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Karcher NR, Sotiras A, Niendam TA, Walker EF, Jackson JJ, Barch DM. Examining the Most Important Risk Factors Predicting Persistent and Distressing Psychotic-like Experiences in Youth. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00142-3. [PMID: 38849031 DOI: 10.1016/j.bpsc.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Persistence and distress distinguish more clinically significant psychotic-like experiences (PLEs) from those that are less likely to be associated with impairment and/or need for care. Identifying risk factors that differentiate clinically relevant PLEs early in development is important for improving our understanding of the etiopathogenesis of these experiences. Machine learning analyses examined the most important baseline factors distinguishing persistent distressing PLEs. METHODS Using Adolescent Brain Cognitive Development Study PLEs data over three time points (ages 9-13), individuals with persistent distressing PLEs (n=303), transient distressing PLEs (n=374), and demographically matched low-level PLEs groups were created. Random forest classification models were trained to distinguish among persistent distressing vs. low-level PLEs, transient distressing vs. low-level PLEs, and persistent distressing vs. transient distressing PLEs. Models were trained using identified baseline predictors as input features (i.e., cognitive, neural [cortical thickness, resting state functional connectivity (RSFC)], developmental milestone delays, internalizing symptoms, adverse childhood events). RESULTS The model distinguishing persistent distressing vs. low-level PLEs showed the highest accuracy (test sample accuracy=69.33%; 95% CI:61.29%-76.59%). The most important predictors included internalizing symptoms, adverse childhood events, and cognitive functioning. Models distinguishing persistent vs. transient distressing PLEs generally performed poorly. CONCLUSIONS Model performance metrics indicated that while most important factors overlapped across models (e.g., internalizing symptoms), adverse childhood events were especially important for predicting persistent distressing PLEs. Machine learning analyses proved useful for distinguishing the most clinically relevant group from the least clinically relevant group but showed limited ability to distinguish among clinically relevant groups that differed in PLE persistence.
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Affiliation(s)
- Nicole R Karcher
- Washington University School of Medicine, Department of Psychiatry.
| | - Aristeidis Sotiras
- Washington University School of Medicine, Department of Radiology; Washington University School of Medicine, Institute for Informatics, Data Science & Biostatistics
| | - Tara A Niendam
- University of California, Davis, Dept. of Psychiatry and Behavioral Sciences
| | | | - Joshua J Jackson
- Washington University in St. Louis, Department of Psychological and Brain Sciences
| | - Deanna M Barch
- Washington University School of Medicine, Department of Psychiatry; Washington University in St. Louis, Department of Psychological and Brain Sciences
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2
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Ouellet J, Assaf R, Afzali MH, Nourbakhsh S, Potvin S, Conrod P. Neurocognitive consequences of adolescent sleep disruptions and their relationship to psychosis vulnerability: a longitudinal cohort study. NPJ MENTAL HEALTH RESEARCH 2024; 3:18. [PMID: 38714732 PMCID: PMC11076494 DOI: 10.1038/s44184-024-00058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/15/2024] [Indexed: 05/10/2024]
Abstract
Adolescence is a key period for neurocognitive maturation where deviation from normal developmental trajectories may be tied to adverse mental health outcomes. Cognitive disruptions have been noted in populations at risk for psychosis and are known to accompany periods of sleep deprivation. This study aims to assess the role of cognition as a mediator between sleep disruptions and psychosis risk. A cohort of 3801 high school students (51% female, mean age = 12.8, SD = 0.45 years) was recruited from 31 Montreal high schools. Measures of sleep, psychotic-like experiences, inhibition, working memory, perceptual reasoning, and delayed recall were collected from participants on a yearly basis over the five years of their high school education. A multi-level model mediation analysis was performed controlling for sex and time squared. Response inhibition was shown to be associated with, and to mediate (B = -0.005, SD = 0.003, p = 0.005*) the relationship between sleep disruptions (B = -0.011, SD = 0.004, p < 0.001*) and psychotic-like experiences (B = 0.411, SD = 0.170, p = 0.005*). Spatial working memory deficits on a given year were associated with a higher frequency of psychotic-like experiences that same year (B = -0.046, SD = 0.018, p = 0.005*) and the following year (B = -0.051, SD = 0.023, p = 0.010*), but were not associated with sleep disturbances. No significant associations were found between our variables of interest and either delayed recall or perceptual reasoning at the within person level. Findings from this large longitudinal study provide evidence that the association between sleep disruptions and psychosis risk is specifically mediated by inhibitory rather than general cognitive impairments. The association of spatial working memory, response inhibition, and sleep disruptions with psychotic-like experiences suggests that these factors may represent potential targets for preventative interventions.
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Affiliation(s)
- Julien Ouellet
- CHU Sainte-Justine Research Center, Montreal, QC, Canada.
- Department of Neuroscience, Université de Montréal, Montreal, QC, Canada.
| | - Roxane Assaf
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | | | - Sima Nourbakhsh
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
- Institut Universitaire en Santé Mentale de Montréal Research Center, Montreal, QC, Canada
| | - Patricia Conrod
- CHU Sainte-Justine Research Center, Montreal, QC, Canada.
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada.
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada.
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3
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Cheng P, Liu Z, Sun M, Zhang W, Guo R, Hu A, Long Y. The relations of psychotic-like experiences (PLEs) and depressive symptoms and the bias of depressive symptoms during the clustering among Chinese adolescents: Findings from the network perspective. J Affect Disord 2024; 350:867-876. [PMID: 38272370 DOI: 10.1016/j.jad.2024.01.180] [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: 06/24/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND There are rare studies about the network structure of psychotic-like experiences (PLEs) and depressive symptoms among adolescents. Studies have widely acknowledged that PLEs in adolescents confer a higher risk of depressive symptoms, but the complex interactions remain inadequately understood. Our study aimed to examine the hierarchy and inter-associations of PLEs and depressive symptoms in a large adolescent sample from the network analysis perspective. METHODS A total of 5008 Chinese adolescents were enrolled in our sample. Community Assessment of Psychic Experiences-42 (CAPE-42) was applied to build the network. Centrality indexes were calculated to represent the significance of nodes in the network. Community detection was conducted to figure out the specific clustering of nodes. Demographic information was collected for the sub-network comparisons. Accuracy and stability of the network were also tested. RESULTS "Failure", "External control", and "Lack of activity" were the most central nodes. The main bridge nodes linking PLEs and depressive symptoms were "Failure", "Guilty", and "No future". Positive PLE "Odd looks" and negative PLE "Unable to terminate" are the two PLEs that were most relevant to depressive nodes. Community detection further demonstrated the bias of depressive nodes in the data-driven clustering. Comparative sub-network analysis suggested that age was the only demographic factor related to the current network. CONCLUSION In this study of a large adolescent sample, we first demonstrated the network structure and specific clustering preference of PLEs and depressive symptoms. Our findings may enhance the understanding of the relationship between PLE and depressive symptoms.
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Affiliation(s)
- Peng Cheng
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zhening Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Meng Sun
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wen Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Rui Guo
- Hunan Xinyang Culture Communication Co., LTD, China
| | - Aimin Hu
- College of Medicine, Jishou University, Jishou, Hunan, China
| | - Yicheng Long
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Pratt DN, Bridgwater M, Schiffman J, Ellman LM, Mittal VA. Do the Components of Attenuated Positive Symptoms Truly Represent One Construct? Schizophr Bull 2023; 49:788-798. [PMID: 36454660 PMCID: PMC10154719 DOI: 10.1093/schbul/sbac182] [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] [Indexed: 12/03/2022]
Abstract
BACKGROUND AND HYPOTHESES Psychosis-risk inventories, like the Structured Interview for Psychosis-Risk Syndromes (SIPS), utilize symptom components and coalesce the information into a single-severity rating. These components include frequency, duration, in-the-moment conviction, retrospective insight, distress, and effect on social/role functioning. While combining components distills a great deal of important information into one practical symptom rating, this approach may mask important details of the greater clinical picture. STUDY DESIGN Individuals at clinical high risk for psychosis (n = 115) were assessed with the SIPS Score Separable Components (SSSC) scale, created to accompany the SIPS positive items by dividing each item into the 7 components identified above. The latent structure of the SSSC was identified with an exploratory factor analysis (EFA). The factors were followed up with validation analyses including hypothesized cognitive, functioning, and symptom measures. Finally, clinical utility analyses were conducted to understand relationships between psychosis risk and common comorbidities. STUDY RESULTS EFA revealed that the SSSC had 3 interpretable factors with the appropriate fit (rmsr = 0.018, TLI = 0.921): Conviction (in-the-moment conviction, retrospective insight), Distress-Impairment (distress, social/role functioning), and Frequency/Duration (frequency, duration). Conviction was minimally valid, Distress-Impairment had excellent validity, and Frequency/Duration was not related to any of the candidate validators. Conviction significantly predicted elevated psychosis risk. Distress-Impairment was related to common comorbid symptoms. Notably, the factors associated more strongly with clinical features than the traditional SIPS scores. CONCLUSIONS The SSSC offers a supplemental approach to single-severity ratings, providing useful clinical insight, mechanistic understanding, and the potential for better capturing heterogeneity in this population.
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Affiliation(s)
- Danielle N Pratt
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Miranda Bridgwater
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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5
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Gong J, Zhang T, Zhou L, Mo Y, Yu F, Liu M, Yang L, Liu J. Gender divergent effect of COMT gene rs4680 polymorphism on the association between executive dysfunction and psychotic-like experiences. Behav Brain Res 2023; 439:114215. [PMID: 36372244 DOI: 10.1016/j.bbr.2022.114215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
AIM Premorbid cognitive impairments are observed prior to the onset of schizophrenia. Catechol-O-methyltransferase (COMT) rs4680 is associated with psychosis and plays a crucial role in the development of the executive function. In addition, genetic COMT variations and gender affect its enzymatic activity. Therefore, the aim of this study was to evaluate the impact of COMT rs4680 on the relationship between executive dysfunction and psychotic-like experiences (PLEs) in college students, with the additional investigation of the gender difference. METHODS A total of 463 students provided biological samples for DNA analysis and the COMT gene rs4680 polymorphism was discriminated by the improved multiplex ligase detection reaction method. They also completed the Prodromal Questionnaire and the Dysexecutive Questionnaire. RESULTS Executive dysfunction significantly predicted positive PLEs in the total, male and female population (β = 0.515, 0.508 and 0.512, p < 0.001). The results of moderated analysis revealed that COMT rs4680 recessive genetic model ('AA genotype' versus 'G carrier') moderated the relationship between executive dysfunction and psychotic-like experience in the total and females (p = 0.002 and p <0.001, respectively), but not in males. CONCLUSION These findings revealed a female-specific effect of COMT rs4680 on the relationship between executive dysfunction and PLEs in young adults.
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Affiliation(s)
- Jingbo Gong
- Shanghai Changning Mental Health Center, Shanghai 200335, China; Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Tingting Zhang
- Department of Student Affairs, Hunan University of Technology, Zhuzhou, Hunan, China
| | - Lihua Zhou
- College of Education Science, Hengyang Normal University, Hengyang, Hunan, China
| | - Yanzi Mo
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Feifei Yu
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Min Liu
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Luobin Yang
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jianbo Liu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen Institute of Mental Health, Shenzhen Key Laboratory of Mental Health, Shenzhen, China.
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Wang D, Ma Z, Scherffius A, Liu W, Bu L, Sun M, Fan F. Sleep disturbance is predictive of psychotic-like experiences among adolescents: A two-wave longitudinal survey. Sleep Med 2023; 101:296-304. [PMID: 36470165 DOI: 10.1016/j.sleep.2022.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/03/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Psychotic-like experiences (PLEs) are prevalent among adolescents and are the most significant predictor of future mental disorders. This study aims to examine the cross-sectional and longitudinal associations between sleep disturbance and PLEs in a large cohort of adolescents. METHODS The 17,722 adolescents in our study were assessed from April 21 to May 12, 2021 (Time 1, T1) and again 6 months later from December 17 to 26, 2021 (Time 2, T2). The Youth Self Rating Insomnia Scale and 8-item Positive Subscale of the Community Assessment of Psychic Experiences were used to assess sleep and PLEs, respectively. Sample characteristics and depression were also evaluated at T1, and negative life events were measured at T2. Sleep duration ≤6 h per night was considered as sleep deprivation, and sleep disturbance was defined as having insomnia or poor sleep quality. RESULTS The prevalence of sleep disturbance and frequent PLEs at T1 were 14.1% and 14.5%, respectively. Sleep disturbance and sleep deprivation at T1 were significantly associated with increased risk for PLEs at T2 after adjusting for sample characteristics, depression, and negative life events. Furthermore, sleep disturbance and sleep deprivation also predicted the new onset and persistence of PLEs. CONCLUSION Sleep disturbance predicts the development and persistence of PLEs. Early assessment and treatment of sleep disturbance may therefore contribute to a comprehensive strategy for the successful prevention and treatment of PLEs in adolescents.
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Affiliation(s)
- Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Andrew Scherffius
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, United States
| | - Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Luowei Bu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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7
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Fekih-Romdhane F, Pandi-Perumal SR, Conus P, Krebs MO, Cheour M, Seeman MV, Jahrami HA. Prevalence and risk factors of self-reported psychotic experiences among high school and college students: A systematic review, meta-analysis, and meta-regression. Acta Psychiatr Scand 2022; 146:492-514. [PMID: 36000793 DOI: 10.1111/acps.13494] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Adolescents are at high risk of incident psychopathology. Fleeting psychotic experiences (PEs) that emerge in young people in response to stress may be warning signs that are missed by research that fails to study stressed populations, such as late high school and college/university students. Our aim in this systematic review was to conduct a meta-analysis that estimates prevalence rates of PEs in students, and to assess whether these rates differ by gender, age, culture, and COVID-19 exposure. METHOD We searched nine electronic databases, from their inception until January 31, 2022 for relevant studies. We pooled the estimates using the DerSimonian-Laird technique and random-effects meta-analysis. Our main outcome was the prevalence of self-reported PEs in high school and college/university students. We subsequently analyzed our data by age, gender, population, country, culture, evaluation tool, and COVID-19 exposure. RESULTS Out of 486 studies retrieved, a total of 59 independent studies met inclusion criteria reporting 210' 024 students from 21 different countries. Nearly one in four students (23.31%; 95% CI 18.41%-29.05%), reported having experienced PEs (heterogeneity [Q = 22,698.23 (62), p = 0.001] τ2 = 1.4418 [1.0415-2.1391], τ = 1.2007 [1.0205-1.4626], I2 = 99.7%, H = 19.13 [18.59-19.69]). The 95% prediction intervals were 04.01%-68.85%. Subgroup analyses showed that the pooled prevalence differed significantly by population, culture, and COVID-19 exposure. CONCLUSION This meta-analysis revealed high prevalence rates of self-reported PEs among teen and young adult students, which may have significance for mental health screening in school settings. An important realization is that PEs may have very different mental health meaning in different cultures.
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Affiliation(s)
- Feten Fekih-Romdhane
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., Toronto, Canada.,Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Odile Krebs
- Inserm, Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S1266 Institut de Psychiatrie et Neurosciences de Paris, Université Paris Descartes, Paris, France.,Institut de Psychiatrie (CNRS GDR 3557), Paris, France.,Faculté de Médecine Paris Descartes, Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Paris, France
| | - Majda Cheour
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Canada
| | - Haitham A Jahrami
- Psychiatric Hospital, Ministry of Health, Manama, Bahrain.,Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Ouellet J, Spinney S, Assaf R, Boers E, Livet A, Potvin S, Conrod P. Sleep as a Mediator Between Cannabis Use and Psychosis Vulnerability: A Longitudinal Cohort Study. SCHIZOPHRENIA BULLETIN OPEN 2022; 4:sgac072. [PMID: 36756192 PMCID: PMC9894023 DOI: 10.1093/schizbullopen/sgac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objectives Increasing evidence implicates cannabis consumption as a key risk factor in the development of psychosis, but the mechanisms underpinning this relationship remain understudied. This study proposes to determine whether sleep disruption acts as a mediator of the cannabis-to-psychosis relationship. Study Design This longitudinal study assessed measures of cannabis use frequency, sleep quality (SQ), and psychotic-like experiences (PLEs) were collected using self-reported questionnaires. Data were collected from September 2012 to September 2018. Data were collected from a general population sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. The study uses data collected on an annual basis from 3801 high school students from grades 7 to 11. The aforementioned measures were measured using the Detection of Alcohol and Drug Problems in Adolescents questionnaire, a SQ Likert scale, and measures the Psychotic-Like Experiences Questionnaire for Children. Study Results Results show a reciprocal 1-year cross-lagged effect of cannabis use and sleep (β = -0.076, 95% CI = -0.037 to -0.018, P = .000), of sleep on cannabis use (β = -.016, 95% CI = -0.025 to -0.006, P = .007), of sleep on PLEs (β = -0.077, 95%CI = -0.014 to -0.051, P = .000), and of PLEs on sleep (β = -0.027, 95% CI = -0.037 to -0.018, P = .000). We additionally found a 2 years indirect lagged-effect of cannabis use on PLEs (β = 0.068, 95% CI = 0.024 to 0.113, P = .011) mediated by 1-year sleep (β = 0.006, 95% CI = 0.003 to 0.009, P = .001). Conclusions Our results suggest sleep disruptions simultaneously aggravate, and are aggravated by, cannabis addiction and PLEs. The longitudinal sleep-mediated effect of cannabis use on PLEs encourages further research into the role of sleep as a potential therapeutic target in the prevention of cannabis-related psychosis.
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Affiliation(s)
- Julien Ouellet
- To whom correspondence should be addressed; tel: 514-833-5026, e-mail:
| | - Sean Spinney
- CHU Sainte-Justine Research Center, Montreal, QC, Canada,Department of Computer Science and Operations Research, Université de Montréal, Montreal, QC, Canada
| | - Roxane Assaf
- CHU Sainte-Justine Research Center, Montreal, QC, Canada,Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Elroy Boers
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
| | - Audrey Livet
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada,Institut Universitaire en Santé Mentale de Montréal Research Center, Montreal, QC, Canada
| | - Patricia Conrod
- CHU Sainte-Justine Research Center, Montreal, QC, Canada,Department of Psychiatry, Université de Montréal, Montreal, QC, Canada,Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
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9
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Liu S, Hu Y. The relationship between family functioning and psychotic-like experiences of college students: Chain multiple mediating effects. Early Interv Psychiatry 2022. [PMID: 36253883 DOI: 10.1111/eip.13355] [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: 03/18/2022] [Revised: 05/09/2022] [Accepted: 09/18/2022] [Indexed: 11/30/2022]
Abstract
AIM To explore the mechanism of the relationship between college students' family functioning and psychotic-like experiences, a chain multi-intermediary model is constructed to investigate the multiple mediating effects of interpersonal adaptation, sleep quality and loneliness on college students' family functioning and psychotic-like experiences. METHODS Seven hundred seven college students in China were surveyed by using the Family Care Index Questionnaire, Loneliness Scale, Pittsburgh Sleep Quality Index Questionnaire, College Students' Interpersonal Adaptability Subscale and Community Assessment of Psychiatric Experiences. RESULTS (a) The detection rate of psychotic-like experiences among college students is 72.14%, of which 6.93% reported frequent psychotic-like experiences; (b) There is a significant correlation between family functioning, sleep quality, loneliness, interpersonal adaptation and psychotic-like experiences of college students; (c) Interpersonal adaptation, loneliness and sleep quality of college students have chain multiple mediating effect in the relationship between family functioning and psychotic-like experiences. CONCLUSION The results reveal the mechanism of the relationship between family functioning and psychotic-like experiences, which helps us to better understand how family functioning affects the occurrence and development of college students' psychotic-like experiences.
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Affiliation(s)
- Shuangjin Liu
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Yiqiu Hu
- School of Educational Science, Hunan Normal University, Changsha, China.,Cognition and Human Behavior Key Laboratory of Hunan Province, Changsha, China
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10
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Wu Z, Wang B, Xiang Z, Zou Z, Liu Z, Long Y, Chen X. Increasing Trends in Mental Health Problems Among Urban Chinese Adolescents: Results From Repeated Cross-Sectional Data in Changsha 2016–2020. Front Public Health 2022; 10:829674. [PMID: 35284369 PMCID: PMC8907598 DOI: 10.3389/fpubh.2022.829674] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/12/2022] [Indexed: 11/25/2022] Open
Abstract
This study performed a repeated cross-sectional analysis to explore possible trends in mental health problems among Chinese adolescents over the years of 2016–2020. A total of 2,837 different seventh-grade students were surveyed in three waves from a junior high school in Changsha city, Hunan province in China (978 in 2016, 949 in 2019, and 910 in 2020) using the Mental Health Inventory of Middle School Students (MMHI-60). The results showed that obsessive-compulsive tendencies, interpersonal sensitivity, depression, anxiety, academic stress, and emotional disturbance problems were significantly increased in surveyed adolescents from 2016 to 2020. Moreover, positive rates of most of these problems were significantly higher in females than males, and were significantly increased in only females. These results highlight the importance of focusing on mental health problems among urban Chinese adolescents, especially among girls.
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Affiliation(s)
- Zhipeng Wu
- National Clinical Research Center for Mental Disorders, Changsha, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Biao Wang
- National Clinical Research Center for Mental Disorders, Changsha, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhibiao Xiang
- National Clinical Research Center for Mental Disorders, Changsha, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhulin Zou
- The High School Attached to Hunan Normal University, Changsha, China
- Bocai Experimental School, Changsha, China
| | - Zhening Liu
- National Clinical Research Center for Mental Disorders, Changsha, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yicheng Long
- National Clinical Research Center for Mental Disorders, Changsha, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- Yicheng Long
| | - Xudong Chen
- National Clinical Research Center for Mental Disorders, Changsha, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Xudong Chen
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11
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Sun M, Wang D, Jing L, Zhou L. Changes in psychotic-like experiences and related influential factors in technical secondary school and college students during COVID-19. Schizophr Res 2021; 231:3-9. [PMID: 33725647 PMCID: PMC9190274 DOI: 10.1016/j.schres.2021.02.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/12/2021] [Accepted: 02/27/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Although students have been found to be at high risk of distress during the COVID-19 pandemic, little is known about the pandemic's impact on psychotic-like experiences (PLEs). We conducted a study in technical secondary school and college students before and during the pandemic to explore changes in PLEs and relevant influential factors. METHODS A total of 938 students completed both waves of the survey through electronic questionnaires. PLEs were assessed using the 15-item Positive Subscale of the Community Assessment of Psychic Experiences (CAPE-P15). Childhood trauma, perceived stress, resilience, and demographic factors were evaluated at baseline, and psychological status was measured during the pandemic. RESULTS The overall CAPE-P15 scores significantly decreased during the pandemic. Students with persistent PLEs showed the most severe COVID-19 related psychological symptoms, followed by new-onset and remitted individuals; those without PLEs exhibited the mildest symptoms (all p < .001). A single parent family (OR = 4.707), more childhood trauma (OR = 1.056), and a higher family income (OR = 1.658) were predictive of new-onset PLEs during the pandemic, while better resilience was a protective factor, associated with remission of previous PLEs (OR = 0.932). CONCLUSIONS Despite a downward trend in the prevalence of PLEs during the pandemic, PLEs predict greater serious psychological impact due to COVID-19, especially for students with persistent PLEs. Interventions that cultivate students' resilience are urgently needed to reduce PLEs and improve mental health, especially for students from single parent households or those who have experienced childhood trauma.
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Affiliation(s)
- Meng Sun
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Dongfang Wang
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - Ling Jing
- Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Liang Zhou
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
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12
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Ahuir M, Crosas JM, Estrada F, Zabala W, Pérez-Muñoz S, González-Fernández A, Tost M, Aguayo R, Montalvo I, Miñano MJ, Gago E, Pàmias M, Monreal JA, Palao D, Labad J. Cognitive biases are associated with clinical and functional variables in psychosis: A comparison across schizophrenia, early psychosis and healthy individuals. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 14:4-15. [PMID: 32950409 DOI: 10.1016/j.rpsm.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/18/2020] [Accepted: 07/04/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We investigated the presence of cognitive biases in people with a recent-onset psychosis (ROP), schizophrenia and healthy adolescents and explored potential associations between these biases and psychopathology. METHODS Three groups were studied: schizophrenia (N=63), ROP (N=43) and healthy adolescents (N=45). Cognitive biases were assessed with the Cognitive Biases Questionnaire for Psychosis (CBQ). Positive, negative and depressive symptoms were assessed with the PANSS and Calgary Depression Scale (ROP; schizophrenia) and with the CAPE-42 (healthy adolescents). Cannabis use was registered. The association between CBQ and psychopathology scales was tested with multiple linear regression analyses. RESULTS People with schizophrenia reported more cognitive biases (46.1±9.0) than ROP (40±5.9), without statistically significant differences when compared to healthy adolescents (43.7±7.3). Cognitive biases were significantly associated with positive symptoms in both healthy adolescents (Standardized β=0.365, p=0.018) and people with psychotic disorders (β=0.258, p=0.011). Cognitive biases were significantly associated with depressive symptoms in healthy adolescents (β=0.359, p=0.019) but in patients with psychotic disorders a significant interaction between schizophrenia diagnosis and CBQ was found (β=1.804, p=0.011), which suggests that the pattern differs between ROP and schizophrenia groups (positive association only found in the schizophrenia group). Concerning CBQ domains, jumping to conclusions was associated with positive and depressive symptoms in people with schizophrenia and with cannabis use in ROP individuals. Dichotomous thinking was associated with positive and depressive symptoms in all groups. CONCLUSIONS Cognitive biases contribute to the expression of positive and depressive symptoms in both people with psychotic disorders and healthy individuals.
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Affiliation(s)
- Maribel Ahuir
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Psychiatry and Clinical Psychology Service, Institute of Neuroscience, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Josep Maria Crosas
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Francesc Estrada
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Wanda Zabala
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Sara Pérez-Muñoz
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Alba González-Fernández
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Meritxell Tost
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain
| | - Raquel Aguayo
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Itziar Montalvo
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Maria José Miñano
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Estefania Gago
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain
| | - Montserrat Pàmias
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - José Antonio Monreal
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Diego Palao
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Javier Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain.
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Ayerbe L, Pérez-Piñar M, Foguet-Boreu Q, Ayis S. Psychosis in children of separated parents: A systematic review and meta-analysis. Eur Psychiatry 2020; 63:e3. [PMID: 32093793 PMCID: PMC7315852 DOI: 10.1192/j.eurpsy.2019.15] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/26/2019] [Accepted: 11/28/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Parental separation is a very common childhood adversity. The association between other adverse childhood experiences and an increased risk of psychosis has been reported. However, the evidence on the risk of psychosis for children of separated parents is limited. In this systematic review, cohort, case-control, and cross-sectional studies, comparing the risk of psychotic disorders for people with and without separated parents, were searched, critically appraised, and summarized. METHODS Studies were searched in PubMed, EMBASE, PsycINFO, and the Web of Science, from database inception to September 2019. A meta-analysis, using random-effects models, was undertaken to obtain pooled estimates of the risk of psychosis among participants with separated parents. RESULTS Twelve studies, with 305,652 participants from 22 countries, were included in the review. A significantly increased risk of psychosis for those with separated parents was observed, with a pooled odds ratio: 1.53 (95% confidence interval [CI]: 1.29-1.76), p < 0.001. The association remained significant when cohort, case-control, and cross-sectional studies were analyzed separately. The five cohort studies included in this review showed and increased risk of psychosis with odds ratio: 1.47 (95% CI: 1.26-1.69), p < 0.001. CONCLUSIONS Parental separation is a common childhood adversity associated with an increased risk of psychosis. Although the risk for an individual child of separated parents is still low, given the high proportion of couple that separate, the increased rates of psychosis may be substantial in the population. Further studies on the risk of psychosis in those with separated parents, and the explanatory factors for this association, are required.
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Affiliation(s)
- Luis Ayerbe
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Centre of Primary Care and Public Health, Queen Mary University of London, London, United Kingdom
- Carnarvon Medical Centre, Southend-on-Sea, United Kingdom
| | | | - Quintí Foguet-Boreu
- Department of Psychiatry, Vic University Hospital, Vic, Spain
- Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Salma Ayis
- School of Population Health and Environmental Sciences, King’s College London, London, United Kingdom
- National Institute for Health Research Biomedical Research Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, South London at King’s College Hospital NHS Foundation Trust, London, United Kingdom
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