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Mallik I, Pasvol T, Frize G, Ayres S, Barrera A, Fidler S, Foster C. Psychotic disorders in young adults with perinatally acquired HIV: a UK case series. Psychol Med 2022; 52:2263-2269. [PMID: 33183361 DOI: 10.1017/s0033291720004134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Increasing numbers of children with perinatally acquired HIV (PaHIV) are transitioning into adult care. People living with behaviourally acquired HIV are known to be at more risk of psychosis than uninfected peers. Young adults living with PaHIV face numerous risk factors; biological: lifelong exposure to a neurotrophic virus, antiretroviral medication and immune dysfunction during brain development, and environmental; social deprivation, ethnicity-related discrimination, and migration-related issues. To date, there is little published data on the prevalence of psychotic illness in young people growing up with PaHIV. METHODS We conducted a retrospective case note review of all individuals with PaHIV aged over 18 years registered for follow up at a dedicated clinic in the UK (n = 184). RESULTS In total, 12/184 (6.5%), median age 23 years (interquartile range 21-26), had experienced at least one psychotic episode. The presentation and course of the psychotic episodes experienced by our cohort varied from short-lived symptoms to long term illness and nine (75%) appear to have developed a severe and enduring mental illness requiring long term care. CONCLUSION The prevalence of psychosis in our cohort was clearly above the lifetime prevalence of psychosis in UK individuals aged 16-34 years, which has been reported to be 0.5-1.0%. This highlights the importance of clinical vigilance regarding the mental health of young people growing up with PaHIV and the need to integrate direct access to mental health services within the HIV centres providing medical care.
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Affiliation(s)
- I Mallik
- Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
- Department of Medicine, Imperial College London, London, UK, and Imperial College NIHR BRC, London, UK
| | - T Pasvol
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
| | - G Frize
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
| | - S Ayres
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
| | - A Barrera
- Oxford Health NHS Trust, Oxford, UK and Oxford University Department of Psychiatry, Oxford, UK
| | - S Fidler
- Department of Medicine, Imperial College London, London, UK, and Imperial College NIHR BRC, London, UK
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
| | - C Foster
- 900 Clinic, Imperial College Healthcare NHS Trust, London, UK
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2
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Cauvet É, Van't Westeinde A, Toro R, Kuja-Halkola R, Neufeld J, Mevel K, Bölte S. The social brain in female autism: a structural imaging study of twins. Soc Cogn Affect Neurosci 2021; 15:423-436. [PMID: 32363404 PMCID: PMC7308659 DOI: 10.1093/scan/nsaa064] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/26/2020] [Accepted: 04/27/2020] [Indexed: 12/30/2022] Open
Abstract
A female advantage in social cognition (SoC) might contribute to women's underrepresentation in autism spectrum disorder (ASD). The latter could be underpinned by sex differences in social brain structure. This study investigated the relationship between structural social brain networks and SoC in females and males in relation to ASD and autistic traits in twins. We used a co-twin design in 77 twin pairs (39 female) aged 12.5 to 31.0 years. Twin pairs were discordant or concordant for ASD or autistic traits, discordant or concordant for other neurodevelopmental disorders or concordant for neurotypical development. They underwent structural magnetic resonance imaging and were assessed for SoC using the naturalistic Movie for the Assessment of Social Cognition. Autistic traits predicted reduced SoC capacities predominantly in male twins, despite a comparable extent of autistic traits in each sex, although the association between SoC and autistic traits did not differ significantly between the sexes. Consistently, within-pair associations between SoC and social brain structure revealed that lower SoC ability was associated with increased cortical thickness of several brain regions, particularly in males. Our findings confirm the notion that sex differences in SoC in association with ASD are underpinned by sex differences in brain structure.
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Affiliation(s)
- Élodie Cauvet
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm 11330, Sweden
| | - Annelies Van't Westeinde
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm 11330, Sweden
| | - Roberto Toro
- Department of Neuroscience, Human Genetics and Cognitive Functions, Institut Pasteur, Paris 75015, France.,CNRS URA 2182 "Genes, synapses and cognition", Pasteur Institute, Paris 75015, France.,Human Genetics and Cognitive Functions, Université Paris Diderot, Sorbonne Paris Cité, Paris 75013, France
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, Sweden
| | - Janina Neufeld
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm 11330, Sweden
| | - Katell Mevel
- GIP Cyceron, Normandy University, Caen 14074, France
| | - Sven Bölte
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Stockholm 11330, Sweden.,Child and Adolescent Psychiatry, Stockholm County Council, Stockholm 11330, Sweden.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia 6102, Australia
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3
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Hwang LD, Mitchell BL, Medland SE, Martin NG, Neale MC, Evans DM. The Augmented Classical Twin Design: Incorporating Genome-Wide Identity by Descent Sharing Into Twin Studies in Order to Model Violations of the Equal Environments Assumption. Behav Genet 2021; 51:223-236. [PMID: 33582897 DOI: 10.1007/s10519-021-10044-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/21/2021] [Indexed: 01/09/2023]
Abstract
The Classical Twin Method (CTM) compares the similarity of monozygotic (MZ) twins with that of dizygotic (DZ) twins to make inferences about the relative importance of genes and environment in the etiology of individual differences. The design has been applied to thousands of traits across the biomedical, behavioral and social sciences and is arguably the most widely used natural experiment known to science. The fundamental assumption of the CTM is that trait relevant environmental covariation within MZ pairs is the same as that found within DZ pairs, so that zygosity differences in within-pair variance must be due to genetic factors uncontaminated by the environment. This equal environments assumption (EEA) has been, and still is hotly contested, and has been mentioned as a possible contributing factor to the missing heritability conundrum. In this manuscript, we introduce a new model for testing the EEA, which we call the Augmented Classical Twin Design which uses identity by descent (IBD) sharing between DZ twin pairs to estimate separate environmental variance components for MZ and DZ twin pairs, and provides a test of whether these are equal. We show through simulation that given large samples of DZ twin pairs, the model provides unbiased estimates of variance components and valid tests of the EEA under strong assumptions (e.g. no epistatic variance, IBD sharing in DZ twins estimated accurately etc.) which may not hold in reality. Sample sizes in excess of 50,000 DZ twin pairs with genome-wide genetic data are likely to be required in order to detect substantial violations of the EEA with moderate power. Consequently, we recommend that the Augmented Classical Twin Design only be applied to datasets with very large numbers of DZ twin pairs (> 50,000 DZ twin pairs), and given the strong assumptions relating to the absence of epistatic variance, appropriate caution be exercised regarding interpretation of the results.
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Affiliation(s)
- Liang-Dar Hwang
- The University of Queensland Diamantina Institute, The University of Queensland, Level 7, 37 Kent St, Brisbane, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Brittany L Mitchell
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.,School of Biomedical Science, Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.,School of Biomedical Science, Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Michael C Neale
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - David M Evans
- The University of Queensland Diamantina Institute, The University of Queensland, Level 7, 37 Kent St, Brisbane, Australia. .,QIMR Berghofer Medical Research Institute, Brisbane, Australia. .,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK. .,Translational Research Institute, Woolloongabba, QLD, 4102, Australia.
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Twin studies of brain structure and cognition in schizophrenia. Neurosci Biobehav Rev 2019; 109:103-113. [PMID: 31843545 DOI: 10.1016/j.neubiorev.2019.12.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 11/20/2022]
Abstract
Twin studies in schizophrenia have been crucial in establishing estimates for the heritability and thus providing evidence for a genetic component in this disorder. Recent years have seen the application of the twin study paradigm to both putative intermediate phenotypes and biomarkers of disease as well as a diversification of its use in schizophrenia research. This review addressed studies of brain structure (T1 morphometry) and cognition in schizophrenia using twin study designs. We review major findings such as the overlap of genetic variance between schizophrenia and cognition as a model for the emergence of psychopathology. The use of novel hybrid models integrating molecular genetic risk markers, as well as the use of twin studies in epigenetics might prove to significantly enhance schizophrenia research in the post-GWAS era.
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Evidence for interaction between genetic liability and childhood trauma in the development of psychotic symptoms. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1045-1054. [PMID: 31209522 DOI: 10.1007/s00127-019-01711-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 04/08/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Whilst childhood trauma (CT) is a known risk factor across the spectrum of psychosis expression, little is known about possible interplay with genetic liability. METHODS The TwinssCan Study collected data in general population twins, focussing on expression of psychosis at the level of subthreshold psychotic experiences. A multilevel mixed-effects linear regression analysis was performed including 745 subjects to assess the interaction between genetic liability and CT. The Symptom Checklist-90 (SCL-90-R) score of the co-twin was used as an indirect measure of genetic liability to psychopathology, while the Childhood Trauma Questionnaire Short-Form (CTQ-SF) was used to assess CT in the domains of physical, emotional and sexual abuse, as well as physical and emotional neglect. The Community Assessment of Psychic Experience (CAPE) questionnaire was used to phenotypically characterize psychosis expression. RESULTS In the model using the CAPE total score, the interaction between CT and genetic liability was close to statistical significance (χ2 = 5.6, df = 2, p = 0.06). Analyses of CAPE subscales revealed a significant interaction between CT and genetic liability (χ2 = 8.8, df = 2, p = 0.012) for the CAPE-negative symptoms subscale, but not for the other two subscales (i.e. positive and depressive). CONCLUSION The results suggest that the impact of CT on subthreshold expression of psychosis, particularly in the negative subdomain, may be larger in the co-presence of significant genetic liability for psychopathology.
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Haram A, Jonsbu E, Hole T, Fosse R. Dialogue therapy in psychosis: A philosophical-ethical approach. NORDIC PSYCHOLOGY 2019. [DOI: 10.1080/19012276.2019.1586570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Annbjørg Haram
- Department of Psychiatry, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Egil Jonsbu
- Department of Psychiatry, Møre and Romsdal Hospital Trust, Ålesund, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torstein Hole
- Clinic of Medicine and Rehabilitation, Møre and Romsdal Hospital Trust, Ålesund, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roar Fosse
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
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Moore DS, Shenk D. The heritability fallacy. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2016; 8. [PMID: 27906501 DOI: 10.1002/wcs.1400] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 05/29/2016] [Indexed: 11/09/2022]
Abstract
The term 'heritability,' as it is used today in human behavioral genetics, is one of the most misleading in the history of science. Contrary to popular belief, the measurable heritability of a trait does not tell us how 'genetically inheritable' that trait is. Further, it does not inform us about what causes a trait, the relative influence of genes in the development of a trait, or the relative influence of the environment in the development of a trait. Because we already know that genetic factors have significant influence on the development of all human traits, measures of heritability are of little value, except in very rare cases. We, therefore, suggest that continued use of the term does enormous damage to the public understanding of how human beings develop their individual traits and identities. WIREs Cogn Sci 2017, 8:e1400. doi: 10.1002/wcs.1400 For further resources related to this article, please visit the WIREs website.
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Affiliation(s)
- David S Moore
- Pitzer College and Claremont Graduate University, Claremont, CA, USA
| | - David Shenk
- DeLTA Center, University of Iowa, Iowa City, IA, USA
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8
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Kaufman JS, Muntaner C. ‘The association between intelligence and lifespan is mostly genetic’. Int J Epidemiol 2016; 45:576-7. [DOI: 10.1093/ije/dyw019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Peedicayil J. Preclinical epigenetic models for screening epigenetic drugs for schizophrenia. J Pharmacol Toxicol Methods 2016; 77:1-5. [DOI: 10.1016/j.vascn.2015.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 08/18/2015] [Accepted: 09/05/2015] [Indexed: 01/09/2023]
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10
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Fosse R, Joseph J, Jones M. Schizophrenia: A critical view on genetic effects. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2015. [DOI: 10.1080/17522439.2015.1081269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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