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DeVylder J, Yamaguchi S, Hosozawa M, Yamasaki S, Ando S, Miyashita M, Endo K, Stanyon D, Usami S, Kanata S, Tanaka R, Minami R, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Adolescent psychotic experiences before and during the COVID-19 pandemic: a prospective cohort study. J Child Psychol Psychiatry 2024; 65:776-784. [PMID: 37953733 DOI: 10.1111/jcpp.13907] [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] [Accepted: 09/09/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Understanding the etiology of psychosis is essential to the development of preventive interventions. The COVID-19 pandemic provides a rare natural experiment that can expand our understanding of the role of social factors in the trajectories and etiology of psychosis across adolescence, particularly in Tokyo where the prevalence of actual COVID-19 infection remained low. We hypothesized that the likelihood of self-reporting psychotic experiences (PEs) would increase following the onset of the COVID-19 pandemic. METHODS The Tokyo Teen Cohort (TTC) is a prospective cohort study of adolescents in the general population of the Tokyo metropolitan area, followed from age 10 to 16 years. We used multi-level linear regression models to test the associations between the phase of the COVID-19 pandemic and self-reported PEs. RESULTS Among 1935 adolescents included in the analysis, a rapid increase in PEs occurred at the onset of the COVID-19 pandemic, following approximately 6 years of steady decline across prior waves. This association was more pronounced for boys compared to girls. This increase became more pronounced as the pandemic moved into later phases, defined based on contemporaneous sociopolitical changes in Tokyo (i.e. changes to school closure, social distancing guidelines, and the state of emergency status). CONCLUSIONS The steady decline in PEs across adolescence was halted and reversed concurrent with the COVID-19 pandemic onset, despite very low rates of COVID-19 infection. This implicates COVID-19 related socioenvironmental factors as contributory etiological factors in the development of PEs in this adolescent cohort.
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Affiliation(s)
- Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
- Silver School of Social Work, New York University, New York, NY, USA
- Unit for Mental Health Promotion, Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Satoshi Yamaguchi
- Unit for Mental Health Promotion, Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Center for Research and Development on Transition from Secondary to Higher Education, The University of Tokyo, Tokyo, Japan
| | - Mariko Hosozawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Syudo Yamasaki
- Unit for Mental Health Promotion, Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Unit for Mental Health Promotion, Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kaori Endo
- Unit for Mental Health Promotion, Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Daniel Stanyon
- Unit for Mental Health Promotion, Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Satoshi Usami
- Center for Research and Development on Transition from Secondary to Higher Education, The University of Tokyo, Tokyo, Japan
- Division of Educational Psychology, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Sho Kanata
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Riki Tanaka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rin Minami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Hiraiwa-Hasegawa
- Unit for Mental Health Promotion, Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Hayama, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
| | - Atsushi Nishida
- Unit for Mental Health Promotion, Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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Johnstad PG. Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use. Front Public Health 2024; 11:1268339. [PMID: 38249418 PMCID: PMC10797041 DOI: 10.3389/fpubh.2023.1268339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however. Objective The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons. Methods Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency. Results From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses. Conclusion This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.
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Paquin V, Philippe FL, Shannon H, Guimond S, Ouellet-Morin I, Geoffroy MC. Associations between digital media use and psychotic experiences in young adults of Quebec, Canada: a longitudinal study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:65-75. [PMID: 37516683 DOI: 10.1007/s00127-023-02537-6] [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: 06/11/2022] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE Digital media use has been associated with psychotic experiences in youth from the community, but the direction of association remains unclear. We aimed to examine between- and within-person associations of digital media use and psychotic experiences in youth. METHODS The sample included 425 participants aged 18-25 years (82.5% female) from the community, followed between May 2021 and January 2022 over 3 time points-of which 263 participants (61.9%) completed at least 2. Digital media use was self-reported as time spent daily on TV and streaming platforms, social media, and video games over the past 3 months. Psychotic experiences in the past 3 months were measured with the 15-item Community Assessment of Psychic Experiences. Associations between digital media use and psychotic experiences were estimated using a random-intercept cross-lagged panel model. RESULTS On average, individuals who reported greater digital media use also reported higher levels of psychotic experiences (r = 0.34, 95% CI 0.15, 0.53). However, a person's variation in digital media use, relative to their personal average, was not significantly associated with subsequent variations in their levels of psychotic experiences, or vice-versa. Results were similar across TV/streaming, social media and video game use, and after adjusting for age, sex, education, sleep, physical activity, and cannabis use. CONCLUSION Individuals with a tendency for higher levels of digital media use also had a tendency for higher levels of psychotic experiences. Understanding this association may help personalize mental health interventions for people with psychotic experiences, which may be offered digitally to promote their accessibility.
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Affiliation(s)
- Vincent Paquin
- Department of Psychiatry, McGill University, Ludmer Research and Training Building, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada.
| | - Frederick L Philippe
- Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | - Holly Shannon
- The Royal's Institute of Mental Health Research and Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Synthia Guimond
- The Royal's Institute of Mental Health Research and Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal, and Research Center of the Montreal Mental Health University Institute, Montreal, QC, Canada
| | - Marie-Claude Geoffroy
- Department of Psychiatry, McGill University, Ludmer Research and Training Building, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
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4
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Spinazzola E, Quattrone D, Rodriguez V, Trotta G, Alameda L, Tripoli G, Gayer-Anderson C, Freeman TP, Johnson EC, Jongsma HE, Stilo S, La Cascia C, Ferraro L, La Barbera D, Lasalvia A, Tosato S, Tarricone I, D'Andrea G, Galatolo M, Tortelli A, Tagliabue I, Turco M, Pompili M, Selten JP, de Haan L, Rossi Menezes P, Del Ben CM, Santos JL, Arrojo M, Bobes J, Sanjuán J, Bernardo M, Arango C, Kirkbride JB, Jones PB, O'Donovan M, Rutten BP, Van Os J, Morgan C, Sham PC, Austin-Zimmerman I, Li Z, Vassos E, Murray RM, Di Forti M. The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study. Psychol Med 2023; 53:7418-7427. [PMID: 37129249 PMCID: PMC10719678 DOI: 10.1017/s0033291723001071] [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: 09/21/2022] [Revised: 01/23/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis. METHODS We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case-control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case-control status. RESULTS Controls (86.1%) and FEPp (75.63%) were most likely to report 'because of friends' as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: 'to feel better' as their RFUC (χ2 = 50.97; p < 0.001). RFUC 'to feel better' was associated with being a FEPp (OR 1.74; 95% CI 1.03-2.95) while RFUC 'with friends' was associated with being a control (OR 0.56; 95% CI 0.37-0.83). The path model indicated an association between RFUC 'to feel better' with heavy cannabis use and with FEPp-control status. CONCLUSIONS Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use 'to feel better'. People who reported their reason for first using cannabis to 'feel better' were more likely to progress to heavy use and develop a psychotic disorder than those reporting 'because of friends'.
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Affiliation(s)
- Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- National Institute for Health Research, Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne, University Hospital (CHUV), Lausanne, Switzerland
- Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM); Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Simona Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Caterina La Cascia
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Michela Galatolo
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Andrea Tortelli
- Institut Mondor de recherché biomedicale, Creteil, France
- Etablissement Public de Sante Maison Blanche, Paris, France
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
- Department of Mental Health and Addiction Services, ASST Lecco, Lecco, Italy
| | - Marco Turco
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Section, AmsterdamUMC, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Cristina M Del Ben
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz”, Cuenca, 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
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Valencia, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - James B Kirkbride
- Reader; Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Michael O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - 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, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pak C Sham
- Department of Psychiatry, Centre for PanorOmic Sciences, and State Key Laboratory of Brain and Cognitive Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Isabelle Austin-Zimmerman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Zhikun Li
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - EU-GEI WP2 Group
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, 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
- Research Foundation, National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and the NIHR BRC at University College London, London, UK
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5
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Radhakrishnan R, Pries LK, Erzin G, ten Have M, de Graaf R, van Dorsselaer S, Gunther N, Bak M, Rutten BPF, van Os J, Guloksuz S. Bidirectional relationships between cannabis use, anxiety and depressive symptoms in the mediation of the association with psychotic experience: further support for an affective pathway to psychosis. Psychol Med 2023; 53:5551-5557. [PMID: 36093677 PMCID: PMC10482707 DOI: 10.1017/s0033291722002756] [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: 12/21/2021] [Revised: 07/21/2022] [Accepted: 08/05/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Empirical evidence suggests that people use cannabis to ameliorate anxiety and depressive symptoms, yet cannabis also acutely worsens psychosis and affective symptoms. However, the temporal relationship between cannabis use, anxiety and depressive symptoms and psychotic experiences (PE) in longitudinal studies is unclear. This may be informed by examination of mutually mediating roles of cannabis, anxiety and depressive symptoms in the emergence of PE. METHODS Data were derived from the second longitudinal Netherlands Mental Health Survey and Incidence Study. Mediation analysis was performed to examine the relationship between cannabis use, anxiety/depressive symptoms and PE, using KHB logit in STATA while adjusting for age, sex and education status. RESULTS Cannabis use was found to mediate the relationship between preceding anxiety, depressive symptoms and later PE incidence, but the indirect contribution of cannabis use was small (for anxiety: % of total effect attributable to cannabis use = 1.00%; for depression: % of total effect attributable to cannabis use = 1.4%). Interestingly, anxiety and depressive symptoms were found to mediate the relationship between preceding cannabis use and later PE incidence to a greater degree (% of total effect attributable to anxiety = 17%; % of total effect attributable to depression = 37%). CONCLUSION This first longitudinal cohort study examining the mediational relationship between cannabis use, anxiety/depressive symptoms and PE, shows that there is a bidirectional relationship between cannabis use, anxiety/depressive symptoms and PE. However, the contribution of anxiety/depressive symptoms as a mediator was greater than that of cannabis.
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Affiliation(s)
- Rajiv Radhakrishnan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Gamze Erzin
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychiatry, Ankara Diskapi Training and Research Hospital, Ankara, Turkey
| | - Margreet ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Nicole Gunther
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Bart P. F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
- Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
| | - Sinan Guloksuz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
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6
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Passiatore R, Antonucci LA, DeRamus TP, Fazio L, Stolfa G, Sportelli L, Kikidis GC, Blasi G, Chen Q, Dukart J, Goldman AL, Mattay VS, Popolizio T, Rampino A, Sambataro F, Selvaggi P, Ulrich W, Weinberger DR, Bertolino A, Calhoun VD, Pergola G. Changes in patterns of age-related network connectivity are associated with risk for schizophrenia. Proc Natl Acad Sci U S A 2023; 120:e2221533120. [PMID: 37527347 PMCID: PMC10410767 DOI: 10.1073/pnas.2221533120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/24/2023] [Indexed: 08/03/2023] Open
Abstract
Alterations in fMRI-based brain functional network connectivity (FNC) are associated with schizophrenia (SCZ) and the genetic risk or subthreshold clinical symptoms preceding the onset of SCZ, which often occurs in early adulthood. Thus, age-sensitive FNC changes may be relevant to SCZ risk-related FNC. We used independent component analysis to estimate FNC from childhood to adulthood in 9,236 individuals. To capture individual brain features more accurately than single-session fMRI, we studied an average of three fMRI scans per individual. To identify potential familial risk-related FNC changes, we compared age-related FNC in first-degree relatives of SCZ patients mostly including unaffected siblings (SIB) with neurotypical controls (NC) at the same age stage. Then, we examined how polygenic risk scores for SCZ influenced risk-related FNC patterns. Finally, we investigated the same risk-related FNC patterns in adult SCZ patients (oSCZ) and young individuals with subclinical psychotic symptoms (PSY). Age-sensitive risk-related FNC patterns emerge during adolescence and early adulthood, but not before. Young SIB always followed older NC patterns, with decreased FNC in a cerebellar-occipitoparietal circuit and increased FNC in two prefrontal-sensorimotor circuits when compared to young NC. Two of these FNC alterations were also found in oSCZ, with one exhibiting reversed pattern. All were linked to polygenic risk for SCZ in unrelated individuals (R2 varied from 0.02 to 0.05). Young PSY showed FNC alterations in the same direction as SIB when compared to NC. These results suggest that age-related neurotypical FNC correlates with genetic risk for SCZ and is detectable with MRI in young participants.
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Affiliation(s)
- Roberta Passiatore
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Georgia Institute of Technology, and Emory University, 30303Atlanta, GA
- Institute of Neuroscience and Medicine, Brain and Behavior, Research Centre Jülich, 52428Jülich, Germany
| | - Linda A. Antonucci
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
| | - Thomas P. DeRamus
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Georgia Institute of Technology, and Emory University, 30303Atlanta, GA
| | - Leonardo Fazio
- Department of Medicine and Surgery, Libera Università Mediterranea Giuseppe Degennaro, 70010Casamassima, Italy
| | - Giuseppe Stolfa
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
| | - Leonardo Sportelli
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, 21205Baltimore, MD
| | - Gianluca C. Kikidis
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, 21205Baltimore, MD
| | - Giuseppe Blasi
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
- Psychiatric Unit, University Hospital, 70124Bari, Italy
| | - Qiang Chen
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, 21205Baltimore, MD
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain and Behavior, Research Centre Jülich, 52428Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, 40225Düsseldorf, Germany
| | - Aaron L. Goldman
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, 21205Baltimore, MD
| | - Venkata S. Mattay
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, 21205Baltimore, MD
- Department of Neurology and Radiology, Johns Hopkins Medical Campus, 21287Baltimore, MD
| | - Teresa Popolizio
- Neuroradiology Unit, Scientific Institute for Research, Hospitalization and Health Care, Casa Sollievo della Sofferenza, 71013San Giovanni Rotondo, Foggia, Italy
| | - Antonio Rampino
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
- Psychiatric Unit, University Hospital, 70124Bari, Italy
| | - Fabio Sambataro
- Section of Psychiatry, Department of Neuroscience, University of Padova, 35121Padua, Italy
| | - Pierluigi Selvaggi
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
- Psychiatric Unit, University Hospital, 70124Bari, Italy
| | - William Ulrich
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, 21205Baltimore, MD
| | - Apulian Network on Risk for Psychosis
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
- Department of Mental Health, Azienda Sanitaria Locale Foggia, 71121Foggia, Italy
- Department of Clinical and Experimental Medicine, University of Foggia, 71122Foggia, Italy
- Department of Mental Health, Azienda Sanitaria Locale Barletta-Andria-Trani, 76123Andria, Italy
- Department of Mental Health, Azienda Sanitaria Locale Bari, 70132Bari, Italy
- Department of Mental Health, Azienda Sanitaria Locale Brindisi, 72100Brindisi, Italy
| | - Daniel R. Weinberger
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, 21205Baltimore, MD
- Department of Neurology and Radiology, Johns Hopkins Medical Campus, 21287Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 21205Baltimore, MD
- Department of Neuroscience, Johns Hopkins University School of Medicine, 21287Baltimore, MD
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, 21287Baltimore, MD
| | - Alessandro Bertolino
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
- Psychiatric Unit, University Hospital, 70124Bari, Italy
| | - Vince D. Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Georgia Institute of Technology, and Emory University, 30303Atlanta, GA
| | - Giulio Pergola
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, 70124Bari, Italy
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, 21205Baltimore, MD
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 21205Baltimore, MD
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7
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Sánchez-Iglesias I, Graña DF. Use and abuse of causal language in non-experimental studies on cannabis use and the development of psychosis. Schizophr Res 2023; 258:53-54. [PMID: 37478693 DOI: 10.1016/j.schres.2023.07.013] [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: 04/30/2023] [Revised: 05/03/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Affiliation(s)
- Iván Sánchez-Iglesias
- Department of Psychobiology & Behavioral Sciences Methods, Complutense University of Madrid, 28223 Madrid, Spain.
| | - Diego F Graña
- Psychometric Models and Applications, Autonomous University of Madrid, 28049 Cantoblanco, Spain.
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8
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Ho BC, Barry AB, Koeppel JA, Macleod J, Boyd A, David A, O’Leary DS. Recreational Marijuana Use, Adolescent Cognitive Development, and Schizophrenia Susceptibility. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:222-232. [PMID: 37124347 PMCID: PMC10140454 DOI: 10.1016/j.bpsgos.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/20/2022] Open
Abstract
Background We investigated how low marijuana (MJ) use levels, the typical use pattern in most adolescent users, affect cognitive maturation and schizophrenia risk. Methods In two complementary adolescent samples where the majority reported minimal MJ use, we compared cognitive performances before and after MJ use initiation. The Iowa sample (40 first-degree relatives and 54 second-degree relatives of patients with schizophrenia and 117 control subjects with no schizophrenia family history) underwent a battery of standardized neuropsychological tests at 0, 18, and 36 months. Based on self-administered Timeline Followback interviews, 26.5% of adolescents had emergent MJ use (eMJ) during follow-up. The second sample (n = 3463), derived from a birth cohort, received substance use and sustained attention assessments between ages 10 and 15 years. Mixed linear models and regression analyses tested the effects of eMJ on longitudinal changes in cognitive performance. Results In the Iowa sample, longitudinal changes in 5 of 8 cognitive domains were significantly associated with eMJ. On sustained attention, visuospatial working memory, and executive sequencing, adolescents with eMJ showed less age-expected improved performance. In addition, first-degree relatives with eMJ were less improved on processing speed and executive reasoning than first-degree relatives without eMJ. In the birth cohort, greater intraindividual variability in reaction times (indicative of poorer sustained attention) was significantly associated with more frequent MJ use and with recreational use levels. Conclusions Nonheavy MJ use disrupts normal adolescent maturation and compounds aberrant adolescent maturation associated with familial schizophrenia risk. These findings underscore the importance of reducing adolescent MJ access in the context of increased availability to high-potency MJ.
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Affiliation(s)
- Beng-Choon Ho
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Amy B. Barry
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Julie A. Koeppel
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - John Macleod
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Andy Boyd
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Anthony David
- Division of Psychiatry, University College London, London, United Kingdom
| | - Daniel S. O’Leary
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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9
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Stanyon D, DeVylder J, Yamasaki S, Yamaguchi S, Ando S, Usami S, Endo K, Miyashita M, Kanata S, Morimoto Y, Hosozawa M, Baba K, Nakajima N, Niimura J, Nakanishi M, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Auditory Hallucinations and Self-Injurious Behavior in General Population Adolescents: Modeling Within-Person Effects in the Tokyo Teen Cohort. Schizophr Bull 2023; 49:329-338. [PMID: 36333883 PMCID: PMC10016404 DOI: 10.1093/schbul/sbac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND HYPOTHESES A wealth of evidence suggests that adolescent psychotic experiences (PEs), and especially auditory hallucinations (AHs), are associated with an increased risk for self-injurious behavior (SIB). However, the directionality and specificity of this association are not well understood, and there are no published studies investigating within-person effects over time. The present study aimed to test whether AHs and SIB prospectively increase reciprocal risk at the individual level during early-to-middle adolescence. STUDY DESIGN Three waves (12y, 14y, and 16y) of self-reported AHs and SIB data from a large Tokyo-based adolescent birth cohort (N = 2825) were used. Random Intercept Cross-Lagged Panel Model (RI-CLPM) analysis was conducted to test the within-person prospective associations between AHs and SIB. STUDY RESULTS At the within-person level, AHs were associated with subsequent SIB over the observation period (12y-14y: β = .118, P < .001; 14-16y: β = .086, P = .012). The reverse SIB->AHs relationship was non-significant at 12-14y (β = .047, P = .112) but emerged from 14y to 16y as the primary direction of influence (β = .243, P < .001). Incorporating depression as a time-varying covariate did not meaningfully alter model estimates. CONCLUSIONS A complex bi-directional pattern of relationships was observed between AHs and SIB over the measurement period, and these relationships were independent of depressive symptoms. Adolescent AHs may be both a predictor of later SIB and also a manifestation of SIB-induced psychological distress.
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Affiliation(s)
- Daniel Stanyon
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Jordan DeVylder
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Satoshi Yamaguchi
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shuntaro Ando
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Usami
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Kaori Endo
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Sho Kanata
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Yuko Morimoto
- Department of Psychology, Ube Frontier University, Yamaguchi, Japan
| | - Mariko Hosozawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kaori Baba
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Naomi Nakajima
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Junko Niimura
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Miharu Nakanishi
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai-shi, Miyagi, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Kanagawa, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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10
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DeVylder J, Anglin D, Munson MR, Nishida A, Oh H, Marsh J, Narita Z, Bareis N, Fedina L. Ethnoracial Variation in Risk for Psychotic Experiences. Schizophr Bull 2023; 49:385-396. [PMID: 36398917 PMCID: PMC10016402 DOI: 10.1093/schbul/sbac171] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND & HYPOTHESIS Psychotic disorders are inequitably distributed by race in the United States, although it is not known whether this is due to assessment biases or inequitable distributions of risk factors. Psychotic experiences are subclinical hallucinations and delusions used to study the etiology of psychosis, which are based on self-report and therefore not subject to potential clinician biases. In this study, we test whether the prevalence of psychotic experiences (PE) varies by race and if this variance is explained by socioenvironmental risk factors. STUDY DESIGN Data on demographics, PE, and socioenvironmental risk factors were collected through the National Survey of Poly-victimization and Mental Health, a national probability sample of US young adults. Logistic regression analyses were used to determine whether PE prevalence varied by race/ethnicity and, if so, whether this was attenuated with inclusion of indicators of income, education, urban/rural living, discrimination, and trauma exposure. STUDY RESULTS Black and Hispanic respondents reported PE at significantly greater rates than White or "other" ethnoracial groups, with hallucinations more commonly reported by Hispanic respondents. PE were significantly associated with police violence exposure, discrimination, adverse childhood experiences, and educational attainment. These factors statistically explained ethnoracial differences in the likelihood of overall PE occurrence and of nearly all PE subtypes. CONCLUSIONS Previously observed racial differences in psychosis extend beyond clinical schizophrenia, and therefore, are unlikely to be explained entirely by clinician biases. Instead, racial disparities in PE appear to be driven by features of structural racism, trauma, and discrimination.
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Affiliation(s)
- Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, USA
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Deidre Anglin
- Department of Psychology, The City College of New York, New York, USA
| | | | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hans Oh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
| | - Jonathan Marsh
- Graduate School of Social Service, Fordham University, New York, USA
| | - Zui Narita
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Natalie Bareis
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY, USA
| | - Lisa Fedina
- University of Michigan School of Social Work, Ann Arbor, MI, USA
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11
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D'Souza DC, DiForti M, Ganesh S, George TP, Hall W, Hjorthøj C, Howes O, Keshavan M, Murray RM, Nguyen TB, Pearlson GD, Ranganathan M, Selloni A, Solowij N, Spinazzola E. Consensus paper of the WFSBP task force on cannabis, cannabinoids and psychosis. World J Biol Psychiatry 2022; 23:719-742. [PMID: 35315315 DOI: 10.1080/15622975.2022.2038797] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVES The liberalisation of cannabis laws, the increasing availability and potency of cannabis has renewed concern about the risk of psychosis with cannabis. METHODS The objective of the WFSBP task force was to review the literature about this relationship. RESULTS Converging lines of evidence suggest that exposure to cannabis increases the risk for psychoses ranging from transient psychotic states to chronic recurrent psychosis. The greater the dose, and the earlier the age of exposure, the greater the risk. For some psychosis outcomes, the evidence supports some of the criteria of causality. However, alternate explanations including reverse causality and confounders cannot be conclusively excluded. Furthermore, cannabis is neither necessary nor sufficient to cause psychosis. More likely it is one of the multiple causal components. In those with established psychosis, cannabis has a negative impact on the course and expression of the illness. Emerging evidence also suggests alterations in the endocannabinoid system in psychotic disorders. CONCLUSIONS Given that exposure to cannabis and cannabinoids is modifiable, delaying or eliminating exposure to cannabis or cannabinoids, could potentially impact the rates of psychosis related to cannabis, especially in those who are at high risk for developing the disorder.
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Affiliation(s)
- Deepak Cyril D'Souza
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marta DiForti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK.,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Suhas Ganesh
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Tony P George
- Addictions Division and Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wayne Hall
- The National Centre for Youth Substance Use Research, University of Queensland, Brisbane, Australia
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University, Copenhagen, Denmark.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Institute for Clinical Sciences, Imperial College London, London, UK
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Timothy B Nguyen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK.,Institute for Clinical Sciences, Imperial College London, London, UK
| | - Godfrey D Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Olin Neuropsychiatry Ctr. Institute of Living, Hartford, CT, USA
| | - Mohini Ranganathan
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Alex Selloni
- Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nadia Solowij
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), New Lambton Heights, NSW, Australia
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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12
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Cannabis and Intentional Self-injury: a Narrative Review. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00453-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Purpose of Review
Observational studies assessing the association of cannabis use with subsequent intentional self-injury have reported mixed findings. Longitudinal studies examining the association of cannabis use with subsequent suicide death are notably rare. Our objective was to review longitudinal studies examining cannabis use and subsequent self-harm, suicide attempt, or suicide death.
Recent Findings
Few population-based studies have focused on self-harm with considerable variability across studies in how this outcome has been operationalized. Studies assessing the association between cannabis use and suicide attempt are equivocal in their conclusions and heterogenous in terms of samples utilized and assessment of confounding bias. The results of one meta-analysis were suggestive of dose dependency. For suicide death, the findings are inconsistent, and there is reason for concern of selection bias.
Summary
The existing evidence base on these associations is not yet rigorous enough to allow drawing conclusions on causality. However, cannabis might be seen as an adverse prognostic marker for intentional self-injury.
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13
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The association between cannabis use and facial emotion recognition in schizophrenia, siblings, and healthy controls: Results from the EUGEI study. Eur Neuropsychopharmacol 2022; 63:47-59. [PMID: 36055075 DOI: 10.1016/j.euroneuro.2022.08.003] [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: 01/07/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022]
Abstract
Schizophrenia is frequently accompanied with social cognitive disturbances. Cannabis represents one established environmental factor associated with the onset and progression of schizophrenia. The present cross-sectional study aimed to investigate the association of facial emotion recognition (FER) performance with cannabis use in 2039 patients with schizophrenia, 2141 siblings, and 2049 healthy controls (HC). FER performance was measured using the Degraded Facial Affect Recognition Task (DFAR). Better FER performance as indicated by higher DFAR-total scores was associated with lifetime regular cannabis use in schizophrenia (B = 1.36, 95% CI 0.02 to 2.69), siblings (B = 2.17, 95% CI 0.79 to 3.56), and HC (B = 3.10, 95% CI 1.14 to 5.06). No associations were found between DFAR-total and current cannabis use. Patients with schizophrenia who started to use cannabis after the age of 16 showed better FER performance than patients who started earlier (B = 2.50, 95% CI 0.15 to 4.84) and non-users (B = 3.72, 95 CI 1.96 to 5.49). Better FER performance was found also in siblings who started to use cannabis after 16 compared to non-users (B = 2.37, 95% CI 0.58 to 4.16), while HC using cannabis performed better than non-users at DFAR-total regardless of the age at onset. Our findings suggest that lifetime regular cannabis use may be associated with better FER regardless of the psychosis risk, but that FER might be moderated by age at first use in people with higher genetic risk. Longitudinal studies may clarify whether there is a cause-and-effect relationship between cannabis use and FER performance in psychotic and non-psychotic samples.
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14
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Dopamine, Psychosis, and Symptom Fluctuation: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10091713. [PMID: 36141325 PMCID: PMC9498563 DOI: 10.3390/healthcare10091713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
It has been hypothesized since the 1960s that the etiology of schizophrenia is linked to dopamine. In the intervening 60 years, sophisticated brain imaging techniques, genetic/epigenetic advances, and new experimental animal models of schizophrenia have transformed schizophrenia research. The disease is now conceptualized as a heterogeneous neurodevelopmental disorder expressed phenotypically in four symptom domains: positive, negative, cognitive, and affective. The aim of this paper is threefold: (a) to review recent research into schizophrenia etiology, (b) to review papers that elicited subjective evidence from patients as to triggers and repressors of symptoms such as auditory hallucinations or paranoid thoughts, and (c) to address the potential role of dopamine in schizophrenia in general and, in particular, in the fluctuations in schizophrenia symptoms. The review also includes new discoveries in schizophrenia research, pointing to the involvement of both striatal neurons and glia, signaling pathway convergence, and the role of stress. It also addresses potential therapeutic implications. We conclude with the hope that this paper opens up novel avenues of research and new possibilities for treatment.
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15
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Lin BD, Pries LK, Sarac HS, van Os J, Rutten BPF, Luykx J, Guloksuz S. Nongenetic Factors Associated With Psychotic Experiences Among UK Biobank Participants: Exposome-Wide Analysis and Mendelian Randomization Analysis. JAMA Psychiatry 2022; 79:857-868. [PMID: 35857297 PMCID: PMC9301596 DOI: 10.1001/jamapsychiatry.2022.1655] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Although hypothesis-driven research has identified several factors associated with psychosis, this one-exposure-to-one-outcome approach fails to embrace the multiplicity of exposures. Systematic approaches, similar to agnostic genome-wide analyses, are needed to identify genuine signals. Objective To systematically investigate nongenetic correlates of psychotic experiences through data-driven agnostic analyses and genetically informed approaches to evaluate associations. Design, Setting, Participants This cohort study analyzed data from the UK Biobank Mental Health Survey from January 1 to June 1, 2021. An exposome-wide association study was performed in 2 equal-sized split discovery and replication data sets. Variables associated with psychotic experiences in the exposome-wide analysis were tested in a multivariable model. For the variables associated with psychotic experiences in the final multivariable model, the single-nucleotide variant-based heritability and genetic overlap with psychotic experiences using linkage disequilibrium score regression were estimated, and mendelian randomization (MR) approaches were applied to test potential causality. The significant associations observed in 1-sample MR analyses were further tested in multiple sensitivity tests, including collider-correction MR, 2-sample MR, and multivariable MR analyses. Exposures After quality control based on a priori criteria, 247 environmental, lifestyle, behavioral, and economic variables. Main Outcomes and Measures Psychotic experiences. Results The study included 155 247 participants (87 896 [57%] female; mean [SD] age, 55.94 [7.74] years). In the discovery data set, 162 variables (66%) were associated with psychotic experiences. Of these, 148 (91%) were replicated. The multivariable analysis identified 36 variables that were associated with psychotic experiences. Of these, 28 had significant genetic overlap with psychotic experiences. One-sample MR analyses revealed forward associations with 3 variables and reverse associations with 3. Forward associations with ever having experienced sexual assault and pleiotropy of risk-taking behavior and reverse associations without pleiotropy of experiencing a physically violent crime as well as cannabis use and the reverse association with pleiotropy of worrying too long after embarrassment were confirmed in sensitivity tests. Thus, associations with psychotic experiences were found with both well-studied and unexplored multiple correlated variables. For several variables, the direction of the association was reversed in the final multivariable and MR analyses. Conclusions and Relevance The findings of this study underscore the need for systematic approaches and triangulation of evidence to build a knowledge base from ever-growing observational data to guide population-level prevention strategies for psychosis.
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Affiliation(s)
- Bochao Danae Lin
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,Brainclinics foundation, Nijmegen, the Netherlands.,Department of Preventive Medicine, Institute of Biomedical Informatics, Bioinformatics Center, School of Basic Medical Sciences, Henan University, Kaifeng, China
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Halil Suat Sarac
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jurjen Luykx
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,Brainclinics foundation, Nijmegen, the Netherlands.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,GGNet Mental Health, Apeldoorn, the Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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16
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Abstract
BACKGROUND Smartphones can facilitate patients completing surveys and collecting sensor data to gain insight into their mental health conditions. However, the utility of sensor data is still being explored. Prior studies have reported a wide range of correlations between passive data and survey scores. AIMS To explore correlations in a large data-set collected with the mindLAMP app. Additionally, we explored whether passive data features could be used in models to predict survey results. METHOD Participants were asked to complete daily and weekly mental health surveys. After screening for data quality, our sample included 147 college student participants and 270 weeks of data. We examined correlations between six weekly surveys and 13 metrics derived from passive data features. Finally, we trained logistic regression models to predict survey scores from passive data with and without daily surveys. RESULTS Similar to other large studies, our correlations were lower than prior reports from smaller studies. We found that the most useful features came from GPS, call, and sleep duration data. Logistic regression models performed poorly with only passive data, but when daily survey scores were included, performance greatly increased. CONCLUSIONS Although passive data alone may not provide enough information to predict survey scores, augmenting this data with short daily surveys can improve performance. Therefore, it may be that passive data can be used to refine survey score predictions and clinical utility may be derived from the combination of active and passive data.
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Affiliation(s)
- Danielle Currey
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Massachusetts, USA
| | - John Torous
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Massachusetts, USA
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17
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Marchi M, Elkrief L, Alkema A, van Gastel W, Schubart CD, van Eijk KR, Luykx JJ, Branje S, Mastrotheodoros S, Galeazzi GM, van Os J, Cecil CA, Conrod PJ, Boks MP. Childhood maltreatment mediates the effect of the genetic background on psychosis risk in young adults. Transl Psychiatry 2022; 12:219. [PMID: 35650188 PMCID: PMC9160238 DOI: 10.1038/s41398-022-01975-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/29/2022] [Accepted: 05/10/2022] [Indexed: 11/09/2022] Open
Abstract
Childhood maltreatment (CM) and genetic vulnerability are both risk factors for psychosis, but the relations between them are not fully understood. Guided by the recent identification of genetic risk to CM, this study investigates the hypothesis that genetic risk to schizophrenia also increases the risk of CM and thus impacts psychosis risk. The relationship between schizophrenia polygenetic risk, CM, and psychotic-like experiences (PLE) was investigated in participants from the Utrecht Cannabis Cohort (N = 1262) and replicated in the independent IMAGEN cohort (N = 1740). Schizophrenia polygenic risk score (SZ-PRS) were calculated from the most recent GWAS. The relationship between CM, PRS, and PLE was first investigated using multivariate linear regression. Next, mediation of CM in the pathway linking SZ-PRS and PLE was examined by structural equation modeling, while adjusting for a set of potential mediators including cannabis use, smoking, and neuroticism. In agreement with previous studies, PLE were strongly associated with SZ-PRS (B = 0.190, p = 0.009) and CM (B = 0.575, p < 0.001). Novel was that CM was also significantly associated with SZ-PRS (B = 0.171, p = 0.001), and substantially mediated the effects of SZ-PRS on PLE (proportion mediated = 29.9%, p = 0.001). In the replication cohort, the analyses yielded similar results, confirming equally strong mediation by CM (proportion mediated = 34.7%, p = 0.009). Our results suggest that CM acts as a mediator in the causal pathway linking SZ-PRS and psychosis risk. These findings open new perspectives on the relations between genetic and environmental risks and warrant further studies into potential interventions to reduce psychosis risk in vulnerable people.
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Affiliation(s)
- Mattia Marchi
- grid.7548.e0000000121697570Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 – 41125 Modena, Italy ,grid.5477.10000000120346234Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Laurent Elkrief
- grid.14848.310000 0001 2292 3357Department of Psychiatry, Université de Montréal, CHU Sainte-Justine Hospital, Montréal, QC Canada ,grid.411418.90000 0001 2173 6322Center Hospitalier Universitaire Sainte-Justine Research Center, Montreal, QC Canada
| | - Anne Alkema
- grid.5477.10000000120346234Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Willemijn van Gastel
- grid.5477.10000000120346234Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Chris D. Schubart
- grid.413202.60000 0004 0626 2490Department of Psychiatry, Tergooi Hospital, Blaricum, The Netherlands
| | - Kristel R. van Eijk
- grid.5477.10000000120346234Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Jurjen J. Luykx
- grid.5477.10000000120346234Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Susan Branje
- grid.5477.10000000120346234Department of Youth and Family, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands
| | - Stefanos Mastrotheodoros
- grid.5477.10000000120346234Department of Youth and Family, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands ,grid.8127.c0000 0004 0576 3437Department of Psychology, University of Crete, Rethymno, Greece
| | - Gian M. Galeazzi
- grid.7548.e0000000121697570Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 – 41125 Modena, Italy ,Department of Mental Health and Addiction Services, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Jim van Os
- grid.5477.10000000120346234Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Charlotte A. Cecil
- grid.5645.2000000040459992XDepartment of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Patricia J. Conrod
- grid.14848.310000 0001 2292 3357Department of Psychiatry, Université de Montréal, CHU Sainte-Justine Hospital, Montréal, QC Canada ,grid.411418.90000 0001 2173 6322Center Hospitalier Universitaire Sainte-Justine Research Center, Montreal, QC Canada
| | - Marco P. Boks
- grid.5477.10000000120346234Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
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18
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Arigo D, Torous J. Development of a Mobile Assessment Tool for Understanding Social Comparison Processes Among Individuals With Schizophrenia: Two-Phase Survey Study. JMIR Form Res 2022; 6:e36541. [PMID: 35499856 PMCID: PMC9112081 DOI: 10.2196/36541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background Digital tools may help to address social deficits in schizophrenia, particularly those that engage social comparison processes (ie, evaluating oneself relative to others). Yet, little is known about social comparison processes in schizophrenia or how best to capture between- versus within-person variability, which is critical to engaging comparisons in digital interventions. Objective The goals of this pilot study were to (1) better understand affective responses to social comparisons among individuals with schizophrenia, relative to healthy controls, using a validated global self-report measure; and (2) test a new brief, mobile assessment of affective responses to social comparison among individuals with schizophrenia, relative to the full measure. This study was conducted in 2 phases. Methods We first compared self-reported affective responses to social comparisons between individuals with schizophrenia (n=39) and healthy controls (n=38) using a traditional self-report measure, at 2 time points. We examined the temporal stability in responses and differences between groups. We then evaluated the performance of brief, mobile assessment of comparison responses among individuals with schizophrenia, completed over 12 weeks (n=31). Results Individuals with schizophrenia showed greater variability in affective responses to social comparison than controls on traditional measures and completed an average of 7.46 mobile assessments over 12 weeks. Mobile assessments captured within-person variability in affective responses in the natural environment (intraclass correlation coefficients of 0.40-0.60). Average scores for mobile assessments were positively correlated with responses to traditional measures. Conclusions Affective responses to social comparison vary both between and within individuals with schizophrenia and capturing this variability via smartphone surveys shows some evidence of feasibility. As affective variability is a potential indicator of poor outcomes among individuals with mental health conditions, in the future, a brief, mobile assessment of affective responses to social comparisons may be useful for screening among individuals with schizophrenia. Further research on this process is needed to identify when specific comparison messaging may be most effective in digital interventions and could suggest new therapeutic targets for illnesses such as schizophrenia.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ, United States.,Department of Family Medicine, Rowan School of Osteopathic Medicine, Stratford, NJ, United States
| | - John Torous
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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19
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Ranjan T, Melcher J, Keshavan M, Smith M, Torous J. Longitudinal symptom changes and association with home time in people with schizophrenia: An observational digital phenotyping study. Schizophr Res 2022; 243:64-69. [PMID: 35245703 DOI: 10.1016/j.schres.2022.02.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Smartphone assessments and sensors offer the ability to easily assess symptoms across environments in a naturalistic and longitudinal manner. However, the value of this new data to make inferences about personal vs population health and the role of environment in moderating symptoms in schizophrenia has not been fully explored in a scalable and reproducible manner. METHODS Eighty-six adults with a diagnosis of schizophrenia were recruited from the Greater Boston Area between August 2019 and May 2021. Using the open-source mindLAMP app in an observational manner, smartphone surveys and sensors (GPS, accelerometer, screen on/off and call and text logs) were collected for up to six months. RESULTS Sixty-three participants were analyzed, who had at least completed one survey in the app. App-based self-reported symptom surveys were highly correlated with scores on gold standard clinical assessments (r = 0.80, p = 10-11 for mood and r = 0.78, p = 10-12 for anxiety). For these app-based assessments, inter-individual differences account for a larger proportion of the correlations in longitudinal symptoms as compared to intra-individual differences. Mood, sleep, and psychosis symptoms reported on app surveys were more severe when taken at home as determined by the smartphone's GPS sensor. DISCUSSION The intra-individual symptom correlations and the stratification of symptoms by home-time highlight the utility of digital phenotyping methods as a diagnostic tool, as well as the potential for personalized psychiatric treatment building on this data.
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Affiliation(s)
- Tanvi Ranjan
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA; Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Jennifer Melcher
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Matcheri Keshavan
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Maurice Smith
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - John Torous
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA.
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20
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Smith RC, Sershen H, Janowsky DS, Lajtha A, Grieco M, Gangoiti JA, Gertsman I, Johnson WS, Marcotte TD, Davis JM. Changes in Expression of DNA-Methyltransferase and Cannabinoid Receptor mRNAs in Blood Lymphocytes After Acute Cannabis Smoking. Front Psychiatry 2022; 13:887700. [PMID: 35859599 PMCID: PMC9290435 DOI: 10.3389/fpsyt.2022.887700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cannabis use is a component risk factor for the manifestation of schizophrenia. The biological effects of cannabis include effects on epigenetic systems, immunological parameters, in addition to changes in cannabinoid receptors 1 and 2, that may be associated with this risk. However, there has been limited study of the effects of smoked cannabis on these biological effects in human peripheral blood cells. We analyzed the effects of two concentrations of tetrahydrocannabinol (THC) vs. placebo in lymphocytes of a subset of participants who enrolled in a double-blind study of the effects of cannabis on driving performance (outcome not the focus of this study). METHODS Twenty four participants who regularly use cannabis participated in an experiment in which they smoked cannabis cigarettes (5.9 or 13.4% THC) or placebo (0.02%) ad libitum. Blood samples were drawn at baseline and several times after smoking. Lymphocytes were separated and stored at -80°C for further analysis. Samples were analyzed for mRNA content for cannabinoid receptors 1 (CB1) and 2 (CB2), methylation and demethylating enzymes (DNMT, TET), glucocorticoid receptor (NRC3) and immunological markers (IL1B, TNFα) by qPCR using TaqMan probes. The results were correlated with THC whole blood levels during the course of the day, as well as THCCOOH baseline levels. Statistical analyses used analysis of variance and covariance and t-tests, or non-parametric equivalents for those values which were not normally distributed. RESULTS There were no differences in background baseline characteristics of the participants except that the higher concentration THC group was older than the low concentration and placebo groups, and the low concentration THC group had higher baseline CB2 mRNA levels. Both the 5.9 and 13.4% THC groups showed increased THC blood levels that then decreased toward baseline within the first hour. However, there were no significant differences between THC blood levels between the 5.9 and 13.4% groups at any time point. At the 4-h time point after drug administration the 13.4% THC group had higher CB2 (P = 0.021) and DNMT3A (P = 0.027) mRNA levels than the placebo group. DNMT1 mRNA levels showed a trend in the same direction (P = 0.056). The higher 13.4% THC group had significantly increased CB2 mRNA levels than the 5.9% concentration group at several post drug administration time points and showed trends for difference in effects for between 5.9 and 13.4% THC groups for other mRNAs. TET3 mRNA levels were higher in the 13.4% THC group at 55 min post-cannabis ingestion. When the high and lower concentration THC groups were combined, none of the differences in mRNA levels from placebo remained statistically significant. Changes in THC blood levels were not related to changes in mRNA levels. CONCLUSION Over the time course of this study, CB2 mRNA increased in blood lymphocytes in the high concentration THC group but were not accompanied by changes in immunological markers. The changes in DNMT and TET mRNAs suggest potential epigenetic effects of THC in human lymphocytes. Increases in DNMT methylating enzymes have been linked to some of the pathophysiological processes in schizophrenia and, therefore, should be further explored in a larger sample population, as one of the potential mechanisms linking cannabis use as a trigger for schizophrenia in vulnerable individuals. Since the two THC groups did not differ in post-smoking blood THC concentrations, the relationship between lymphocytic changes and the THC content of the cigarettes remains to be determined.
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Affiliation(s)
- Robert C Smith
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States.,Department of Psychiatry, NYU Grossman School of Medicine, New York University, New York, NY, United States
| | - Henry Sershen
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States.,Department of Psychiatry, NYU Grossman School of Medicine, New York University, New York, NY, United States
| | - David S Janowsky
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Abel Lajtha
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States.,Department of Psychiatry, NYU Grossman School of Medicine, New York University, New York, NY, United States
| | - Matthew Grieco
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Jon A Gangoiti
- Department of Pediatrics, University of California, San Diego, San Diego, CA, United States
| | - Ilya Gertsman
- Department of Pediatrics, University of California, San Diego, San Diego, CA, United States
| | - Wynnona S Johnson
- Department of Pediatrics, University of California, San Diego, San Diego, CA, United States
| | - Thomas D Marcotte
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - John M Davis
- Department of Psychiatry, Psychiatric Institute, University of Illinois Chicago, Chicago, IL, United States
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21
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Radhakrishnan R, Guloksuz S, D'Souza DC, van Os J. Editorial: Gone to Pot: Examining the Association Between Cannabis Use and Medical/Psychiatric Disorders. Front Psychiatry 2022; 13:837757. [PMID: 35211046 PMCID: PMC8861305 DOI: 10.3389/fpsyt.2022.837757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rajiv Radhakrishnan
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States
| | - Sinan Guloksuz
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States.,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Deepak C D'Souza
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States
| | - Jim van Os
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
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22
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Weiss DM, Bernier E, Robbins DR, Elacqua KM, Johnson KA, Powers K, Mesholam-Gately RI, Woodberry KA. Using Experience Sampling Methodology Data to Characterize the Substance Use of Youth With or At-Risk of Psychosis. Front Psychiatry 2022; 13:874246. [PMID: 35599768 PMCID: PMC9116148 DOI: 10.3389/fpsyt.2022.874246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/11/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Psychotic-spectrum disorders emerge during adolescence and early adulthood, which corresponds with the peak period for substance use initiation. Clinical and epidemiological data provide support that substance use is associated with psychotic symptom onset and severity. Experience-sampling methodology (ESM) data may provide additional insight into dynamic associations between substance use and psychotic symptoms. This is one of the first efforts to characterize substance use frequency and dynamic associations with psychotic symptoms and negative affect from ESM data in both clinical high risk (CHR) and early psychosis (EP) individuals. METHODS Using ESM, 33 individuals, including 17 with CHR and 16 EP (age range: 15-24), provided information on substance use, negative affect, and psychotic symptoms 6 times a day across a 21-day data collection window. Psychotic symptoms and negative affect included multi-item variables rated on a seven-point Likert Scale. Participants reported recent substance use for 4 drug classes (nicotine, cannabis, depressants, stimulants) via a yes/no item. Descriptive information included data on substance use frequency, and momentary negative affect and psychotic symptoms. Exploratory analyses included multi-level and person-level dynamic structural equation models, which assessed contemporaneous and lagged associations between substance use and symptoms. RESULTS Twenty-seven individuals (82%) reported recurrent substance use including stimulants (n = 12, 46%), nicotine (n = 9, 27%), cannabis (n = 6, 18%), and depressants (n = 4, 12%). Individuals with any recurrent substance use indicated usage at 47.7% of answered prompts; stimulants at 23.6%; nicotine at 74.2%; cannabis at 39.1%; and depressants at 20.1%. A multi-level dynamic structural equation model reflected that substance use (any class) was associated with lagged negative affect (β = -0.02, CI: -0.06, < -0.00) but no significant contemporaneous or lagged associations between substance use and psychotic symptoms. Person-level models suggest potentially meaningful inter-individual variability. CONCLUSIONS CHR and EP individuals use a range of substances that may both reflect and influence other experiences in daily life experiences. Data reflected moderate to high rates of recurrent substance use with more consistent use within nicotine and cannabis classes. ESM data have the potential to increase our understanding of the dynamic relationships between substance use and symptoms and to inform treatment for individuals in early course psychosis.
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Affiliation(s)
- David M Weiss
- Maine Medical Center Research Institute, MaineHealth, Portland, ME, United States
| | - Elizabeth Bernier
- Maine Medical Center Research Institute, MaineHealth, Portland, ME, United States
| | - Douglas R Robbins
- Maine Medical Center Research Institute, MaineHealth, Portland, ME, United States.,Department of Psychiatry, Tufts University School of Medicine, Boston, MA, United States
| | - Katherine M Elacqua
- Maine Medical Center Research Institute, MaineHealth, Portland, ME, United States
| | - Kelsey A Johnson
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Kate Powers
- Maine Medical Center Research Institute, MaineHealth, Portland, ME, United States
| | - Raquelle I Mesholam-Gately
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Kristen A Woodberry
- Maine Medical Center Research Institute, MaineHealth, Portland, ME, United States.,Department of Psychiatry, Tufts University School of Medicine, Boston, MA, United States
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