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Friedlander A, Sinai D, Zilcha-Mano S, Weiser M, Caspi A, Lichtenberg P, Amitai Z, Tzur Bitan D. Development of the Therapeutic Alliance in Alternative Settings to Psychiatric Hospitalization: An Open Comparative Study. Psychiatr Serv 2024:appips20230009. [PMID: 38500450 DOI: 10.1176/appi.ps.20230009] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Patient-therapist alliance in two alternative treatment settings developed similarly to that in traditional psychiatric hospitalization.
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Affiliation(s)
- Avraham Friedlander
- Department of Behavioral Sciences, Ariel University, Ariel, Israel (Friedlander); Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel (Friedlander, Weiser, Caspi, Amitai); Ramat-Chen Brüll Mental Health Center, Tel Aviv District, Clalit Health Services Community Division, Tel Aviv, Israel (Sinai); Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel (Sinai); Departments of Psychology (Zilcha-Mano) and Community Mental Health (Tzur Bitan), University of Haifa, Haifa, Israel; Department of Psychiatry, Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel (Weiser, Amitai); Soteria Israel, Jerusalem Mental Health Center, and Department of Psychiatry, Hebrew University of Jerusalem, Jerusalem (Lichtenberg); Shalvata Mental Health Center, Hod Hasharon, Israel (Tzur Bitan)
| | - Dana Sinai
- Department of Behavioral Sciences, Ariel University, Ariel, Israel (Friedlander); Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel (Friedlander, Weiser, Caspi, Amitai); Ramat-Chen Brüll Mental Health Center, Tel Aviv District, Clalit Health Services Community Division, Tel Aviv, Israel (Sinai); Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel (Sinai); Departments of Psychology (Zilcha-Mano) and Community Mental Health (Tzur Bitan), University of Haifa, Haifa, Israel; Department of Psychiatry, Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel (Weiser, Amitai); Soteria Israel, Jerusalem Mental Health Center, and Department of Psychiatry, Hebrew University of Jerusalem, Jerusalem (Lichtenberg); Shalvata Mental Health Center, Hod Hasharon, Israel (Tzur Bitan)
| | - Sigal Zilcha-Mano
- Department of Behavioral Sciences, Ariel University, Ariel, Israel (Friedlander); Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel (Friedlander, Weiser, Caspi, Amitai); Ramat-Chen Brüll Mental Health Center, Tel Aviv District, Clalit Health Services Community Division, Tel Aviv, Israel (Sinai); Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel (Sinai); Departments of Psychology (Zilcha-Mano) and Community Mental Health (Tzur Bitan), University of Haifa, Haifa, Israel; Department of Psychiatry, Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel (Weiser, Amitai); Soteria Israel, Jerusalem Mental Health Center, and Department of Psychiatry, Hebrew University of Jerusalem, Jerusalem (Lichtenberg); Shalvata Mental Health Center, Hod Hasharon, Israel (Tzur Bitan)
| | - Mark Weiser
- Department of Behavioral Sciences, Ariel University, Ariel, Israel (Friedlander); Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel (Friedlander, Weiser, Caspi, Amitai); Ramat-Chen Brüll Mental Health Center, Tel Aviv District, Clalit Health Services Community Division, Tel Aviv, Israel (Sinai); Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel (Sinai); Departments of Psychology (Zilcha-Mano) and Community Mental Health (Tzur Bitan), University of Haifa, Haifa, Israel; Department of Psychiatry, Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel (Weiser, Amitai); Soteria Israel, Jerusalem Mental Health Center, and Department of Psychiatry, Hebrew University of Jerusalem, Jerusalem (Lichtenberg); Shalvata Mental Health Center, Hod Hasharon, Israel (Tzur Bitan)
| | - Asaf Caspi
- Department of Behavioral Sciences, Ariel University, Ariel, Israel (Friedlander); Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel (Friedlander, Weiser, Caspi, Amitai); Ramat-Chen Brüll Mental Health Center, Tel Aviv District, Clalit Health Services Community Division, Tel Aviv, Israel (Sinai); Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel (Sinai); Departments of Psychology (Zilcha-Mano) and Community Mental Health (Tzur Bitan), University of Haifa, Haifa, Israel; Department of Psychiatry, Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel (Weiser, Amitai); Soteria Israel, Jerusalem Mental Health Center, and Department of Psychiatry, Hebrew University of Jerusalem, Jerusalem (Lichtenberg); Shalvata Mental Health Center, Hod Hasharon, Israel (Tzur Bitan)
| | - Pesach Lichtenberg
- Department of Behavioral Sciences, Ariel University, Ariel, Israel (Friedlander); Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel (Friedlander, Weiser, Caspi, Amitai); Ramat-Chen Brüll Mental Health Center, Tel Aviv District, Clalit Health Services Community Division, Tel Aviv, Israel (Sinai); Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel (Sinai); Departments of Psychology (Zilcha-Mano) and Community Mental Health (Tzur Bitan), University of Haifa, Haifa, Israel; Department of Psychiatry, Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel (Weiser, Amitai); Soteria Israel, Jerusalem Mental Health Center, and Department of Psychiatry, Hebrew University of Jerusalem, Jerusalem (Lichtenberg); Shalvata Mental Health Center, Hod Hasharon, Israel (Tzur Bitan)
| | - Ziv Amitai
- Department of Behavioral Sciences, Ariel University, Ariel, Israel (Friedlander); Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel (Friedlander, Weiser, Caspi, Amitai); Ramat-Chen Brüll Mental Health Center, Tel Aviv District, Clalit Health Services Community Division, Tel Aviv, Israel (Sinai); Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel (Sinai); Departments of Psychology (Zilcha-Mano) and Community Mental Health (Tzur Bitan), University of Haifa, Haifa, Israel; Department of Psychiatry, Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel (Weiser, Amitai); Soteria Israel, Jerusalem Mental Health Center, and Department of Psychiatry, Hebrew University of Jerusalem, Jerusalem (Lichtenberg); Shalvata Mental Health Center, Hod Hasharon, Israel (Tzur Bitan)
| | - Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Ariel, Israel (Friedlander); Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel (Friedlander, Weiser, Caspi, Amitai); Ramat-Chen Brüll Mental Health Center, Tel Aviv District, Clalit Health Services Community Division, Tel Aviv, Israel (Sinai); Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel (Sinai); Departments of Psychology (Zilcha-Mano) and Community Mental Health (Tzur Bitan), University of Haifa, Haifa, Israel; Department of Psychiatry, Tel Aviv University, Faculty of Medicine, Tel Aviv, Israel (Weiser, Amitai); Soteria Israel, Jerusalem Mental Health Center, and Department of Psychiatry, Hebrew University of Jerusalem, Jerusalem (Lichtenberg); Shalvata Mental Health Center, Hod Hasharon, Israel (Tzur Bitan)
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Caspi A, Tzur Bitan D, Halaly O, Hallaly O, Friedlander A, Barkai G, Zimlichman E, Stein O, Shani M, Amitai Z, Ansbacher T, Weiser M. Technologically assisted intensive home treatment: feasibility study. Front Psychiatry 2023; 14:1196748. [PMID: 37575571 PMCID: PMC10415008 DOI: 10.3389/fpsyt.2023.1196748] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction In recent year, many attempts have been made to provide patients with alternatives to psychiatric hospitalization during acute distress. Although several hospitalization alternatives have been offered, most of them still require patients to be distanced from their families, friends, and the social environment. Methods In this report we describe the implementation of a novel approach to psychiatric care termed "Technologically assisted Intensive Home Treatment", where patients arriving to emergency settings are directed to home care with technological aids that enable close monitoring and ongoing contact with their therapists. Results We describe the rationale and treatment principles of the treatment, and provide an elaborative description of the implementation process during the first year of implementation. Discussion Additional attention is given to factors associated with early dropout from the program, in order to inform readers of predictors to optimal care. Limitations and directions for future research and practice are discussed.Clinical Trial Registration: The study was registered in the database of clinical trials (registration number SHEBA-19-6555-MW-CTIL) and in the Ministry of Health (registration number MOH_2022-08-22_011992).
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Affiliation(s)
- Asaf Caspi
- The Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel
| | - Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
- Shalvata Mental Health Center, Hod Hasharon, Israel
| | - Ofir Halaly
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Ofri Hallaly
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Avraham Friedlander
- The Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Galia Barkai
- Central Management, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
- Sackler Faculty of Health, Tel-Aviv University, Tel-Aviv, Israel
| | - Eyal Zimlichman
- Central Management, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
- Sackler Faculty of Health, Tel-Aviv University, Tel-Aviv, Israel
| | - Orit Stein
- Maccabi Health Services, Tel Aviv, Israel
| | - Mordechai Shani
- Sackler Faculty of Health, Tel-Aviv University, Tel-Aviv, Israel
| | - Ziv Amitai
- The Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Health, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Mark Weiser
- The Drora and Pinchas Zachai Division of Psychiatry, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Health, Tel-Aviv University, Tel-Aviv, Israel
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Grasa E, Seppälä J, Alonso-Solis A, Haapea M, Isohanni M, Miettunen J, Caro Mendivelso J, Almazan C, Rubinstein K, Caspi A, Unoka Z, Farkas K, Usall J, Ochoa S, van der Graaf S, Jewell C, Triantafillou A, Stevens M, Reixach E, Berdun J, Corripio I. m-RESIST, a Mobile Therapeutic Intervention for Treatment-Resistant Schizophrenia: Feasibility, Acceptability, and Usability Study. JMIR Form Res 2023; 7:e46179. [PMID: 37389933 PMCID: PMC10365616 DOI: 10.2196/46179] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/21/2023] [Accepted: 04/23/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND In the European Union, around 5 million people are affected by psychotic disorders, and approximately 30%-50% of people with schizophrenia have treatment-resistant schizophrenia (TRS). Mobile health (mHealth) interventions may be effective in preventing relapses, increasing treatment adherence, and managing some of the symptoms of schizophrenia. People with schizophrenia seem willing and able to use smartphones to monitor their symptoms and engage in therapeutic interventions. mHealth studies have been performed with other clinical populations but not in populations with TRS. OBJECTIVE The purpose of this study was to present the 3-month prospective results of the m-RESIST intervention. This study aims to assess the feasibility, acceptability, and usability of the m-RESIST intervention and the satisfaction among patients with TRS after using this intervention. METHODS A prospective multicenter feasibility study without a control group was undertaken with patients with TRS. This study was performed at 3 sites: Sant Pau Hospital (Barcelona, Spain), Semmelweis University (Budapest, Hungary), and Sheba Medical Center and Gertner Institute of Epidemiology and Health Policy Research (Ramat-Gan, Israel). The m-RESIST intervention consisted of a smartwatch, a mobile app, a web-based platform, and a tailored therapeutic program. The m-RESIST intervention was delivered to patients with TRS and assisted by mental health care providers (psychiatrists and psychologists). Feasibility, usability, acceptability, and user satisfaction were measured. RESULTS This study was performed with 39 patients with TRS. The dropout rate was 18% (7/39), the main reasons being as follows: loss to follow-up, clinical worsening, physical discomfort of the smartwatch, and social stigma. Patients' acceptance of m-RESIST ranged from moderate to high. The m-RESIST intervention could provide better control of the illness and appropriate care, together with offering user-friendly and easy-to-use technology. In terms of user experience, patients indicated that m-RESIST enabled easier and quicker communication with clinicians and made them feel more protected and safer. Patients' satisfaction was generally good: 78% (25/32) considered the quality of service as good or excellent, 84% (27/32) reported that they would use it again, and 94% (30/32) reported that they were mostly satisfied. CONCLUSIONS The m-RESIST project has provided the basis for a new modular program based on novel technology: the m-RESIST intervention. This program was well-accepted by patients in terms of acceptability, usability, and satisfaction. Our results offer an encouraging starting point regarding mHealth technologies for patients with TRS. TRIAL REGISTRATION ClinicalTrials.gov NCT03064776; https://clinicaltrials.gov/ct2/show/record/NCT03064776. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2017-021346.
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Affiliation(s)
- Eva Grasa
- Mental Health, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Jussi Seppälä
- Social Insurance Institution of Finland, Kuopio, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Anna Alonso-Solis
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Mental Health Division, Fundació Althaia, Xarxa Assistencial Universitaria de Manresa, Manresa, Spain
| | - Marianne Haapea
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Matti Isohanni
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Cari Almazan
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain
| | - Katya Rubinstein
- The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Asaf Caspi
- The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Zsolt Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Kinga Farkas
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Judith Usall
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Susana Ochoa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | | | | | | | - Matthias Stevens
- EDiT Department, imec, Ghent/Antwerp, Belgium
- Solutions Department, imec, Leuven, Belgium
| | - Elisenda Reixach
- TicSalut Health Department, Generalitat de Catalunya, Barcelona, Spain
| | - Jesus Berdun
- Digital Health Unit, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Iluminada Corripio
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Mental Health and Psychiatry Department, Vic Hospital Consortium, Vic, Spain
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Newbury JB, Arseneault L, Caspi A, Moffitt TE, Odgers CL, Belsky DW, Sugden K, Williams B, Ambler AP, Matthews T, Fisher HL. Association between genetic and socioenvironmental risk for schizophrenia during upbringing in a UK longitudinal cohort. Psychol Med 2022; 52:1527-1537. [PMID: 32972469 PMCID: PMC9226384 DOI: 10.1017/s0033291720003347] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/12/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Associations of socioenvironmental features like urbanicity and neighborhood deprivation with psychosis are well-established. An enduring question, however, is whether these associations are causal. Genetic confounding could occur due to downward mobility of individuals at high genetic risk for psychiatric problems into disadvantaged environments. METHODS We examined correlations of five indices of genetic risk [polygenic risk scores (PRS) for schizophrenia and depression, maternal psychotic symptoms, family psychiatric history, and zygosity-based latent genetic risk] with multiple area-, neighborhood-, and family-level risks during upbringing. Data were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of 2232 British twins born in 1994-1995 and followed to age 18 (93% retention). Socioenvironmental risks included urbanicity, air pollution, neighborhood deprivation, neighborhood crime, neighborhood disorder, social cohesion, residential mobility, family poverty, and a cumulative environmental risk scale. At age 18, participants were privately interviewed about psychotic experiences. RESULTS Higher genetic risk on all indices was associated with riskier environments during upbringing. For example, participants with higher schizophrenia PRS (OR = 1.19, 95% CI = 1.06-1.33), depression PRS (OR = 1.20, 95% CI = 1.08-1.34), family history (OR = 1.25, 95% CI = 1.11-1.40), and latent genetic risk (OR = 1.21, 95% CI = 1.07-1.38) had accumulated more socioenvironmental risks for schizophrenia by age 18. However, associations between socioenvironmental risks and psychotic experiences mostly remained significant after covariate adjustment for genetic risk. CONCLUSION Genetic risk is correlated with socioenvironmental risk for schizophrenia during upbringing, but the associations between socioenvironmental risk and adolescent psychotic experiences appear, at present, to exist above and beyond this gene-environment correlation.
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Affiliation(s)
- J. B. Newbury
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - L. Arseneault
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - A. Caspi
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, and Centre for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - T. E. Moffitt
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, and Centre for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - C. L. Odgers
- Social Science Research Institute, Duke University, Durham, NC, USA
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, CA, USA
| | - D. W. Belsky
- Department of Epidemiology and Robert N Butler Aging Center, Columbia University, Mailman School of Public Health, NY, USA
| | - K. Sugden
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - B. Williams
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - A. P. Ambler
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - T. Matthews
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - H. L. Fisher
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
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Amiaz R, Kimel Naor S, Caspi A, Czerniak E, Noy S, Pelc T, Mintz M, Plotnik M. Responses to balance challenges in persons with panic disorder: A pilot study of computerized static and dynamic balance measurements. Brain Behav 2022; 12:e2411. [PMID: 34843172 PMCID: PMC8785611 DOI: 10.1002/brb3.2411] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/22/2021] [Accepted: 09/05/2021] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Several studies have shown an association between panic disorder (PD) and reduced balance abilities, mainly based on functional balance scales. This pilot study aims to demonstrate the feasibility of studying balance abilities of persons with PD (PwPD) using computerized static and, for the first time, dynamic balance measurements in order to characterize balance control strategies employed by PwPD. METHODS Twelve PwPD and 11 healthy controls were recruited. PD diagnosis was confirmed using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), and the severity of symptoms was evaluated using the Hamilton Anxiety Scale (HAM-A), PD Severity Scales (PDSS), and Panic and Agoraphobia Scale (PAS). Balance was clinically assessed using the Activities-Specific Balance Confidence (ABC) scale and physically by the Mini-Balance Evaluation Systems Test (Mini-BESTest). Dizziness was evaluated using the Dizziness Handicap Inventory (DHI) scale. Postural control was evaluated statically by measuring body sway and dynamically by measuring body responses to rapid unexpected physical perturbations. RESULTS PwPD had higher scores on the HAM-A (17.6 ± 10.3 vs. 3.0 ± 2.9; p < .001), PDSS (11.3 ± 5.1 vs. 0; p < .001), and PAS (20.3 ± 8.7 vs. 0; p < .001) questionnaires and lower scores on the balance scales compared to the controls (ABC scale: 156.2 ± 5.9 vs. 160 ± 0.0, p = .016; Mini-BESTest: 29.4 ± 2.1 vs. 31.4 ± 0.9, p = .014; DHI: 5.3 ± 4.4 vs. 0.09 ± 0.3, p < .001). In the static balance tests, PwPD showed a not-significantly smaller ellipse area of center of pressure trajectory (p = .36) and higher body sway velocity (p = .46), whereas in the dynamic balance tests, PwPD had shorter recovery time from physical perturbations in comparison to controls (2.1 ± 1.2s vs. 1.6 ± 0.9 s, p = .018). CONCLUSION The computerized balance tests results point to an adoption of a ''postural rigidity'' strategy by the PwPD, that is, reduced dynamic adaptations in the face of postural challenges. This may reflect a nonsecure compensatory behavior. Further research is needed to delineate this strategy.
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Affiliation(s)
- Revital Amiaz
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shani Kimel Naor
- The Center of Advanced Technologies in Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Asaf Caspi
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efrat Czerniak
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomo Noy
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tatiana Pelc
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Matti Mintz
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Meir Plotnik
- The Center of Advanced Technologies in Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Alonso-Solís A, Ochoa S, Grasa E, Rubinstein K, Caspi A, Farkas K, Unoka Z, Usall J, Huerta-Ramos E, Isohanni M, Seppälä J, Reixach E, Berdún J, Corripio I, Group MRESIST. A Method to Compare the Delivery of Psychiatric Care for People with Treatment-Resistant Schizophrenia. Int J Environ Res Public Health 2020; 17:ijerph17207527. [PMID: 33081208 PMCID: PMC7589763 DOI: 10.3390/ijerph17207527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Community services are gaining ground when it comes to attention to patients with psychiatric diseases. Regarding patients with treatment-resistant schizophrenia (TRS), the use of information and communication technology (ICT) could help to shift the focus from hospital-centered attention to community services. This study compares the differences in mental health services provided for patients with TRS in Budapest (Hungary), Tel-Aviv (Israel) and Catalonia (Spain) by means of a method for the quick appraisal of gaps among the three places, for a potential implementation of the same ICT tool in these regions. METHODS An adapted version of the Description and Standardised Evaluation of Services and Directories in Europe for Long Term Care (DESDE-LTC) instrument was made by researchers in Semmelweis University (Budapest, Hungary), Gertner Institute (Tel-Aviv, Israel) and Hospital de la Santa Creu I Sant Pau and Parc Sanitari Sant Joan de Déu (Catalonia, Spain). RESULTS Two types of outpatient care services were available in the three regions. Only one type of day-care facility was common in the whole study area. Two residential care services, one for acute and the other for non-acute patients were available in every region. Finally, two self-care and volunteer-care facilities were available in the three places. CONCLUSION Although the availability of services was different in each region, most of the services provided were sufficiently similar to allow the implementation of the same ICT solution in the three places.
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Affiliation(s)
- Anna Alonso-Solís
- Psychiatry Department, Institutd’ Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa CreuiSant Pau; Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain; (A.A.-S.); (E.G.); (I.C.)
- CIBERSAM, Biomedical Research Networking Centre Consortium on Mental Health, 28029 Madrid, Spain; (S.O.); (E.H.-R.)
| | - Susana Ochoa
- CIBERSAM, Biomedical Research Networking Centre Consortium on Mental Health, 28029 Madrid, Spain; (S.O.); (E.H.-R.)
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi Llobregat, Barcelona, Spain
| | - Eva Grasa
- Psychiatry Department, Institutd’ Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa CreuiSant Pau; Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain; (A.A.-S.); (E.G.); (I.C.)
- CIBERSAM, Biomedical Research Networking Centre Consortium on Mental Health, 28029 Madrid, Spain; (S.O.); (E.H.-R.)
| | - Katya Rubinstein
- The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Aviv University, 6997801 Tel Aviv, Israel; (K.R.); (A.C.)
| | - Asaf Caspi
- The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Aviv University, 6997801 Tel Aviv, Israel; (K.R.); (A.C.)
| | - Kinga Farkas
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1083 Budapest, Hungary; (K.F.); (Z.U.)
| | - Zsolt Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1083 Budapest, Hungary; (K.F.); (Z.U.)
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi Llobregat, Barcelona, Spain
- Correspondence:
| | - Elena Huerta-Ramos
- CIBERSAM, Biomedical Research Networking Centre Consortium on Mental Health, 28029 Madrid, Spain; (S.O.); (E.H.-R.)
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi Llobregat, Barcelona, Spain
| | - Matti Isohanni
- Centre for Life Course Health Research, University of Oulu, 90570 Oulu, Finland; (M.I.); (J.S.)
- Department of Psychiatry, Oulu University Hospital, 90220 Oulu, Finland
| | - Jussi Seppälä
- Centre for Life Course Health Research, University of Oulu, 90570 Oulu, Finland; (M.I.); (J.S.)
- South Carelia Social and Health Care District, Psychiatric and Substance Use Services, 53130 Lappeenranta, Finland
| | - Elisenda Reixach
- TicSalut Health Department, Generalitat de Catalunya 08005 Barcelona, Spain; (E.R.); (J.B.)
| | - Jesús Berdún
- TicSalut Health Department, Generalitat de Catalunya 08005 Barcelona, Spain; (E.R.); (J.B.)
| | - Iluminada Corripio
- Psychiatry Department, Institutd’ Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa CreuiSant Pau; Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain; (A.A.-S.); (E.G.); (I.C.)
- CIBERSAM, Biomedical Research Networking Centre Consortium on Mental Health, 28029 Madrid, Spain; (S.O.); (E.H.-R.)
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Melchior M, Moffitt T, Poulton R, Sugden K, Caspi A. High Work Demands and Depression: The Moderating Role of the Serotonin Transporter Gene (5-HTT) and Work Control. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(09)70892-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background:High work demands (i.e. a heavy workload, tight time pressures, conflicting work tasks) put individuals at high risk of depression. Our aim was to test whether the relationship between high work demands and depression is moderated by genetic vulnerability to depression and by work control.Methods:Participants are members of the Dunedin Study, a 1972-73 longitudinal birth cohort assessed most recently in 2004-2005, at age 32 (96% response rate). This analysis included all participants who were employed at age 32. Depression was measured using the Diagnostic Interview Schedule. Work demands and work control were assessed in an interview. Genetic vulnerability to stress was ascertained by the serotonin transporter gene (5-HTT).Results:Among individuals exposed to high work demands, symptoms of depression were significantly higher among those who carried two short alleles of the 5-HTT gene (‘s/s’ group) than among ‘l’ carriers (interaction between 5-HTT gene and work demands: β=4.22, se=1.86, p=0.02). However, this gene-environment interaction was only present among those individuals who had low control over their work (interaction between 5-HTT gene and high work demands: β: 7.21, se: 2.73, p=0.009), not among those who had high work control (interaction between 5-HTT gene and high work demands: β: 1.32, se: 2.53, p=0.60).Conclusion:Pending replication, the serotonin transporter gene appears to moderate the effects of high work demands on symptoms of depression. This gene-environment interaction is attenuated by high work control.
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8
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Alonso-Solís A, Rubinstein K, Corripio I, Jaaskelainen E, Seppälä A, Vella VA, Caro-Mendivelso J, Caspi A, Isohanni M, Unoka Z, Van der Graff S, Farkas K, Huerta-Ramos E, Marcó-García S, Stevens M, Coenen T, Hospedales M, Berdún J, Grasa EM. Mobile therapeutic attention for treatment-resistant schizophrenia (m-RESIST): a prospective multicentre feasibility study protocol in patients and their caregivers. BMJ Open 2018; 8:e021346. [PMID: 30012788 PMCID: PMC6082494 DOI: 10.1136/bmjopen-2017-021346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Treatment-resistant schizophrenia (TRS) is a severe form of schizophrenia. In the European Union, approximately 40% of people with schizophrenia have TRS. Factors such as the persistence of positive symptoms or higher risk of comorbidities leave clinicians with a complex scenario when treating these patients. Intervention strategies based on mHealth have demonstrated their ability to support and promote self-management-based strategies. Mobile therapeutic attention for treatment-resistant schizophrenia (m-RESIST), an innovative mHealth solution based on novel technology and offering high modular and flexible functioning, has been developed specifically for patients with TRS and their caregivers. As intervention in TRS is a challenge, it is necessary to perform a feasibility study before the cost-effectiveness testing stage. METHODS AND ANALYSIS This manuscript describes the protocol for a prospective multicentre feasibility study in 45 patients with TRS and their caregivers who will be attended in the public health system of three localities: Hospital Santa Creu Sant Pau (Spain), Semmelweis University (Hungary) and Gertner Institute & Sheba Medical Center (Israel). The primary aim is to investigate the feasibility and acceptability of the m-RESIST solution, configured by three mHealth tools: an app, wearable and a web-based platform. The solution collects data about acceptability, usability and satisfaction, together with preliminary data on perceived quality of life, symptoms and economic variables. The secondary aim is to collect preliminary data on perceived quality of life, symptoms and economic variables. ETHICS AND DISSEMINATION This study protocol, funded by the Horizon 2020 Programme of the European Union, has the approval of the ethics committees of the participating institutions. Participants will be fully informed of the purpose and procedures of the study, and signed inform consents will be obtained. The results will be published in peer-reviewed journals and presented in scientific conferences to ensure widespread dissemination. TRIAL REGISTRATION NUMBER NCT03064776; Pre-results.
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Affiliation(s)
- Anna Alonso-Solís
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital Santa Creu i Sant Pau; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
| | - Katya Rubinstein
- The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Iluminada Corripio
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital Santa Creu i Sant Pau; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
| | - Erika Jaaskelainen
- Centre for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Annika Seppälä
- Centre for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Vincenzo Alberto Vella
- Agency for Quality and Health Assessment of Catalonia (AQuAS), Health Ministry, Barcelona, Spain
| | - Johanna Caro-Mendivelso
- Agency for Quality and Health Assessment of Catalonia (AQuAS), Health Ministry, Barcelona, Spain
| | - Asaf Caspi
- The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Matti Isohanni
- Centre for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Zsolt Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - Kinga Farkas
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Elena Huerta-Ramos
- Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
- Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Deu (PSSJD), Sant Boi Llobregat, Spain
| | - Silvia Marcó-García
- Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Deu (PSSJD), Sant Boi Llobregat, Spain
| | | | | | | | - Jesús Berdún
- TicSalut Health Department, Generalitat de Catalunya, Barcelona, Spain
| | | | - Eva M Grasa
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital Santa Creu i Sant Pau; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Mental Health Networking Biomedical Research Centre, CIBERSAM, Madrid, Spain
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9
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Wertz J, Caspi A, Belsky DW, Beckley AL, Arseneault L, Barnes JC, Corcoran DL, Hogan S, Houts RM, Morgan N, Odgers CL, Prinz JA, Sugden K, Williams BS, Poulton R, Moffitt TE. Genetics and Crime: Integrating New Genomic Discoveries Into Psychological Research About Antisocial Behavior. Psychol Sci 2018. [PMID: 29513605 PMCID: PMC5945301 DOI: 10.1177/0956797617744542] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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] [Indexed: 12/16/2022] Open
Abstract
Drawing on psychological and sociological theories of crime causation, we tested the
hypothesis that genetic risk for low educational attainment (assessed via a genome-wide
polygenic score) is associated with criminal offending. We further tested hypotheses of
how polygenic risk relates to the development of antisocial behavior from childhood
through adulthood. Across the Dunedin and Environmental Risk (E-Risk) birth cohorts of
individuals growing up 20 years and 20,000 kilometers apart, education polygenic scores
predicted risk of a criminal record with modest effects. Polygenic risk manifested during
primary schooling in lower cognitive abilities, lower self-control, academic difficulties,
and truancy, and it was associated with a life-course-persistent pattern of antisocial
behavior that onsets in childhood and persists into adulthood. Crime is central in the
nature-nurture debate, and findings reported here demonstrate how molecular-genetic
discoveries can be incorporated into established theories of antisocial behavior. They
also suggest that improving school experiences might prevent genetic influences on crime
from unfolding.
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Affiliation(s)
- J Wertz
- 1 Department of Psychology & Neuroscience, Duke University
| | - A Caspi
- 1 Department of Psychology & Neuroscience, Duke University.,2 Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine.,3 Center for Genomic and Computational Biology, Duke University.,4 Social, Genetic, & Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, & Neuroscience, King's College London
| | - D W Belsky
- 5 Department of Medicine, Duke University School of Medicine.,6 Social Science Research Institute, Duke University
| | - A L Beckley
- 1 Department of Psychology & Neuroscience, Duke University.,7 Demography Unit, Department of Sociology, Stockholm University
| | - L Arseneault
- 4 Social, Genetic, & Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, & Neuroscience, King's College London
| | - J C Barnes
- 8 School of Criminal Justice, University of Cincinnati
| | - D L Corcoran
- 3 Center for Genomic and Computational Biology, Duke University
| | - S Hogan
- 9 Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago
| | - R M Houts
- 1 Department of Psychology & Neuroscience, Duke University
| | - N Morgan
- 10 Home Office, London, United Kingdom
| | - C L Odgers
- 11 Sanford School of Public Policy, Duke University
| | - J A Prinz
- 3 Center for Genomic and Computational Biology, Duke University
| | - K Sugden
- 1 Department of Psychology & Neuroscience, Duke University
| | - B S Williams
- 1 Department of Psychology & Neuroscience, Duke University
| | - R Poulton
- 9 Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago
| | - T E Moffitt
- 1 Department of Psychology & Neuroscience, Duke University.,2 Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine.,3 Center for Genomic and Computational Biology, Duke University.,4 Social, Genetic, & Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, & Neuroscience, King's College London
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10
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Schaefer J, Caspi A, Cook S, Moffitt T. A-81Are Cognitive Inefficiencies a Predictor or Consequence of Major Depressive Disorder? Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.81] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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11
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Williams MJA, Milne BJ, Ambler A, Theodore R, Ramrakha S, Caspi A, Moffitt TE, Poulton R. Childhood body mass index and endothelial dysfunction evaluated by peripheral arterial tonometry in early midlife. Int J Obes (Lond) 2017; 41:1355-1360. [PMID: 28465609 PMCID: PMC5585033 DOI: 10.1038/ijo.2017.108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 04/01/2017] [Accepted: 04/19/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND/OBJECTIVES Endothelial dysfunction predicts mortality but it is unknown whether childhood obesity predicts adult endothelial dysfunction. The aim of this study was to determine whether anthropometric indices of body fat in childhood, adolescence and early midlife are associated with endothelial dysfunction in early midlife. SUBJECTS/METHODS Participants belonged to a representative birth cohort of 1037 individuals born in Dunedin, New Zealand in 1972 and 1973 and followed to age 38 years, with 95% retention (the Dunedin Multidisciplinary Health and Development Study). We assessed anthropometric indices of obesity at ages 3, 5, 7, 9, 11, 13, 15, 18, 21, 26, 32 and 38 years. We tested associations between endothelial function assessed by peripheral arterial tonometry (PAT) at age 38 and; age 38 cardiovascular risk factors; age 3 body mass index (BMI); and four BMI trajectory groups from childhood to early midlife. RESULTS Early midlife endothelial dysfunction was associated with BMI, large waist circumference, low high-density lipoprotein cholesterol, low cardiorespiratory fitness and increased high-sensitivity C-reactive protein. After adjustment for sex and childhood socioeconomic status, 3-year-olds with BMI 1 s.d. above the mean had Framingham-reactive hyperemia index (F-RHI) ratios that were 0.10 below those with normal BMI (β=-0.10, 95% confidence interval (CI) -0.17 to -0.03, P=0.007) at age 38. Cohort members in the 'overweight', 'obese' and 'morbidly obese' trajectories had F-RHI ratios that were 0.08 (β=-0.08, 95% CI -0.14 to -0.03, P=0.003), 0.13 (β=-0.13, 95% CI -0.21 to -0.06, P<0.001) and 0.17 (β=-0.17, 95% CI -0.33 to -0.01, P=0.033), respectively, below age-peers in the 'normal' trajectory. CONCLUSIONS Childhood BMI and the trajectories of BMI from childhood to early midlife predict endothelial dysfunction evaluated by PAT in early midlife.
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Affiliation(s)
- M J A Williams
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - B J Milne
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | - A Ambler
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - R Theodore
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - S Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - A Caspi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
- Departments of Psychology and Neuroscience and Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - T E Moffitt
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
- Departments of Psychology and Neuroscience and Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - R Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
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12
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Matthews T, Danese A, Gregory AM, Caspi A, Moffitt TE, Arseneault L. Sleeping with one eye open: loneliness and sleep quality in young adults. Psychol Med 2017; 47:2177-2186. [PMID: 28511734 PMCID: PMC5551384 DOI: 10.1017/s0033291717000629] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 02/15/2017] [Accepted: 02/15/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Feelings of loneliness are common among young adults, and are hypothesized to impair the quality of sleep. In the present study, we tested associations between loneliness and sleep quality in a nationally representative sample of young adults. Further, based on the hypothesis that sleep problems in lonely individuals are driven by increased vigilance for threat, we tested whether past exposure to violence exacerbated this association. METHOD Data were drawn from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2232 twins born in England and Wales in 1994 and 1995. We measured loneliness using items from the UCLA Loneliness Scale, and sleep quality using the Pittsburgh Sleep Quality Index. We controlled for covariates including social isolation, psychopathology, employment status and being a parent of an infant. We examined twin differences to control for unmeasured genetic and family environment factors. RESULTS Feelings of loneliness were associated with worse overall sleep quality. Loneliness was associated specifically with subjective sleep quality and daytime dysfunction. These associations were robust to controls for covariates. Among monozygotic twins, within-twin pair differences in loneliness were significantly associated with within-pair differences in sleep quality, indicating an association independent of unmeasured familial influences. The association between loneliness and sleep quality was exacerbated among individuals exposed to violence victimization in adolescence or maltreatment in childhood. CONCLUSIONS Loneliness is robustly associated with poorer sleep quality in young people, underscoring the importance of early interventions to mitigate the long-term outcomes of loneliness. Special care should be directed towards individuals who have experienced victimization.
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Affiliation(s)
- T. Matthews
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A. Danese
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National and Specialist Child Traumatic Stress and Anxiety Clinic, South London and Maudsley NHS Foundation Trust, London, UK
| | - A. M. Gregory
- Department of Psychology, Goldsmiths University, London, UK
| | - A. Caspi
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
| | - T. E. Moffitt
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
| | - L. Arseneault
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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13
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Caspi A, Amiaz R, Davidson N, Czerniak E, Gur E, Kiryati N, Harari D, Furst M, Stein D. Computerized assessment of body image in anorexia nervosa and bulimia nervosa: comparison with standardized body image assessment tool. Arch Womens Ment Health 2017; 20:139-147. [PMID: 27796596 DOI: 10.1007/s00737-016-0687-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 10/14/2016] [Indexed: 10/20/2022]
Abstract
UNLABELLED Body image disturbances are a prominent feature of eating disorders (EDs). Our aim was to test and evaluate a computerized assessment of body image (CABI), to compare the body image disturbances in different ED types, and to assess the factors affecting body image. The body image of 22 individuals undergoing inpatient treatment with restricting anorexia nervosa (AN-R), 22 with binge/purge AN (AN-B/P), 20 with bulimia nervosa (BN), and 41 healthy controls was assessed using the Contour Drawing Rating Scale (CDRS), the CABI, which simulated the participants' self-image in different levels of weight changes, and the Eating Disorder Inventory-2-Body Dissatisfaction (EDI-2-BD) scale. Severity of depression and anxiety was also assessed. Significant differences were found among the three scales assessing body image, although most of their dimensions differentiated between patients with EDs and controls. Our findings support the use of the CABI in the comparison of body image disturbances in patients with EDs vs. CONTROLS Moreover, the use of different assessment tools allows for a better understanding of the differences in body image disturbances in different ED types.
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Affiliation(s)
- Asaf Caspi
- Department of Psychiatry, The Chaim Sheba, Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Revital Amiaz
- Department of Psychiatry, The Chaim Sheba, Medical Center, Tel Hashomer, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Noa Davidson
- Department of Psychology, The Hebrew University at Jerusalem, Jerusalem, Israel
| | - Efrat Czerniak
- Department of Psychiatry, The Chaim Sheba, Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eitan Gur
- The Eating Disorders Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Nahum Kiryati
- Electrical Engineering-Systems Department, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Harari
- Electrical Engineering-Systems Department, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Miriam Furst
- Electrical Engineering-Systems Department, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Stein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Pediatric Psychosomatic Department, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel
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14
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Huerta-Ramos E, Escobar-Villegas MS, Rubinstein K, Unoka ZS, Grasa E, Hospedales M, Jääskeläinen E, Rubio-Abadal E, Caspi A, Bitter I, Berdun J, Seppälä J, Ochoa S, Fazekas K, Corripio I, Usall J. Measuring Users' Receptivity Toward an Integral Intervention Model Based on mHealth Solutions for Patients With Treatment-Resistant Schizophrenia (m-RESIST): A Qualitative Study. JMIR Mhealth Uhealth 2016; 4:e112. [PMID: 27682896 PMCID: PMC5062002 DOI: 10.2196/mhealth.5716] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 07/29/2016] [Accepted: 08/21/2016] [Indexed: 12/25/2022] Open
Abstract
Background Despite the theoretical potential of mHealth solutions in the treatment of patients with schizophrenia, there remains a lack of technological tools in clinical practice. Objective The aim of this study was to measure the receptivity of patients, informal carers, and clinicians to a European integral intervention model focused on patients with persistent positive symptoms: Mobile Therapeutic Attention for Patients with Treatment-Resistant Schizophrenia (m-RESIST). Methods Before defining the system requirements, a qualitative study of the needs of outpatients with treatment-resistant schizophrenia was carried out in Spain, Israel, and Hungary. We analyzed the opinions of patients, informal carers, and clinicians concerning the services originally intended to be part of the solution. A total of 9 focus groups (72 people) and 35 individual interviews were carried out in the 3 countries, using discourse analysis as the framework. Results A webpage and an online forum were perceived as suitable to get both reliable information on the disease and support. Data transmission by a smart watch (monitoring), Web-based visits, and instant messages (clinical treatment) were valued as ways to improve contact with clinicians. Alerts were appreciated as reminders of daily tasks and appointments. Avoiding stressful situations for outpatients, promoting an active role in the management of the disease, and maintaining human contact with clinicians were the main suggestions provided for improving the effectiveness of the solution. Conclusions Positive receptivity toward m-RESIST services is related to its usefulness in meeting user needs, its capacity to empower them, and the possibility of maintaining human contact.
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Czerniak E, Caspi A, Litvin M, Amiaz R, Bahat Y, Baransi H, Sharon H, Noy S, Plotnik M. A Novel Treatment of Fear of Flying Using a Large Virtual Reality System. Aerosp Med Hum Perform 2016; 87:411-6. [PMID: 27026126 DOI: 10.3357/amhp.4485.2016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Fear of flying (FoF), a common phobia in the developed world, is usually treated with cognitive behavioral therapy, most efficiently when combined with exposure methods, e.g., virtual reality exposure therapy (VRET). We evaluated FoF treatment using VRET in a large motion-based VR system. The treated subjects were seated on a moving platform. The virtual scenery included the interior of an aircraft and a window view to the outside world accompanied by platform movements simulating, e.g., takeoff, landing, and air turbulence. Relevant auditory stimuli were also incorporated. CASE REPORT Three male patients with FoF underwent a clinical interview followed by three VRETs in the presence and with the guidance of a therapist. Scores on the Flight Anxiety Situation (FAS) and Flight Anxiety Modality (FAM) questionnaires were obtained on the first and fourth visits. Anxiety levels were assessed using the subjective units of distress (SUDs) scale during the exposure. All three subjects expressed satisfaction regarding the procedure and did not skip or avoid any of its stages. Consistent improvement was seen in the SUDs throughout the VRET session and across sessions, while patients' scores on the FAS and FAM showed inconsistent trends. Two patients participated in actual flights in the months following the treatment, bringing 12 and 16 yr of avoidance to an end. DISCUSSION This VR-based treatment includes critical elements for exposure of flying experience beyond visual and auditory stimuli. The current case reports suggest VRET sessions may have a meaningful impact on anxiety levels, yet additional research seems warranted.
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Affiliation(s)
- Efrat Czerniak
- Th e Center of Advanced Technologies in Rehabilitation, the Division of Psychiatry, and the Department of Physiotherapy Services, Sheba Medical Center, Ramat Gan, Israel
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Shihmanter R, Nulman I, Goland S, Caspi A, Bar-Haim A, Harary I, Berkovitch M, Arcavi L. Variation in the CYP2D6
genotype is not associated with carvedilol dose changes in patients with heart failure. J Clin Pharm Ther 2014; 39:432-8. [DOI: 10.1111/jcpt.12154] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 02/20/2014] [Indexed: 11/27/2022]
Affiliation(s)
- R. Shihmanter
- Clinical Pharmacology Unit; Kaplan Medical Center; Hebrew University and Hadassah Medical School; Rehovot Jerusalem Israel
| | - I. Nulman
- Division of Clinical Pharmacology and Toxicology; The Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - S. Goland
- Department of Cardiology; Kaplan Medical Center; Hebrew University and Hadassah Medical School; Rehovot Jerusalem Israel
| | - A. Caspi
- Department of Cardiology; Kaplan Medical Center; Hebrew University and Hadassah Medical School; Rehovot Jerusalem Israel
| | - A. Bar-Haim
- Biochemistry and Pharmacogenetics Laboratory; Assaf Harofeh Medical Center; Zerifin Israel
| | - I. Harary
- Biochemistry and Pharmacogenetics Laboratory; Assaf Harofeh Medical Center; Zerifin Israel
| | - M. Berkovitch
- Clinical Pharmacology Unit; Assaf Harofeh Medical Center; Zerifin Israel
| | - L. Arcavi
- Clinical Pharmacology Unit; Kaplan Medical Center; Hebrew University and Hadassah Medical School; Rehovot Jerusalem Israel
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17
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Fisher HL, Caspi A, Poulton R, Meier MH, Houts R, Harrington H, Arseneault L, Moffitt TE. Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: a birth cohort study. Psychol Med 2013; 43:2077-86. [PMID: 23302254 PMCID: PMC3758773 DOI: 10.1017/s0033291712003091] [Citation(s) in RCA: 214] [Impact Index Per Article: 19.5] [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: 12/20/2022]
Abstract
BACKGROUND Childhood psychotic symptoms have been used as a subclinical phenotype of schizophrenia in etiological research and as a target for preventative interventions. However, recent studies have cast doubt on the specificity of these symptoms for schizophrenia, suggesting alternative outcomes such as anxiety and depression. Using a prospective longitudinal birth cohort we investigated whether childhood psychotic symptoms predicted a diagnosis of schizophrenia or other psychiatric disorders by 38 years of age. METHOD Participants were drawn from a birth cohort of 1037 children from Dunedin, New Zealand, who were followed prospectively to 38 years of age (96% retention rate). Structured clinical interviews were administered at age 11 to assess psychotic symptoms and study members underwent psychiatric assessments at ages 18, 21, 26, 32 and 38 to obtain past-year DSM-III-R/IV diagnoses and self-reports of attempted suicides since adolescence. RESULTS Psychotic symptoms at age 11 predicted elevated rates of research diagnoses of schizophrenia and posttraumatic stress disorder (PTSD) and also suicide attempts by age 38, even when controlling for gender, social class and childhood psychopathology. No significant associations were found for persistent anxiety, persistent depression, mania or persistent substance dependence. Very few of the children presenting with age-11 psychotic symptoms were free from disorder by age 38. CONCLUSIONS Childhood psychotic symptoms were not specific to a diagnosis of schizophrenia in adulthood and thus future studies of early symptoms should be cautious in extrapolating findings only to this clinical disorder. However, these symptoms may be useful as a marker of adult mental health problems more broadly.
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Affiliation(s)
- H L Fisher
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK.
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18
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Shalev I, Moffitt TE, Sugden K, Williams B, Houts RM, Danese A, Mill J, Arseneault L, Caspi A. Exposure to violence during childhood is associated with telomere erosion from 5 to 10 years of age: a longitudinal study. Mol Psychiatry 2013; 18:576-81. [PMID: 22525489 PMCID: PMC3616159 DOI: 10.1038/mp.2012.32] [Citation(s) in RCA: 350] [Impact Index Per Article: 31.8] [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] [Received: 12/02/2011] [Revised: 02/02/2012] [Accepted: 03/05/2012] [Indexed: 12/23/2022]
Abstract
There is increasing interest in discovering mechanisms that mediate the effects of childhood stress on late-life disease morbidity and mortality. Previous studies have suggested one potential mechanism linking stress to cellular aging, disease and mortality in humans: telomere erosion. We examined telomere erosion in relation to children's exposure to violence, a salient early-life stressor, which has known long-term consequences for well-being and is a major public-health and social-welfare problem. In the first prospective-longitudinal study with repeated telomere measurements in children while they experienced stress, we tested the hypothesis that childhood violence exposure would accelerate telomere erosion from age 5 to age 10 years. Violence was assessed as exposure to maternal domestic violence, frequent bullying victimization and physical maltreatment by an adult. Participants were 236 children (49% females; 42% with one or more violence exposures) recruited from the Environmental-Risk Longitudinal Twin Study, a nationally representative 1994-1995 birth cohort. Each child's mean relative telomere length was measured simultaneously in baseline and follow-up DNA samples, using the quantitative PCR method for T/S ratio (the ratio of telomere repeat copy numbers to single-copy gene numbers). Compared with their counterparts, the children who experienced two or more kinds of violence exposure showed significantly more telomere erosion between age-5 baseline and age-10 follow-up measurements, even after adjusting for sex, socioeconomic status and body mass index (B=-0.052, s.e.=0.021, P=0.015). This finding provides support for a mechanism linking cumulative childhood stress to telomere maintenance, observed already at a young age, with potential impact for life-long health.
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Affiliation(s)
- I Shalev
- Department of Psychology and Neuroscience, Duke University, Suite 201 Grey House, 2020 West Main Street, Box 104410, Durham, NC 27708, USA.
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19
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Ahuja AK, Yeoh J, Dorn JD, Caspi A, Wuyyuru V, McMahon MJ, Humayun MS, Greenberg RJ, Dacruz L. Factors Affecting Perceptual Threshold in Argus II Retinal Prosthesis Subjects. Transl Vis Sci Technol 2013; 2:1. [PMID: 24049718 DOI: 10.1167/tvst.2.4.1] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [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: 05/28/2012] [Accepted: 01/31/2013] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The Argus II epiretinal prosthesis has been developed to provide partial restoration of vision to subjects blinded from outer retinal degenerative disease. Participants were surgically implanted with the system in the United States and Europe in a single arm, prospective, multicenter clinical trial. The purpose of this investigation was to determine which factors affect electrical thresholds in order to inform surgical placement of the device. METHODS Electrode-retina and electrode-fovea distances were determined using SD-OCT and fundus photography, respectively. Perceptual threshold to electrical stimulation of electrodes was measured using custom developed software, in which current amplitude was varied until the threshold was found. Full field stimulus light threshold was measured using the Espion D-FST test. Relationships between electrical threshold and these three explanatory variables (electrode-retina distance, electrode-fovea distance, and monocular light threshold) were quantified using regression. RESULTS Regression analysis showed a significant correlation between electrical threshold and electrode-retina distance (R2 = 0.50, P = 0.0002; n = 703 electrodes). 90.3% of electrodes in contact with the macula (n = 207) elicited percepts at charge densities less than 1 mC/cm2/phase. These threshold data also correlated well with ganglion cell density profile (P = 0.03). A weaker, but still significant, inverse correlation was found between light threshold and electrical threshold (R2 < 0.52, P = 0.01). Multivariate modeling indicated that electrode-retina distance and light threshold are highly predictive of electrode threshold (R2 = 0.87; P < 0.0005). CONCLUSIONS Taken together, these results suggest that while light threshold should be used to inform patient selection, macular contact of the array is paramount. TRANSLATIONAL RELEVANCE Reported Argus II clinical study results are in good agreement with prior in vitro and in vivo studies, and support the development of higher-density systems that employ smaller diameter electrodes. (clinicaltrials.gov identifier: NCT00407602).
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Affiliation(s)
- A K Ahuja
- Second Sight Medical Products, Inc., Sylmar, CA ; Doheny Eye Institute, Keck School of Medicine, Los Angeles, CA
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Abstract
Between one-third and one-half of the individuals who meet diagnostic criteria for schizophrenia remain actively ill despite optimal pharmacological treatment. These individuals tend to progressively deteriorate in terms of social and vocational functioning despite major public and private investments in their rehabilitation. For patients who do not respond to the first prescribed antipsychotic drug, current clinical practice is to switch to a second and a third drug, and eventually to clozapine, the only antipsychotic drug proven to be effective in treatment-refractory schizophrenia (TRS). Occasionally, two antipsychotics are given concomitantly or psychotropic drugs are added to antipsychotic drugs; however, very few empirical data exist to support this practice. Although there are many exceptions, patients who do not benefit from the first prescribed drug will not benefit from any pharmacological intervention. Therefore, efforts are under way to determine the reason for lack of response to available treatments and devise novel, more effective treatments. To be successful these efforts must result in a more specific definition of TRS, as well as in a better understanding of the illness pathophysiology and the mechanism of action of the drugs.
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Affiliation(s)
- Asaf Caspi
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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21
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Gordon C, Zivotofsky A, Caspi A. Could Different Smooth Pursuit and Saccadic Abnormalities in Spinocerebellar Ataxia Type 3 (SCA3) Be Explained by a Single Deficient Mechanism? (P02.259). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.259] [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: 11/15/2022] Open
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22
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Grisham JR, Fullana MA, Mataix-Cols D, Moffitt TE, Caspi A, Poulton R. Risk factors prospectively associated with adult obsessive-compulsive symptom dimensions and obsessive-compulsive disorder. Psychol Med 2011; 41:2495-2506. [PMID: 21672296 DOI: 10.1017/s0033291711000894] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Very few longitudinal studies have evaluated prospective neurodevelopmental and psychosocial risk factors for obsessive-compulsive disorder (OCD). Furthermore, despite the heterogeneous nature of OCD, no research has examined risk factors for its primary symptom dimensions, such as contamination/washing. METHOD Potential risk factors for symptoms or diagnosis of OCD in adulthood and for specific adult obsessive-compulsive (OC) symptom dimensions were examined in the Dunedin Study birth cohort. The presence of obsessions and compulsions and psychological disorders was assessed using the Diagnostic Interview Schedule (DIS) at ages 26 and 32 years. Individuals with a diagnosis of OCD at either age (n=36) were compared to both a healthy control group (n=613) and an anxious control group (n=310) to determine whether associations between a risk factor and an OCD diagnosis were specific. RESULTS Childhood neurodevelopmental, behavioral, personality and environmental risk factors were associated with a diagnosis of OCD and with OC symptoms at ages 26 and 32. Social isolation, retrospectively reported physical abuse and negative emotionality were specific predictors of an adult OCD diagnosis. Of note, most risk factors were associated with OC symptoms in adulthood and several risk factors predicted specific OCD dimensions. Perinatal insults were linked to increased risk for symmetry/ordering and shameful thoughts dimensions, whereas poor childhood motor skills predicted the harm/checking dimension. Difficult temperament, internalizing symptoms and conduct problems in childhood also predicted specific symptom dimensions and lower IQ non-specifically predicted increased risk for most dimensions. CONCLUSIONS The current findings underscore the need for a dimensional approach in evaluating childhood risk factors for obsessions and compulsions.
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Affiliation(s)
- J R Grisham
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.
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23
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Danese A, Caspi A, Williams B, Ambler A, Sugden K, Mika J, Werts H, Freeman J, Pariante CM, Moffitt TE, Arseneault L. Biological embedding of stress through inflammation processes in childhood. Mol Psychiatry 2011; 16:244-6. [PMID: 20157309 PMCID: PMC4212809 DOI: 10.1038/mp.2010.5] [Citation(s) in RCA: 202] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A Danese
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, London, UK
| | - A Caspi
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK,Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
| | - B Williams
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK,Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
| | - A Ambler
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - K Sugden
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK,Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
| | - J Mika
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - H Werts
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - J Freeman
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - CM Pariante
- Department of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - TE Moffitt
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK,Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
| | - L Arseneault
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
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Ahuja AK, Dorn JD, Caspi A, McMahon MJ, Dagnelie G, Dacruz L, Stanga P, Humayun MS, Greenberg RJ. Blind subjects implanted with the Argus II retinal prosthesis are able to improve performance in a spatial-motor task. Br J Ophthalmol 2010; 95:539-43. [PMID: 20881025 DOI: 10.1136/bjo.2010.179622] [Citation(s) in RCA: 227] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To determine to what extent subjects implanted with the Argus II retinal prosthesis can improve performance compared with residual native vision in a spatial-motor task. METHODS High-contrast square stimuli (5.85 cm sides) were displayed in random locations on a 19″ (48.3 cm) touch screen monitor located 12″ (30.5 cm) in front of the subject. Subjects were instructed to locate and touch the square centre with the system on and then off (40 trials each). The coordinates of the square centre and location touched were recorded. RESULTS Ninety-six percent (26/27) of subjects showed a significant improvement in accuracy and 93% (25/27) show a significant improvement in repeatability with the system on compared with off (p<0.05, Student t test). A group of five subjects that had both accuracy and repeatability values <250 pixels (7.4 cm) with the system off (ie, using only their residual vision) was significantly more accurate and repeatable than the remainder of the cohort (p<0.01). Of this group, four subjects showed a significant improvement in both accuracy and repeatability with the system on. CONCLUSION In a study on the largest cohort of visual prosthesis recipients to date, we found that artificial vision augments information from existing vision in a spatial-motor task. Clinical trials registry no NCT00407602.
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Affiliation(s)
- A K Ahuja
- Second Sight Medical Products, Sylmar, CA 91342, USA.
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25
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Moffitt TE, Caspi A, Taylor A, Kokaua J, Milne BJ, Polanczyk G, Poulton R. How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychol Med 2010; 40:899-909. [PMID: 19719899 PMCID: PMC3572710 DOI: 10.1017/s0033291709991036] [Citation(s) in RCA: 538] [Impact Index Per Article: 38.4] [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: 11/06/2022]
Abstract
BACKGROUND Most information about the lifetime prevalence of mental disorders comes from retrospective surveys, but how much these surveys have undercounted due to recall failure is unknown. We compared results from a prospective study with those from retrospective studies. METHOD The representative 1972-1973 Dunedin New Zealand birth cohort (n=1037) was followed to age 32 years with 96% retention, and compared to the national New Zealand Mental Health Survey (NZMHS) and two US National Comorbidity Surveys (NCS and NCS-R). Measures were research diagnoses of anxiety, depression, alcohol dependence and cannabis dependence from ages 18 to 32 years. RESULTS The prevalence of lifetime disorder to age 32 was approximately doubled in prospective as compared to retrospective data for all four disorder types. Moreover, across disorders, prospective measurement yielded a mean past-year-to-lifetime ratio of 38% whereas retrospective measurement yielded higher mean past-year-to-lifetime ratios of 57% (NZMHS, NCS-R) and 65% (NCS). CONCLUSIONS Prospective longitudinal studies complement retrospective surveys by providing unique information about lifetime prevalence. The experience of at least one episode of DSM-defined disorder during a lifetime may be far more common in the population than previously thought. Research should ask what this means for etiological theory, construct validity of the DSM approach, public perception of stigma, estimates of the burden of disease and public health policy.
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26
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Caspi A, Hirschberger G, Ein-Dor T, Zivotofsky AZ. Looking away from death: The influence of subliminal priming on eye movement decisions. J Vis 2010. [DOI: 10.1167/6.6.488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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27
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Caspi A, Beutter BR, Eckstein MP. The accumulation of visual information driving the 1st saccade during visual search probed with spatiotemporal noise. J Vis 2010. [DOI: 10.1167/3.9.69] [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: 11/24/2022] Open
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28
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Hancox RJ, Poulton R, Ely M, Welch D, Taylor DR, McLachlan CR, Greene JM, Moffitt TE, Caspi A, Sears MR. Effects of cannabis on lung function: a population-based cohort study. Eur Respir J 2009; 35:42-7. [PMID: 19679602 DOI: 10.1183/09031936.00065009] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The effects of cannabis on lung function remain unclear and may be different from those of tobacco. We compared the associations between use of these substances and lung function in a population-based cohort (n = 1,037). Cannabis and tobacco use were reported at ages 18, 21, 26 and 32 yrs. Spirometry, plethysmography and carbon monoxide transfer factor were measured at 32 yrs. Associations between lung function and exposure to each substance were adjusted for exposure to the other substance. Cumulative cannabis use was associated with higher forced vital capacity, total lung capacity, functional residual capacity and residual volume. Cannabis was also associated with higher airway resistance but not with forced expiratory volume in 1 s, forced expiratory ratio or transfer factor. These findings were similar among those who did not smoke tobacco. In contrast, tobacco use was associated with lower forced expiratory volume in 1 s, lower forced expiratory ratio, lower transfer factor and higher static lung volumes, but not with airway resistance. Cannabis appears to have different effects on lung function from those of tobacco. Cannabis use was associated with higher lung volumes, suggesting hyperinflation and increased large-airways resistance, but there was little evidence for airflow obstruction or impairment of gas transfer.
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Affiliation(s)
- R J Hancox
- Dunedin Multidisciplinary Health and Development Research Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
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Caspi A, Vishne T, Reichenberg A, Weiser M, Dishon A, Lubin G, Shmushkevitz M, Mandel Y, Noy S, Davidson M. Refractive errors and schizophrenia. Schizophr Res 2009; 107:238-41. [PMID: 19019632 DOI: 10.1016/j.schres.2008.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Revised: 09/22/2008] [Accepted: 09/28/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Refractive errors (myopia, hyperopia and amblyopia), like schizophrenia, have a strong genetic cause, and dopamine has been proposed as a potential mediator in their pathophysiology. The present study explored the association between refractive errors in adolescence and schizophrenia, and the potential familiality of this association. METHODS The Israeli Draft Board carries a mandatory standardized visual accuracy assessment. 678,674 males consecutively assessed by the Draft Board and found to be psychiatrically healthy at age 17 were followed for psychiatric hospitalization with schizophrenia using the Israeli National Psychiatric Hospitalization Case Registry. Sib-ships were also identified within the cohort. RESULTS There was a negative association between refractive errors and later hospitalization for schizophrenia. Future male schizophrenia patients were two times less likely to have refractive errors compared with never-hospitalized individuals, controlling for intelligence, years of education and socioeconomic status [adjusted Hazard Ratio=.55; 95% confidence interval .35-.85]. The non-schizophrenic male siblings of schizophrenia patients also had lower prevalence of refractive errors compared to never-hospitalized individuals. CONCLUSIONS Presence of refractive errors in adolescence is related to lower risk for schizophrenia. The familiality of this association suggests that refractive errors may be associated with the genetic liability to schizophrenia.
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Affiliation(s)
- Asaf Caspi
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel.
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Milne B, Caspi A, Crump R, Poulton R, Rutter M, Sears M, Moffitt T. The validity of the family history screen for assessing family history of mental disorders. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:41-9. [PMID: 18449865 PMCID: PMC3750954 DOI: 10.1002/ajmg.b.30764] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [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] [Indexed: 11/10/2022]
Abstract
There is a need to collect psychiatric family history information quickly and economically (e.g., for genome-wide studies and primary care practice). We sought to evaluate the validity of family history reports using a brief screening instrument, the Family History Screen (FHS). We assessed the validity of parents' reports of seven psychiatric disorders in their adult children probands from the Dunedin Study (n = 959, 52% male), using the proband's diagnosis as the criterion outcome. We also investigated whether there were informant characteristics that enhanced accuracy of reporting or were associated with reporting biases. Using reports from multiple informants, we obtained sensitivities ranging from 31.7% (alcohol dependence) to 60.0% (conduct disorder) and specificities ranging from 76.0% (major depressive episode) to 97.1% (suicide attempt). There was little evidence that any informant characteristics enhanced accuracy of reporting. However, three reporting biases were found: the probability of reporting disorder in the proband was greater for informants with versus without a disorder, for female versus male informants, and for younger versus older informants. We conclude that the FHS is as valid as other family history instruments (e.g., the FH-RDC, FISC), and its brief administration time makes it a cost-effective method for collecting family history data. To avoid biasing results, researchers who aim to compare groups in terms of their family history should ensure that the informants reporting on these groups do not differ in terms of age, sex or personal history of disorder.
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Affiliation(s)
- B.J. Milne
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College, London, UK,Correspondence to: B.J. Milne, Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, P080, De Crespigny Park, London SE5 8AF, UK.,
| | - A. Caspi
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College, London, UK,Departments of Psychology and Neuroscience, and Psychiatry and Behavioral Sciences, Institute for Genome Sciences and Policy, Duke University, Durham, North Carolina
| | - R. Crump
- Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - R. Poulton
- Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - M. Rutter
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College, London, UK
| | - M.R. Sears
- Department of Medicine, McMaster University, Firestone Institute for Respiratory Health, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - T.E. Moffitt
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College, London, UK,Departments of Psychology and Neuroscience, and Psychiatry and Behavioral Sciences, Institute for Genome Sciences and Policy, Duke University, Durham, North Carolina
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Milne BJ, Moffitt TE, Crump R, Poulton R, Rutter M, Sears MR, Taylor A, Caspi A. How should we construct psychiatric family history scores? A comparison of alternative approaches from the Dunedin Family Health History Study. Psychol Med 2008; 38:1793-1802. [PMID: 18366822 PMCID: PMC3752774 DOI: 10.1017/s0033291708003115] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [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: 11/06/2022]
Abstract
BACKGROUND There is increased interest in assessing the family history of psychiatric disorders for both genetic research and public health screening. It is unclear how best to combine family history reports into an overall score. We compare the predictive validity of different family history scores. METHOD Probands from the Dunedin Study (n=981, 51% male) had their family history assessed for nine different conditions. We computed four family history scores for each disorder: (1) a simple dichotomous categorization of whether or not probands had any disordered first-degree relatives; (2) the observed number of disordered first-degree relatives; (3) the proportion of first-degree relatives who are disordered; and (4) Reed's score, which expressed the observed number of disordered first-degree relatives in terms of the number expected given the age and sex of each relative. We compared the strength of association between each family history score and probands' disorder outcome. RESULTS Each score produced significant family history associations for all disorders. The scores that took account of the number of disordered relatives within families (i.e. the observed, proportion, and Reed's scores) produced significantly stronger associations than the dichotomous score for conduct disorder, alcohol dependence and smoking. Taking account of family size (i.e. using the proportion or Reed's score) produced stronger family history associations depending on the prevalence of the disorder among family members. CONCLUSIONS Dichotomous family history scores can be improved upon by considering the number of disordered relatives in a family and the population prevalence of the disorder.
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Affiliation(s)
- B J Milne
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK.
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Weiser M, Reichenberg A, Werbeloff N, Kleinhaus K, Lubin G, Shmushkevitch M, Caspi A, Malaspina D, Davidson M. Advanced parental age at birth is associated with poorer social functioning in adolescent males: shedding light on a core symptom of schizophrenia and autism. Schizophr Bull 2008; 34:1042-6. [PMID: 18796466 PMCID: PMC2632511 DOI: 10.1093/schbul/sbn109] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Evidence indicates an association between older parents at birth and increased risk for schizophrenia and autism. Patients with schizophrenia and autism and their first-degree relatives have impaired social functioning; hence, impaired social functioning is probably an intermediate phenotype of the illness. This study tested the hypothesis that advanced father's age at birth would be associated with poorer social functioning in the general population. To test this hypothesis, we examined the association between parental age at birth and the social functioning of their adolescent male offspring in a population-based study. METHODS Subjects were 403486, 16- to 17-year-old Israeli-born male adolescents assessed by the Israeli Draft Board. The effect of parental age on social functioning was assessed in analyses controlling for cognitive functioning, the other parent's age, parental socioeconomic status, birth order, and year of draft board assessment. RESULTS Compared with offspring of parents aged 25-29 years, the prevalence of poor social functioning was increased both in offspring of fathers younger than 20 years (odds ratio [OR] = 1.27, 95% confidence interval [CI] = 1.08-1.49) and in offspring of fathers 45 years old (OR = 1.52, 95% CI = 1.43-1.61). Male adolescent children of mothers aged 40 years and above were 1.15 (95% CI = 1.07-1.24) times more likely to have poor social functioning. CONCLUSIONS These modest associations between parental age and poor social functioning in the general population parallel the associations between parental age and risk for schizophrenia and autism and suggest that the risk pathways between advanced parental age and schizophrenia and autism might, at least partially, include mildly deleterious effects on social functioning.
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Affiliation(s)
- Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.
| | | | - Nomi Werbeloff
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel
| | | | - Gad Lubin
- IDF, Division of Mental Health, Israel
| | | | - Asaf Caspi
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel,Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | | | - Michael Davidson
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel,Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel
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Weiser M, Lubin G, Caspi A, Rabinowitz J, Shmushkevitz M, Yoffe R, Werbeloff N, Halperin D, Davidson M. Dysthymia in male adolescents is associated with increased risk of later hospitalization for psychotic disorders: a historical-prospective cohort study. Early Interv Psychiatry 2008; 2:67-72. [PMID: 21352135 DOI: 10.1111/j.1751-7893.2008.00060.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Retrospective studies indicate that patients with psychotic disorders and schizophrenia often suffer from depressive symptoms before the onset of psychosis. In a historical-prospective design, we studied the association between dysthymia in adolescence and later hospitalization for psychotic disorders and schizophrenia. METHODS The Israeli Draft Board screens the entire, unselected population of 16-17 years old male adolescents for psychiatric disorders. These adolescents were followed for hospitalization for psychotic disorders and schizophrenia using the Israeli National Psychiatric Hospitalization Case Registry. Of 275,705 male adolescents screened, 1267 (0.5%) were hospitalized for psychotic disorders (International Classification of Diseases [ICD]-10 20.0-29.9), and 757 (0.3%) were hospitalized for schizophrenia (ICD-10 20.0-20.9) over the next 1-10 years. RESULTS Of 275,705 male adolescents screened, 513 (0.2%) were diagnosed as suffering from dysthymia by the Draft Board. Of these adolescents, 10/513 (2.0%) were later hospitalized for psychotic disorders (including schizophrenia, HR=3.967, 95%CI (confidence intervals): 2.129-7.390), and 4/513 (0.8%) were later hospitalized for schizophrenia (HR=2.664, 95%CI: 0.997-7.116). CONCLUSIONS In this population-based cohort of male adolescents, dysthymia was associated with increased risk for future psychotic disorders. Dysthymia in some adolescents might be a prodromal symptom, while in others it might be a risk factor for later psychosis. Clinicians assessing dysthymic adolescents should be aware that these symptoms might be part of the prodrome.
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Affiliation(s)
- Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel.
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Caspi A, Vishne T, Sasson Y, Gross R, Livne A, Zohar J. Relationship between childhood sexual abuse and obsessive-compulsive disorder: case control study. Isr J Psychiatry Relat Sci 2008; 45:177-182. [PMID: 19398821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The psychiatric sequelae of childhood sexual abuse (CSA) is associated with a variety of psychiatric disorders, such as eating disorders, depression, posttraumatic-stress disorder and borderline personality disorder. This study examined the association of CSA and obsessive-compulsive disorder (OCD) in adults. METHODS Frequency of CSA was examined among 30 OCD patients and in two control groups: 17 patients with panic disorder (PD) and 26 non-psychiatric rheumatic patients (NPRP). Study tool was a semi-structured interview. RESULTS A significantly higher frequency of CSA involving physical contact was found among the OCD (53.3%) and PD patients (52.9%) as compared to NPRP (23.1%). No significant differences were found in the frequencies of non-contact CSA. LIMITATIONS Differences could partially be attributed to the tendency of psychiatric patients to provide personal information, especially when motivated to pinpoint an external factor for their illness. CONCLUSIONS A positive association was found between contact-CSA and OCD as well as PD.While it is not definitely clear whether CSA is a unique entity or has influence similar to any other stressful life event, the findings of this study support further investigation of the role of contact CSA in OCD and PD, as well as in other psychiatric disorders.
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Affiliation(s)
- Asaf Caspi
- The Chaim ShebaMedical Center, Division of Psychiatry, Tel Hashomer, Israel
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Caspi A. Prolegomena to a model of continuity and change in behavioural development. Ciba Found Symp 2007; 156:209-19; discussion 219-23. [PMID: 1855413 DOI: 10.1002/9780470514047.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
It is now widely acknowledged that personality and behaviour are shaped in large measure by interactions between the person and the environment. There are many kinds of interaction but we suggest that three types play particularly important roles both in sustaining behavioural continuity across the life course and in guiding the trajectory of the life course itself. Reactive interaction occurs when different individuals exposed to the same environment experience it, interpret it and react to it differently. Evocative interaction occurs when an individual's personality evokes distinctive responses from others. Proactive interaction occurs when individuals select or create environments of their own. Within this framework we also examine systematic change and turning points in behavioural development. We have recently advanced a paradoxical theory suggesting that behavioural continuities are especially likely to be evident during periods of social discontinuity; that is, dispositional factors influence behaviour most when individuals enter new situations and assume new statuses. This model receives empirical support from both experimental and longitudinal-correlational research. The model also presents interesting implications for our understanding of turning points in behavioural development: to effect change in the life course, new situations must eliminate old options and create new opportunities. Convergent evidence from experimental and naturalistic designs is introduced to support this claim.
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Affiliation(s)
- A Caspi
- Department of Psychology, University of Wisconsin, Madison 53706
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Zornitzki T, Ayzenberg O, Gandelman G, Vered S, Yaskil E, Faraggi D, Caspi A, Goland S, Shvez O, Schattner A, Knobler H. Diabetes, but not the metabolic syndrome, predicts the severity and extent of coronary artery disease in women. QJM 2007; 100:575-81. [PMID: 17693419 DOI: 10.1093/qjmed/hcm066] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous studies have suggested that diabetes and metabolic syndrome are significant risk factors for coronary artery disease (CAD). However, in women, their relative importance remains controversial. AIM To evaluate risk factors for CAD in women and their association with the severity and extent of coronary angiographic findings. METHODS We clinically evaluated 243 consecutive female patients with chest pain who underwent coronary angiography. The location and extent of coronary artery occlusions were assessed using the modified Gensini index. RESULTS Compared with women with normal coronary arteries (n = 90), those with CAD (n = 153) reported less physical activity (p = 0.001), and had higher prevalences of diabetes (p = 0.046), hypertension (p = 0.002), and the metabolic syndrome (p = 0.001). They also had lower HDL cholesterol levels (p = 0.017), higher levels of triglycerides (p = 0.005), and higher fasting plasma glucose (FPG) (p < 0.001). Physical activity, FPG, serum triglycerides and HDL-cholesterol, but not the metabolic syndrome, were independent predictors of CAD. A score combining the extent and severity of angiographic findings was significantly higher in women with diabetes (p = 0.007), hypertension (p = 0.010) and FPG >or=100 mg/dl (p = 0.031), but showed no association with the metabolic syndrome. In a multivariate linear regression analysis, diabetes was an independent predictor of the extent and severity of angiographic score (p = 0.013). DISCUSSION Diabetes, fasting plasma glucose and hypertension, but not the metabolic syndrome, were associated with severity of coronary angiographic findings in these women.
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Affiliation(s)
- T Zornitzki
- Metabolic Unit, Kaplan Medical Center, Rehovot, Hebrew University Hadassah Medical School, Jerusalem, Israel
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37
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Caspi A, Reichenberg A, Weiser M, Rabinowitz J, Shmushkevich M, Lubin G, Nahon D, Vishne T, Davidson M. Premorbid behavioral and intellectual functioning in schizophrenia patients with poor response to treatment with antipsychotic drugs. Schizophr Res 2007; 94:45-9. [PMID: 17544633 DOI: 10.1016/j.schres.2007.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2006] [Revised: 03/05/2007] [Accepted: 04/15/2007] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Approximately one third of schizophrenia patients show partial or no response to pharmacotherapy. Despite intensive investigations, the phenomenological and biological characteristics of such patients are far from elucidated. This study examined the premorbid behavioral and intellectual functioning of schizophrenia patients who showed poor response to antipsychotic treatment. METHOD One hundred twenty-nine schizophrenia patients who showed poor response to treatment were ascertained from a national register and matched by gender, age and education to 129 patients who showed adequate response. The groups were compared on premorbid measures of behavioral and intellectual functions. RESULTS As a group, treatment-resistant male patients had significantly lower (worse) social functioning [p=0.002], and individual autonomy [p<0.0001] scores before the onset of the illness compared to treatment non-resistant patients. Male and female treatment-resistant patients did not differ from non-resistant patients in premorbid intellectual functioning [p>0.1]. CONCLUSIONS Low premorbid social functioning and individual autonomy, but not intellectual functioning, could serve as predictors of poor treatment response in schizophrenia.
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Affiliation(s)
- Asaf Caspi
- Sheba Medical Center, Tel Hashomer, Israel
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Kim-Cohen J, Caspi A, Taylor A, Williams B, Newcombe R, Craig IW, Moffitt TE. MAOA, maltreatment, and gene-environment interaction predicting children's mental health: new evidence and a meta-analysis. Mol Psychiatry 2006; 11:903-13. [PMID: 16801953 DOI: 10.1038/sj.mp.4001851] [Citation(s) in RCA: 600] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Previous research on adults has shown that a functional polymorphism in the promoter region of the monoamine oxidase A (MAOA) gene moderates the impact of childhood maltreatment on risk for developing antisocial behavior. Thus far, attempts to replicate this finding have been mixed. The current study (i) presents new data investigating this finding in a sample of 975 seven-year-old boys, and (ii) evaluates the extant data by conducting a meta-analysis of published findings. We replicated the original finding by showing that the MAOA polymorphism moderates the development of psychopathology after exposure to physical abuse, we extended the finding to childhood closer in time to the maltreatment experience, and we ruled-out the possibility of a spurious finding by accounting for passive and evocative gene-environment correlation. Moreover, meta-analysis demonstrated that across studies, the association between maltreatment and mental health problems is significantly stronger in the group of males with the genotype conferring low vs high MAOA activity. These findings provide the strongest evidence to date suggesting that the MAOA gene influences vulnerability to environmental stress, and that this biological process can be initiated early in life.
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Affiliation(s)
- J Kim-Cohen
- Department of Psychology, Yale University, New Haven, CT 06520, USA.
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39
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Boydell J, van Os J, Caspi A, Kennedy N, Giouroukou E, Fearon P, Farrell M, Murray RM. Trends in cannabis use prior to first presentation with schizophrenia, in South-East London between 1965 and 1999. Psychol Med 2006; 36:1441-1446. [PMID: 16854250 DOI: 10.1017/s0033291706008440] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is evidence that cannabis use might be relevant to the aetiology of schizophrenia. We aimed to measure any change in cannabis use over time in those first presenting with schizophrenia in South-East London from 1965 to 1999, and compare this with change in use in those presenting with non-psychotic psychiatric disorders. METHOD The rate of cannabis use in the year prior to first ever presentation was measured over seven time periods. Logistic regression modelling was used to determine (a) whether cannabis use changed over time, after controlling for age, sex and ethnicity, and (b) whether there was an interaction between diagnosis and time. RESULTS Cannabis use increased over time in both the schizophrenia group [odds ratio per time period (OR) 2.03, 95% confidence interval (CI) 1.74-2.38, p<0.0001] and the non-psychotic disorders group (OR 1.24, 95% CI 1.05-1.47, p=0.012), after controlling for age, sex and ethnicity. However, the effect of time was significantly greater in the schizophrenia group than in the non-schizophrenia group (chi2=17, p<0.0001). CONCLUSION Cannabis use in the year prior to presentation with schizophrenia increased markedly between 1965 and 1999, and disproportionately so compared to increase in cannabis use in other psychiatric disorders.
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Affiliation(s)
- J Boydell
- Division of Psychological Medicine, Institute of Psychiatry, London, UK.
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40
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Reichenberg A, Weiser M, Rapp MA, Rabinowitz J, Caspi A, Schmeidler J, Knobler HY, Lubin G, Nahon D, Harvey PD, Davidson M. Premorbid intra-individual variability in intellectual performance and risk for schizophrenia: a population-based study. Schizophr Res 2006; 85:49-57. [PMID: 16626941 DOI: 10.1016/j.schres.2006.03.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Accepted: 03/03/2006] [Indexed: 11/28/2022]
Abstract
BACKGROUND Some, but not most, schizophrenia patients have below-average intelligence years before they manifest psychosis. However, it is not clear if those whose intelligence falls within-normal-range nevertheless have cognitive abnormalities. We examined the association between intra-individual variability in intellectual performance and risk for schizophrenia in individuals with normal IQ. METHODS 555,326 adolescents, mandatory assessed by the Israeli Draft Board were followed up over 8 to 17 years for psychiatric hospitalization by means of the Israeli National Psychiatric Hospitalization Case Registry. Data were available on 4 intelligence sub-tests, and on behavioral and psychosocial variables. Variability was computed from the variance of the four intelligence tests' standardized scores. RESULTS There was a significant monotonic association between increased intra-individual variability in intellectual performance and risk of schizophrenia in individuals with within-normal-range IQ. Individuals with the highest variability were 3.8 times more likely to have schizophrenia [95%CI: 2.32-6.08; p < 0.0001] compared with individuals with the lowest variability. This association held after controlling for the effects of potential confounders. CONCLUSIONS Despite within-normal-range premorbid IQ, apparently healthy adolescents who will later on manifest schizophrenia, nevertheless have cognitive abnormalities such as increased variability across intellectual tasks, possibly related to frontal lobe abnormalities.
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Affiliation(s)
- Abraham Reichenberg
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
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41
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Bricker JB, Stallings MC, Corley RP, Wadsworth SJ, Bryan A, Timberlake DS, Hewitt JK, Caspi A, Hofer SM, Rhea SA, DeFries JC. Genetic and environmental influences on age at sexual initiation in the Colorado Adoption Project. Behav Genet 2006; 36:820-32. [PMID: 16710776 DOI: 10.1007/s10519-006-9079-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2005] [Accepted: 04/18/2006] [Indexed: 11/26/2022]
Abstract
Whereas the majority of research on adolescent sexual initiation has focused solely on environmental factors, the present study used behavioral genetic analyses to investigate the relative contributions of genetic and environmental influences. Structural equation models were fitted to data from adoptive and non-adoptive sibling pairs (231 biologically related pairs and 169 unrelated pairs) from the Colorado Adoption Project. Information from censored individuals who had not yet experienced sexual initiation was maximized by adapting the twin survival analysis method of Pickles et al. (Behav Genet 24(5):457-468, 1994) to accommodate adoptive and non-adoptive siblings. Point estimates of variance components from an ACE model, including additive genetic (A), shared environmental (C), and non-shared environmental (E) influences were 28%, 24%, and 48%, respectively. Despite the lower point estimate for shared environmental effects than additive genetic effects, a CE model provided the best fit to the data. However, because adoptive siblings provide a direct estimate of shared environmental influences there is greater power to detect shared environmental effects in adoption designs. Evidence for genetic influences from our data were somewhat lower than those obtained in previous twin studies, possibly reflecting a return to more socially conservative sexual attitudes, changing sexual behaviors, or ambiguities in the wording of questions commonly used in research on adolescent sexuality.
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Affiliation(s)
- J B Bricker
- Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO 80309, USA.
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Reichenberg A, Weiser M, Caspi A, Knobler HY, Lubin G, Harvey PD, Rabinowitz J, Davidson M. Premorbid intellectual functioning and risk of schizophrenia and spectrum disorders. J Clin Exp Neuropsychol 2006; 28:193-207. [PMID: 16484093 DOI: 10.1080/13803390500360372] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Evidence from longitudinal studies indicates that lower IQ score in childhood and early adolescence increases risk of schizophrenia and schizophrenia spectrum disorders (SSD). This study investigated the association between premorbid IQ and risk of SSD in a population-based cohort of 17-year-old conscripts. Fifty four thousand males assessed by the Israeli Draft Board during two consecutive years were followed by means of the Israeli National Psychiatric Hospitalization Case Registry for up to 11 years. Tests of verbal and non-verbal reasoning, mathematical knowledge and instructions comprehension and several psychosocial variables were recorded by the Draft Board. Risk for SSD increased with decreasing IQ score. Only poorer non-verbal reasoning conferred a significant increased risk for SSD after taking into account general intellectual ability. IQ was not associated with age of onset. These results confirm the importance of low intellectual functioning as a risk factor for SSD. This is unlikely to be due to prodrome.
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Affiliation(s)
- Abraham Reichenberg
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L Levey Place, Box 1230, New York, NY 10029, USA.
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Reichenberg A, Weiser M, Rapp MA, Rabinowitz J, Caspi A, Schmeidler J, Knobler HY, Lubin G, Nahon D, Harvey PD, Davidson M. Elaboration on premorbid intellectual performance in schizophrenia: premorbid intellectual decline and risk for schizophrenia. ACTA ACUST UNITED AC 2005; 62:1297-304. [PMID: 16330717 DOI: 10.1001/archpsyc.62.12.1297] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Consistent evidence indicates that some, but not most, patients with schizophrenia have below-average intelligence years before they manifest psychosis. However, it is not clear whether this below-average premorbid intelligence is stable or progressive. OBJECTIVE To examine whether increased risk for schizophrenia is associated with declining intellectual performance from childhood through adolescence. DESIGN Historical cohort study of an entire population using record linkage for psychiatric hospitalization during an 8- to 17-year follow-up period. SETTING Mandatory assessment by the draft board of Israeli conscripts. PARTICIPANTS Population-based cohort of 555 326 adolescents born in Israel. Data were available on 4 intelligence subtests as well as on reading and spelling abilities and on behavioral and psychosocial variables. A regression-based approach was used to assess the discrepancy between actual IQ at age 17 years and estimated IQ during childhood based on reading and spelling abilities. MAIN OUTCOME MEASURES Hospitalization for schizophrenia (as per the International Statistical Classification of Diseases, 10th Revision criteria). RESULTS Lower-than-expected IQ at age 17 years was associated with increased risk for later hospitalization for schizophrenia. Results were held after controlling for potential confounders. For 75% of patients with schizophrenia with low actual IQ (<85) at age 17 years and for 23% of patients with actual IQ within the normal range (> or =85), actual IQ was 10 or more points lower than expected. Lower-than-expected IQ was not associated with bipolar disorder or with depression or anxiety disorder. CONCLUSIONS Indirect evidence suggests that intellectual deterioration from childhood through adolescence is associated with increased risk for schizophrenia. Despite within-normal-range premorbid IQ scores, apparently healthy adolescents who will later manifest schizophrenia nevertheless have intellectual decline.
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Affiliation(s)
- Abraham Reichenberg
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
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Caspi A, Zivotofsky AZ. Multi-word buffering during bilingual bidirectional reading as evidenced by saccade direction reversals. J Vis 2005. [DOI: 10.1167/5.8.805] [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: 11/24/2022] Open
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Abstract
To achieve the best therapeutic results in schizophrenia--like most other disorders--primary prevention is preferable to early and prompt treatment, which, in turn, is preferable to treatment of chronically established illness. Unfortunately, there currently exist no accurate markers that can provide information regarding the future course of illness and guide treatment in asymptomatic or mildly symptomatic individuals. Therefore, most treatment efforts are currently focused on patients who have already experienced their first psychotic episode. This paper reviews the efforts to identify accurate markers heralding psychotic illness, as well as treatment considerations in the early phase of the disease.
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Affiliation(s)
- Michael Davidson
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Davidson M, Caspi A, Noy S. The treatment of schizophrenia: from premorbid manifestations to the first episode of psychosis. Dialogues Clin Neurosci 2005; 7:7-16. [PMID: 16060592 PMCID: PMC3181721] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
To achieve the best therapeutic results in schizophrenia--like most other disorders--primary prevention is preferable to early and prompt treatment, which, in turn, is preferable to treatment of chronically established illness. Unfortunately, there currently exist no accurate markers that can provide information regarding the future course of illness and guide treatment in asymptomatic or mildly symptomatic individuals. Therefore, most treatment efforts are currently focused on patients who have already experienced their first psychotic episode. This paper reviews the efforts to identify accurate markers heralding psychotic illness, as well as treatment considerations in the early phase of the disease.
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Affiliation(s)
- Michael Davidson
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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47
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Ram-Tsur R, Caspi A, Gordon CR, Zivotofsky AZ. The saccadic system more readily co-processes orthogonal than co-linear saccades. Exp Brain Res 2004; 160:398-403. [PMID: 15645227 DOI: 10.1007/s00221-004-2129-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2004] [Accepted: 09/25/2004] [Indexed: 11/28/2022]
Abstract
Real-life visual tasks such as tracking jumping objects and scanning visual scenes often require a sequence of saccadic eye movements. The ability of the ocular motor system to parallel process saccades has been previously demonstrated. We recorded the monocular eye movements of five normal human subjects using the magnetic search coil technique in a double step paradigm. Initial target jumps were always purely horizontal or purely vertical. We were interested in the latency to onset of the second saccade as a function of direction in relation to the first saccade. When the inter stimulus interval (ISI) was 150 or 180 ms orthogonal second saccades were of significantly shorter latency than second co-linear saccades. When the ISI was 250 ms the latencies of orthogonal and co-linear second saccades were statistically indistinguishable. Based on these findings it is postulated that the ocular motor system can more readily co-process orthogonal than co-linear saccades.
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Affiliation(s)
- R Ram-Tsur
- The Gonda Multidisciplinary Brain Research Center, Gonda Brain Science Program, Bar Ilan University, 52900 Ramat Gan, Israel
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48
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Canetti M, Feigenberg Z, Caspi A, Leor J, Hod H, Green M, Hasin Y, Battler A, Garty M, Mittelman M, Porath A, Grossman E, Behar S. [Out-of-hospital resuscitation in Israel 2000]. Harefuah 2004; 143:785-9, 839. [PMID: 15603265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The aim of the study was to evaluate the impact of pre-hospital cardio-pulmonary resuscitation, performed by mobile intensive cardiac care units of Magen David Adom (MDA) teams in the framework of a national survey conducted in the period February and March 2000. During the survey, MDA performed 539 resuscitations, 485 of which were performed by mobile intensive care units of MDA, and they constitute the study population of the present analysis. The average age of the patients was 70.5 years, and 68% were men. The mean response time of the mobile intensive care units was 10.3 minutes. In 14% of the cases, a bystander initiated basic cardiac life support before the arrival of the MDA team. Upon arrival of the resuscitation team, 242 patients (50%) had asystole, 19% ventricular tachycardia (VT)/ventricular fibrillation (VF), 13% pulseless electrical activity (PEA), and 18% had other severe arrhythmias. One hundred and ninety-nine patients (41%) were transferred alive to the hospital after successful resuscitation. Hospital summaries were obtained for 148 of these patients. The cause of cardiac arrest was cardiac in 64% of the cases and 48% of the patients who reached the hospital had a previous history of heart disease. Fifty-three patients (11%) were discharged alive from the hospital. Patients discharged alive were younger, more promptly resuscitated, 78% had a cardiac cause of death and 38% of them were in ventricular tachycardia/fibrillation when first seen by the resuscitation team. The rate of successful resuscitation to discharge in the sub-group with VT/VF was 21%, and only 4% for patients in asystole, which is in line with other studies. However, the rate of initiation of resuscitation by bystanders is low in Israel. These data may help the medical staff and the health policy providers in Israel.
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Affiliation(s)
- M Canetti
- Heart Institute Meir Hospital, Tel-Aviv
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Weiser M, Knobler H, Lubin G, Nahon D, Kravitz E, Caspi A, Noy S, Knobler HY, Davidson M. Body mass index and future schizophrenia in Israeli male adolescents. J Clin Psychiatry 2004; 65:1546-9. [PMID: 15554770 DOI: 10.4088/jcp.v65n1117] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Compared with the general population, individuals suffering from schizophrenia are more likely to be overweight, a finding attributed to the effect of antipsychotic medications, poor nutrition, and sedentary lifestyle. As evidence accumulates indicating that some aspects of the illness manifest before the onset of psychosis and establishment of the diagnosis, it has been suggested that increased weight, like other metabolic dysfunctions, might precede active illness. METHOD Data on height and weight of 203,257 male adolescents assessed by the Israeli Draft Board, and followed for 2-6 years for later hospitalization for schizophrenia using the Israeli National Psychiatric Hospitalization Case Registry, were analyzed. RESULTS From the entire cohort, 309 (0.15%) were later hospitalized for schizophrenia (ICD-10). After removing adolescents with evidence of illness before or within 1 year of the Draft Board assessment, 204 future schizophrenia patients were available for analysis. Compared with the rest of the cohort, future schizophrenia patients had lower body mass indexes (21.24 +/- 3.3 kg/m2 vs. 21.77 +/- 3.5 kg/m2; F = 4.682, df = 1, p = .03) and weighed slightly but significantly less (64.2 +/- 11.6 kg vs. 66.3 +/- 12.0 kg; F = 6.615, df = 1, p = .01). The mean height of the future patients did not differ significantly from the mean height of the remaining cohort (173.63 +/- 6.7 cm vs. 174.40 +/- 6.9 cm; F = 2.520, df = 1, p = .112). When reanalyzing the data, controlling for physical activity and socioeconomic status, the differences between the groups remained significant. CONCLUSION Before the onset of illness, future schizophrenia patients are not heavier compared with their peers. This implies that the increased weight of patients with schizophrenia is related to illness effects, including the effects of antipsychotic medication.
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Affiliation(s)
- Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel.
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Thomson WM, Poulton R, Milne BJ, Caspi A, Broughton JR, Ayers KMS. Socioeconomic inequalities in oral health in childhood and adulthood in a birth cohort. Community Dent Oral Epidemiol 2004; 32:345-53. [PMID: 15341619 DOI: 10.1111/j.1600-0528.2004.00173.x] [Citation(s) in RCA: 232] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine whether adult oral health is predicted by (a) childhood socioeconomic advantage or disadvantage (controlling for childhood oral health), or (b) oral health in childhood (controlling for childhood socioeconomic advantage or disadvantage), and whether oral health in adulthood is affected by changes in socioeconomic status (SES). METHODS Participants in a longstanding cohort study underwent systematic dental examination for dental caries and tooth loss at ages 5 and 26 years. The examination at age 26 years included the collection of data on periodontal attachment loss and plaque level. Childhood SES was determined using parental occupation, and adult SES was determined from each study member's occupation at age 26 years. Regression models were used to test the study hypotheses. RESULTS Complete data were available for 789 individuals (47.4% female). After controlling for childhood oral health, those who were of low SES at age 5 years had substantially greater mean DFS and DS scores by age 26 years, were more likely to have lost a tooth in adulthood because of caries, and had greater prevalence and extent of periodontitis. A largely similar pattern was observed (after controlling for childhood SES) among those with greater caries experience at age 5 years. For almost all oral health indicators examined, a clear gradient was observed of greater disease at age 26 years across socioeconomic trajectory groups, in the following order of ascending disease severity and prevalence: 'high-high', 'low-high' (upwardly mobile), 'high-low' (downwardly mobile) and 'low-low'. CONCLUSION Adult oral health is predicted by not only childhood socioeconomic advantage or disadvantage, but also by oral health in childhood. Changes in socioeconomic advantage or disadvantage are associated with differing levels of oral health in adulthood. The life-course approach appears to be a useful paradigm for understanding oral health disparities.
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Affiliation(s)
- W M Thomson
- Department of Oral Sciences, School of Dentistry, The University of Otago, Dunedin, New Zealand.
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