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Hitczenko K, Segal Y, Keshet J, Goldrick M, Mittal VA. Speech characteristics yield important clues about motor function: Speech variability in individuals at clinical high-risk for psychosis. Schizophrenia (Heidelb) 2023; 9:60. [PMID: 37717025 PMCID: PMC10505148 DOI: 10.1038/s41537-023-00382-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/24/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND AND HYPOTHESIS Motor abnormalities are predictive of psychosis onset in individuals at clinical high risk (CHR) for psychosis and are tied to its progression. We hypothesize that these motor abnormalities also disrupt their speech production (a highly complex motor behavior) and predict CHR individuals will produce more variable speech than healthy controls, and that this variability will relate to symptom severity, motor measures, and psychosis-risk calculator risk scores. STUDY DESIGN We measure variability in speech production (variability in consonants, vowels, speech rate, and pausing/timing) in N = 58 CHR participants and N = 67 healthy controls. Three different tasks are used to elicit speech: diadochokinetic speech (rapidly-repeated syllables e.g., papapa…, pataka…), read speech, and spontaneously-generated speech. STUDY RESULTS Individuals in the CHR group produced more variable consonants and exhibited greater speech rate variability than healthy controls in two of the three speech tasks (diadochokinetic and read speech). While there were no significant correlations between speech measures and remotely-obtained motor measures, symptom severity, or conversion risk scores, these comparisons may be under-powered (in part due to challenges of remote data collection during the COVID-19 pandemic). CONCLUSION This study provides a thorough and theory-driven first look at how speech production is affected in this at-risk population and speaks to the promise and challenges facing this approach moving forward.
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Affiliation(s)
- Kasia Hitczenko
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, ENS, EHESS, CNRS, PSL University, Paris, France.
| | - Yael Segal
- Faculty of Electrical and Computer Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Joseph Keshet
- Faculty of Electrical and Computer Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Matthew Goldrick
- Department of Linguistics, Northwestern University, Evanston, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Cognitive Science Program, Northwestern University, Evanston, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Cognitive Science Program, Northwestern University, Evanston, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Department of Psychiatry, Northwestern University, Evanston, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Evanston/Chicago, IL, USA
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Cattarinussi G, Gugliotta AA, Sambataro F. The Risk for Schizophrenia-Bipolar Spectrum: Does the Apple Fall Close to the Tree? A Narrative Review. Int J Environ Res Public Health 2023; 20:6540. [PMID: 37569080 PMCID: PMC10418911 DOI: 10.3390/ijerph20156540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/24/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
Schizophrenia (SCZ) and bipolar disorder (BD) are severe psychiatric disorders that share clinical features and several risk genes. Important information about their genetic underpinnings arises from intermediate phenotypes (IPs), quantifiable biological traits that are more prevalent in unaffected relatives (RELs) of patients compared to the general population and co-segregate with the disorders. Within IPs, neuropsychological functions and neuroimaging measures have the potential to provide useful insight into the pathophysiology of SCZ and BD. In this context, the present narrative review provides a comprehensive overview of the available evidence on deficits in neuropsychological functions and neuroimaging alterations in unaffected relatives of SCZ (SCZ-RELs) and BD (BD-RELs). Overall, deficits in cognitive functions including intelligence, memory, attention, executive functions, and social cognition could be considered IPs for SCZ. Although the picture for cognitive alterations in BD-RELs is less defined, BD-RELs seem to present worse performances compared to controls in executive functioning, including adaptable thinking, planning, self-monitoring, self-control, and working memory. Among neuroimaging markers, SCZ-RELs appear to be characterized by structural and functional alterations in the cortico-striatal-thalamic network, while BD risk seems to be associated with abnormalities in the prefrontal, temporal, thalamic, and limbic regions. In conclusion, SCZ-RELs and BD-RELs present a pattern of cognitive and neuroimaging alterations that lie between patients and healthy individuals. Similar abnormalities in SCZ-RELs and BD-RELs may be the phenotypic expression of the shared genetic mechanisms underlying both disorders, while the specificities in neuropsychological and neuroimaging profiles may be associated with the differential symptom expression in the two disorders.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, 35131 Padova, Italy; (G.C.); (A.A.G.)
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
| | - Alessio A. Gugliotta
- Department of Neuroscience (DNS), University of Padova, 35131 Padova, Italy; (G.C.); (A.A.G.)
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, 35131 Padova, Italy; (G.C.); (A.A.G.)
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
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Carpendale EJ, Cullen AE, Dickson H, Laurens KR. Dissociable impairments of verbal learning differentiate childhood risk profiles for schizophrenia. Schizophr Res Cogn 2022; 28:100239. [PMID: 35242608 PMCID: PMC8861403 DOI: 10.1016/j.scog.2022.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 11/18/2022] Open
Abstract
Poor verbal learning and memory function is well-documented among individuals with schizophrenia and those at clinical high-risk for psychosis. This study aimed to identify these impairments among children aged 9–12 years with different schizophrenia risk profiles (family history or antecedents of schizophrenia, each of higher[H] or lower[L] risk load) relative to typically developing peers. These three groups were recruited via community-screening, and differentiated for analysis into: typically developing children (TD = 45); children who had 1 first- or ≥2 second-degree affected relatives (FHxH = 16) or one second-degree relative (FHxL = 15); and children presenting multiple replicated antecedents of schizophrenia whose clinical symptoms persisted at 2- and/or 4-year follow-up (ASzH = 16) or remitted during follow-up (ASzL = 16). Verbal learning/memory measures assessed at baseline (age 9–12 years) included: (i) total recall; (ii) trial 1 recall; (iii) learning score; (iv) intrusions; (v) total words lost; and (vi) serial position patterns. Analyses of variance indicated that FHxH and ASzH youth demonstrated impaired total recall compared to TD and ASzL children and lost significantly more words between trials than TD and FHxL children. Learning score was impaired among both FHxH and FHxL relative to TD and ASzL children. Thus, among putatively at-risk children, total words recalled and lost distinguished those with higher risk load (by family history or persistent antecedent symptomology), whereas learning score indexed familial vulnerability. Follow-up of the sample is needed to determine the capacity of verbal learning deficits to predict later illness and provide a potential avenue for early remediation to improve clinical or functional outcomes.
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Affiliation(s)
- Emma J. Carpendale
- Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, Queensland, Australia
| | - Alexis E. Cullen
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Hannah Dickson
- King's College London, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Kristin R. Laurens
- Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, Queensland, Australia
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
- University of New South Wales, School of Psychiatry, Sydney, New South Wales, Australia
- Corresponding author at: School of Psychology and Counselling, O Block, B Wing, Level 5, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia.
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Wang B, Giannakopoulou O, Austin-Zimmerman I, Irizar H, Harju-Seppänen J, Zartaloudi E, Bhat A, McQuillin A, Kuchenbäcker K, Bramon E. Adolescent Verbal Memory as a Psychosis Endophenotype: A Genome-Wide Association Study in an Ancestrally Diverse Sample. Genes (Basel) 2022; 13:106. [PMID: 35052446 PMCID: PMC8774761 DOI: 10.3390/genes13010106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/16/2021] [Accepted: 12/29/2021] [Indexed: 02/04/2023] Open
Abstract
Verbal memory impairment is one of the most prominent cognitive deficits in psychosis. However, few studies have investigated the genetic basis of verbal memory in a neurodevelopmental context, and most genome-wide association studies (GWASs) have been conducted in European-ancestry populations. We conducted a GWAS on verbal memory in a maximum of 11,017 participants aged 8.9 to 11.1 years in the Adolescent Brain Cognitive Development Study®, recruited from a diverse population in the United States. Verbal memory was assessed by the Rey Auditory Verbal Learning Test, which included three measures of verbal memory: immediate recall, short-delay recall, and long-delay recall. We adopted a mixed-model approach to perform a joint GWAS of all participants, adjusting for ancestral background and familial relatedness. The inclusion of participants from all ancestries increased the power of the GWAS. Two novel genome-wide significant associations were found for short-delay and long-delay recall verbal memory. In particular, one locus (rs9896243) associated with long-delay recall was mapped to the NSF (N-Ethylmaleimide Sensitive Factor, Vesicle Fusing ATPase) gene, indicating the role of membrane fusion in adolescent verbal memory. Based on the GWAS in the European subset, we estimated the SNP-heritability to be 15% to 29% for the three verbal memory traits. We found that verbal memory was genetically correlated with schizophrenia, providing further evidence supporting verbal memory as an endophenotype for psychosis.
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Affiliation(s)
- Baihan Wang
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
| | - Olga Giannakopoulou
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
- UCL Genetics Institute, Division of Biosciences, University College London, London WC1E 6BT, UK
| | - Isabelle Austin-Zimmerman
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Haritz Irizar
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
- Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jasmine Harju-Seppänen
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
| | - Eirini Zartaloudi
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
| | - Anjali Bhat
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
| | - Andrew McQuillin
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
| | - Karoline Kuchenbäcker
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
- UCL Genetics Institute, Division of Biosciences, University College London, London WC1E 6BT, UK
| | - Elvira Bramon
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London W1T 7BN, UK; (O.G.); (I.A.-Z.); (H.I.); (J.H.-S.); (E.Z.); (A.B.); (A.M.); (K.K.)
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Laurens KR, Murphy J, Dickson H, Roberts RE, Gutteridge TP. Trajectories of Mismatch Negativity and P3a Amplitude Development From Ages 9 to 16 Years in Children With Risk Factors for Schizophrenia. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 5:1085-1094. [PMID: 32981879 DOI: 10.1016/j.bpsc.2020.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 07/17/2020] [Accepted: 07/17/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Mismatch negativity (MMN) and P3a amplitude reductions are robust abnormalities of sensory information processing in schizophrenia, but they are variably present in different profiles of risk (family history vs. clinical high risk) for the disorder. This study aimed to determine whether these abnormalities characterize children presenting replicated risk factors for schizophrenia, using longitudinal assessment over the ages of 9-16 years in children with multiple replicated antecedents of schizophrenia (ASz) and with family history of schizophrenia (FHx), relative to typically developing (TD) peers. METHODS A total of 105 children (52 female) sampled from the community were assessed at ages 9-12 years and approximately 2 and 4 years later. Linear mixed models were fitted to MMN and P3a peak amplitudes and latencies, with intercept and slope estimates from 32 ASz and 28 FHx children compared with those of 45 TD peers. RESULTS In ASz relative to TD children, MMN amplitude initially increased and then prominently decreased during adolescence. Both ASz and FHx children had greater P3a amplitude than TD children at 11 years, which decreased with age, in contrast to P3a amplitude increasing during adolescence in TD youths. MMN abnormalities were specific to ASz children who continued to present symptoms during follow-up. CONCLUSIONS Age-dependent MMN and P3a abnormalities demarcate adolescent development of ASz and FHx from TD children, with auditory change detection abnormalities specific to ASz children with continuing symptoms and attention-orienting abnormalities characterizing both ASz and FHx risk profiles. Follow-up is required to determine whether these abnormalities index vulnerability for schizophrenia or an illness nonspecific developmental delay.
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Affiliation(s)
- Kristin R Laurens
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Jennifer Murphy
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ruth E Roberts
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Division of Psychology and Language Sciences, University College London, London, United Kingdom; Kantor Centre of Excellence, Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Tiffany P Gutteridge
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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6
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Abstract
BACKGROUND Cognitive impairments in childhood are associated with increased risk of schizophrenia in later life, but the extent to which poor academic achievement is associated with the disorder is unclear. METHODS Major databases were searched for articles published in English up to 31 December 2019. We conducted random-effects meta-analyses to: (1) compare general academic and mathematics achievement in youth who later developed schizophrenia and those who did not; (2) to examine the association between education level achieved and adult-onset schizophrenia; and, (3) compare general academic achievement in youth at-risk for schizophrenia and typically developing peers. Meta-regression models examined the effects of type of academic assessment, educational system, age at assessment, measurement of educational level attained, school leaving age, and study quality on academic achievement and education level among individuals with schizophrenia. RESULTS Meta-analyses, comprising data of over four million individuals, found that: (1) by age 16 years, those who later developed schizophrenia had poorer general academic (Cohen's d = -0.29, p ⩽ 0.0001) and mathematics achievement (d = -0.23, p = 0.01) than those who did not; (2) individuals with schizophrenia were less likely to enter higher education (odds ratio = 0.49, p ⩽ 0.0001); and, (3) youth reporting psychotic-like experiences and youth with a family history of schizophrenia had lower general academic achievement (d = -0.54, p ⩽ 0.0001; d = -0.39, p ⩽ 0.0001, respectively). Meta-regression analyses determined no effect modifiers. DISCUSSION Despite significant heterogeneity across studies, various routinely collected indices of academic achievement can identify premorbid cognitive dysfunction among individuals who are vulnerable for schizophrenia, potentially aiding the early identification of risk in the population.
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Affiliation(s)
- Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily P Hedges
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Shin Y Ma
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexis E Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James H MacCabe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Johnny Downs
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kristin R Laurens
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Queensland University of Technology (QUT), School of Psychology and Counselling, and Institute of Health and Biomedical Innovation, Brisbane, QLD, Australia
- School of Psychiatry, University of New South Wales, NSW, Australia
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Tor J, Dolz M, Sintes-Estevez A, de la Serna E, Puig O, Muñoz-Samons D, Pardo M, Rodríguez-Pascual M, Sugranyes G, Sánchez-Gistau V, Baeza I. Neuropsychological profile of children and adolescents with psychosis risk syndrome: the CAPRIS study. Eur Child Adolesc Psychiatry 2020; 29:1311-24. [PMID: 31897849 DOI: 10.1007/s00787-019-01459-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 12/11/2019] [Indexed: 12/27/2022]
Abstract
Neuropsychological underperformance is well described in young adults at clinical high risk for psychosis, but the literature is scarce on the cognitive profile of at-risk children and adolescents. The aim of this study is to describe the neuropsychological profile of a child and adolescent sample of patients with psychosis risk syndrome (PRS) compared to healthy controls and to analyze associations between attenuated psychotic symptoms and cognitive impairment. Cross-sectional baseline data analysis from a longitudinal, naturalistic, case-control, two-site study is presented. Eighty-one help-seeking subjects with PRS and 39 healthy controls (HC) aged between 10 and 17 years of age were recruited. PRS was defined by: positive or negative attenuated symptoms, Brief Limited Intermittent Psychotic Symptoms (BLIPS), genetic risk (first- or second-degree relative), or schizotypal personality disorder plus impairment in functioning. A neuropsychological battery was administered to assess general intelligence, verbal and visual memory, visuospatial abilities, speed processing, attention, and executive functions. The PRS group showed lower general neuropsychological performance scores at a multivariate level and lower scores than controls in general intelligence and executive functions. Lower scores on executive function and poorer attention were associated with high scores of positive attenuated psychotic symptoms. No association with attenuated negative symptoms was found. This study provides evidence of cognitive impairment in PRS children and adolescents and shows a relationship between greater cognitive impairment in executive functions and attention tasks and severe attenuated positive symptoms. However, longitudinal studies are needed to clarify the nature of cognitive impairment as a possible vulnerability marker.
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Damme KSF, Osborne KJ, Gold JM, Mittal VA. Detecting motor slowing in clinical high risk for psychosis in a computerized finger tapping model. Eur Arch Psychiatry Clin Neurosci 2020; 270:393-7. [PMID: 31432263 DOI: 10.1007/s00406-019-01059-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/13/2019] [Indexed: 10/26/2022]
Abstract
Finger tapping is sensitive to motor slowing and emerging symptoms in individuals at clinical high risk for psychosis (CHR). A sensitive, computerized finger tapping task would be beneficial in early psychosis screening batteries. The study included 41 CHR and 32 healthy volunteers, who completed a computerized finger tapping task and clinical interviews. This computerized finger tapping task was sensitive to slowing in the CHR group compared to healthy volunteers, and as expected negative but not positive symptoms related to motor slowing. Computerized finger tapping tasks may be an easily dispersible tool for early symptom detection battery relevant to emerging negative symptoms.
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Dickson H, Roberts RE, To M, Wild K, Loh M, Laurens KR. Adolescent trajectories of fine motor and coordination skills and risk for schizophrenia. Schizophr Res 2020; 215:263-9. [PMID: 31672386 DOI: 10.1016/j.schres.2019.10.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/09/2019] [Accepted: 10/03/2019] [Indexed: 12/31/2022]
Abstract
Premorbid motor dysfunction is one of the earliest of developmental antecedents identified among individuals who develop schizophrenia in adulthood. However, among individuals with schizophrenia, premorbid motor dysfunction is not apparent at all stages of childhood development and may reduce with increasing age. Currently, little is known about the trajectories of motor development during adolescence among youth at-risk for the disorder. One hundred and one participants were assessed repeatedly, at approximately 24-month intervals (time 1, aged 9-12 years; time 2, 11-14 years; and time 3, 13-16 years), on the Purdue Pegboard assessment, comprising four subtests: Dominant Hand (DH), Non-Dominant Hand (NDH), Both Hands (BH), and Assembly. Fine motor and coordination skills development between ages 9-16 years was compared between youth characterised by a triad of developmental antecedents of schizophrenia (ASz, N = 32); youth with at least one affected relative with schizophrenia/schizoaffective disorder (FHx; N = 26); and typically developing youth without antecedents or family history (TD, N = 43). Longitudinal mixed models for repeated measures indicated significant motor skills improvements with age in TD youth on the Assembly subtest only. Relative to TD youth, we found evidence for developmental deficits (i.e., dysfunction that emerged early and remained stable) among ASz youth on DH and BH subtests, and among FHx youth on the Assembly subtest. ASz youth were characterised by a developmental delay on the Assembly subtest (i.e., initial performance decrement in middle childhood that caught up with peers' performance during adolescence). These divergences from normative motor development may reflect differences in structural and functional neural correlates.
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Akiyama K, Saito A, Saito S, Ozeki Y, Watanabe T, Fujii K, Shimoda K. Association of genetic variants at 22q11.2 chromosomal region with cognitive performance in Japanese patients with schizophrenia. Schizophr Res Cogn 2019; 17:100134. [PMID: 31193788 PMCID: PMC6543121 DOI: 10.1016/j.scog.2019.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/21/2019] [Accepted: 02/21/2019] [Indexed: 11/11/2022] Open
Abstract
22q11.2 heterozygous multigene deletions confer an increased risk of schizophrenia with marked impairment of cognition. We explored whether genes on 22q11.2 are associated with cognitive performance in patients with idiopathic schizophrenia. A total of 240 schizophrenia patients and 240 healthy controls underwent the Japanese-language version of the Brief Assessment of Cognition in Schizophrenia (BACS) and were genotyped for 115 tag single-nucleotide polymorphisms (tag SNPs) at the 22q11.2 region using the golden gate assay (Illumina®). Associations between z-scores of the BACS cognitive domains and SNPs and haplotypes were analyzed using linear regression in PLINK 1.07. An additional set of 149 patients with bipolar disorder were included for cognitive assessment and selected SNPs were genotyped using real-time PCR. Patients with schizophrenia and bipolar disorder showed qualitatively comparable profiles of cognitive impairment across BACS subdomains, as revealed by significant correlation between the two groups in the resulting cognitive effect sizes relative to controls. rs4819522 (TBX1) and rs2238769 (UFD1L) were significantly and nominally associated, respectively, with symbol coding in patients with schizophrenia. Haplotype analyses revealed that haplotypes containing the A allele at rs4819522 and G allele at rs2238769 showed significant negative associations with symbol coding in patients with schizophrenia. There was no effect of any haplotypes on cognition in patients with bipolar disorder. Our results have implications for the understanding of the role of haplotypes of UFD1L and TBX1 genes associated with symbol coding in patients with schizophrenia. Further replication studies in a cohort of newly diagnosed patients and other ethnicities are warranted.
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Dickson H, Cullen AE, Jones R, Reichenberg A, Roberts RE, Hodgins S, Morris RG, Laurens KR. Trajectories of cognitive development during adolescence among youth at-risk for schizophrenia. J Child Psychol Psychiatry 2018; 59:1215-1224. [PMID: 29683193 DOI: 10.1111/jcpp.12912] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Among adults with schizophrenia, evidence suggests that premorbid deficits in different cognitive domains follow distinct developmental courses during childhood and adolescence. The aim of this study was to delineate trajectories of adolescent cognitive functions prospectively among different groups of youth at-risk for schizophrenia, relative to their typically developing (TD) peers. METHOD Using linear mixed models adjusted for sex, ethnicity, parental occupation and practice effects, cognitive development between ages 9 and 16 years was compared for youth characterised by a triad of well-replicated developmental antecedents of schizophrenia (ASz; N = 32) and youth with a least one affected relative with schizophrenia or schizoaffective disorder (FHx; N = 29), relative to TD youth (N = 45). Participants completed measures of IQ, scholastic achievement, memory and executive function at three time-points, separated by approximately 24-month intervals. RESULTS Compared to TD youth, both ASz and FHx youth displayed stable developmental deficits in verbal working memory and inhibition/switching executive functions. ASz youth additionally presented with stable deficits in measures of vocabulary (IQ), word reading, numerical operations, and category fluency executive function, and a slower rate of growth (developmental lag) on spelling from 9 to 16 years than TD peers. Conversely, faster rates of growth relative to TD peers (developmental delay) were observed on visual and verbal memory, and on category fluency executive function (ASz youth only) and on matrix reasoning (IQ) and word reading (FHx youth only). CONCLUSIONS These differential patterns of deviation from normative adolescent cognitive development among at-risk youth imply potential for cognitive rehabilitation targeting of specific cognitive deficits at different developmental phases.
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Affiliation(s)
- Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexis E Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
| | - Abraham Reichenberg
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Psychiatry and Preventive Medicine, The Freidman Brain Institute, Ichan School of Medicine at Mount Sinai, New York, NY, USA
| | - Ruth E Roberts
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sheilagh Hodgins
- Département de Psychiatrie, Université de Montréal, Montreal, QC, Canada
| | - Robin G Morris
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Kristin R Laurens
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,School of Psychology, Australian Catholic University, Brisbane, QLD, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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12
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Sheffield JM, Karcher NR, Barch DM. Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective. Neuropsychol Rev 2018; 28:509-533. [PMID: 30343458 DOI: 10.1007/s11065-018-9388-2] [Citation(s) in RCA: 237] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/15/2018] [Indexed: 12/15/2022]
Abstract
Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated with the experience of psychosis. These impairments negatively impact functional outcome, contributing to the disabling nature of schizophrenia, bipolar disorder, and psychotic depression. The robust and reliable nature of cognitive deficits has led researchers to explore the timing and profile of impairments, as this may elucidate different neurodevelopmental patterns in individuals who experience psychosis. Here, we review the literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences, highlighting the dimensional nature of both psychosis and cognitive ability. We identify premorbid generalized cognitive impairment in schizophrenia that worsens throughout development, and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course. Research in affective psychosis is less clear, with mixed evidence regarding premorbid deficits, but a fairly reliable generalized deficit at first-episode, which appears to worsen into the chronic state. In general, cognitive impairments are most severe in schizophrenia, intermediate in bipolar disorder, and the least severe in psychotic depression. In all groups, cognitive deficits are associated with poorer functional outcome. Finally, while the generalized deficit is the clearest and most reliable signal, data suggests specific deficits in verbal memory across all groups, specific processing speed impairments in schizophrenia and executive functioning impairments in bipolar disorder. Cognitive deficits are a core feature of psychotic disorders that provide a window into understanding developmental course and risk for psychosis.
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Affiliation(s)
- Julia M Sheffield
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Nashville, TN, 37212, USA.
| | - Nicole R Karcher
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
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13
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Bechi M, Spangaro M, Agostoni G, Bosinelli F, Buonocore M, Bianchi L, Cocchi F, Guglielmino C, Bosia M, Cavallaro R. Intellectual and cognitive profiles in patients affected by schizophrenia. J Neuropsychol 2018; 13:589-602. [DOI: 10.1111/jnp.12161] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 04/30/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Margherita Bechi
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Marco Spangaro
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | | | | | - Mariachiara Buonocore
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Laura Bianchi
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Federica Cocchi
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Carmelo Guglielmino
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Marta Bosia
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
- Vita‐Salute San Raffaele University Milan Italy
| | - Roberto Cavallaro
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
- Vita‐Salute San Raffaele University Milan Italy
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14
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MacKenzie LE, Patterson VC, Zwicker A, Drobinin V, Fisher HL, Abidi S, Greve AN, Bagnell A, Propper L, Alda M, Pavlova B, Uher R. Hot and cold executive functions in youth with psychotic symptoms. Psychol Med 2017; 47:2844-2853. [PMID: 28587688 DOI: 10.1017/s0033291717001374] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Psychotic symptoms are common in children and adolescents and may be early manifestations of liability to severe mental illness (SMI), including schizophrenia. SMI and psychotic symptoms are associated with impairment in executive functions. However, previous studies have not differentiated between 'cold' and 'hot' executive functions. We hypothesized that the propensity for psychotic symptoms is specifically associated with impairment in 'hot' executive functions, such as decision-making in the context of uncertain rewards and losses. METHODS In a cohort of 156 youth (mean age 12.5, range 7-24 years) enriched for familial risk of SMI, we measured cold and hot executive functions with the spatial working memory (SWM) task (total errors) and the Cambridge Gambling Task (decision-making), respectively. We assessed psychotic symptoms using the semi-structured Kiddie Schedule for Affective Disorders and Schizophrenia interview, Structured Interview for Prodromal Syndromes, Funny Feelings, and Schizophrenia Proneness Instrument - Child and Youth version. RESULTS In total 69 (44.23%) youth reported psychotic symptoms on one or more assessments. Cold executive functioning, indexed with SWM errors, was not significantly related to psychotic symptoms [odds ratio (OR) 1.36, 95% confidence interval (CI) 0.85-2.17, p = 0.204). Poor hot executive functioning, indexed as decision-making score, was associated with psychotic symptoms after adjustment for age, sex and familial clustering (OR 2.37, 95% CI 1.25-4.50, p = 0.008). The association between worse hot executive functions and psychotic symptoms remained significant in sensitivity analyses controlling for general cognitive ability and cold executive functions. CONCLUSIONS Impaired hot executive functions may be an indicator of risk and a target for pre-emptive early interventions in youth.
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Affiliation(s)
- L E MacKenzie
- Department of Psychology and Neuroscience,Dalhousie University,Halifax, Nova Scotia,Canada
| | - V C Patterson
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - A Zwicker
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - V Drobinin
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - H L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London,UK
| | - S Abidi
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - A N Greve
- Psychosis Research Unit,Aarhus University Hospital,Risskov,Denmark
| | - A Bagnell
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - L Propper
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - M Alda
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - B Pavlova
- Department of Psychiatry,Dalhousie University,Halifax, Nova Scotia,Canada
| | - R Uher
- Department of Psychology and Neuroscience,Dalhousie University,Halifax, Nova Scotia,Canada
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15
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Grot S, Légaré VP, Lipp O, Soulières I, Dolcos F, Luck D. Abnormal prefrontal and parietal activity linked to deficient active binding in working memory in schizophrenia. Schizophr Res 2017; 188:68-74. [PMID: 28095997 DOI: 10.1016/j.schres.2017.01.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/06/2017] [Accepted: 01/09/2017] [Indexed: 11/16/2022]
Abstract
Working memory deficits have been widely reported in schizophrenia, and may result from inefficient binding processes. These processes, and their neural correlates, remain understudied in schizophrenia. Thus, we designed an FMRI study aimed at investigating the neural correlates of both passive and active binding in working memory in schizophrenia. Nineteen patients with schizophrenia and 23 matched controls were recruited to perform a working memory binding task, in which they were instructed to memorize three letters and three spatial locations. In the passive binding condition, letters and spatial locations were directly presented as bound. Conversely, in the active binding condition, words and spatial locations were presented as separated, and participants were instructed to intentionally create associations between them. Patients exhibited a similar performance to the controls for the passive binding condition, but a significantly lower performance for the active binding. FMRI analyses revealed that this active binding deficit was related to aberrant activity in the posterior parietal cortex and the ventrolateral prefrontal cortex. This study provides initial evidence of a specific deficit for actively binding information in schizophrenia, which is linked to dysfunctions in the neural networks underlying attention, manipulation of information, and encoding strategies. Together, our results suggest that all these dysfunctions may be targets for neuromodulation interventions known to improve cognitive deficits in schizophrenia.
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Affiliation(s)
- Stéphanie Grot
- Centre de recherche, Institut universitaire en santé mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Virginie Petel Légaré
- Centre de recherche, Institut universitaire en santé mentale de Montréal, Montreal, Canada; Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Olivier Lipp
- Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Isabelle Soulières
- Centre de recherche, Institut universitaire en santé mentale de Montréal, Montreal, Canada; Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Florin Dolcos
- Department of Psychology, Neuroscience Program, and Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - David Luck
- Centre de recherche, Institut universitaire en santé mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, Canada; Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, Canada.
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16
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Ullman VZ, Hornik-Lurie T, Reichenberg A. A population-based study of premorbid scholastic achievement among patients with psychiatric disorders. Psychiatry Res 2017; 253:281-286. [PMID: 28411576 DOI: 10.1016/j.psychres.2017.04.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 04/07/2017] [Indexed: 10/19/2022]
Abstract
Population-based studies of premorbid cognitive functioning in schizophrenia have found verbal deficits and low IQ scores. It remains unclear, however, whether premorbid deficits are specific to schizophrenia, compared with other psychiatric disorders. Moreover, studies using school-based measures are few and their results inconsistent. This study assesses the eighth-grade (ages 13-14; n=11, 418) scholastic performance of adults with psychiatric disorders (n=194, 1.7, particularly with schizophrenia (n=86, 0.8%), comparing the results with those of their normative peers. The researchers examined report cards of eighth-graders at state secular schools in Jerusalem over a ten-year period (1978-1988), applying ANOVA and logistic regression models to evaluate associations between school performance and subsequent psychiatric hospitalization. The findings indicated that participants hospitalized with varied psychiatric disorders had lower grades in mathematics, gym, handcraft and academic core subjects, with significantly lower overall scores. Amended logistic regression models indicate that reduced performance (in mathematics, gym, handcraft and overall scores) was correlated with an increasing likelihood of hospitalization for the psychiatric disorders group and the subgroup with schizophrenia-related ailments. These results imply that eighth-grade school performance in core subjects is poorer among persons later hospitalized with psychiatric disorders than that of their classmates.
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Affiliation(s)
- Vardit Zerem Ullman
- Mailman School of Public Health, Columbia University, New York, USA; Ashkelon Academic College, Israel.
| | - Tzipi Hornik-Lurie
- The Falk Institute for Mental Health Studies, Kfar Shaul Hospital, Givat Shaul, Jerusalem, Israel; Public Health and Health Systems Management Program, Department of Management, Bar Ilan University, Ramat Gan, Israel
| | - Abraham Reichenberg
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
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17
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Harave VS, Shivakumar V, Kalmady SV, Narayanaswamy JC, Varambally S, Venkatasubramanian G. Neurocognitive Impairments in Unaffected First-degree Relatives of Schizophrenia. Indian J Psychol Med 2017; 39:250-253. [PMID: 28615756 PMCID: PMC5461832 DOI: 10.4103/0253-7176.207335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Neurocognitive impairments of attention and executive functioning are trait abnormalities in schizophrenia, and these are considered to be endophenotypes. These deficits have been convincingly linked to prefrontal cortical functioning. In this study, we examined the cognitive performance in the domains of attention and executive functioning among first-degree relatives of Indian people with schizophrenia (high-risk [HR] patients) compared to healthy controls (HC). MATERIALS AND METHODS Siblings of patients with DSM-IV schizophrenia, HR patients (n = 17), were compared with HC (n = 30) (matched as a group for age, sex, years of education, and handedness) using the following neurocognitive tests for attention and executive function - digit span test (DST), trail making test, letter-number sequencing (LNS), and spatial span test. RESULTS HR patients had significantly deficient performance in attention and executive function tasks (DST-forward [P < 0.001], DST-backward [P < 0.001], spatial span-forward [P < 0.001], spatial span-backward [P < 0.001], and LNS [P < 0.001]). CONCLUSIONS This study replicates the findings that neurocognitive deficits involving executive function task performance, attention, and working memory, which are considered as principal features in patients with schizophrenia, are also significantly present in the first-degree relatives of patients. Thus, these neurocognitive parameters can be considered as potential endophenotypes in schizophrenia.
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Affiliation(s)
- Virupaksha Shanmugam Harave
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Venkataram Shivakumar
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sunil V Kalmady
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Janardhanan C Narayanaswamy
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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18
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Tempelaar WM, Termorshuizen F, MacCabe JH, Boks MPM, Kahn RS. Educational achievement in psychiatric patients and their siblings: a register-based study in 30 000 individuals in The Netherlands. Psychol Med 2017; 47:776-784. [PMID: 27873559 DOI: 10.1017/s0033291716002877] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Poor educational achievement is associated with a range of psychiatric disorders. Several studies suggest that this underperformance is due to cognitive deficits that commence before disease onset and reflect a genetic risk for this disorder. However, the specificity and the familial contribution of this cognitive deficit are not clear. We analysed lifetime educational achievement of psychiatric patients diagnosed with schizophrenia, bipolar or depressive disorder and their unaffected siblings. METHOD In a register-based case-control study, 1561 patients with schizophrenia, 813 patients with bipolar disorder, 8112 patients with depression, and their siblings were each matched with eight population controls. Patients, siblings and controls were compared on the highest educational stream they completed. RESULTS Lower educational achievement was present in schizophrenia patients from primary school onwards [completing primary school: odds ratio (OR) 0.69; completing secondary school: OR 0.69; completing academic education: OR 0.46], compared to patients with bipolar disorder or depression. Siblings of schizophrenia, bipolar or depressed patients showed no underachievement at primary or secondary school, but siblings of schizophrenia patients as well as siblings of depressed patients were less successful in their educational achievement after secondary school (completing academic education, schizophrenia siblings: OR 0.90; depressive disorder siblings: OR 0.91). CONCLUSIONS Educational underachievement from primary school onwards is specifically related to schizophrenia and not to bipolar disorder or depression. Moreover, it appears to be a harbinger of the illness, since it is not found in their siblings. These results add to evidence that early cognitive deficits are a distinct feature of the schizophrenia phenotype.
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Affiliation(s)
- W M Tempelaar
- Department of Psychiatry,Brain Center Rudolf Magnus,University Medical Centre Utrecht,Utrecht,The Netherlands
| | - F Termorshuizen
- Julius Centre for Health Sciences and Primary Care,University Medical Centre Utrecht,Utrecht,The Netherlands
| | - J H MacCabe
- Department of Psychosis Studies,Institute of Psychiatry,Psychology and Neuroscience,King's College London,London,UK
| | - M P M Boks
- Department of Psychiatry,Brain Center Rudolf Magnus,University Medical Centre Utrecht,Utrecht,The Netherlands
| | - R S Kahn
- Department of Psychiatry,Brain Center Rudolf Magnus,University Medical Centre Utrecht,Utrecht,The Netherlands
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19
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Kelleher I, Ramsay H, DeVylder J. Psychotic experiences and suicide attempt risk in common mental disorders and borderline personality disorder. Acta Psychiatr Scand 2017; 135:212-218. [PMID: 28185269 DOI: 10.1111/acps.12693] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Recent research has demonstrated a strong relationship between psychotic experiences and suicidal behaviour. No research to date, however, has investigated the role of borderline personality disorder (BPD) in this relationship, despite the fact that BPD is highly comorbid with common mental disorders and is associated with both recurrent suicidal behaviour and psychotic experiences. This paper examined the relationship between psychotic experiences and suicide attempts, including interrelationships with BPD and common mental disorders. METHOD We used the 2007 Adult Psychiatric Morbidity Study, a stratified, multistage probability sample of households in England, which recruited a nationally representative sample aged 16 years and older. Participants were assessed for common mental disorders, BPD (clinical and subclinical), suicidal behaviour, and psychotic experiences. RESULTS Approximately 4% of the total sample (n = 323) reported psychotic experiences. Psychotic experiences were associated with increased odds of suicide attempts in individuals with BPD (OR = 2.23, 95% CI = 1.03-4.85), individuals with a common mental disorder (OR = 2.47, 95% CI = 1.37-4.43), individuals without a common mental disorder (OR = 3.99, 95% CI = 2.47-6.43), and individuals with neither a common mental disorder nor BPD (OR = 3.20, 95% CI = 1.71-5.98). CONCLUSION Psychotic experiences are associated with high odds of suicidal behaviour in individuals with and without psychopathology. This relationship is not explained by clinical or subclinical BPD.
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Affiliation(s)
- I Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - H Ramsay
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Psychiatry, University of Oulu, Oulu, Finland
| | - J DeVylder
- Department of Social Work, University of Maryland, Baltimore, MD, USA
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20
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Chow TJ, Tee SF, Yong HS, Tang PY. Genetic Association of TCF4 and AKT1 Gene Variants with the Age at Onset of Schizophrenia. Neuropsychobiology 2017; 73:233-40. [PMID: 27305091 DOI: 10.1159/000446285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 04/19/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Age at onset (AAO) is a known prognostic indicator for schizophrenia and is hypothesized to correlate with cognition and symptom severity. TCF4 and AKT1 are schizophrenia risk genes involved in cognitive functions. The current study examined the interactive effects of TCF4 and AKT1 variants with gender, family history of psychiatric disorders and ethnicity on the AAO of schizophrenia. METHODS This study consisted of 322 patients with schizophrenia meeting the DSM-IV criteria. Six single nucleotide polymorphisms (SNPs) of TCF4 (rs12966547, rs8766, rs2958182, rs9960767, rs10401120 and rs17512836) and seven AKT1 SNPs (rs2498804, rs3803304, rs2494732, rs3730358, rs1130214, rs2498784 and rs3803300) were genotyped using the TaqMan® SNP genotyping-based assays method. The relationship of AAO with each variant was investigated using analyses of covariance. RESULTS Among the TCF4 variants, rs12966547 (p = 0.024) and rs8766 (p = 0.021) were significantly associated with earlier AAO. We found a lower average AAO in patients with the AA genotype of rs12966547, while the CT genotype of rs8766 was demonstrated to have a protective effect on AAO. For rs8766, there was significant gene × gender interaction (p = 0.012) in influencing AAO. However, these results were not significant after false discovery rate correction. Significant gene × ethnicity interactions were observed to influence AAO (p < 0.05). The Kaplan-Meier curve of the minor AA genotype of rs12966547 displayed a significant trend (p = 0.008) for onset after 19 years of age. Similarly, the minor CC genotype of rs8766 showed a significantly (p = 0.034) lower AAO compared to the TT genotype. CONCLUSION Our analyses suggest that individual risk genotypes may influence the risk of schizophrenia in an age-specific manner.
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Affiliation(s)
- Tze Jen Chow
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Tunku Abdul Rahman University, Kajang, Malaysia
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21
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Pruessner M, Cullen AE, Aas M, Walker EF. The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities. Neurosci Biobehav Rev 2017; 73:191-218. [DOI: 10.1016/j.neubiorev.2016.12.013] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 01/29/2023]
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22
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Lin A, Di Prinzio P, Young D, Jacoby P, Whitehouse A, Waters F, Jablensky A, Morgan VA. Academic Performance in Children of Mothers With Schizophrenia and Other Severe Mental Illness, and Risk for Subsequent Development of Psychosis: A Population-Based Study. Schizophr Bull 2017; 43:205-213. [PMID: 27131155 PMCID: PMC5216844 DOI: 10.1093/schbul/sbw042] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE We examined the academic performance at age 12 years of children of mothers diagnosed with schizophrenia or other severe mental illness using a large whole-population birth cohort born in Western Australia. We investigated the association between academic performance and the subsequent development of psychotic illness. METHOD The sample comprised 3169 children of mothers with severe mental illness (schizophrenia, bipolar disorder, unipolar major depression, delusional disorder or other psychoses; ICD-9 codes 295-298), and 88 353 children of comparison mothers without known psychiatric morbidity. Academic performance of children was indexed on a mandatory state-wide test of reading, spelling, writing and numeracy. RESULTS A larger proportion of children (43.1%) of mothers with severe mental illness performed below the acceptable standard than the reference group (30.3%; children of mothers with no known severe mental illness). After adjusting for covariates, children of mothers with any severe mental illness were more likely than the reference group to perform below-benchmark on all domains except reading. For all children, poor spelling was associated with the later development of psychosis, but particularly for those at familial risk for severe mental illness (hazard ratio [HR] = 1.81; 95% CI for HR = 1.21, 2.72). CONCLUSIONS Children of mothers with a severe mental illness are at increased risk for sub-standard academic achievement at age 12 years, placing these children at disadvantage for the transition to secondary school. For children with familial risk for severe mental illness, very poor spelling skills at age 12 years may be an indicator of risk for later psychotic disorder.
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Affiliation(s)
- Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Perth, Australia;
| | - Patsy Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Deidra Young
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Peter Jacoby
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Andrew Whitehouse
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Flavie Waters
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia;,Clinical Research Centre, North Metropolitan Health Service Mental Health, Perth, Australia
| | - Assen Jablensky
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Vera A. Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia;,Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
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23
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Li X, Thermenos HW, Wu Z, Momura Y, Wu K, Keshavan M, Seidman L, DeLisi LE. Abnormal interactions of verbal- and spatial-memory networks in young people at familial high-risk for schizophrenia. Schizophr Res 2016; 176:100-105. [PMID: 27481817 DOI: 10.1016/j.schres.2016.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/19/2016] [Accepted: 07/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Working memory impairment (especially in verbal and spatial domains) is the core neurocognitive impairment in schizophrenia and the familial high-risk (FHR) population. Inconsistent results have been reported in clinical and neuroimaging studies examining the verbal- and spatial-memory deficits in the FHR subjects, due to sample differences and lack of understanding on interactions of the brain regions for processing verbal- and spatial-working memory. METHODS Functional MRI data acquired during a verbal- vs. spatial-memory task were included from 51 young adults [26 FHR and 25 controls]. Group comparisons were conducted in brain activation patterns responding to 1) verbal-memory condition (A), 2) spatial-memory condition (B), 3) verbal higher than spatial (A-B), 4) spatial higher than verbal (B-A), 5) conjunction of brain regions that were activated during both A and B (A∧B). Group difference of the laterality index (LI) in inferior frontal lobe for condition A was also assessed. RESULTS Compared to controls, the FHR group exhibited significantly decreased brain activity in left inferior frontal during A, and significantly stronger involvement of ACC, PCC, paracentral gyrus for the contrast of A-B. The LI showed a trend of reduced left-higher-than-right pattern for verbal-memory processing in the HR group. CONCLUSIONS Our findings suggest that in the entire functional brain network for working-memory processing, verbal information processing associated brain pathways are significantly altered in people at familial high risk for developing schizophrenia. Future studies will need to examine whether these alterations may indicate vulnerability for predicting the onset of Schizophrenia.
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Affiliation(s)
- Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA; Department of Electric and Computer Engineering, , New Jersey Institute of Technology, Newark, NJ, USA.
| | | | - Ziyan Wu
- Department of Electric and Computer Engineering, , New Jersey Institute of Technology, Newark, NJ, USA
| | - Yoko Momura
- Department of Psychology, Queens College, City University of New York, NY, USA
| | - Kai Wu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Matcheri Keshavan
- Harvard Medical School, Boston, MA, USA; Beth Israel-Deakoness Hospital, MA, USA
| | - Lawrence Seidman
- Harvard Medical School, Boston, MA, USA; Beth Israel-Deakoness Hospital, MA, USA
| | - Lynn E DeLisi
- VA Boston Healthcare System, Brockton, MA, USA; Harvard Medical School, Boston, MA, USA
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24
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Schmitt A, Rujescu D, Gawlik M, Hasan A, Hashimoto K, Iceta S, Jarema M, Kambeitz J, Kasper S, Keeser D, Kornhuber J, Koutsouleris N, Lanzenberger R, Malchow B, Saoud M, Spies M, Stöber G, Thibaut F, Riederer P, Falkai P. Consensus paper of the WFSBP Task Force on Biological Markers: Criteria for biomarkers and endophenotypes of schizophrenia part II: Cognition, neuroimaging and genetics. World J Biol Psychiatry 2016; 17:406-28. [PMID: 27311987 DOI: 10.1080/15622975.2016.1183043] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Schizophrenia is a group of severe psychiatric disorders with high heritability but only low odds ratios of risk genes. Despite progress in the identification of pathophysiological processes, valid biomarkers of the disease are still lacking. METHODS This comprehensive review summarises recent efforts to identify genetic underpinnings, clinical and cognitive endophenotypes and symptom dimensions of schizophrenia and presents findings from neuroimaging studies with structural, functional and spectroscopy magnetic resonance imaging and positron emission tomography. The potential of findings to be biomarkers of schizophrenia is discussed. RESULTS Recent findings have not resulted in clear biomarkers for schizophrenia. However, we identified several biomarkers that are potential candidates for future research. Among them, copy number variations and links between genetic polymorphisms derived from genome-wide analysis studies, clinical or cognitive phenotypes, multimodal neuroimaging findings including positron emission tomography and magnetic resonance imaging, and the application of multivariate pattern analyses are promising. CONCLUSIONS Future studies should address the effects of treatment and stage of the disease more precisely and apply combinations of biomarker candidates. Although biomarkers for schizophrenia await validation, knowledge on candidate genomic and neuroimaging biomarkers is growing rapidly and research on this topic has the potential to identify psychiatric endophenotypes and in the future increase insight on individual treatment response in schizophrenia.
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Affiliation(s)
- Andrea Schmitt
- a Department of Psychiatry and Psychotherapy , LMU Munich , Germany ;,b Laboratory of Neuroscience (LIM27), Institute of Psychiatry , University of Sao Paulo , Sao Paulo , Brazil
| | - Dan Rujescu
- c Department of Psychiatry, Psychotherapy and Psychosomatics , University of Halle , Germany
| | - Micha Gawlik
- d Department of Psychiatry, Psychotherapy and Psychosomatics , University of Würzburg , Germany
| | - Alkomiet Hasan
- a Department of Psychiatry and Psychotherapy , LMU Munich , Germany
| | - Kenji Hashimoto
- e Division of Clinical Neuroscience , Chiba University Center for Forensic Mental Health , Chiba , Japan
| | - Sylvain Iceta
- f INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PsyR2 Team , Lyon , F-69000 , France ; Hospices Civils De Lyon, France
| | - Marek Jarema
- g Department of Psychiatry , Institute of Psychiatry and Neurology , Warsaw , Poland
| | - Joseph Kambeitz
- a Department of Psychiatry and Psychotherapy , LMU Munich , Germany
| | - Siegfried Kasper
- h Department of Psychiatry and Psychotherapy , Medical University of Vienna , Austria
| | - Daniel Keeser
- a Department of Psychiatry and Psychotherapy , LMU Munich , Germany
| | - Johannes Kornhuber
- i Department of Psychiatry and Psychotherapy , Friedrich-Alexander-University Erlangen-Nuremberg , Erlangen , Germany
| | | | - Rupert Lanzenberger
- h Department of Psychiatry and Psychotherapy , Medical University of Vienna , Austria
| | - Berend Malchow
- a Department of Psychiatry and Psychotherapy , LMU Munich , Germany
| | - Mohamed Saoud
- f INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PsyR2 Team , Lyon , F-69000 , France ; Hospices Civils De Lyon, France
| | - Marie Spies
- h Department of Psychiatry and Psychotherapy , Medical University of Vienna , Austria
| | - Gerald Stöber
- d Department of Psychiatry, Psychotherapy and Psychosomatics , University of Würzburg , Germany
| | - Florence Thibaut
- j Department of Psychiatry , University Hospital Cochin (Site Tarnier), University of Paris-Descartes, INSERM U 894 Centre Psychiatry and Neurosciences , Paris , France
| | - Peter Riederer
- k Center of Psychic Health; Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg , Germany
| | - Peter Falkai
- a Department of Psychiatry and Psychotherapy , LMU Munich , Germany
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25
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Hou CL, Xiang YT, Wang ZL, Everall I, Tang Y, Yang C, Xu MZ, Correll CU, Jia FJ. Cognitive functioning in individuals at ultra-high risk for psychosis, first-degree relatives of patients with psychosis and patients with first-episode schizophrenia. Schizophr Res 2016; 174:71-76. [PMID: 27197904 DOI: 10.1016/j.schres.2016.04.034] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate and compare cognitive functioning of first-degree relatives of people with schizophrenia who were also at ultra-high risk (UHR) for psychosis with patients with first-episode (FE) schizophrenia, first degree relatives of patients not fulfilling UHR criteria (FDR), and healthy control (HC) subjects. METHOD Forty subjects in each group were included, underwent a face-to-face interview and completed a neurocognitive test battery, including the Trail Making Test-A (TMT-A, psychomotor functions), Stroop Color Word Test (attention), Digit Symbol Coding Test (DST, processing speed and working memory) and Hopkins Verbal Leaning Test-Revised (HVLT-R, verbal memory). RESULTS Functioning in all the cognitive test domains displayed a gradual decrease from the HC, FDR, UHR to FE groups. After controlling for covariates, there were still significant differences in TMT-A (F(7160)=35.4, P<0.001), DST (F(7160)=38.9, P<0.001), Stroop Color Word Test (F(7160)=35.0, P<0.001), Stroop Word Test (F(7160)=36.2, P<0.001), Stroop Color Test (F(7160)=40.9, P<0.001) and HVLT-R (F(7160)=62.5, P<0.001) between the four groups, indicating that the cognitive functioning in the UHR group was intermediate between the FE and FDR groups, while the FDR group had poorer performance than the HC group, and the FE group had the poorest cognitive functioning across all four examined domains. CONCLUSION The results indicate that impairments in processing speed, attention, working memory and verbal memory exist in both UHR and FDR subjects. In order to clarify the associations between cognitive functioning and UHR and schizophrenia, longitudinal studies are warranted.
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Affiliation(s)
- Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
| | - Zhong-Lei Wang
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Ian Everall
- Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Yi Tang
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Chengjia Yang
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Ming-Zhi Xu
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Christoph U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China.
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26
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Rossi R, Zammit S, Button KS, Munafò MR, Lewis G, David AS. Psychotic Experiences and Working Memory: A Population-Based Study Using Signal-Detection Analysis. PLoS One 2016; 11:e0153148. [PMID: 27120349 PMCID: PMC4847914 DOI: 10.1371/journal.pone.0153148] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 03/24/2016] [Indexed: 01/15/2023] Open
Abstract
Psychotic Experiences (PEs) during adolescence index increased risk for psychotic disorders and schizophrenia in adult life. Working memory (WM) deficits are a core feature of these disorders. Our objective was to examine the relationship between PEs and WM in a general population sample of young people in a case control study. 4744 individuals of age 17–18 from Bristol and surrounding areas (UK) were analyzed in a cross-sectional study nested within the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study. The dependent variable was PEs, assessed using the semi-structured Psychosis-Like Symptom Interview (PLIKSi). The independent variable was performance on a computerized numerical n-back working memory task. Signal-Detection Theory indices, including standardized hits rate, false alarms rate, discriminability index (d’) and response bias (c) from 2-Back and 3-Back tasks were calculated. 3576 and 3527 individuals had complete data for 2-Back and 3-Back respectively. Suspected/definite PEs prevalence was 7.9% (N = 374). Strongest evidence of association was seen between PEs and false alarms on the 2-Back, (odds ratio (OR) = 1.17 [95% confidence intervals (CI) 1.01, 1.35]) and 3-back (OR = 1.35 [1.18, 1.54]) and with c (OR = 1.59 [1.09, 2.34]), and lower d’ (OR = 0.76 [0.65, 0.89]), on the 3-Back. Adjustment for several potential confounders, including general IQ, drug exposure and different psycho-social factors, and subsequent multiple imputation of missing data did not materially alter the results. WM is impaired in young people with PEs in the general population. False alarms, rather than poor accuracy, are more closely related to PEs. Such impairment is consistent with different neuropsychological models of psychosis focusing on signal-to-noise discrimination, probabilistic reasoning and impaired reality monitoring as a basis of psychotic symptoms.
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Affiliation(s)
- Rodolfo Rossi
- Section of Psychiatry, University School of Medicine Federico II, Naples, Italy
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom
- * E-mail:
| | - Stanley Zammit
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | | | - Marcus R. Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, United Kingdom
| | - Anthony S. David
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom
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27
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Laurens KR, Cullen AE. Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study. Soc Psychiatry Psychiatr Epidemiol 2016; 51:475-91. [PMID: 26670311 PMCID: PMC4823320 DOI: 10.1007/s00127-015-1151-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/08/2015] [Indexed: 11/02/2022]
Abstract
PURPOSE The London Child Health and Development Study (CHADS) is a prospective, longitudinal investigation of children, sampled from the general community aged 9-11 years and assessed biennially, who present premorbid risk markers for schizophrenia. The study aims to characterise developmental trajectories of psychological, cognitive, and biological functioning in at-risk children and identify potential targets for early preventative intervention. This review summarises CHADS findings, discusses these in the context of recent theory regarding aetiology and prevention of schizophrenia, and highlights challenges to be addressed with future research. METHODS We review (1) epidemiological information on the prevalence and correlates of developmental antecedents of schizophrenia in the general child population, (2) evidence of psychosocial, cognitive, and biological dysfunctions in at-risk children presenting multiple antecedents of schizophrenia and at-risk children with a family history of schizophrenia, and (3) related findings from an associated sample of help-seeking children receiving intervention. RESULTS Community-based screening of 9-11-year olds identified ~9 % with a triad of antecedents of schizophrenia [including psychotic-like experiences (PLEs)] who are putatively at-risk of psychosis; these children reported greater exposure and responsivity to stressors, impairments in general intelligence and specific cognitive functions, brain structure and function abnormalities, and neuromotor dysfunction. Preliminary evidence suggests distressing PLEs are a viable target for cognitive-behavioural intervention in at-risk children. CONCLUSIONS Intervention in early, premorbid phases of illness might alleviate current difficulties and avert future schizophrenia using benign treatments. The CHADS programme has identified several markers that may index early pathophysiology and constitute potential targets for preventative intervention.
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Affiliation(s)
- Kristin R Laurens
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia.
- Schizophrenia Research Institute, Sydney, Australia.
| | - Alexis E Cullen
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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28
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Mark W, Toulopoulou T. Cognitive intermediate phenotype and genetic risk for psychosis. Curr Opin Neurobiol 2016; 36:23-30. [DOI: 10.1016/j.conb.2015.08.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/11/2015] [Accepted: 08/26/2015] [Indexed: 12/26/2022]
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29
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Jeppesen P, Larsen JT, Clemmensen L, Munkholm A, Rimvall MK, Rask CU, van Os J, Petersen L, Skovgaard AM. The CCC2000 Birth Cohort Study of Register-Based Family History of Mental Disorders and Psychotic Experiences in Offspring. Schizophr Bull 2015; 41:1084-94. [PMID: 25452427 PMCID: PMC4535626 DOI: 10.1093/schbul/sbu167] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Psychotic experiences (PE) in individuals of the general population are hypothesized to mark the early expression of the pathology underlying psychosis. This notion of PE as an intermediate phenotype is based on the premise that PE share genetic liability with psychosis. We examined whether PE in childhood was predicted by a family history of mental disorder with psychosis rather than a family history of nonpsychotic mental disorder and whether this association differed by severity of PE. The study examined data on 1632 children from a general population birth cohort assessed at age 11-12 years by use of a semistructured interview covering 22 psychotic symptoms. The Danish national registers were linked to describe the complete family history of hospital-based psychiatric diagnoses. Uni- and multivariable logistic regressions were used to test whether a family history of any mental disorder with psychosis, or of nonpsychotic mental disorder, vs no diagnoses was associated with increased risk of PE in offspring (hierarchical exposure variable). The occurrence of PE in offspring was significantly associated with a history of psychosis among the first-degree relatives (adjusted relative risk [RR] = 3.29, 95% CI: 1.82-5.93). The risk increased for combined hallucinations and delusions (adjusted RR = 5.90, 95% CI: 2.64-13.16). A history of nonpsychotic mental disorders in first-degree relatives did not contribute to the risk of PE in offspring nor did any mental disorder among second-degree relatives. Our findings support the notion of PE as a vulnerability marker of transdiagnostic psychosis. The effect of psychosis in first-degree relatives may operate through shared genetic and environmental factors.
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Affiliation(s)
- Pia Jeppesen
- Child and Adolescent Mental Health Center, Mental Health Services, The Capital Region of Denmark, Glostrup, Denmark; Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark;
| | - Janne Tidselbak Larsen
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark;,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
| | - Lars Clemmensen
- Child and Adolescent Mental Health Center, Mental Health Services, The Capital Region of Denmark, Glostrup, Denmark;,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anja Munkholm
- Child and Adolescent Mental Health Center, Mental Health Services, The Capital Region of Denmark, Glostrup, Denmark;,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kristian Rimvall
- Child and Adolescent Mental Health Center, Mental Health Services, The Capital Region of Denmark, Glostrup, Denmark;,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Ulrikka Rask
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark;,Child and Adolescent Psychiatric Centre Risskov, Aarhus University Hospital, Aarhus, Denmark
| | - Jim van Os
- Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry, London, UK;,Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Liselotte Petersen
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark;,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
| | - Anne Mette Skovgaard
- Child and Adolescent Mental Health Center, Mental Health Services, The Capital Region of Denmark, Glostrup, Denmark;,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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30
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Kendler KS, Ohlsson H, Sundquist J, Sundquist K. IQ and schizophrenia in a Swedish national sample: their causal relationship and the interaction of IQ with genetic risk. Am J Psychiatry 2015; 172:259-65. [PMID: 25727538 PMCID: PMC4391822 DOI: 10.1176/appi.ajp.2014.14040516] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The authors sought to clarify the relationship between IQ and subsequent risk for schizophrenia. METHOD IQ was assessed at ages 18-20 in 1,204,983 Swedish males born between 1951 and 1975. Schizophrenia was assessed by hospital diagnosis through 2010. Cox proportional hazards models were used to investigate future risk for schizophrenia in individuals as a function of their IQ score, and then stratified models using pairs of relatives were used to adjust for familial cluster. Finally, regression models were used to examine the interaction between IQ and genetic liability on risk for schizophrenia. RESULTS IQ had a monotonic relationship with schizophrenia risk across the IQ range, with a mean increase in risk of 3.8% per 1-point decrease in IQ; this association was stronger in the lower than the higher IQ range. Co-relative control analyses showed a similar association between IQ and schizophrenia in the general population and in cousin, half-sibling, and full-sibling pairs. A robust interaction was seen between genetic liability to schizophrenia and IQ in predicting schizophrenia risk. Genetic susceptibility for schizophrenia had a much stronger impact on risk of illness for those with low than high intelligence. The IQ-genetic liability interaction arose largely from IQ differences between close relatives. CONCLUSIONS IQ assessed in late adolescence is a robust risk factor for subsequent onset of schizophrenia. This association is not the result of a declining IQ associated with insidious onset. In this large, representative sample, we found no evidence for a link between genius and schizophrenia. Co-relative control analyses showed that the association between lower IQ and schizophrenia is not the result of shared familial risk factors and may be causal. The strongest effect was seen with IQ differences within families. High intelligence substantially attenuates the impact of genetic liability on the risk for schizophrenia.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond VA, USA,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden,Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden,Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
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Nishida A, Xu KM, Croudace T, Jones PB, Barnett J, Richards M. Adolescent self-control predicts midlife hallucinatory experiences: 40-year follow-up of a national birth cohort. Schizophr Bull 2014; 40:1543-51. [PMID: 24714378 PMCID: PMC4193720 DOI: 10.1093/schbul/sbu050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Associations between self-control in adolescence and adult mental health are unclear in the general population; to our knowledge, no study has investigated self-control in relation to psychotic-like symptoms. AIMS To investigate the relationship between adolescent self-control and the midlife mental health outcomes of anxiety and depression symptoms and psychotic-like experiences (PLEs), controlling for the effect of adolescent conduct and emotional problems and for parental occupational social class and childhood cognition. METHODS A population-based sample, the MRC National Survey of Health and Development (the British 1946 birth cohort) was contacted 23 times between ages 6 weeks and 53 years. Teachers completed rating scales to assess emotional adjustment and behaviors, from which factors measuring self-control, behavioral, and emotional problems were extracted. At age 53 years, PLEs were self-reported by 2918 participants using 4 items from the Psychosis Screening Questionnaire; symptoms of anxiety and depression were assessed using the scaled version of the General Health Questionnaire (GHQ-28). RESULTS After adjustment for the above covariates, poor adolescent self-control was associated with the presence of PLEs in adulthood, specifically hallucinatory experiences at age 53 years, even after adjustment for GHQ-28 scores. CONCLUSIONS Lower self-control in adolescence is a risk factor for hallucinatory experiences in adulthood.
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Affiliation(s)
- Atsushi Nishida
- Department of Psychiatry & Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; MRC Unit for Lifelong Health and Ageing at UCL, London, UK;
| | - Kate Man Xu
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Tim Croudace
- Department of Health Sciences and Hull York Medical School, University of York, York, UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK;,CAMEO, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Jenifer Barnett
- Department of Psychiatry, University of Cambridge, Cambridge, UK;,Cambridge Cognition Ltd, Cambridge, UK
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32
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Cullen AE, Zunszain PA, Dickson H, Roberts RE, Fisher HL, Pariante CM, Laurens KR. Cortisol awakening response and diurnal cortisol among children at elevated risk for schizophrenia: relationship to psychosocial stress and cognition. Psychoneuroendocrinology 2014; 46:1-13. [PMID: 24882153 PMCID: PMC4065330 DOI: 10.1016/j.psyneuen.2014.03.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 03/19/2014] [Accepted: 03/20/2014] [Indexed: 01/28/2023]
Abstract
Abnormal hypothalamic-pituitary-adrenal (HPA) axis function, as indexed by elevated diurnal cortisol levels and/or a blunted cortisol awakening response (CAR), has been observed among patients with first episode psychosis and associated with neurocognitive deficits in this population. However, the extent to which these features precede illness onset is unclear. The current study aimed to determine whether children who are at putatively elevated risk for psychosis because they present multiple antecedents of schizophrenia (ASz), and high-risk children with a family history of illness (FHx), are characterized by abnormal cortisol levels when compared with their typically developing (TD) peers. A further aim was to investigate the extent to which cortisol levels are associated with psychosocial stress and neurocognitive function. Thirty-three ASz children, 22 FHx children, and 40 TD children were identified at age 9-12 years using a novel community-based screening procedure or as relatives of individuals with schizophrenia. All participants were antipsychotic-naive and not currently seeking treatment for their symptoms. At age 11-14 years, participants provided salivary cortisol samples and completed psychosocial stress measures and tests of memory and executive function. Results indicated that FHx children, but not ASz children, were characterized by a blunted CAR relative to their TD peers (effect size=-0.73, p=0.01) that was not explained by psychosocial stress exposure or by distress relating to these experiences. Neither FHx nor ASz children were characterized by elevated diurnal cortisol. Among both FHx and ASz children, more pronounced HPA axis function abnormalities (i.e., higher diurnal cortisol levels and greater blunting of the CAR) were associated with poorer performance on tests of verbal memory and executive function. These findings support the notion that at least some HPA axis abnormalities described in psychosis precede illness onset, rather than being a subsequent epiphenomenon. We speculate that the blunted CAR may constitute an early (potentially genetically mediated) marker of psychosis vulnerability, whilst elevated diurnal cortisol levels may emerge only proximally to disease onset.
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Affiliation(s)
- Alexis E Cullen
- Department of Forensic and Neurodevelopmental Sciences (Box P023), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Patricia A Zunszain
- Section of Stress, Psychiatry and Immunology, Department of Psychological Medicine, Institute of Psychiatry, King's College London, 125 Coldharbour Lane, London SE5 9NU, United Kingdom
| | - Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences (Box P023), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Ruth E Roberts
- Department of Forensic and Neurodevelopmental Sciences (Box P023), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Helen L Fisher
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Carmine M Pariante
- Section of Stress, Psychiatry and Immunology, Department of Psychological Medicine, Institute of Psychiatry, King's College London, 125 Coldharbour Lane, London SE5 9NU, United Kingdom
| | - Kristin R Laurens
- Department of Forensic and Neurodevelopmental Sciences (Box P023), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom; Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia; Schizophrenia Research Institute, Sydney, Australia.
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