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Feola B, Moussa-Tooks AB, Sheffield JM, Heckers S, Woodward ND, Blackford JU. Threat Responses in Schizophrenia: A Negative Valence Systems Framework. Curr Psychiatry Rep 2024; 26:9-25. [PMID: 38183600 PMCID: PMC10962319 DOI: 10.1007/s11920-023-01479-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE OF REVIEW Emotions are prominent in theories and accounts of schizophrenia but are largely understudied compared to cognition. Utilizing the Research Domain Criteria (RDoC) Negative Valence Systems framework, we review the current knowledge of emotions in schizophrenia. Given the pivotal role of threat responses in theories of schizophrenia and the substantial evidence of altered threat responses, we focus on three components of Negative Valence Systems tied to threat responses: responses to acute threat, responses to potential threat, and sustained threat. RECENT FINDINGS Individuals with schizophrenia show altered responses to neutral stimuli during acute threat, bed nucleus of the stria terminalis connectivity in response to potential threat, and threat responses associated with sustained threat. Our review concludes that Negative Valence Systems are altered in schizophrenia; however, the level and evidence of alterations vary across the types of threat responses. We suggest avenues for future research to further understand and intervene on threat responses in schizophrenia.
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Affiliation(s)
- Brandee Feola
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN, 37212, USA.
| | - Alexandra B Moussa-Tooks
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN, 37212, USA
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, USA
| | - Julia M Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN, 37212, USA
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN, 37212, USA
| | - Neil D Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN, 37212, USA
| | - Jennifer U Blackford
- Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA
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2
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Schaug JP, Storebø OJ, Pedersen MB, Haahr UH, Simonsen E. How first-episode psychosis patients' subjective beliefs about their childhood trauma's causal effect provide support for potential schizophrenia subtypes. Schizophr Res 2023; 262:175-183. [PMID: 37992561 DOI: 10.1016/j.schres.2023.11.005] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/04/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Childhood and adolescent trauma is a risk factor for developing psychosis-spectrum disorders. The current study aimed to assess how childhood trauma might predict psychosis symptomatology, and how patients' beliefs of whether trauma is the cause of psychosis might affect this association. METHODS Ninety-six first-episode psychosis patients were assessed for childhood traumatic experiences with the Brief Betrayal Trauma Survey, and for psychosis symptoms with the Positive and Negative Syndrome Scale. RESULTS Non-interpersonal trauma predicted higher positive symptoms, whereas more trauma domains experienced predicted lower negative symptoms. Almost half of the participants believed trauma to be related to psychosis, were 12 times more likely to reexperience trauma through psychosis, and had higher excitative and emotional symptoms. Non-interpersonal trauma also predicted higher positive symptoms in this group. Those who did not believe trauma to be the cause of psychosis had higher negative symptoms, and a negative dose-response was found for negative and disorganised symptoms, in which more trauma domains experienced predicted lower scores. CONCLUSIONS Results imply two traumagenic pathways to psychosis, one characterised by positive, excitative, and emotional symptoms, and one negative subtype, characterised by negative and disorganised symptoms. Clinical implications for how findings might contribute to better treatments are discussed.
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Affiliation(s)
- Julie Perrine Schaug
- Centre for Evidence-Based Psychiatry, Psychiatric Research Unit, Psychiatric Services Region Zealand, 4200 Slagelse, Denmark
| | - Ole Jakob Storebø
- Centre for Evidence-Based Psychiatry, Psychiatric Research Unit, Psychiatric Services Region Zealand, 4200 Slagelse, Denmark; Department of Psychology, University of Southern Denmark, Faculty of Health Sciences, 5230 Odense M, Denmark; Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, 4000 Roskilde, Denmark.
| | - Marlene Buch Pedersen
- Early Psychosis Intervention Centre, Psychiatric Services Region Zealand East, 4000 Roskilde, Denmark
| | - Ulrik Helt Haahr
- Psychiatric Research Unit, Psychiatric Services Region Zealand, 4200 Slagelse, Denmark
| | - Erik Simonsen
- Early Psychosis Intervention Centre, Psychiatric Services Region Zealand East, 4000 Roskilde, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
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Thomas M, Rakesh D, Whittle S, Sheridan M, Upthegrove R, Cropley V. The neural, stress hormone and inflammatory correlates of childhood deprivation and threat in psychosis: A systematic review. Psychoneuroendocrinology 2023; 157:106371. [PMID: 37651860 DOI: 10.1016/j.psyneuen.2023.106371] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/20/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
Childhood adversity increases the risk of developing psychosis, but the biological mechanisms involved are unknown. Disaggregating early adverse experiences into core dimensions of deprivation and threat may help to elucidate these mechanisms. We therefore systematically searched the literature investigating associations between deprivation and threat, and neural, immune and stress hormone systems in individuals on the psychosis spectrum. Our search yielded 74 articles, from which we extracted and synthesized relevant findings. While study designs were heterogeneous and findings inconsistent, some trends emerged. In psychosis, deprivation tended to correlate with lower global cortical volume, and some evidence supported threat-related variation in prefrontal cortex morphology. Greater threat exposure was also associated with higher C-reactive protein, and higher and lower cortisol measures. When examined, associations in controls were less evident. Overall, findings indicate that deprivation and threat may associate with partially distinct biological mechanisms in the psychosis spectrum, and that associations may be stronger than in controls. Dimensional approaches may help disentangle the biological correlates of childhood adversity in psychosis, but more studies are needed.
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Affiliation(s)
- Megan Thomas
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia.
| | - Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia; Neuroimaging Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
| | - Margaret Sheridan
- Department of Psychology & Neuroscience, University of North Carolina, United States
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, United Kingdom; Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, United Kingdom
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
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Merritt K, Luque Laguna P, Sethi A, Drakesmith M, Ashley SA, Bloomfield M, Fonville L, Perry G, Lancaster T, Dimitriadis SI, Zammit S, Evans CJ, Lewis G, Kempton MJ, Linden DEJ, Reichenberg A, Jones DK, David AS. The impact of cumulative obstetric complications and childhood trauma on brain volume in young people with psychotic experiences. Mol Psychiatry 2023; 28:3688-3697. [PMID: 37903876 PMCID: PMC10730393 DOI: 10.1038/s41380-023-02295-6] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 11/01/2023]
Abstract
Psychotic experiences (PEs) occur in 5-10% of the general population and are associated with exposure to childhood trauma and obstetric complications. However, the neurobiological mechanisms underlying these associations are unclear. Using the Avon Longitudinal Study of Parents and Children (ALSPAC), we studied 138 young people aged 20 with PEs (n = 49 suspected, n = 53 definite, n = 36 psychotic disorder) and 275 controls. Voxel-based morphometry assessed whether MRI measures of grey matter volume were associated with (i) PEs, (ii) cumulative childhood psychological trauma (weighted summary score of 6 trauma types), (iii) cumulative pre/peri-natal risk factors for psychosis (weighted summary score of 16 risk factors), and (iv) the interaction between PEs and cumulative trauma or pre/peri-natal risk. PEs were associated with smaller left posterior cingulate (pFWE < 0.001, Z = 4.19) and thalamus volumes (pFWE = 0.006, Z = 3.91). Cumulative pre/perinatal risk was associated with smaller left subgenual cingulate volume (pFWE < 0.001, Z = 4.54). A significant interaction between PEs and cumulative pre/perinatal risk found larger striatum (pFWE = 0.04, Z = 3.89) and smaller right insula volume extending into the supramarginal gyrus and superior temporal gyrus (pFWE = 0.002, Z = 4.79), specifically in those with definite PEs and psychotic disorder. Cumulative childhood trauma was associated with larger left dorsal striatum (pFWE = 0.002, Z = 3.65), right prefrontal cortex (pFWE < 0.001, Z = 4.63) and smaller left insula volume in all participants (pFWE = 0.03, Z = 3.60), and there was no interaction with PEs group. In summary, pre/peri-natal risk factors and childhood psychological trauma impact similar brain pathways, namely smaller insula and larger striatum volumes. The effect of pre/perinatal risk was greatest in those with more severe PEs, whereas effects of trauma were seen in all participants. In conclusion, environmental risk factors affect brain networks implicated in schizophrenia, which may increase an individual's propensity to develop later psychotic disorders.
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Affiliation(s)
- Kate Merritt
- Division of Psychiatry, Institute of Mental Health, University College London, London, UK.
| | - Pedro Luque Laguna
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Arjun Sethi
- Department of Forensic & Neurodevelopmental Sciences, IOPPN, King's College London, London, UK
| | - Mark Drakesmith
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Sarah A Ashley
- Division of Psychiatry, Institute of Mental Health, University College London, London, UK
| | - Michael Bloomfield
- Division of Psychiatry, Institute of Mental Health, University College London, London, UK
| | | | - Gavin Perry
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Tom Lancaster
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
- Department of Psychology, Bath University, Bath, UK
| | - Stavros I Dimitriadis
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Stanley Zammit
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
- Bristol Medical School (PHS), University of Bristol, Bristol, UK
| | - C John Evans
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Glyn Lewis
- Division of Psychiatry, Institute of Mental Health, University College London, London, UK
| | - Matthew J Kempton
- Psychosis Studies Department, IOPPN, King's College London, London, UK
| | - David E J Linden
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | - Derek K Jones
- The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Anthony S David
- Division of Psychiatry, Institute of Mental Health, University College London, London, UK
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5
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Fan F, Tan S, Liu S, Chen S, Huang J, Wang Z, Yang F, Li CSR, Tan Y. Subcortical structures associated with childhood trauma and perceived stress in schizophrenia. Psychol Med 2023; 53:5654-5662. [PMID: 36154670 DOI: 10.1017/s0033291722002860] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Childhood trauma influences the clinical features of schizophrenia. In this study, we examined how childhood trauma and perceived stress are associated with clinical manifestations and subcortical gray matter volumes (GMVs) in patients with schizophrenia. METHODS We recruited 127 patients with schizophrenia and 83 healthy controls for assessment of early childhood trauma, perceived stress, and clinical symptoms. With structural brain imaging, we identified the GMVs of subcortical structures and examined the relationships between childhood trauma, perceived stress, clinical symptoms, and subcortical GMVs. RESULTS Compared to controls, patients with schizophrenia showed higher levels of childhood trauma and perceived stress. Patients with schizophrenia showed significantly smaller amygdala and hippocampus GMVs as well as total cortical GMVs than age-matched controls. Childhood trauma score was significantly correlated with the severity of clinical symptoms, depression, perceived stress, and amygdala GMVs. Perceived stress was significantly correlated with clinical symptoms, depression, and hippocampus and amygdala GMVs. Further, the association between childhood trauma (emotional neglect) and stress coping ability was mediated by right amygdala GMV in patients with schizophrenia. CONCLUSIONS Patients with schizophrenia had more exposure to early-life trauma and poorer stress coping. Both childhood trauma and perceived stress were associated with smaller amygdala volumes. The relationship between early-life trauma and perceived stress was mediated by right amygdala GMV in patients with schizophrenia. These findings together suggest the long-term effects of childhood trauma on perceived stress and the subcortical volumetric correlates of the effects in schizophrenia.
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Affiliation(s)
- Fengmei Fan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
| | - Shuping Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
| | - Shibo Liu
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
| | - Song Chen
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
| | - Junchao Huang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
| | - Zhiren Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
| | - Fude Yang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, P. R. China
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Pollok TM, Kaiser A, Kraaijenvanger EJ, Monninger M, Brandeis D, Banaschewski T, Eickhoff SB, Holz NE. Neurostructural Traces of Early Life Adversities: A Meta-Analysis Exploring Age- and Adversity-specific Effects. Neurosci Biobehav Rev 2022; 135:104589. [DOI: 10.1016/j.neubiorev.2022.104589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/13/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
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7
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Qi Y, Wei Y, Yu F, Lin Q, Yin J, Fu J, Xiong S, Lv D, Dai Z, Peng Q, Wang Y, Zhang D, Wang L, Ye X, Lin Z, Lin J, Ma G, Li K, Luo X. Association study of a genetic variant in the long intergenic noncoding RNA (linc01080) with schizophrenia in Han Chinese. BMC Psychiatry 2021; 21:613. [PMID: 34879837 PMCID: PMC8653569 DOI: 10.1186/s12888-021-03623-2] [Citation(s) in RCA: 3] [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] [Received: 02/18/2021] [Accepted: 11/24/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Schizophrenia is currently considered to be a polygene-related disease with unknown etiology. This research will verify whether the single nucleotide polymorphism (SNP) of the long intergenic noncoding RNA01080 (linc01080) contributes to the susceptibility and phenotypic heterogeneity of schizophrenia, with a view to providing data support for the prevention and individualized treatment of this disease. METHOD The SNP rs7990916 in linc01080 were genotyped in 1139 schizophrenic and 1039 controls in a Southern Chinese Han population by the improved multiplex ligation detection reaction (imLDR) technique. Meanwhile, we assessed and analyzed the association between this SNP and schizophrenics' clinical symptoms, and the cognitive function. RESULT There was no significant difference in genotype distribution, allele frequency distribution, gender stratification analysis between the two groups. However, the SNP of rs7990916 was significantly associated with the age of onset in patients with schizophrenia (P = 8.22E-07), patients with T allele had earlier onset age compared with CC genotype carriers. In terms of cognitive function, patients with T allele scored lower than CC genotype carriers in the Tower of London score and symbol coding score in the Brief assessment of Cognition (BACS), and the difference was statistically significant (P = 0.014, P = 0.022, respectively). CONCLUSION Our data show for the first time that linc01080 polymorphism may affect the age of onset and neurocognitive function in patients with schizophrenia.
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Affiliation(s)
- Yi Qi
- grid.410560.60000 0004 1760 3078The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, 524023 China
| | - Yaxue Wei
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China ,grid.410652.40000 0004 6003 7358Psychiatric and Psychological Clinical Rehabilitation Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021 China
| | - Fengyan Yu
- grid.410560.60000 0004 1760 3078The Second Clinical School, Guangdong Medical University, Dongguan, 523808 China
| | - Qianxing Lin
- grid.410560.60000 0004 1760 3078The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, 524023 China
| | - Jingwen Yin
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Jiawu Fu
- grid.410560.60000 0004 1760 3078Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Susu Xiong
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Dong Lv
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Zhun Dai
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Qian Peng
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Ying Wang
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Dandan Zhang
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Lulu Wang
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Xiaoqing Ye
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Zhixiong Lin
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Juda Lin
- grid.410560.60000 0004 1760 3078Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Guoda Ma
- grid.410560.60000 0004 1760 3078Maternal and Children’s Health Research Institute, Shunde Maternal and Children’s Hospital, Guangdong Medical University, Foshan, 528300 China
| | - Keshen Li
- Department of Neurology and Stroke Center, The First Affiliated Hospital, Jinan University, Guangzhou, 510630, China. .,Clinical Neuroscience Institute of Jinan University, Guangzhou, 510630, China.
| | - Xudong Luo
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China.
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Xiang Z, Liu Z, Cao H, Wu Z, Long Y. Evaluation on Long-Term Test-Retest Reliability of the Short-Form Childhood Trauma Questionnaire in Patients with Schizophrenia. Psychol Res Behav Manag 2021; 14:1033-1040. [PMID: 34285605 PMCID: PMC8286147 DOI: 10.2147/prbm.s316398] [Citation(s) in RCA: 7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/03/2021] [Indexed: 12/27/2022] Open
Abstract
Background Many studies have reported an association between childhood trauma exposure and schizophrenia. Among these studies, the Short-form Childhood Trauma Questionnaire (CTQ-SF) is one of the most widely used measures of childhood trauma. However, little is known regarding the long-term reliability of the CTQ-SF, especially in patients with psychopathology. Methods The CTQ-SF was administered to 50 patients diagnosed with schizophrenia from a hospital in Changsha, Hunan, China. These patients were asked to re-complete the CTQ-SF when they were re-hospitalized or received outpatient treatments in the same hospital within 4 years of follow-up. Intraclass correlation coefficient (ICC) was used to assess test–retest reliability of the CTQ-SF over the intervals. Associations of the CTQ-SF with the Positive and Negative Syndrome Scale (PANSS) and Wechsler Adult Intelligence Scale (WAIS) were tested using Spearman correlation coefficients. Results Among the participants, 35 (70.0%) patients re-completed the CTQ-SF after an interval averaging 11.26 months. Excellent test–retest reliabilities (with ICC > 0.75) were found for the total CTQ-SF score (ICC = 0.772) as well as scores of the emotional abuse (ICC = 0.808), physical abuse (ICC = 0.756), sexual abuse (ICC = 0.877) and physical neglect (ICC = 0.751) subscales. Meanwhile, a moderate test–retest reliability was found for the emotional neglect subscale (ICC = 0.538). At both baseline and follow-up, no significant correlations (p > 0.05) were found between CTQ-SF scores and any other clinical assessments. Conclusion Our results suggest that CTQ-SF is reliable to assess childhood trauma exposures in schizophrenia over relatively long intervals, regardless of patients’ current symptoms and states of cognition.
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Affiliation(s)
- Zhibiao Xiang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Mental Health Institute of Central South University, Changsha, Hunan, People's Republic of China.,China National Clinical Research Center on Mental Disorders, Changsha, Hunan, People's Republic of China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Mental Health Institute of Central South University, Changsha, Hunan, People's Republic of China.,China National Clinical Research Center on Mental Disorders, Changsha, Hunan, People's Republic of China
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Hempstead, NY, USA.,Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Zhipeng Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Mental Health Institute of Central South University, Changsha, Hunan, People's Republic of China.,China National Clinical Research Center on Mental Disorders, Changsha, Hunan, People's Republic of China
| | - Yicheng Long
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Mental Health Institute of Central South University, Changsha, Hunan, People's Republic of China.,China National Clinical Research Center on Mental Disorders, Changsha, Hunan, People's Republic of China
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9
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Rokita KI, Holleran L, Dauvermann MR, Mothersill D, Holland J, Costello L, Kane R, McKernan D, Morris DW, Kelly JP, Corvin A, Hallahan B, McDonald C, Donohoe G. Childhood trauma, brain structure and emotion recognition in patients with schizophrenia and healthy participants. Soc Cogn Affect Neurosci 2021; 15:1336-1350. [PMID: 33245126 PMCID: PMC7759212 DOI: 10.1093/scan/nsaa160] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/25/2020] [Accepted: 11/26/2020] [Indexed: 12/19/2022] Open
Abstract
Childhood trauma, and in particular physical neglect, has been repeatedly associated with lower performance on measures of social cognition (e.g. emotion recognition tasks) in both psychiatric and non-clinical populations. The neural mechanisms underpinning this association have remained unclear. Here, we investigated whether volumetric changes in three stress-sensitive regions—the amygdala, hippocampus and anterior cingulate cortex (ACC)—mediate the association between childhood trauma and emotion recognition in a healthy participant sample (N = 112) and a clinical sample of patients with schizophrenia (N = 46). Direct effects of childhood trauma, specifically physical neglect, on Emotion Recognition Task were observed in the whole sample. In healthy participants, reduced total and left ACC volumes were observed to fully mediate the association between both physical neglect and total childhood trauma score, and emotion recognition. No mediating effects of the hippocampus and amygdala volumes were observed for either group. These results suggest that reduced ACC volume may represent part of the mechanism by which early life adversity results in poorer social cognitive function. Confirmation of the causal basis of this association would highlight the importance of resilience-building interventions to mitigate the detrimental effects of childhood trauma on brain structure and function.
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Affiliation(s)
- Karolina I Rokita
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Laurena Holleran
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Maria R Dauvermann
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland.,Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, MIT, Cambridge, MA 02135, USA
| | - David Mothersill
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland.,School of Business, National College of Ireland, Dublin, Ireland
| | - Jessica Holland
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Laura Costello
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Ruán Kane
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Declan McKernan
- Pharmacology & Therapeutics, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Derek W Morris
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - John P Kelly
- Pharmacology & Therapeutics, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Aiden Corvin
- Department of Psychiatry, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland
| | - Brian Hallahan
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland.,Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Colm McDonald
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland.,Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Gary Donohoe
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
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10
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Quidé Y, Bortolasci CC, Spolding B, Kidnapillai S, Watkeys OJ, Cohen-Woods S, Carr VJ, Berk M, Walder K, Green MJ. Systemic inflammation and grey matter volume in schizophrenia and bipolar disorder: Moderation by childhood trauma severity. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110013. [PMID: 32540496 DOI: 10.1016/j.pnpbp.2020.110013] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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] [Received: 01/24/2020] [Revised: 05/28/2020] [Accepted: 06/09/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Elevated levels of systemic inflammation are consistently reported in both schizophrenia (SZ) and bipolar-I disorder (BD), and are associated with childhood trauma exposure. We tested whether childhood trauma exposure moderates associations between systemic inflammation and brain morphology in people with these diagnoses. METHODS Participants were 55 SZ cases, 52 BD cases and 59 healthy controls (HC) who underwent magnetic resonance imaging. Systemic inflammation was measured using a composite z-score derived from serum concentrations of interleukin 6, tumor necrosis factor alpha and C-reactive protein. Indices of grey matter volume covariation (GMC) were derived from independent component analysis. Childhood trauma was measured using the Childhood Trauma Questionnaire (CTQ Total score). RESULTS A series of moderated moderation analyses indicated that increased systemic inflammation were associated with increased GMC in the striatum and cerebellum among all participants. Severity of childhood trauma exposure moderated the relationship between systemic inflammation and GMC in one component, differently among the groups. Specifically, decreased GMC in the PCC/precuneus, parietal lobule and postcentral gyrus, and increased GMC in the left middle temporal gyrus was associated with increased systemic inflammation in HC individuals exposed to high (but not low or average) levels of trauma and in SZ cases exposed to low (but not average or high) levels of trauma, but not in BD cases. CONCLUSIONS Increased systemic inflammation is associated with grey matter changes in people with psychosis, and these relationships may be partially and differentially moderated by childhood trauma exposure according to diagnosis.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia.
| | - Chiara C Bortolasci
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Briana Spolding
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Srisaiyini Kidnapillai
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Oliver J Watkeys
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia
| | - Sarah Cohen-Woods
- Discipline of Psychology, Flinders University, Adelaide, SA, Australia; Flinders Centre for Innovation in Cancer, Adelaide, SA, Australia; Órama Institute, College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Michael Berk
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia; Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, Australia; Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Ken Walder
- Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, VIC, Australia; Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia
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11
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Popovic D, Ruef A, Dwyer DB, Antonucci LA, Eder J, Sanfelici R, Kambeitz-Ilankovic L, Oztuerk OF, Dong MS, Paul R, Paolini M, Hedderich D, Haidl T, Kambeitz J, Ruhrmann S, Chisholm K, Schultze-Lutter F, Falkai P, Pergola G, Blasi G, Bertolino A, Lencer R, Dannlowski U, Upthegrove R, Salokangas RKR, Pantelis C, Meisenzahl E, Wood SJ, Brambilla P, Borgwardt S, Koutsouleris N. Traces of Trauma: A Multivariate Pattern Analysis of Childhood Trauma, Brain Structure, and Clinical Phenotypes. Biol Psychiatry 2020; 88:829-842. [PMID: 32782139 DOI: 10.1016/j.biopsych.2020.05.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 10/23/2019] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Childhood trauma (CT) is a major yet elusive psychiatric risk factor, whose multidimensional conceptualization and heterogeneous effects on brain morphology might demand advanced mathematical modeling. Therefore, we present an unsupervised machine learning approach to characterize the clinical and neuroanatomical complexity of CT in a larger, transdiagnostic context. METHODS We used a multicenter European cohort of 1076 female and male individuals (discovery: n = 649; replication: n = 427) comprising young, minimally medicated patients with clinical high-risk states for psychosis; patients with recent-onset depression or psychosis; and healthy volunteers. We employed multivariate sparse partial least squares analysis to detect parsimonious associations between combinations of items from the Childhood Trauma Questionnaire and gray matter volume and tested their generalizability via nested cross-validation as well as via external validation. We investigated the associations of these CT signatures with state (functioning, depressivity, quality of life), trait (personality), and sociodemographic levels. RESULTS We discovered signatures of age-dependent sexual abuse and sex-dependent physical and sexual abuse, as well as emotional trauma, which projected onto gray matter volume patterns in prefronto-cerebellar, limbic, and sensory networks. These signatures were associated with predominantly impaired clinical state- and trait-level phenotypes, while pointing toward an interaction between sexual abuse, age, urbanicity, and education. We validated the clinical profiles for all three CT signatures in the replication sample. CONCLUSIONS Our results suggest distinct multilayered associations between partially age- and sex-dependent patterns of CT, distributed neuroanatomical networks, and clinical profiles. Hence, our study highlights how machine learning approaches can shape future, more fine-grained CT research.
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Affiliation(s)
- David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Max Planck Society, Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Linda A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; Department of Education, Psychology and Communication, University of Bari Aldo Moro, Bari, Italy
| | - Julia Eder
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Rachele Sanfelici
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; Max Planck School of Cognition, Max Planck Schools, Leipzig, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Omer Faruk Oztuerk
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Max Planck Society, Munich, Germany
| | - Mark S Dong
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Riya Paul
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; Max Planck Institute of Psychiatry, Max Planck Schools, Munich, Germany
| | - Marco Paolini
- Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Dennis Hedderich
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, Munich, Germany
| | - Theresa Haidl
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Katharine Chisholm
- School of Psychology, University of Birmingham, Birmingham, United Kingdom; Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Giulio Pergola
- Group of Psychiatric Neuroscience, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Blasi
- Group of Psychiatric Neuroscience, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Bertolino
- Group of Psychiatric Neuroscience, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Rachel Upthegrove
- School of Psychology, University of Birmingham, Birmingham, United Kingdom; Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia; Melbourne Health, Carlton South, Victoria, Australia
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Stephen J Wood
- School of Psychology, University of Birmingham, Birmingham, United Kingdom; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, Victoria, Australia
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefan Borgwardt
- Neuropsychiatry and Brain Imaging Group, Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Max Planck Society, Munich, Germany.
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12
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Farnia V, Farshchian F, Farshchian N, Alikhani M, Sadeghi Bahmani D, Brand S. Comparisons of Voxel-Based Morphometric Brain Volumes of Individuals with Methamphetamine-Induced Psychotic Disorder and Schizophrenia Spectrum Disorder and Healthy Controls. Neuropsychobiology 2020; 79:170-178. [PMID: 31794972 DOI: 10.1159/000504576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Received: 05/16/2019] [Accepted: 11/03/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several psychological and neurological pathways are described to explain the emergence and maintenance of psychiatric disorders, and changes in brain volumes and brain activity are observed as correlates of psychiatric disorders. In the present study, we investigated if and to what extent specific voxel-based morphometric brain volume differences could be observed among individuals with methamphetamine-induced psychosis (MAIP) and schizophrenia spectrum disorder (SSD) compared to healthy controls. METHODS A total of 69 individuals took part in the present study. Of those, 26 were diagnosed with MAIP, 23 with SSD, and 20 were healthy controls. After a thorough psychiatric assessment, participants underwent brain volume measurement. RESULTS Compared to healthy controls, participants with MAIP had smaller volumes for left caudate and left and right parahippocampal gyrus. Compared to healthy controls, participants with SSD had smaller volumes for the gray and white matter, left amygdala, left hippocampus, left parahippocampal gyrus, left putamen, and the total volume. Compared to individuals with MAIP, individuals with SSD had a lower white matter brain volume. CONCLUSIONS The pattern of results suggests that individuals with MAIP and SSD showed specific and regional brain atrophies on the left hemisphere, always compared to healthy controls. Given the cross-sectional design, it remains undisclosed if specific and regional brain atrophies were the cause or the consequence of the psychiatric issues.
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Affiliation(s)
- Vahid Farnia
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Firoozeh Farshchian
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nazanin Farshchian
- Department of Radiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Dena Sadeghi Bahmani
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress, and Sleep Disorders (ZASS), Basel, Switzerland.,Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Serge Brand
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran, .,University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress, and Sleep Disorders (ZASS), Basel, Switzerland, .,University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland,
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13
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Abstract
Stress exposure represents a major environmental risk factor for schizophrenia and other psychiatric disorders, as it plays a pivotal role in the etiology as well as in the manifestation of disease symptomatology. It may be inferred that pharmacological treatments must be able to modulate the behavioral, functional, and molecular alterations produced by stress exposure to achieve significant clinical outcomes. This review aims at examining existing clinical and preclinical evidence that supports the ability of atypical antipsychotic drugs (AAPDs) to modulate stress-related alterations. Indeed, while the pharmacodynamic differences between AAPDs have been extensively characterized, less is known on their ability to regulate downstream mechanisms that are critical for functional recovery and patient stabilization. We will discuss stress-related mechanisms, spanning from neuroendocrine function to inflammation and neuronal plasticity, which are relevant for the manifestation of schizophrenic symptomatology, and we will discuss if and how AAPDs may interfere with such mechanisms. Considering the impact of stress in everyday life, we believe that a better understanding of the potential effects of AAPDs on stress-related mechanisms may provide novel and important insights for improving therapeutic strategies aimed at promoting coping mechanisms and enhancing the quality of life of patients affected by psychiatric disorders.
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Affiliation(s)
| | - Marco A. Riva
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Giuseppe Balzaretti 9, 20133 Milan, Italy;
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14
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Tryon VL, Garman HD, Loewy RL, Niendam TA. Links Between Human and Animal Models of Trauma and Psychosis: A Narrative Review. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 6:154-165. [PMID: 33309566 DOI: 10.1016/j.bpsc.2020.09.012] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/08/2020] [Accepted: 09/16/2020] [Indexed: 11/26/2022]
Abstract
Traumatic experiences during development are associated with an increased risk of developing psychosis. Individuals with psychosis also report a higher rate of past trauma than healthy control subjects and worse outcomes than those who do not have these experiences. It is thought that traumatic experiences negatively impact specific neurobiological processes to confer this increased risk, and that systems affected by trauma are similarly changed in individuals with psychosis. Examining animal models of psychosis and the shared neurobiological changes in response to stressors can offer valuable insight into biological mechanisms that mediate symptoms and targets for intervention. This targeted review highlights a subset of models of psychosis across humans and animals, examines the similarities with the brain's response to stress and traumatic events, and discusses how these models may interact. Suggestions for future research are described.
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Affiliation(s)
- Valerie L Tryon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis
| | - Heather D Garman
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Rachel L Loewy
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Tara A Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis.
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15
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Alameda L, Rodriguez V, Carr E, Aas M, Trotta G, Marino P, Vorontsova N, Herane-Vives A, Gadelrab R, Spinazzola E, Di Forti M, Morgan C, Murray RM. A systematic review on mediators between adversity and psychosis: potential targets for treatment. Psychol Med 2020; 50:1966-1976. [PMID: 32744193 DOI: 10.1017/s0033291720002421] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Various psychological and biological pathways have been proposed as mediators between childhood adversity (CA) and psychosis. A systematic review of the evidence in this domain is needed. Our aim is to systematically review the evidence on psychological and biological mediators between CA and psychosis across the psychosis spectrum. This review followed PRISMA guidelines. Articles published between 1979 and July 2019 were identified through a literature search in OVID (PsychINFO, Medline and Embase) and Cochrane Libraries. The evidence by each analysis and each study is presented by group of mediator categories found. The percentage of total effect mediated was calculated. Forty-eight studies were included, 21 in clinical samples and 27 in the general population (GP) with a total of 82 352 subjects from GP and 3189 from clinical studies. The quality of studies was judged as 'fair'. Our results showed (i) solid evidence of mediation between CA and psychosis by negative cognitive schemas about the self, the world and others (NS); by dissociation and other post-traumatic stress disorder symptoms; and through an affective pathway in GP but not in subjects with disorder; (iii) lack of studies exploring biological mediators. We found evidence suggesting that various overlapping and not competing pathways involving post-traumatic and mood symptoms, as well as negative cognitions contribute partially to the link between CA and psychosis. Experiences of CA, along with relevant mediators should be routinely assessed in patients with psychosis. Evidence testing efficacy of interventions targeting such mediators through cognitive behavioural approaches and/or pharmacological means is needed in future.
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Affiliation(s)
- Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), CH-1008Lausanne, Switzerland
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Spain
- Instituto de Investigacion Sanitaria de Sevilla, IBiS, Spain
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ewan Carr
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paolo Marino
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Natasha Vorontsova
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrés Herane-Vives
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Departamento de Clínicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Romayne Gadelrab
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Marta Di Forti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King's College London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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16
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Soares AR, Gildawie KR, Honeycutt JA, Brenhouse HC. Region-specific effects of maternal separation on oxidative stress accumulation in parvalbumin neurons of male and female rats. Behav Brain Res 2020; 388:112658. [PMID: 32339550 DOI: 10.1016/j.bbr.2020.112658] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 12/16/2022]
Abstract
Early life adversity in humans is linked to cognitive deficits and increased risk of mental illnesses, including depression, bipolar disorder, and schizophrenia, with evidence for different vulnerabilities in men versus women. Modeling early life adversity in rodents shows similar neuropsychological deficits that may partially be driven by sex-dependent dysfunction in parvalbumin (PV) interneurons in the prefrontal cortex (PFC), hippocampus (HPC), and basolateral amygdala (BLA). Research demonstrates that PV interneurons are particularly susceptible to oxidative stress; therefore, accumulation of oxidative damage may drive PV dysfunction following early life adversity. The goal of this study was to quantify oxidative stress accumulation in PV neurons in rats exposed to maternal separation (MS). Pups were separated from their dam and littermates for 4 h per day from postnatal day (P)2 to 20. Serial sections from the PFC, HPC, and BLA of juvenile (P20) rats of both sexes were immunohistochemically stained with antibodies against PV and 8-oxo-dG, a marker for oxidative DNA damage. PV cell counts, colocalization with 8-oxo-dG, and intensity of each signal were measured in each region to determine the effects of MS and establish whether MS-induced oxidative damage varies between sexes. A significant increase in colocalization of PV and 8-oxo-dG was found in the PFC and HPC, indicating increased oxidative stress in that cell population following MS. Region-specific sex differences were also revealed in the PFC, BLA, and HPC. These data identify oxidative stress during juvenility as a potential mechanism mediating PV dysfunction in individuals with a history of early life adversity.
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17
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Cancel A, Dallel S, Zine A, El-Hage W, Fakra E. Understanding the link between childhood trauma and schizophrenia: A systematic review of neuroimaging studies. Neurosci Biobehav Rev 2019; 107:492-504. [DOI: 10.1016/j.neubiorev.2019.05.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 02/07/2023]
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18
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Popovic D, Schmitt A, Kaurani L, Senner F, Papiol S, Malchow B, Fischer A, Schulze TG, Koutsouleris N, Falkai P. Childhood Trauma in Schizophrenia: Current Findings and Research Perspectives. Front Neurosci 2019; 13:274. [PMID: 30983960 PMCID: PMC6448042 DOI: 10.3389/fnins.2019.00274] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 03/07/2019] [Indexed: 01/09/2023] Open
Abstract
Schizophrenia is a severe neuropsychiatric disorder with persistence of symptoms throughout adult life in most of the affected patients. This unfavorable course is associated with multiple episodes and residual symptoms, mainly negative symptoms and cognitive deficits. The neural diathesis-stress model proposes that psychosocial stress acts on a pre-existing vulnerability and thus triggers the symptoms of schizophrenia. Childhood trauma is a severe form of stress that renders individuals more vulnerable to developing schizophrenia; neurobiological effects of such trauma on the endocrine system and epigenetic mechanisms are discussed. Childhood trauma is associated with impaired working memory, executive function, verbal learning, and attention in schizophrenia patients, including those at ultra-high risk to develop psychosis. In these patients, higher levels of childhood trauma were correlated with higher levels of attenuated positive symptoms, general symptoms, and depressive symptoms; lower levels of global functioning; and poorer cognitive performance in visual episodic memory end executive functions. In this review, we discuss effects of specific gene variants that interact with childhood trauma in patients with schizophrenia and describe new findings on the brain structural and functional level. Additive effects between childhood trauma and brain-derived neurotrophic factor methionine carriers on volume loss of the hippocampal subregions cornu ammonis (CA)4/dentate gyrus and CA2/3 have been reported in schizophrenia patients. A functional magnetic resonance imaging study showed that childhood trauma exposure resulted in aberrant function of parietal areas involved in working memory and of visual cortical areas involved in attention. In a theory of mind task reflecting social cognition, childhood trauma was associated with activation of the posterior cingulate gyrus, precuneus, and dorsomedial prefrontal cortex in patients with schizophrenia. In addition, decreased connectivity was shown between the posterior cingulate/precuneus region and the amygdala in patients with high levels of physical neglect and sexual abuse during childhood, suggesting that disturbances in specific brain networks underlie cognitive abilities. Finally, we discuss some of the questionnaires that are commonly used to assess childhood trauma and outline possibilities to use recent biostatistical methods, such as machine learning, to analyze the resulting datasets.
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Affiliation(s)
- David Popovic
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Lalit Kaurani
- German Center of Neurodegenerative Diseases, University of Göttingen, Göttingen, Germany
| | - Fanny Senner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Sergi Papiol
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Hospital of Jena, Jena, Germany
| | - Andre Fischer
- German Center of Neurodegenerative Diseases, University of Göttingen, Göttingen, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
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19
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Abstract
This paper reviews the literature on the association between experiences of child abuse and neglect and the development of psychoses. It then explores the premise that psychotic patients with a history of maltreatment may comprise a clinically and biological distinct subgroup. The review demonstrates that there is a growing consensus in the field that experiences of child maltreatment contribute to the onset of psychotic symptoms and psychotic disorders. There is also strong support for the premise that patients with psychotic disorders and histories of child maltreatment have distinct clinical characteristics and unique treatment needs, and emerging preliminary data to suggest psychotic patients with a history of maltreatment may comprise a distinct neurobiological subgroup. The mechanisms by which experiences of child maltreatment confers risk for psychotic disorders remains unknown, and the review highlights the value of incorporating translational research perspectives to advance knowledge in this area.
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Affiliation(s)
- Joan Kaufman
- Kennedy Krieger Institute, Center for Child and Family Traumatic Stress, 1741 Ashland Avenue, Baltimore, MD 21205, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States.
| | - Souraya Torbey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
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Kuo SS, Pogue-Geile MF. Variation in fourteen brain structure volumes in schizophrenia: A comprehensive meta-analysis of 246 studies. Neurosci Biobehav Rev 2019; 98:85-94. [PMID: 30615934 DOI: 10.1016/j.neubiorev.2018.12.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [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: 05/02/2018] [Revised: 11/21/2018] [Accepted: 12/31/2018] [Indexed: 12/24/2022]
Abstract
Despite hundreds of structural MRI studies documenting smaller brain volumes on average in schizophrenia compared to controls, little attention has been paid to group differences in the variability of brain volumes. Examination of variability may help interpret mean group differences in brain volumes and aid in better understanding the heterogeneity of schizophrenia. Variability in 246 MRI studies was meta-analyzed for 13 structures that have shown medium to large mean effect sizes (Cohen's d≥0.4): intracranial volume, total brain volume, lateral ventricles, third ventricle, total gray matter, frontal gray matter, prefrontal gray matter, temporal gray matter, superior temporal gyrus gray matter, planum temporale, hippocampus, fusiform gyrus, insula; and a control structure, caudate nucleus. No significant differences in variability in cortical/subcortical volumes were detected in schizophrenia relative to controls. In contrast, increased variability was found in schizophrenia compared to controls for intracranial and especially lateral and third ventricle volumes. These findings highlight the need for more attention to ventricles and detailed analyses of brain volume distributions to better elucidate the pathophysiology of schizophrenia.
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Affiliation(s)
- Susan S Kuo
- Department of Psychology, University of Pittsburgh, 4209 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA.
| | - Michael F Pogue-Geile
- Department of Psychology, University of Pittsburgh, 4209 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA; Department of Psychology and Department of Psychiatry, University of Pittsburgh, 4207 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA.
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Dauvermann MR, Donohoe G. The role of childhood trauma in cognitive performance in schizophrenia and bipolar disorder - A systematic review. Schizophr Res Cogn 2018; 16:1-11. [PMID: 30581765 PMCID: PMC6293032 DOI: 10.1016/j.scog.2018.11.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/09/2018] [Accepted: 11/27/2018] [Indexed: 12/13/2022]
Abstract
Childhood trauma (CT) has repeatedly been associated with cognitive deficits in patients with psychosis but many inconsistencies have been reported so that the nature of the relationship remains unclear. The purpose of this review was to better characterize the contribution of CT to cognitive deficits by considering the type, severity and frequency of childhood traumatic events and their relationships with psychosis at all stages. Relevant studies were identified via electronic and manual literature searches and included original studies that investigated the relationship between CT and higher cognitive performance or social cognitive performance in patients with schizophrenia, bipolar disorder and psychosis at all stages of the illness stages (i.e. ultra-high risk, first episode or chronic phase). Overall, a majority of studies reported that patients who experienced CT displayed deficits in general cognitive ability compared to patients with psychosis without such a history. Associations between CT and other cognitive function were more mixed. When comparing patient groups, the association between CT and cognitive function was more inconsistent in patients with chronic schizophrenia than in healthy participants, ultra-high risk individuals, first-episode patients and patients with chronic bipolar disorder. In understanding the variability in the reported relationships between CT and cognition across study populations, we highlight the variety of questionnaires used and discuss the likelihood of there being differences in cognitive function based on specific stressors, severity and frequency. Finally, we consider future research steps that may shed light on psychobiological mechanisms underlying CT and cognitive performance in patients with psychosis.
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Wong KK, Raine A, Venables P. The effect of being left home alone at age 3 years on schizotypy and antisocial behavior at ages 17 and 23 years. J Psychiatr Res 2018; 105:103-12. [PMID: 30218842 DOI: 10.1016/j.jpsychires.2018.08.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/31/2018] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Negative home environments are associated with both schizophrenia-spectrum disorders and crime, but whether this is due to the social or cognitive sequelae of such environments is unclear. This study investigates the effect of early home environments on adult mental health. METHOD Using data from the Mauritius Child Health Project, a multiple time-point prospective study where all children born in 1969 in two towns (Quatre Bornes and Vacaos) were recruited at age 3 years (N = 1794), a group of children left home alone at age 3 (n = 34) were compared to children cared for by siblings/relatives (n = 222), or by mothers (n = 1498) on antisocial behavior and schizotypal personality at ages 11, 17, and 23 years. RESULTS Home alone children showed higher scores on psychotic behavior and conduct disorder at age 17, and also schizotypal personality and crime at 23 years compared to the other groups. No negative behavioral or cognitive effects were observed at age 11. Findings were not accounted for by social adversity or ethnicity and appear to be 'sleeper effects' in that they do not emerge until later adolescence and into adulthood. CONCLUSIONS Findings appear to be the first to show the negative effects of dual-parental daytime absence on adult schizotypy and crime, a finding that cannot be accounted for by verbal and spatial cognitive impairments. Results suggest an early common psychosocial denominator to the two comorbid conditions of antisocial behavior and schizotypy.
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Quidé Y, O'Reilly N, Watkeys OJ, Carr VJ, Green MJ. Effects of childhood trauma on left inferior frontal gyrus function during response inhibition across psychotic disorders. Psychol Med 2018; 48:1454-1463. [PMID: 28994360 DOI: 10.1017/s0033291717002884] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 12/12/2022]
Abstract
BACKGROUND Childhood trauma is a risk factor for psychosis. Deficits in response inhibition are common to psychosis and trauma-exposed populations, and associated brain functions may be affected by trauma exposure in psychotic disorders. We aimed to identify the influence of trauma-exposure on brain activation and functional connectivity during a response inhibition task. METHODS We used functional magnetic resonance imaging to examine brain function within regions-of-interest [left and right inferior frontal gyrus (IFG), right dorsolateral prefrontal cortex, right supplementary motor area, right inferior parietal lobule and dorsal anterior cingulate cortex], during the performance of a Go/No-Go Flanker task, in 112 clinical cases with psychotic disorders and 53 healthy controls (HCs). Among the participants, 71 clinical cases and 21 HCs reported significant levels of childhood trauma exposure, while 41 clinical cases and 32 HCs did not. RESULTS In the absence of effects on response inhibition performance, childhood trauma exposure was associated with increased activation in the left IFG, and increased connectivity between the left IFG seed region and the cerebellum and calcarine sulcus, in both cases and healthy individuals. There was no main effect of psychosis, and no trauma-by-psychosis interaction for any other region-of-interest. Within the clinical sample, the effects of trauma-exposure on the left IFG activation were mediated by symptom severity. CONCLUSIONS Trauma-related increases in activation of the left IFG were not associated with performance differences, or dependent on clinical diagnostic status; increased IFG functionality may represent a compensatory (overactivation) mechanism required to exert adequate inhibitory control of the motor response.
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Affiliation(s)
- Y Quidé
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
| | - N O'Reilly
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
| | - O J Watkeys
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
| | - V J Carr
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
| | - M J Green
- School of Psychiatry,University of New South Wales,Randwick,NSW,Australia
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Quidé Y, Ong XH, Mohnke S, Schnell K, Walter H, Carr VJ, Green MJ. Childhood trauma-related alterations in brain function during a Theory-of-Mind task in schizophrenia. Schizophr Res 2017; 189:162-168. [PMID: 28215391 DOI: 10.1016/j.schres.2017.02.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [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: 09/27/2016] [Revised: 02/06/2017] [Accepted: 02/09/2017] [Indexed: 01/03/2023]
Abstract
Childhood trauma is a risk factor for schizophrenia that affects brain functions associated with higher cognitive processes, including social cognition. Alterations in Theory-of-Mind (ToM), or mentalizing skills, are a hallmark feature of schizophrenia, and are also evident in individuals exposed to childhood trauma. However, the impact of childhood trauma exposure on brain function during social cognition in schizophrenia remains unclear. We thus examined the association between childhood trauma and brain function during the performance of a ToM task in 47 patients diagnosed with schizophrenia or schizoaffective disorder. All participants completed the Childhood Trauma Questionnaire (CTQ) and underwent functional magnetic resonance imaging while performing an established visual-cartoon affective ToM task. Whole-brain multiple regression analysis was performed on ToM-related brain activation, with CTQ total score as regressor of interest, while accounting for the effects of age, sex, diagnosis, symptom severity, behavioural performance, intelligence and medications levels. First, using a small-volume correction approach within a mask made of key regions for ToM [including bilateral temporo-parietal junctions (TPJ), medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC)/precuneus], total CTQ scores were positively associated with activation of the PCC/precuneus. Second, exploratory analyses for the rest of the brain (i.e., ROIs masked-out), revealed a positive association between trauma exposure and activation of the dorsomedial prefrontal cortex (dmPFC), and a negative association with activation of the anterior section of the TPJ. These results suggest that childhood trauma exposure may, at least partially, contribute to functional alterations of brain regions essential for effective mental state inference in schizophrenia.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales Research Unit for Schizophrenia Epidemiology Randwick, NSW Australia; Neuroscience Research Australia, Randwick, NSW, Australia.
| | - Xin H Ong
- Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Sebastian Mohnke
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Knut Schnell
- Department of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales Research Unit for Schizophrenia Epidemiology Randwick, NSW Australia; Neuroscience Research Australia, Randwick, NSW, Australia; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales Research Unit for Schizophrenia Epidemiology Randwick, NSW Australia; Neuroscience Research Australia, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia; ARC Centre for Cognition and its Disorders (CCD), Macquarie University, Sydney, NSW, Australia
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Andrianarisoa M, Boyer L, Godin O, Brunel L, Bulzacka E, Aouizerate B, Berna F, Capdevielle D, Dorey JM, Dubertret C, Dubreucq J, Faget C, Gabayet F, Llorca PM, Mallet J, Misdrahi D, Rey R, Richieri R, Passerieux C, Schandrin A, Tronche AM, Urbach M, Vidailhet P, Schürhoff F, Fond G; FACE-SCZ Group. Childhood trauma, depression and negative symptoms are independently associated with impaired quality of life in schizophrenia. Results from the national FACE-SZ cohort. Schizophr Res 2017; 185:173-81. [PMID: 28109668 DOI: 10.1016/j.schres.2016.12.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [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: 10/04/2016] [Revised: 12/18/2016] [Accepted: 12/18/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Depression and negative symptoms have been associated with impaired Quality of life (QoL) in schizophrenia (SZ). However, childhood trauma may influence both QoL and depression in SZ patients, with consequences for the management of impaired QoL in SZ patients. The aim of the present study was to determine if childhood trauma was associated with impaired QoL in schizophrenia. METHOD A sample of 544 community-dwelling stabilized SZ patients enrolled in FACE-SZ cohort were utilized in this study (74.1% males, mean aged 32.3years, mean illness duration 10.6years). QoL was self-reported with the S-QoL18 questionnaire. Childhood trauma was self-reported with the Childhood Trauma Questionnaire. Depression was measured by the Calgary Depression Rating Scale for Schizophrenia. Psychotic severity was measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS). Other clinical factors, treatments, comorbidities, functioning and sociodemographical variables were also recorded, with validated scales. RESULTS Overall, 151 participants (27.8%) had a current major depressive episode and 406 (82.5%) reported at least one episode of historical childhood trauma. In multivariate analyses, lower QoL total score was associated with a history of childhood trauma (β=-0.21, p<0.0001), psychotic negative symptoms (β=-0.11, p=0.04), current depression (β=-0.0.38, p<0.0001) and male gender (β=-0.16, p<0.0001). CONCLUSION Impaired QoL is independently associated with negative symptoms, depression and childhood trauma in schizophrenia.
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Cancel A, Comte M, Boutet C, Schneider FC, Rousseau PF, Boukezzi S, Gay A, Sigaud T, Massoubre C, Berna F, Zendjidjian XY, Azorin JM, Blin O, Fakra E. Childhood trauma and emotional processing circuits in schizophrenia: A functional connectivity study. Schizophr Res 2017; 184:69-72. [PMID: 27979699 DOI: 10.1016/j.schres.2016.12.003] [Citation(s) in RCA: 27] [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] [Received: 08/30/2016] [Revised: 11/17/2016] [Accepted: 12/05/2016] [Indexed: 12/20/2022]
Abstract
Childhood trauma strongly impacts emotional responses in schizophrenia. We have explored an association between early trauma and the amygdala functional connectivity using generalized psychophysiological interaction during an emotional task. Twenty-one schizophrenia patients and twenty-five controls were included. In schizophrenia patients, higher levels of sexual abuse and physical neglect during childhood were associated with decreased connectivity between the amygdala and the posterior cingulate/precuneus region. Additionally, patients showed decreased coupling between the amygdala and the posterior cingulate/precuneus region compared to controls. These findings suggest that early trauma could impact later connectivity in specific stress-related circuits affecting self-consciousness and social cognition in schizophrenia.
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Affiliation(s)
- Aïda Cancel
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France.
| | - Magali Comte
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - Claire Boutet
- Inserm U1059, Univ Lyon, Department of Radiology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Fabien C Schneider
- Inserm U1059, Univ Lyon, Department of Radiology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pierre-François Rousseau
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France; Psychiatry Unit, Saint Anne Military Training Hospital, Toulon, France
| | - Sarah Boukezzi
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - Aurélia Gay
- Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France; TAPE Laboratory, EA7423, Jean Monnet University, Saint-Etienne, France
| | - Torrance Sigaud
- Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France; TAPE Laboratory, EA7423, Jean Monnet University, Saint-Etienne, France
| | - Catherine Massoubre
- Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France; TAPE Laboratory, EA7423, Jean Monnet University, Saint-Etienne, France
| | - Fabrice Berna
- Department of Psychiatry, University Hospital of Strasbourg, INSERM U1114, Strasbourg, France
| | | | - Jean-Michel Azorin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France; Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | - Olivier Blin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France; Public Assistance for Marseille Hospitals (APHM) Unit for Clinical Pharmacology and Therapeutic Evaluation (CIC-UPCET), CHU Timone Hospital, Marseille, France
| | - Eric Fakra
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France; TAPE Laboratory, EA7423, Jean Monnet University, Saint-Etienne, France
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Nestsiarovich A, Obyedkov V, Kandratsenka H, Siniauskaya M, Goloenko I, Waszkiewicz N. Disorganization at the stage of schizophrenia clinical outcome: Clinical-biological study. Eur Psychiatry 2017; 42:44-8. [PMID: 28192769 DOI: 10.1016/j.eurpsy.2016.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 12/11/2016] [Accepted: 12/16/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND According to the multidimensional model of schizophrenia, three basic psychopathological dimensions constitute its clinical structure: positive symptoms, negative symptoms and disorganization. The latter one is the newest and the least studied. Our aim was to discriminate disorganization in schizophrenia clinical picture and to identify its distinctive biological and socio-psychological particularities and associated genetic and environmental factors. METHODS We used SAPS/SANS psychometrical scales, scales for the assessment of patient's compliance, insight, social functioning, life quality. Neuropsychological tests included Wisconsin Card Sorting Test (WCST), Stroop Color-Word test. Neurophysiological examination included registration of P300 wave of the evoked cognitive auditory potentials. Environmental factors related to patient's education, family, surrounding and nicotine use, as well as subjectively significant traumatic events in childhood and adolescence were assessed. Using PCR we detected SNP of genes related to the systems of neurotransmission (COMT, SLC6A4 and DRD2), inflammatory response (IL6, TNF), cellular detoxification (GSTM1, GSTT1), DNA methylation (MTHFR, DNMT3b, DNMT1). RESULTS Disorganization is associated with early schizophrenia onset and history of psychosis in family, low level of insight and compliance, high risk of committing delicts, distraction errors in WCST, lengthened P300 latency of evoked cognitive auditory potentials, low-functional alleles of genes MTHFR (rs1801133) and DNMT3b (rs2424913), high level of urbanicity and psychotraumatic events at early age. CONCLUSIONS Severe disorganization at the stage of schizophrenia clinical outcome is associated with the set of specific biological and social-psychological characteristics that indicate its epigenetic nature and maladaptive social significance.
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Paquola C, Bennett MR, Lagopoulos J. Understanding heterogeneity in grey matter research of adults with childhood maltreatment—A meta-analysis and review. Neurosci Biobehav Rev 2016; 69:299-312. [DOI: 10.1016/j.neubiorev.2016.08.011] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/18/2016] [Accepted: 08/06/2016] [Indexed: 12/20/2022]
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Azorin JM, Fakra E. Questionnements sur les « jeunes schizophrènes ». Encephale 2016; 42 Suppl 3:S1-S2. [DOI: 10.1016/s0013-7006(16)30214-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Badcock JC, Panton K, Cohen A, Badcock DR. Both harmful and (some) helpful behaviours from others are associated with increased expression of schizotypal traits. Psychiatry Res 2016; 239:308-14. [PMID: 27058156 DOI: 10.1016/j.psychres.2016.03.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/24/2015] [Revised: 03/19/2016] [Accepted: 03/26/2016] [Indexed: 10/22/2022]
Abstract
Negative treatment from others is related to elevated levels of trait schizotypy, signifying increased risk for psychosis, but associations with helpful behaviour have been much less studied. Using the Stereotype Content Model we tested the hypothesis that passive and active forms of help would be associated with increased and decreased expression of schizotypy, respectively. Schizotypal traits were assessed in students (N=631) using positive (Perceptual Aberration) and negative (Social Anhedonia) subscales of the Wisconsin Schizotypy Scales-Brief. Experiences of active (intentional) and passive (less deliberative) harm and help were assessed with the Behaviour from Intergroup Affect and Stereotypes Treatment Scale. As predicted, the results showed that experiences of passive help from others were associated with a 2-3 fold increase in scores on schizotypy scales, whilst reports of active help tended to be associated with a decrease in scores on these scales. Results also showed that increased reports of active and passive harm were associated with elevated scores on negative and positive schizotypy subscales, consistent with prior research. These findings, bridging research on social stereotyping and schizotypal personality, challenge the assumption that helpful behaviour from others is always beneficial for individuals with schizotypal traits who are at increased risk for psychosis.
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Affiliation(s)
- Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth, Western Australia 6000, Australia; Cooperative Research Centre - Mental Health, Barry Street, Carlton, Victoria, Australia.
| | - Kirsten Panton
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
| | - Alex Cohen
- Department of Psychology, 224 Audubon Hall, Louisiana State University, Baton Rouge, LA 70803, USA.
| | - David R Badcock
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
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Sheikh MA, Abelsen B, Olsen JA. Clarifying Associations between Childhood Adversity, Social Support, Behavioral Factors, and Mental Health, Health, and Well-Being in Adulthood: A Population-Based Study. Front Psychol 2016; 7:727. [PMID: 27252668 PMCID: PMC4879780 DOI: 10.3389/fpsyg.2016.00727] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/29/2016] [Indexed: 11/13/2022] Open
Abstract
Previous studies have shown that socio-demographic factors, childhood socioeconomic status (CSES), childhood traumatic experiences (CTEs), social support and behavioral factors are associated with health and well-being in adulthood. However, the relative importance of these factors for mental health, health, and well-being has not been studied. Moreover, the mechanisms by which CTEs affect mental health, health, and well-being in adulthood are not clear. Using data from a representative sample (n = 12,981) of the adult population in Tromsø, Norway, this study examines (i) the relative contribution of structural conditions (gender, age, CSES, psychological abuse, physical abuse, and substance abuse distress) to social support and behavioral factors in adulthood; (ii) the relative contribution of socio-demographic factors, CSES, CTEs, social support, and behavioral factors to three multi-item instruments of mental health (SCL-10), health (EQ-5D), and subjective well-being (SWLS) in adulthood; (iii) the impact of CTEs on mental health, health, and well-being in adulthood, and; (iv) the mediating role of adult social support and behavioral factors in these associations. Instrumental support (24.16%, p < 0.001) explained most of the variation in mental health, while gender (21.32%, p < 0.001) explained most of the variation in health, and emotional support (23.34%, p < 0.001) explained most of the variation in well-being. Psychological abuse was relatively more important for mental health (12.13%), health (7.01%), and well-being (9.09%), as compared to physical abuse, and substance abuse distress. The subjective assessment of childhood financial conditions was relatively more important for mental health (6.02%), health (10.60%), and well-being (20.60%), as compared to mother's and father's education. CTEs were relatively more important for mental health, while, CSES was relatively more important for health and well-being. Respondents exposed to all three types of CTEs had a more than two-fold increased risk of being mentally unhealthy (RR Total Effect = 2.75, 95% CI: 2.19-3.10), an 89% increased risk of being unhealthy (RR Total Effect = 1.89, 95% CI: 1.47-1.99), and a 42% increased risk of having a low level of well-being in adulthood (RR Total Effect = 1.42, 95% CI: 1.29-1.52). Social support and behavioral factors mediate 11-18% (p < 0.01) of these effects. The study advances the theoretical understanding of how CTEs influence adult mental health, health, and well-being.
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Affiliation(s)
- Mashhood A Sheikh
- Department of Community Medicine, University of Tromsø Tromsø, Norway
| | - Birgit Abelsen
- Department of Community Medicine, University of Tromsø Tromsø, Norway
| | - Jan A Olsen
- Department of Community Medicine, University of Tromsø Tromsø, Norway
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Cancel A. Traumatismes infantiles, morphologie cérébrale et schizophrénie : quels liens ? Eur Psychiatry 2015. [DOI: 10.1016/j.eurpsy.2015.09.049] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Les facteurs environnementaux constituent les facteurs de risques les plus fortement associés à la schizophrénie, devant la majorité des gènes candidats . Les traumatismes infantiles en particulier joueraient un rôle majeur dans l’apparition de la psychose et le développement cérébral. Les traumatismes ou les facteurs de stress précoces sont ainsi associés à des altérations cérébrales qui partagent des similitudes avec les anomalies retrouvées dans la schizophrénie . Cependant, si la grande majorité des auteurs se sont intéressé aux abus physiques ou sexuels, retrouvés associés aux hallucinations auditives, le rôle des négligences infantiles a rarement été étudié dans la schizophrénie. Nous avons réalisé une étude d’imagerie dans le but d’explorer les liens entre les différents types de traumatismes infantiles, morphologie cérébrale et symptomatologie chez 21 schizophrènes et 30 sujets témoin. Les résultats ont confirmé que les schizophrènes ont subi plus de traumatismes dans leur enfance que les sujets témoins. De plus, le volume total de matière grise est corrélé négativement à la négligence émotionnelle dans les deux groupes, la corrélation étant plus forte chez les schizophrènes. Cette association avec la sévérité de la négligence émotionnelle est également retrouvée chez les sujets schizophrènes au niveau de la matière grise du cortex préfrontal dorsolatéral (CPFDL) droit. Enfin, nous avons utilisé des modèles d’équations structurelles, basés sur le modèle stress-vulnérabilité, pour expliciter les liens entre négligence émotionnelle, matière grise et symptomatologie. Ainsi, le meilleur modèle indique que la négligence émotionnelle prédit la densité de matière grise dans le CPFDL, qui elle-même prédit le score de désorganisation . Ces résultats rappellent tout l’intérêt de l’étude de la négligence infantile dans la schizophrénie et suggèrent que les différents types de traumatismes infantiles pourraient avoir des impacts distincts sur le développement cérébral de sujets vulnérables, via des mécanismes spécifiques.
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