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Rodríguez-Toscano E, Martínez K, Fraguas D, Janssen J, Pina-Camacho L, Arias B, Vieta E, Mezquida G, Amoretti S, Bernardo M, Castro-Fornieles J, Cuesta-Zorita MJ, Lobo A, González-Pinto A, Collado IC, Mané A, Arango C, Parellada M. Prefrontal abnormalities, executive dysfunction and symptoms severity are modulated by COMT Val 158Met polymorphism in first episode psychosis. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:74-87. [PMID: 35840287 DOI: 10.1016/j.rpsmen.2022.07.001] [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: 05/17/2021] [Accepted: 11/06/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Core dysfunctions proposed for psychotic disorders include prefrontal cortex (PFC) dopaminergic hypoactivity, executive function (EF) deficits and reduced gray matter in the PFC. The Val variant of COMT Val158Met polymorphism is associated with reduced dopaminergic signaling in the PFC. However, it is unclear how COMT Val158Met modulates PFC gray matter reduction, EF deficits and symptom severity at the time of the first psychotic episode. METHODS The effect of COMT on both EF performance and prefrontal volume (PFC-VOL) was tested in 158 first episode psychosis (FEP) patients and 141 healthy controls (HC) matched for age (range 9-35 years), sex, ethnicity, handedness and COMT Val158Met distribution. EF and PFC-VOL were compared between FEP and HC groups within each polymorphism status (Met/Met versus Val carriers) to assess whether COMT influenced diagnostic differences. Next, correlations between PFC-VOL and EF performance were computed, as well as between both variables and other clinical characteristics of interest (PANSS scores, PAS infancy and premorbid IQ) in the FEP sample. RESULTS COMT influenced the diagnostic differences mainly in PFC-VOL, but also in EF performance. FEP-Val carriers showed lower EF scores and reduced PFC-VOL compared to the HC group but also poorer EF performance than FEP Met/Met. Poorer EF performance was associated with smaller PFC-VOL, and both were related to increased severity of negative symptoms, poorer premorbid adjustment, and lower estimated premorbid IQ in FEP patients. CONCLUSIONS Our findings suggest that COMT Val158Met polymorphism might contribute to PFC-VOL reductions, executive dysfunctions and symptom severity in FEP patients.
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Affiliation(s)
- Elisa Rodríguez-Toscano
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Experimental Psychology, Cognitive Psychology and Speech & Language Therapy Immunology, Faculty of Psychology, Universidad Complutense Madrid, Spain.
| | - Kenia Martínez
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain
| | - David Fraguas
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain
| | - Laura Pina-Camacho
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Bárbara Arias
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, CIBERSAM, Barcelona, Spain
| | - Eduard Vieta
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Gisela Mezquida
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Spain
| | - Silvia Amoretti
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Spain
| | - Miguel Bernardo
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain
| | - Manuel Jesús Cuesta-Zorita
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Zaragoza University, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, CIBERSAM, Madrid, Spain
| | - Ana González-Pinto
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Department of Neurociences, University of the Basque Country, Vitoria, Spain
| | - Iluminada Corripio Collado
- Department of Psychiatry, Sant Pau Hospital, Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Anna Mané
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital del Mar Medical Research Institute (IMIM), Spain; Autonomous University of Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain; School of Medicine, Universidad Complutense, Madrid, Spain
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Hamm NC, Hamad AF, Wall-Wieler E, Roos LL, Plana-Ripoll O, Lix LM. Multigenerational health research using population-based linked databases: an international review. Int J Popul Data Sci 2021; 6:1686. [PMID: 34734126 PMCID: PMC8530190 DOI: 10.23889/ijpds.v6i1.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Family health history is a well-established risk factor for many health conditions but the systematic collection of health histories, particularly for multiple generations and multiple family members, can be challenging. Routinely-collected electronic databases in a select number of sites worldwide offer a powerful tool to conduct multigenerational health research for entire populations. At these sites, administrative and healthcare records are used to construct familial relationships and objectively-measured health histories. We review and synthesize published literature to compare the attributes of routinely-collected, linked databases for three European sites (Denmark, Norway, Sweden) and three non-European sites (Canadian province of Manitoba, Taiwan, Australian state of Western Australia) with the capability to conduct population-based multigenerational health research. Our review found that European sites primarily identified family structures using population registries, whereas non-European sites used health insurance registries (Manitoba and Taiwan) or linked data from multiple sources (Western Australia). Information on familial status was reported to be available as early as 1947 (Sweden); Taiwan had the fewest years of data available (1995 onwards). All centres reported near complete coverage of familial relationships for their population catchment regions. Challenges in working with these data include differentiating biological and legal relationships, establishing accurate familial linkages over time, and accurately identifying health conditions. This review provides important insights about the benefits and challenges of using routinely-collected, population-based linked databases for conducting population-based multigenerational health research, and identifies opportunities for future research within and across the data-intensive environments at these six sites.
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Affiliation(s)
- Naomi C Hamm
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3
| | - Amani F Hamad
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3
| | - Elizabeth Wall-Wieler
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, CANADA, R3E 3P5
| | - Leslie L Roos
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, CANADA, R3E 3P5
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, DENMARK, 8210
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3
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Rodríguez-Toscano E, Martínez K, Fraguas D, Janssen J, Pina-Camacho L, Arias B, Vieta E, Mezquida G, Amoretti S, Bernardo M, Castro-Fornieles J, Cuesta-Zorita MJ, Lobo A, González-Pinto A, Collado IC, Mané A, Arango C, Parellada M. Prefrontal abnormalities, executive dysfunction and symptoms severity are modulated by COMT Val158Met polymorphism in first episode psychosis. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021. [DOI: 10.1016/j.rpsm.2021.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Fraguas D, Díaz-Caneja CM, Corripio I, González-Pinto A, Lobo A, Bioque M, Cuesta MJ, Sanjuán J, Rodríguez-Toscano E, Arias B, Sarró S, Cabrera B, Bulbena A, Vieta E, Castro-Fornieles J, Arango C, Bernardo M, Parellada M. Gene-environment interaction as a predictor of early adjustment in first episode psychosis. Schizophr Res 2017; 189:196-203. [PMID: 28262436 DOI: 10.1016/j.schres.2017.02.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/14/2017] [Accepted: 02/16/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study aims to explore the gene-environment interaction hypothesis applied to pre-symptomatic neurodevelopmental phenotypes of first episode psychosis (FEP), that is, genetic factors might increase vulnerability to the effects of environmental adverse conditions occurring at later stages of development. METHODS We constructed a schematic 'two-hit' model, with Val/Val homozygosity for the catechol-O-methyltransferase (COMT) Val158Met polymorphism as the 'first hit' and history of obstetric complications and parental socioeconomic status as 'second hits'. Early adjustment, measured using the Premorbid Adjustment Scale, was considered the main outcome. The study population comprised 221 adolescents and adults with FEP and 191 sex- and age-matched controls. RESULTS The interaction between the Val/Val COMT genotype and a positive history of obstetric complications plus low parental socioeconomic status was significantly associated with poorer early adjustment. These results were observed both in FEP individuals and in controls, and remained significant after controlling for age, sex, and diagnosis. CONCLUSIONS Individuals carrying Val/Val seem to be more sensitive to the synergistic effect of environmental factors acting early in neurodevelopment, which leads to vulnerability phenotypes such as impaired early adjustment.
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Affiliation(s)
- David Fraguas
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona; Universitat Autònoma de Barcelona (UAB), CIBERSAM, Barcelona, Spain
| | - Ana González-Pinto
- BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, CIBERSAM, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, CIBERSAM, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, Hospital Clinic, University of Valencia, INCLIVA, CIBERSAM, Valencia, Spain
| | - Elisa Rodríguez-Toscano
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Bárbara Arias
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, IBUB, CIBERSAM, Barcelona, Spain
| | - Salvador Sarró
- FIDMAG Hermanas Hospitalarias, CIBERSAM, Barcelona, Spain
| | - Bibiana Cabrera
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain
| | - Antoni Bulbena
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona; Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona UAB, Bellaterra, Spain
| | - Eduard Vieta
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit, Neurosciences Institute, Hospital Clínic, Barcelona, Spain; Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
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Hennig T, Jaya ES, Koglin U, Lincoln TM. Associations of attention-deficit/hyperactivity and other childhood disorders with psychotic experiences and disorders in adolescence. Eur Child Adolesc Psychiatry 2017; 26:421-431. [PMID: 27623819 DOI: 10.1007/s00787-016-0904-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 09/06/2016] [Indexed: 12/31/2022]
Abstract
Prodromal symptoms of psychosis are associated with an increased risk of transition, functional impairment, poor mental health, and unfavorable developmental prospects. Existing interventions targeting the prodrome are non-satisfactory. It may thus be more promising to attempt to identify risk factors in the premorbid phase preceding the prodrome to increase the chances of successful preventive approaches. Here, we investigate whether childhood mental disorders in general and attention-deficit/hyperactivity disorder (ADHD) specifically indicate a risk for subsequent psychotic experiences and disorders. We used a sample from the prospective Avon Longitudinal Study of Parents and Children (N = 5528). When the participants were 7 years old, mental disorders were assigned according to the DSM-IV. In standardized interviews, psychotic experiences were assessed at age 12 and psychotic disorders at age 18. We examined the associations of each of the childhood mental disorders alone and in combination with psychotic experiences at age 12 and psychotic disorders at age 18 using logistic regression. Compared to participants without a disorder, participants with a mental disorder had a higher risk of psychotic experiences at age 12 (OR 1.70, 95 % CI 1.28-2.27) and of psychotic disorders at age 18 (OR 2.31, 95 % CI 1.03-5.15). Particularly, the ADHD combined subtype at age 7 was strongly associated with psychotic experiences at age 12 (OR 3.26, 95 % CI 1.74-6.10). As expected, childhood mental disorders are risk indicators of psychotic experiences and disorders. To improve prevention, health care professionals need to screen for psychotic experiences in children with non-psychotic disorders.
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Affiliation(s)
- Timo Hennig
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Hamburg, Germany.
| | - Edo S Jaya
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Hamburg, Germany
| | - Ute Koglin
- Department of Special Needs Education and Rehabilitation, University of Oldenburg, Oldenburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Hamburg, Germany
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Papiol S, Fatjó-Vilas M, Schulze TG. Neurological soft signs in patients with schizophrenia: current knowledge and future perspectives in the post-genomics era. ACTA ACUST UNITED AC 2016. [DOI: 10.3402/tdp.v4.30071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Schiffman J, Kline E, Jameson N, Sorensen HJ, Dodge S, Tsuji T, Mortensen EL, Mednick S. Premorbid multivariate prediction of adult psychosis-spectrum disorder: A high-risk prospective investigation. Schizophr Res 2015; 168. [PMID: 26213343 PMCID: PMC4591206 DOI: 10.1016/j.schres.2015.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Premorbid prediction of psychosis-spectrum disorders has implications for both understanding etiology and clinical identification. The current study used a longitudinal high-risk for psychosis design that included children of parents with schizophrenia as well as two groups of controls (children whose parents had no mental illness, and children with at least one parent with a non-psychotic psychiatric diagnosis). Premorbid neurological factors and an indication of social function, as measured when participants were 10-13years of age, were combined to predict psychosis-spectrum disorders in adulthood. Through a combination of childhood predictors, the model correctly classified 82% (27 of 33) of the participants who eventually developed a psychosis-spectrum outcome in adulthood. With replication, multivariate premorbid prediction, including genetic risk, social, and neurological variables, could potentially be a useful complementary approach to identifying individuals at risk for developing psychosis-spectrum disorders.
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Affiliation(s)
- Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, United States.
| | - Emily Kline
- Department of Psychiatry, Harvard Medical School at Beth Israel, Deaconess Medical Center
| | - Nicole Jameson
- Department of Psychology, University of Maryland, Baltimore County
| | - Holger J. Sorensen
- Department of Psychiatry, Amager Hospital, Capital Region of Denmark, Copenhagen University Hospital, Denmark,Institute of Public Health and Center for Healthy Aging, University of Copenhagen
| | - Shana Dodge
- University of Hawaii (currently works for Engility Corporation)
| | - Thomas Tsuji
- Department of Psychology, University of Maryland, Baltimore County
| | - Erik L. Mortensen
- Institute of Public Health and Center for Healthy Aging, University of Copenhagen,Institute of Preventive Medicine, Copenhagen University Hospital, Denmark
| | - Sarnoff Mednick
- Institute of Preventive Medicine, Copenhagen University Hospital, Denmark,University of Southern California
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Bratlien U, Øie M, Haug E, Møller P, Andreassen OA, Lien L, Melle I. Self-reported symptoms and health service use in adolescence in persons who later develop psychotic disorders: a prospective case-control study. Early Interv Psychiatry 2015; 9:221-7. [PMID: 24224904 DOI: 10.1111/eip.12102] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 09/22/2013] [Indexed: 01/12/2023]
Abstract
AIM To investigate self-reported psychiatric and somatic symptoms and health service use at age 16 in persons who later developed a psychotic disorder compared with a control group from the same geographical areas. METHOD Responses concerning psychiatric or somatic health and health service use from Norwegian youth studies in a cohort of 15- and 16-year-olds in three Norwegian counties (N = 11 101, 90% response rate) were gathered. The questionnaire responses from persons later identified with a lifetime diagnosis of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) psychotic disorders (n = 30) (confirmed psychosis, CP) were compared with responses from the rest of the group (population control, PC) (n = 11 067). Follow-up analyses were made for cases with a confirmed onset of a psychotic disorder after the time of the survey (n = 21). RESULTS The main significant differences between the CP and PC groups were more self-reported anxiety, depression and 'feeling in need of treatment for eating disorders' at age 16 in the CP group. The rate of self-reported eating disorder symptoms alone reached the level of statistical significance in the follow-up analyses. The CP group did not use available health services to a markedly greater extent than the control group. CONCLUSION We found that, in comparison with others, youths who were later identified with a psychotic disorder reported more symptoms at age 16.
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Affiliation(s)
- Unni Bratlien
- Division of Mental Health, Innlandet Hospital Trust, Ottestad, Norway
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Davidsen KA, Harder S, MacBeth A, Lundy JM, Gumley A. Mother-infant interaction in schizophrenia: transmitting risk or resilience? A systematic review of the literature. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1785-98. [PMID: 26454698 PMCID: PMC4654744 DOI: 10.1007/s00127-015-1127-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 09/22/2015] [Indexed: 12/02/2022]
Abstract
PURPOSE The parent-infant relationship is an important context for identifying very early risk and resilience factors and targets for the development of preventative interventions. The aim of this study was to systematically review studies investigating the early caregiver-infant relationship and attachment in offspring of parents with schizophrenia. METHODS We searched computerized databases for relevant articles investigating the relationship between early caregiver-infant relationship and outcomes for offspring of a caregiver with a diagnosis of schizophrenia. Studies were assessed for risk of bias. RESULTS We identified 27 studies derived from 10 cohorts, comprising 208 women diagnosed with schizophrenia, 71 with other psychoses, 203 women with depression, 59 women with mania/bipolar disorder, 40 with personality disorder, 8 with unspecified mental disorders and 119 non-psychiatric controls. There was some evidence to support disturbances in maternal behaviour amongst those with a diagnosis of schizophrenia and there was more limited evidence of disturbances in infant behaviour and mutuality of interaction. CONCLUSIONS Further research should investigate both sources of resilience and risk in the development of offspring of parents with a diagnosis of schizophrenia and psychosis. Given the lack of specificity observed in this review, these studies should also include maternal affective disorders including depressive and bipolar disorders.
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Affiliation(s)
- Kirstine Agnete Davidsen
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark. .,Department of Child and Adolescent Mental Health Odense, Research Unit, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.
| | - Susanne Harder
- />Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Angus MacBeth
- />School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, UK
| | - Jenna-Marie Lundy
- />Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Andrew Gumley
- />Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
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Abstract
After over 100 years of research without clarifying the aetiology of schizophrenia, a look at the current state of knowledge in epidemiology, genetics, precursors, psychopathology, and outcome seems worthwhile. The disease concept, created by Kraepelin and modified by Bleuler, has a varied history. Today, schizophrenia is considered a polygenic disorder with onset in early adulthood, characterized by irregular psychotic episodes and functional impairment, but incident cases occur at all ages with marked differences in symptoms and social outcome. Men’s and women’s lifetime risk is nearly the same. At young age, women fall ill a few years later and less severely than men, men more rarely and less severely later in life. The underlying protective effect of oestrogen is antagonized by genetic load. The illness course is heterogeneous and depressive mood the most frequent symptom. Depression and schizophrenia are functionally associated, and affective and nonaffective psychoses do not split neatly. Most social consequences occur at the prodromal stage. Neither schizophrenia as such nor its main symptom dimensions regularly show pronounced deterioration over time. Schizophrenia is neither a residual state of a neurodevelopmental disorder nor a progressing neurodegenerative process. It reflects multifactorial CNS instability, which leads to cognitive deficits and symptom exacerbations.
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Artigue J, Tizón JL. [Review of risks factors in childhood for schizophrenia and severe mental disorders in adulthood]. Aten Primaria 2014; 46:336-56. [PMID: 24697917 PMCID: PMC6985599 DOI: 10.1016/j.aprim.2013.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 11/08/2013] [Accepted: 11/11/2013] [Indexed: 11/04/2022] Open
Abstract
AIM To provide scientific evidence, using a literature review on psychosocial risk factors in mental health, that a high exposure to psychosocial stress situations in childhood increases the risk of mental disorders in adulthood,. DESIGN A literature review up to December 2011 in the electronic databases from Medline, Universitat de Barcelona, and the Universitat Autonoma de Barcelona. The keywords used were: childhood, prenatal, vulnerability, risk, abuse, neglect, child mental disorder, schizophrenia, and prevention. Inclusion criteria for the studies reviewed: 1) designed to investigate childhood risk factors; 2) Comparative studies with persons without risk factors; 3) Studies with sufficient statistical significance; 4) Studies with "n" participants equal to o more than 30 persons. RESULTS There are a group of easily identifiable mental health risk factors in childhood that can help in the prevention of mental disorders in the adulthood. They can be grouped into four categories: A) Pregnancy, birth and perinatal problems; B) Poor interpersonal relations with parents; C) Adverse life events in the first two years of life; D) Cognitive deficits in primary school, and social isolation during school years. CONCLUSIONS There are life events that may increase the possibilities of suffering some kind of Psychopathology. It is necessary to consider those events as Risk Factors for Mental Health. The accumulation of these Risk Factors increases vulnerability to Mental Disorders.
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Affiliation(s)
- Jordi Artigue
- Psicólogo clínico, Doctor en Psicología, Psicoanalista IPB, Grupo de investigación Pareja y Familia, Universitat Ramón Llull, Barcelona, España.
| | - Jorge L Tizón
- Psiquiatra, Psicoanalista SEP-IPA, Institut Universitari de Salut Mental, Universitat Ramón Llull, Barcelona, España
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12
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Fryers T, Brugha T. Childhood determinants of adult psychiatric disorder. Clin Pract Epidemiol Ment Health 2013; 9:1-50. [PMID: 23539489 PMCID: PMC3606947 DOI: 10.2174/1745017901309010001] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 06/22/2012] [Accepted: 07/07/2012] [Indexed: 02/06/2023]
Abstract
The aim of this project was to assess the current evidence from longitudinal studies for childhood determinants of adult mental illness. Because of the variable and often prolonged period between factors in childhood and the identification of mental illness in adults, prospective studies, particularly birth cohorts, offer the best chance of demonstrating associations in individuals. A review was undertaken in 2006 of the published literature from longitudinal studies, together with some large-scale retrospective studies and relevant reviews which provided supplementary evidence. The main focus was upon potentially ameliorable characteristics, experiences or situations of childhood; however, other factors, not determinants but pre-cursors, associated with later mental illness could not be left out. Seven major electronic data-bases of published research were interrogated with a range of key-words and the results supplemented from personal searches, enquiries and reference trails. In excess of 1,500 abstracts were read to select 250 papers for full review. The material was assessed in relation to ten factors: Psychological disturbance; Genetic Influences; Neurological Deviance; Neuroticism; Behaviour; School Performance; Adversity; Child Abuse or Neglect; Parenting and parent-child relationships; Disrupted and Disfunctional Families. In 2011 the search was repeated for the period 2006 to mid-2011, using the same search terms and supplemented in the same manner. Over 1,800 abstracts emerged and almost 200 papers selected for more detailed review. These were then integrated into the original text with modifications where necessary. The whole text was then revised and edited in January / February 2012. There is continuing evidence for the association with later mental ill-health for each of these ten factors, but with different degrees of conviction. The evidence for each is discussed in detail and weighed both separately and in relation to others. These are then summarised, and the research implications are considered. Finally, the implications for prevention are discussed together with the practical potential for preventive and health-promoting programmes.
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Affiliation(s)
- Tom Fryers
- International and Public Health, School of Health Sciences, New York Medical College, USA ; Department of Health Sciences, University of Leicester, UK
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Golembo-Smith S, Schiffman J, Kline E, Sørensen HJ, Mortensen EL, Stapleton L, Hayashi K, Michelsen NM, Ekstrøm M, Mednick S. Premorbid multivariate markers of neurodevelopmental instability in the prediction of adult schizophrenia-spectrum disorder: a high-risk prospective investigation. Schizophr Res 2012; 139:129-35. [PMID: 22664169 PMCID: PMC3393829 DOI: 10.1016/j.schres.2012.05.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 05/05/2012] [Accepted: 05/10/2012] [Indexed: 10/28/2022]
Abstract
The authors examined whether multiple childhood indicators of neurodevelopmental instability known to relate to schizophrenia-spectrum disorders could predict later schizophrenia-spectrum outcomes. A standardized battery of neurological and intellectual assessments was administered to a sample of 265 Danish children in 1972, when participants were 10-13 years old. Parent psychiatric diagnoses were also obtained in order to evaluate the predictive strength of neurodevelopmental factors in combination with genetic risk. Adult diagnostic information was available for 244 members of the sample. Participants were grouped into three categories indicating level of genetic risk: children with a parent with schizophrenia (n=94); children with a parent with a non-psychotic mental health diagnosis (n=84); and children with a parent with no records of psychiatric hospitalization (n=66). Variables measured included minor physical anomalies (MPAs), coordination, ocular alignment, laterality, and IQ. Adult diagnoses were assessed through psychiatric interviews in 1992, as well as through a scan of the national psychiatric registry through 2007. Through a combination of multiple childhood predictors, the model correctly classified 73% (24 of 33) of the participants who eventually developed a schizophrenia-spectrum outcome in adulthood. Results suggest that, with replication, multivariate premorbid prediction could potentially be a useful complementary approach to identifying individuals at risk for developing a schizophrenia-spectrum disorder. Genetic risk, MPAs, and other markers of neurodevelopmental instability may be useful for comprehensive prediction models.
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Affiliation(s)
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County
| | - Emily Kline
- Department of Psychology, University of Maryland, Baltimore County
| | - Holger J. Sørensen
- Department of Psychiatry, Amager Hospital, Capital Region of Denmark, Copenhagen University Hospital, Denmark,Institute of Preventive Medicine, Copenhagen University Hospital, Denmark
| | - Erik L. Mortensen
- Institute of Public Health and Center for Healthy Aging, University of Copenhagen, Denmark,Institute of Preventive Medicine, Copenhagen University Hospital, Denmark
| | | | | | - Niels M. Michelsen
- Institute of Preventive Medicine, Copenhagen University Hospital, Denmark
| | - Morten Ekstrøm
- Institute of Preventive Medicine, Copenhagen University Hospital, Denmark
| | - Sarnoff Mednick
- Institute of Preventive Medicine, Copenhagen University Hospital, Denmark
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Lukkari S, Hakko H, Herva A, Pouta A, Riala K, Räsänen P. Exposure to obstetric complications in relation to subsequent psychiatric disorders of adolescent inpatients: specific focus on gender differences. Psychopathology 2012; 45:317-26. [PMID: 22797654 DOI: 10.1159/000336073] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 12/27/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Exposure to obstetric complications is known to be associated with subsequent development of psychiatric disorders. However, earlier findings are mainly based on adult populations having a long follow-up time for onset of psychiatric illness. We examined whether the association of obstetric complications with severe mental disorders is already seen in a population of underage adolescents admitted to psychiatric inpatient care. METHOD The study population was a clinical sample of adolescents (n = 508) aged 12-17 years admitted to psychiatric hospital. DSM-IV diagnoses of the psychiatric disorders of the adolescents as well as information on obstetric (i.e., pregnancy, delivery and perinatal) complications and substance use during pregnancy reported by the mothers of the adolescents were based on the semi-structured Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime. RESULTS A total of 96 (19%) adolescents had been exposed to obstetric complications. The prevalence of pregnancy, delivery or perinatal complications reported by the mothers of the offspring was 55 (57%), 57 (59%) and 13 (14%), respectively. Among adolescents with conduct disorder, exposure to delivery complications was more common among males compared to females (16 vs. 5%, p = 0.006); this was particularly true for section delivery (7 vs. 1%, p = 0.023). A trend towards a significant gender difference was also found among adolescents with anxiety disorder (21 vs. 8%, p = 0.085). CONCLUSIONS Boys seem to be more vulnerable to the exposure of delivery complications than girls. Exposure to obstetric complication may be associated with development of subsequent psychiatric disorder; particularly conduct disorder of adolescent boys.
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Affiliation(s)
- Sari Lukkari
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
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Subramaniam M, Verma S, Cheok C, Lee IM, Wong J, Chong SA. Prevalence and correlates of psychotic symptoms among Asian males. Soc Psychiatry Psychiatr Epidemiol 2012; 47:137-44. [PMID: 21046067 DOI: 10.1007/s00127-010-0318-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 10/22/2010] [Indexed: 11/25/2022]
Abstract
PURPOSE Psychotic symptoms have been reported at varying rates in the general population in the West. We studied the association of psychotic symptoms with educational attainment and other psychiatric disorders in 23,248 male pre-enlistees for National Service in Singapore. METHODS In a 2-stage assessment, these enlistees were first screened with the Self-Reporting Questionnaire (SRQ-24) and the CRAFFT. Those screened positive were then assessed by the Composite International Diagnostic Interview (CIDI) to establish the presence of psychiatric disorders based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). RESULTS The rate of psychotic symptoms (after excluding those with psychotic disorders) was 8.2% (n = 1,909). A multinomial logistic regression using the controls as the reference group revealed that younger age, lower PSLE scores, and mood and anxiety disorder remained significantly associated with both the diagnoses of psychotic disorders and the presence of psychotic symptoms. CONCLUSIONS A combination of categorical and dimensional representation of psychopathology for the diagnosis of psychotic disorders would better inform treatment and prognosis as there is a considerable overlap in the presentation of psychotic symptoms and psychotic disorders.
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Affiliation(s)
- Mythily Subramaniam
- Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Republic of Singapore.
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Margari F, Petruzzelli MG, Lecce PA, Todarello O, De Giacomo A, Lucarelli E, Martinelli D, Margari L. Familial liability, obstetric complications and childhood development abnormalities in early onset schizophrenia: a case control study. BMC Psychiatry 2011; 11:60. [PMID: 21492438 PMCID: PMC3090339 DOI: 10.1186/1471-244x-11-60] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 04/14/2011] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Genetic and environmental risk factors and gene-environment interactions are linked to higher likelihood of developing schizophrenia in accordance with the neurodevelopmental model of disease; little is known about risk factors and early development in early-onset schizophrenia (EOS) and very early-onset schizophrenia (VEOS). METHODS We present a case-control study of a sample of 21 patients with EOS/VEOS and a control group of 21 patients with migraine, recruited from the Child Neuropsychiatry Unit, Department of Neurologic and Psychiatric Science, University of Bari, Italy. The aim was to assess the statistical association between VEOS/EOS and family history for psychiatric disorders, obstetric complications and childhood developmental abnormalities using 2 × 2 tables and a Chi Squared or Fisher test. RESULTS The results show a statistical association between EOS/VEOS and schizophrenia and related disorders (P = 0.02) and personality disorders (P = 0.003) in relatives, and between EOS/VEOS and developmental abnormalities of early relational skills (P = 0.008) and learning (P = 0.04); there is not a statistically relevant difference between cases and controls (P > 0.05) for any obstetric complications (pre, peri and postpartum). CONCLUSIONS This study confirms the significant role of familial liability but not of obstetric complications in the pathogenesis of VEOS/EOS; the association between childhood developmental abnormalities and EOS/VEOS supports the neurodevelopmental model of disease.
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Affiliation(s)
- Francesco Margari
- Department of Neurologic and Psychiatric Sciences, Child Neuropsychiatric Unit, University of Bari, Bari, Italy.
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17
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A possible role for the striatum in the pathogenesis of the cognitive symptoms of schizophrenia. Neuron 2010; 65:585-96. [PMID: 20223196 DOI: 10.1016/j.neuron.2010.02.014] [Citation(s) in RCA: 334] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2010] [Indexed: 11/22/2022]
Abstract
The cognitive symptoms of schizophrenia are largely resistant to current treatment and are thus a life-long burden of the illness. Studies of cognitive symptoms have commonly focused on prefrontal cortex because of its demonstrated importance for executive function and working memory--key components of the deficit. The role of striatal-cortical circuitry and therefore the striatum itself has received much less attention. Here we review longstanding evidence that the striatum and its cortical connections are critical for complex cognition and discuss emerging evidence of the striatum's potential involvement in cognitive symptoms. Finally, we suggest how mouse models might test ideas about the contribution of early striatal dysfunction to the cognitive symptoms of schizophrenia.
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Welham J, Scott J, Williams GM, Najman JM, Bor W, O'Callaghan M, McGrath J. The antecedents of non-affective psychosis in a birth-cohort, with a focus on measures related to cognitive ability, attentional dysfunction and speech problems. Acta Psychiatr Scand 2010; 121:273-9. [PMID: 19694626 DOI: 10.1111/j.1600-0447.2009.01470.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Adults with non-affective psychosis show subtle deviations in a range of developmental trajectories as children and adolescents. METHOD Based on a birth-cohort (n = 3801), we examined the Peabody Picture Vocabulary Test (PPTV) at age 5, and Raven's Standard Progressive Matrices (RSPM) and Wide Range Achievement Test reading scale (WRAT-R) at age 14. Items related to speech problems and attentional dysfunction were available from maternal- or self-report. At age 21, we identified 60 cohort members who were screen-positive for non-affective psychosis (SP-NAP). RESULTS Impaired performance on the PPVT and RSPM (but not WRAT-R) predicted SP-NAP for males only. Male cohort members in the highest quartile for attentional dysfunction at ages 5 and 14 were about 5-8 times more likely to develop SP-NAP. SP-NAP in males was significantly associated with speech problems at age 14. CONCLUSION Males who develop non-affective psychoses have subtle impairments in cognitive capacity prior to the development of their psychotic disorder.
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Affiliation(s)
- J Welham
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia
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Academic attainment: a predictor of psychiatric disorders? Soc Psychiatry Psychiatr Epidemiol 2009; 44:999-1004. [PMID: 19294321 DOI: 10.1007/s00127-009-0027-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Accepted: 02/24/2009] [Indexed: 10/21/2022]
Abstract
AIM Poor academic performance can reflect the neurobiological abnormalities underlying schizophrenia and has been suggested as a premorbid marker for the disorder. However, it is not clear as to how academic performance compares as a marker for other mental disorders. The objective of this study was to examine whether educational attainment is a candidate marker for certain psychiatric disorders. METHODS Using a retrospective cohort design, we compared the early educational performance of 6957 National Service male conscripts. The presence of mental illness was assessed using the Composite International Diagnostic Interview. Academic performance was assessed using the results of a standardized national examination after 6 years of primary education. RESULTS Adjusting for ethnicity, the scores from this examination revealed that those with schizophrenia spectrum disorders scored significantly lower than those without any mental illness. CONCLUSIONS Poor educational attainment predicts the onset of schizophrenia spectrum disorders and could be a possible predictor for this specific group of mental illness.
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Dutt A, McDonald C, Dempster E, Prata D, Shaikh M, Williams I, Schulze K, Marshall N, Walshe M, Allin M, Collier D, Murray R, Bramon E. The effect of COMT, BDNF, 5-HTT, NRG1 and DTNBP1 genes on hippocampal and lateral ventricular volume in psychosis. Psychol Med 2009; 39:1783-1797. [PMID: 19573260 DOI: 10.1017/s0033291709990316] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Morphometric endophenotypes which have been proposed for psychotic disorders include lateral ventricular enlargement and hippocampal volume reductions. Genetic epidemiological studies support an overlap between schizophrenia and bipolar disorder, and COMT, BDNF, 5-HTT, NRG1 and DTNBP1 genes have been implicated in the aetiology of both these disorders. This study examined associations between these candidate genes and morphometric endophenotypes for psychosis. METHOD A total of 383 subjects (128 patients with psychosis, 194 of their unaffected relatives and 61 healthy controls) from the Maudsley Family Psychosis Study underwent structural magnetic resonance imaging and genotyping. The effect of candidate genes on brain morphometry was examined using linear regression models adjusting for clinical group, age, sex and correlations between members of the same family. RESULTS The results showed no evidence of association between variation in COMT genotype and lateral ventricular, and left or right hippocampal volumes. Neither was there any effect of the BDNF, 5-HTTLPR, NRG1 and DTNBP1 genotypes on these regional brain volumes. CONCLUSIONS Abnormal hippocampal and lateral ventricular volumes are among the most replicated endophenotypes for psychosis; however, the influences of COMT, BDNF, 5-HTT, NRG1 and DTNBP1 genes on these key brain regions must be very subtle if at all present.
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Affiliation(s)
- A Dutt
- NIHR Biomedical Research Centre, Institute of Psychiatry (King's College London)/South London and Maudsley NHS Foundation Trust, London, UK.
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Welham J, Isohanni M, Jones P, McGrath J. The antecedents of schizophrenia: a review of birth cohort studies. Schizophr Bull 2009; 35:603-23. [PMID: 18658128 PMCID: PMC2669575 DOI: 10.1093/schbul/sbn084] [Citation(s) in RCA: 173] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Birth cohort (BC) studies demonstrate that individuals who develop schizophrenia differ from the general population on a range of developmental indices. The aims of this article were to summarize key findings from BC studies in order to identify areas of convergence and to outline areas requiring further research. METHOD We define BC studies as studies based on general population BCs where data are collected prospectively from birth or childhood and which identify schizophrenia or related disorders as an outcome. To identify such studies, we searched various electronic databases using the search parameters (schizo* OR psych*) AND (birth cohort). We also checked the references of relevant articles and previous reviews. RESULTS We identified 11 BCs from 7 countries that have examined schizophrenia as an outcome in adulthood. There is relatively consistent evidence that, as a group, children who later develop schizophrenia have behavioral disturbances and psychopathology, intellectual and language deficits, and early motor delays. Evidence with respect to alterations in language, educational performance, and physical growth has also been identified in some studies. BC studies have also contributed evidence about a wide range of putative risk factors for schizophrenia. CONCLUSIONS BC studies have provided important, convergent insights into how the developmental trajectory of individuals who develop schizophrenia differs from their peers. The combination of new paradigms and larger cohorts, with the tools of modern epidemiology and biomedical science, is advancing our understanding of the developmental pathways to schizophrenia.
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Affiliation(s)
- Joy Welham
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia.
| | - Matti Isohanni
- Department of Psychiatry, University of Oulu, PO BOX 5000, Oulu 90014, Finland
| | - Peter Jones
- Department of Psychiatry, University of Cambridge, Cambridge CB2QQ, UK
| | - John McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia,Department of Psychiatry,Queensland Brain Institute, University of Queensland, St Lucia, QLD 4072, Australia,To whom correspondence should be addressed; tel: +61-7-3271-8694, fax: +61-7-3271-8698, e-mail:
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Koponen H, Mäki P, Halonen H, Miettunen J, Laitinen J, Tammelin T, Moilanen I, Taanila A, Ruokonen A, Korkeila J, Veijola J. Insulin resistance and lipid levels in adolescents with familial risk for psychosis. Acta Psychiatr Scand 2008; 117:337-41. [PMID: 18241302 DOI: 10.1111/j.1600-0447.2008.01154.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Type 2 diabetes and dyslipidemias co-occur frequently with schizophrenia. It is not known how common they are in adolescents with a familial risk for psychosis. METHOD The Northern Finland 1986 Birth Cohort consists of 9432 children born alive in the two Northernmost provinces in Finland. At the age of 15/16 they participated in clinical examination including measurements of glucose, lipids and IR, and a questionnaire including items about their diet and physical activity. The Finnish Hospital Discharge Register was used to find out non-organic psychoses in parents during 1972-2000. This familial risk was found out in 54 boys and 68 girls. Their results were compared with other cohort members. RESULTS No differences were observed in the cardiometabolic risk factors between the study groups. CONCLUSION Our results suggest that familial risk for psychosis is not directly associated with disturbances of glucose and lipid metabolism among adolescents.
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Affiliation(s)
- H Koponen
- Department of Psychiatry, University of Kuopio, and Academy of Finland, Kuopio, Finland.
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Walshe M, Taylor M, Schulze K, Bramon E, Frangou S, Stahl D, Kravariti E, Daly E, Fearon P, Murray RM, McDonald C. Familial liability to schizophrenia and premorbid adjustment. Br J Psychiatry 2007; 191:260-1. [PMID: 17766769 DOI: 10.1192/bjp.bp.106.033688] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We assessed premorbid functioning during childhood and adolescence in 50 people with schizophrenia from multiply affected families, 39 of their unaffected siblings, 69 people with schizophrenia with no family history of psychosis, 67 of their unaffected siblings and 83 controls. People with schizophrenia had poorer premorbid social and academic adjustment and exhibited a decline between childhood and adolescence compared with controls. Unaffected siblings from multiply affected families also had poor academic functioning in adolescence, with a decline between childhood and adolescence. This may represent a familial (presumed genetic) effect.
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Affiliation(s)
- Muriel Walshe
- Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
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Abstract
By describing patterns of disease distribution within populations, identifying risk factors, and finding associations, epidemiologic studies have contributed to the current understanding of schizophrenia. Advanced paternal age and the association with autoimmune diseases are some of the newly described epidemiologic findings shaping the current definition of schizophrenia. Although early intervention strategies have gained momentum, primary prevention of schizophrenia still seems a very distant aspiration. This article reviews the major epidemiological features of schizophrenia, with particular attention to the recent advances using population-based data. It also discusses some pervasive misconceptions about schizophrenia epidemiology, such as universal distribution and gender equality.
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Affiliation(s)
- Erick Messias
- Department of Psychiatry, Medical College of Georgia, Augusta, GA
| | - Chuan-Yu Chen
- Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Taipei, Taiwan
| | - William W. Eaton
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Sluzki CE. Lyman C. Wynne and transformation of the field of family-and-schizophrenia. FAMILY PROCESS 2007; 46:143-9. [PMID: 17593879 DOI: 10.1111/j.1545-5300.2007.00198.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Carlos E Sluzki
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, USA.
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Abstract
The purpose of this article is to describe the current status of research on hope and schizophrenia. The CINAHL database was used to identify the articles that met the criteria. The searches were conducted using the terms 'hope', 'hope instillation (IOWA NIC)', 'hope (IOWA NOC)', 'schizophrenia' and their combinations. The findings were limited to research articles. In addition, Pub Medical database was used by searching the words 'hope' and 'schizophrenia' from the fields 'title' or 'abstract'. Four new articles were found. The data consist of 17 articles on hope and schizophrenia published in peer-reviewed journals, which were analysed using content analysis. Existing research has focused on people with schizophrenia (n = 8), significant others (n = 4), staff (n = 2), hope-engendering interventions (n = 2) and treatment evaluation related to hope (n = 2) in the care of people with schizophrenia. Different data collection methods have been used in these studies. The most common method was interview (n = 9), followed by questionnaires (n = 8) and observation (n = 1). Most studies used quantitative methods (n = 9). Hope is considered a positive factor in the life of a person living with schizophrenia, in significant others as well as in staff members. Existing research provides evidence of the following themes: factors associated with hope and factors contributing to hope in people with schizophrenia; hope from the perspective of significant others of people with schizophrenia; staff hopefulness and factors contributing to their hope, hope-engendering interventions and treatment evaluation in regard to hope. Based on this review, research evidence of hope in the context of schizophrenia is quite scant and limited, even though the importance of hope in schizophrenia has been underlined in research reports and the literature. It is clear that hope is important to people with schizophrenia, their significant others and the healthcare personnel caring for them. It is therefore also important to study hope among these people.
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Affiliation(s)
- J Kylmä
- University of Kuopio, Department of Nursing Science, Kuopio, Finland.
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Lakhan SE. Schizophrenia proteomics: biomarkers on the path to laboratory medicine? Diagn Pathol 2006; 1:11. [PMID: 16846510 PMCID: PMC1538632 DOI: 10.1186/1746-1596-1-11] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2006] [Accepted: 07/17/2006] [Indexed: 01/12/2023] Open
Abstract
Over two million Americans are afflicted with schizophrenia, a debilitating mental health disorder with a unique symptomatic and epidemiological profile. Genomics studies have hinted towards candidate schizophrenia susceptibility chromosomal loci and genes. Modern proteomic tools, particularly mass spectrometry and expression scanning, aim to identify both pathogenic-revealing and diagnostically significant biomarkers. Only a few studies on basic proteomics have been conducted for psychiatric disorders relative to the plethora of cancer specific experiments. One such proteomic utility enables the discovery of proteins and biological marker fingerprinting profiling techniques (SELDI-TOF-MS), and then subjects them to tandem mass spectrometric fragmentation and de novo protein sequencing (MALDI-TOF/TOF-MS) for the accurate identification and characterization of the proteins. Such utilities can explain the pathogenesis of neuro-psychiatric disease, provide more objective testing methods, and further demonstrate a biological basis to mental illness. Although clinical proteomics in schizophrenia have yet to reveal a biomarker with diagnostic specificity, methods that better characterize the disorder using endophenotypes can advance findings. Schizophrenia biomarkers could potentially revolutionize its psychopharmacology, changing it into a more hypothesis and genomic/proteomic-driven science.
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Shukunami KI, Nishijima K, Shukunami M, Kotsuji F. Is gestational week at birth a predictor of schizophrenia? Br J Psychiatry 2005; 187:589; author reply 589. [PMID: 16353413 DOI: 10.1192/bjp.187.6.589] [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] [Indexed: 11/23/2022]
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