated effect on positive psychotic symptomatology. AS evaluation could allow a better characterization of psychosis as well as explain the presence of positive symptoms in adults with SSDs who experienced CTA.
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Affiliation(s)
- Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Matteo Aloi
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy; Department of Clinical and Experimental Medicine, University of Messina, Italy.
| | | | - Valentina Pugliese
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Elvira Anna Carbone
- Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Italy.
| | - Marianna Rania
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Renato Dulbecco, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Italy.
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy.
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Ribolsi M, Prosperi Porta D, Sacco R, Di Lorenzo G, Fiori Nastro F, Albergo G, Di Lazzaro V, Costa A. Psychopathological characteristics in ultra-high risk for psychosis with and without comorbid ADHD. Early Interv Psychiatry 2024; 18:578-582. [PMID: 38690753 DOI: 10.1111/eip.13539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/15/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
AIM This study investigates the psychopathological characteristics of a sample of individuals at ultra-high risk for psychosis with and without comorbid attention-deficit hyperactivity disorder (ADHD). METHODS Twenty-eight subjects (aged 13-21 years; 13 females) with attenuated psychosis syndrome (APS) were recruited in a cross-sectional study and divided into two groups, each with 14 patients, according to the presence or absence of ADHD. RESULTS The APS group showed a significantly higher prevalence of negative symptoms than the APS + ADHD group. Other characteristics investigated (positive symptoms, aberrant salience, psychotic-like experiences and prodromal symptoms) did not differ between groups. CONCLUSIONS The different profiles of negative symptoms in the APS with or without ADHD might suggest the presence of a specific subtype among individuals at ultra-high risk for psychosis. Longitudinal studies with larger samples will provide information about the role of negative symptoms in determining conversion to full psychosis in those people with 'pure' APS and those with APS + ADHD.
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Affiliation(s)
- Michele Ribolsi
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, Campus Bio-Medico University, Rome, Italy
- Istituto Clinico Interuniversitario - Consorzio Universitario Humanitas, Rome, Italy
| | - Davide Prosperi Porta
- Chair of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Roberto Sacco
- Unit of Child & Adolescent Neuropsychiatry, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giorgio Di Lorenzo
- Chair of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Federico Fiori Nastro
- Chair of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Giuliano Albergo
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | - Anna Costa
- Unit of Child & Adolescent Neuropsychiatry, Campus Bio-Medico University of Rome, Rome, Italy
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Pelizza L, Leuci E, Quattrone E, Azzali S, Pupo S, Paulillo G, Menchetti M, Pellegrini P. Adverse outcome analysis in people at clinical high risk for psychosis: results from a 2-year Italian follow-up study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1177-1191. [PMID: 38091031 DOI: 10.1007/s00127-023-02597-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 11/20/2023] [Indexed: 06/15/2024]
Abstract
PURPOSE Since January 2016, the Parma Department of Mental Health (in Italy) developed a specialized care program for Early Intervention (EI) in individuals at Clinical High Risk for Psychosis (CHR-P). As unfavorable outcomes other than transition to psychosis were not systematically reported in the current literature (thereby compromising more sophisticated prognostic stratifications), the aims of this research were (1) to investigate adverse outcome indicators (i.e., service disengagement, psychosis transition, hospitalization, prolonged functioning impairment, prolonged persistence of CHR-P criteria, suicide attempts) in an Italian CHR-P population enrolled within a specialized EI service across a 2-year follow-up period, and (2) to examine their relevant associations with sociodemographic and clinical characteristics of the CHR-P total sample at baseline. METHODS All participants were young CHR-P help-seekers aged 12-25 years. They completed the "Comprehensive Assessment of At-Risk Mental States" (CAARMS) and the Health of the Nation Outcome Scale (HoNOS). Both univariate and multivariate Cox regression analyses were performed. RESULTS 164 CHR-P individuals were enrolled in this study. Across the follow-up, 30 (18.0%) dropped out the EI program, 23 (14%) transitioned to psychosis, 24 (14.6%) were hospitalized, 23 (14%) had a prolonged persistence of CHR-P criteria and 54 (47%) showed prolonged impairment in socio-occupational functioning. CONCLUSION As almost half of our participants did not functionally remit over time, sustained clinical attention for young CHR individuals people should be offered in the longer term, also to monitor unfavorable outcomes and to improve long-term prognosis.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.
- Department of Biomedical and Neuromotor Sciences, Istituto di Psichiatria "Paolo Ottonello", "Alma Mater Studiorum"-Università di Bologna, Via Pepoli, 5, 40126, Bologna, BO, Italy.
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy
| | - Simona Pupo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, PR, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, Istituto di Psichiatria "Paolo Ottonello", "Alma Mater Studiorum"-Università di Bologna, Via Pepoli, 5, 40126, Bologna, BO, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
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6
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Biancalani A, Occhionero M, Leuci E, Quattrone E, Azzali S, Paulillo G, Pupo S, Pellegrini P, Menchetti M, Pelizza L. Disorganization in individuals at clinical high risk for psychosis: psychopathology and treatment response. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01855-3. [PMID: 38914855 DOI: 10.1007/s00406-024-01855-3] [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: 12/04/2023] [Accepted: 06/17/2024] [Indexed: 06/26/2024]
Abstract
Disorganization is a nuclear dimension of psychosis, especially in schizophrenia. Despite its relevant association with poor prognosis and negative outcomes, it is still under-investigated compared to positive and negative symptoms, in particular at the onset of illness. This study explored disorganization in youth at Clinical High Risk for Psychosis (CHR-P) over a 2-year period. A sample of 180 CHR-P participants (50% males; 51.1% with baseline second-generation antipsychotic medication) recruited within a specialized CHR-P service completed the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) scale. Across the follow-up, we examined key associations of disorganization with other domains of psychopathology, functioning, and treatment response using Spearman's rank correlation coefficients and linear regression analyses. Our results showed a significant longitudinal reduction in disorganization severity levels across the follow-up. This decrease was significantly associated with improvements in negative symptoms and daily functioning, with a shorter duration of untreated psychiatric symptoms, and with baseline equivalent dose of antipsychotic medication. No significant longitudinal associations with other treatment component of the PARMS program were found. Our findings suggest a longitudinal improvement in disorganization dimension in CHR-P individuals, especially in the context of early interventions targeting reduction in the duration of untreated psychiatric symptoms and favoring a prompt antipsychotic therapy.
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Affiliation(s)
- Arianna Biancalani
- Department of Biomedical and Neuromotor Sciences, "Paolo Ottonello" Psychiatry Institute, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, Bologna, 40123, Italy
| | - Michele Occhionero
- Department of Biomedical and Neuromotor Sciences, "Paolo Ottonello" Psychiatry Institute, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, Bologna, 40123, Italy
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, Parma, 43100, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, Parma, 43100, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addictions, Azienda USL-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia, 43100, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, Parma, 43100, Italy
| | - Simona Pupo
- Division of Pain Medicine, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, Parma, 43100, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, Parma, 43100, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, "Paolo Ottonello" Psychiatry Institute, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, Bologna, 40123, Italy
| | - Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences, "Paolo Ottonello" Psychiatry Institute, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli 5, Bologna, 40123, Italy.
- Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, Parma, 43100, Italy.
- Department of Mental Health and Pathological Addictions, Azienda USL di Bologna, Via Castiglione 29, Bologna, 40124, Italy.
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Mourad M, Atallah EP, Raad G, Haddad R, Richa S. Effectiveness of a two-stage strategy using the 16-item Prodromal Questionnaire (PQ16/fPQ16) and the Comprehensive Assessment of At Risk Mental States (CAARMS) in the early detection of Ultra High Risk (UHR) patients in Lebanon: a cross-sectional pilot study. L'ENCEPHALE 2024; 50:40-47. [PMID: 36717331 DOI: 10.1016/j.encep.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/23/2022] [Indexed: 01/30/2023]
Abstract
OBJECTIVES This study aims to identify the prevalence of Ultra High Risk (UHR) adults in a sample of patients in Lebanon and to compare screening and diagnostic tools. METHODS This is a cross-sectional pilot study which targeted patients aged 17-30 years willingly seeking psychiatric care in a university hospital in Beirut, Lebanon. Participants were invited to fill either the English or the French version of the Prodromal Questionnaire (respectively, PQ16 or fPQ16). The abbreviated version of the "Comprehensive Assessment of At-Risk Mental States" (CAARMS) was then administered to all participants. The latter were subsequently sorted into one of the three UHR groups - vulnerability group, attenuated psychosis (APS), intermittent psychosis (BLIPS) - or were diagnosed as suffering from a psychotic disorder. RESULTS Thirty-one patients participated in this study. The prevalence of positive screening on the PQ16/fPQ16 and positive diagnosis of UHR on the CAARMS were respectively of 61.29% and 45%. The APS group was the most prevalent (71.42%). A positive psychosis screening on PQ16/fPQ16 was statistically related to a UHR diagnosis on CAARMS (p-value: 0.011 on Chi2 test), OR=8.5 (95% CI: 1.4-50.9; p-value: 0.018). No relation was found between PQ16/fPQ16 results and risk stratification or between the number of "True" responses on PQ16/fPQ16 and the intensity of symptoms on CAARMS. PQ16/fPQ16 statements 5, 9, 11 and 16 predicted a UHR diagnosis on CAARMS (p-value of 0.045, 0.006, 0.045 and 0.045, respectively). CONCLUSION This two-stage strategy for identifying UHR patients can be adopted in a tertiary health care center.
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Affiliation(s)
- M Mourad
- Department of Psychiatry, University Hospital Center, Hôtel-Dieu de France, Saint Joseph University of Beirut, Beirut, Lebanon; Department of Psychiatry, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - E P Atallah
- Department of Psychiatry, University Hospital Center, Hôtel-Dieu de France, Saint Joseph University of Beirut, Beirut, Lebanon; Department of Psychiatry, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - G Raad
- Department of Psychiatry, University Hospital Center, Hôtel-Dieu de France, Saint Joseph University of Beirut, Beirut, Lebanon; School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - R Haddad
- Department of Psychiatry, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon; Department of Psychiatry, Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - S Richa
- Department of Psychiatry, University Hospital Center, Hôtel-Dieu de France, Saint Joseph University of Beirut, Beirut, Lebanon; Department of Psychiatry, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Merola GP, Boy OB, Fascina I, Pecoraro V, Falone A, Patti A, Santarelli G, Cicero DC, Ballerini A, Ricca V. Aberrant Salience Inventory: A meta-analysis to investigate its psychometric properties and identify screening cutoff scores. Scand J Psychol 2023; 64:734-745. [PMID: 37243361 DOI: 10.1111/sjop.12931] [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] [Received: 02/18/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
INTRODUCTION The Aberrant Salience Inventory (ASI) is a useful tool to measure salience abnormalities among the general population. There is strong clinical and scientific evidence that salience alteration is linked to psychosis. To the present day, no meta-analysis evaluating ASI's psychometric properties and screening potential has been published. MATERIALS AND METHODS PubMed, Google Scholar, Scopus, and Embase were searched using terms including "psychosis," "schizophrenia," and "Aberrant Salience Inventory." Observational and experimental studies employing ASI on populations of non-psychotic controls and patients with psychosis were included. ASI scores and other demographic measures (age, gender, ethnicity) were extracted as outcomes. Individual patients' data (IPD) were collected. Exploratory factor analysis (EFA) was performed on the IPD. RESULTS Eight articles were finally included in the meta-analysis. ASI scores differ significantly between psychotic and non-psychotic populations; a novel three-factor model is proposed regarding subscales structure. Theoretical positive predictive values (PPVs) and negative predictive values (NPVs) were calculated and presented together with different cutoff points depending on preselected specific populations of interest. DISCUSSION PPV and NPV values reached levels adequate for ASI to be considered a viable screening tool for psychosis. The factor analysis highlights the presence of a novel subscale that was named "Unveiling experiences." Implications regarding the meaning of the new factor structure are discussed, as well as ASI's potential as a screening tool.
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Affiliation(s)
| | - Ottone Baccaredda Boy
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Isotta Fascina
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Vincenzo Pecoraro
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Andrea Falone
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Andrea Patti
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Gabriele Santarelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Andrea Ballerini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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9
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Pelizza L, Leuci E, Quattrone E, Paulillo G, Pellegrini P. The 'Parma At-Risk mental states' (PARMS) program: General description and process analysis after 5 years of clinical activity. Early Interv Psychiatry 2023. [PMID: 36639137 DOI: 10.1111/eip.13399] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/28/2022] [Accepted: 01/01/2023] [Indexed: 01/15/2023]
Abstract
AIM From January 2016, the Parma Department of Mental Health developed a specialized care protocol - the 'Parma At-Risk Mental States' (PARMS) program - as a diffused service for early intervention in individuals at Clinical High Risk for Psychosis (CHR-P). The aims of this investigation were (1) to describe the PARMS structural organization and (2) to examine specific process indicators during the first 5 years of its clinical activity. METHODS All participants were adolescent and young adult help-seekers (aged 12-25 years) at CHR-P in accordance with well-defined psychometric criteria. RESULTS At entry, 52 subjects were provided with a dedicated protocol of care and only 14 dropped out during the first year of treatment. The Duration of Untreated Illness (DUI) overall decreased over time. Most of CHR-P participants suffered from 'Attenuated Psychotic Symptoms' and 'Brief, Limited, Intermittent Psychotic Symptoms' in the same percentage (48.1% [n = 25]). The most common DSM-IV-TR diagnosis was schizotypal personality disorder, followed by borderline personality disorder and brief psychotic disorder. CONCLUSIONS A specialized, evidence-based care protocol for CHR-P individuals within Italian adult and child/adolescent psychiatric services is feasible, also in adolescents, who have a high risk of falling through the child/adult service gap.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy.,Department of Biomedical and NeuroMotor Sciences, "Alma Mater Studiorum", Università degli Studi di Bologna, Bologna, Italy
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
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10
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Baklushev ME, Nazarova MA, Novikov PA, Nikulin VV. [Methods for assessing aberrant and adaptive salience]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:30-35. [PMID: 37655407 DOI: 10.17116/jnevro202312308130] [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: 09/02/2023]
Abstract
The term «salience» is most often used to describe «aberrant salience», which means assigning false significance to insignificant facts and details, that is inherent to patients with schizophrenia. Most often it is used in combination with «aberrant salience», which is understood as the assignment of false significance to insignificant facts and details. The term «adaptive salience» is less commonly used and means the «correct» assignment of the significance to important biological information. It is believed that in schizophrenia there is a decrease of adaptive salience in combination with an increase of aberrant salience. The concepts of aberrant and adaptive salience are a kind of link between the dopamine imbalance underlying the pathogenesis of schizophrenia and the diverse clinic of the disease. This article provides a review of the literature on methods for assessing, including quantitatively assessment, salience in schizophrenia. The comparison of these methods and their possible clinical and scientific application are provided.
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11
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Grimmer HJ, Laukkonen RE, Freydenzon A, von Hippel W, Tangen JM. Thinking style and psychosis proneness do not predict false insights. Conscious Cogn 2022; 104:103384. [PMID: 35933801 DOI: 10.1016/j.concog.2022.103384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/13/2022] [Accepted: 07/26/2022] [Indexed: 11/03/2022]
Abstract
The FIAT paradigm (Grimmer et al., 2021) is a novel method of eliciting 'Aha' moments for incorrect solutions to anagrams in the laboratory, i.e. false insights. There exist many documented reports of psychotic symptoms accompanying strong feelings of 'Aha!' (Feyaerts, Henriksen, Vanheule, Myin-Germeys, & Sass, 2021; Mishara, 2010; Tulver, Kaup, Laukkonen, & Aru, 2021), suggesting that the newly developed FIAT could reveal whether people who have more false insights are more prone to psychosis and delusional belief. To test this possibility, we recruited 200 participants to take an adapted version of the FIAT and complete measures of thinking style and psychosis proneness. We found no association between experimentally induced false insights and measures of Schizotypy, Need for Cognition, Jumping to Conclusions, Aberrant Salience, Faith in Intuition, or the Cognitive Reflection Task. We conclude that experiencing false insights might not be constrained to any particular type of person, but rather, may arise for anyone under the right circumstances.
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Affiliation(s)
| | | | - Anna Freydenzon
- Institute of Molecular Bioscience, The University of Queensland, Australia
| | | | - Jason M Tangen
- School of Psychology, The University of Queensland, Australia
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12
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Pugliese V, de Filippis R, Aloi M, Rotella P, Carbone EA, Gaetano R, De Fazio P. Aberrant salience correlates with psychotic dimensions in outpatients with schizophrenia spectrum disorders. Ann Gen Psychiatry 2022; 21:25. [PMID: 35786401 PMCID: PMC9250738 DOI: 10.1186/s12991-022-00402-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Aberrant salience is a well-known construct associated with the development and maintenance of psychotic symptoms in schizophrenia. However, only a few studies have investigated aberrance salience as a trait, with no study investigating the association between the five aberrant salience domains and psychotic symptoms. We aimed to explore the role of aberrant salience and its domains on psychotic dimensions in both clinically remitted and non-remitted patients. METHODS A sample of 102 patients diagnosed with schizophrenia spectrum disorders was divided according to the Positive and Negative Syndrome Scale (PANSS) remission criteria into two groups: remitted and non-remitted. Differences regarding psychotic symptomatology assessed by the PANSS and aberrant salience measured by the Aberrant Salience Inventory (ASI) were explored. Finally, a correlation analysis between the PANSS and the ASI was run. RESULTS Significantly higher ASI scores were evident among non-remitted patients. Positive symptoms (i.e. delusions, conceptual disorganization, and hallucinatory behaviour) and general psychopathology (i.e. postural mannerisms, unusual thought content) were correlated to the aberrant salience subscales 'sharpening of senses', 'heightened emotionality' and 'heightened cognition' and with the ASI total score. Significant correlations emerged between negative symptoms (blunted affect and social withdrawal) and 'heightened cognition'. Finally, lack of spontaneity of conversation was related to the subscales 'heightened emotionality' and 'heightened cognition', as well as to the ASI total score. CONCLUSIONS These preliminary results support the hypothesis of an association between aberrant salience and psychotic symptoms in schizophrenia. Further research is needed, especially into the mechanisms underlying salience processing, in addition to social and environmental factors and cognitive variables.
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Affiliation(s)
- Valentina Pugliese
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Matteo Aloi
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Paola Rotella
- Department of Mental Health of Catanzaro, Lamezia Terme, Italy
| | - Elvira Anna Carbone
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Raffaele Gaetano
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
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